Oct
01
2006

Good Nutrition Is Gender Specific

By | Cancer, Health, Heart Disease, Nutrition, Prevention, Stroke

It is well known that various health concerns are related to the gender of a person, but there are findings that suggest that even nutrition has to be tailored to the needs of males or females.
Calcium is known to be beneficial to bone health, and while high calcium diet may protect a woman from osteoporosis, it does not have the same evidence for men. As a matter of fact, high calcium intake in males may increase their risk of prostate cancer. For the male it means that calcium should be used in moderation and vitamin D intake could help to offset some risks.
Fat choices, mostly sources of monounsaturated fats in the form of olive oil are important for both, men and women, and for both the omega-3 fatty acids that are found in fish are excellent. Men, especially those with a risk of prostate cancer, should be cautious about loading up on flaxseed and canola oil. Alpha-linolenic acid in these two oils may be a problem for the prostate.
Iron is also emphasized in healthy nutrition, but men need less than women. In the presence of an abnormal gene, excessive iron can accumulate to harmful deposits in various organs.
Social habits, for example the drinking of alcohol seem to have more grave implication to women than to men. The glass of wine that may help reduce the risk of heart attacks and certain strokes may seem harmless enough, and average men don’t seem to develop health problems, as long as the alcohol intake is low. Larger amounts will increase the risk of many ills for males and females alike, but even low doses of alcohol may increase a woman’s risk of breast cancer.
“Super Foods” have made headlines, and all of them are known because of their high content in antioxidants. A recent study from the University of Oslo, Norway, under Dr. Bente Halverson examined, which of them are ranking highest. At the top are, in the order of strength: blackberries, grape juice from Concord grapes, artichoke hearts, walnuts and strawberries. The researchers came up with a list of high oxidant foods on the basis of typical serving sizes.

Good Nutrition Is Gender Specific

Everybody needs to find healthy food

These are the winners among the super foods and spices: blackberries, walnuts, strawberries, artichokes, cranberries, brewed coffee, raspberries, pecans, blueberries, ground cloves, grape juice and unsweetened baking chocolate. Males as well as females of all age groups will benefit from those.
Dr H. Simon, associate professor of medicine at Harvard Medical School points out that there are fundamental facts in nutrition that apply to everyone. But there is also a fine print, which varies according to gender, age and medical conditions.

More information about nutrition: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/

Reference: The Medical Post, September 19, 2006, page 25

Last edited November 1, 2014

Oct
01
2006

Lowering Cholesterol Aggressively Saves Lives

By | Diabetes, Heart Disease, Obesity, Stroke

A 5-year multinational prospective study (“Treating to New Targets or TNT Study” involving top cardiologists from around the world has found significant benefits in using higher doses of statins. They investigated the effects of increasing the statin concentration (a cholesterol lowering medication) and have now come to new insights how to approach the metabolic syndrome, which is the metabolic derangement associated with obesity. Of 10,001 patients aged 35–75 years with clinically proven heart disease 5,584 patients had metabolic syndrome at the same time. Half of them were put on 10 milligrams of Atorvastatin (brand name: Lipitor, made by Pfizer Inc.), the other half on 80 milligrams per day. They were followed for 5 years and many questions were asked, blood tests done and statistics kept. Of particular concern was whether survival rates and numbers of heart attacks or strokes would be different for the various groups. The major focus of interest was on people who were over weight or obese.

As the image above shows, percentages of complications (heart attacks and strokes) were used as clear end points of cardiovascular complications to measure the response to the statin. The results showed that two subgroups of obese patients, those who have at the same time diabetes and those who don’t, were both benefitting from the higher dose of Lipitor in an equal manner (about a 30% relative reduction of risk).

The amazing result was that dosage of the statin mattered very much. In the past it was thought that taking a pill for high cholesterol was all that mattered. However, now we know that physicians need to watch the blood level response of the bad cholesterol (LDL cholesterol) and titrate the abnormal levels down to a normal level by using adequate dosing. The authors came to the conclusion that metabolic syndrome patients with heart disease, and particularly those where diabetes was present at the same time, would need more intensive statin therapy (higher dosage) than patients who were only having cardiovascular disease. The new goal post for lowering the low-density lipoprotein cholesterol (LDL cholesterol) of 1.8 mmol/L (70 mg/dL) was recommended.

