Welcome to my Medical Library

A Compilation of Articles on Relevant Health and Wellness Topics.

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Table of Contents

20,000 and You: Unlocking the Genetic Code

January 9, 2018

Unlocking-the-genetic-code-v1-300x208 - 20,000 and You: Unlocking the Genetic Code

In just the past few years, there has been a significant shift in the practical uses of genetic testing, which examines changes, or variants, in your genes that may lead to illness or disease. Once considered more of an investment in the future and less applicable to individual patient care, opportunities to guide health and lifestyle decisions in the here …

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A Quick Spin on Dizziness, Vertigo and Other Balance Disorders

November 20, 2017

A Quick Spin on Dizziness, Vertigo and Other Balance Disorders

November 20, 2017

Age-Related Macular Degeneration: New Hope

February 13, 2015

In Our Sights: Sharper Focus on Macular Degeneration Offers New Hope In the not so distant past, age-related macular degeneration (AMD), characterized by a loss of central vision, was deemed just another unfortunate consequence of growing older. The gradual breakdown of light-sensing retinal tissue that results in a blind spot directly ahead has caused each generation to struggle with driving a car, reading a printed page or recognizing a friend’s face. However, as the population ages, the sheer numbers of people affected — another case of AMD is diagnosed every three minutes in the U.S. — is changing the focus. More than 2.1 million Americans with advanced AMD now will grow to 3.7 million by the year 2030, according to the National Eye Institute, who warns the condition will soon take on aspects of an epidemic. A surge of clinical trials and investigative research aims to prevent that from happening, with sights set firmly on restorative, curative solutions. Scientists exploring the possible causes have made much progress isolating a group of genes that increases the likelihood of an individual developing AMD. Other studies point to inflammation as the trigger. The macula needs a constant, rich blood supply to work correctly, and any interference such as narrowing of the blood vessels, fatty plaque deposits, or a shortage of antioxidants, can cause the macula to malfunction and become diseased. Treatments have likewise advanced. Last fall, a decades-old drug used to treat HIV/AIDS was reported in Science as unexpectedly exhibiting the capability to halt retinal degeneration. Nucleoside reverse transcriptase inhibitors, known as NRTIs, are already FDA-approved and can be rapidly and inexpensively translated into therapies for both dry and wet AMD (see sidebar), say the study’s authors. At the same time, a nanosecond laser treatment was successfully used to reduce drusen (small fatty deposits beneath the retina) and the thickening of Bruch’s membrane, both hallmark features of early AMD. Importantly, the structure of the retina remained intact, suggesting “this treatment has the potential to reduce AMD progression,” according to Medical News Today. Stem cell transplantation shows enormous promise, as reported in Lancet, with sight restored long-term to a group of patients with severe vision loss. Additionally, injectible drugs and pills that target inflammation associated with AMD are in nationwide trials. Technological innovations to help AMD patients include the 2013 introduction of a miniature telescope implanted behind the iris to magnify images. Google is moving into the space with a patent for a contact lens containing a built-in camera that will enable audible warnings via a remote device, detect and describe faces, and act as a text reader. Today’s AMD patients have no shortage of low-vison aids to help them adapt and live well. Computers, electronic magnifying device and lighted spectacles enlarge printed materials, as well as a profusion of large print and electronic books, e-book readers and audio books. Additional solutions range from ‘smart’ thermostats, watches and remote controls to talking devices. Finally, understanding who is at risk for developing AMD can be key to prevention. These include: white, female, smoker, family member with AMD, high blood pressure, lighter eye color, obesity, and possibly, over-exposure to sunlight. To minimize risk, follow a healthy diet with plenty of leafy green vegetables and fish high in omega-3 fatty acids, exercise to keep weight and blood pressure under control, eliminate tobacco use, and wear sunglasses to protect from UV rays and high-energy visible (HEV) radiation. When Dry Becomes Wet Diagnosis of AMD is first confirmed with a visual acuity exam and testing with an Amsler grid. Those with AMD see the grid’s straight lines as wavy or blurred with dark areas at the center. Additional tests help determine the type of AMD — the dry form affects about 85 percent of AMD patients, and in about 10 to 15 percent of cases, progresses to wet. The difference is significant. The wet form usually leads to more serious vision loss, caused by new blood vessels that leak fluid and blood beneath the retina, resulting in permanent damage. While no treatment currently exists for dry AMD, in the last decade, a number of effective therapies have been implemented for wet AMD. These include monthly, intraocular injections (anti-VEGF) to inhibit a protein that stimulates formulation of new blood vessels, photodynamic or ‘cold’ laser treatment, thermal (heat) laser photocoagulation…and on the horizon are topical eyedrops that may someday replace injections. Nutritional supplements containing antioxidant vitamins, lutein and zeaxanthin are also effective in reducing the chances of dry AMD worsening to wet.

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Aging Well, Aging Healthy…a continuing series

November 20, 2017

HealthWise_Winter2016_Hasson-274x300 - Aging Well, Aging Healthy…a continuing series

As almost 10,000 Baby Boomers officially become senior citizens each day, the focus on preventing and treating age-related ailments becomes distinctly more urgent. HealthWise presents an ongoing look at research that provides valuable insights to help today’s seniors – and the generations set to follow – create a vibrant next chapter. We began with strategies to keep the aging brain …

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Aging Well, Aging Healthy…a continuing series

November 20, 2017

HealthWise_Spring2016_Hasson-300x295 - Aging Well, Aging Healthy…a continuing series

HealthWise presents an ongoing look at research that provides valuable insights to help today’s seniors – and the generations set to follow – create a vibrant next chapter. We have looked at strategies to keep the aging brain healthy and to protect the aging senses. In this issue, we get under your skin to learn how to keep it supple …

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Allergies: Food Allergies

January 27, 2014

Not Your Imagination: Food Allergies Are on the Rise Peanut-free tables in school cafeterias, grade schoolers armed with EpiPens…it is impossible to miss the signs of almost 15 million Americans who cope with increasingly prevalent food allergies. According to the Centers for Disease Control and Prevention, between 1997 and 2011 a significant spike occurred in American children, with one in every 13 now affected by food allergies. Scientists and physicians are working to discover the reasons behind the change. While there is no single answer, several credible theories are being considered. Hygiene Hypothesis – Multiple studies show that children raised on farms are less likely to have allergies. Researchers believe exposure to animals and various microbes at a young age actually strengthens the immune system, according to the American College of Allergy, Asthma and Immunology. Children raised in overly hygienic homes, who overuse antibacterial soaps, no longer have to fend off “bugs” and infections. Therefore, their immune systems overreact to things that should be harmless, such as wheat or peanuts. Microbiota Hypothesis –This takes the hygiene hypothesis a step further by proposing that use of antibiotics and fluoridated water are killing off good bacteria in the intestinal tract, making it more difficult for the good germs to fight off the bad germs (Nature Magazine, May 2012). Evidence continues to mount indicating that children who are given antibiotics early in life are more likely to have food allergies. Vitamin D Hypothesis – Another theory points to a lack of Vitamin D, as more time is spent indoors and more sunscreen is used when outside. Vitamin D deficiency has increased in the past 15 to 20 years, and there is a noticeable increase in allergies in northern climates compared to southern, where people spend more time outside, reports Pacific Standard Magazine. The Environment Hypothesis – The overall role of environment is key, say researchers in the relatively new field of epigenetics, who claim that while genetics definitely predispose an individual to allergies (children of allergic parents have an 85 percent chance of developing some kind of allergy themselves), it does not explain their recent rise. They are finding that environment can modify an individual’s genetic makeup, and these modified genes can be passed on from one generation to the next. The Good News – Of the eight foods that account for 90 percent of all allergic reactions – milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish – several may be outgrown by age 16. The majority of allergies to eggs, milk, soy and wheat diminish as children mature; only peanuts, fish and shellfish appear to be lifelong allergens (Food Allergy Research and Education). Strict avoidance of a food allergen is strongly recommended, as even trace amounts can trigger severe skin, gastrointestinal and respiratory reactions requiring emergency treatment. Experts advise you to be aware that although most food allergies start in childhood, they can develop at any time in a person’s life, even to foods previously eaten with no problem. If you or a family member are experiencing symptoms, please consult your personal physician. Not a Food Allergy, Celiac Disease is also on the Increase There is good reason for the preponderance of gluten-free foods lining supermarket shelves and appearing on restaurant menus. Sensitivity to gluten, a protein found in wheat, impacts more than six million adults – four times more common than it was 60 years ago. Modern varieties of wheat have been pinpointed as the reason celiac disease, an abnormal immune reaction to gluten, has quadrupled since 1950. Others disagree, citing studies that show no significant differences in gluten levels in wheat from the early part of the 20th century. Rather, they attribute the increased prevalence of celiac disease and gluten sensitivity to the not yet fully understood dynamics triggering other food sensitivities. “Whatever has happened with celiac disease has happened since 1950,” affirms Mayo Clinic gastroenterologist Joseph Murray, MD, whose recent study involving frozen blood samples of Air Force recruits from the early 1950s clearly showed that today’s young men were 4.5 times likelier to have celiac disease. “It suggests something has happened in a pervasive fashion from the environmental perspective.”

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Allergies: Seasonal Allergies or a Cold?

April 27, 2010

Do You Suffer From Seasonal Allergies? The National Institute of Allergy and Infectious Diseases estimates that more than 50 million Americans suffer from allergic diseases. Allergies are the sixth leading cause of chronic disease in United States. They arise from loss of the body’s natural resistance to allergens – substances that in some people the immune system recognizes as “foreign” or “dangerous.” These same substances cause no reaction for most people. An allergen can be almost anything as long as it provokes an allergic response in a person. If the onset of symptoms is rather sudden and these same symptoms occur at the same time every year, it is usually indicative of a seasonal allergy. If you are allergic, your immune system reacts very quickly when it encounters a certain substance, because it mistakenly thinks that substance is “dangerous” to you. Seasonal allergies are caused by pollen and spores. They can occur at any time of the year, but frequently they start in early spring through the end of May, when the primary cause is windborne tree pollen. This is followed by grass through mid-July and ragweed from late summer until the first frost. Mold spores typically peak in mid-summer and last until temperatures begin to drop. The problems are complicated by pollen and spores carried into your home on clothes or through open windows. How can I reduce the effects of seasonal allergies? Take off your shoes as soon as you enter the house to avoid spreading allergens. Keep your home and car windows closed, and run the air conditioner to keep cool. Avoid mowing the lawn, keep away from freshly cut grass, and try to limit outdoor exposure on windy days. Know the pollen count for your allergen and stay indoors when it is high. Treatment of seasonal allergies can include over-the-counter or prescription antihistamines, nasal steroid sprays, decongestants, as well as alternative treatments. Many of the medications have ingredients that can elevate your blood pressure and heart rate, so it’s medically important to ensure they are appropriate for you. I encourage you to discuss your symptoms with me.

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Apps for Healthcare

August 27, 2013

There’s an App for That Apps (short for “applications”), are pieces of software that you can download and utilize on your computer, phone or other electronic device. The initial explosion of apps in 2010 has grown exponentially each year, with more than 40,000 medical and health ones now available to users of iPhones, iPads, Androids and others. These apps offer the opportunity to do everything from counting calories to calculating cardiac risk and managing diabetes. Clearly, the potential for patients is enormous, but as you might suspect not all apps are created equal. How to sort through the myriad offerings and select the most trustworthy and reliable? Although many consider this industry the “new Wild West,” there are some outstanding apps with proven value. However, it is very important to remember: no app, website, or online discussion can take the place of a phone call or office visit with your own personal physician. Because of the growing availability of online medical resources, the Food and Drug Administration (FDA) has divided apps into two categories— those that assist with healthful lifestyles and those that turn your phone into a medical device for recording vital measurements such as blood pressure and then send those readings to a doctor. Some approved medical device apps are available only with a physician’s prescription. For example, smart phone apps which link to cardiac devices, record the signals and forward the data. There are also mobile diabetes management systems. Conversely, there are medical apps to beware of; at the top of the list would be those that claim to detect skin cancer. In a study published in the January, 2013 issue of JAMA Dermatology, three out of four smartphone apps used to detect melanomas incorrectly defined 30% of melanomas as insignificant; one app missed 93% of all melanomas. Studies like these are why the FDA will be issuing regulations for mobile medical apps in the near future. According to a recent study by Medical Economics, apps for managing diabetes and cardiovascular disease which are recommended most frequently by physicians include: Diabetes, iCookbook Diabetic, Diabetes In Check, and Glucose Companion, which enable patients to monitor their condition, track food consumption, access diabetes-friendly recipes and plan meals, track blood sugar and weight, and share tracking results with the physician’s office. iCalcRisk app encourages healthier lifestyles by calculating your cardiac risk; Blood Pressure Monitor and Heart- Wise Blood Pressure Tracker help monitor blood pressure, resting heart rate, and weight. Numerous health and fitness apps are also available. We have highlighted a few: iTriage allows you to check symptoms and easily locate a physician or hospital in the event of an emergency.   Tummy Trends helps you track irritable bowel syndrome symptoms, exercise habits, water intake, fiber intake, stress levels and share results with the physician.   Couch-to-5K by The Active Network for those just beginning to get in shape.   Fooducate works with you as you shop—scan the barcode on packaged food items and each receives a grade from A to D, with healthier alternatives offered.   Luminosity Brain Trainer sharpens the mind with memory and attention games.   Epocrates Rx provides a handy drug reference with photos of pills and how they interact.   Sleep Cycle gauges your movements as you sleep, waking you while you’re in your lightest sleep cycle during a preset 30-minute window.   Drink Tracker lets you know when it’s time to hand over the car keys after a night out by tracking your blood alcohol concentration. You may want to try some of these apps and discuss with your personal physician what you have found most helpful.

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Arthritis – Cause of Aches and Pains?

June 27, 2012

Aches And Pains…Arthritis? The human body has a remarkable way of speaking to us. While there may be plausible explanations for certain aches and pains, such as exercise overexertion or the natural aging process, persistent painful joints may indicate a more serious health issue, such as arthritis. There are two main categories of arthritis in adults, osteoarthritis (primary and secondary) and rheumatoid arthritis. Osteoarthritis (OA) is a chronic disease affecting approximately 27 million Americans. For some unknown reason, more women are affected than men. Cartilage acts as a cushion between the bones, allowing for easy motion and movement. When cartilage begins to break down over time, its ability to act as a cushion decreases. This causes the bones to rub against one another resulting in stiffness and pain around the affected joint. Arthritis most commonly impacts joints in the hands, neck, lower back, knees and hips, but can occur in any joint in the body. The Arthritis Foundation and the Mayo Clinic refer to primary osteoarthritis as “wear-and-tear” arthritis because, as the name says, it is most commonly related to aging joints and the“wear and tear” that comes with living an active life. However, because OA is a disease, it does not necessarily affect everyone. Secondary osteoarthritis has the same symptoms as primary osteoarthritis, but can develop at a younger age as the result of a specific cause, usually an injury. Obesity also can cause secondary OA. Excess weight places added stress on joints, particularly the knees and hips. Common symptoms of both primary and secondary OA include: pain in the affected joint during movement; tenderness to the joint upon touch; stiff joints, particularly after periods of inactivity; and loss of flexibility. If these symptoms persist over an extended period of time, it is wise to seek medical attention. Osteoarthritis is a chronic, degenerative disease that worsens over time. It can be treated but not cured. Treatments are aimed at reducing pain and maintaining joint movement and function. Depending on the individual, this can be achieved through a variety of medications, physical therapy, and in some extreme cases, joint replacement surgery is indicated. Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects nearly 1.3 million Americans. It also affects more women than men. RA occurs when the body’s immune system, which normally protects the body from bacteria or viruses, mistakenly attacks the body’s own tissues. In RA, this “attack” is aimed at the synovium, a thin membrane lining the joints. This results in a build-up of fluids and painful joint inflammation. Rheumatoid arthritis is a systemic disease, meaning it can affect the whole body. While those with rheumatoid arthritis may feel pain and stiffness in their joints, fatigue and fever may also be present. Early symptoms of RA tend to occur in the smaller joints first, such as where the hands connect to the fingers, or the toes connect to the feet. Over time, similar symptoms may develop in larger joints throughout the body, such as the knees, hips, elbows and shoulders. Why certain individuals develop rheumatoid arthritis is uncertain. Clearly, smoking is a risk factor. A combination of genetics and environmental factors, such as a virus or bacteria, also seem to play a certain role. Genetic markers, including those associated with the immune system and chronic inflammation, combined with these environmental factors have been discovered to cause a “tenfold probability of developing rheumatoid arthritis,” according to the Arthritis Foundation. Rheumatoid arthritis normally develops between the age of 40 and 60, although it can occur at any age. Although there is no known cure for RA, a variety of highly successful treatments exist that can put the disease into remission. Being diagnosed and treated at early onset of the disease has been shown to significantly contribute to remission of the disease. Also, according to the Arthritis Foundation, there are a variety of drug treatment options, those that relieve symptoms and reduce inflammation and those that can modify the disease or cause remission. A combination of both drugs may be prescribed, as appropriate. Rheumatoid arthritis can sometimes be difficult to diagnose because its symptoms are similar to those of other diseases, particularly other autoimmune diseases, such as lupus or scleroderma. Prevention and Management Research has shown that regular physical activity—an important factor in overall good health—can be highly successful in helping manage both osteoarthritis and rheumatoid arthritis. Exercise helps keep the muscles around the joints strong and flexible, offering better stabilization of the joints. Exercise also minimizes stiffness because strong, flexible muscles allow for greater range of motion. Several studies also have shown that in people with arthritis, exercise resulted in increased cartilage and reduced joint inflammation. Shedding excess weight puts less stress on the joints. This can help prevent secondary arthritis (caused by obesity) or ease symptoms associated with primary (wear-and-tear) osteoarthritis.

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Artificial Sweeteners vs. Sugar

May 13, 2014

The Sweet Life: Artificial Sweeteners vs. Sugar When you reach for the artificial sweetener, do you pick the pink, nab a yellow, prefer the blue or go green? The difference may be less important than you think. Each of the sweeteners contains a different FDA-approved main ingredient. For example, Sweet ‘N Low contains saccharin, aspartame is in NutraSweet and Equal, neotame and sucralose in Splenda and stevia is in Truvia. All promise fewer calories and more sweetness than natural sugar (16 calories per teaspoon), making it a seemingly ideal choice for those who want to lower their caloric intake. Substituting one zero-calorie soft drink daily for regular soda (150 calories) can save 4,500 calories a month—a potential weight loss of one pound. The downside: safety and health concerns have been swirling around for decades. Beginning in the 1970s, saccharin was linked to bladder cancer in rats, however, subsequent studies did not find evidence of the same effect in humans. Aspartame was scrutinized as a potential carcinogen, and sucralose was reported to potentially wipe out beneficial bacteria in the intestinal tract. Additionally, respected research showed daily consumption of any type of diet drink linked to increased risk of type 2 diabetes. Even the more natural stevia, made from the leaves of a South American shrub, has come under fire for being processed and blended with additives. Dr. David Ludwig, obesity specialist at Boston Children’s Hospital, discourages use of artificial sweeteners, saying they overstimulate sugar receptors and induce cravings for more sweet food. Artificial sweeteners are 200 to 600 times sweeter than sugar, and can distort taste preferences, making foods like a juicy apple seem not sweet-tasting. In 2012, the American Heart Association and American Diabetes Association, made a somewhat guarded endorsement. “While they are not magic bullets, smart use of non-nutritive sweeteners could help you reduce added sugars in your diet, therefore lowering the number of calories you eat.” The caution: “Research, to date, is inconclusive on whether using nonnutritive sweeteners to displace caloric sweeteners can reduce carbohydrate intake, calorie intake or body weight, benefit appetite or lower other risk factors associated with diabetes and heart disease in the long run.” There are also natural sweeteners such as agave nectar, barley malt, xylitol and birch syrup which the Institute for Integrative Nutrition says are generally considered safer than processed white sugar and artificial sweeteners, and create fewer fluctuations in blood sugar levels, when used in moderation. The best solution: reduce your intake of both processed sugar and artificial sweeteners by retraining your taste buds with a healthier diet, advises Harvard School of Public Health. Quench your thirst with water, plain or bubbly; opt for unsweetened teas, plain yogurt and unflavored oatmeal. It may surprise you to see how little sugar you need to add to satisfy your sweet tooth.

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Artificial Sweeteners vs. Sugar

May 13, 2014

The Sweet Life: Artificial Sweeteners vs. Sugar When you reach for the artificial sweetener, do you pick the pink, nab a yellow, prefer the blue or go green? The difference may be less important than you think. Each of the sweeteners contains a different FDA-approved main ingredient. For example, Sweet ‘N Low contains saccharin, aspartame is in NutraSweet and Equal, …

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Artificial Sweeteners vs. Sugar

May 13, 2014

The Sweet Life: Artificial Sweeteners vs. Sugar When you reach for the artificial sweetener, do you pick the pink, nab a yellow, prefer the blue or go green? The difference may be less important than you think. Each of the sweeteners contains a different FDA-approved main ingredient. For example, Sweet ‘N Low contains saccharin, aspartame is in NutraSweet and Equal, …

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Artificial Sweeteners vs. Sugar

May 13, 2014

The Sweet Life: Artificial Sweeteners vs. Sugar When you reach for the artificial sweetener, do you pick the pink, nab a yellow, prefer the blue or go green? The difference may be less important than you think. Each of the sweeteners contains a different FDA-approved main ingredient. For example, Sweet ‘N Low contains saccharin, aspartame is in NutraSweet and Equal, …

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Artificial Sweeteners vs. Sugar

May 13, 2014

The Sweet Life: Artificial Sweeteners vs. Sugar When you reach for the artificial sweetener, do you pick the pink, nab a yellow, prefer the blue or go green? The difference may be less important than you think. Each of the sweeteners contains a different FDA-approved main ingredient. For example, Sweet ‘N Low contains saccharin, aspartame is in NutraSweet and Equal, …

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Aspirin? Tylenol? Advil? Aleve?…What’s the difference?

