June 23rd, 2009 by Jerome Ecker, M.D. in Better Health Network, Health Tips
Tags: Cardiac Rehabilitation, Cardiology, Heart Attack, Physical Medicine And Rehabilitation, Physical Therapy
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Cardiac rehabilitation, or guided exercise under direction of a physical therapist, is a valuable yet underutilized therapy for patients suffering a heart attack. Importantly, in those patients with ongoing risk factors related to obesity and insulin resistance/diabetes, aggressive cardiac rehab was recently shown to be especially effective.
Specifically, two groups of patients were enrolled in high intesity (5-7 days weekly of 45-60 minutes exercise) versus standard (3 days weekly of 25-40 minutes exercise).
High intensity patients lost more than twice as much weight over 5 months as standard patients (18 pounds vs. 8 pounds and had significantly greater reductions in 2 major cardiac risk factors — waist circumference and insulin resistance. At 1 year, both groups had gained a couple of pounds over 5-month weights, but total body-fat percentages in the aggressive group remained significantly lower than initial readings. Other cardiac risk factors changed too – including decreased insulin resistance, increased HDL (good) cholesterol, and decreased measures of insulin, triglycerides, blood pressure, plasminogen activator inhibitor-1, and the ratio of total to HDL (good) cholesterol.
Overall then, patients who took advantage of their motivation after heart attack to aggressively address exercise goals reduced potential risk factors and set the tone for a healthier life. If you have been a heart attack sufferer, ask your doctor about cardiac rehab. If you are not a heart attack sufferer but have risks, ask your doctor about trying a program like this on your own.
Questions and comments welcome as always!
*This blog post was originally published at eDocAmerica*
June 17th, 2009 by admin in Better Health Network, Health Tips
Tags: Diet, Edamame, Food and Nutrition, Nutrition, Safety, Soy
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I have had several people recently ask me about whether eating foods from soy is harmful. Some have asked because they have a thyroid problem and heard that soy interferes with their synthroid, others are worried about breast cancer, and most recently I guess some negative press has been writing about men and soy. Let me try to set the record straight.
What is soy?
All soy foods come from soybeans. Soy has a high protein content as well as carbs, fiber, vitamins, minerals, and some healthy fats. Soy is an excellent source of plant-based protein because it is known as a “complete protein” meaning it contains all of the essential amino acids. Whole soy is best, meaning it has been minimally processed and you are getting the naturally occurring nutrients found in the soybean. Foods that contain whole soy are edamame, soynuts, and surprisingly a bar called SOYJOY. Tofu and soymilk are also great sources of soy.
Health Benefits/Dispelling Myths
Numerous health benefits of soy have been very well documented in literature. In addition, many myths about soy have been dismissed with research studies.
Heart health: Soy is cholesterol free, low in saturated fat, and contains healthy fats. Some evidence also shows that it helps to lower LDL, or “bad” cholesterol.
Breast cancer: A high soy intake during puberty has been shown to reduce breast cancer risk, but consuming it as an adult has not been linked to lowering risk. Some animal studies have connected soy isoflavones with breast cancer growth, but no data on humans has supported this. In fact, some studies show a favorable impact on breast cancer outcomes with soy. Check with your physician before taking a soy isoflavone supplement. The American Cancer Society suggests that up to 3 servings of soyfoods per day is safe for a breast cancer survivor.
Bone health: Soybeans and calcium-fortified soyfoods are good choices because of the soy isoflavones as well as calcium and Vitamin K which can help bone mineralization.
Menopause: Over 50 studies have examined whether soy can relieve hot flashes in menopause and the consensus is that it may for many women but it depends on hot many hot flashes you get and how much soy isoflavone is taken.
Reproduction: No human data shows that consuming soy causes abnormal testosterone or estrogen levels. Several studies found no affect on sperm or semen when consuming soy isoflavones.
Thyroid: A comprehensive review of literature concluded that soy does not adversely affect thyroid function. Researchers recommended that thyroid function be reassessed if there is a large increase or decrease in soy intake, but normal day-to-day variations are unlikely to affect normal thyroid function.
Good for the Planet
Soy is environmentally friendly. The amount of fossil fuel to process soybeans is estimated to be 6-20 times less than that used to produce meat.
Bottom line
Soy foods can be part of a healthy diet for men and women. Eating 2-3 servings per day of soy foods is safe and very healthy. Soy contains important protein, amino acids, fiber, calcium, potassium, zinc, iron, and folic acid.
For more information:
www.soyconnection.com
www.soyjoy.com
This post, Is Soy Safe?, was originally published on
Healthine.com by Brian Westphal.
June 15th, 2009 by Paul Auerbach, M.D. in Better Health Network, Health Tips, News
Tags: Beaches, Beachwater, E. Coli, Infectious Disease
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Summer has arrived and so many of us are headed for the beaches that line the coasts of the United States as well as those of our inland waters, such as lakes and rivers. There are plentiful healthcare concerns for beachgoers. These include sunburn, drowning, jellyfish stings, sprains, strains, and cuts and bruises. What perhaps doesn’t receive as much attention as it deserves is ocean water quality – specifically, whether or not the water is contaminated by environmental toxins and/or harmful bacteria.
Nearly a year ago, reports circulated in the press that indicated that at least 7% of beach water samples in the U.S. exceeded acceptable (from a health perspective) levels of bacteria. A writer for the New York Times reported, “The number of beach closings and health warnings issued to swimmers as a result of pollution fell in 2007 from a record level in 2006,” according to the Natural Resources Defense Council (NRDC). But the writer continued that the NRDC noted “that American beaches ‘continue to suffer from serious water pollution that puts swimmers at risk.'” He cited that the NRDC analyzed “data obtained from the Environmental Protection Agency on more than 3,500 beaches,” revealing “that beaches across the country closed because of pollution or issued pollution-related health advisories for a total of more than 22,000 days in 2007, down from more than 25,000 days in 2006.”
