STRESS CAN LEAD TO HEART ATTACKS

     Research has found that stress can lead to heart attacks.  In an analysis based on data gathered from 22,086 participants it was found that high stress jobs (where there is little control) were 67 per cent more likely to have a heart attack than those in less intense jobs.  This analysis was based on 22,086 over a ten year period and was published in the July 2012 issue of the journal PLoS One.  “Stress is a natural part of life,” says Michelle Albert, M.D., M.PH, an associate professor of medicine at Harvard Medical School and cardiologist at Brigham and Women’s and a cardiologist at Brigham and Women’s Hospital in Boston.  She says that an abundance of stress can overpower the body and put you in a constant “fight or flight” mode which can have negative effects on multiple organ systems, including the heart.

    Research has also linked to type 2 diabetes, impaired immunity, and worsening depression.  A recent poll of 1,200 adults by the American Psychological (APA) suggests that the way people cope can be unhealthy too.  “Stress doesn’t cause a cold or flu, viruses cause them.  For example, 44 percent of respondents reported lying awake at night when they were stressed, and 39 percent said they overate on junk food.  That underscores the need to find healthy coping mechanisms.  Stress does reduce your ability to fight infection in two ways – behavioral and biological – that can lead to illness.  People under stress tend to smoke more, skip exercises, consume sugar drinks, feel tense, and be susceptible to heart disease,” says Dr. Sheldon Cohen, a professor at Carnegie  Mellon University in Pittsburgh.   

    “Fatigue is one of the most common stress symptoms that sends people to a doctor,” says Tracy Stevens, M.D., a cardiologist at St. Luke’s Mid America Heart Institute in Kansas City, Mo.  “Another complaint is heart palpitations, a fast or skipped heartbeats or a sensation that the heart is pounding.  Many go for comfort foods such as French fries or macaroni and cheese.” adds Dr. Stevens.  Stress can be lessened by reading, praying, spending time with family and friends and mental professional help.  Humming a hymn or getting a massage also helps.  In a May 2012 study of 100 adults, researchers wanted to find out if mindful-meditation skills could be learned from an online course.  Participants said their stress-level scores dropped by 10 points out of 40 points by the end of the program.  Results were published in the journal BMJ.  Biofeedback and electronic devices to measure heart rate are other device measurements that can also be tried.

     

      

HARMING THE HEALTHY

   Our Three Minutes Consult today comes from Ray Moynihan, senior research fellow at Bond University, Queensland, Australia, and co-author of “Selling Sickness” (New York, Nation Books, (2005).  Consumer reports on Health, describes the details of “disease mongering,” which means selling disease.  One might say it is really just raising the awareness of diseases, but the other argument says it is driven by vested interests who want to maximize their markets.  Or is it turning shyness into social phobia that needs medication and call it female sexual dysfunction.

   Moynihan believes that some women are told they have a condition called osteopenia and widens the boundaries of illness to catch more healthy people to create a pre-condition such as pre-diabetes, pre-high blood pressure or pre-osteoporosis, and offer prescriptions for it, opening the door to lifelong medication use that may do more harm than the condition.

   What is over-diagnosis?” you may ask.  Some people may believe that you either have a medical condition or you don’t.  A most frightening example is breast cancer, called a ductal carcinoma in situ.  The natural history of this disease is so benign that a few years ago the National Institutes of Health suggested changing the name to get rid of the word “carcinoma.” 

   Something like that is going on with prostate cancer, which is why PSA tests for both prostate and breast cancer is that when early signs are detected, it cannot be possible to know whether that cancer will go on to kill or not.  We need to get better at distinguishing the harmful from the not-so-harmful.  Some experts suggest new approaches to very early signs of breast cancer, such as taking a “watch and wait” approach.

