Sunday, February 27, 2011

Partially Hydrogenated is a Four Letter Word

Oils have been hydrogenated for decades by injecting hydrogen gas at high pressure, thus converting them into trans fats. Hydrogenated oil is far more stable and will not go bad (ie, rancid) quickly; therefore, it keeps foods fresher longer (have a longer shelf life) and feeling less greasy. Trans fat also has a higher melting point and is used more often for frying and pastries. Commercially baked goods such as doughnuts and french fries usually contain trans fats. Shortenings and some margarine's are also often high in trans fats. The good news is that major food chains have caught on: in a large order of McDonald's french fries, the trans fat dropped from 7 1/4 grams to zero and saturated fat went from 5½ grams to 3½ grams; and Gorton's Crunchy Golden Fish Sticks dropped from 3 grams of trans fat per serving to zero. I am not saying fries and fish sticks are healthy, they are now just less unhealthy.

How do you know whether food contains trans fat? Look for the words "partially hydrogenated" or shortening. Two common examples of partially hydrogenated products are Crisco and margarine. In some highly hydrogenated oils, trans fats can make up almost half of the total calories. The American Heart Association recommends that no more than 1 percent of your total daily calories come from trans fats. There is also evidence to suggest that trans fatty acids may accumulate in the body because the digestive system has difficulty figuring out what to do with them. Trans fats are particularly risky because they lead to plaque formation. As a result, a diet high in trans fats will result in weight gain, heart disease, increase risk of stroke and diabetes.

Trans fat has also been shown to have these harmful effects:
 Increases triglycerides.
 Decreases HDLs (good cholesterol)
 Increases LDLs (bad cholesterol)
 Causes more inflammation, damaging the lining of blood vessels (the main cause of
 strokes).

Wednesday, February 23, 2011

Restless Leg Syndrome

Restless legs syndrome (RLS) is a neurological disorder characterized by throbbing, pulling, aching or other unpleasant sensations in the legs and an uncontrollable urge to move them. Symptoms occur primarily at night and can increase in severity during the night. Moving the legs generally relieves the discomfort. The sensations range in severity from uncomfortable to irritating or painful. More than 80 percent of people with RLS also experience a more common condition known as periodic limb movement of sleep (PLMS). PLMS is characterized by involuntary leg twitching or jerking movements during sleep. There is no specific tests for restless leg syndrome. RLS is a chronic condition which can be debilitating if not managed properly.

Cause of RLS:
RLS is related to a dysfunction in the brain’s circuitry that uses the neurotransmitter dopamine, which is needed to produce smooth, purposeful muscle activity and movement. Disruption of these pathways frequently results in the involuntary movements. Alcohol and sleep deprivation often aggravate or trigger symptoms. Certain medications may aggravate symptoms including anti-nausea drugs, anti-psychotic drugs, antidepressants and some cold or allergy medications.

Symptoms:
Usually occur at night when you lie down or sit for long periods of time.
May be described as creeping, crawling, aching, pulling, searing or tingling.
Sometimes they also occur in the upper legs, feet, or arms.
You may feel an irresistible urge to walk or move your legs to relieve the discomfort.
Most patients have rhythmic leg movements during sleep hours.
Symptoms can make it difficult to travel or sit through classes or meetings.
Symptoms may also be worse during stress.

Diagnosis: (patients will generally have the following)
Symptoms that are worse at night and are absent in the morning;
A strong and often overwhelming need or urge to move the affected limbs.
Sensory symptoms that are triggered by rest, relaxation, or sleep. 
Symptoms are relieved with movement.

Treatment: (is aimed at reducing stress and helping the muscles relax):
Warm baths
Stretching exercises
Massage
Heating pad
Decreased use of caffeine, alcohol, and tobacco
Maintaining a regular sleep pattern

Medications for RLS:
Dopamine agonist: Ropinirole (Requip) and pramipexole (Mirapex), both Parkinson's medications, which are approved for the treatment of moderate to severe RLS.
Side effects are usually mild and may include nausea, lightheadedness and fatigue.
Opioids: Medications, such as codeine and oxycodone may help, but may be addicting.
Muscle relaxants and sleep medications may help you sleep better at night, but they will not eliminate the leg sensations, and  may cause daytime drowsiness. Commonly used sedatives for RLS include clonazepam (Klonopin), ramelteon (Rozerem), temazepam (Restoril), zaleplon (Sonata) and zolpidem (Ambien) and eszopiclone (Lunesta).
Medications for epilepsy such as gabapentin (Neurontin), may work for some.