5-Year Study Shows Further Reduction of Major Cardiovascular Complications In Patients
(Expressed as %) With Metabolic Syndrome Using Higher Doses of Atorvastatin(P. Deedwania et al. Lancet 368, No. 9539: 919-928, Sept. 9, 2006)
 

 

 

 

 

 

 

 

 

 

This study showed that there was a 44% increase in absolute risk for an adverse outcome in coronary heart disease patients who also have metabolic syndrome than those without metabolic syndrome. This justifies a very aggressive treatment with Lipitor down to the new target blood values indicated above that your doctor needs to monitor. In high risk patients for heart attacks and strokes where more than 3 cardiovascular risk factors are present the patient’s outlook (longer survival) can be improved by several years. This was shown with treatment using the higher dose of Lipitor when blood levels and cardiovascular complications were compared between 5 years of treatment and the treatment results after the first year of the study.

More information on:

1. Treatment of a heart attack: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/treatment-heart-attack/

2. Metabolic syndrome and obesity: http://nethealthbook.com/hormones/metabolic-syndrome/

Reference: The Lancet 2006; 368:919-928 (09 September 2006)

Last edited November 1, 2014

Aug
01
2006

New Screening For Cardiovascular Disease

By | Health, Heart Disease, Nutrition

Checking out the patient’s heart disease risk factors used to be very basic. Lifestyle questions were one aspect: was the patient smoking? Did he have a lack of exercise? Did he have a risk of heart disease in the family? The patient’s diet was analyzed and the body weight was assessed. Cholesterol and triglyceride levels were the basic labs that provided more information. The risk factor assessment, as exemplified by criteria from the Framingham study, made a lot of sense.

In the meantime cardiologists are concerned that all these points are no longer sufficient in identifying individuals at risk for heart disease. Dr. Morteza Naghavi, president for the Association for the Eradication of Heart Attacks, is concerned that it is not only obesity and hypertension that bear the risk for heart attacks, but atherosclerosis. A lot of heart attacks occur in the low- and moderate risk groups. As far as he is concerned, every man aged 45-75 and every woman from 55-75 needs to be screened. We are better equipped to do something for people who have a high plaque burden (deposits in the blood vessels.) Statins are the medication of choice to help these patients.

Screening techniques have become less invasive, as imaging technology has made large progress in recent years. The condition of the carotid artery can be assessed by ultrasound (carotid intima-media thickness or CIMT). Coronary calcification score (CACS) can be measured by CT scanner. The tests are done in a few minutes, and the cost at the most is a few hundred dollars. A patient would only be screened every five years. Screening procedures work and save lives, as demonstrated in the screening for breast cancer. The SHAPE team (The Screening for Heart Attack Prevention and Education) has calculated that the screening cost is even better than breast cancer screening. There are other tests that improve the sensitivity of traditional criteria, like the blood test for C-reactive protein, but in assessing the patient’s risk, it does make sense to go to the source of disease. The striking color image that demonstrates the atherosclerotic burden will allow the patients to see the problem with their own eyes.

New Screening For Cardiovascular Disease

New Screening For Cardiovascular Disease

It may be a healing shock that has a beneficial effect on the compliance of patients. Test results of laboratory work are words, but here a picture is worth a thousand words when it comes to encourage the patient to actively work on prevention.

More information on heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

Reference: National Review Of Medicine, July 30, 2006, page 7

Last edited November 1, 2014

Jul
01
2006

Better Blood Pressure Control With New Drug

By | Heart Disease, High Blood Pressure, Prevention, Stroke

Numerous medications for blood pressure control are in circulation. Treatment of high blood pressure patients is crucial in the prevention of strokes, but despite the multitude of drugs that are on the market, the treatment has its challenges. Some of the drugs have side effects, like an irritating cough, and a suitable medication has to be tried out first. Even, when all is well and there are no unpleasant side effects, many patients have a problem with compliance. Pills that have to be taken several times per day are forgotten. As a result, the patient will have poor blood pressure control.
Blood pressures must be controlled on an ongoing basis. Ideally there are no big fluctuations, whether it is day or night. For this purpose, a medication has to stay in the system of the patient long enough. This time stretch is called the half-life of a drug.
The first drug in a new class of agents for the treatment of high blood pressure does exactly that: it has a long half-life, so blood pressure control is smooth and continuous, day or night. The oral direct renin inhibitor aliskiren has the potential to protect the heart and other organs with a once-daily dosage of 150 mg or 300 mg. The drug is being developed by Novartis, and clinical trials are on their way.
The medication in combination with a diuretic provides significant additional blood pressure reduction. The agent at work is a renin inhibitor (also known medically as “renin antagonist” as it blocks the effects of renin). In the past, renin inhibitors for treatment of hypertension (high blood pressure) could only be used as intravenous solution and this was only effective for a short time.

