Dec
01
2008

Disease Of Peripheral Blood Vessels Occurs With Metabolic Changes

By | Diabetes, Heart Disease, High Blood Pressure, Prevention, Weight loss

Metabolic syndrome has serious health consequences: diabetes, high blood pressure and heart disease are just a few conditions that are associated with it. It is also known that diabetic patients are prone to pressure sores and ulcers of their feet and if the leg became gangrenous, the patient would lose it due to the need to amputate. Peripheral artery disease or PAD has recently been studied by Dr. Aruna D. Pradhan, and the prospective study involved 27,000 women. At the beginning of the study the middle aged women were free of cardiovascular disease, but a quarter of them had the hallmarks of metabolic syndrome. Twenty five percent of those with the condition also were diabetic. During the 13 years of follow-up 114 women developed peripheral artery disease and those patients with metabolic syndrome were 62% more likely to develop the disease. The individuals with metabolic syndrome had other features: they were less likely to exercise, more likely to smoke and their weight was higher. But 7,000 women with metabolic syndrome had another important feature in their lab tests: they had markedly higher levels of biomarkers of systemic inflammation, which was manifested in higher levels of C-reactive protein.

Disease Of Peripheral Blood Vessels Occurs With Metabolic Changes

Metabolic syndrome causes peripheral artery disease

 

 

Once all the criteria are stacked up against each other, it becomes obvious that the presence of metabolic syndrome alone is not responsible for the most significant increase in peripheral artery disease. It is not the high cholesterol levels or the high triglyceride readings that are the villains in this condition. The driving force is systemic inflammation, as documented by the high C-reactive protein levels in blood tests.

More information about hardening of arteries: http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

American Heart Association, New Orleans, Nov. 8 to 12, 2008

Last updated Nov. 6, 2014

Jul
01
2008

Genetic Difference Influences Sweet Tooth

By | Diabetes, Nutrition, Obesity, Weight loss

Environmental factors and ethnic customs can influence us to have certain likes and dislikes of foods, but researcher Ahmed El-Sohemy has found in his studies that there is also a biological and genetic basis for some of our food preferences. Researchers from the University of Toronto have discovered a genetic difference in people who consume extra sugar in their diet. The specific genetic constellation which the researchers have called GLUT2 does not only work in the pancreas, but it also is responsible for turning on satiety signals in the brain. It seems to have an impaired ability to notice high blood sugar levels that ultimately send “stop eating” signals to the brain. The habit to eat more sweets has been researched in persons with diabetes, but Dr. El-Sohemy does not believe that diabetes is directly connected with gene GLUT2. On the other hand he does not suggest that the presence of the gene should be an excuse to overindulge in sugar high foods. He states that food habits in humans are often connected to the availability of foods: if there is a birthday party and birthday cake, the people with a liking of sweets will be the first to get a slice of cake. On the other hand, if there are no sweets available, they will not make an extra trip to the store just for a piece of cake. The most logical approach is to minimize the availability of foods that are high in sugar, which is especially important for individuals who have GLUT2, the ”sweet tooth gene”, so they are not tempted to overindulge.

Genetic Difference Influences Sweet Tooth

Genetic Difference Influences Sweet Tooth

Much was learnt from two separate studies that involved 100 older adults on the one hand who were overweight or obese and 587 healthy younger adults who were mostly lean. Foods and beverages that were consumed were carefully recorded. In both investigations blood was drawn for DNA analysis and the presence or absence of the variation of the GLUT2 gene was compared to the food intake data. The older obese group with the variant gene consumed 112 grams of sugar per day versus 86 Grams per day for the non-variant gene group (normal control). The younger population carrying the variant gene consumed 131 Grams of sugar per day, while the non-variant control of young people consumed 115 Grams of sugar per day. This illustrates how genetic influences have an effect on our eating habits and also that younger people ought to be careful that they do not overuse sugar containing foods.

It also points to the solution of controlling your weight, if you belong to the higher risk group with the GLUT2 gene: you must exercise more to burn up the extra calories you tend to eat. A brisk walk on a treadmill will consume about 300 or 350 Cal in 30 minutes depending on the slope and the miles per hour setting.

