Sunday, January 31, 2010
Sports Injuries Three things lead to this blurb. Today a running friend mentioned that another friend was out having surgery. Someone said, "oh his knee?" and another said,
" no, his shoulder." Last night my niece mentioned that she had re injured her meniscus and might have to have surgery again. Both of these persons had these issues from tennis. SO I decided to research which sport had the most injuries. It appears to be football, which is exactly why the men in next week's Super Bowl have opted out of the Pro Bowl. Interestingly, the top two sports for injuries are football and basketball and the top injury for both is the KNEE. Otherwise, injuries are definitely related to contact, to improper form, improper equipment, lack of warm up and over use. Over use injuries are probably more common in tennis and running.
Zyprexa Zyprexa is a medication that is considered an anti psychotic and is in the psychotropic class. This means it is a mood altering drug. It is also one of the many drugs in this class that have been shown to cause weight gain. (personally I think we need to educate the patient on weight control if and when prescribing the medicine, but I did not ever see that happen when I worked in the field of psychiatry) Because Zyprexa, made by or sold by Lilly, has been approved for use in adolescents (scare me!) the FDA has now put out a warning about the weight gain and the increase in levels of blood fats. If you are on Zyprexa and develop hyperlipidemia, you are likely to be prescribed ANOTHER drug to treat that condition. That my friends is how polypharmacy gets started. Anyway, the new alert advises that other meds be tried before Zyprexa. We especially do not want our kids on meds for chronic disease conditions before they even graduate high school!
Tobacco and Heart Disease February will bring us heart health month again and I will likely write more about that. In the meantime, I have been studying for a February 4th community presentation on smoking and heart disease. Seriously, I have a great article that was forwarded to me by the author, Neal Benowtiz, MD. I have had to look up about 40 words, repeatedly, and feel like I need another couple initials after my name to understand it. But , I can say that chemicals in the tobacco smoke have a significant effect on hemodynamics, viscosity, thrombosis, and endothelial function. Just kidding - well , I mean it is true, but it means that the blood of smokers is thicker, that atherosclerosis (plaque build up) is activated from the chemicals and that platelets are also activated and clump together, putting smokers at significant risk of thrombosis, or blood clot. Smokers have heart attacks and sudden death at much younger ages than non smokers and are more likely to die during heart surgery. Their stents are more likely to clog and blood flow is likely to become impaired a second time. People who live with smokers have a 30% higher risk of heart disease themselves and only breathe 1% of the smoke that smoker's inhale. Crazy right! And heart disease kills 30% of smokers. The other top diseases of smokers are lung cancer and COPD.
Walking with Weights No doubt you know that weight training should NOT be done at the same time as the cardio portion of your workout, but can be done alternately. Well, yesterday I saw my favorite local really super gorgeous scuba instructor walking on our popular Sarasota Bridge (only hill in town) carrying two 8-10 weights in his hands. I was aghast.
Okay I believe that is it for now...... and for January ... ba bye...
Saturday, January 30, 2010
Friday, January 29, 2010
The belief that I am referring to is that exercise alone is a weight loss strategy. It is not. In order to lose the extra weight you've put on over the holidays or the weight you have carried for years which is putting you at risk for high blood pressure, heart disease, diabetes, arthritis and disability - you MUST eat less.
Exercise is vital to improve health and will have a positive impact on resting heart rate, blood pressure, functionality, cholesterol levels, and blood sugar, but it will not take the pounds off and until you take them off (if indeed you need to) the risk for all of the above conditions will still be greater for YOU than for people of normal weights. We can debate which measure determines "normal" whether it be BMI, WHR or Waist Circumference, but instead let us say, it is the weight at which you do not have the symptoms of disease.
This information is NOT meant to deter or dissuade you but to prompt you into action. What we do have in the 00s that we didn't have in the 90s is the Internet and the explosion of web based programs and tools that are FREE and full of information that can help you to first understand caloric need and balance and then to do something about it.
I have done some exploring in order to write the post and I refer you again to the Cooper Institute's Stand Up and Eat site which can help you determine the amount of calories you need to maintain or lose weight (BTW I need LESS than 1700 and I am considered VERY active, so chances are you are overestimating your needs. A moderately active woman who is 5ft 5 and weighs 150 pounds only needs 1860. A moderately active 180 lb man who is 5ft 10 needs about 2100)
Learn what you need and then you can use some of the tools on the MyPyramid site to track activity and track calories consumed. But as always, my favorite is the data base of the USDA. Of course, label reading is a must! I do think you should bookmark the links in this section.
I mentioned a few people earlier this week who said they lost weight by tracking their calories. If you are not losing weight ,and need to, this is something that you might try.
Well - now is as good a time as any.....
Thursday, January 28, 2010
Wednesday, January 27, 2010
It is a funny thing, this mantra of many. Everything in moderation. Where did that come from exactly? (well, I know where it came from, a Greek temple and it was "nothing in excess", but anyway) This is the phrase we like to voice when we either want more of something that we'd be better off without or we want to do less of something we really should be doing more. For example, french fries and ice cream are really NOT something we should have in moderation, but something we should limit, but when we want to eat them we say, "everything in moderation." Physical activity and exercise are things we should do more of - a lot of - every day of - but we see the people who walk or run most days of the week when we don't and shake our heads saying, "everything in moderation."