   Most people already know they need to have a healthy skepticism about potentially harmful treatments.  They are also going to have to become more skeptical about labels and diagnoses, because many of them may be unnecessary.  How to better communicate about over diagnosis will be the theme at an international conference being hosted next year by the Dartmouth Institute for Health Policy and Clinical Practice, in partnership with Bond University, the British Medical Journal, and Consumer Reports (preventingoverdiagnosis.net).

BOOSTING BRAIN POWER

    If you draw a blank when trying to remember a friend’s name, can’t find your car in a parking lot or misplace your reading glasses, it is normal to have some types of memory loss “but some types of memory loss are more substantial than others as we age,” says Arthur Kramer, Ph.D., a professor of psychology and neuroscience at the University of Illinois at Urbana-Champaign.  “If you meet someone at a party and can’t remember their name and what you talked about,” Kramer said, “One aspect of memory relates different pieces of information and puts them all together, and that’s the type that isn’t quite what it used to be.” 

    The brain is surprisingly adept at compensating for aging, and other types of memory can improve or remain intact over time.  More encouraging is that a set of relatively simple and inexpensive lifestyle changes, described below can go a long way toward maintaining a vigorous mind.  In late adulthood – the hippocampus – the brain region responsible for forming some types of memory shrinks up to 2 percent annually and increased risk for dementia.  Regular aerobic exercise encourages the growth of new brain cells, even if the workouts are not strenuous.  In a trial published in Proceedings of the National Academy of Sciences in January 2011, older adults were asked to either exercise or stretch.  The exercisers started with 10 minute walking sessions, extending them by 5 minutes each week until they walked for 40 minutes, three times a week.  Over a year, their hippocampus volume increased by 2 percent on MRI brain scans.  Those who only stretched showed a decrease in this volume.  Aim for at least 30 minutes a day five days a week.

    Pleasant helpful people retain brain vitality.  The International Neuropsychological Society followed 1,138 elderly people who did volunteer work and participated in social groups and attended religious services.  Over 5 years, the rate of decline on a broad range of cognitive abilities, was 70 percent lower in the most socially active people compared with the least socially active.  Other activities count, including gardening, playing the piano or other instrument, studying a new language, bird watching, or memorizing dance steps.  Foods for thought include fish, fruit and vegetables including dark leafy greens to protect mental agility.  The University of Pittsburgh tracked diets over 10 years and found those who baked or broiled fish at least once a week had larger and healthier cells in brain areas responsible for memory.     

ABOUT NUTS

     In his One Minute Consult, Consumer Reports on Health has a message for us from Richard D. Mattes, M.P.H., Ph.D., R.D., professor of nutrition science, Purdue University, West Lafayette, Ind.

     “At one time nuts were viewed as problematic for weight gain and heart disease.  But epidemiological evidence almost unanimously shows that people who consume nuts more frequently weigh less than people who don’t.  These findings were surprising and prompted a number of clinical trials.  They found that adding tree nuts as well as peanuts to the diet did not lead to the theoretical change in body weight based on their energy content.  There are several likely reasons for this.  First, nuts are very satiating, so consequently people eat less food than at other times.  This offsets between two-thirds and three quarters of the energy.  Second, people often chew nuts thoroughly, so somewhere between 5 and 15 percent of the fat they contain is not absorbed.  Third, although this is less substantiated by research, consuming nuts regularly may elevate energy expenditure.”

   There is very strong evidence that regularly eating nuts reduces cardiovascular risk factors like elevated LDL (bad cholesterol) and triglycerides.  Nuts are also rich sources of other nutrients – walnuts of omega-3 fatty acids, almonds of Vitamin E, and peanuts for protein.  They are also high in fiber.  The government has approved what is called a qualified health claim for most nuts, based on their effect on cardiovascular disease risk.  It covers almonds, peanuts, pecans, pistachios, and walnuts, but not cashews, which has not been studied as well as the others.  If you wonder about the right amount of nuts – the recommendation is to eat l.5 ounces a day.  An ounce of almonds fits in an Altoids mint tin, and the pack of peanuts you get on airplanes is usually about half an ounce.  The work we’re doing now suggests that whether they are honey-roasted, salted, or raw doesn’t adversely affect their health benefits.  For safety sake one can rub off most the salt if your doctor has warned you about getting too much salt.   