Better Blood Pressure Control With New Drug

Better Blood Pressure Control With New Drug

The new development is a breakthrough, as the medication is taken by mouth and it continues to work even when the drug is gone from the blood stream. It is ideal for daily dosing, and there is no apparent buildup in the body.

More information about hypertension (high blood pressure): http://nethealthbook.com/cardiovascular-disease/high-blood-pressure-hypertension/

Reference: The Medical Post, June 13, 2006, page 38

Comment on Nov. 13, 2012: Aliskiren  (brand name “Tekturna”) was approved by the FDA in March of 2007. However, as all drugs, it does have some side-effects like headaches, cough, angioedema, skin rash, elevated uric acid with gout etc. (see this Wikipedia link).

Last edited Nov. 1, 2014

Jul
01
2006

Exercise Can Reverse Risk Of Heart Disease

By | Fitness, Heart Disease, Prevention

A growing health concern is cardiovascular illness. As a rule the risk increases with unhealthy life style choices. The most common neglect is the lack of physical activity, and a couch-potato existence is a sure recipe for poor health. Often juvenile “couch potatoes” lay the groundwork for health problems in their middle age years.
Jennifer Robbins of Duke University in Durham, N.C. led a follow-up study on a group of participants. The objective was to examine, how much impact an exercise program would have on the overall condition of the participants. Fitness parameters included weight, waist circumference, visceral and subcutaneous fat, cholesterol levels and metabolic score.
In a control group 61 subjects were instructed not to change their dietary habits or exercise habits for 6 months. Researchers expected that the general health condition of these people would stay the same. What was observed, however, was a deterioration of all the fitness parameters. The sedentary group actually got worse! At the end of the study, all the 61 were offered to participate in one of the exercise programs offered to the other groups. 53 participants decided to take part, and they were enrolled in a low- intensity, medium-intensity and high- intensity exercise program. The two lower groups managed to reverse the detrimental effects of inactivity on cardio-vascular risk in a half-year exercise program. The researchers noted also that the ones who had deteriorated the most during the sedentary period achieved the most improvement from the exercise program.

Exercise Can Reverse Risk Of Heart Disease

Exercise Can Reverse Risk Of Heart Disease

Exercise Physiologist Jennifer Robbins and her team concluded, that the study result gives encouragement to those who don’t exercise and feel bad about it, as they will reap the most benefits. The results also give doctors more incentive to make physical exercise part of a prescription regimen. With a word of recommendation from the physician patients are more likely to enrol in an exercise program and stick with it.

More info about:

Heart disease: http://nethealthbook.com/cardiovascular-disease/heart-disease/

Fitness and exercise: http://nethealthbook.com/health-nutrition-and-fitness/fitness/ 

Reference: The Medical Post, June 20, 2006, page 47

Last edited Nov. 1, 2014

Jun
01
2006

Probiotics Help Gut Against Stress

By | Cancer, Gastrointestinal Disease, Health, Heart Disease, High Blood Pressure, Nutrition

In times of stress our bodies react: the heart will beat faster, palms will feel sweaty, and a difficult situation may manifest itself in other reactions of the body. In every day’s terms we speak about something “being a pain in the neck”, or the fear of an exam showing up as “butterflies in the stomach”.
Dr. Mary Perdue of the Intestinal Diseases Research Program at Mc Master University in Hamilton, Ontario went a step further. The fact that mental stress can bring physiologic changes in the lining of the intestine has been known for some time. As a result the epithelium (the lining) is more vulnerable to the attack of pathogenic bacteria. The researchers put a solution of lactobacillus to the test, to see whether these gut-friendly bacilli could offer some help. Stressed rats that received the treatment with lactobacillus showed a remarkable degree of protection. The stressed and treated animals were almost as resistant to intestinal pathogens as animals that had not been stressed at all. Contrary to that the non-stressed animals did not show much evidence of bacterial adhesion or penetration: they were more resistant to the attack of bacteria to their guts.
Dr. Perdue explains that it may be difficult to extrapolate from the rat model to the human model. Yet it is clear that humans who are stressed can develop intestinal dysfunction over time, or gastrointestinal symptoms can be exacerbated by stress.
In the meantime probiotics are recommended by many doctors and nutritionists to help restore the gut’s natural flora. New guidelines from Yale Medical School recommend them for diarrhea in children and adults and in diarrhea, which comes as a result of treatment with antibiotics.

Probiotics Help Gut Against Stress

Probiotics Help Gut Against Stress

More research is needed, but existing data suggest that probiotics can help manage lactose intolerance, prevent infections, and reduce inflammation. It can lower cholesterol and lower blood pressure and may help with prevention of colon cancer.