So let us think about the recommendation guidelines from health experts that are meant to improve our health and well being and are based in science. Science of course is dynamic, meaning what we knew 60 years ago does not always mesh with what we know today. It is dynamic, ever changing, and so must we be. I gander to say that even antediluvian postulations did not call for consumption of everything and anything at moderate levels. But we do not have to go back to biblical times to do our work, we can start with the 1800s. Lucky for me, a young woman named Lisa Green who is a student at UF, has a webpage that describes the history of our food guidelines. We are most familiar with the Basic 4, the 4 Food Groups. According to Lisa's history, President Roosevelt had actually commissioned the USDA to create the Basic 7, but that was too complicated. I remember the 4 Food Groups from school. But since then we have have the Food Guide Pyramid (USDA), the DASH diet (NHLBI), the Mediterranean Diet (classified by research and highly recommended), the New Food Guide Pyramid (Harvard -Walter Willett), New American Plate(AICR), the Go Slow Whoa program (NHLBI) and the AHA's recommendations on eating to prevent heart disease. And yes, a two years ago, , the US Government came out with its first recommendations for physical activity. (other agencies have done so for ten or twenty years)
Every single one of the aforementioned guides distinguishes food amounts by food type. For example, saturated fats, oils, butters, whole milk and whole milk products and sugars are to be consumed in limited quantities while vegetables, according to Dr. Willett are to be consumed with abandon. Alcohol should only be one or two glasses of the measured amount per day. Trans fats are to be avoided at ALL COSTS and ALL TIMES. Red meat is to be consumed much less and fish much more... I can stop now can't I? No , no I really can't, it is just who I am.
The absolute best advice, scientific advice, is to eat a variety of foods with special attention to lean meats or proteins, low or no fat dairy products, whole grains and complex carbs, fish, mono unsaturated fats, many fruits and most vegetables, measured alcohol intake, and little to no saturated fats and sugars.
The CDC has great information about fats, and that is a perfect example. We are asked to keep our fat intake between 20-30% of our total daily calories and our saturated fat intake at no more than 10%. They say on this web page that even though some fats are health promoting we STILL need to keep overall intake under 30%. Which is why you cannot eat cups of almonds all day!
Fat is just one example. There are very specific and different recommended daily allowances for salt, for fiber, for protein, for carbs, and oh my gosh WATER, which is very individually specific. etc. So if it IS everything in moderation - then it must follow that some things are more moderate than others. Moderation means nothing to excess, but it also means nothing at a level that is considered harmful and that is the real issue.
Fats, sugars and alcohol can be harmful at much lower levels than people who enjoy them would like to acknowledge. Additionally, exercise levels have to be much higher than sedentary people would like to believe before considered harmful. Remember the Physical Activity Guidelines for Americans state:
Additional health benefits are provided by increasing to 5 hours (300 minutes) a week of moderate-intensity aerobic physical activity, or 2 hours and 30 minutes a week of vigorous-intensity physical activity, or an equivalent combination of both. With an additional two days of strength training. For most health outcomes, additional benefits occur as the amount of physical activity increases through higher intensity, greater frequency, and/or longer duration and the benefits of physical activity far outweigh the possibility of adverse outcomes.
I repeat - Moderation means nothing to excess, but it also means nothing at a level that is considered harmful and that is the real issue.
(side note: you can eat the right amount of a food and still get a belly ache and you can do the right amount of exercise and still strain a muscle - we are not talking about these acute things!)
(second side note, if you receive this blog in your email, you may have to come to the website to see the links and to leave comments)
Tuesday, January 26, 2010
Earlier this week I shared a USA Today article on my Facebook page, regarding one of the persons in the Weight Loss Challenge. The woman had lost a significant amount of weight and said that she had done so by adhering to a 1500 calorie a day meal plan while also incorporating a lot of physical activity into her week. She reached her first goal but then starting slipping when she stopped tracking her calories. A friend of mine commented that she had lost her extra weight by counting calories and thought she might need a booster to take off a few of the pounds she since gained back. Her weight is close to ideal and she is VERY active, she is in the maintenance phase.
At the same time, I read an article about exercise and diet. Both diet alone and exercise alone can lead to weight loss, but only diet and exercise together were effective in changing the biomarkers of disease beyond pounds.
Another friend who has lost some weight but is in the improvement stage, mentioned that she was felt like grazing today. That also stayed in my mind as I went about the afternoon.
Additionally, I have been reading about goals - a review for me, but review is good!
So firstly, people can be in different stages when implementing a plan of action. The plan for us is living healthy lives and at times that involves weight loss. As I said, the best strategy for that is related to both calorie's consumed and calorie's burned. We have initial, improvement and maintenance stages. All of them should be goal directed and all goals should meet the following criteria, often abbreviated as SMART.
They are to be specific (exactly what you are going to do), they must be measurable and action oriented, realistic or achievable and timed. So hypothetically:
I am going to lose 5 pounds in two months.
I am going to eat 1500 calories every day.
I will walk 40 minutes four times a week and jog 20 minutes one time a week.
I will weigh myself every Wednesday morning before breakfast starting the first Wednesday in February.
Okay, the firstone is safe, possible, specific and certainly measurable. The second one is too and can be broken down further. One has to know how to find the calories in a food, so the first part of that step is learning about reading labels or using resources to get a general idea of calories per gram in foods one prepares themselves. The physical activity part has to include something environmentally possible as well as physically. If there is no where to walk or the persons feet hurt, then maybe it is cycling or swimming, etc that should be done.
Goals are not the only things that can make or break a wellness plan. To increase the chance of success it is helpful to believe in yourself, to make a list of the benefits and the costs, so that the benefits are GREATER, and it is very helpful to have people around you who also believe in wellness and believe in you. For instance, if everyone in the family or on the job is smoking when you want to quit - THAT will be hard. But if everyone in your office is avoiding junk food and taking walks everyday and you LIKE those people and want to be like them, then you have a better chance of succeeding.
This reminds me of my friend who mentioned grazing. There are two things to say about this - one is that grazing is not the same as having several small meals throughout the day and eating healthy snacks. Grazing is usually something that will get you in trouble. But my friend added that though she felt like grazing she was relieved that the office has numerous low calorie foods to choose from so that she didn't do alot of damage with junk. She is in a supportive environment and it became that way a little at a time. You can be the one to make your environment positive.
Now it is important that you do what is best for you when you set you goals and review your goals. Goals are both short and long term and include the process - the process above were the steps - lose 5 pounds by eating 1500 cals a day and exercising 180 min a week. A long term goal could be to lose 30 pounds and to maintain that weight within 4 pounds up or down forEVER. Another long term goal is to eat well and exercise most days of the week into perpetuity in order to have an active long life. That one is mine! And how you meet those goals are personal.