BENEFITS OF A BETTER BREAKFAST

    “It is better to substitute the classic breakfast of high sugar cereal with a whole grain cereal for the first food of the day,” suggests spokeswoman and registered dietician for the American Dietetic Association, Sari Greaves.  “Select a whole grain cereal that has five grams of fiber.  To half a cup of this cereal add a quarter cup of raisins and a quarter cup of ground almonds which is healthier than white sugar and has nine essential vitamins, as well as calcium and other minerals.  Hot cereals like oatmeal are another good choice.  It is high in fiber and has a low glycemic index which means it doesn’t tend to raise blood sugar too quickly.” 

    Hot cereals can be made in a slow cooker,” adds Jeanette Bessinger, at the website www.realfoodmoms.com.  “You can also add chunks of raw sweet potato or yams.  For a different take, add leftover quinoa or rice and serve with cinnamon or cardamom.”  For gluten free pancakes, waffles and quick breads, Tracee Yablon-Benner, a registered dietician and author of Real Food Mom, recommends using whole grain mixes with three grams of fiber or more per serving.  “Eating a plain waffle could raise your blood sugar immediately,” Bessinger warns, which can cause a rebound.  Instead spread a toasted waffle with butter or nut butter and slices of fruit and ground flaxseed.  Protein and the fat from this will cause the sugar to be released gradually.  For gluten-free waffles and quick breads, Tracee Yablon-Benner, recommends using teff, a tiny grain that is high in protein or use any other grain that is high in protein and fiber to replace toast or bagels and can be served with cream cheese or a dollop of nut butter or cream cheese.  Teff is a high protein ancient grain that is available here in a Vernon health store called “Simply Delicious.”

     Boost your dairy with low fat cottage cheese and sliced fruit for a healthful breakfast or lunch and more calcium by substituting a part-skim ricotta cheese.  For a smoothie mix, use almond or other nut milk.  A scoop of whey powder and some heart healthy fat such as flax seed or avocado makes the smoothie creamy.  In a restaurant, order broad based vegetable soup.  For lunch Greaves suggests trading a Kaiser roll for a whole grain wrap made of two sturdy romaine lettuce leaves.  In a future blog we will talk more about foods for home and restaurants that are best for all times of the day. 

         

  

COPING WITH A PRE-DISEASE DIAGNOSIS

   A pre-emptive strategy – such as adopting healthful habits to fend off heart disease and stroke – clearly saves lives but critics worry the “pre” label may turn healthy people into patients.  Concerned about what we are doing to the well, Gilbert Welch, M.D., M.PH, lead author of the book “Overdiagnosed” and a professor of medicine at the Dartmouth Medical School advises to go slow with medications.  The pre-disease concept might put pressure on doctors to try medication first rather than to try to convince the patient to make the necessary lifestyle changes.  But people in this category have less to gain from medication because medications can confuse the real situation when lifestyle change is the real need to improve general health to make them better.  The drug could do more harm than good.  The preferred treatment for most diseases is to have a healthful lifestyle.  “If the label calls attention to doing that it is a plus,” says Howard Brody M.D., Ph.D., director for the Institute for the Medical Humanities at the University of Texas Medical Branch in Galveston.  “I’m concerned that the anxiety it causes will outweigh the benefit.”  Patients wonder if there is any evidence that the condition will prevent bad outcomes, like a heart attack or bone fracture when the need is really lifestyle change to reduce a negative risk.  For example, if you are facing cancer surgery, lifestyle changes could eliminate 40 percent of colorectal cancer.