Reference: Medical Post Vol 44, No. 16, June 16, 2008: page 19 (based on May issue of Physiological Genomics)

Last edited December 4, 2012

Sep
01
2007

Weight Loss Surgery Reduces Mortality

By | Diabetes, Heart Disease, Nutrition, Obesity

Excessive bodyweight contributes to a host of illnesses. Diets and lifestyle changes, physical activity and exercise programs can contribute to successful weight loss, but for a group of patients morbid obesity remains a significant problem. Weight loss surgery, also known as bariatric surgery has been on the increase.

Opinions about the usefulness of bariatric surgery have been divided. Often it was seen as a heroic effort with lots of risks and questionable benefits. In some procedures patients did not show significant weight loss, and there were some doubts whether the risk of surgery was worth taking.

Dr. Lars Sjoestroem of Gothenburg University has a detailed study on 4,047 Swedish patients with obesity, of which 2,010 underwent bariatric surgery, while 2,037 received non-surgical treatment. The two groups were compared for overall mortality after 11 years. The non-surgical control group lost little or no weight. The bariatric surgery patients did better. The most successful group was the one which received gastric bypass surgery with a weight loss of 25%. Vertical-based gastroplasty patients lost 16% of their weight, and those who underwent gastric banding lost 14% of their weight over 10 years.

Weight Loss Surgery Reduces Mortality

Gastric bypass surgery

At follow up the overall mortality was significantly decreased in the group that underwent surgery. Death risk from disease which is associated with obesity, such as coronary artery disease was significantly decreased by 56%. The risk of death from diabetes was decreased by 92% and the risk of death from cancer also showed a reduction of 60%.

US data show similar results of a decrease in long-term mortality in obese patients who underwent bariatric surgery and lost weight.

More information on weight loss: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/weight-loss/

Reference: August 23, 2007 issue of The New England Journal of Medicine.

Last edited November 3, 2014

Dec
01
2006

Cinnamon And Multivitamins May Boost Fertility

By | Health, Nutrition, obstetrics, Vitamins and supplements, Women’s Diseases

Prenatal vitamin supplements are the norm, as folic acid has been known to play a role in the prevention of neural tube defect. Generally they are taken once pregnancy has been confirmed.
Dr Jorge Chavarro from the department of nutrition at the Harvard School of Public Health in Boston pointed out, that multivitamin supplementation has its place earlier than just after the pregnancy test has become positive. In one of the largest studies involving 18,000 married pre-menopausal women, regular use of multivitamin supplements were associated with a decrease of infertility. The key is in the regular use. Women who took two multivitamin tablets per week had similar infertility rates as women who did not take supplements at all. Those who took 6 or more multivitamins had a 40% lower risk of anovultation, a condition where no eggs are released by the ovaries.
Most of the women were Caucasian between the ages 24 and 42.
The importance of nutrition is coming increasingly into the forefront in reproductive medicine. One condition known as polycystic ovary syndrome (PCOS) is often a reason for infertility. It is one of the red flags that point to the condition of insulin resistance, and it manifests itself in menstrual irregularity and higher levels of androgens, often showing as increased facial hair. As the metabolism is headed for trouble, diabetes, high blood pressure, high cholesterol and heart disease would tend to develop.
Researchers at Columbia University in New York conducted a pilot study to see if insulin sensitivity in women with PCOS could be improved. Cinnamon, a well-known spice, has been known to have a favorable effect on the insulin response of the body. Researchers found that eight weeks of treatment with cinnamon extract significantly decreased fasting glucose and insulin resistance in women with polycystic ovary syndrome.

Cinnamon And Multivitamins May Boost Fertility

Cinnamon And Multivitamins May Boost Fertility

Dr. Jeff Wang who conducted the study reported that no side effects or adverse reactions were reported throughout the study period. If large-scale prospective studies confirm these findings, then recommending cinnamon as a dietary factor may be a simple, inexpensive lifestyle change that can be easily followed. Reducing insulin resistance is a key to improve the overall health status in patients with PCOS, and it ties in with reproductive health benefits as well.