I will say that telling yourself "everything in moderation" is NOT going to achieve any goals. That isn't really based on any science, and it doesn't have action steps! I think I will blog about that another time. So yes, for me - I plan. I plan my exercise by week, basically, but flex on days according to weather or body messages. I plan my meals by day and I like that very much. No grazing if it isn't in my lunch box. I am too rigid for most, but just perfect for me.
SO set your goals, test out your action steps and GET A MOVE ON..
Monday, January 25, 2010
We have known that diet and physical activity matter. We know that staying involved with people and engaged in life promotes well being and can improve cognitive functioning. (cognition is thought, thinking, mental activities)
It looks like a few Universities are being funded to study the effects of video games on the aging brain. Some are using off the shelf games while others are indeed using the Wii. The Wii has the added bonus of including physical activity which increases heart rate and can help to improve cardiovascular and physical function as well as mental status. Ironically, my MOM just got back from a trip where she was playing boxing with her great grand daughter.
So sharpen your pencils and do the crossword, play mind teasers, go for walks, eat fish, play Wii bowling, ride a bike, learn a new sport (pickle ball anyone?), use Rosetta Stone, travel, take a dance class........... live a little and then live long. :)
and by all means, if one of the research studies comes to your town, participate! It isn't like they are asking you to take a drug - nothing to risk here - so play, play, play
I didn't find a specific link to the video game research, but here is a link to the Prevention Research Centers affiliated with the CDC
Sunday, January 24, 2010
Fruit Cups: I was at an event during which lunch was served. The people attending were of various ages. I looked up at one point and noticed happily that the young persons all had cups of fruit. In front of them at another table were two overweight older women and both of them had cookies. I did mention how awesome it was that the young persons were eating fruit! I said this maybe before I realized that the ladies were not. One said something about her bad choice and I concurred in a way, saying that the youth were roll modeling for the adults. And they were. (I am not the food police. The women spoke of their struggles with regulating food intake. It is sad and hard for me because I like the women and want them to be healthy)
Short Cuts Don't Help: At a popular place for walking I noticed a person get out of her car and instead of walking to the sidewalk at the stop light to then go on the mile walk over the bridge, she cut through the grass and up the embankment. She obviously came there to exercise and then took about a 100 steps off the walk. My question is WHY, why shorten your workout like that? There are NO shortcuts to health, people.
Self Efficacy: At first thought, you might think that self efficacy, self confidence and self esteem are the same thing, but they are not. Self esteem and self confidence really cannot be willed "improved." Self efficacy, which is often discussed in regards to behavior change, CAN be nurtured and expanded in such a way as to increase ones self confidence and self esteem. Self efficacy is one's belief in their ability to do something. There are several ways to boost it. One is to successfully do something, so set achievable goals. The more things a person has accomplished or survived, the more that they believe they can do or endure. Also, one's belief in their ability to do something can be increased if they see someone very similar to themselves doing that same thing. People who encourage a person also build their self efficacy as does the trickier interpretation of results. What I mean by that is knowing that what you did led to the outcome that is positive For me the simplest example is knowing that my body is tired because I accomplished a certain physical activity goal which is making me stronger. I am a much more confident person in my 40s than I was in my 20s and 30s and I owe this to a exponential improvement in my feelings of self efficacy.
Time to Exercise: I was the speaker at a training this weekend. At a break someone was telling me their story of losing 50 pounds and striving to be healthier. She asked me if I worked out and a discussion ensued between several of us. At some point, then or later, I cannot be sure, one of the participants said to me, "You seem to work a lot, when do you find time to exercise?" And you know, it isn't even EVER a question. I don't consider my exercise to be something I will do if I have time. My exercise is how I start most of my days and everything else can wait.
ok, Minn is still playing as I blog - and I am forecasting the Vikings and the Colts for the 44th Super Bowl. This sucks because a Manning is always worth routing for - and yet, I am a fan of the Giants who are an NFC team.... so that is it, the Vikings have my support.... of course, if the Saints win.... Peyton gets me back...
Saturday, January 23, 2010
Yesterday, a man named Brian Orelli spoke about a drug from Pfizer that has been found to be effective in the treatment of a rare form of pancreatic cancer. Ok. Stop right there. Pancreatic cancer has more than one form? Yes, several. Overall, only 3% of the cancers that affect Americans are pancreatic, where as prostate and breast occur at 25 and 27 percent. The biggest cancer killer however, is lung cancer. It kills 30% of men and 27% of women who have any type of cancer. Pancreatic cancer is responsible for 6% of the deaths related to cancer.
Pancreatic cancer is not our most common cancer, but it does finish out our top ten. Several high profile people have or have died from this cancer and the person with the RARE form that Pfizer's drug seems to affect, is Steve Jobs. Now here is the thing about drugs and drug trials.
A drug trial or study, from phase I-III, costs a lot of money. Trials are stopped early in a few circumstances. The drug is showing no effect whatsoever, people taking the drug are dieing, or the drug works so well that people with the illness need it and not a placebo ( as it would be cruel and unethical to deprive them of a treatment that may save their lives).
So Dr. Orelli tells about this new finding on Sutent. It dramatically slows the growth of tumors in this particular type of pancreatic cancer. Interesting thing, the drug was originally formulated to treat another cancer. In fact, the FDA approved treatments for Sutent are kidney cancer and a form of gastrointestinal cancer. The treatment of this neuroendocrine type of pancreatic cancer is not yet approved. Remember a company benefits most when a drug can be used to treat a multitude of cancers or diseases.