June 27, 2010

 Aspirin? Tylenol? Advil? Aleve? What’s the Difference? You’ve no doubt heard the question, “Does anyone have an aspirin?” Most of the time, people don’t have a particular brand in mind, just as people ask for a Kleenex when they want a tissue or Xerox when they want to make a copy. But, with aspirin-like products – Bayer, Bufferin, Motrin, Advil, Tylenol, Aleve and others – there are clear differences and their desired effects and disadvantages can be significant. Acetylsalicylic acid/aspirin (Bayer, Bufferin) Aspirin was the first over-the-counter pain reliever to be mass produced. In 1900, aspirin was sold as a powder, and by 1915 the first aspirin tablets were made. Aspirin is used to treat headaches, to quell minor aches and pains, and to reduce inflammation. However, it can cause stomach upset, heartburn, and it is also an anticoagulant (blood thinner) which means that people on certain medications, such as Coumadin, should not take pain relievers containing aspirin. That said, aspirin is still the most common over-the-counter pain reliever, available in both brand names and generic versions. Importantly, it is now playing a positive role in the prevention and treatment of heart disease because it is an anticoagulant. Ibuprofen (Motrin, Advil) Ibuprofen belongs to a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). Ibuprofen is chemically similar to regular aspirin and functions in the body in a comparable way. So how is it different from aspirin? Most importantly, it is usually less irritating to the esophagus and stomach. For patients with ulcers or acid reflux disease, for example, ibuprofen may be the better product. It is also prescribed frequently to reduce menstrual cramps, inflammation from arthritis, sprains, etc. with better results than aspirin. Naproxen (Aleve) Although some patients use this medication for headache relief, it is most effective as an anti-inflammatory medication. For arthritis, sprains, sunburn and other inflammation-based pain, naproxen seems to be one of the best products in the over-the-counter pain-reliever marketplace. In comparable doses, it also has a longer-lasting effect in the body, tending to last 8-12 hours rather than 4-8 hours. Note: always be careful to follow dosing instructions. This strong medication can cause serious gastrointestinal problems, sometimes without warning and at any time while you are taking this medication. It is always wise to check with our office before selecting this medication. Acetaminophen (Tylenol) All of these aspirin-like products are definitely not the same…as exemplified by acetaminophen. This pain reliever lowers fevers and usually soothes headaches, but is not useful or effective as an anti-inflammatory aid. One of its major benefits is that it causes very few problems with the digestive tract overall, making it the best headache treatment for people with any stomach sensitivities. It is also safer for people on blood-thinning medications, for hemophiliacs, and for children. However, taken regularly over a prolonged period of time, or taken in excessive doses, acetaminophen can be toxic to the liver. The usual dosage for pain relief and its overdose amount are not incredibly different, therefore acetaminophen is sometimes considered to be more dangerous than aspirin, arguing that it is easier to overdose unintentionally. In summary, make certain to read the ingredients label of these and all over-the-counter medications, to see what else it is partnered with and whether there are additional side-effects. There are various combinations of acetaminophen, ibuprofen and aspirin available – cough and flu, sinus, etc. If you take certain products together you may accidentally take too much of one type of medication. For example, if you take Tylenol and a cough medication in combination, make sure the cough medicine does not also contain acetaminophen. Inadvertently you may be exceeding the recommended dosage. It is always important to read the drug product labels very carefully. Some, such as aspirin products, have been linked to Reyes Syndrome and should never be administered to children or teenagers with viral or flu-like symptoms. Others, such as Aleve, recommend that you avoid alcohol and prolonged exposure to sunlight. All of these over-the-counter pain relievers may interact with certain prescription medications that you may already be taking. If you have any questions or concerns about which of these over-the-counter medications may be best for your symptoms, please call our office and we will be happy to talk with you about your options.

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Body Mass Index (BMI)

August 27, 2011

Body Mass Index (BMI) The Body Mass Index (BMI) is a quick, easy and efficient screening tool to identify weight problems in adults. While BMI is a strong indicator of body fat percentage, it can vary for age, race and sex. It is important to note that the BMI should only be utilized as a screening tool and is not, in and of itself, diagnostic. For example, older people tend to have more body fat that those who are younger, and women tend to have more body fat than men. Also, some athletes may score a higher BMI because they have increased muscle mass; therefore, they weigh more because the weight is muscle not fat. In fact, some patients notice when they combine diet and exercise, they may go down a clothing size while their weight remains the same. Overall, learning your BMI is a great starting point for a discussion of your health goals with your physician. How is BMI determined? Body Mass Index calculates a person’s fat level by using a complex mathematical formula based an individual’s height and weight. Automatic calculators can be found online at http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html. The chart to the right, created with information provided by the Centers for Disease Control, highlights BMI scores and their correlating weight status. Once it is determined that you have a weight problem through this calculation, follow up with appropriate assessments for specific health risks that may be associated with a BMI of “underweight,” “overweight” or “obese” is recommended. Body weight is only one indicator of disease risk. Combined with a high BMI, the following factors can place you at an even greater risk for certain diseases: High blood pressure (hypertension) High LDL cholesterol (“bad” cholesterol) Low HDL cholesterol (“good” cholesterol) High triglycerides High blood glucose (sugar) Family history of premature heart disease Physical inactivity Cigarette smoking In conjunction with BMI numbers, a person’s waist circumference is also an effective way to assess weight and health risk. People who carry most of their fat around their waist, an appleshaped body, are at greater risk for type 2 diabetes and heart disease. The risk increases with a waist size that is more than 35 inches for women and greater than 40 inches for men. Scientific evidence shows that when people carry weight around their waistline, abdominal fat tends to surround internal organs, impairing their function. Conversely, people who carry their weight around their hips, a “pear shaped” body, accumulate fat directly under the skin, and thus the fat does not interfere with their organ function. Just as a BMI over 25 can have negative health implications, so too can a BMI of 18.5 or lower, categorized as “underweight” for an adult. A BMI this low could indicate a variety of medical conditions. People with underweight body mass indexes are at increased risk for poor bone health, such as osteoporosis. Younger women classified as underweight may have disruptions of their menstrual cycle and difficulty getting pregnant. Other issues from being underweight can include anemia or a weakened immune system. Together we can discuss appropriate options for diet and exercise that are tailored for you, and that will put you on the path of minimizing your future health risks. Learning your BMI is a great step in this direction.

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Brain Health and Exercise

January 27, 2013

Exercise & Brain Health Everyone knows the correlation between physical activity and good health. Now, exciting new research supports the link between a physically active lifestyle and brain cognition… and even longevity! Researchers at the University of Iowa examined more than 100 studies linking exercise and brain health. These studies indicate that exercise is not only good for the brain, but also can safeguard it from cognitive deterioration as part of the aging process. The study, published in the Journal of Applied Physiology, gave credence to the value of both aerobic exercise and resistance exercises (such as lifting weights). Findings indicated that both aerobic and resistance exercises improved concentration, while aerobic exercise also helps the brain retain the ability to coordinate tasks and long-term planning. Amazingly, the study found that people in their 60s who exercised for just six months increased the gray and white matter in their brains that normally diminish with age. Growth was also seen in parts of their brain responsible for memory function. Further, men with a family history of Alzheimer’s, who were physically inactive, were four times more likely to develop Alzheimer’s compared to men with a similar family history who exercised. Another study by neurological researchers at Rush University Medical Center in Chicago showed that any kind of daily physical activity may reduce risk of Alzheimer’s disease and cognitive decline. Published in 2012 in the medical journal Neurology, the study involved 716 older individuals (average age of 82) without dementia who are part of the ongoing Rush Memory and Aging Project. Participants wore an activity monitoring device called an actigraph on the wrist of their non-dominant hand continuously for 10 days. All exercise and non-exercise physical activity was recorded. Participants also were given annual cognitive tests. In 3 1/2 years of follow-up, 71 of the 716 participants developed Alzheimer’s disease. The findings indicated that both daily physical activity and intensity of exercise mattered. Those individuals who were the least active physically or whose activity intensity was the lowest were more than twice as likely to develop Alzheimer’s, compared to those who were most physically active or whose intensity level was the highest. Aron S. Buchman, MD, the lead author of the Rush study commented in Science Daily, saying, “The results of our study indicate that all physical activities including exercise as well as other activities such as cooking, washing the dishes and cleaning are associated with a reduced risk of Alzheimer’s disease. These results provide support for efforts to encourage all types of physical activity even in very old adults who might not be able to participate in formal exercise, but can still benefit from a more active lifestyle.” Mild to moderate aerobic activity includes walking, taking stairs and raking leaves; more intense aerobic activity includes brisk walking, jogging, bicycling, swimming, and using exercise equipment (treadmill, stationary bicycle). Resistance exercise (strength training) includes free weights, weight machines and calisthenics (push-ups, sit-ups). As research shows, not only is resistance exercise linked to improved concentration, but it is also critical as we age for maintaining strength, muscle mass and bone density, while reducing chronic diseases like osteoporosis and arthritis. It also enhances ability to perform aerobic activities. Research published in 2011 in the Journal of the American Medical Association reveals that our walking speed (gait) may predict longevity. In the gait research at the University of Pittsburgh, researchers analyzed nine studies involving nearly 35,000 people 65 years or older. The research showed that walking speed turned out to be a reliable predictor of one’s survival across age, race and health. Our bodies self-select walking speeds that accommodate the circulatory, respiratory, skeletal, muscular and nervous systems that are all needed for walking. The researchers pointed out that gait pace, like blood pressure, is but one indicator of overall health. Walking faster won’t necessarily improve your health, but the research found people who improved their gait speed over a year did have an increased life expectancy. It is noteworthy that academic studies continue to reinforce that ongoing physical activity is important. While it might be praiseworthy to have been active in the past, findings indicate that current physical activity is vital for health and longevity. Individuals, no matter their age, should be encouraged that it’s never too late to reap the rewards, both physical and mental, of an exercise regimen.

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Bring It Down: Healthy Blood Pressure Numbers May Go Even Lower

November 20, 2017

Caffeine – What’s the Buzz?

April 27, 2012

What’s the Buzz on Caffeine? If you are among more than 50% of Americans who drink caffeinated coffee daily, you may be confused by the roller coaster of studies that highlight caffeine’s benefits one day and outline risks the next day. Caffeine is both a naturally derived and synthetically-produced substance that stimulates the central nervous system. It is found in coffee, teas, sodas, some energy drinks and chocolate, but has no nutritional benefit. Genetic make-up, age or body size may determine your sensitivity to the effects of caffeine. Most physicians agree that an acceptable amount of caffeine is approximately 250-300 milligrams (mg) per day, about one to two 8 ounce cups of coffee. Be aware—all “cups” are not created equal. At Dunkin Donuts, a small coffee is 10 ounces, McDonald’s is 12 ounces and a Starbucks “tall” is 12 ounces. Strongly brewed coffee or tea does contain more caffeine. Staying within these limits for most healthy adults poses no health risks and may actually offer some health benefits. Recent studies appear to have found benefits to moderate consumption of caffeine, including a reduced chance of developing Parkinson’s disease and perhaps Type 2 diabetes (absent other risk factors). The Mayo Clinic cites studies that moderate coffee intake may reduce asthma symptoms and gallstone formation. Caffeine may also offer some protection against liver disease. As a stimulant, it is widely known that caffeine increases alertness for several hours, which is why many people enjoy a cup of coffee in the morning or why students might drink caffeinated beverages while studying. When too much caffeine is consumed (more than 500 to 600 mg daily), it becomes counter-productive and even those with minimal sensitivity may feel its effects. Insomnia, nervousness, restlessness, irritability, shaky hands, heart palpitations and upset stomach can result from excess consumption. Caffeine can stay in the body anywhere from five to 15 hours. Avoiding caffeinated products in the late afternoon diminishes the stimulant effect by bedtime, enabling a better night’s sleep. If needed, it is advised to gradually reduce caffeine intake to avoid withdrawal symptoms such as headaches and drowsiness. Caffeine amounts vary in food and beverages, so check labels or product websites. Below are common foods and beverages containing significant amounts of caffeine, and the estimated range per 8 ounce cup serving: Coffee, brewed, 1 cup, 40-180 mg Tea, brewed American or imported, 1 cup, 20-110 mg Energy drinks, 8 ounces, 47-80 mg Caffeinated soft drinks, 12 ounces, 35-90 mg Chocolate (bittersweet), 1 ounce, 5-35 mg per ounce Recent studies have shown that most harmful side effects of caffeine are generally limited to people who ingest too much or are highly sensitive to it. This should ease the minds of moderate consumers. If you think you may be consuming too much caffeine, this should be a topic for discussion at your next medical appointment.

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Calorie Counting: A Weigh In

August 19, 2014

Weighing in on the Calorie Counting Debate Conventional wisdom: a calorie is a calorie, and to lose weight, you must take in fewer calories than you expend. Fast forward to today: all calories are not created equal. What makes up that calorie is more important than the calorie itself, emphatically stated by Jim Kirchoff, former CEO ofWeight Watchers. “When we have a 100-calorie apple in one hand and a 100-calorie pack of cookies in the other, and view them as being the same, it says everything that needs to be said about the limitations of just using calories in guiding food choices.” Whether for weight loss or simply for seeking a balanced diet, the emphasis today has shifted away from calorie counting and toward minimally processed natural foods, with high protein and fiber favored over fat and carbohydrates. Calories are units of energy, the fuel your body needs to run. Protein, fat and carbohydrates each provide a different number of calories per gram weight. The Atwater system, developed in the 1890s, assigns four calories per gram for protein and carbohydrates, and nine calories per gram for fat. Nutritionists explain that carbohydrate-loaded, highly processed foods are more rapidly absorbed by the body and turned into fat. Plant-based, high-fiber foods, however, make the body work harder to digest them. By slowing the rate that sugar is absorbed into the bloodstream, fiber prevents blood glucose levels from rising too fast and then falling rapidly, resulting in that familiar “crash” which causes you to feel hungry again, and overeat. “If you’re focusing only on calories, you can easily be misguided. In a complex organism like a human being, foods influence satiety, metabolic rate, brain activity, blood sugar and the hormones that store fat in very different ways,” says Dr. Dariush Mozaffarian, Harvard epidemiologist. As recently illustrated in the documentary Fed Up, the modern food industry tends to maximize the number of calories it takes to feel full, by adding unnecessary sugar to all types of products. High-fiber, high-volume, nutrient-dense foods have the opposite effect, minimizing the number of calories needed to feel satisfied. “Making better food choices offers us ways to feel full on fewer calories and be lean without constantly feeling hungry,” explains Dr. David Katz, founder, Yale University’s Prevention Research Center. That forms the basis of Jonathan Bailor’s eating plan detailed in The Calorie Myth, based on 13 years of nutritional research. The key is to begin with high-volume vegetables (start with a salad, for example), followed by protein, then whole food fats such as nuts and seeds, and end the meal with low-fructose fruits (strawberries, kiwi). “It’s nearly impossible to overeat like this, because your stomach would be uncomfortably full,” says Bailor. Other experts agree that a focus on “real food” will naturally lead to consumption of fewer calories. Start your grocery shopping by concentrating on the perimeter of the store, where fresh vegetables and fruits abound. Purchase sparingly from the inner aisles, where highly processed foods are more likely to be located. Additionally, learn how to quickly scan nutrition labels for information that may be hidden. For example, four grams of sugar is equivalent to a teaspoon of sugar, which means that even low-fat yogurts often contain up to six teaspoons of sugar per serving. The payoff: as you eliminate superfluous sugar, salt, trans fat and food chemicals, your taste buds become more sensitive and ultimately prefer unprocessed, more nutritious foods. “This process can be reverse-engineered one step a time, so we can climb a staircase up to the health and vitality we want, and deserve,” says Dr. Katz.

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Calorie Counting: A Weigh In

August 19, 2014

Weighing in on the Calorie Counting Debate Conventional wisdom: a calorie is a calorie, and to lose weight, you must take in fewer calories than you expend. Fast forward to today: all calories are not created equal. What makes up that calorie is more important than the calorie itself, emphatically stated by Jim Kirchoff, former CEO ofWeight Watchers. “When we …

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Calorie Counting: A Weigh In

August 19, 2014

Weighing in on the Calorie Counting Debate Conventional wisdom: a calorie is a calorie, and to lose weight, you must take in fewer calories than you expend. Fast forward to today: all calories are not created equal. What makes up that calorie is more important than the calorie itself, emphatically stated by Jim Kirchoff, former CEO ofWeight Watchers. “When we …

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Diabetes and Aging – Know your Risks

June 27, 2011

Diabetes And Aging – Know Your Risks By David S. Oyer, MD, FACE Many people have the perception that type 2 diabetes is a health risk only for overweight individuals. It is true that those who are obese account for approximately 60% of the 17 million adults with diabetes in the United States. However, aging also plays a significant role in increasing the odds of developing type 2 (adult onset) diabetes. As we age, our cells become more resistant to insulin. The onset of type 2 diabetes occurs more than 50% of the time in adults over 55 years of age, according to the American Diabetes Association (ADA). The hormone insulin is essential for enabling our bodies to use glucose (blood sugar) for energy. In type 2 diabetes, the body does not produce enough insulin or the cells ignore the insulin. Glucose is the basic fuel for our body’s cells and is created when our body breaks down the sugars and starches in the foods we eat. Insulin carries this blood sugar into our cells for energy. When glucose builds up in the blood instead, it can lead to diabetes complications. Certain factors besides obesity and age put patients at greater risk for developing type 2 diabetes. These include excessive fatty tissue around the abdomen, high cholesterol and glucose intolerance. Importantly, people with high blood pressure are more than twice as likely to develop type 2 diabetes than those with normal blood pressure. Today, doctors are utilizing a blood test called the hemoglobin A1C to help identify those individuals at risk for developing diabetes. This A1C test has been used for years to monitor blood sugar levels of patients who have already been diagnosed with diabetes. The general goal recommended by the ADA is below 7%, but higher or lower goals may be appropriate for a given individual. In January 2010, the ADA began recommending that physicians utilize the hemoglobin A1C to identify patients at increased risk of developing type 2 diabetes. The traditional normal range in non-diabetics for an A1C test is 4-6%. To use the A1C test to screen for increased risk of diabetes, the ADA splits the A1C results into three categories: normal (5.6% or less), prediabetes (5.7% to 6.4%) and diabetes (6.5% or more). The higher the A1C, the greater the risk of developing diabetes. Pre-diabetes in this context implies that the patient is at an increased risk of diabetes. However, this simplification does not take into account ethnic or genetic variability of A1C results. For example, A1C averages 0.3% higher in African-Americans and averages 0.3% lower in Asians. The A1C test can also be misleading in patients who have other medical conditions that make the result falsely low, such as bleeding or hereditary spherocytosis (a condition affecting the red blood cells that causes anemia, among other symptoms). So, sometimes the A1C result is only part of the story, and the fasting glucose or post-meal glucose has to be considered as well. The value of the new category of pre-diabetes (increased risk of diabetes) is that we have proof that diet and exercise can help reduce the risk of progressing to overt diabetes. The Diabetes Prevention Trial has shown that patients “at risk” for type 2 diabetes reduced their risk of progressing to overt diabetes by 60% through a program of diet and exercise; the benefit was primarily related to weight loss. If you have had an A1C test for screening for diabetes, your doctor will help evaluate the number for you and make recommendations. Whether your test results are normal, pre-diabetic or diagnostic for diabetes, you can do your part to optimize your health by eating a low carbohydrate diet and by getting regular exercise.

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Diet Soda

January 27, 2013

The Skinny on Diet Soda Diet sodas have become a popular alternative to high-calorie, sugar-laden beverages. According to the University of Texas Health Science Center, 59% of adult Americans report drinking diet soda regularly, to assist with weight control by decreasing calories and to reduce sugar consumption. However, recent research studies now indicate that diet drinks may not aid in long-term weight loss, and may have side-effects as well. Most experts feel that diet soda will be found to be healthier than drinking regular sodas which contain sugar. However, it is far from clear that diet sodas do not cause harm. For example, the University of Texas study reported that those who drank diet soda, compared with participants who did not, had an increased waist circumference. While the study did not point to specific reasons for the waist increase, various experts surmise that people may overcompensate when drinking diet sodas by eating other high calorie foods. According to the National Institutes of Health, measuring waist circumference is one of the screening tools for possible health risks associated with obesity. Individuals are often at a higher risk for heart disease and Type 2 diabetes if most of their body fat is stored around their waist. Hence, research suggests that consumption of diet soft drinks may have some unintended negative effects. The higher acidity levels found in diet sodas may be detrimental to our teeth. Diet sodas contain citric or phosphoric acid, which wears down tooth enamel. This thin, outer covering of our teeth is the first line of defense against tooth decay and cavities. Using a straw may help alleviate the effects of acidity levels on tooth enamel. Also, brushing your teeth should be done about an hour after drinking diet soda because the acid temporarily softens tooth enamel and makes it prone to damage from immediate brushing. Moreover, the phosphoric acid found in diet and regular colas can affect your bones. When there is a higher than normal amount of phosphorus and not enough calcium in bones, the natural balance in our bodies can be disturbed resulting in a loss of bone density. In fact, a study at Tufts University in Boston showed a link between cola consumption and low bone mineral density in women, regardless of age or calcium intake. While there are legitimate concerns about diet drinks, the Mayo Clinic says moderate consumption of diet soda (a can or two a day) “isn’t likely to hurt you,” but warns that diet sodas contain no nutritional value. Because diet sodas contain no calories, some people feel justified in drinking large quantities on a daily basis. Caffeinated diet sodas can lead to a so-called “diet soda addiction.” A 12 ounce serving of diet cola contains 46 milligrams (mg) of caffeine… the most consumed stimulant in the world. Most physicians recommend limiting caffeine consumption to 250-300 mg per day. Four or five servings of diet cola places someone right near or above that limit, not taking into account other sources of caffeine consumed throughout the day. There are a variety of healthy, low-calorie beverage alternatives to drink, including seltzer waters, flavored waters, or unsweetened herbal tea. With these, you can be reassured they are better for you, with none of the concerns that accompany diet sodas.