More information about infertility: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/infertility-php/

Reference: The Medical Post, November 14, 2006, page 32

Last edited November 2, 2014

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Nov
01
2006

Think Feet With Diabetes

By | Diabetes, Prevention, Skin Disorders

This article is about “think feet with diabetes”. About 2 million Canadians are currently living with diabetes. It can be a “silent” disease, as patients may have few symptoms. Once diagnosed with diabetes it is of great importance to be vigilant of lifestyle and nutrition to keep the condition under control. A common problem for about 15% of diabetics is the development of a diabetic foot ulcer. Of those afflicted 14-24% will require an amputation of a lower extremity as a result. In addition to this the mortality rate of patients with below knee amputation due to the complications of a diabetic foot ulcer is 19-55% after three years.
Even though these statistics sound ominous, patients can do a lot in the way of prevention. According to the Canadian Diabetes Association guidelines, a diabetic patient should have a foot exam performed at least annually. Diabetic peripheral neuropathy is the leading cause of diabetic foot ulcers. The physician can examine the feet for loss of sensation. He will check for foot calluses and will debride those, which are pre-ulcer state. The physician also checks for poor circulation in the foot at that time.
If there is no loss of protective sensation, an annual exam will suffice, but if there is loss of sensation, several exams per year may be needed. A vascular surgeon may have to assess the patient to see if the foot circulation is sufficient. Infection is a warning sign and has to be treated promptly. Finally, any source of pressure to the foot needs to be removed or offloaded.
A proactive approach to keep the feet healthy starts at home.

Think Feet With Diabetes

Think Feet With Diabetes

The following points are important especially to the patient with diabetes:
-Inspect your feet on a daily basis. Check for sores, blisters or cracks that don’t heal.
-Check your footwear. If there is debris (sand, pebbles) remove promptly.
-Wash your feet daily with warm, not hot water and dry them well, especially between your toes.
-Trim your toenails. If you have difficulties doing that, seek out the help of a podiatrist. Also don’t use the homemade approach cutting corns and calluses.
-Keep the circulation to your feet going: put up your feet when you sit. Wiggle your toes, move your ankles, don’t cross your legs for long stretches of time.
-Shop for suitable footwear! Ask the sales clerk to measure both of your feet in order to determine the proper size. Shop in the afternoon, as your feet can swell during the day.
-Don’t break in a tight fitting new shoe! This may injure your feet. A new shoe should be comfortable right away.
-Don’t delay looking after problems. If a cut, sore, bruise or blister does not start to heal after a day, see a physician.

Reference: Parkhurst Exchange, October 2006 Edition, page 26

Last edited November 1, 2014

Jan
01
2006

Prevent Foot Problems In Diabetics

By | Diabetes, Hormones, Prevention, Skin Disorders

Diabetes has reached epidemic proportions in North America. Two million Canadians (about 20 million in the US) have diabetes, and the number is expected to rise dramatically. At one time or another about 15-20% of patients with diabetes will need hospitalization with a diabetic foot complication. The conditions, which are of concern, are diabetic foot ulcers, severe infection and circulation problems in fingers and feet (peripheral circulation). Health budgets are stretched, as the cost of treating a single foot ulcer has been estimated at $2,183, so the total cost over the lifetime of current diabetics will exceed $650 million (about 6.5 billion $ in the US). Foot ulcers appear like a small item considering the fact that the need for amputation of a lower extremity is the next severe problem that can arise. The average patient who undergoes a below knee amputation will spend 84 days in hospital and another 38 days in rehabilitation.
To prevent the development of foot ulcers, it is important to screen diabetic patients for predisposing factors like the loss of protective sensation in the feet (diabetic neuropathy) as well as structural changes resulting in areas of increased pressure. A study conducted in southwestern Ontario found that only 15% of patients with type 2 diabetes were screened to identify those at risk for foot ulcers. Screening is the first step, after which a podiatrist will have to take over. Footwear prescribed by a podiatrist can be an avenue of prevention, but ongoing podiatric care as well. The small number of diabetic foot screenings shows that podiatric medicine has not been used as a tool to recognize and treat diabetic foot problems.

Prevent Foot Problems In Diabetics

Prevent Foot Problems In Diabetics

The proactive approach of seeking the input of a podiatrist early will translate into significant benefits for the patient with type 2 diabetes.