The Motley Fool article points out that this spectacular finding on Sutent won't really get Pfizer a pay day because only two to four million people get this illness. Even though they have the market on this disease the drug competes with two other drugs for the treatment of kidney cancer and doesn't work significantly better than the competition. And so far, it hasn't been able to impact lung cancer at all, which would be the jackpot. If Pfizer shareholders were really going to celebrate, Sutent would enter that fray with about five other drugs. HMMM... maybe that is why Pfizer has Chantix. Lung cancer is caused by smoking 78% of the time so if people stop smoking maybe they won't get lung cancer and those other drug companies will lose money.
my info on cancer sites and rates is from the ACS
************************foot note from yesterday
Apparently a counterfeit version of the over the counter weight loss product Ali, which is the one that blocks fat and causes incredible gastrointestinal complications, you know, leaky stools, flatulence and the like - has been found in the USA. This counterfeit version does NOT have the orlistat ingredient but instead has sibutramine... YES, what I told you about last night -the active ingredient of Meridia, which can cause cardiovascular problems even death. So this is disconcerting, so would knowing that any of you were using it... but here is the FDA alert so you know what to do if you are.....and of course, I like you just the same!
Friday, January 22, 2010
Today the FDA applied restrictions to the weight loss drug Meridia. As you know, I blast weight loss drugs probably more than any other class of medicines. Merida is an appetite suppressant that is sold by prescription only and is in fact a scheduled drug or controlled substance because of fear of abuse. It acts in the central nervous system by blocking the re uptake of certain neurotransmitters. It also elevates heart rate and blood pressure and has been the subject of controversy for no less than eight years.
Public Citizen has had it on it's Do Not Use list since 2002 and states that the risks far outweigh the minimal benefit of trace weight loss. Guess what their website suggests one do as an alternative to taking the drug? Oh come on, you know this one: Lifestyle changes, diet, and exercise.
Now Meridia, just like Vioxx began with a cardiovascular risk profile. But today the FDA told prescribers not to use it with anyone who has a history of heart disease, specifically, ever having a stroke or heart attack, of having a diagnosis or history of congestive heart failure (regards the inability of the heart to pump sufficiently), of an irregular heart beat, of peripheral artery disease and of high blood pressure that is not kept in control with medicine.
This is history about to repeat itself, but not in Europe. Today they banned the drug based on the USAs FDA report. Crazy that they did and USA didn't.
I can tell you that I was on Vioxx and my blood pressure seemed to rise when I took it (hey doc, I can hear my heart beating in my ears when I workout) and my doc said, OH, that blood pressure warning is ONLY for people who already have heart disease. And then what? People without a history of heart disease died and the drug was YANKED off the market and multimillion dollar lawsuits followed.
SIGH.......... just madness......
More often than not, which is the opposite of what people think, but more often than NOT, pills are the wrong option............they almost always carry risk and we almost always don't know the extent of the risk until people start having heart attacks and such.
As I usually say, however, sometimes, the medicine is the RIGHT choice and you should always have a conversation with your health care provider before starting or stopping anything.
Thursday, January 21, 2010
Wednesday, January 20, 2010
It is called Lurosil and unfortunately, all my usual trusted sources have no mention of it. That leaves me with the general Internet and even there, the only references to the product are on the products own website. The last place one should go to vet a product is the products website. I already know that the claims are bunk and the product is at the least ineffective and at the most harmful. But I have no proof.
What should keep you from buying this product is how it is advertised, the claims that are made and the lack of research to support its use. The ad is made to look like a health or fitness column where someone has written in to this person named Julie. There is no information provided to attest to what if any education or credentials this Julie has. The writer talks about having a bad knee or ankle or some joint, where the cartilage is damaged or tendons and ligaments strained and such. The writer heard about this product and tried it and it was awesome and they were writing to see where to find more. So Julie says that yes this Lusorsil is available and is awesome! It can lubricate, strengthen and cushion the joints. Lurisol, she says, contains ingredients that can do certain things to improve joint health and longevity. ,Now as I have warned you guys before, just because something contains an ingredient that was found to be helpful in some amount in some formula does not mean that the PRODUCT they are selling will do the same. The most outlandish statement in the ad is that the supplement is completely safe and all natural. Bullshit. That is my scientific, educated response to that statement.
Of course, the ad also has a little asterisk which might have you seek the fine print at the bottom. That is the print that tells you that the statements and the product have NOT been evaluated by the FDA and the product isn't meant to treat or cure anything. Well, if it isn't going to cure or treat your problem why in the heck would you take it. And if it were effective, then it WOULD be a medicine and would have FDA approval. (remember that FDA approval requires research studies of large numbers of persons who take a substance compared to a similar large number of persons who do not and a statistically significant difference between the two must be seen and must not be explained by chance. Supplements do not have to prove ANYTHING because they are not FDA approved or regulated. They can legally say it worked if one person benefited and that one person might have benefited from the placebo effect)
ah... sigh... I wear myself out.
Tuesday, January 19, 2010
But in Scotland, England and Northern Ireland it is a wine that was originally created and sold by the monks of Buckfast Abbey. The monks no longer sell it themselves and it is no longer known as a tonic nor advertised as having health benefits (it once was!).
I only heard about it yesterday when listening to the BBC Scotland and as I researched it today, I saw that the controversy did not begin yesterday but has been going for years.
I think that the new attention is due to a documentary being aired in the UK that speaks to the significant number of crimes in Scotland that have some association with Buckfast. Buckfast is also called Buckie and some other names ("wreck the hoose juice" is my favorite). In fact, it sort of reminds me of the cheap, sweet wine that teenagers drank in my coming up years, Boone's Farms.
The difference is that Buckfast has double the alcohol content of Boone's Farms and also contains a significant amount of caffeine. Buckie is sold in a green and a brown bottle with a bit of a variation in alcohol content and caffeine. The caffeine is 35-55 mg per 3 ounces and the alcohol is near 15% for the same. In the USA a wine serving is supposed to be 4 ounces and is usually served as 6-8 . (also, coffee has on average 60 mg of caffeine)
The controversy involves where to pin the blame for the high crime association. The news regards a report that a particular precinct in Scotland had over 5000 incidents which included mention of Buckfast, that nearly half the people involved in them were drinking it before hand and that the bottle itself was used as a weapon over one hundred times. The numbers are for a recent three year period.
The arguments made include that the alcohol itself is the problem and should be banned, that the people drinking it are the problem, that the area where the report has come from is the problem and that caffeinated alcohol is the issue. We have had that last concern come up in America and the USA was noted in that regard in at least one article. Others say that it isn't fair to pick on Buckfast and that comparison statistics for other beverages should also be put in the press.