More information on:

1. Stress management: http://nethealthbook.com/health-nutrition-and-fitness/fitness/stress-management-relaxation-techniques/

2. Probiotics: https://www.askdrray.com/probiotics-important-for-your-health/

Reference: National Review of Medicine, May 15, 2006, page 8

Last edited Oct. 31, 2014

May
01
2006

Blood Clots Related To Air Travel

By | Health, Heart Disease

Extended air travel and sitting in the narrow seat of a plane has been blamed for the risk of deep vein thromboses (DVT). The formation of a blood clot in the leg veins is not only an inconvenience that causes severe leg swelling. It cannot be ignored, as untreated it may progress to an embolus, a clot that travels in the blood stream to lung or brain. Pulmonary embolism can kill! The affected patient needs treatment with blood thinners to dissolve the clot.
Pamphlets in planes encourage the traveler to move legs, feet and toes to counteract a stagnant blood flow in the leg veins. It remains a good practice for any traveler to get up and move about on lengthy flights. Some individuals are more susceptible than others to develop blood clots. It has been known for a while that the use of oral contraceptives is associated with a risk of clotting.
Dutch researchers under the leadership of Dr. Frits Rosendaal of Leiden Medical Center in the Netherlands recently published some of their findings.

They examined, whether sitting for extended periods in narrow spaces would be the main risk for the formation of DVT. The volunteers were 15 individuals with no known risk factors for DVT. The group also had 11 women, who were carrying the factor V gene (a known risk for blood clotting), 15 women who were taking oral contraceptives, and another group of 15 women who had the factor V Leiden and were taking oral contraceptives. The entire group was taken on an 8-hour flight aboard a chartered 757 jet. Blood samples were taken before, during and after the flight. Several weeks later the same people sat through a movie marathon at a cinema, where the seats had the same legroom as the plane. Blood work was done as with the previous setting on the plane. No one was allowed to drink alcohol, take aspirin or wear compression stockings during the experiments. The test persons were asked to remain seated as much as possible, both during the flight and at the movies.
Finally the group was monitored for 8 hours while they went about their normal day-to-day routines.
The results showed that 17% of the entire group had early signs of possible clotting in their blood after the flight. After the movie marathon only 3% showed the same signs. The rates dropped to 1% during normal everyday routines. As predictable, the group with the factor V gene who were also taking oral contraceptives was at the highest risk.

Blood Clots Related To Air Travel

Blood Clots Related To Air Travel

As a result of these findings, the researchers believe, that sitting is not the only risk for the development of blood clots. The combination of low cabin pressure and low oxygen levels in jet travel may increase the risk for DVT in susceptible individuals.

More on blood clots: http://nethealthbook.com/lung-disease/pulmonary-emboli/

Reference: The Medical Post, March 28,2006, page 50

Last edited Oct. 31, 2014

Sep
01
2005

Dark Chocolate For Lower Blood Pressure

By | Heart Disease, High Blood Pressure, Nutrition

Chocolate, as long as it is consumed in moderation, can be good for you. The beneficial ingredients are the bioflavonoids, the same substances that are also found in fruit and vegetables.
Dr. Jeffrey Blumberg, PhD, at Tufts University in Boston reported about a study, where 20 adults with hypertension (high blood pressure) were asked to eat white chocolate or dark chocolate for 15 days. Blood pressure was reduced by an average of 12/9 mmHg with the dark chocolate. White chocolate had no effect, as blood pressures stayed the same. Dark chocolate also caused a dip in the LDL cholesterol and lowered insulin resistance.
The reason for the benefits lies in the bioflavonoids content: dark chocolate is rich in bioflavonoids, whereas milk chocolate contains little, and white chocolate the least of the three.
For all chocoholics this is not a ticket for a box of Belgian dark chocolates or an assortment of candy bars in one sitting.

Dark Chocolate For Lower Blood Pressure

Dark Chocolate For Lower Blood Pressure

Moderation is still the key, and you may consider consuming cocoa, perhaps as a Mexican chocolate drink without the fat and without the sugar.

References: The Medical Post, August 9, 2005, page 19

Last edited December 7, 2012

Aug
01
2005

Tight Blood Sugar Control In Diabetics Cuts Heart Disease

By | Diabetes, Heart Disease

Successful treatment of type 1 diabetes in the past usually meant compliance in taking insulin shots and paying attention to a diabetic diet. Since the arrival of specific lab tests like the HbA1c levels, patient education has become more sophisticated: it is not enough to just be on shots, eat sensibly and otherwise hope for the best. As a result, it is a must for patients to monitor their glucose levels closely.
Research that was presented at the American Diabetes Association during the 65th annual scientific session spelled out the benefits very clearly: strict control of glucose levels helps patients with type 1 diabetes to decrease the risk of stroke and cardiovascular disease by 57%!