Tuesday, February 22, 2011

Autism

Autism is defined as a range of complex neurological and developmental disorders, characterized by social impairments, communication difficulties, and restricted or repetitive behavior. These signs all begin before a child is three years old. Autism is sometimes called autism spectrum disorder (or classical ASD) which is the most severe form, while other conditions along the spectrum include a milder form known as Asperger's syndrome or pervasive developmental disorder (usually referred to as PDD). PPD is diagnosed when the full set of criteria for autism or Asperger's syndrome are not met. 

Although autism varies significantly in character and severity, it occurs in all ethnic and socioeconomic groups. Autism has a strong genetic basis, although the reasons are complex and unclear. The Center for Disease Control (CDC) report concluded that the prevalence of autism had risen to 1 in every 110 births in the United States and almost 1 in 70 boys, but only 1–2 per 1,000 people worldwide (???). Males are several times more likely to have autism than females. The number of people diagnosed with autism has increased dramatically since the 1980s. The question is whether the actual prevalence has increased or are we just more aware? Controversies surround other proposed environmental causes, such as pesticides, heavy metals, or childhood vaccines. The vaccine hypotheses (especially those with thiomersal; ie, mercury) has never been proven and studies done after the removal of thiomersal from vaccines have nevertheless shown autism rates continuing to rise. Despite a great concern for the risk of autism after vaccination, we chose to vaccinate our children with thiomersal free vaccines.

Autism affects information processing by altering how nerve cells connect and organize. Those with autism have social impairments and often lack the intuition that many people take for granted. Their unusual social development becomes apparent early in childhood. Autistic infants show less attention to stimuli such as smiling and respond infrequently. Toddlers make less eye contact and rarely express themselves. They also have difficulty making their needs understood. Three to five year-old autistic children are less likely to exhibit social understanding or respond to expressed emotions. They will often communicate non verbally and generally do not like to share.

Some children and adults with autism show unusual and often amazing talents such as an incredible memory or extraordinary mathematical abilities (think Rain Man) and are known as autistic savants. Many individuals with autism also show superior skills in perception and attention compared to the general population. Sensory abnormalities are found in over 90% of those with autism and are considered one of the core features. An estimated 75% of autistic individuals have poor muscle tone, poor motor skills, and exhibit toe walking.

Here are some classic signs to look for :
 Lack of or delay in speech
 Repetitive movements (hand-flapping, twirling of objects)
 Little or no eye contact
 Lack of interest in peer relationships (friends)
 Lack of spontaneous or make-believe play
 Persistent fixation on objects

About 75% of children with autism will be extremely selective in their diet. In other words, getting a child with autism to eat a somewhat healthy may be extremely difficult. Another controversial area concerning autism concerns gluten (wheat, rye, barley) and casein (milk) in the diet. However, a tightly controlled University of Rochester study found that eliminating gluten and casein from the diets of children with autism had no impact on their behavior, sleep or bowel patterns. That being said, one can find some fairly convincing testimony on how their child improved dramatically after removing gluten and casein from their diet. The most important variable in the development of autistic children is early recognition and treatment.

Monday, February 21, 2011

Ground Flax Seed

Flax seed (also known as common flax or linseed) is not a grain, but has a similar vitamin and mineral profile; however, the amount of fiber, antioxidants, and omega-3 fatty acids is far superior. Flax seed is high in phytochemicals and many antioxidants. Flax is also very low in carbohydrates and it's combination of healthy fat and high fiber content make it excellent for weight loss and maintenance. You’d be hard-pressed to find a food higher in fiber than flax. This is probably responsible for its cholesterol-lowering effects. Fiber in the diet also helps stabilize blood sugar, and is therefore extremely helpful in the management of diabetes. Since flax seed has such a high fiber content, start with a small amount in your diet and increase slowly to prevent cramping or a laxative effect. If you have irritable bowel syndrome, take extra precaution.

Flax seed is high in most of the B vitamins, magnesium, and manganese. It is perhaps our best source of lignans (phytoestrogens, antioxidents), which tend to balance out the female hormones. Omega-3 fatty acids have strong anti-inflammatory properties and inflammation may play an important part in causing chronic diseases such as heart disease, arthritis, diabetes, and probably some cancers. Having too little omega-3 intake especially in relation to Omega-6 fatty acid intake is well known to promote such diseases. The American diet is probably 20 or 30 to 1 in Omega 6 to Omega 3 (it should be 4 to 1).

Note: Flax seed needs to be ground to make the nutrients available and  flax seed oil alone contains neither the fiber nor the phytochemicals of flax seed meal.