* Eat less red meat.  Red meats and processed meats form carcinogenic chemicals.  According to a 2011 meta-analysis combining the results of 21 studies it could eliminate many other cancers. Data from the U.S. Polyp Prevention Trial, it is important to eat more vegetables, fruit and fiber. A recent study using data from the U.S. Polyp Prevention trial looked at the impact of diet on l900 people with a history of precancerous polyps.  Those who met goals cutting fat and consumed at least 18 grams of fiber and 3.5 servings of fruit and vegetables per l,000 calories each day were 35 percent less likely to develop new polyps during the study.

* Exercise.  Sedentary people are about twice as likely to develop colorectal cancer as highly active exercisers.  Aim for at least 30 minutes a day of moderately intense exercise.  Don’t rely too much on drugs or supplements. All pose additional health risks.  Limit alcohol.  People who average two to four drinks a Day have a 23 percent higher risk than those averaging less than one drink a day.  Don’t smoke.  Researchers have enough evidence to conclude definitively that smoking contributes to colorectal cancer.

TIME, TALENTS AND TREASURES

Thank you Lord for your gift of life,

  With Talents, Time and Treasures

Given from God for Earthly life,

  To practice with His measure.

Gifts to share with those in need,

    Inspiring others as well,

Sharing joys with family,

  That ring heart’s joyous bells.

Borrow three letters from the title above

  Use the second letter from each,

They spell AIR – confirming that

  Hearts and Ears can be used for speech.

This is your gift from Heaven’s trust

  So put them to use each day,

Flashing from those Heavenly spheres,

  Your help is on the way.

Using your life to help Mother Earth

  Our hearts will respond each day,

Her command, “Protect your ozone layer

   Then descendants here can stay.”

She’ll honour us as we honour God,

  With our Talents, Time and Treasures,

Satisfaction with each act and deed,

   Brings joys in generous measure.

  Our souls advise us what to do,

As we practice God’s Rule on Earth,

  “Do to others as you’d like done to you.”

Then you’ll feel and sense your worth.

  The gift of the sun urges plants to respond.

The mix needed for Earth’s care.

   Contentment and happiness restores each life

As we daily become aware. 

October 8, 2012

S.B. Davis,

  

 

ARTHRITIS TREATMENT

   Half of all adults – and two-thirds of obese adults – will develop arthritic knees during their lifetime.  Medical treatments include rubs, shots and pills but offer little help and sometimes cause side effects.  A popular alternative is glucosamine supplements but is largely unproven.  “No one therapy is as effective as we’d like,” says Roy D. Altman, M.D., a professor of medicine at the University of California, Los Angeles.  “Patients are often best served by combining treatments.  Patients sometimes mix and match until they find the combination that works best for them.”

   Lifestyle Changes:   Excess weight can erode the cartilage that can line the bone surfaces between joints, causing stiffness and sometimes a sticking sensation.  Shedding just 10 pounds of excess weight can take 40 pounds of pressure off the knees.  Dropping 15 pounds can cut knee pain in half.  To determine your body mass index (BMI,) divide your weight in pounds by your height in inches squared, and multiply by 703.  Go to: www.ConsumerReportsHelalth.org/BMI.

Physical activity:  “In Cochrane review of 12 studies, aim for 30 minutes a day.  If an aggravated knee deters you, sit high on a stationary bike.” advises John tongue, M.D., vice president of the American Academy of Orthopedic Surgeons.  That takes the stress off hips and knees while lubricating those joints.  Try to walk on soft surfaces wearing a low heel with a soft absorbing sole.  A cane, crutch or walker can be used when walking to work.  Some experts suggest trying a knee sleeve, available at local pharmacies.”  While generally considered safe, glucosamine might pose risks to people who also take blood-thinning drugs such as warfarin.  Acupuncture has been suggested by some.  A friend of mine said it cured her mother’s back ailment.  Our provincial health system covers the major part of it.  Eight weeks of massage relieved painful knees for some participants.  This was published in the Archives of Internal Medicine.  Your doctor can recommend a massage therapist who works with arthritic patients using lotion or oil but warns not to massage a joint that is very swollen or painful.  Tylenol (over the counter acetaminophen) has been tried because it has fewer risks but even it poses some risks.  Excess doses of this can damage the liver.  Tramadol has been modestly effective but side effects such as dizziness, drowsiness and nausea has caused seizures.  Altering the diet by avoiding sweets and including more vegetables and fruits with fish and chicken for protein has helped others.