Scottish politicians are concerned over proliferation of the drunken Scot stereotype. This reminds me of one of my favorite lines from one of my favorite authors in my all time favorite books, Diana Gabaldon and the Outlander Series. Now I must say, the reason I listen to BBC Scotland is partly because of these books, but more so because it is my heritage. My ancestry is Scotch, Dutch and Italian. If you've taken a look at my profile picture it is likely no surprise to you that I did not list them in order of amount!
Anyways, I am going to add to the stereotype with absence of malice and in honor of my Scotch/Dutch father.
" The only time you'll find a Scot not drinking is at a funeral - and that's only if he's the one in the coffin. "
Monday, January 18, 2010
The finding of the study was that smokers who quit smoking were more likely to develop diabetes in the three years following their quit, than non smokers or former smokers in that same time period. After about 12 years of quitting, however, the extra risk is about zero. The study did take into consideration many factors that might affect ones risk of getting the disease. The increase risk stood in light of some of those confounders and was associated with more years and more packs per day, but was mediated by consideration of systemic inflammation and weight. In other words, if the quitter gained weight in the years immediately following the quit, that could and did explain why the developed. Also, smoking leads to an inflammatory response and inflammation can lead to both heart disease and diabetes.
A couple of things to say here. The first is that while reading the current study, it was noted that smoking is a "well known" risk factor for new case diabetes II. Well, I had not believed that to be the case and according to our CDC and the Surgeon General reports, the evidence is not yet strong enough to make that conclusion. However, according to the article I am currently reading by Dr. Neal Benowitz of UC and also the Cancer Council of Australia's Tobacco in Australia, smoking most definitely is a risk for the disease as it appears to cause insulin resistance.
It is clear, and supported scientifically, that diabetics who use tobacco have much worse outcomes and significant risk for fatal heart disease.
But what of the current smoker and the quitting? Should they keep smoking? They do have a 50% chance of not developing any of the 30 or so diseases associated with tobacco use (though they have a 100% chance of smelling bad). Personally, I think 50-50 odds are ridiculous when the excess risk of these diseases could be zero. So the thing to do is watch the weight gain and to counsel the smoker about this risk.
Many people will tell you these two things and I stand fiercely against both. 1)
quitting smoking will lead to some weight gain and 2) the weight gain is not as bad as the continued smoking.
First, the only thing that causes weight gain is consuming more calories than your body needs. The caloric balance may shift when quitting, but that is not a guarantee of weight gain, it is a call to action. And well, the second part has been disproved by this research study.
Remember what I said the other day. You can choose neither. The option is NOT smoke or be overweight. Smoking is a negative coping skill and more positive ways for dealing with life exist. Eating too many calories is also often a negative coping skill. Increasing physical activity and utilizing some of the valuable tenets of both Volumetrics and Weight Watchers can offset that. (so can learning positive coping skills!)
Sunday, January 17, 2010
J&J - kicking back - no not relaxing because they had a good year, but giving kick backs, it is alleged. The company and some of its subsidiaries are accused of being quite aggressive in efforts to get a certain pharmacy to prescribe certain drugs. The worst part is the drugs and the patients involved. Psychotropic Risperdal, pain meds Duragesic and Ultram and an antibiotic Levaquin. Because of the push, it is said that hundreds of millions of dollars were spent on these drugs from 1994-2004. These drugs come with such risk and to think that the push was towards nursing home and thus frail elderly persons is an outrage. I KNOW I was there starting in 2000 and a lot of times Nursing Homes did want the patient I was trying to get admitted to be placed on Risperdal. I am glad this issue is in the press and that Charles Grassley may do something about it. Over medication is a PROBLEM in this country. (story is in numerous outlets, NY Times, USA Today, NPR)
Walking the Dog -OK, there is probably a good explanation for this. One that will lead to my embarrassment once it's found out, but initially - I saw this and went NUTs. What in the hell is the matter with people? I was sitting in my Mom's house and out the window I saw a golf cart go by. Well , ok, we live in Florida and it was a complex and that is how people get around sometimes... any hoo.... the cart goes by the window and there along side on a long leash is this little dog, running to keep up. WHAT?! You cannot WALK your dog? Which reminded me of something that happened a week or two ago.....
Skateboarding: I had a skateboard when I was a kid, but skateboarding wasn't as popular as it became in say the 1990s. I am a supporter of skateboarding and skate parks (as long as the kids were protective equipment of course!). I am not a supporter of lazy skateboarders. I was running one recent evening and behind me came a skateboarder, except he wasn't really. He was ON a skate board but it was MOTORIZED, it had a little engine. It wasn't enough that the kid almost ran me over, he also left me breathing his toxic carbon monoxide. Me and the environment. But the worst part was how lazy it was........ I feel the same about electric bicycles....
Pepsi - You guys should have gathered by now that I like pro football. Well, no cheers this week. Instead of the NFL Play 60 ad, I got to see, not for the first time, the new ad from Pepsi. The marketing company is trying to latch on to the whole retro thing by calling it Pepsi throw back - the original Pepsi, and what does the original have?? REAL Sugar. Yeah, lets not make that cool, okay.
Protein -I reviewed an article today regarding whether or not one could change the PH balance of their body by consuming foods high or low in acid or alkaline. You cannot so don't get caught in the hoopla. The body has to regulate PH, if it is not "normal" you will get sick and die. Anyways, in the article I was reading, written by a Gabe Mirkin Md, he did note a theory, one which he didn't denounce, that people who consume excess protein may have lower bone mass. This is because the excess protein leads to increased blood acidity and calcium is released from the bones to correct that.
Consistency - I had some notes about this somewhere, but they are not in my lap as I type. Oh Yes, I remember. On Facebook this week someone made a comment about my being too disciplined. In the same stream, someone said my arms were buff and that I looked 'great' ALREADY. Now that is certainly subjective, and I, like many of you, do not see myself looking "great". But the point is, IF my arms are toned and IF I look fit and trim, it is precisely because I AM disciplined or consistent, not in spite of it. I know, I am rigid, I have disclosed that to you already. But when I see my friends going on diets and expressing guilt and malaise over indulgences, followed by the temporary ban of dessert, coffee, and alcohol and the need to increase sleep - I think , you know, my body seems a lot more content with its consistency.