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Eating Patterns and Good Health

July 17, 2014

Building the Groundwork: Linking Eating Patterns and Good Health For generations, people have considered two distinctly different questions about eating habits: which diet is healthiest versus which diet results in the greatest weight loss. It has long been thought that the Mediterranean approach to eating is healthy, and new research has given additional credence to this fact. The New England Journal of Medicine recently published the first large-scale study addressing the impact of how what we eat influences health outcomes. They focused on the Mediterranean Diet, and suggested for the first time that this way of eating is healthier than others. The Mediterranean Diet is characterized by: high intake of extra virgin olive oil, nuts, fruits, vegetables and cereals; moderate intake of fish and poultry; low amounts of dairy products, red meat, processed meats and sweets; and wine in moderation consumed with meals. The study followed 7,400 people for an average of 4.8 years who lived in the Mediterranean (Spain) and randomly assigned them to one of three different eating plans. Two groups consumed variations of the Mediterranean Diet. These participants received free weekly allotments of either extra-virgin olive oil (about 4 tablespoons per day) or mixed nuts (1/4 cup daily of walnuts, almonds, and hazelnuts combined). The third group, a control group, consumed a diet designed to be low-fat. The study was intended to look for three things: the incidence of stroke, heart attack, or death from cardiovascular causes. The researchers did not monitor changes in weight, cholesterol or blood sugar. The study found an impressive 30% lower risk of stroke in the Mediterranean Diet participants. There was no difference in the rate of heart attacks or in cardiovascular-caused deaths between the groups. However, the positive effect of stroke reduction was so pronounced that the study’s Safety Board stopped the study before its designated end date. They felt it would be unethical for the control group participants to continue on the low-fat diet. Many researchers would have preferred that the study had been continued. Would a longer study have determined a difference in heart attacks or death rate (the other two indicators that were being studied)? Did the diet alter weight, cholesterol or blood sugar? Would a weight gain negate the study’s health improvements? While the results point to a strong positive health benefit of the Mediterranean Diet, a major concern for Americans accustomed to large portions, is the ability to limit the intake of “healthy” but high caloric foods. For example, the Mediterranean Diet allows ¼ cup daily (approximately 200 calories per day) of mixed nuts. Nuts are a very high calorie food at approximately 800 calories per cup. Even though Mediterranean Diet participants consumed a small fistful of nuts, overall they ate about 100 more calories per day than the control group. This study raises more questions than it answers, but it provides the first amount of reputable documented evidence that some foods contribute to better health. It is the first time that a large-scale study used scientific methods to examine the role of specific eating patterns on one’s health. The results bode well for future scientific studies to further investigate the role of how what we eat impacts our long-term health.

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Eating Patterns and Good Health

July 16, 2014

Building the Groundwork: Linking Eating Patterns and Good Health For generations, people have considered two distinctly different questions about eating habits: which diet is healthiest versus which diet results in the greatest weight loss. It has long been thought that the Mediterranean approach to eating is healthy, and new research has given additional credence to this fact. The New England …

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Eating Patterns and Good Health

July 16, 2014

Building the Groundwork: Linking Eating Patterns and Good Health For generations, people have considered two distinctly different questions about eating habits: which diet is healthiest versus which diet results in the greatest weight loss. It has long been thought that the Mediterranean approach to eating is healthy, and new research has given additional credence to this fact. The New England …

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Exercise – A Key Component to Healthy Aging

January 27, 2012

Exercise – A Key Component to Healthy Aging We all experience changes to our bodies as a natural part of growing older. Adapting to these changes can be challenging. While we cannot stop our body’s aging process, we can proactively address the physiological changes that occur in order to reduce the impact of aging on our general health. Commonly, mobility and balance are affected adversely by our aging bones and joints. As balance and mobility become compromised, this can lead to falls. One out of every three Americans over the age of 65 has a significant fall each year, according to the U.S. Centers for Disease Control and Prevention (CDC). Among individuals age 65-84, falls account for 87% of all fractures. Although many individuals may experience problems with their equilibrium as they get older, one of the main causes for a decrease in coordination and balance correlates to decreased muscle mass. As we age, we lose muscle mass (the weight of our muscle) if we do not exercise. A loss in muscle mass translates into decreased strength, flexibility and agility. Additionally, bones tend to shrink in size and density with age, weakening them and putting us at risk for osteoporosis (brittle bones) or broken bones. Research has proven that exercise at any age should improve our health. One such study showed that after participating in an exercise session just three times a week for 20 weeks, participants in their late 60s increased muscle strength. Moreover, the study’s older participants increased blood flow to their legs that was comparable to that of study participants in their late 20s. Blood flow, or circulation, carries oxygen and other nutrients to all the cells in our body, including our lungs, and also rids our body of carbon dioxide and lactic acid. In the process of circulation, endorphins also are released. Endorphins are biochemical substances which help the body naturally relieve pain and can bring about a feeling of well-being. According to the National Association of Sports Medicine, building or improving muscle mass provides the following benefits as we age: Improved bone density and joint health—Strengthening muscle mass places healthy stress on bones which prevents joints and bones from breaking down. Adding muscle tissue through strength training, such as using free weights, helps reduce the chances of osteoporosis, arthritis, joint injury, loss of balance and falling. A healthy metabolism and prevention of weight gain—Muscle burns twice the amount of calories as fat tissue, so by sustaining muscle tissue through proper nutrition and exercise, a healthy metabolism is maintained. In turn, a healthy metabolism can prevent extra weight gain as well as reduce the risk of heart disease and diabetes. Improved strength and balance—An exercise as simple as walking helps keep leg, back and shoulder muscles active and working. This maintains overall flexibility and balance, thus reducing risk for serious falls. If you are looking to begin an exercise routine, feel free to consult our office. We can recommend reputable resources to help you get started safely. The benefits of exercise for every person at every age are well documented. The type of exercise you select is not as significant as the fact that you are doing something to contribute to your long term health and wellness.

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Eyes – In Focus

April 27, 2013

Focus on the Eyes It is safe to assume that many readers of this newsletter put on their reading glasses first! For most of us, vision changes seem to be noticed in our 40’s. We may have first noticed difficulty reading the fine print on a label or perhaps a restaurant menu, particularly when lights are dim. As we age, our eyes are susceptible to various health issues, some common and others more serious. Reading with a sense of eye strain in middle age results from presbyobia. This common rite of passage for our eyes occurs when the lens can no longer change shape enough to allow the eye to focus clearly on close objects. (The lens is a clear part of the eye that helps to focus light, or an image, on the retina. The retina is the light-sensitive tissue at the back of the eye.) Presbyobia is commonly addressed with “cheaters” or reading glasses, and sometimes prescription glasses are needed. The lens power may increase as we age. Many people experience symptoms of dry eye—the inability to produce sufficient tears to lubricate and nourish the eye. Tears help reduce the risk of eye infections, wash away foreign objects, and keep the surface of the eyes smooth and clear. Over-the-counter eye drops can be effective in replacing natural tears. It is also helpful to keep the humidity level high in your home, stay well hydrated, and wear sunglasses outside to protect against the drying wind and sun. If working at a computer screen for long periods of time, remember to blink regularly. More than half of people age 65 and older have some form of cataracts, often referred to as an age-related eye disease. Cataracts are formed when the lens of the eye begins to cloud. The lens is composed mainly of water and protein arranged to keep the lens clear and let light pass through it. Cataracts are formed when these proteins cluster together and begin to cloud part of the lens. The cataract can grow larger over time, clouding a larger part of the lens and affecting our vision more seriously. Smoking, diabetes and prolonged exposure to the sun also increases risk for cataracts. In more advanced cases, surgery is required. According to the National Eye Institute (NEI), cataract removal is one of the most common operations performed in the United States, with improved vision seen in 90% of the cases. Some eye conditions that are considered more serious and may to lead to blindness. These include diabetic retinopathy, age-related macular degeneration (AMD) and glaucoma. Diabetic retinopathy results from changes in the retina’s blood vessels, which can swell and leak fluid. In some cases, abnormal new blood vessels may grow on the retina’s surface. These changes are only visible through a comprehensive eye exam and early intervention is critical. Once a person is diagnosed with diabetes, a complete eye exam is recommended with annual exams thereafter. Age-related Macular Degeneration (AMD) is most common in people age 50 and older and gradually causes vision loss in the central field of vision. AMD destroys the macula, located at the center of the retina, making it difficult to recognize faces, close objects or to drive, although peripheral vision may be retained. AMD can result in loss of vision in one or both eyes. Glaucoma causes damage to the eye’s optic nerve when drainage canals become blocked over time. African-Americans, people over 60 and those with a family history of the disease are at higher risk. Glaucoma can result in blindness. Without treatment, people slowly lose their peripheral vision. The NEI recommends several steps to help maintain eye health. Schedule a comprehen – sive, dilated eye exam at least once every two years and know your family eye disease history. Many serious as well as common eye problems can only be detected with a thorough exam. Wear protective eyewear when appropriate, such as home improvement projects or if required at work. Protect eyes from ultra violet rays by wearing sunglasses outdoors. Don’t smoke. Finally, eat healthy! A diet that includes fruits and vegetables, as well as fish high in Omega 3 fatty acids, has proven beneficial for our eyes.

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Fats – What the skinny on them?

August 27, 2010

What’s the Skinny on Fats? We’ve all heard the recommendation to decrease our intake of saturated fats and trans fats. We’ve all heard that eating the wrong kinds of fats can cause serious health problems. We’ve also heard there are good fats and bad fats. Here’s the “skinny”… The Best Fat Monounsaturated fat is the best type because it both increases the good cholesterol (HDL) and decreases the bad cholesterol (LDL) in your blood. Sources of monounsaturated fat are olive oil, peanut oil, canola oil, most nuts, olives and avocados. The Second Best Fat Polyunsaturated fat is also good for you because it decreases the LDL (bad cholesterol). Sources of the polyunsaturated fat include corn, soybeans, sunflower oils, walnuts, and most mayonnaise and salad dressings. The Bad Fat Saturated fats are bad fats. They are easily identifiable because most are solid at room temperature. These fats are poor choices as they can actually increase the bad cholesterol in your blood stream, which can cause deposits of fat in the blood, leading to increased risk of heart attacks and even stroke. Sources of saturated fat are butter, cream and whole milk, sour cream, cream cheese, cheese, bacon and high-fat meats. The American Heart Association recommends that you consume no more than 8 grams of saturated fat per 1000 calories. For example, a breakfast composed of two eggs and two slices of bacon has 5.6 grams of saturated fat (two-thirds of your daily allotment!). If you substitute two egg whites for one of the eggs, replace 1 ounce of Canadian bacon for the regular bacon, you will have reduced the saturated fat to 3 grams while retaining the nutritional value of the meal. Contrary to popular belief, turkey bacon has 1 gram of fat per slice so it is not a significant improvement from regular bacon. The Worst Fat Trans fats are the most dangerous kind of fats and should be avoided because they do all the wrong things. These fats lower good cholesterol while also raising bad cholesterol. Trans fats are double trouble for your health. They can lead to heart disease, stroke, diabetes and obesity. Trans fats are essentially unsaturated plant fats that have been chemically modified to become a solid so they perform like a saturated fat. The process, called hydrogenation, makes the fat denser, raises the melting point, and results in the fat having a longer shelf life. Trans fats have traditionally been used by food manufacturers to provide a desirable texture (ie. crispy crackers) and also to make them stay fresh longer. Sources of trans fat are stick margarine, baked goods, fried foods, and many packaged food mixes. If a food contains less than 0.5 g per serving, the food manufacturer can legally list the trans fat content as “zero.” To determine if there is actually trans fat in a product, look for words like “hydrogenated” or “partially hydrogenated” in the ingredient list. New evidence indicates that trans fats stimulate genes to increase inflammation and insulin resistance. The bottom line is for better health and cholesterol management avoid trans fats and limit saturated fats in your diet whenever possible.

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Fiber 101

April 27, 2011

Fiber 101 Bread and cereal labels beckon you with phrases such as “whole grain guarateed,” “high-fiber” and even “extra fiber.” We know that a certain amount of fiber in our daily diet helps promote good health, but why? Years ago, our mothers called it “roughage,” but even then, they knew fiber was good for “keeping us regular.” Matriarch wisdom aside, research has since shown that fiber has benefits beyond digestive health. According to the Mayo Clinic, a diet that contains the recommended daily amount of fiber can promote good health in many ways: Good for the Heart – Soluble fibers lower “bad” cholesterol. A diet high in fiber also can help reduce blood pressure and inflammation. Diabetes Control and Prevention – A reduction in the risk for acquiring adult onset/Type 2 diabetes has been associated with fiber intake. Fiber slows the absorption of sugar in the body. Weight Loss Support – Consuming high-fiber foods provide bulk and help us feel full longer. While some studies have shown a correlation between a high-fiber diet and a reduced incidence of colorectal cancer, further research is still needed. There are two types of fibers, soluble fiber and insoluble fiber: Soluble fiber dissolves in water, forming a gel-like consistency during the digestive process. This slows digestion and regulates nutrient absorption including cholesterol. Further, when soluble fiber ferments in our bodies, it produces fatty acids that help to stabilize blood glucose levels. Soluble fiber is found in oat bran, peas, beans, apples, oranges and other citrus fruits. Insoluble fiber adds bulk to the stool and promotes quick movement of food through our digestive system. This type of fiber is particularly beneficial for people who struggle with bowel irregularity. Insoluble fiber is found in nuts and dark, leafy green vegetables such as spinach and broccoli. For some patients, particularly those with ongoing constipation issues or irritable bowel syndrome, physician-recommended over-the-counter fiber supplements, like Metamucil or Miralax, can be beneficial. However, these supplements do not provide the vitamins and minerals found in fiber rich foods and vegetables. The American Dietetic Association’s recommended daily amount of fiber for men is 38 grams, but drops to 30 grams for men over age 50. Women should consume 25 grams of fiber daily, 21 grams after age 50. If you consume more than 50 grams of fiber in one day, its benefits become counterproductive, lowering your body’s ability to absorb other vitamins and minerals during digestion. Begin introducing fiber to your diet gradually over several weeks. Otherwise, it can result in gas and bloating. Drinking adequate amounts of fluids is especially important when consuming fiber or fiber-rich foods. Fiber absorbs water from the small and large intestines, the water then increases bulk and keeps the food particles and digestive juices soft and moving through the system. Without sufficient fluid intake, the fiber will not be effective in this process. Liquids can be tea, coffee, fruit juices, or other beverages…but the recommended liquid of choice is pure water!

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Find Your Roots with Winter’s Best Veggies

November 20, 2017

Healthwise-Winter-2015-FINAL-Hasson-2 - Find Your Roots with Winter’s Best Veggies

While they may not have the crisp appeal of sugar snap peas or the sleek appearance of a summer tomato, winter’s bounty of root vegetables and greens brings some of the year’s most nutrient-rich dishes to the table. Serve up as chips or gratins, roasted or braised, mashed or raw, in soups or salads…see our recommendations for a taste of the season below. …

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Food/Drug Interaction Awareness

April 27, 2011

Be Aware of Food/Drug Interactions For some of us, an increase in the use of prescription drugs might be a rite of passage as we age. For others who live with a chronic illness, taking several prescription drugs daily is routine. In any circumstance, patients should be knowledgeable about their own medication’s possible side effects, as well as how each drug interacts not only with other medications but also with foods and beverages. For example, the liver makes proteins with the help of Vitamin K, which form blood clots. Warfarin, commonly known by the brand name Coumadin, is a blood thinner prescribed to block the effects of Vitamin K, thus making it more difficult for blood to clot. Vitamin K can be found in vegetables, fruits, dairy products, beverages, meats and fish, and fats and oils. Because warfarin and Vitamin K work against each other, what you eat could impact warfarin’s effect. Foods containing high amounts of Vitamin K include broccoli, Brussels sprouts, cabbage, mayonnaise and canola oil. It is not necessary to avoid foods with Vitamin K, but rather to keep your diet consistent. A sharp increase or decrease in Vitamin K may require your medication to be modified. Typically, patients taking warfarin have their blood tested periodically to measure clotting time, and dosages may be adjusted accordingly. Statins, drugs that lower blood cholesterol levels, block the action of a chemical in the liver that is essential for making cholesterol. Eating grapefruit or drinking grapefruit juice can interfere with the statin drugs Zocor (simvastatin), Mevacor (lovastatin), and Lipitor (atorvastatin). Grapefruit or grapefruit juice…as little as one glass or one grapefruit, can interfere with enzymes in the stomach, which in turn prevent them from breaking down these statins. This causes a high accumulation of the drug in your body and could cause liver or muscle damage. Patients taking a statin usually have their blood tested after six weeks and then annually or more frequently to monitor for potential liver or muscle damage. The class of antibiotics known as tetracyclines is commonly prescribed for treatment of some infections. Drinking or eating dairy products, such as milk or cheese, or taking calcium pills or iron supplements, can interfere with most “cycline” drugs’ effectiveness. These medications are absorbed mainly in the stomach and can bind with calcium, which slows their absorption into the bloodstream. For optimum effectiveness, patients are advised to take cycline medication about one hour before or two hours after consuming calcium rich foods. There are frequently warnings on prescriptions that say, “avoid alcoholic beverages while taking this medication.” Just how dangerous is having a drink when our prescription bottle warns us otherwise? Amy Peak, PharmD, Director of Drug Information Services for the College of Pharmacy and Health Services at Butler University, says that, “A glass of wine at dinner when you are taking a pain medication might cause you to become groggy more quickly. Drinking a glass of wine and then driving even a short distance home while groggy impairs your ability to react, and that’s a problem.” Caffeinated drinks like coffee, tea and soda when mixed with some medications, including oral contraceptives or certain antibiotics, can alter how caffeine is metabolized. This causes higher concentrations of this stimulant in the body, resulting in an increased impact of caffeine’s effects (shaky hands, rapid heart rate and inability to sleep). If you are taking medication for high blood pressure and drink a lot of coffee, the combination can inhibit the drug’s effectiveness. When any new medication is prescribed, be clear on dosage, side effects and any possible interactions. Prescription drugs are accompanied by a “Personal Prescription Information” flyer that delineates side effects and interactions beyond what is indicated on the container.

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Forget Me Not: Normal Aging, Mild Cognitive Impairment or Dementia?

November 20, 2017

Gas, Constipation and other Irregularities

August 27, 2011

Gas, Constipation and other Irregularities Gastrointestinal (GI) discomfort, such as gas, constipation or loose stools, are issues everyone experiences at some point. However, if these issues are frequent or persistent, they should not be ignored. For some people, this may be easier said than done. Generally, talking about GI issues and discussing your bowel habits with your physician is outside of our societal norms and comfort zone. As with any health issue, the more details you share (especially family history) the better. How you interpret symptoms and how your physician interprets them may vary dramatically, thus having an impact on an appropriate diagnosis. Many factors can cause GI-related discomfort such as gas, constipation, diarrhea and cramps. Sometimes, we can have extreme discomfort simply because we ate a food that did not agree with us. However, when these symptoms are experienced with some regularity, the culprit may be a diet low in fiber, stress level, medication (including iron pills and narcotics), lack of exercise, travel or other changes in our routine. Interestingly, there is a direct connection between your brain and your stomach, and when you’re feeling stressed, your stomach reacts. Stress can present in many ways, from “butterflies in the stomach,” to nausea, diarrhea or constipation. Despite a vacation’s promise of relaxation and stress reduction, many people encounter intestinal discomfort when traveling. This can be the body’s normal reaction to a change in diet and daily routine (including regular visits to the bathroom). Furthermore, the air on board planes is extremely dry, which can lead to dehydration, and, in turn, constipation. It is important to keep well hydrated when traveling. Persistent diarrhea, abdominal pain and rectal bleeding are warning signs not to be ignored. Early medical intervention is essential to help diagnose—or rule out—a serious disease or condition. Following are examples of symptoms. It is important to note that the symptoms of these minor to very serious diseases can be similar, underscoring the importance of making an appointment with your physician. Irritable Bowel Syndrome (IBS): This disorder is characterized most commonly by cramping, abdominal pain, bloating, constipation and diarrhea. Although IBS can cause great discomfort, the intestines are not permanently harmed and it is not likely to lead to a more serious disease. According to the National Institutes of Health it is thought that people suffering from IBS have colons that are more sensitive and reactive to specific foods and stress. Inflammatory Bowel Disease (IBD): Crohn’s disease and ulcerative colitis are collectively known as inflammatory bowel disease with the following distinctions: Crohn’s disease This chronic disorder causes inflammation of the digestive tract, most commonly affecting the small intestine and/or colon. Ulcerative colitis Similar to Crohn’s disease, ulcerative colitis affects the large intestine, marked by inflammation and ulceration of the colon’s innermost lining. Symptoms of the two diseases are similar, including continual diarrhea, cramp-like abdominal pain, fever and sometimes, rectal bleeding. Celiac Disease: This autoimmune disease causes damage to the lining of the small intestine and prevents food absorption, depriving the body of nutrients. Damage results from a reaction to gluten, which is found in all forms of wheat and related grains like rye and barley. Symptoms may include abdominal cramping, intestinal gas, bloated stomach, chronic diarrhea or constipation, and anemia. Colon Cancer: This type of cancer occurs when cancer cells form in the tissues of the colon. Symptoms can include a change in bowel habits, blood in the stool, diarrhea, frequent gas pains, bloating and cramps. Gastric Cancer: When cancer cells form in the lining of the stomach, it is called gastric cancer. The disease forms in the innermost lining of the stomach and spreads outward. Early stage symptoms of gastric cancer may include indigestion, mild nausea, heartburn and loss of appetite. As is well known, early diagnosis for colorectal cancers is critical for a cure. Screening tests such as a colonoscopy have become a mandatory recommendation in preventive healthcare planning. Finally, taking a cue from our professional peer Dr. Mehmet Oz and what he calls the “no embarrassment zone,” it is a good idea to monitor your own bowel movements. Shape, consistency, color and odor can be a blunt assessment of your GI health. Anything outside of your norm could indicate a range of issues from simple food irritants to serious problems such as internal bleeding. Because the symptoms of many GI-related diseases are common with lesser disorders, patients often self-diagnose and treat their complaint with over-the-counter medications, which may be all that is needed. However, trust your instinct. If you think you should see a physician, you should! As with any medical condition, early intervention is optimal for the best treatment options.

