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Diet Soda And Your Risk For Heart Attack Or Stroke

It tastes sweet. It’s pleasurably fizzy. And free of calories. What’s more, the FDA says NutraSweet (aspartame) is safe. So what’s not to like about diet soft drinks?

A bunch. The ongoing debate about the healthiness of diet soft drinks reminds me of the old adage, “If something sounds to be true, it probably is.”

Artificially-sweetened “diet” drinks get touted as healthy alternatives to sugary drinks because they contain no calories or carbohydrates. On paper it seems plausible to think they are inert, no more dangerous than water. The Coca-Cola Company sublimely strengthens this assertion by putting a big red heart on Diet Coke cans.

But diet-cola news (Los Angeles Times) presented at the International Stroke Conference 2011 suggests otherwise. This widely-publicized observational study of 2,500 older patients (average age=69) from New York showed that drinking diet soda on a daily basis increased the risk of having a heart attack or stroke by 61 percent. The abstract — not a peer-reviewed study — stated that this association persisted after controlling for other pertinent variables.

Sure, this is only a look back at 559 patients who had a vascular event. The study asserts only an association, not that diet colas cause heart attacks and strokes. That’s a big difference.

That said, however, I don’t view these results as trivial either. This trial builds on the results of prior studies of diet drinks which strongly suggest that despite their lack of calories, diet drinks don’t prevent obesity. Read more »

*This blog post was originally published at Dr John M*

Stress In Life: Respond Differently And Live Longer?

“This job is killing me” is not a statement of jest. It is a desperate plea of outright sincerity.

Stress, anxiety, depression — all have been associated with an increased risk of cardiovascular disease and mortality. But can interventions to help people cope with stress positively affect longevity and decrease risk of dying? The results of a new study in the Archives of Internal Medicine would imply the answer is an encouraging “yes.”

Constructively dealing with stress is easier said than done, but it would seem logical that if we can reduce our psychological and social stressors we might live longer and delay the inevitable wear and tear on our vessels. This study proved that one such intervention, cognitive behavioral therapy (CBT) for patients who suffered a first heart attack, lowered the risk of fatal and nonfatal recurrent cardiovascular disease events by 41 percent over eight years. Nonfatal heart attacks were almost cut in half. Excitement may be dampened by the fact that all-cause mortality did not statistically differ between the intervention and control groups, but did trend towards an improvement in the eight years of follow up.

Definitely less suffering. Maybe less deaths.

The authors state that psychosocial stressors have been shown to account for an astounding 30 percent of the attributable risk of having a heart attack. Chronic stressors include low socioeconomic status, low social support, marital problems, and work distress. Emotional factors also correlated with cardiovascular disease include major depression, hostility, anger, and anxiety. Read more »

*This blog post was originally published at The Examining Room of Dr. Charles*

Prevention Magazine Pushes Non-Evidence-Based Heart Screening

Prev. mag pullout.jpgThe February issue of Prevention magazine has an article entitled “Surprising Faces of Heart Attack” profiling “three women (who) didn’t think they were at high risk. Their stories are proof that you could be in danger without even knowing it.” No, their stories are not proof of that.

The story is about three women in their 40s. The story varyingly states that the three should have had the following screening tests:

– Advanced cholesterol test, carotid intimal medial thickness test ( CIMT)
– Advanced cholesterol test and stress echocardiography
– Cardiac calcium scoring and CIMT

 There’s an accompanying piece: ”7 Tests You’re Not Having That Could Save Your Life.”

Harry Demonaco photo.jpgI asked one of our medical editors, Harold Demonaco, director of the Innovation Support Center at the Massachusetts General Hospital, to review the two pieces. As his day-job title suggests, he deals with review of the evidence for new and emerging healthcare technologies. He wrote: 

The section “7 Tests you are not having that could save your life” states: “If you have not had these cutting edge screenings, put this magazine down and call your doctor. Now.”

Wow. While much of the information is correct, it is the context that is disturbing. Suggesting that these tests are essential in everyone is a bit over the top. Some of the information provided for each test is basically correct. However in some cases the recommendations go well beyond national guidelines.

The major issue here is the tacit assumption that tests are infallible, without any downsides and are always a good thing. That is simply not the case. So who should get these tests? Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Snoring During Pregnancy: A Risk For Gestational Diabetes?

A recent medical study reported a fairly unique finding:  Pregnant women who snore frequently are at an increased risk for developing gestational diabetes.

The Associated Professional Sleep Societies (TAPSS) reported that 24 percent of habitual snorers had an official diagnosis of gestational diabetes as opposed to 17 percent of nonsnorers. As gestational diabetes affects 4 to 6 percent of all pregnant women, this study is significant according to Louise O’Brien, Ph.D. who is associated with the department of neurology at the University of Michigan in Ann Arbor.

Snoring is nothing new among women but it becomes more pronounced with the onset of menopause or weight gain. Approximately one-third of all women in the U.S. are obese and at risk for snoring and sleep apnea. Being overweight can cause bulky throat tissue which then physically blocks air flow.

Up until the publication of the University of Michigan study, the health risks associated with snoring included greater than ten seconds of interruptions of breathing, frequent waking from sleep, potential strain on the heart which then results in hypertension, increased risk of heart attacks, and stroke. Now the tide has changed. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Taking Chocolate To Heart

darkchocolate Chocolate: The Newest Heart Healthy FoodIt’s beginning to look like chocolate, especially dark chocolate, really and truly is a heart healthy snack, though only if it’s consumed in small quantities.

A delectable taste of this news came last spring, in the form of a study by German scientists which appeared in the European Heart Journal. It was a retrospective study of nearly 20,000 people, and it showed that folks in the highest quartile for chocolate consumption (meaning they consumed 7.5 grams of chocolate per day — the equivalent of 2 to 3 small squares of a Hershey bar), had lower blood pressure, a 27 percent lower risk of heart attack, and a 48 percent lower risk of stroke than those in the lowest quartile (about 1.7 grams per day).

Now, a new study in the journal Cardiovascular Pharmacology has lent credence to those findings by suggesting a mechanism through which chocolate reduces blood pressure. In the study, Ingrid Persson and colleagues at Linkoping University showed that dark chocolate inhibits the activity of the angiotensin-converting enzyme (ACE). This enzyme helps regulate fluids and salt metabolism in the body. It is the target of many well-known antihypertensive drugs including captopril, lisinopril and enalopril. Read more »

*This blog post was originally published at Pizaazz*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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