Saturday, January 16, 2010
I chose this time, to make my donation to the charity below. It is a four star charity, which means that 90% of the money it receives actually goes to aid and succor. You can find a list of other 4 star charities that are involved in Haitian relief at the Charity Navigator site.
Please consider a donation. Alms giving is good for your health.
CARE :: Defending Dignity, Fighting Poverty
Friday, January 15, 2010
With regard to chronic and terminal disease, health experts are consistent and quick to say that lifestyle is the most important factor for either risk or protection (things we do or don't do make it more or less likely that we will become ill or injured). We hear most often that we should moderate our diets, exercise and not smoke. Experts say that our lifestyle is more important than our genetics or any other factor. It has the most influence. Today on Talk of the Nation (I only caught the end), which had several guests, I believe Esteban González Burchard, MD is the one who said that the two most important determinants of health were SES and lifestyle.
SES is socioeconomic status. I believe that the reason SES was mentioned is because they were discussing race and that race is important to know when doing research and forming plans for health promotion etc, because disease is NOT an equal opportunity destroyer. Dr. Burchard was saying that having more of a certain disease condition in a particular race was NOT about the race itself, and that the culture and environment had to be considered.
A person with less education (less than 12), low (minimum wage +) paying, low skilled jobs (or none) and little income has a low SES. Persons in these conditions are more often exposed to things that may lead to disease. Perhaps a person works in a factory where they are exposed to toxic chemicals, or have limited safety equipment. Or the person is forced to seek low income and inner city(pollution) or isolated rural (farm work? tobacco use?) housing where there is no access to healthy food or exercise facilities. And surely, persons with low SES have limited access to medical treatment and even less access to preventative measures, like PAP smears, colonoscopy and the like. Persons with less education may not understand messages about healthful eating, or warnings about products. They may never even hear that sunscreen is protective against skin cancer and vitamin D is a wonder drug. The exact opposite could be said of person with higher socioeconomic status and this is why the speaker noted that SES is an important determinant of health.
It is imperative that education on the lifestyle that promotes active long life be targeted to groups that would not normally be exposed to it. The promotion must also be delivered in a way that all persons can understand, accept and adopt. I hope to be involved in that kind of health promotion as soon as possible :)
Thursday, January 14, 2010
The title was, You Can Choose NEITHER.
I then told you about recent reports on tobacco and obesity related health outcomes. Tobacco users, it is said, are more likely to die early. On average they die 14 years sooner than is expected and our life expectancy (USA) is around 77 these days.
Obese persons do not necessarily lose actual life years, but they lose quality life years. Obese persons often have debilitating conditions that limit functioning and require long term medication. It is said that obesity is more of a burden to our economy than tobacco has been.
And my point was... Instead of a dying young or dying slow - you can choose NEITHER! By maintaining a health promoting weight and not using tobacco you significantly increase your odds of living a long AND active life.
sigh - using tonight's post to explain last nights was inspired by my friend Paula.. who is no longer scratching her head!
Wednesday, January 13, 2010
The research study involves data collected from both the Behavioral Risk Factor Surveillance System and the National Health Interview Survey - multi year multi method strategies for gathering data on the behavior and the disease outcomes of Americans. The study authors have found a difference in the way tobacco use and obesity alter our lives. Simply put, a smoker loses more years of life, period. They die much younger as a rule. Obese persons do not die younger but they spend many more years with disabling conditions. These conditions make them less active and less comfortable. Often they are on numerous medications as well. Thus, obesity costs the country much more money that tobacco. Also smoking rates continue to decline where as in the last fifteen years obesity, BMI over 30, has increased an astounding 85%.
Now on the radio show, it was noted that the ascent of obesity seems to have plateaued. Experts credit this to more awareness of obesity as a health issue and more acceptance of being active and watching the high fat or high calorie foods. Dr. Dietz spoke about public awareness campaigns and TFAH discussed the health reform bills which have provisions for including things such as calorie content on menus and mandated physical activity. Both men discussed the need for an environment that is conducive for the types of change people need to make.
That leads to my observation. It seems that we have made healthy lifestyles socially acceptable now we have to spend our dollars and efforts on making them socially possible.
Tuesday, January 12, 2010
Exercise is such an important part of disease prevention and health promotion that the American College of Sports Medicine is partnering with a medical group to brand and expand the concept of "Exercise is Medicine." Soon health care providers will be pressed to write exercise recommendations on prescription pads so that YOU and I will get the very important message to get moving.
Depending on where you are living just now, the weather may be an obstacle to your maintaining a regular physical activity routine, but heat, cold, rain and wind are not the only challenges we face. Sometimes our jobs, school and family pose challenges, money can as well. Those are outside things. Some times the obstacle is internal - that voice that tells you it is okay to skip one day . The day that turns into weeks..
Many websites, megazines, groups and organizations have advice on how to get active and stay active. Of course no idea is going to work for you if 1) you don't know what it is, 2) you don't like it, and 3) you don't do it.
The best thing to have is intrinsic motivation - the voice that reminds you of how important your exercise is and in the end, how much you really do enjoy the benefit from it if not the actual "doing" of it. It is okay to start with extrinsic motivation - an event, a disease, a dress - fake it till you make it your own.
If it is the weather getting you down you have options. Equipment is available at gyms, or can be purchased for the home. Walking inside is free (at malls and such). TV or Internet exercise shows can be used, some free some for pay. If you just don't like exercise, think of what it will get you and concentrate on that. Whatever you do make sure you adjust your attitude as well. For instance, if I have to run on the treadmill I play games (literaly - speed work and such) and tell myself how lucky I am to have access to a gym. If I am running outside and it is cold when I start - which makes me cranky - I tell myself how nice it is to run outside.