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Germs – Surprising places they hide

January 27, 2011

Surprising Places where Germs hide When it comes to avoiding germs, your smart phone may not be so smart. Experts say cell phones are hot spots for bacteria growth. As we head into the height of cold and flu season, it is important to be aware of where germs lurk and some practical ways to avoid these germs and stay healthy. Cell phones are so commonly used by most people that they are almost an extension of our ears and hands. They are also a popular depository for germs and bacteria, including staph and salmonella, based not only on their proximity to our mouths, but also where we set them down. These devices are set on tables at restaurants, dropped on the ground and placed on gym equipment during a work-out. Also, the protective cases covering cell phones provide additional nooks and crannies for germs to hide. Be aware of where you put your phone and make a habit of cleaning both your cell phone and its case twice a week with a disinfecting wipe. In addition, take the time to regularly wipe down the television and video game remote controls in your home, particularly if someone who is sick handles these devices. The same advice applies to office and home phones. Think about the frequency that elevator buttons are pushed. Therefore, it is not surprising that these buttons become a depository for germs— particularly the first floor button. It is just as easy to use your knuckle or elbow instead of your fingertip— or wait to see if someone else pushes your floor first! If you do use the elevator buttons, or hold an escalator handrail, wash your hands at the next opportunity or use a hand sanitizer. Remember, the keypads on your microwave oven, telephone, home and office computer, and ATMs are also germ depositories. For keypads in your home, wipe them down regularly with a disinfectant wipe or spray. When using keypads in public, use your knuckle or wash your hands soon after touching. How Clean is Your Kitchen? The kitchen is often the hub of our homes. As a heavy traffic area for family and friends, and the site of our daily food preparation, the kitchen has many areas needing special cleaning attention. Prevention magazine recently reported that in thousands of homes across the United States, 7 percent of kitchen dish towels were contaminated with MRSA (methicillin-resistant Staphylococcus aureus), the difficult-to-treat staph bacteria that can cause life-threatening skin infections. Part of the cause is that people use dish towels to wipe up kitchen spills, hang them to dry, and then use them again. Instead, use paper towels to wipe down counter tops and soak up spills. Dish towels should be replaced and laundered at least twice a week, more frequently for families with children where usage is high. When cleaning refrigerators, most people are diligent about the inside, but forget one crucial area—the seal around the doors. A University of Arizona survey found that the home refrigerator seals tested positive 83% of the time for common molds. These molds can spread to food or become airborne each time the door is open. Finally, don’t forget the kitchen sink and the garbage disposal. The sink and disposal are the final stops for foods that we rinse off or meals that we scrape down the disposal. Make sure to clean these areas with a diluted bleach solution once a week. Pay close attention to the seal around the disposal and give it a good scrub to remove the particles of food that accumulate there. Consider running your sink stopper/strainer through your dishwasher on a regular basis. Finally, most of us know that sponges are a breeding ground for germs—and they are. However, the Agricultural Research Service, (the in-house research arm of the U.S. Department of Agriculture), found that micro – waving sponges for one minute or running them through a dishwasher, killed approximately 99.9 percent of bacteria present on the sponges. Good Old Fashioned Hand Washing… and Hand Sanitizing According to the Infectious Disease Society of America, hand washing with soap remains the best way to prevent infection from germs. Remember to rub your hands vigorously while washing with soap, for at least 20 seconds. Alcohol-based hand sanitizers are a good alternative if there is not a sink and soap readily available. They should contain at least 60% alcohol. Like hand washing, use enough sanitizer to wet your hands completely and rub together for at least 20 seconds until your hands are dry. It is important to note that the majority of the germs that exist in our environment are not “bad”. Scientific and medical experts agree that most of the estimated 60,000 germs that people come in contact with daily are harmless. It is estimated that only 1 to 2 percent of these germs are potentially unsafe to people with normal immunity, according to Philip Tierno, PhD, author of the book The Secret Life of Germs. Common sense and good hygiene are always the best defense against germs.

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GMOs – Genetically Modified Organisms

August 27, 2013

Genetically Modified Organisms Although we have been ingesting them for the last two decades, foods that are Genetically Modified Organisms, (or GMOs…also referred to as GE, for genetically engineered) are currently the subject of intense scrutiny. GMOs were introduced 20 years ago as a possible solution to world hunger, by modifying wheat, for example, to withstand drought. The process consists of scientists removing a gene from one food organism and transferring that gene to a different organism. In most cases, this engineered gene produces a new protein that provides a trait such as resistance to pests and viruses. By 2011, more than 170 million acres of genetically modified crops were grown in the United States. This accounts for almost 90 percent of all field corn, soybeans, sugar beets and cotton, used for everything from canola oil to high fructose corn syrup. Although it appears as if eating foods with GMOs is inescapable, experts at the Center for Science in the Public Interest (CSPI) contend that the process of producing the oil, sugar and corn syrup from the crops eliminates virtually all of the genetically engineered gene and its protein product, exposing us to very little engineered product. However, questions around the safety of food made from GM crops continue to grow. At last count, 26 states have bills pending to require GMO labeling of food. While the FDA regulates GMOs, it is a voluntary notification process, and even CSPI admits that “FDA oversight is not as rigorous or independent as it should be, and the FDA often does not get all the data it needs to perform a fully informed safety review.” Further, Dr. Thierry Vrain, former research scientist for Agriculture Canada says scientific studies proving their safety have been done for companies with a vested interest in the products. He also contends that in the 1990s, the FDA warned of indirect effects from eating GM crops, such as toxins, allergens, and nutritional deficiencies. Like many consumers, you may be concerned. A recent New York Times poll showed 93 percent of respondents favor GMO identification of foods; 61 countries already label. Respected voices for sustainable foods have also voiced concern. Whole Foods will require suppliers to identify products containing GMOs within five years, and last summer, Chipotle became the first restaurant company to voluntarily label GMOs on their menu, and committed to eliminating them completely. The only certainty is the uncertainty. In the meantime, if you want to avoid GMO foods, buy certified organic products. Federal standards ensure that products from organic crops will contain either no or only inadvertent trace amounts of genetically engineered ingredients.

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Got Milk? Or Calcium Supplements? Or Neither?

November 20, 2017

HealthWise_Winter2016_Hasson-1-300x248 - Got Milk? Or Calcium Supplements? Or Neither?

Calcium, so essential to strong bones and teeth, as well as nerve transmission, muscle contraction and blood clotting, can be in short supply as we age. Exactly how much is needed of this important mineral, and Vitamin D, its companion to ensure optimal absorption, has been the subject of intense scrutiny over several decades. However, a clear cut consensus has …

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Headaches – Simple or Serious?

April 27, 2010

Headaches…Simple or Serious? There are many different types of headaches. They have their own names, their own symptoms, and their own best treatments. The sooner you can identify your type of headache, the better you will be able to manage it. Most people get tension headaches. Symptoms include soreness in the temples, a tightening vice-like ache around the forehead, and pain in the head and/or neck muscles. The pain is steady, continuous and very annoying. Most people get relief in an hour or two with an overthe counter pain reliever. Somefind the best relief comes from combining their analgesic medication with a long walk, a short nap or a good night’s sleep. If you get these headaches almost daily, then you may suffer from chronic tension headaches, which can be more serious and should not be ignored. Sinus headaches are also common. These headaches are caused by sinus congestion and inflammation called sinusitis. They occur when your sinuses (the air-filled cavities around your nose, eyes, and cheeks) become inflamed because of an allergic reaction or an infection. Bending down or leaning over generally makes the pain worse, as does cold and damp weather. Sinus headaches begin when you get up in the morning, usually because at night while you are lying down the mucus collects and drains. You may feel better by the afternoon. Sinus risk factors include a history of allergies, asthma, nasal polyps (noncancerous overgrowths in the nasal passages) or if you recently have been flying or hiking in high altitudes. Frequent swimming or diving can also produce symptoms. Generally, antihistamines or decongestants are recommended along with antibiotics if you have an infection. A migraine headache often starts with a dull ache, which progresses to a continuous pulsating, throbbing pain, usually at the temple and the front or back of one side of your head. For some people a warning aura is a signal of impending pain. Most commonly, there is a visual indicator such as a flashing light or black zigzag lines. Migraine sufferers are sensitive to light, noise, and even smells, and may becomenauseous. Migraine headaches frequently begin in childhood and worsen through adolescence. Although more young boys than girls have migraines, conversely more adult women than adult men have migraines. Over time, for both sexes the frequency of migraine onset diminishes and they become infrequent after age 50. Migraines have a tendency to run in families. In fact, four out of five migraine sufferers have a family history. If one parent has had migraines, you have a 50% chance of developing migraines, and if both parents have a history of migraines, the risk jumps to 75%. Rebound headaches can result when people take too much headache medication—more than prescribed recommendations or the label’s instruction—causing a recurrence. This is especially true if your medication contains caffeine, which speeds the effectiveness of the other ingredients but can also make your headache more likely to recur. Sometimes it is difficult to tell the difference between a tension headache, a sinus headache or a migraine without an office visit. A wide range of treatments have been proven to prevent or treat headaches. They range from prescription medications to over-the-counter analgesics… and in some cases may also include acupuncture, meditation, and a variety of selfhelp and life style therapies. Occasional headaches are common.But it is important to take headaches seriously. Please call our office if: You regularly have two or more headaches a week You take a pain reliever for your headaches every day or almost every day You need more than the recommended dose of over-the-counter-pain remedies to relieve symptoms Your headache pattern changes Your headaches are getting worse Seek medical help immediately if your headache: Is sudden and severe Accompanies a fever, stiff neck, confusion, seizure, double vision, weakness, numbness or difficulty speaking Follows a head injury Gets worse despite rest and pain medication

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Healthy Snacks

January 27, 2013

Healthy Snacks Just when the holiday season is over—we’re back on track with healthy eating and an exercise routine—Super Bowl Sunday arrives and often derails our best intentions. After Thanksgiving, Super Bowl Sunday is the day that Americans consume the most food, averaging 1,300 calories during the game itself—in addition to what already has been eaten before kick-off. An “average” daily caloric intake ranges from 2,000 to 2,500 calories. You can enjoy the festivities surrounding the game without having a penalty called on your snack choices. Advanced planning and a few substitutions can help you call the right nutrition plays! If you are hosting a Super Bowl party, you can control the menu with a few tasty changes that are lower in calories. If you are invited to a party, bring a healthy snack to share. The following suggestions may help. Chicken wings with blue cheese dressing are one of the most popular Super Bowl snacks, but are high in calories and laden with fat—347 calories and a whopping 29 grams of fat for four wings and two tablespoons of dressing. Remember, the average daily recommended amount of fat is 50-70 grams. A tasty substitute is four ounces of grilled skinless chicken breast (140 calories and 6 grams of fat), served on skewers with salsa or a dip of Greek yogurt with spices and herbs. It is easy to “graze” throughout the party and lose track of how much you have eaten. The American Dietetic Association (ADA) recommends using a plate, even for small servings, to help gauge your portion size. Snack food can derail diets. Four ounces of mixed nuts (a 1/2 cup) contain nearly 700 calories and 60 grams of fat. By comparison, the same amount of in-shell pistachios contain only 170 calories and 14 grams of fat. Two ounces of baked potato chips (220 calories, 4 grams of fat) or tortilla chips (220 calories, 2 grams of fat) compared to regular potato chips (310 calories, 21 grams of fat) or tortilla chips (276 calories, 13 grams of fat), reduce calories and fat. Pair chips or vegetables with salsas and low-fat dips such as hummus. Make a pre-game strategy. The ADA suggests having a small snack before the party. Arriving hungry often results in overeating. Drink alcohol in moderation as it causes blood sugar levels to drop, which will make you feel hungry. Smart substitutions and informed choices can carry you to your goal of guiltless eating and a good time…without a “fumble”.

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Heart Attack Symptoms – More than only Chest Pains

April 27, 2011

Heart Attack Symptoms – more than just chest pain When most people hear the words “heart attack,” a dramatic image of someone (usually a man clutching his chest) typically comes to mind. This dramatic perception is what the American Heart Association calls the “movie heart attack.” And while it is true that many heart attacks are sudden and powerful, most begin with more subtle symptoms. Coronary heart disease is the number one killer of both men and women in the United States, according to the American Heart Association. In fact, more women die of the disease annually than men! Knowing your own risks, as well as the common signs of a heart attack—some of which might surprise you—are vitally important to your long term health and wellness. The most common symptom that can indicate a heart attack is some type of chest pain, pressure or discomfort. Chest discomfort with profuse sweating and a sense of dread in a 72 year old with high blood pressure and is a former smoker almost certainly indicates a heart attack. However, there are lesser known indicators that can also signal a heart attack. Many of these symptoms are rather common and nonspecific. Look for patterns. Upper Body Discomfort: Pain or tingling in other areas of the upper body besides the chest, including the neck, shoulder, arm, upper back, or jaw. Shortness of Breath: This symptom may occur by itself or accompany chest pain/upper body discomfort. Miscellaneous Symptoms: Nausea/vomiting, breaking out in a cold sweat or lightheadedness/ dizziness. Women are more likely to experience lesser known symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain. Once heart attack symptoms occur, time is of the essence. Call 9-1-1 or the emergency response number for your community. Do not drive yourself to the hospital or wait for someone to give you a ride—the sooner you can be evaluated by emergency services personnel and brought to a hospital emergency room, the better your chances of survival. During a heart attack, blood flow to the heart muscle is reduced or obstructed. When heart muscle is deprived of oxygen-rich blood, it dies. Acting quickly when you first notice the symptoms can save your life and diminish heart damage. Treatment ideally should begin within 60 minutes of the onset of symptoms (called “the golden hour” by medical personnel). According to the American Heart Association, more than 83 percent of people who die from coronary heart disease are over the age of 65. In this age range, women who have heart attacks are more likely than men to die within a few weeks. Still, men have a greater risk overall of heart attack then women do. The American Heart Association outlines some major risk factors that can be changed, treated or controlled by altering your lifestyle: Tobacco: The risk of developing coronary heart disease is two to four times greater for smokers. Cigarette smoking narrows the blood vessels to the heart, thus restricting the flow of oxygen. Every cigarette you smoke adds to the damage. High blood pressure: The heart is forced to work harder when you have high blood pressure, and increases your risk for stroke and kidney failure. Also, the pressure itself inside the vessels leads to plaque formation – just as with cigarettes. High blood cholesterol: The higher your blood cholesterol level, the greater your risk of coronary heart disease. Cholesterol is a waxy, fat-like substance that plays many important roles in our bodies such as maintaining cell walls. But when there is too much cholesterol, it builds up on the linings of our arteries, which slows or blocks the flow of blood and oxygen to the heart. Being overweight: Quite simply, when people maintain a healthy weight, their bodies function better—your blood circulates efficiently, fluid levels are maintained and you are less likely to develop heart disease and diabetes. People who are overweight have higher levels of fat in their body cells, which need oxygen to survive, requiring blood vessels to circulate more blood to the fat tissue. This taxes the heart, forcing it to work harder and contributing to high blood pressure. The presence of more fat also contributes to high cholesterol. Having diabetes: If your blood sugar is not controlled properly, the risk is even greater. Diabetes hastens the hardening of the arteries, which can restrict or block the flow of blood and oxygen to the heart. Heredity: Some risks cannot be altered. Children of parents with heart disease are more likely to develop it themselves. Know your family history. Research studies have solidly documented that regular aerobic exercise, including brisk walking, not only maintains and improves fitness levels but also aids in controlling many of the risk factors discussed, including high blood cholesterol, diabetes, obesity and high blood pressure. Being informed about potential symptoms and your risks for a heart attack, along with the changes you can personally make to reduce risk and improve overall heart health, are important ways that together we can proactively address this serious disease.

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Hepatitis C Testing Recommended for All Baby Boomers

November 20, 2017

It’s called ‘the forgotten virus,’ but after a sustained advertising campaign and years of strong recommendations for testing by the Centers for Disease Control it’s almost certain that the liver-damaging Hepatitis C will be remembered…and for good reason. All people born between 1945 and 1965 – the Baby Boomer years – are now advised to take a screening test for …

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Hepatitis C Testing Recommended for All Baby Boomers

November 20, 2017

It’s called ‘the forgotten virus,’ but after a sustained advertising campaign and years of strong recommendations for testing by the Centers for Disease Control it’s almost certain that the liver-damaging Hepatitis C will be remembered…and for good reason. All people born between 1945 and 1965 – the Baby Boomer years – are now advised to take a screening test for …

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How Much Vitamin D Do We Really Need?

November 20, 2017

Healthwise-Winter-2015-FINAL-Hasson-300x244 - How Much Vitamin D Do We Really Need?

In the multi-lettered world of vitamins and minerals, why did Vitamin D move to the top of the list…and should it be there? Following is a look at the paradox of the “sunshine vitamin,” critical to the body’s healthy function in numerous ways, but may not be important enough to warrant regular screenings, according to the latest national recommendations. The undisputed connection between Vitamin D, the sun …

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In Our Sights: Sharper Focus on Macular Degeneration Offers New Hope

November 20, 2017

Healthwise-Winter-2015-FINAL-Hasson-1-300x202 - In Our Sights: Sharper Focus on Macular Degeneration Offers New Hope

In the not so distant past, age-related macular degeneration (AMD), characterized by a loss of central vision, was deemed just another unfortunate consequence of growing older. The gradual breakdown of light-sensing retinal tissue that results in a blind spot directly ahead has caused each generation to struggle with driving a car, reading a printed page or recognizing a friend’s face. As the population ages, the sheer number of …

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Inoculations

June 27, 2013

Inoculations:  Are You Up To Date? Vaccinations are a vital part of preventive health maintenance beginning in infancy. Some vaccines that we received as children should be repeated in adulthood, and there are others that are specifically targeted for diseases that adults become susceptible to as they age. Additionally, some adults may not have received certain vaccinations as children and may now be advised by their physician to receive them. The Centers for Disease Control (CDC) recommends guidelines for when inoculations should be administered. At the top of their list is an annual influenza vaccine. The Mayo Clinic advises that adults receive a flu shot annually in fall as protection against this potentially serious viral infection. However, there are some adults who, because of their health history, should not receive a flu vaccine. Every year this option should be reviewed with your physician. In infancy and early childhood, a series of vaccinations are typically administered which include protection for many different diseases. One of the vaccinations that children usually receive is the five-dose DTaP vaccine – diphtheria, tetanus and pertussis (whooping cough.) The DTaP has replaced the older DTP vaccine which was known to cause immunization reactions. This vaccination is also recommended for children older than seven years of age who did not receive their complete five-dose series of DTaP. For adults, it is commonly known that a tetanus booster is needed every ten years. Maintenance of this tetanus booster is extremely important because it protects against serious infections from common medical incidents such as cuts, puncture wounds and bee stings, to name a few. Most of us do not even realize that along with the tetanus vaccine, we receive the diphtheria vaccine as well. This inoculation is called a Td, and it protects against tetanus and diphtheria. However, with the more widespread outbreaks of pertussis in recent years, the CDC now recommends that protection against pertussis be included, at least once in adulthood. This vaccine is called the Tdap. The CDC also recommends a single dose of the shingles vaccine for adults over age 60. Shingles occurs in 20% of people who have had chicken pox as a child. When a person contracts shingles, the chicken pox virus which was lying dormant reactivates, often causing severe pain, tingling, and possibly an itchy rash or blisters that resemble chicken pox. Only someone who has had chicken pox or, in rare instances, someone who has received a chicken pox vaccine, can contract shingles. For people with chronic illness, or those who are on immunosuppressant drugs, have severe allergies, or allergies to the components of the shingles vaccine, inoculation is likely not appropriate. Therefore, always discuss thoroughly with your physician before receiving any updated vaccines. For adults who have never had chicken pox, the CDC does recommend being inoculated. While chicken pox might be uncomfortable and relatively harmless in children, adult chicken pox can pose more dangerous complications such as bacterial infection. There is a vaccine which helps protect against types of bacteria called pneumococcus. This vaccine protects against illnesses including pneumonia, meningitis, the blood disease bacteremia, and middle ear and sinus infections. All of these are caused by pneumococcus bacteria. It is recommended that adults over age 65 receive the pneumococcal vaccine. This vaccine may also be recommended for younger adults who have a compromised immune system. There are several other vaccines (such as Hepatitis A and Hepatitis B) that the CDC recommends only for adults with certain risks related to their health, job or lifestyle that put them at a higher threat for serious diseases. These risk factors should be discussed with your physician to determine what is appropriate for you. If you are traveling outside the United States, there may be additional vaccines either required or recommended to safeguard you in your travels. Certain diseases, such as typhoid and yellow fever, are rare in the United States but are prevalent in other countries. Again, it is wise to check with your physician several months before leaving the country. Many infectious diseases that once were serious health risks for infants, children and adults have decreased significantly or been eradicated in the United States. This is due to strong advocacy, general public education on the importance of maintaining vaccinations, as well as school requirements. Diligence in maintaining personal health records on inoculation history, combined with staying current on the recommended vaccinations helps prevent serious diseases, both for ourselves and the risk of passing on disease to others.

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Insomnia – the Waking Game

August 27, 2010

Insomnia the Waking Game There is a reason for the phrase “I slept like a baby” when describing a good night’s rest. According to the American Academy of Sleep Medicine, once people reach adulthood approximately 30 percent have symptoms of insomnia. For people over age 60, that number climbs to about 50 percent. As people age, they have a hard time falling asleep, difficulty staying asleep and often wake up too early, unable to go back to bed. It’s no surprise that people who are sleep deprived don’t feel well-rested the next day. You may wonder why a baby—or even a teenager or college student— sleeps so soundly while nearly a third of adults struggle with insomnia. Simply put, older adults’ body clocks are completely different than the finely-tuned body clock that ticked inside us in our youth. Older adults are less likely to sleep for long periods of time. Sleep is not as deep, and there is a greater tendency to wake during the night. As we age, our body clock (actually our body’s physiological functions), may cause us to produce less of the hormone melatonin, which regulates sleep. Increased sensitivity to changes around us, such as lighting, noise or a new environment may cause us to awake more frequently. More than half of pre-menopausal and menopausal women are affected by insomnia. However, insomnia is actually more common in men than women. Aging may also bring on additional medical problems that can affect sleep. If medications are prescribed for other health issues, these can also be a factor contributing to insomnia. Contrary to popular belief, older adults still need seven to eight hours of sleep each night to function well—and safely. Lack of sleep or continued poor quality sleep can affect our daily routines, from making us moody, irritable and tired, to lack of concentration… all of which can lead to inadequate job performance or even contribute to accidents. Older adults should not despair, however. Lifestyle adjustments can be made to help promote better sleep—some more obvious than others. Avoid caffeine starting in the afternoon, as well as limit alcoholic beverages. Smoking is problematic, as nicotine is a stimulant that can interfere with sleep. Exercise in general will help you sleep better and stay healthy, be it as simple as walking, gardening or dancing, but avoid workout routines closer to bedtime. Bedtime rituals, such as a relaxing bath or shower, listening to soothing music or taking some time for quiet reflection can also help ready our bodies for sleep. Avoid liquid intake about 90 minutes before bed—this decreases the likelihood of needing to use the bathroom in the middle of the night and not being able to fall back asleep as a result. Sunshine may also contribute to improved sleep. Bright sunlight increases melatonin, the very sleep regulating hormone that our body produces less of as we age. We might also learn a lesson from the sleeping baby or toddler who is rejuvenated from a nap. Try a brief nap of between 15 minutes to an hour (no longer), in the late morning or early afternoon. Avoid napping later in the day or close to bedtime. When Insomnia is More Than Just a Symptom of Aging Although insomnia is common in older adults and may be mitigated by lifestyle changes, for some people it can be a serious problem or indicative of a more critical health concern. If you attempt to address your insomnia on your own without much success, contact us to see if we can come up with a plan that will work for you. Please do not lose any sleep worrying about it!

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Is What You’re Reading What You’re Eating?

November 20, 2017

HealthWise_Spring2016_Hasson-2-300x119 - Is What You’re Reading What You’re Eating?