    

STOPPING A TREATABLE CANCER

     Only 65 percent of the adults who should be screened, a government survey has found.  Colorectal cancer remains the second leading cause of cancer-related deaths in the U.S. for both men and women.  (Lung cancer is the first.)  The top three reasons for not getting screened for colorectal cancer were:

·        The failure of a health-care professional to suggest testing.

·        A lack of awareness about whether they should be screened.

·        A belief that testing is too costly.  Medicare and new private insurance plans are required to cover most types of colorectal cancer screening with no co-payments or deductibles.)

     Patients said they avoided colorectal cancer screening because they considered it “too embarrassing” or feared the results.  They also dreaded preparing for it.  Colorectal cancer usually develops over 10 to 15 years without causing symptoms.  Most cases start as non-cancerous polyps in the lining of the large intestine or its final segment, the rectum.  Removing these cancerous growths can be done early.  “We are talking about the opportunity to prevent cancer from occurring,” says Durado D. Brooks, M.D., M.P.H., director of prostate and colorectal cancer programs for the American Cancer Society.

          FOLLOW AN ANTICANCER LIFESTYLE

·        Eat less red meat and processed meats that use carcinogenic chemicals.

·        Eat more vegetables, fruit and fiber.  Those who met goals for cutting fat and consumed at least 18 grams of fiber and 3.5 servings of fruit and vegetables per 1,000 calories each day were less likely to develop new polyps during a study of 1900 people during 21 studies.

·        Exercise.  Sedentary people are likely twice as likely to develop colorectal cancer as highly active exercisers.

·        Maintain a healthy weight.  A waist size that exceeds 35 inches for women and 40 inches for men could be a more important risk than overall body weight. 

·        Don’t rely too much on drugs or supplements, aspirin, related NSAIDs and calcium supplements.

·        Limit alcohol to one drink a day and of course don’t smoke.

COUNTERFEITING FOOD

   An assistant professor of the anti-counterfeiting and product protecting program at Michigan State University in East Lansing talks about food fraud.  “Our program deals with all kinds of fraud but with a special focus on food.  If you haven’t heard of food fraud before don’t be alarmed because we only published the formal definition just over a year ago. Another name for it is an ‘economically motivated adulteration’ or criminal adulteration of food for economic gain.  Sometimes a cheaper ingredient instead of a more expensive one is used including lying about the country this food is from. Many people cannot taste the difference or saying something is organic when it is not.  This can be dangerous even though it is not because these people cannot differentiate, for example, the difference between pure olive oil or if it has been diluted with cheaper hazelnut oil.

    Fraud is also a function of counterfeiting in connection with luxury goods but a function of opportunity and production capability.  If you owned a toothpaste plant in a country with slack law enforcement, would you counterfeit Swiss watches or toothpaste?  The most notorious example of food fraud happened in China in 2007 and 2008 – the deliberate adulteration of pet food, milk, and infant formula powder with melamine, an inexpensive ingredient normally used to make dishes, plates and adhesives.  These products were being sold to manufacturers for further processing and the melamine helped them pass low cost tests used to determine protein content.  These contaminants in the melamine caused kidney stones, kidney failure as well as some deaths. 

     It is hard to catch food fraud when there seems no reason for it.  For example why would they need to test milk for fraud?  We have now developed multiple tests to keep fraud from duping those protein tests.  Larger companies and retailers now have more resources to keep fraudsters from duping those protein tests.  Look for the country of origin printed right on the back of the package and buy from people you trust.  Even at a farmers market, be sure you trust the farmer.  A three minute consult column from John Spink, Ph.D., in Consumer Reports, September 2012.