A reporter for the Los Angeles Times wrote that the NRDC found that “Los Angeles County is home to the dirtiest beaches in the state (California), with repeat offenders Avalon on Santa Catalina Island and Santa Monica among those with the highest levels of fecal bacteria in ocean water.” Overall, the NRDC found that, “Illinois has the most coastal beaches in the country with water samples exceeding acceptable levels of (potentially harmful) bacteria, such as E. coli.”
The NRDC posts an informative page on beach pollution. The major takeaway is that the beachgoer should be well aware of the current situation with regard to pollution or contamination of any body of water for which human entry is contemplated.
Here is the status of the federal Beach Protection Act of 2008, as reported by OpenCongress:
Read more »
This post, Contaminated Beachwater May Be Hazardous To Your Health, was originally published on
Healthine.com by Paul Auerbach, M.D..
June 13th, 2009 by RamonaBatesMD in Better Health Network, Health Tips
Tags: Cell Phone Elbow, Cubital Tunnel Syndrome, Nerve Injury, Neurology, Physical Medicine And Rehabilitation
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Last Tuesday, this tweet from @AllergyNotes caught my eye.
Call cubital tunnel syndrome a “cell phone elbow” and you make the front page of CNN.com: http://bit.ly/RaXrt and http://bit.ly/TTRfg
Cubital tunnel syndrome I know, but I had not heard it called “cell phone elbow.” The first link is to the Cleveland Clinic Journal of Medicine article (full reference below). It is an excellent article and well worth reading. The second link is to CNN news article picking up the “cell phone elbow” line.
Cubital tunnel syndrome is a nerve compression syndrome (like carpal tunnel syndrome). In the case of cubital tunnel syndrome, the nerve involved is the ulnar nerve and the location is at the elbow. From the article
… the ulnar nerve as it traverses the posterior elbow, wrapping around the medial condyle of the humerus. When people hold their elbow flexed for a prolonged period, such as when speaking on the phone or sleeping at night, the ulnar nerve is placed in tension; the nerve itself can elongate 4.5 to 8 mm with elbow flexion……..
As with other nerve compression syndromes, the clinical picture is representative of the nerves enervation. In the case of the ulnar nerve, this involves numbness or paresthesias in the small and ring fingers. There may also be numbness of the dorsal ulnar hand which will NOT be present if the ulnar nerve compression is in the Guyon’s canal at the wrist level (distal ulnar nerve compression). If the compression is chronic enough, the symptoms progress to hand fatigue and weakness. The small intrinsic muscles of the hand are important in hand strength needed to open jars. More from the article
Chronic and severe compression may lead to permanent motor deficits, including an inability to adduct the small finger (Wartenberg sign) and severe clawing of the ring and small fingers (a hand posture of metacarpophalangeal extension and flexion of the proximal and distal interphalangeal joints due to dysfunction of the ulnar-innervated intrinsic hand musculature). Patients may be unable to grasp things in a key-pinch grip, using a fingertip grip instead (Froment sign).
It may be an old joke (Patient: Doctor, it hurts when I do this. … Doctor: Well don’t do it.), but in the case of cubital tunnel syndrome it fits. Prevention is key. Prolonged extreme flexion of the elbow (elbows bent tighter than 90 degrees) is not kind to the ulnar nerve. Switch hands or use a head set or blue tooth.
REFERENCES
Q:What is cell phone elbow, and what should we tell our patients?; Cleveland Clinic Journal of Medicine May 2009 vol. 76 5 306-308 (doi: 10.3949/ccjm.76a.08090); Darowish, Michael MD, Lawton, Jeffrey N. MD, and Evans, Peter J MD, PhD
Cubital Tunnel Syndrome: eMedicine Article, Feb 9, 2007; James R Verheyden, MD and Andrew K Palmer, MD
*This blog post was originally published at Suture for a Living*
June 4th, 2009 by Jerome Ecker, M.D. in Better Health Network, Health Tips
Tags: ASA, Aspirin, Cardiology, Cardioprotection, Family Medicine, Internal Medicine, Neurology, Primary Care, Stroke Prevention
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Aspirin? – Yes, I should take that to prevent heart attack and stroke, right??
Well……perhaps. A new study (called a meta-analysis), the largest comparative trial of its kind, shows that being overzealous about aspirin use for prevention of initial heart attack and stroke may be unsubstantiated.
Specifically 95,000 subjects were evaluated, producing 1671 vascular events in the aspirin group and 1883 in the control group. Aspirin was associated with an absolute reduction of 0.06% heart-related events per year. Correspondingly, aspirin did not significantly reduce ischemic stroke risk, but researchers noted a borderline-significant increase in hemorrhagic stroke. Aspirin also increased the incidence of bleeding outside the brain. Overall, aspirin was not associated with a significant reduction in vascular death.
What does it mean? The advantages of aspirin in low risk patients are scant. As cardiovascular risk factors (like smoking, high cholesterol, high blood pressure, diabetes, family history of early stroke/heart attack) pile up, aspirin gains a bit more support, though there is a modest associated bleeding risk.
We will be following this data and it’s analysis further. In the meantime, it may be reasonable to discuss things with your doctor, or perhaps cut aspirin dosing to the appropriate lowest dose (81mg in most patients).
Want the original?
See Collins R et al. for the Antithrombotic Trialists’ (ATT) Collaboration. Aspirin in the primary and secondary prevention of vascular disease: Collaborative meta-analysis of individual participant data from randomised trials. Lancet 2009 May 30; 373:1849. We will post the appropriate links after publication to make it easier.
*This blog post was originally published at eDocAmerica*