While the evidence is not yet in on the enhanced nutritional value of organic or natural foods, consumers appear to have made their own decision.  The latest research shows more than 62 percent of Americans now regularly shop for these types of products and pay premium prices for ‘farm to table’ dishes when dining out. Many questions remain, however, chief among …

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Junk Food – What’s so Trashy?

August 27, 2011

What’s so Trashy About Junk Food? “Junk foods” tend to be a way of life for today’s on-the-go society, whether it is a quick snack or a fast food meal. Eating while driving or watching television is a common pastime. In both cases, people are distracted and tend not to pay attention to portion sizes or ingredients. The main concerns about so called junk foods (such as chips, candy bars, French fries, and other fast food items) is that they contain a high percentage of preservatives and additives, tend to be high in fat and sodium, and have little or no nutritional value. Junk food is apt to contain higher amounts of preservatives and additives for a variety of reasons—to achieve a certain taste or color, or to give a product a longer shelf life. Although food additives are approved by the Federal Food and Drug Administration, this does not mean that they are good for you—as proven by the FDA’s ongoing research and changing recommendations. For example, the artificial sweetener saccharin once carried a food warning label because it was found to cause cancer in laboratory animals. That warning was rescinded in 2000, but saccharin’s use had already diminished. The artificial fat substitute Olestra debuted in the 1990s. FDA-approved, it was manufactured in chips and ice cream, but lost popularity because of its side-effects that included cramping and loose stools. Some U.S. products still contain Olestra, but its use is banned in Canada. “Generally, junk foods are processed products. Their natural nutrition as nature intended has been altered and may no longer be available to the body for various metabolic needs, thus also effecting overall health,” said registered dietitian Debbi Beauvais, a spokesperson for the American Dietetic Association. Be aware of nutrition labels and ingredients and practice moderation. Treating yourself to a serving of potato chips (1 ounce) is not unhealthy when balanced with recommended amounts of fruits, vegetables and proteins. “When it comes to fun foods we crave, you have to be mindful of what you are eating and how much,” Beauvais said. One serving of potato chips (about 1 ounce/15 chips) contains roughly 10 grams of fat (10 percent your recommended daily allowance). The snack size bag of chips usually contains more than two servings, so you can easily push those numbers to an unhealthy level if you do not pay attention to portion size. Educate yourself by keeping up with the latest studies and government findings. Recently, a Harvard University School of Public Health study found that regular consumption of processed meats, like hot dogs and cold cuts, increases the risk of diabetes by as much as 50 percent. When you have a craving, try to select junk foods with the least amount of fat, sodium and preservatives. If your body could say “thank you,” it would!

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Leg Cramp Relief

August 27, 2009

Relief from Leg Cramps Leg cramps, those painful muscle contractions that occur so suddenly, usually strike during the night and shock you awake from sleep. Sometimes called “Charley horses,” they can also attack during the day while you’re driving your car, riding a bicycle, or participating in sports and other activities. Mostly they assault your calf muscles, though they may sometimes involve the muscles in your feet or thighs. Night-time leg cramps tend to increase in frequency as we age. Pregnant women are often more at risk. Fortunately, most nocturnal leg cramps are harmless and have no known causes, except in rare instances where there is an underlying condition (see “Causes” below). How to Stop a Leg Cramp You can do a number of things to get fast relief when a leg cramp strikes. You may have to experiment with various techniques before discovering which ones work best for you. For many, the quickest thing to do is what seems like the worst possible thing. Force yourself to stand up, place your foot firmly on the floor, and put all your weight on it. As unlikely as that seems, it usually works; and once you discover that it does, you’ll feel much more confident about doing it the next time. The Website www.WebMD.com offers these suggestions for stopping a cramp: Walk around. Jiggle your leg. Stretch your calf muscles (see adjacent sidebar). Take a hot shower or a warm bath. Rub the calf with an ice pack. Preventing Leg Cramps When it comes to prevention, there are various things you can do to avoid leg cramps. The Mayo Clinic’s Website, www.MayoClinic.com, suggests the following: Drinking plenty of fluids to avoid dehydration Wearing shoes that have proper support Stretching your leg muscles, or riding a stationary bicycle, for a few minutes before you go to bed Untucking the bed covers at the foot of your bed To reduce leg cramps and other discomforts of pregnancy, the Weight-control Information Network (WIN) recommends regular, moderate-intensity physical exercise. WIN is an information service established by the National Institutes of Health (NIH). We also recommend eating plenty of potassium-rich foods, such as bananas, tomatoes, potatoes, broccoli, cantaloupe, oranges, and grapefruit. What Causes Leg Cramps? In most cases, nocturnal leg cramps have no identifiable cause, according to the www.MayoClinic.com Website. Rarely, however, night leg cramps may sometimes be associated with: Addison’s disease Alcoholism Blood pressure medications Cirrhosis Dehydration Type 2 diabetes Diarrhea Diuretics Electrolyte imbalance Flatfeet Hypothyroidism (underactive thyroid) Kidney failure, chronic Muscle fatigue Oral contraceptives Parkinson’s disease Second trimester pregnancy Peripheral artery disease (PAD) Gastric bypass surgery If you think your leg cramps may be caused by any of these or other medical conditions or circumstances, please schedule an appointment with our office. You should also contact our office if cramps keep you awake so that you can’t function the next day or if you experience muscle weakness; and if you have severe and relentless cramping, call us immediately. How to Stretch your Calf Muscles You can stretch your muscles either while sitting or standing. While sitting, straighten your leg and flex your foot up toward your knee. It may help to place a rolled towel under the ball of your foot and, while holding the towel at both ends, gently pull the towel toward you while keeping your knee straight. While standing about two feet from a wall, lean forward against the wall. Keep the knee of the affected leg straight and the heel on the ground. Do this while you bend the knee of the other leg. These exercises stretch your calf muscles, and you will probably feel the leg cramp go away after a few minutes. Source: www.WebMD.com

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Lyme Disease: Solving the Puzzle

May 1, 2015

Misunderstood, Misdiagnosed and Often Mistreated: Solving the Puzzle of Lyme Disease Unsurprisingly for an illness known as “The Great Imitator,” the misconceptions surrounding Lyme Disease continue to proliferate. Acute or chronic? Highly treatable or stubbornly resistant? Misdiagnosed because of symptoms that mimic conditions like lupus, multiple sclerosis, Parkinson’s and Lou Gehrig’s disease, or overestimated for the same reason? While television celebrity Yolanda Foster recently gained national attention during her bout with chronic Lyme disease, she also fanned the flames of controversy surrounding this sometimes mystifying condition. A brief overview of current knowledge follows…however experts have not yet reached a consensus on all aspects of this disease. Research indicates that Lyme disease is transmitted to humans by a bite from a tick infected by the spirochete bacteria, primarily found on the East Coast and in the Midwest. Carried by deer and migratory birds, Lyme disease is on the rise, estimated at 300,000 cases annually in America, considerably larger than the 30,000 cases earlier reported by the Centers for Disease Control (CDC). The distinctive bull’s eye rash is one identifiable marker of the disease, seen in 70 percent of patients. In the early stages, fatigue and flu-like aches and pains are typical; in later stages, nerve numbness or pain, facial paralysis or weakness, and heart problems are seen; and if not treated, serious and long-term complications that affect the brain, joints, nerves, heart and muscles can occur, according to the Lyme Research Alliance. Lab tests are generally needed to confirm the diagnosis, followed by a course of oral antibiotics. However, people with early Lyme disease do not develop antibodies for several weeks, resulting in frequent false negatives on the commonly used ELISA or Western Blot antibody tests. For that reason, treating patients based solely on clinical findings, such as a rash and known exposure to ticks, is recommended by some experts, while others advise more aggressive, longer and individualized treatment. All agree, however, that earlier treatment is more effective. About 20 percent of patients with Lyme disease continue to experience symptoms months and years after treatment ends…and this is where the real debate begins. Muscle and joint pain, cardiac and neurological problems and fatigue have been reported by those with chronic Lyme disease. Some experts believe it indicates an ongoing bacterial infection, while others attribute lingering symptoms to residual damage to tissue and the immune system. Still others, including Dr. Allen Steere, who first recognized Lyme disease back in 1975, say it is being over-diagnosed, mistaken for chronic fatigue or chronic pain. The continued questioning spurred John Aucott, MD, assistant professor of rheumatology at Johns Hopkins University School of Medicine and founder of the Lyme Disease Research Foundation, to launch the nation’s first controlled study examining long-term health and outcomes of the disease. “It does no good to keep debating the existence of long-term problems related to Lyme disease while people are suffering a debilitating illness. These patients are lost. No one really knows what to do with them. It’s a challenge, but the first thing we need to do is recognize this is a problem,” he said. The headwinds have been strong. Lyme disease ranks well below breast cancer and HIV/AIDS for federal funding, despite a significantly higher rate of cases, according to lymedisease.org, but Aucott’s study and others represent hopeful progress. In the meantime, decrease your risk of contracting Lyme disease by wearing shoes, long pants tucked into your socks, a long-sleeved shirt, hat and gloves when walking in woodsy areas; sticking to trails and avoiding low bushes and long grass; and using insect repellents with a 20 percent or higher concentration of DEET. If you are bitten by a tick, call my office promptly, but do not panic…your chances of acquiring Lyme disease are no more than 1.4 percent.

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Medical Mysteries – Sneeze, Shivers, Yawns, Goose Bumps and Hiccups

January 27, 2014

Deconstructing the Sneeze, Decoding the Yawn…And More The miracles of the human body are on continual display each day. Even involuntary actions, such as sneezing and shivering, help our bodies function optimally. The big sneeze. Every time we breathe in foreign particles, sensors in our noses and sinuses detect this, and signal the cilia (hairlike structures that line the nostrils) to sweep mucus and trapped debris upward to be eliminated. We constantly produce mucus – about four cups a day on average. The mucus is either swallowed, pushed out through the lungs, or sneezed out. The sneeze produces a burst of air which neatly clears the nasal passages, almost like pressing the reset button on your computer. For almost 16 million Americans with chronic sinusitis, however, the mucus is the problem. As reported in the Journal of the Federation of American Societies for Experimental Biology, researchers discovered that people with chronic sinus issues are not able to ‘reboot’ and clear the mucus from their nose, causing them to sneeze more often, with ineffective results. Post-nasal drip occurs from the additional mucus, which drips continuously down the nose or throat of sinus sufferers, according to Harvard Health Watch. Shivers and yawns. The brain is constantly monitoring, responding and adjusting to stimuli. Shivering and yawning are two automatic and subconscious regulatory body functions controlled by the brain. When the surface of the skin gets chilled, receptors send signals to the brain, which activates the body’s warming reflexes. Shivers occur when the muscles in your arms, legs and jaw contract and expand quickly. As one of nature’s best defenses against hypothermia, shivering is the body’s way of producing heat within the skeletal muscles in order to maintain a core temperature of 98.6°F. Surprisingly, the true function of yawning might also be to maintain correct temperature in the brain, not to get more oxygen, as previously assumed. The human brain works hard, and tends to heat up more than other organs, according to Smithsonian Magazine. When you yawn, the gulp of air produced travels up to the nasal and oral cavities, and increases the rate of blood flow to the skull; inhaling at the same time brings cooler blood to the brain. This explains why we yawn more frequently at bedtime or upon awakening, as brain temperatures are highest before falling asleep, decline during the night, and rise rapidly in the morning. Goose bumps. Triggered by a variety of unrelated events – from the chill you feel after leaving warm water or when entering an overly-air-conditioned restaurant, to watching a horror movie, or even hearing the national anthem – goose bumps are a physiological reaction to both emotion and cold temperature. They result from a contraction of muscles attached to your hair follicles, creating a shallow dimple on the skin surface and making the hair on your head, arms and legs literally stand on end. This gives your skin a strong resemblance to that of plucked poultry. Caused by the subconscious release of the stress hormone, adrenaline, add goose bumps to the sweaty palms, trembling hands and stomach butterflies many experience during strong emotions. Hiccups. Hiccups are involuntary contractions of the diaphragm that occur when the vagus nerve, which runs from brain to abdomen, becomes irritated. There are many causes, from digestive disturbances to sudden excitement. As you inhale with each spasm, the opening that permits air to pass through the voice box snaps shut, creating the characteristic “hic.” From the literally hundreds of home remedies suggested for eliminating hiccups, the NY Times recommends: taking a deep breath and holding it, gargling with ice water, putting pressure on the eyeballs, or the tried-and-true method of breathing in and out of a paper bag. Mayo Clinic recommends contacting your physician if you have hiccups consistently for more than 48 hours. Don’t take them for granted: however common, each yawn, sneeze, shiver, goose bump and hiccup represents a small medical marvel.

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Medications – What you should know!

January 27, 2010

Things to Know about Your Medications Here are some common medication questions—with answers! Are generics and branded drugs identical? Patients wonder why generics don’t look or taste the same as branded drugs, and they worry about generics’ side-effects. According to the Food and Drug Administration (FDA), “The active ingredient (in generic drugs) is chemically the same as the branded counterpart.” Regarding appearance, they cannot look identical because in the United States, trademark regulations prevent the sale of generic drugs that look exactly like the brand-name drug. Also, inactive ingredients such as flavors and preservatives, and the manufacturing process may differ. Side effects and treatment efficacy may vary based on these and other subtle differences. So while these drugs are not exactly identical, generics will often be recommended when they are available. Most patients will ask for the generic prescription option, since it is almost always a cost savings. Not all drugs have a generic counterpart. In being your own health care advocate, I suggest if the pharmacist offers a generic substitution, check with our office to determine what is most appropriate for you. What about off-label drugs? In the United States new drugs are tested in three phases of clinical trials (research studies) before they are approved for use by the general public. The clinical trials are done to prove that the drug effectively treats a certain medical condition, works the way it is supposed to, and is safe when used as directed. When the FDA is satisfied that the drug is safe and effective, it works with the maker of the drug to create the drug label. This is not an actual label that sticks onto a container, but a report of very specific information. The FDA also must approve this report, which is made available to physicians and pharmacists who prescribe and dispense the drug. The drug label contains information about the drug, including the approved doses and how it is to be given to treat the particular medical condition for which it was approved. When a drug is used “off-label” it is most commonly given for a different disease or medical condition than described in the FDA-approved label. Or, it may be given by a different route, or in a different dosage. For example, most of us are familiar with the benefits of Botox Cosmetic as a facial wrinkle treatment. Botox injections for migraines were discovered accidentally during clinical testing for Botox Cosmetic. When test patients who normally suffered from headaches reported fewer facial lines and fewer migraines, Botox began its progression from popular cosmetic treatment to medical remedy. Botox injections for migraines are currently in Phase III of their clinical studies. While the treatment has not yet been FDA-approved for migraines, these injections for headaches are commonly administered by physicians as a viable treatment option. This is considered off-label use. When doctors discover that an off-label use works well, it can become the “standard of care.” Is it OK to split pills in half? The answer is – sometimes. Generally, a pill that is twice your normal dosage costs about the same as the smaller dose. So, by splitting double-dose pills in half, your savings could be substantial. The pills best suited to splitting – and according to some medical professionals, the only pills – are those scored down the middle, making them easier to divide. But splitting only works well for certain medications, and numerous reports warn that some pills should never be split. Examples include: longacting, extended- or continued-release tablets or capsules, any capsules that contain powders or gels, birth control pills, and chemo therapy drugs. If you are thinking about splitting your pills, talk to my office about which of the medications you take can be split safely… and be sure to purchase an inexpensive pill-splitting device rather than using a knife. What are the effects of medication on taste? Some drugs cause food to taste differently, or they can cause a metallic, salty, or bitter taste in your mouth. Clinical studies have implicated over 250 drugs that can alter taste sensations. And, while it is not known exactly how these medications influence taste, it has been established that medications can have an impact on taste through decreased secretion of saliva. This side effect from certain medications can also lead to problems with chewing and swallowing food. In turn, some patients decrease their food intake, which can be dangerous for many people—especially those who are older or who already have health problems. If your symptom is significant, please call our office as sometimes there can be alternative solutions. Is it safe to take drugs that have expired? Today the general consensus from pharmaceutical professionals is that most expired drugs are safe to take for a limited period of time after the expiration date. The expiration date on both prescription and non-prescription medication signifies that the drug will remain at full potency up until that date. However, this does not mean that drugs past this expiration date are necessarily unsafe to use or are spoiled. Before taking a pill beyond the expiration date, keep in mind that liquid medications and medications that have been stored in a warm, moist environment degrade more quickly than solid medications that have been stored in a cool dry place. All of the above being stated, use your own good judgment. The wisest choice with an expired drug is to call your pharmacy and ask before you take even one dose. After all, good health is a collaborative effort!

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Milk

June 27, 2013

Mooo-re Milk Options Homogenized cow’s milk has been a staple in most people’s daily diet since early childhood. However, many individuals have allergies, are lactose intolerant, or simply don’t like the taste. The good news, as displayed in the dairy section of most supermarkets today, is that many more options are now available. Cow’s milk contains a significant amount of the recommended daily allowance (RDA) of calcium as well as protein. Cow’s milk comes in four options: whole, 1%, 2% and fat-free skim. Fat content, and therefore calories for each 8 ounce serving of milk varies as follows: whole milk, 8 grams of fat (136 calories); 2% milk, 5 grams of fat (120 calories); 1% milk, 2.5 grams of fat (102 calories). Skim milk is fat free and contains 87 calories per 8 ounce serving. It is important to note that only skim and 1% milk are considered “low fat”. Consumption of this type of fat can raise LDL or “bad cholesterol” levels. Regardless of fat content, all varieties of cow’s milk contain the same recommended daily allowance of nutrients. Lactose-free milk is a good option for those who are lactose intolerant (the inability to digest lactose, a sugar found in cow’s milk). Lactose-free milk is cow’s milk in which the enzyme lactase is added. The addition of this enzyme helps to break down the lactose. Lactose-free milk contains the same nutrients and calories as regular varieties of cow’s milk. Soy milk is also a good option for people who are lactose intolerant or have milk allergies. Derived from soybeans, soy milk contains similar nutrients to the same 8 ounce serving of any type of cow’s milk or lactose-free milk. One cup averages about 100 calories. Soy milk also comes in different flavors, vanilla being the most popular. Almond milk is made from ground almonds and water, and is a good alternative for those who have milk allergies or are lactose intolerant. However, it is important to note that almond milk is not suitable for people allergic to almonds or other tree nuts. Plain, flavored and sweetened varieties are available, which may alter the sugar and calorie content. Almond milk has far less protein than soy or cow’s milk, but is richer in calcium. Rice Milk is made from cooked brown rice and water. Depending on the brand, rice milk may contain added sweeteners, and most commercial brands are fortified with vitamins. Rice milk offers less than a gram of protein per cup, but is otherwise nutritionally similar to cow’s milk. Although nutrients may vary, the assortment of “milk” varieties available now provide choices for people with special dietary concerns, particularly for those individuals who have allergies, are lactose intolerant or who follow special diets.

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MIND Your Diet

November 20, 2017

Hasson_HW_2017_Summer_FINAL-2-300x177 - MIND Your Diet

Let food be thy medicine and medicine be thy food. – Hippocrates Food’s healing properties is a concept that stems back to the earliest days of medicine, but has taken on new significance as a natural way to prevent or manage today’s most devastating illnesses, from dementia to heart disease. The regimens presented below are not ‘diets’ in the traditional …

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Organic Labeling

April 27, 2013

Defining Organic Labeling Organic food, once only available in health food stores, is now a mainstay in most grocery chains across the country. What does “organic” really mean? Are organic foods really healthier? In the United States, organic products must adhere to strict production and labeling requirements set by the U.S. Department of Agriculture (USDA) National Organic Program. The requirements apply to farming, production, and specify how a product’s packaging can be labeled as organic. According to USDA guidelines, “certified organic” foods: Cannot be produced with methods used to genetically modify organisms or influence their growth and development by means that are not possible under natural conditions or processes (such as chemical fertilizers), ionizing radiation or sewage sludge. Must adhere to the National List of Allowed and Prohibited Substances specifying what can or cannot be used in organic crop and livestock production. Must be overseen by a USDA National Organic Program-authorized certifying agent. Products can be certified “100% Organic,” defining them as completely organic or made with totally organic ingredients. Products that are 95% or more USDA-certified organic may carry a special USDA seal. Products labeled “Made with Organic Ingredients” means that these contain 70% or more of organic ingredients. Products containing less than 70% of organic ingredients cannot use the word “organic” on package labeling, but their individual certified organic ingredients can be individually listed as such. A 2012 Stanford University study published in the Annals of Internal Medicine found it inconclusive as to whether eating organic foods can significantly impact one’s health. Yet there are compelling reasons to choose organic. Requirements for organically grown produce restrict or prohibit the use of food additives and also have a lower risk of pesticide contamination. Therefore, purchasing organic produce and foods can reduce our exposure to these substances. Organic foods are grown using environmentally friendly sustainable farming practices, which can account for why organic foods cost more, as these practices are more expensive. The USDA Food Safety Inspection Service also verifies other labels, including: “Grass-fed” animals receive a majority of their nutrients from grass, which can result in an overall lower beef fat content. “Grass-fed” does not limit the use of antibiotics, hormones or pesticides, unless labeled “grass-fed organic.” “Free-range” indicates poultry was provided shelter with unlimited access to food, fresh water and continuous access to the outdoors. The label is mainly an indication of animal welfare. No definitive research has shown greater health benefits from eating free-range poultry. Read food labels carefully. Always wash produce to remove pesticide residue, dirt and any germs from handling. Remember… organic labeling is a sensible criteria, but it doesn’t always equate to healthier food—check fat, sodium, sugar and calorie counts.

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Osteoporosis – Can you avoid the break?