It has been known that tight glucose control helped to reduce diabetic nephropathy (kidney disease) and diabetic retinopathy (eye disease) in diabetics, but this is the first time that controlling glucose levels has been associated with cardiovascular disease, reports the main investigator, Dr.David Nathan from, director of the diabetes center at Massachusetts General Hospital in Boston. He also reported that every 1% reduction in HbA1c (glycosated hemoglobin) correlated with a 20% reduction in cardiovascular risk for the diabetes type 1 patient.

These findings are significant, as the risk reduction is larger than seen in any other trials, like administering medication (statins) or placing stents.

Tight Blood Sugar Control In Diabetics Cuts Heart Disease

Tight Blood Sugar Control In Diabetics Cuts Heart Disease

A similar risk reduction may also occur in patients with type 2 diabetes, but at this point no specific research on this group is available. In the meantime it is of great importance to any patient with type 1 diabetes.

More information about:

1. Diabetes treatment: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/treatment-type-2-diabetes/

2. Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

Reference: The Medical Post, July 5,2005,page1, 58.

Last edited October 29, 2014

Jul
01
2005

Tooth Implants For Better Health

By | Dentistry, Health, Heart Disease

Missing teeth are often just ignored -why bother? There are still all the others around to assume the necessary functions! The truth is different: missing teeth can affect us in the way we eat, speak, rest, and appear. They can influence our behavior and overall functioning. A missing tooth can also compromise the dental health of its neighbor.
In the past the only options for missing teeth was either dental bridges or dentures. Bridges and dentures still have their place now, but the benefits for dental implants are significant.
-They help to preserve remaining natural bone structure.
-They reduce the need to cut out adjacent teeth for a bridge.
-They eliminate the need for removable partials or dentures and the sores that may go along with them.
-The roof of the mouth does not need to be covered by removable partials or complete dentures.
-They look, feel and work just like natural teeth.
-They support face shape, smile and provide confidence when eating and speaking.
-A few exceptions apply: people who smoke and people who have diabetes, particularly when uncontrolled and severe, have much less success with implants, as healing is impaired. However, you may consider quitting smoking and diabetes may be able to be controlled better with the help of a specialist. Other patients who have pacemakers, artificial heart valve replacements or other implanted devices may have to stay away from implants and they may have to stick to more conventional methods such as bridges and dentures.
The dentist will do a thorough examination to decide, whether you are a candidate for dental implants. Each tooth will be examined and a medical and dental history will be taken. Special x-rays (panoramic and tomograms) are needed to determine whether there is enough bone available. This helps to decide whether the implants can be placed directly, or whether grafting more bone will be necessary. This step is very important. It also helps the dentist to identify important structures, like nerves, sinuses and adjacent tooth roots. You will discuss all the treatment options with your dentist, which also helps to clarify expectations about the final results. This comprehensive treatment plan can be compared to building the foundation of a house. The foundation has to be solid, so the final structure holds up. A properly done dental implant should be a one-time job.

Tooth Implants For Better Health

Tooth Implants For Better Health

The procedure itself is done in the dental office or in a surgical suite under a local anesthetic, and over-the-counter pain medication may be needed after the surgery. The time it takes to heal can be variable. It may take up to six months, but it is important that healthy bone develop around your implant, which is the strong bond that is needed to hold the implant in place. Once the healing is complete, your dentist takes a final impression, which is needed by the dental laboratory to create the permanent teeth.
Once the permanent teeth are placed you will receive care and a dental hygienist will instruct you in dental hygiene. Special plastic cleaning instruments are used to avoid scratching the titanium surface of the implant. Just as with natural teeth, implant-retained teeth need to be cleaned daily and need to be regularly checked by a dentist.
Looking at the overall picture it is clear, that the dental health and function of our teeth closely relates to every facet of our overall health, from speech to the function of our digestive tract and proper nutritional status, which affects cardiovascular health as well. A tooth implant involves a lot of detail work and effort, but its benefits are far reaching.

Reference: Family Health, Vol. 21, No.2, Summer 2005 (June), page 9-13; published by The College of Family Physicians of Canada

Other links re dental implants:

Association of Prosthodontists of Canada

American College of Prosthodontists

Last edited December 7, 2012