More information on complications of diabetes:  http://nethealthbook.com/hormones/diabetes/complications-diabetes/

Reference: Parkhurst Exchange, December 2005, page 162

Last edited October 30, 2014

Nov
01
2005

Pre-Conception Nutrition For Healthy Children

By | Health, Nutrition, obstetrics, Prevention, Vitamins and supplements

The importance for good maternal nutrition during pregnancy has been emphasized for a long time. Of course in this case it was up to the mom-to-be to avoid toxins, such as smoking and alcohol and to take prenatal supplements along with sensible nutrition. Enticing the women away from the excesses of the standard Western diet would yield handsome health benefits for the country. Dr. David Barker, a medical advisor to the British government pointed out, that this approach would reduce heart disease, diabetes and other chronic diseases in the mothers as well as in their offspring. This concept does not address all the aspects, which are important for a healthy pregnancy and a healthy baby.
For the past 20 years a group of around 20 British family physicians, obstetricians and researchers under the name of Foresight has been putting a program into practice, which identifies and addresses the health deficiencies in prospective parents. Almost all couples that followed the pre-conception program had previously experienced problems relating to conception, pregnancy and birth. In one follow-up study of 367 couples that followed the Foresight program from 1990 to 1992, 327(89%) of the women became pregnant and had healthy, well-developed babies. None of the babies suffered malformations and none was transferred to special care. Of the 367 couples, 217(59 %) had suffered from infertility (from 1 to 10 years) and 139 (38%) had histories from 1 to 5 previous miscarriages. Eleven (3%) had previously given birth to a stillborn child, 40 had small-for-date babies and 15 had already had a low birth weight baby (less than 2,500 g). Seven couples had a previous baby with malformations and three had lost a baby to sudden infant death.
In a larger follow-up study of 1,076 couples, almost all of whom had previous fertility or miscarriage problems, 846 conceived success rate of 78%, as reported by Belinda Barnes, who runs Foresight. There were four problem pregnancies, including one Down syndrome baby, two terminations and one child with an adhesion of the intestine, which was correctable. This is a complication rate of only 0.47 %.

Pre-Conception Nutrition For Healthy Children

Pre-Conception Nutrition For Healthy Children

As the complication rate in the general population amounts to 6.43%, the pre-conception program has only 1/7th of the complications, a strong indicator that a pre-conception program does make a difference.

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

Reference: The Medical Post, September 27, 2005, page 33

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

May
01
2005

Inflammation Connected To Sudden Heart Death

By | Diabetes, Heart Disease, Prevention

It is a well-known fact that certain diseases go together, for instance diabetes and heart disease. Every effort has to be made for this reason to control a disease in order to minimize the risk for other associated illnesses.
New research from rheumatologist Dr. Sherin Gabriel at the Mayo Clinic points to another health condition. Patients affected by rheumatoid arthritis have a higher risk of early death than others, and these deaths are mostly due to cardiovascular disease. The relationship between these two diseases is complex, reports Dr. Gabriel, and the common denominator between heart disease and rheumatoid arthritis seems to be systemic inflammation.

Research from the Mayo Clinic in Rochester, Minnesota, has been published in March, and it was found that inflammation documented by laboratory tests such as an erythrocyte sedimentation rate of over 60mm per hour increased the risk for heart disease by a factor of two. Rheumatoid arthritis vasculitis increased the risk to 2.4, and RA lung disease showed a risk increase of 2.3. Traditional risk factors for heart disease like smoking, alcohol, obesity and diabetes were accounted for, yet the more dramatic risk factor in the population with RA (rheumatoid arthritis) was the aspect of inflammation. The results of this research are based on data from the Rochester Epidemiology Project, in which 603 persons with rheumatoid arthritis were followed over 15 years. In this time span 364 of these patients died, and heart disease was the primary cause of death in 176 of them. The subjects of this group were three times as likely as an age-matched population to have been hospitalized for a heart attack and had five times the risk of having an unrecognized heart attack. This group is also more vulnerable, because patients with rheumatoid arthritis suffer of joint pains, receive painkillers, and often chest pain can be masked by pain medication and go unrecognized.