August 27, 2012

When “Break A Leg”  Doesn’t Mean Good Luck One in two women over the age of 50 will break a bone due to osteoporosis. The National Osteoporosis Foundation (NOF) reports that by 2020, half of all male and female Americans over the age of 50 are likely to have osteoporosis or low bone density. Of the approximately 10 million individuals in the United States with osteoporosis, eight million are women. Osteoporosis literally means “porous bone.” It results when the body’s bones are weakened from depletion of calcium, phosphorous and other minerals as we age. Individuals with the disease can break a bone from something as seemingly harmless as a minor fall. Any bone is susceptible, but those most impacted are the hips, wrists or the spine. Osteoporosis is sometimes referred to as a “silent disease” because people often are not aware they have osteoporosis until they actually break a bone. The disease is more prevalent in women mainly because their estrogen protects bone mass. As women age, this hormone is depleted, resulting in a loss of up to 20% of bone density in the five to seven years following menopause. Other risk factors include a family history of osteoporosis and previous broken bones. People weighing less than 127 pounds are also at increased risk because they have less bone mass. Certain medications may contribute to bone loss. These include, but are not limited to: heparin, lithium, aluminum containing antacids, anti-seizure medications (Dilantin®, Phenobarbital), cancer-fighting chemotherapy drugs and certain antidepressants (Lexapro®, Prozac®, Zoloft®). Many steroids can also cause bone loss, including cortisone, dexamethasone (Decadron®), methylprednisolone (Medrol®) and prednisone. Prevention of osteoporosis should start at a young age, since approximately 85 to 95% of our bone mass is attained by the age of 20, according to the NOF. Peak bone mass occurs by age 30. Building strong bones early in life can prevent osteoporosis. The following safeguards can help optimize bone health: Include proper amounts of both calcium and Vitamin D in your diet. These nutrients are important because the body needs Vitamin D in order to absorb calcium. For adults 19 and older, the Institute of Medicine, a nonprofit organization that works independently of the government to provide unbiased advice, recommends 1,000 – 1,200 mg of calcium daily. Good sources of calcium include dairy products, cereals, almonds, kale, broccoli, spinach, salmon and soy products. Experts recommend 600 IU (International Units) of Vitamin D daily up to age 70. Men and women over age 70 should have 800 IU daily. Vitamin D is found in foods such as whole eggs, fatty/oily fishes (halibut, herring, oysters) and fortified milk. Exposing our body to natural sunlight is one of the most effective ways to produce Vitamin D. Absorbing the necessary amount through sunlight will vary by skin type, region and season. For example, fair-skinned individuals require less exposure than those with darker skin tones, and sunlight in tropical climates is more intense so less exposure is required. Incorporate weight-bearing and muscle strengthening exercises in your fitness routine. These forms of exercise help increase bone strength. Examples include walking, dancing, and stair climbing, as well as lifting weights (free weights or weight machines) or using exercise bands. Don’t smoke and consume alcohol in moderation. Smoking prohibits bones from absorbing calcium. Drinking heavily can also prohibit calcium absorption and increase the risk of falling. A bone density test is the only test that can diagnose osteoporosis before a bone is broken. The test uses dual energy x-ray absorptiometry (DXA) that measures bone density in various locations in the body. It also provides a person’s risk of fracture, called a FRAX® score. This score combines risk factors, along with age, previously broken bones and bone density. The resulting information can predict the risk for future fractures and prescribe more targeted medical care. Most people diagnosed with osteoporosis take medication to prevent fractures. Physical therapy may also be prescribed to improve bone strength, posture and balance—all of which aid in decreasing the risk of falling. There is no cure for osteoporosis, but proper treatment and following these simple proactive steps may not only sustain or improve bone health but may also prevent or at least slow its onset.

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Pain Management: The Opioid Crisis Sparks a Painful New Reality

March 7, 2017

Peripheral Neuropathy

August 27, 2013

Peripheral Neuropathy It can start as “pins and needles,” as if your hand or foot has fallen asleep, followed by burning, feelings of electric shock, muscle weakness, or extreme sensitivity to the lightest touch. Peripheral neuropathy (PN) is a chronic and painful condition which involves damage to the nerves outside the brain and spinal cord. This condition is more common among older adults. There are over 100 known types of neuropathy, a third of them are idiopathic, meaning the cause is unknown. Neuropathy is often difficult to diagnose, is frequently mistaken for other disorders, or even dismissed as something that is imagined. Increased awareness of neuropathy is important, because early diagnosis can result in effective treatment which will allow peripheral nerves to slowly regenerate. Also, pain can be managed, restoring quality of life. If ignored, symptoms may intensify to include loss of sensation, lack of coordination, weakness, dizziness, digestive disorders, unremitting pain and disability. Who is at the greatest risk of developing peripheral neuropathy? Consider the risk factors which could cause the onset of this disease. They include traumatic injuries, infections, autoimmune disease, repeated nerve pressure, metabolic disorder and exposure to toxins. But by far the greatest risk factor exists for those with diabetes. Approximately 60 to 70 percent of all diabetics develop diabetic peripheral neuropathy (DPN), and that risk rises with age and longer duration of diabetes, reports the National Diabetes Information Clearinghouse. As a result of the increasing number of diabetics in the United States, as well as chemotherapy survivors, another high risk group, the incidence of peripheral neuropathy continues to climb. Awareness of this disease, however, remains at a very low seven percent. Many more people are affected than the 1-in-15 currently reported, according to Tina Tockarshewsky, president and CEO, The Neuropathy Association. Previously, 20 million Americans were diagnosed with the condition, but another 79 million people with pre-diabetes are also at risk for developing DPN. “We are all gravely underestimating the millions of people struggling and suffering with neuropathies,” contends Tocharshewsky. The severity of the condition varies depending on the location and type of the affected nerves, according to Medical News Today. Motor nerve damage can leave patients with muscle weakness, cramps, spasms, a loss of balance and coordination, and heaviness of the lower extremities, making it difficult to walk or run. Damage to arm nerves may make it difficult to do routine tasks such as opening jars or turning door knobs. Sensory nerve damage can cause tingling, numbness, pinching and pain, and frequently patients report a sensation of wearing an invisible glove or stocking. Autonomic nerve damage affects internal organs and involuntary functions which can lead to abnormal blood pressure and heart rate, reduced ability to perspire, constipation, bladder dysfunction, diarrhea, incontinence, sexual dysfunction and thinning of the skin. If you experience any of these symptoms, it is of utmost importance to discuss them promptly with your physician. A referral to a neurologist for a complete workup may be indicated. Even if the underlying cause cannot be identified or corrected, there are fortunately a number of highly effective ways to control pain and restore function. Not surprisingly, one of the top recommendations from Mayo Clinic is a healthy lifestyle: a diet rich in fruits, vegetables, whole grains and lean protein, especially foods with vitamin B-12 (meats, fish, eggs, low-fat dairy foods and fortified cereals), regular exercise, drinking only in moderation, and no smoking at all. For diabetic patients, management of blood glucose levels is essential, along with the same healthy lifestyle choices listed above. A wide variety of prescription medications have been proven to control pain in neuropathy patients. Additionally, according to a new study from the University of Texas, anti-oxidants appear to offer great potential in the ongoing quest to minimize neuropathy pain and improve quality of life. Antioxidant supplements should not be taken without physician approval. Current research projects funded by the National Institute of Neurological Disorders and Stroke (NINDS) are exploring the implication of genetics, biological factors in diabetesassociated neuropathies, and how the immune system contributes to peripheral nerve damage. Developing more effective therapies for neuropathic pain is also under the microscope at NINDS. This new research is encouraging for the millions afflicted with any form of this disease. If you are experiencing symptoms or have questions, please consult your personal physician.

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Plant the Seeds of Healthy Eating

January 9, 2018

Seeds-of-healthy-eating-v1-300x300 - Plant the Seeds of Healthy Eating

Plant-based eating proponents are growing at a rapid clip in the US, buoyed by ongoing reports that following the regimen faithfully can result in a multitude of health benefits, ranging from increased energy and elevated mood to lower risks of diabetes, high blood pressure and heart disease. The abundance of antioxidants in whole plant foods may also help prevent or …

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Potassium – How it Affects You

January 27, 2012

Pass the Potassium Bananas, rich in potassium, have long been a nutritional staple, particularly after athletic pursuits. Eating a banana after vigorous exercise helps replace valuable electrolytes lost through sweating. Recent studies reveal other advantages to meeting the recommended daily allowance of potassium, found in a variety of fresh foods. Potassium is critical for maintaining the body’s fluid balance as well as electrical and cellular functions. It helps regulate blood pressure and is vital for the heart, kidneys, muscles, nerves and digestive system performance. Potassium lowers blood pressure by diminishing the adverse effects of too much sodium and helps reduce risk factors for developing kidney stones and bone loss. The U.S. Department of Agriculture recommends a daily intake of potassium as 4,700 milligrams (mg), but says most Americans actually consume less than this amount. Daily potassium intake should be acquired through foods we eat rather than relying on supplements, which are not as effective. This should be relatively easy, as there are a wide variety of foods rich in potassium. Following are some foods high in potassium: 3/4 cup orange juice (355 mg); 1 cup low-fat milk (348 mg); 3 ounces avocado (540 mg); baked potato with skin (844 mg); 1/2 cup raisins (553 mg); 1/4 cup cantaloupe (412 mg); 1 cup butternut squash (583 mg); baked sweet potato (694 mg); 3 ounces baked salmon (319 mg); 3 ounces lean beef (224 mg); 1 cup yogurt (531 mg); 1 medium banana (451 mg). Potassium deficiency, hypokalemia, can occur in people taking diuretics for high blood pressure or heart failure, or in individuals with eating disorders. Laxatives, vomiting and diarrhea can cause loss of potassium. Steroid and some antibiotic use also reduces potassium in our system. Too much potassium, hyperkalemia, is most commonly caused by reduced kidney function, particularly with people on dialysis. Certain medications, such as for high blood pressure, can interfere with the body’s ability to eliminate potassium. Recent studies have documented the added benefits of potassium in our diet. Research published in the August 2011 Swedish medical journal Stroke concluded that an increased intake of potassium may reduce chances of having a stroke. Researchers prospectively analyzed 10 international studies that included more than 250,000 middle-age and older adults. Scientists found that risk for stroke decreased as an individual’s reported intake of potassium increased. For every 1,000 mg increase in daily potassium, the odds for having a stroke in the next five to 14 years decline by 11%. Eating recommended amounts of potassium is an important component for good health. As the latest research indicates, potassium’s benefits are increasing. Because it is found in many foods, incorporating this important nutrient into our diets can be a delicious challenge that is easy to achieve and maintain.

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Prescriptions: Take Exactly as Directed

August 19, 2014

Prescription for Health: “Take Exactly as Directed” Look inside your medicine cabinet at your prescription bottles and ask: Have I read the label, stickered warnings and instructions? Have I discarded medications past their expiration dates? The Centers for Disease Control (CDC) reports that 80 percent of patients do not take their medications as prescribed. The prevalence of non-adherence to prescription directions has been cited as “America’s other drug problem” by the CDC. The agency estimates more than 125,000 people die annually from problems related to prescription medications, in part due to failure to read or follow label instructions. This number has the potential to increase dramatically over the next few decades, with the growing numbers of seniors, who are prescribed medication most frequently. Currently, 76 percent of Americans 60 and older use two or more prescription drugs, and by age 65, 42 percent take at least five medications weekly. At every age, it is crucial to know the details about any medication prescribed to you. Consider these commonly asked questions, and you will understand why reading the fine print is essential. Why do I need to finish an antibiotic? Probably the most common instance of non-compliance is taking fewer or partial doses of an antibiotic, which may allow the resistant bacteria to not only survive, but thrive. Taking a full course of antibiotics is the only way to kill all the harmful bacteria. Additionally, if the first course does not work, subsequent treatments may be more costly, with possible serious side effects. What happens if I take more or less than prescribed? If you miss a dose, or take less because you feel better, the effectiveness may be reduced and can result in flare-ups of the condition—only if the prescription indicates ‘as needed’’ should you modify the dose. In most cases, experts advise returning to your regular medication schedule, but not to take two doses to make up for the dose you missed, as that can cause unintended side effects. Be careful not to take an extra over-the-counter pain relief pill (acetaminophen) for an intractable headache, as the narrow safety margin places many people “close to a toxic dose in the ordinary course of use,” according to the FDA. Why do some medications need to be taken with food and others on an empty stomach? Stomach upset, a common side effect, can be lessened by taking a drug with meals, as indicated. For some medicines, the opposite is true, and ingesting food beforehand can delay or decrease absorption of the drug. If ‘take on an empty stomach’ is directed, take the medication first thing in the morning and wait 30 minutes before eating to give the body time to absorb it. Why is the time of day important? Certain drugs are more effective or better tolerated with specific timing, according to new AARP research. Taking statins at bedtime is advised as cholesterol production in the liver is highest after midnight and lowest in the morning and early afternoon. Pain medications used for osteoarthritis are best swallowed four to six hours before the pain is anticipated to be at its worst. Asthma patients gain the most relief by taking oral medication in the mid-afternoon and inhaled steroids in late afternoon to prevent attacks most commonly experienced at night. Why can’t I have alcohol with prescription medication? Consumption of alcohol when taking a prescription medication may cause nausea, headaches or fainting. It can also exacerbate medication’s effects, causing you to feel sleepy or lightheaded, and making it harder to concentrate and perform certain tasks. Why can’t I drive or operate heavy machinery? Some drugs, like those for anti-anxiety, can dull alertness and slow reaction time, while stimulants can impair judgment. Common side effects of medication—drowsiness, dizziness, blurred vision, excitability—all point to the need to stay off the road. Why should certain foods be avoided? Some medications may not work as well when taken with specific foods. For example, grapefruit contains a compound that affects the way a number of medications are metabolized by the liver and should be avoided or limited as indicated. When taking the frequently prescribed blood thinner warfarin (Coumadin), doctors recommend keeping your diet consistent, particularly with regard to your intake of leafy green vegetables which may impact blood levels. Can I take drugs after the expiration date? Discard outdated drugs, which may not have full potency, particularly ones in solution or that require refrigeration. Take particular note of medications such as insulin, oral nitroglycerin, biologicals, blood products and epinephrine. Medications with preservatives, such as eye drops, may be unsafe past expiration, as bacterial growth can occur. New technology can help, such as electronic pillboxes and smartphone apps, or simply use the tried and true pillbox.

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Prescriptions: Take Exactly as Directed

August 19, 2014

Prescription for Health: “Take Exactly as Directed” Look inside your medicine cabinet at your prescription bottles and ask: Have I read the label, stickered warnings and instructions? Have I discarded medications past their expiration dates? The Centers for Disease Control (CDC) reports that 80 percent of patients do not take their medications as prescribed. The prevalence of non-adherence to prescription …

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Prescriptions: Take Exactly as Directed

August 19, 2014

Prescription for Health: “Take Exactly as Directed” Look inside your medicine cabinet at your prescription bottles and ask: Have I read the label, stickered warnings and instructions? Have I discarded medications past their expiration dates? The Centers for Disease Control (CDC) reports that 80 percent of patients do not take their medications as prescribed. The prevalence of non-adherence to prescription …

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Salad – What Color is Yours?

January 27, 2011

What Color is your Salad? People will often say they order salads in restaurants when they are trying to lose weight. They believe eating a salad will decrease their calorie intake … but not all salads are created equal. If you are not careful, your salad could have as many calories as a burger! However, the right kind of salad can offer a weight loss advantage. It will provide a large plate of food with relatively few calories and will contribute to the feeling of being full. You can judge how healthy your salad is by looking at the color. The more color in the salad, the more vitamins, minerals, and antioxidants it should contain. Colorful salads have fewer calories and less fat, especially if the vegetables are primarily non-starchy such as lettuce and spinach, tomatoes, carrots, celery, cucumbers, broccoli, cauliflower, mushrooms, and a variety of colorful peppers. Many salad additions can provide a source of lean protein. Grilled chicken, fish, garbanzo beans or other dried peas or beans are examples of lean proteins that tend to slow digestion and help you feel satisfied longer. Dried beans and peas also provide fiber, which contributes to your feeling full. Adding high fat items like cheese and bacon bits may add color, but they increase the calories without any added health benefit. The biggest challenge when ordering a salad at a restaurant is avoiding high-fat, high-calorie ingredients. Mayonnaise based foods, like pasta salad, contribute a tremendous amount of fat and calories. Adding ½ cup of pasta salad adds 180 calories compared to ½ cup broccoli which adds 15 calories. Salad dressing can turn a healthy salad into a high calorie meal choice. For example, ranch dressing has 140 calories per two tablespoons, which is the size of a golf ball. Salad bar ladles usually contain twice that much (four tablespoons). Do you ever use more than 1 ladle-full? Healthy fats like nuts, olives, and avocados can be added in moderation, but be aware that these items are also high in calories. One last suggestion: If you eat out frequently, take time to use the nutrition facts posted on a restaurant’s website to evaluate menu items before you enter a restaurant. You may be surprised at the calorie range! As an example, Chili’s offers three popular salad choices…. Boneless Buffalo Chicken with ranch dressing has 1010 cal, 49g carb, 68g fat, 48g protein Caribbean Salad with Grilled Chicken and dressing has 610 cal, 64g carb, 25g fat, 35g protein Classic Sirloin Guiltless Grill with sides has 370 cals, 20g carb, 8g fat, 53g protein As you can see, the sirloin salad has about 1/3 the overall calories of the buffalo chicken salad, with less than half the amount of carbohydrates, a fraction of the fats and more protein – the best option by far! So remember, ordering a salad is a good choice to limit fat and calorie intake, but only if you choose your ingredients wisely.

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Salt Shake Down: Sodium Reduction is on the Table

November 20, 2017

Turkey sandwiches…soups…deli meats. Are these the building blocks of a healthy meal or stealthy contributors of excess sodium? Both, according to experts, but improved versions are in the works, thanks to June 2016 Food and Drug Administration (FDA) recommended guidelines and commitments from food manufacturers and restaurant operators to shake down the salt. Implicated in a litany of ills from …

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Seasonal Affective Disorder

January 27, 2010

Feeling SAD When It Is Dark And Gloomy? Do you feel moody or have trouble waking up when the days grow shorter and darker? Many people do—and the symptoms can range from mild unhappiness at the lack of sunshine to a clinical condition called “Seasonal Affective Disorder (SAD).” The National Institutes of Health estimates that more than 36 million Americans suffer from a seasonal depression that begins in the fall and may last until the daylight hours increase significantly. Some of the symptoms may include: Loss of energy Oversleeping (feeling like you want to pull the covers over your head) Appetite changes, especially a craving for foods high in carbohydrates – often associated with weight gain Loss of interest in activities you normally would enjoy Difficulty concentrating and processing information Irritability Anxiety Many experts blame a lack of light as the culprit. Exactly how the darker days cause depression is still in question… but the January 2008 issue of the Harvard Health Letter offered these theories: On many winter days our only exposure is to indoor lighting, which may be too weak to perk up some sufferers. Lack of light may put people out of sync with their biological clocks, so their internal timers want them in bed when they should be awake and active. Additionally, this lack of adequate bright light may disrupt brain chemicals such as serotonin and dopamine, which play a role in monitoring mood. Our brains also produce a hormone called melatonin during hours of darkness. It is involved with regulation of sleep, body temperature, and release of hormones. Some people produce too much melatonin during long dark winter months. This disrupts the internal body clock, leading to depressive symptoms. If the above symptoms describe how you feel at about the same time every year, there is no need to brush off that yearly feeling as simply a case of “winter blues” or a seasonal funk that you believe you have to “tough out” on your own. Feel free to call my office and we can talk about treatment options. These may include light therapy (phototherapy), medications, and/or psychotherapy. Addressing the problem now can help you keep your mood and motivation steady throughout the year.

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Shingles Vaccine

January 27, 2010

Shingles Vaccine You’ve probably had chickenpox. Perhaps your parents even exposed you to the virus as a small child, when you were likely to have a mild case and be done with it. However, the virus remains dormant in your body throughout your lifetime, and could reappear at any time as a painful disease called “shingles” (medical term herpes zoster). Shingles can be very unpleasant, starting as a skin rash and often erupting with blisters. Its symptoms usually last a week or ten days, sometimes longer, and may include severe pain, chills, fever, headaches, and an upset stomach. About a million Americans get shingles each year, and they all have had chickenpox or received the chickenpox vaccine. It is estimated that half the people who reach age 85 will get shingles at some point. As people age, they become more susceptible to the disease and it can be more severe. The good news is there is now a shingles vaccine. Approved by the FDA in 2006, the vaccine has been successful in helping prevent the disease. Some of your friends have probably already had the shingles shot, and you may be wondering if it is right for you. The Centers for Disease Control and Prevention (CDC) recommends it for people age 60 and older, with some exceptions. You should not get the vaccine if you have a weakened immune system or if you have ever had an allergic reaction to gelatin, neomycin, or any of the vaccine’s other ingredients. Other reasons to avoid the shot include a history of certain cancers or tuberculosis, or if you are undergoing radiation or chemotherapy. Studies show the vaccine prevents shingles in about half the people vaccinated. However, even when it doesn’t prevent the disease itself, it usually reduces the pain and severity of the disease, including permanent scarring and skin discoloration. Importantly, it helps inhibit a lingering and debilitating condition called “postherpetic neuralgia” that affects some 20 percent of shingles patients, can last months, and may even become chronic. The shingles vaccination involves a single injection of a live, weakened virus. Because it is a live vaccine, side effects might include headache as well as tenderness, redness, swelling, and pain at the injection site. If you develop a rash from the vaccine, it is possible to transmit the virus to a susceptible person, who may get chickenpox but not shingles. If you are age 60 or older, have had chickenpox, and don’t believe you have any health issues that would prevent you from being a candidate, I recommend that you consider the shingles vaccination. If you have any questions, please call my office and I will be happy to talk further with you. As mentioned earlier, even if you receive the injection and still get shingles, the vaccine could help you avoid more serious complications. Patients Inquire… Since shingles is a herpes virus, is it related to other herpes disorders, such as cold sores or genital herpes? The answer is “No.” The only connection is that each of these conditions is a form of herpes, defined as “a viral disease causing skin eruptions.”

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Skin Spots – What are they telling you?