Flax seeds come in two basic varieties: brown and yellow (or golden). Yellow flax called solin (or Linola) has a different oil profile and is lower in omega-3s than brown. Yellow flax also seems to taste better (more nutty) than brown. The oil in flax seed is highly unsaturated which means it is very prone to oxidation (rancidity) unless it is stored correctly (ie, cold and not ground). Refrigerated or frozen flax seed will stay safe to eat for at least a year. The ground meal, if kept cold, will keep fresh for a few months, and the oil must be protected by refrigeration in a dark container.  For this reason, many people choose to buy whole flax seed and grind it themselves (in a blender or coffee grinder). If you by the meal, then purchase it from a source where you’re sure there is rapid turnover. Ideally the meal should be refrigerated at the store and the bag should be opaque and vacuum-packed.

Tips for serving flax seed: (plenty of recipes are available)
 Drink plenty of water, otherwise constipation may result.
 Remember to start slowly if you aren’t used to a high-fiber diet.
 If you purchase the whole seeds, you need to grind them up to get the benefit.
 Flax can be used as an egg substitute in baked goods.
 About 3/4 cup of flax seed yields 1 cup of flax meal.
 Raw or toasted: Sprinkle over cottage cheese, ricotta, yogurt or breakfast cereal.
 Cooked: add to hot cereals, meatloaf, casseroles, meatballs.
 In baked goods: Add ground flax to any recipe which uses flour:


Flax Seed Nutrition (From Wikipedia)
Nutritional value per 100 g (3.5 oz)
Energy2,234 kJ (534 kcal)
Carbohydrates28.88 g
Sugars1.55 g
Dietary fiber27.3 g
Fat42.16 g
Protein18.29 g
Thiamine (Vit. B1)1.644 mg (126%)
Riboflavin (Vit. B2)0.161 mg (11%)
Niacin (Vit. B3)3.08 mg (21%)
Pantothenic acid (B5)0.985 mg (20%)
Vitamin B60.473 mg (36%)
Folate (Vit. B9)0 μg (0%)
Vitamin C0.6 mg (1%)
Calcium255 mg (26%)
Iron5.73 mg (46%)
Magnesium392 mg (106%)
Phosphorus642 mg (92%)
Potassium813 mg (17%)
Zinc4.34 mg (43%)

Saturday, February 19, 2011

Fibromyalgia

Fibromyalgia is a syndrome in which people experience long-term, whole body pain and tender points in joints, muscles and tendons. It is also accompanied by fatigue, headaches, depression, anxiety, sleep, memory and mood issues. Researchers believe that fibromyalgia causes pain by affecting the way your nerves process pain signals. Symptoms may begin after trauma, surgery, infection or significant stress; they may also gradually occur over time. Women (age 25-50), are much more likely to develop fibromyalgia (10-1) than are men. This disorder is also associated with headaches, temporomandibular joint (TMJ) disorders and irritable bowel syndrome. The cause of fibromyalgia is unknown. 
The exact locations of the pain are called tender points. The pain then spreads out from these areas. The pain is described as deep-aching, radiating, gnawing, shooting or burning and ranges from mild to severe. The joints are not affected, although the pain may feel like it is coming from the joints. People with fibromyalgia tend to wake up with body aches or stiffness. For many, pain improves during the day and increases again during the evening. Pain can increase with activity, cold or damp weather, anxiety or stress. People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain or other sleep disorders such as restless leg syndrome (RLS).

What causes the pain?
Current thinking centers around a theory called central sensitization. This theory states that people with fibromyalgia have a lower threshold for pain because of increased sensitivity in the brain. The pain associated with fibromyalgia often is described as a constant dull ache arising from muscles. To be considered fibromyalgia, the pain must occur on both sides of your body above and below your waist. Fibromyalgia is characterized by increased pain when mild but firm pressure is applied to the "tender points".

Common symptoms may include:
Irritable bowel syndrome
Memory difficulties 
Cloudy thinking
Numbness and tingling in hands and feet
Palpitations
Sad or depressed mood
Tension or migraine headaches
Chronic neck or back pain
Chronic fatigue syndrome
Depression
Hypothyroidism
Lyme disease
Sleep disorders

Tender point locations include:
Back of the head
Between shoulder blades
Top of shoulders
Front sides of neck
Upper chest
Outer elbows
Upper hips
Sides of hips
Inner knees

Diagnosis:
Widespread pain lasting at least three months with at least 11 positive tender points, out of a total possible of 18. No other underlying conditions are discovered that might be causing the pain. There is no lab test to confirm a diagnosis of fibromyalgia.

Coexisting conditions:
Fatigue
Anxiety
Depression
Headaches
Irritable bowel syndrome

Treatment:
Treatment should focus on relieving symptoms and helping patients learn how to cope with their symptoms. Patients usually start with physical therapy, exercise (start slow), and methods for reducing stress. Cognitive-behavioral therapy and support groups are also helpful. Eating a well-balanced diet and avoiding caffeine may help with sleep and  reduce the severity of the symptoms. Exercise helps to stretch tight, sore muscles.   Massage, acupressure, acupuncture, and relaxation techniques may also be helpful.