Inflammation Connected To Sudden Heart Death

Inflammation Connected To Sudden Heart Death

Co-author Dr. Hilal Maradit points out that rheumatoid arthritis remains a multifactor problem, and one factor alone does not explain the entire story, but in the meantime the link of inflammation in RA to cardiovascular disease is an important step closer to early recognition and successful control.

More info about:

Rheumatoid arthritis: http://nethealthbook.com/arthritis/rheumatoid-arthritis/

Gingivitis: http://nethealthbook.com/dentistry/gingivitis/

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

Reference: National Review Of Medicine, April 15, 2005, page 3

Last edited October 28, 2014

Jan
01
2005

Doctor Recommended Diet Against Obesity

By | Diabetes, Health, Heart Disease, Nutrition, Weight loss

After overindulging over the holidays, new years resolutions often have diets and life style choices high on the list.
These concerns are not something new. Doctors have had concerns about heart disease, diabetes, bulging waistlines and elevated cholesterol. For over three decades there have been concerns that elevated insulin levels may be associated with heart disease, and the constellation of symptoms was called “syndrome X” and later the “insulin resistance syndrome”.

Most recently the evils that are associated with body fat have been called the “metabolic syndrome”.The problem has assumed epidemic proportions: by 2001, 30% of US adults were considered obese with a body mass index of over 30, and 50% were overweight with a body mass index over 25. The form of type 2 diabetes (the adult onset of the disease) is predicted to double in the next 20 years. Physicians are reporting that they are seeing increasing numbers of children who are obese and suffer of type 2 diabetes. The major concern with an accumulation of body fat is the area of the abdomen (think of the “apple shape” with fat around the abdomen). This visceral fat tissue is not just innocently sitting there stopping you from closing buttons and zippers. It is very metabolically active and the substances it releases are a threat to your health. These fat cells secret pro-inflammatory substances called “cytokines.”

They also form substances that influence blood-clotting, factors that increase insulin resistance, substances like angiotensin, which are signing responsible for high blood pressure as well. Among the host of damaging substances is also the C-reactive protein, which is recognized as a risk factor for heart disease.

Doctor Recommended Diet Against Obesity

Doctor Recommended Diet Against Obesity

There is only one solution: to reduce the risk, excessive weight has to be shed. A sensible diet to achieve that goal has to contain less saturated fat, more fiber, and low glycemic index carbohydrates. Proper dietary habits are only one part. The other as important measure is life style intervention, which includes 2.5 to 3 hours of moderate exercise per week.
Many of the current diets promise weight loss without compromising health. All of them promote weight loss, provided they are strictly adhered to.
The high protein diets (Atkins, Protein Power Plan) are useful for rapid initial weight loss, however due to the overload of protein long term use is highly questionable. Kidney dysfunction as a consequence is a threat to health and no benefit at all!
Moderate carbohydrate diets, moderate fat, as well as moderate protein will remain the answer for long-term life style changes. It is also of significance that the glycemic index of carbohydrates plays a major role. Food intake, which favors carbohydrates with a low glycemic index, is associated with less heart disease. It has also been documented that insulin levels are more stable. Low glycemic carbohydrates include most vegetables, beans, lentils, as well as fruit like apples, pears and oranges. In contrast, high glycemic carbohydrates result in a fast insulin release, which ultimately leads to insulin resistance. Among these items are potatoes, crackers and other flour products, rice, puffed or flaked breakfast cereals, and tropical fruit (papayas, pineapple, melons).

For short-term dieters, it is an option to embark on any of the current diets without deleterious effects, no matter whether they are high-carb or low-carb. But at this point only the diets with moderate carbohydrates have shown to have some benefits on heart health.
Ultimately the wiser choice is to consume foods with a low to moderate glycemic index, by increasing the intake of vegetable proteins and oils and by choosing increased servings of vegetables and fruit instead of highly processed items. So, when you next walk through your supermarket, remember that most of the good stuff is in the periphery, namely the area where all the fresh, unprocessed or minimally processed foods are found.

More info about Mediterranean diet: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

Reference: Metabolic Syndrome Rounds, Oct. 2004, Vol. 2, Issues 8, St. Michael’s Hospital, University of Toronto/On/Canada

Last edited October 27, 2014