July 27, 2012

What Your Skin Might Be Telling You Summer weather means a change in our clothing to more abbreviated attire that exposes our skin, giving us the opportunity to take a better look at ourselves. Sometimes we’re surprised at what we find. Age Spots: Referred to as “sun spots” or “liver spots,” (although they have nothing to do with the liver), these flat, brown, gray or black spots form from sun exposure over the years. They most often appear in people over age 40, on parts of the body most exposed to the sun, including the face, hands, arms, legs or back. Whatever you call these spots, they are generally harmless and do not require medical treatment. Recently, some new cosmetic products have been touted to fade their intensity, and the claims appear to have some validity for many consumers. Age spots can be minimized by using a good sunscreen or avoiding direct sun exposure. Seborrheic Keratosis: Middle-aged and older adults might notice the appearance of these small, rough little bumps. They are often flesh colored and can appear anywhere on the body. The American Academy of Dermatology describes these skin growths as having a “waxy, stuckon- the-skin look.” Although they may invoke concern, they are not cancerous or contagious. Such growths can be removed if they are unsightly or cause excessive irritation. Rosacea: This is a chronic, inflammatory skin condition that most commonly affects adults between ages 30 and 60. It causes redness in the face, particularly, and may produce small, red, pus-filled bumps. The Mayo Clinic warns that a number of factors can exacerbate the appearance of rosacea including temperature extremes and sunlight. Sun exposure makes rosacea worse by increasing blood flow to the surface of the skin, as does spicy food, caffeine and alcohol, among others. Topical creams and prescription antibiotics can reduce rosacea’s redness and skin-irritation. Medication-induced Sunburn: Exposure to the sun while taking certain medications may cause a rash to develop, which commonly looks like a sunburn. Drugs that may cause a photosensitive reaction include: diuretics, antibiotics, anti-inflammatory medications, high blood pressure and diabetes medications, and some cancer fighting drugs. Not everyone taking these types of medications will develop photosensitivity, but fair-skinned individuals should be especially careful. As with any new prescription, ask your pharmacist or physician about possible sun-drug interactions. Understandably, what people worry most about is developing skin cancer. Although only a physician can make a definitive diagnosis, there are visible warning signs that may appear with moles on your body. These are most easily remembered with the first five letters of the alphabet—ABCDE. Following is a list and description of these characteristics provided by the American Cancer Fund: Asymmetric: If you draw a line through the mole, the two halves will not match. Border: The borders tend to be uneven. The edges may be scalloped or notched. Color: Having a variety of colors is another warning signal. A number of different shades of brown, tan or black on one mole could appear. They may also appear red or blue. Diameter: Sometimes small when first detected, these moles can grow larger in diameter than the size of a pencil eraser. Evolving: Any change—in size, shape, color, elevation, or any new symptom such as bleeding, itching or crusting—should be brought to your physician’s attention. Proper skin care, sun protection, regular self-exams and being attuned to body changes year-round can proactively safeguard your skin…and your overall health.

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Sleep: A Prescription for Better Health

May 1, 2015

Eyes Wide Shut: Why Eight Hours of Sleep is a Prescription for Better Health In today’s time-pressed world, a full night’s sleep has become akin to a luxury, but beware: it is a vital necessity. Lack of sleep affects your health, from stress to heart disease to overall well-being. Even an occasional all-nighter impedes our ability to concentrate, analyze information, and significantly, to drive, making sleepiness at the wheel the cause of over 100,000 car accidents each year. Call it a by-product of our increasingly hectic lifestyle: we now sleep two hours less nightly than our ancestors, and in just the last decade, another 38 minutes has been shaved off. Despite the fact that at least seven to nine hours of sleep is recommended for the average individual under 65, and for over 65, an average seven to eight hours, 40 percent of adults report sleeping less than six hours nightly. Additionally, between 50 and 70 million adults suffer from some sort of sleep disorder, with one in three saying they had trouble falling or staying asleep, according to the National Sleep Foundation. To sleep, perchance to dream… To understand why these numbers concern the medical community, consider how critical sleep is to human functioning. Many essential physiological activities that aid digestion, cell and tissue repair and growth, muscle growth, protein synthesis and release of growth hormone occur mostly, or sometimes only, during sleep. Sleep also regulates the hormones epinephrine, dopamine and serotonin, which are closely linked to mood and behavior. The rejuvenating power of sleep is most evident during REM (rapid eye movement). This deepest, last, and most important phase accounts for 25 to 30 percent of the sleep cycle, when dreaming occurs. At this point, the learning region of the brain is stimulated, new neuronal connections are formed and proteins associated with aging and neural degeneration are eliminated. For example, one expert theory states the production of adenosine in brain cells remains high during wakefulness, but promotes the “drive to sleep.” Once the body has a chance to clear adenosine from the system during sleep, we wake feeling rested and more alert. What happens when the body is regularly deprived of life-sustaining sleep? It’s enough to keep you more awake at night, with research pointing to the potential for: more frequent colds; irritability; lower quality of life; elevated blood pressure which can increase the risk of kidney disease; decreased insulin sensitivity and glucose tolerance (diabetes); impaired pancreatic cell responsiveness; calcification of coronary arteries (heart disease and stroke); mood disorders (anxiety and depression); and obesity (lower levels of appetitecontrolling hormone, leptin, and higher levels of ghrelin, which tends to make people ravenous). The immune system is particularly affected, as production of proteins needed by the body to fight infections and inflammations decreases. Sleep easy Reassuringly, an extra 15 to 30 minutes of sleep each night can make a significant difference in overall health and quality of life. Sleep specialists offer these tips: Disconnect. Sixty percent of Americans bring electronic devices along for the night. “We can’t resist the stimulation,” says Sleepless in America director John Hoffman. “It’s exceeding anything that we were designed to experience…its keeping us up beyond what we’re designed for.” Turn off phones, tablets and TV one hour before sleep time. Avoid alcohol before bedtime. Trickier than caffeine, alcohol typically makes it easier to fall asleep but the sleep is of poorer quality. Most people will fall asleep sooner, but spend less time in REM sleep and consequently wake up feeling less refreshed. Adjust your bedroom environment by decreasing light, noise and temperature so that you are comfortable for the night. Avoid discussing emotional issues or exercising right before bed, both of which can cause the body to secrete the stress hormone cortisol, associated with alertness. Try mindful meditation. Focusing on breathing and remaining in the present moment was found to improve sleep quality in older adults with moderate sleep disturbance, according to JAMA Internal Medicine. Reset your body clock. Frequent travelers and seniors are at particular risk for sleeping problems, including advanced sleep phase syndrome, which causes earlier than normal sleepiness and too-early wake up the next morning. Using specialized light boxes before bed or taking melatonin, the “sleep hormone,” have proven effective in readjusting circadian rhythms. Still can’t get a good night’s sleep? Please call my office.

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Smoothies: Nutrition That Goes Down Easy

August 19, 2014

Nutrition that Goes Down Easy: Stir Up a Healthy Smoothie Freeze the fruit and boot up the blender—summer is the perfect time to develop a taste for smoothies. With the right ingredients, a day’s worth of vitamins and minerals can be packed into a remarkably healthy breakfast or working lunch. Smoothies can be found everywhere from juice bars to yogurt shops, but the best way to ensure nutritious value is to make them yourself. Be mindful of your choices…calories can add up despite healthy ingredients, and even if used as a meal substitute, smoothies containing liberal amounts of fruits and nuts can be more caloric than you may suppose. Check your totals on one of the many calorie tracking apps available online (www.myfitnesspal.com) to make certain you stay within your ideal amount. Ideally, all well-balanced smoothies should include the following: Fruit: Berries are a wonderful source of antioxidants. Try blueberries, strawberries, raspberries, and blackberries for variety. Including half a banana not only adds thick texture, but also generous amounts of potassium known for normalizing blood pressure and heart function. Kiwi is a powerful source of Vitamins C, E, A and fiber. Avocado makes a creamier smoothie while also adding healthy amounts of Vitamin E. Avoid high sugar fruits such as grapes, oranges and dates, and limit the pineapple. Vegetables: The founders of Simple Green Smoothies.com recommend a ratio of 40 percent greens to 60 percent fruit. Green your smoothie with a generous handful of nutritional powerhouses such as spinach, kale, chard or arugula. These dark leafy greens contain phytonutrients that support your immune system, heart-healthy omega-3 fatty acids, and virtually every ingredient found in a daily multivitamin. Liquid: Use between ½ to one cup of liquid. Healthy options may include coconut water, high in potassium and electrolytes, or calcium-rich, low-fat almond or soy milk. Go easy on the fruit juice because of the high sugar content and added calories. Ice can be added to your smoothie to pump up the volume. Proteins: Greek yogurt and low-fat cottage cheese are natural protein ingredients. Additionally, protein powders can be added to boost nutritional levels. Fiber: Add healthy crunch with nuts and seeds. Raw walnuts and seeds such as flaxseed, sunflower seeds, and chia seeds are loaded with fiber, protein and essential fatty acids. Try a spoonful of uncooked steel cut oatmeal or a teaspoon of nut butter, both containing plenty of fiber to keep you full. Spices: A healthy flavorful addition to the smoothie—try cinnamon, cumin, vanilla, ginger, or even cayenne pepper. For smoothest blending of the nuts and veggies, top-end commercial models make the process effortless, but less expensive models work too—look for one with an 800-watt or higher motor. Smoothies are incredibly versatile and are only limited by your imagination and willingness to experiment.

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Smoothies: Nutrition That Goes Down Easy

August 19, 2014

Nutrition that Goes Down Easy: Stir Up a Healthy Smoothie Freeze the fruit and boot up the blender—summer is the perfect time to develop a taste for smoothies. With the right ingredients, a day’s worth of vitamins and minerals can be packed into a remarkably healthy breakfast or working lunch. Smoothies can be found everywhere from juice bars to yogurt …

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Smoothies: Nutrition That Goes Down Easy

August 19, 2014

Nutrition that Goes Down Easy: Stir Up a Healthy Smoothie Freeze the fruit and boot up the blender—summer is the perfect time to develop a taste for smoothies. With the right ingredients, a day’s worth of vitamins and minerals can be packed into a remarkably healthy breakfast or working lunch. Smoothies can be found everywhere from juice bars to yogurt …

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Smoothies: Nutrition That Goes Down Easy

August 19, 2014

Nutrition that Goes Down Easy: Stir Up a Healthy Smoothie Freeze the fruit and boot up the blender—summer is the perfect time to develop a taste for smoothies. With the right ingredients, a day’s worth of vitamins and minerals can be packed into a remarkably healthy breakfast or working lunch. Smoothies can be found everywhere from juice bars to yogurt …

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Snoring – Some Sound Advice

January 27, 2012

Sound Advice on Snoring According to the National Sleep Foundation, about 90 million adults in the United States snore, which is almost 45% of all adults. Clearly, snoring is a phenomenon that cannot be ignored. It is difficult to imagine just what causes the variety of unusual and sometimes incredibly loud sounds that occur when a person snores. When we fall into a deep sleep, our muscles relax—including those in our upper airways such as the mouth, tongue and throat. This muscle relaxation can narrow or even obstruct the airway, creating a forceful airflow. This, in turn, causes tissue vibration—producing the sound of snoring. The narrower the obstruction, the louder the snore. There is a strong possibility that even if you did not snore as a younger adult, as your muscles increasingly relax during the aging process you likely will begin to snore. Occasional snoring is not a serious concern. However, habitual snoring could have health implications. Beyond the natural aging process, there are other factors that can cause snoring, including: Consuming alcohol in the evening or taking a muscle relaxant before bedtime. Nasal problems, such as a deviated septum or chronic nasal congestion. A deviated septum occurs when the thin wall separating our nostrils is crooked or off-center, causing reduced airflow through one of the two nasal passages. Other anatomical abnormalities. A low, thick soft palate, enlarged tonsils or adenoids, and a large uvula are all tissues that when too large can obstruct airways. Obesity. Fatty tissue around the jaw and throat can cause tissues to collapse into the throat, obstructing the airway. Sleep apnea. When this occurs, people actually stop breathing for intermittent, short periods. In many cases, snoring actually awakens the snorer, causing disruptive sleep patterns. This can result in a variety of complications in daily living. The most obvious is daytime sleepiness, which can have serious implications on mood, and how we function and concentrate. Relationships may also suffer if snoring is making it difficult for a partner to sleep. Sometimes a change as simple as sleeping on your stomach can help. Certainly, not drinking alcoholic beverages within a few hours before bedtime could also be a simple solution. Other more complex factors, such as the anatomy of your throat or nasal problems can be explored further with a visit to our office. One of the most serious causes for snoring is sleep apnea, a disorder affecting nearly half of people who snore. Breathing is interrupted while you slumber—in fact, you actually stop breathing sometimes for 10 seconds or more. Sleep apnea is distinguished by snoring followed by brief silence and then a loud intake of air. This can happen numerous times during the night. Sleep apnea can cause the percentage of oxygen in our body’s circulation to drop significantly, sometimes to dangerously low levels. As a result, our lungs work harder trying to compensate for an obstructed airway, and the heart must work harder to support the lungs’ efforts. Obstructive sleep apnea is the most common form, whereby the soft tissue in the back of the mouth relaxes to the extent that the airway is blocked. Central sleep apnea is caused by irregularities in the normal signals our brain sends out to control breathing. Many people may not realize they have sleep apnea unless it is observed by someone who watches them sleep. To definitively diagnose sleep apnea, patients undergo a sleep study conducted in a controlled setting in which they are observed overnight. Breathing, brain activity and heart rhythms are monitored. If diagnosed, sleep apnea can be addressed with a variety of treatments specific to a patient’s individual medical history. Treatment can vary from special pillows designed to prevent sleeping on one’s back or even devices worn to keep the airway open during sleep. In some cases a CPAP (Continuous Positive Airway Pressure) machine may be recommended. A CPAP machine blows pressurized air into a mask worn by the patient when sleeping. It is important to note that there is no general treatment—the protocol depends on an individual’s personal medical history. People who are chronic snorers are at an increased risk for hypertension, diabetes, heart failure and stroke. Also, researchers have found a strong link between loud snoring and heart disease. Although sporadic snoring may be a nuisance, keep in mind that if it is chronic, it could be an audible clue for an underlying health issue. For many diseases or disorders, we are not always as fortunate to have such an obvious symptom to remind us to seek medical advice.

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Soy – A Healthy Protein Alternative

June 27, 2012

Soy: A Healthy Protein Alternative Tofu, edamame and soy milk, to name a few, are food derivatives from the soybean. Long a food staple in Asian diets, soy has gained popularity in the United States as a plant-based protein alternative to animal protein. Proteins are essential for growing and repairing the skin, muscles and vital organs of the body. To assure the body functions in a healthy and efficient manner, it is important to consume a variety of protein sources daily, such as poultry, fish, beef, dairy products, nuts, grains and beans. Soy, like animal proteins, is a complete protein, meaning it contains almost all of the essential protein nutrients the body requires. The Centers for Disease Control and Prevention recommends that 10% to 35% of our daily calories should come from protein. This translates to approximately 46 grams of protein for female adults and 56 grams for male adults, allowing for age and weight variations. The Harvard School of Public Health notes that both plant and animal proteins have the same effects on our health. However, they caution that individuals need to be aware of other nutritional ingredients contained in various animal proteins. As an example, the School noted that a 6-ounce porterhouse steak provides 40 grams of complete protein. However, that same steak also contains 38 grams of fat (or about 60% of the recommended daily allowance for fat consumption). As our culture focuses increasingly on the problems associated with obesity and the positive results achieved by healthy eating, soy products continue to expand in the marketplace, offering an acceptable protein supplement. In contrast to the porterhouse steak, a cup of tofu contains the same 40 grams of protein and only 12 grams of fat. One cup of soy milk contains 11 grams of protein and 4 grams of fat, while whole cow’s milk contains 8 grams of protein and 8 grams of fat. A word of caution: phytoestrogens are plant hormones found in soy. These have shapes similar to that of human estrogen. Therefore, pregnant women are advised to check with their physician before substituting soy products in their diet. Soy products also contain the natural substance purine, which can worsen symptoms of gout. People with gout should not eat large amounts of soy products. As with any food, moderation is key. The American Heart Association’s Committee on Nutrition notes that soy foods can be healthy protein choices, particularly as an alternative to foods such as red meat. Soy is low in saturated fat, but contains plenty of vitamins and minerals, and, in some foods such as edamame, plenty of fiber.

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Statins – Offering a viable option for improving a cholesterol profile

August 27, 2010

Statins – A viable option for improving your cholesterol profile With heart disease the single leading cause of death in America and stroke the third leading cause, the use of statins offers many patients viable treatment and prevention options not previously available. Controlling your cholesterol level is an important factor in maintaining good health. Cholesterol contributes to heart disease, which can lead to strokes and heart attacks. The World Health Organization estimates that almost 20 percent of all strokes and over 50 percent of all heart attacks can be linked to high cholesterol. But despite the very best efforts at healthy eating and regular exercise, people with a genetic predisposition have bodies that make too much cholesterol no matter what they eat. Certainly, a healthy diet helps, but taking a statin turns down the body’s ability to make new cholesterol. Statins are a class of drugs prescribed to lower blood cholesterol levels. These drugs block the action of a chemical in the liver that is necessary for making cholesterol. Cholesterol is important for metabolizing fat soluble vitamins like A, D, and E, helping manufacture bile, which helps digest fats. It is also critical for building and maintaining cell membranes. Too much cholesterol in your blood can clog arteries, causing them to narrow or in the most severe cases, blocking them. This can lead to heart attacks and stroke. In some instances, statins can also help the body reabsorb the problematic plaque that has built up on the arteries, thereby preventing further blockage and reducing the chance of a heart attack. There are many different brands of cholesterol medication, but as yet there is no convincing evidence that any one medication is better than another. Some of the well known medications currently prescribed include Lipitor (atovastatin), Zocor (simivvastatin) and Mevacor (lovastatin). Generic versions, which are less costly, also are available for prescription and may be appropriate in certain situations. Are statins right for you? When prescribing a statin, physicians consider other risk factors including: family history of high cholesterol or heart disease; degree of activity in your lifestyle; blood pressure; age—55 or older for men, 60 or older for women; general health condition; diabetes; weight; smoking; and narrowing of the arteries in the neck, arms or legs. If it is determined that statins are a good option for you, a specific dose will be prescribed. Depending on the severity of your high cholesterol, the dose and brand can vary. Once you begin taking a statin, you may need to continue taking it indefinitely. Some people make significant lifestyle changes, lowering their cholesterol enough to go off statins if their doctor advises it. There can be side effects and risks that come with taking statins as with any prescription drug. Together we will weigh the risks along with the anticipated benefits from taking statins. Common side effects include muscle and joint pain, nausea, diarrhea and constipation. Some people can tolerate statins well, and even those who experience some of the side effects may see them go away over time as their bodies adjust to the medication. Please consult with our office or your pharmacist on whether or not statins may adversely interact with any of your other medications. It is wise to be aware that a more potentially severe side effect includes liver damage. Statins work by interfering with the production of cholesterol in your liver. As a result, statin use may cause an increase in liver enzymes. We strongly advise having a blood test several weeks after beginning this drug to check liver function, and then periodic blood tests to continue monitoring liver enzymes. If an increase in liver enzymes becomes severe, patients may need to discontinue statin use because this can result in permanent liver damage. Keep our office apprised of any unusual or persistent pain that you may experience if you start taking statins. Research continues into the impact of statins on our bodies. Some investigation has already shown other benefits beyond lowering cholesterol, including their anti-inflammatory abilities that stabilize the lining of the blood vessels. This could contribute to lower blood pressure and reduced risk of blood clots. Very importantly, statins apparently decrease the potential rupture of plaque on the blood vessel linings, which is one of the most common causes of stroke and heart attack. There is also early indication that statins may help prevent diseases not related to the heart, including reduced risk of arthritis and bone fractures, some forms of cancer, dementia and Alzheimer’s disease and kidney disease. Statins hold great potential for improving the health of people with chronic high cholesterol who are at risk for increased incidences of heart attack and stroke. If you would like to discuss whether this medication option is a good one for you, please call our office to make an appointment.

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Stay Strong, Flexible and Balanced with Exercise

May 13, 2014

Tipping Point: Stay Strong, Flexible and Balanced with Exercise Much of life is a balancing act…from learning to sit up as an infant through avoiding falls in the later years. Balance is the ability to distribute your weight in a way that enables you to remain upright and steady. This requires multiple systems in your body to be working in sync with your brain, including: the central nervous system (spinal cord), the vestibular system (inner ear), the visual system (eyes), as well as position-sensing nerves, muscles and bones. While balance is important at every stage of life, changes associated with aging such as weaker, more inflexible muscles, slower reflexes, worsening eyesight and fewer cells in the vestibular system can affect your balance. Inner ear disorders, Parkinson’s disease, stroke, neuropathy and dips in blood pressure can also impact balance. According to the Centers for Disease Control and Prevention, at least one out of every three people over 65 experiences a fall each year. The good news is that a wide variety of exercises, from weight training and aerobics to simple daily walks, can help you maintain and significantly improve balance as you age. A consistent regimen of training rehabilitates and strengthens muscles and improves stability and postural alignment. The benefits extend to a person’s emotional and psychological well-being. According to experts, “fear of falling” is ironically one of the biggest predictors of a fall, and faithful adherence to an exercise routine that includes balance-specific training replaces the fear with confidence. A program to improve balance does not need to be complicated. Begin slowly with regular walks, and try simple exercises such as balancing on one foot or following along with a guided routine on a DVD. More targeted balance training may be done at a fitness center or through the use of a personal trainer or physical therapist. Professionals can assist you in conditioning the core—the set of muscles, bones and joints that link the upper and lower body and enable you to bend, twist, rotate or stand in one spot without losing your balance. An effective core workout may include exercises such as squats, lunges, twists and ab crunches. Exercise experts also can introduce you to the use of specific equipment to challenge you while improving your balance, such as a BOSU (both sides utilized) balance trainer, a stability ball, or standing on a spongy, unstable surface. Pilates, yoga, and the ancient Chinese art of tai chi, are also excellent for improving balance and core strength. Tai chi combines meditation with slow, graceful movements and deep breathing and relaxation, helping people achieve an inner serenity. This approach benefits both mind and body, shown in multiple studies to: build up bones, stabilize joints, lower blood pressure and heart rate, bolster cardiovascular health and immunity, enhance quality of sleep, reduce stress and enhance mood. Practicing tai chi has been shown to reduce falls in seniors by up to 45 percent, and has proven effective in helping people with Parkinson’s disease achieve better balance. A fall can occur anywhere at any time at any age. Therefore, the importance of body balance in one’s daily life should not be minimized. The American College of Sports Medicine recommends a program that combines strength, balance, flexibility and endurance. Explore one of these options you believe may work for you, call my office…and get started!