I have started a little mantra too> Think of what you want to be doing, walking, cycling, swimming, stepping, golfing, playing tennis etc - so your goal is to Be a _____ . "look it, feel it, believe it, become it" - Look like a golfer (wear the clothes), feel like one, believe you ARE a golfer, and before you know it - you have become one....
And let me just say - today it was 30 degrees when I went out and I passed two other people who were on an exercise walk and they were BOTH over age 70! Remember them when you think you are too tired. ( And remember that you blessed with the ability to move your body, not everyone can and if you stop moving your body, your body will stop moving.)
And then tonight, the only night that my favorite teacher teaches step aerobics, I opened my gym bag, and I FORGOT my workout clothes!!! I could have just went home, I mean I ran this morning. But I didn't, I wore the pants I had on for work, my tennis shoes, an old t shirt that was in my bag and my NOT sports bra. Too funny - great class.
Oh , I better go and pack my bag right now so I don't do the same thing for Thursday's dance class!. Good night all
Monday, January 11, 2010
A public service announcement that is being broadcast on You Tube is grossing some people out. The PSA is meant to discourage people from drinking soda. The video is being used in New York which is usually on the cutting edge with these types of things. They were aggressive about smoking bans, getting TFAs out of foods, ordering calorie content charts and now - confronting the beverage industry. Much of what happens in NY trickles down, so I am optimistic.
The video shows a kid drinking a soda and gobs of wet sugar run out of his mouth and down his face. I can't remember the important health message that followed - something like soda or sugar makes you fat.
The American Beverage Association, a trade group for soda makers, is upset about this commercial. They say that it is true that sugary beverages are not without disadvantages, but that they also offer low and no calorie choices. They propose a less offensive means of suggesting people limit their intake of soda. Then they point out that ALL of their products are fat free.
Yup, that is the part that got me. Hello? Not having fat doesn't change a thing. And comparing sugar to fat is ridiculous. There is no "good sugar bad sugar" debate, it is ALL bad sugar. We have healthy promoting, in fact, life sustaining, good fats, but there is no amount of sugar that the body needs. [not referring to that which occurs naturally in fruits and vegetables].
Sunday, January 10, 2010
I start with the most positive observation:
Yogurt for Power Lifters: I do not drink sports drinks (just my elete water electrolyte mix) and I do not consume protein shakes, powders or bars. I DO eat protein and carbs and I do fuel with protein and carbs when I work out. As you might have deduced, I am going to the gym now a days, as opposed to any time since about 2006. Many days, I see a man there who appears to be training three or four young guys. Maybe they are highschool athletes, possibly wrestlers. The workouts they do are INTENSE. So on Friday, there I was doing my focused but simple weight training, while the 'boys' were doing their own routine. The leader is standing there eating a container of yogurt! He was chided a bit by some of the other muscle bound men, but stuck to his guns about protein in a natural form. I was SO impressed!
Calorie Content: I guess this is the worst thing I read all week. There is a good amount of error in the nutrition content information both on fast food or other restaurant menus and websites AND even on the labels of frozen foods, like Lean Cuisine and Weight Watchers. GASP> Well, if you are consistently eating the same things it isn't going to matter, but if you are switching to something and tracking your calories, you could be making costly mistakes. Always round up for sure. This is one of the reasons I just order my food the way I want it cooked, i.e. no oil, fat or butter instead of ordering a menu item that is considered a dieter option with a specified calorie content. Remember, calories do count and if you count them, you want a certain amount of accuracy.
Orange Juice: Always a fan of whole fruit and never one of juice, my thought on the news that orange juice prices were going to sky rocket due to the crazy Arctic weather in the South, was - GOOD. Now maybe people will drink less of it.
Words to Ponder: I was having a conversation about exercise with a physical therapist the other day. She said the follow three things about exercise; 1) it increases quality of life 2) it increases mobility 3) it decreases pain. She then added that it is a protective factor for almost every disease there is.
Restaurant Need to Know: Eating out with my family the other night. I asked for my broccoli to be steamed with no oil, fat or butter. Now, I know that you guys, my sweet, naive readers, think that if a vegetable is steamed it is also free of butter - MMMAWHAHAHAHA - not so. At the restaurant, I did get my fish and veggies cooked the way I wanted, but then the waiter asked me, "so how is that broccoli? (great) I had to go find some in the freezer. Does it taste okay without butter? (delicious) I didn't even know we had that freezer!" That my friends is funny, but also terribly sad. It is also why ordering a vegetable plate over a small steak may NOT be the smartest move you've ever made.
IN the Wake of My Travels: I was happy that my great niece and her dad enjoyed my international coffee (sugar free) so much that they bought some more. I usually have my own decaf skinny cappuccino, but when I travel I buy that. And today, my niece (her mom), let me know that she and her husband were drinking Deirdre cocktails, Seagram Seven and Fresca! I love it when people adopt some of my calorie saving strategies!
Saturday, January 9, 2010
Most importantly, if we want our children to be healthy, we must be mindful of their nutrition. An overweight child faces some challenges, and there are enough of those without adding extra. Not only does the weight itself pose problems, but the typical overnutrition that supports weight gain, also compromises performance, learning and social acceptance.
In order to better serve our children, we should better serve ourselves. It is as important to remove junk as it is to provide healthy food. If it is not there they will not eat it. That goes for both. If you want your children to be healthy and to care about their bodies, then you must do the same. It is a mandate for the entire household. Nor does it stop with food. Do you want active children? Be active.
We cannot afford to miss the boat on this. Overweight children end up with chronic diseases. Sure we have medications for that, but starting a 13 year old on a blood pressure medication is, oh I don't know, INSANE...... it is not the answer.
To reduce the disease impact, a child might lose weight, but to prevent the disease altogether, the parent might make obesity much less of a possibility. I have to say, it reminds me of a phrase I often voice in the tobacco wars, which is, "It is far easier to never smoke than it is to quit." And so, it IS easier to never get fat then it is to lose weight.
Perhaps it sounds offensive to say "fat" but it is what it is and it is not an aesthetic thing. Fatness, or obesity is a disease construct.