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Stay Strong, Flexible and Balanced with Exercise

May 13, 2014

Tipping Point: Stay Strong, Flexible and Balanced with Exercise Much of life is a balancing act…from learning to sit up as an infant through avoiding falls in the later years. Balance is the ability to distribute your weight in a way that enables you to remain upright and steady. This requires multiple systems in your body to be working in …

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Stay Strong, Flexible and Balanced with Exercise

May 13, 2014

Tipping Point: Stay Strong, Flexible and Balanced with Exercise Much of life is a balancing act…from learning to sit up as an infant through avoiding falls in the later years. Balance is the ability to distribute your weight in a way that enables you to remain upright and steady. This requires multiple systems in your body to be working in …

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Stay Strong, Flexible and Balanced with Exercise

May 13, 2014

Tipping Point: Stay Strong, Flexible and Balanced with Exercise Much of life is a balancing act…from learning to sit up as an infant through avoiding falls in the later years. Balance is the ability to distribute your weight in a way that enables you to remain upright and steady. This requires multiple systems in your body to be working in …

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Stay Strong, Flexible and Balanced with Exercise

May 13, 2014

Tipping Point: Stay Strong, Flexible and Balanced with Exercise Much of life is a balancing act…from learning to sit up as an infant through avoiding falls in the later years. Balance is the ability to distribute your weight in a way that enables you to remain upright and steady. This requires multiple systems in your body to be working in …

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Step Up to the Plate: Nutritionists Weigh in on Healthy Eating

November 20, 2017

HealthWise_Winter2016_Hasson-2-300x281 - Step Up to the Plate: Nutritionists Weigh in on Healthy Eating

Picturing a healthy meal has never been more accessible, thanks to the ubiquity of visual aids such as MyPlate, successor to the well-known Food Pyramid of the ‘90s. A quick scan of the plate’s quadrants enables users to see at a glance proportions of vegetables, proteins and other foods recommended for a nutritionally balanced day of eating. Hailed as a …

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Stressed Out? A Guide to Signs, Symptoms

November 20, 2017

“I think that you will all agree that we are living in most interesting times. I never remember myself a time in which our history was so full, in which day by day brought us new objects of interest, and, let me say also, new objects for anxiety.” Was the above heard: 1. At a recent town hall meeting in …

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Stressed Out? A Guide to Signs, Symptoms

November 20, 2017

“I think that you will all agree that we are living in most interesting times. I never remember myself a time in which our history was so full, in which day by day brought us new objects of interest, and, let me say also, new objects for anxiety.” Was the above heard: 1. At a recent town hall meeting in …

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Stroke Awareness and Prevention

April 27, 2012

Saving Lives…Stroke Awareness and Prevention Nearly 800,000 people in the United States have a stroke each year. Stroke is the fourth leading cause of death and the nation’s leading cause of disability. While the majority of individuals who have a stroke are over the age of 65, surprisingly nearly 25% are younger. Reducing risk factors and being aware of symptoms can be an important line of defense for prevention. A stroke is caused by severe restriction or loss of blood flow to the brain, depriving the brain of oxygen. In a seemingly “short” time period (as little as four to five minutes), oxygen deprivation can result in memory loss, difficulty talking or swallowing, muscle loss, paralysis or even death. There are two major types of strokes: Ischemic stroke accounts for approximately 87% of cases and is caused when a blood vessel supplying blood to the brain is blocked by a blood clot. The underlying cause of the clot can be from plaque build-up in the arteries or from an embolism. For patients who have experienced even one episode of atrial fibrillation, the risk for an embolism is greatly increased. For patients with high cholesterol, risk increases as plaque forms on the walls of the arteries. Blood clots lead to two types of blockages: The clot breaks off from a blood vessel in another part of the body (often the heart), travels to the brain causing a blockage, which is called an embolic stroke or embolism. The blood clot forms in an already narrowed artery, which is called a thrombotic stroke. Hemorrhagic stroke accounts for approximately 13% of cases and is the result of a weakened blood vessel in the brain that bursts, causing blood to leak into the brain. As the blood accumulates, it puts pressure on the brain tissue. Two types of weakened blood vessels cause hemorrhagic stroke: An aneurysmis a swelling of a weakened area of a blood vessel. If not treated, it may continue to weaken until it ruptures and bleeds into the brain. An arteriovenous malformation (AVM) is a cluster of abnormally formed blood vessels, which can rupture and cause bleeding into the brain. These occur in less than 1% of the general population. In many cases, there are warning signs. A transient ischemic attack (TIA) is sometimes called a “ministroke” or “warning stroke.” A TIA is a brief episode of symptoms lasting less than five minutes. TIA is caused by a clot; however, rather than a prolonged lack of blood supply, a TIA is temporary. After the clot dislodges and moves on, blood flow is restored and there is little to no permanent brain damage. A third of those who experience TIA will eventually have a stroke, usually within a year if symptoms are ignored or left untreated. TIA is an important warning signal to seek prompt medical attention. TIA and stroke warning signs include: Sudden numbness or weakness of the face, arm or leg, especially on one side of the body Sudden confusion, trouble speaking or understanding Sudden difficulty seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden, severe headache with no known cause Sudden buzzing, pulsing or vibrating in your head A stroke is a major medical emergency. Swift medical treatment is critical for survival and recovery. If you or someone you know experiences these symptoms, call 911 immediately. Do not drive yourself to the hospital and, importantly, note the time of the onset of symptoms. According to the American Stroke Association, “Time lost is brain lost.” Genetics, age, race and gender play a role in the risk for stroke. Risk is higher if a parent, grandparent, sister or brother had a stroke. Chances almost double for each decade of life beyond age 55. African Americans have a higher risk than Caucasians. Stroke is more common in men than women, although women are more likely to die from stroke. Some risk factors for stroke can be altered, treated or controlled. For patients with a family history of brain aneurysm, a CT angiogram may be considered. Although high blood pressure is one of the leading causes for stroke, it is the most controllable risk factor. Cigarette smoking, obesity, heavy alcohol consumption and inactivity are lifestyle patterns that, when addressed and modified, reduce risk. Health conditions such as heart disease, atrial fibrillation, diabetes, sickle cell anemia and peripheral artery disease also increase risk. Fewer Americans die from stroke or stroke-related complications than just 20 years ago, largely due to increased public awareness, our ability to control some of the major risk factors and improved medical treatment. An educated understanding of the risk factors and warning signs is having a positive impact on preventing and treating this disease.

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Superfoods Boost your Health

June 27, 2011

Superfoods Boost your Health Hardly a week goes by without a new study touting the health benefits of some food or beverage. Recently the word “superfood” has emerged as a label for an assortment of foods that help boost our health. What are some of these foods and why are they so super? Most superfoods are in the fresh fruit, vegetable, fish and grain families. These foods go above and beyond basic nutritional benefits and each contains several nutrients. The Mayo Clinic categorizes superfoods as those that meet three or more of the following criteria: Excellent source of fiber, vitamins, minerals and other nutrients. High in plant nutrients (phytonutrients) and antioxidant compounds, such as vitamins A and E and beta carotene. Antioxidants protect cells from damage caused by unstable molecules called “free radicals,” which have been linked to cancer, cardiovascular disease and Alzheimer’s disease. Low in calorie density: bigger portions with fewer calories. Readily available to consumers. Below are some common superfoods and their nutritional benefits: Quinoa (pronounced keen-wa) is the new health rage, but is actually an ancient grain. Cooked quinoa has a fluffy, slightly crunchy texture and is a tasty, gluten-free substitute for rice or pasta. Quinoa is a complete protein, containing all nine essential amino acids needed for building muscles. It also is a good source of the antioxidants manganese and copper, as well as magnesium, which can relax muscles and blood vessels. Sweet Potatoes are rich in fiber and high in the antioxidant beta carotene, which is converted to vitamin A in the body. Vitamin A may assist in slowing the aging process. Sweet potatoes are a good source of fiber, vitamin C (for growth and repair of tissues), vitamin B-6 (keeps skin moisturized and helps regulate metabolism) and potassium. They are fat-free, filling and low calorie. Fatty Cold-Water Fish, such as wild salmon, contain monounsaturated fats, omega-3 fatty acids and protein. Monounsaturated fats are good fats that help lower cholesterol, reduce heart disease and stroke, and minimize illnesses linked to inflammation, such as lupus and arthritis. Blueberries are an excellent source of vitamin C, essential to the formation of collagen, which connects and supports our body’s tissues, including skin, bone, tendons and cartilage. Blueberries are high in dietary fiber, which promotes digestive health and are an excellent source of manganese for bone development. Almonds provide phytonutrients and are high in monounsaturated fat, which can help lower cholesterol. Bursting with nutrients, almonds contain fiber, riboflavin, magnesium, iron and calcium. One serving (about 23 almonds) also provides 15% of the Recommended Dietary Allowance (RDA) of vitamin E, a powerful antioxidant that helps keep blood vessels clear of fatty plaques. Other superfoods include apples, beans, broccoli, pumpkin, spinach, walnuts and yogurt. These foods are super easy to incorporate into many meals: try yogurt sprinkled with almonds for breakfast or a super simple dinner of grilled salmon, baked sweet potato and broccoli. Superfoods will give your diet a healthy boost!

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Sweet Surrender: Is Sugar Off the Table for Healthy Eaters?

November 20, 2017

As we become more aware of what comprises healthy eating, sugar is increasingly viewed with a wary eye. Evidence is mounting that a sugar-filled diet – and the resulting weight gain – can lead to increased cholesterol, blood pressure and inflammation, and to a higher risk of obesity and obesity-related conditions such as diabetes, pre-diabetes, cancer and cardiovascular disease (CVD). …

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Sweet Surrender: Is Sugar Off the Table for Healthy Eaters?

November 20, 2017

As we become more aware of what comprises healthy eating, sugar is increasingly viewed with a wary eye. Evidence is mounting that a sugar-filled diet – and the resulting weight gain – can lead to increased cholesterol, blood pressure and inflammation, and to a higher risk of obesity and obesity-related conditions such as diabetes, pre-diabetes, cancer and cardiovascular disease (CVD). …

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The Enemy Within: Autoimmune Disease is on the Rise

January 16, 2018

autoimmune-disease-1000x1000-300x300 - The Enemy Within: Autoimmune Disease is on the Rise

A condition that is thought to have tripled in prevalence over the last 50 years, impacting over 23 million people, could justifiably be seen as an epidemic, or at least, a growing health concern. Autoimmune diseases, though, are not often thought of in that way because they manifest as 80+ different illnesses that nevertheless share the same root cause: a …

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The Healthy Aging Brain: Making Strides by Taking Strides

November 20, 2017

“Walking is man’s best medicine.” Hippocrates Put away the handheld brain games and turn your focus from lifelong learning to lifelong walking. The road to sustaining brain health is an active one and taking that first step, followed by thousands more on a daily basis, can make an enormous difference in quality of life in your later years. Arthur Kramer, PhD, director of the Beckman Institute …

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The Healthy Aging Brain…a Continuing Series

November 20, 2017

HealthWise-Fall-2015-Hasson-FINAL-300x192 - The Healthy Aging Brain...a Continuing Series

While exercise has an undisputed key role in maintaining brain health throughout our lives, promising new research points to a number of other factors that can spell the difference between thriving or just surviving the senior years. We checked in with Eric Terman, MD, personal physician and Assistant Professor of Internal Medicine and Geriatrics at Northwestern University for an informed view of the …

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The Painful New Reality of Opioid Prescriptions

November 20, 2017

HealthWise_Summer2016_Hasson-FINAL-300x291 - The Painful New Reality of Opioid Prescriptions

Nothing erodes the quality of life faster than pain and unfortunately more than half of American adults report they live with it on a chronic, recurring basis. That makes it easy to understand why, when seemingly safe, effective opioid drugs became widely available in the 1990s, they were quickly embraced by physicians and patients. Considered one of the most promising …

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Thinking on Your Feet: The Latest on Warning Signs from Below

November 20, 2017

HealthWise-Fall-2015-Hasson-FINAL-1-292x300 - Thinking on Your Feet: The Latest on Warning Signs from Below

Every step you take is a physiological marvel, made possible by the 26 bones, 33 joints and over 100 ligaments of the foot working together to ensure maximum movement. The intricate sequence begins as your heel hits the ground, and ends with a push off the big toe at the same time the Achilles tendon lifts the heel, requiring a force that is about 50 …

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Unlocking the Genetic Code: Spotlighting Pharmacogenomics

November 20, 2017

This is the first in a series exploring some of the most promising advances inspired by the Human Genome project. From the burgeoning field of pharmacogenomics to consumer genetic testing such as 23 and Me, the time from discovery to application is progressing rapidly. We’ll look at some of the latest thinking and its impact on personalizing medicine in the …

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Vegetables: The Best Winter Veggies

February 13, 2015

Find Your Roots with Winter’s Best Veggies While they may not have the crisp appeal of sugar snap peas or the sleek appearance of a summer tomato, winter’s bounty of root vegetables and greens brings some of the year’s most nutrient-rich dishes to the table. Serve up as chips or gratins, roasted or braised, mashed or raw, in soups or salads… see our recommendations for a taste of the season below. If you like kale, try collard greens, a super-green that can be thinly sliced and used in salads, or braised with mushrooms for satisfying flavor without meat. Anti-inflammatory, antioxidant (cancer preventive) and cholesterol-lowing nutrients are on the long list of benefits. Looking for low-carb substitutes for mashed or fried potatoes? Pureed cauliflower makes a delightful stand-in for mashed potatoes, especially when blended with Greek yogurt. Less common are Romanesco, an excellent source of vitamins C and K, fiber and carotenoids; Kohlrabi, with edible roots, leaves and stems packed with potassium and Vitamin C; and Celeriac, also known as root-celery, containing antioxidants, Vitamin K and phosphorus. For a healthy alternative to French fries, consider Jerusalem artichokes, or sunchokes, with a mellow taste and flaky texture, and plenty of energy-boosting iron and cholesterol-lowering soluble fiber. Slice matchstick-thin, mix in a sprinkle of vegetable oil, rosemary, cayenne, salt and pepper and bake for 15 minutes. Or enjoy a baked sweet potato, skin and all, for a winter treat that’s high in Vitamin A and fiber, with a minimum of calories. Beets, high in folic acids, offer crunch, color and taste. Sautee with garlic and some olive oil or use in soups for a nutritional boost. Change up onions with leeks, which have a milder, sweeter flavor, and compounds such as allicin that fight free radicals in your body and flavonols that may help fight cancer and lower the risk of heart disease. Carrots are always a sturdy choice, rich in beta carotene, a compound that may reduce heart disease and certain types of cancer (although supplements are not recommended, especially for smokers), and Vitamin A, which bolsters vision and bone growth. Parsnips offer a change of pace, with a sweet flavor, double the fiber of carrots, potassium and folate for cardiovascular benefits, and almost 40 percent of the daily requirement of Vitamin K, a nutrient associated with bone health. Winter squash, in a variety of shapes, colors and flavors, are rich in Vitamins C and A, and can be boiled, baked, roasted, simmered, steamed, microwaved or sautéed. For a low-calorie alternative to pasta, try spaghetti squash which yields long yellow strands when cooked. Sweet potato fans will enjoy butternut squash, with a similar sweet nuttiness and an even silkier texture. Broccoli contains calcium, folate, iron, protein, Vitamins A and C and fiber, and is versatile enough to steam, roast, stir fry, puree for soups or eat raw. Give winter salads a spin with a bowl of curly endive, radicchio, beets, fennel, kohlrabi and turnip greens. Roast or boil until tender and dress while still warm to allow the flavors to be completely absorbed. There are many more choices in the produce aisle…go browse your local grocery store and try something new this winter!

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Vitamin D…How Much Do We Really Need?

February 13, 2015

How Much Vitamin D Do We Really Need? In the multi-lettered world of vitamins and minerals, why did Vitamin D move to the top of the list…and should it be there? Following is a look at the paradox of the “sunshine vitamin,” critical to the body’s healthy function in numerous ways, but not important enough to warrant regular screenings, according to the latest national recommendations. The undisputed connection between Vitamin D, the sun and bone strength was established early in the 20th century, when doctors discovered that sunlight triggers the production of Vitamin D and helped cure rickets in children. Essential for strong bones, Vitamin D helps the body absorb calcium. Unlike other vitamins, however, it is naturally present in very few foods (fish like salmon and mackerel, eggs, mushrooms and commercially fortified milk). Dr. John Cannell, who founded the Vitamin D Council to better advocate for its use, cautions: “It’s nearly impossible to get what you need from food.” For many Americans, lack of sunshine except during the short summer season poses a concern because exposure to the sun is necessary to turn a chemical in the skin into Vitamin D. Even in sunny climates, people who spend most of their day indoors or faithfully apply sunscreen are at risk of Vitamin D deficiency, according to research that emerged in the 2000s. Low levels of the vitamin were increasingly linked to a litany of the world’s ills—cancer, heart disease, diabetes, arthritis, even depression. By 2012, researchers had discovered that Vitamin D receptors were found not only in the intestines, but in many other organs. “We know that basically every cell in your body has a vitamin D receptor; it has been found in the brain, skeletal muscle, colon, breast, prostate, and the list goes on,” Dr. Michael F. Holick, a prominent expert at Boston University Medical Center, told Endocrine News. Additional research bolstered the importance of Vitamin D, such as a recent British Medical Journal study that tracked more than 95,000 participants for nearly 40 years to find that genes associated with permanent low levels of vitamin D raised the risk of early death by up to 40 percent. However, the study’s author cautioned that the relationship was not proven to be causal and therefore, no recommendations for supplements can be made. The chicken-egg conundrum is explained by Dr. JoAnn Manson, professor of medicine at Harvard Medical School: “We’re at a crossroads because we really don’t know if there’s a cause and effect relationship between vitamin D status and outcomes such as heart disease and cancer.” Obesity and lack of exercise contribute to higher rates of cancer and heart disease, so those factors could explain the illnesses, rather than a low vitamin D level, she said. In fact, despite the mountains of research, the U.S. Preventive Services Task Force (USPSTF) stated late in 2014 there is insufficient evidence to justify taking mega-doses of Vitamin D to prevent chronic diseases, and did not recommend regular testing of blood levels. All eyes are now on the national, 26,000-participant VITAL trial, which will conclusively report in 2017 the effects of Vitamin D or fish oil on reducing the risk of cancer, heart disease and stroke. For now, uncertainty continues, with no agreement on what is considered a Vitamin D deficiency, which can range between 20 and 30 ng/ml (nanograms per milliliter of blood), or on optimal daily dosage. The Institute of Medicine’s guidelines state 600 IU (International Units) for ages 14 to 70, and 800 IU for age 71 and above; the Endocrine Society recommends 1,500-2,000 IU per day, and the Vitamin D Council advises “safe, sensible sun exposure, and if that’s not possible, 5,000 IU a day.” Please call my office for recommendations on the right amount of Vitamin D for you.

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Wine and Spirits – Are There Any Benefits?

August 27, 2012

Straight Up Facts About Alcohol Does enjoying a glass of wine or beer fit into a healthy lifestyle? Does white wine have the same heart-healthy benefits as red wine? Do “clear” alcoholic beverages equate to fewer calories? Which drinks contain the least alcohol? Up-to-the-minute facts as we know them today are delineated here. Importantly, this information applies to one drink per day for women and up to two drinks per day for men, according to the U.S. Centers for Disease Control (CDC). Wine offers heart-healthy benefits. Both red and white wines contain antioxidants that may be beneficial to heart health. Antioxidants can protect our cells against free radicals, which are molecules produced in two ways: when the body breaks down food or by environmental factors (tobacco smoke, pollution). Free radicals damage the body’s cells and may play a role in chronic diseases such as cancer or heart disease. Red wine contains resveratrol, an antioxidant that may help keep your heart healthy. The Mayo Clinic cites research linking resveratrol to reduced risk of inflammation and blood clotting, factors contributing to heart disease. Resveratrol is found in the skin of grapes used in making red wine. While grape skins are not used to make white wine, the grapes themselves contain other antioxidants which are beneficial. Eating grapes or drinking grape juice offers much the same benefit. Standard servings of wine, beer and other “hard liquors” contain the same amount of alcohol. The CDC defines a “standard drink equivalent” as 0.6 ounces of pure alcohol. Generally, this amount is found in: 12 ounces of beer, 5 ounces of wine and 1.5 ounces (a “shot”) of 80-proof distilled spirits, such as vodka or whiskey. Clear liquor, like gin and vodka, contains fewer calories than some other drinks. Most clear liquors, including whisky and rum, contain about 100 calories per standard serving, slightly fewer calories as compared to those in a standard serving of beer or wine. These clear liquors, however, are often mixed with another beverage. Mixing regular tonic with gin, for example, adds approximately 83 more calories. Beer usually contains more calories than wine. On average, a glass of wine (red or white), contains 120 calories. A 12-ounce serving of beer averages around 140 calories. Craft or stout beers tend to have higher caloric content, while light beers generally have less. Calorie count is indicated on the label. It is interesting to note that beer also contains valuable antioxidants. Making decisions related to our health are best made with accurate information that takes into consideration solid facts.

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Yogurt Culture

January 27, 2014

The New Yogurt Culture Yogurt is recognized as a solid nutritional choice that delivers multiple benefits with each spoonful. It is made from pasteurized milk that has been fermented, and contains active cultures known as probiotics. Probiotics are live microbial food ingredients that, when ingested in sufficient quantities, provide notable health benefits. These living organisms have been recognized for centuries for their potential in fighting yeast infections, boosting the body’s immune system and possibly preventing certain types of cancer. Particularly important as we age, adding probiotics to the diet repopulates the intestinal track with beneficial bacteria that protect against infection-causing toxins. In addition, yogurt offers plentiful calcium, potassium, protein, zinc, vitamins B6 and B12. Greek yogurt adds even more to the full plate of benefits. In most Greek varieties, much of the liquid whey, lactose and sugar found in traditional yogurts is strained out, giving this yogurt a thicker, creamier texture while being lower in sugar, carbohydrates and sodium. Greek yogurt also contains twice the protein content of regular yogurt, helping to promote a feeling of fullness when eaten. A typical six-ounce serving provides 15 to 20 grams of protein, an amount equivalent to two to three ounces of lean meat. The richer taste makes it a satisfying substitute for more fattening ingredients such as cream cheese, mayonnaise, butter, sour cream or oil. The only caution: opt for low fat or fat free varieties, as full-fat Greek yogurt often contains up to 16 grams of saturated fat, almost all of the daily allowance based on a 2,000-calorie diet. How should consumers make smart choices when attempting to sift through the literally dozens of yogurts on the market today? First, be aware that not all yogurt contains the beneficial live and active cultures. Some brands are heat-treated to increase the shelf-life and decrease tartness, which kills off the good bacteria. For that reason, opt for those labeled with the “Live & Active Cultures” seal. Established by the National Yogurt Association, the seal guarantees specific minimum levels are present at time of manufacture – at least 100 million cultures per gram for regular yogurt, and at least 10 million for frozen. While the program is voluntary, and not monitored by the FDA, many manufacturers seek to earn the seal as proof that buyers will receive the full health attributes of their yogurt product. Additionally, aim for a brand that includes at least 15 percent of the daily calcium requirement. Beware of additions like hydrogenated oils and artificial sweeteners. Finally, keep the calories down by skipping toppings and avoid yogurts that list sugar as the first or second ingredient. Be sure and stock up on your healthy choices. A Harvard School of Public Health study that followed more than 120,000 people over the course of two decades showed that yogurt, among all foods, was most strongly correlated with weight loss. That’s why yogurt remains a superfood mainstay – an easy-to-swallow way to fight infection, ingest nutrients and control weight.

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