Go through your kitchen this weekend, or next. Make it a healthy one. Everything in moderation and more so some things than others, but don't expect your children to take care of their bodies if you are not willing to do the same. Make it a Family Affair - to Fair Well.
Friday, January 8, 2010
-There may be a slight change in your metabolism (or energy burn) when you quit using tobacco. -You may feel hungry more often than when you used tobacco.
-Food is going to smell and taste better!
-You might want to eat to keep from smoking or dipping.
-Exercise can help keep your energy burn from slowing, including weight lifting.
But the most important thing you need to know:
Tobacco does NOT make you thin and quitting WILL NOT make you fat.
Eating more than you burn off will cause weight gain. So eat, but eat smart.
Change Your Plate!
-Eat several meals throughout the day.
-Drink plenty of water.
-Choose certain fruits and vegetables that are high in fiber, nutrients and water.
-Choose foods low in saturated fat.
American Institute for Cancer Research
-Choose foods low in sugar.
-Choose lean proteins like canned light tuna in water, chicken without skin, beef labeled loin or round, fish (broiled, not breaded or fried), peanut butter, tofu, beans… -Avoid butter, dips, sauces, full fat cheeses and oils as much as possible.
-Drink calorie free beverages like coffee, tea and water.
-Choose whole grains.
-Read your labels and watch out for fat, sodium, sugar and calories.
Check out this website for more on labels: http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/
Check out this book from the library:
The Volumetrics Eating Plan by Barbara J. Rolls Ph.D.
Watch healthy lifestyle videos on YouTube: “Deerunstoo” channel
Thursday, January 7, 2010
Now the topic of the documentary is one for which I have GREAT passion - obesity. It would be a film about people's tendencies to over eat and to become obese. It will address this relationship we have with food and how obesity can lead to serious adverse health outcomes.
Now you might ask why GSK would make such an investment, and believe me, they plan to spend the money - use their resources as they say -
It is because GSK wants to bring attention to the problem. They say that they will give the production crew free reign to create what they call an educational product. An educational product that they hope will lead to more prescriptions of their supposed weight loss drug, Alli. (the same type of educational programs drug companies have infamously provided to health care providers for the last ten years. - yes?)
Have I written about Alli? You are damn straight I have.
I absolutely believe that there should be health education and health promotion regarding obesity, its effects and what to do about it. I believe that there should be policy aimed at reducing the amount of high fat, high sugar, high calorie foods that are available to children, hospital patients and to employees. I believe a true non profit, a university or a government agency, like the CDC should make this happen.
I do not believe drugs are the answer and as far as this drug goes, the efficacy is not well documented and Public Citizen has it listed as a Do Not Use drug.
GSK has as its goal, to make a profit. Period. If people are convinced that they are over weight and in danger and that a pill is the answer, then they will go to the store and buy Alli. They do not even have to ask their doctor for it. This sounds like one big direct to consumer marketing ploy -
I wish Bill Gates would make a film about obesity and then we could use the commercial I created in grad school that encourages people to ask their doctors if they are at risk for an obesity related illness.
Here it is in case you missed it.
Wednesday, January 6, 2010
Several schools and several researchers were involved in both studies. They
evaluated existing clinical trials, some which weren't published but made available through the freedom of information act, and they LOOKED BEYOND THE HEADLINES... In some cases of severe depression, which was not defined, but from my experience would include persons with nihilistic delusions, severe apathy, extreme weight loss or gain and inability to function - there was some effect, with some of the drugs, some of the time. BTW, electroconvulsive therapy also works!
Instead, most studies show that there was no difference between the drug and a placebo. With the great risk associated with these drugs, mostly weight gain and then diabetes, that should be a treatment changing finding. This is the type of research we need. Billions of dollars are spent on these drugs - Paxil, Prozac, Zoloft, Effexor and more.
One drug company that responded to the study said that the design of their studies and the university studies were not the same so they really weren't going to comment beyond noting that their medications had improved the quality of life for many people who take them.
Drug companies say that they are not creating the drugs for people with mild to moderate depression, but you sure wouldn't think that from watching their ads. If anything, they seem driven to convince us all that we have clinical depression and their pill could eradicate it in a day. Truth be told, even when drugs are deemed effective, it is after several weeks of taking them.
Two things in the Forbes article by R. Langreth are worth repeating. One clinician advised that alternatives to medicine should be considered and that includes exercise and talk therapy - I am sure that some of the strategies for managing stress in yesterday's post would also be helpful.
Another scientist noted that the idea that drugs that keep serotonin (a mood stabilizing neurotransmitter) available in the brain (uptake inhibitors) really were not effective and that the idea that a lack of serotonin leading to depression is a MYTH! I think they should concentrate on endorphins and dopamine which is probably why so many studies do show that exercise is at least as effective as drugs in treating this condition and a helluva lot safer.
I will share a personal story with you now. It is something that happened to me at least a hundred years ago, or maybe ten...
I was having a bad time and went for some counseling. This was after my first round of college but before my graduate work, etc. I saw the counselor a few times and then one day she said, "I spoke with your insurance company and they think the best thing to do, the thing that will work the fastest, is to put you on medication - an antidepressant." I cannot in words express to you how angry I became. I certainly used very bad language. I could not believe that I had come in to get a sense of direction, do a little brainstorming and goal planning and was told that I had clinical depression and needed pills. I told her that I would not take medicine, I was not depressed, but had issues with the way my life was going - or the path I was on. I was unhappy, yes, but I was going through a crisis. She did say, something like wow, that is the first real emotion you've shown since we started. WHATEVER! :) But you know, this was a turning point to me and what I said to her then is very important for all of us.
I was going through a crisis. And contrary to what Big Pharma wants you to believe, life stresses and even significant crisis do NOT require medication and even if they did, the ones out there do NOT work. I am not talking clinical and severe depression and please, never abruptly (or without telling your doc) stop a medication that you have been prescribed, but also know that sometimes the only way out of something is through it - you have to take one step at a time and get through it. Exercise and writing or talking things out - that'll help.