Cognitive therapy helps people learn to:
Deal with negative thoughts
Recognize what makes their symptoms worse
Seek out enjoyable activities
Set limits

The goal of using medication is to improve sleep and pain tolerance. Patients should receive drug treatments along with exercise, patient education, and behavioral therapies. Duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella) are medications that are approved specifically for treating fibromyalgia. However, anti-seizure drugs, antidepressants, muscle relaxants, sleeping aids and pain medications are also used to treat the condition.: 

Other helpful lifestyle changes:
Reduce stress
Get enough sleep
Exercise regularly
Pace yourself
Maintain a healthy lifestyle

Expectations (prognosis):
Fibromyalgia is a chronic problem. The symptoms sometimes improve; at other times, the symptoms may worsen and continue for months or years. The key is an approach including lifestyle changes, education and medication therapy (when necessary).

Friday, February 18, 2011

Daibetes

Diabetes mellitus is a metabolic disease in which a person has high blood sugar either because the body does not produce enough insulin and/or because the body does not respond to the insulin produced. About 24 million people in the United States have diabetes and over 6 million are undiagnosed. Because of the potential damage diabetes does to the body, people must take charge of their disease. This includes monitoring blood glucose levels, strict dietary management, physical activity and keeping weight under control. Medications will frequently be required for diabetes; insulin for type 1 DM and oral medications for type 2 DM.

Acanthosis nigricans, is the velvety dark skin changes around the neck, armpits, or groin area.  It is associated with obesity and/or type 2 diabetes. Children with this condition should be screened and monitored closely for the development of diabetes. Those with acanthosis nigricans should also watch their weight and diet carefully due to this risk factor.

Types of diabetes:
Type 1 diabetes:  Also known as insulin-dependant (IDDM) or juvenile diabetes; results from the body's failure to produce insulin and requires insulin. Type 1 diabetes is approximately 10% of diabetes cases in North America.  
Type 2 diabetes: Also known as adult-onset diabetes (AODM) results from insulin resistance or a decrease in insulin production; a condition in which cells fail to use insulin properly. Type 2 diabetes causes approximately 90% of diabetes mellitus cases in North America.   
Gestational diabetes: A condition in which pregnant women have an elevated blood glucose level during pregnancy and no previous history. Gestational diabetes (GDM) is a significant risk factor as 30%–50% of affected women develop type 2 diabetes later in life.

Early symptoms of diabetes: 
Increased thirst, dry mouth
Increased hunger
Frequent urination
Unexplained weight loss
Fatigue
Headaches

Late symptoms of diabetes:
Slow-healing sores or cuts
Frequent yeast infections
Weight gain
Numbness and tingling of the hands and feet
Decreased or blurred vision
Impotency
Loss of consciousness (severe)

Risk factors for diabetes: (from the NIH)
 obesity
 inactivity
 strong family history
 African American, Alaska Native, American Indian,
 Asian American,  Hispanic, Pacific Islander
 gestational diabetes
 having high blood pressure
 having HDL, or “good,” cholesterol below 35 mg/dL,
 or a triglyceride level above 250 mg/dL
 having polycystic ovary syndrome (PCOS)
 having an elevated fasting glucose (greater than 125)
 Acanthosis Nigricans
 having a history of cardiovascular disease

Medical treatment:
 Insulin: (for type 1 DM)
 Rapid-acting: Humalog,Novolog
 Short-acting: Humulin, Novolin
 Intermediate-acting: NPH, Lente
 Long-acting: Ultralente, Lantus
 Mixed: Humulin 70/30, Novolin 70/30, Novolog 70/30
 Using an insulin pump is an alternative to injections.

Oral medications: (for type 2 DM)
Sulfonylureas: Most commonly used, they stimulate the pancreas to produce more insulin. Examples include: tolbutamide (Orinase), chlorpropamide (Diabinese), tolzamide (Tolinase), gylburide,(Micronase, Diabeta), glipizide (Glucotrol), and glimepiride (Amaryl).
Biguanides: Work by inhibiting the production and release of glucose from your liver. Most commonly used is Metformin (Glucophage).
Thiazolidinediones: Works to increase the body's sensitivity to its own insulin. This includes pioglitazone (Actos) and rosiglitazone (Avandia).
Meglitinides: They stimulate the pancreas to produce more insulin. repaglinide Two examples are (Prandin) and nateglinide (Starlix).
DPP-IV Inhibitors: They stimulate the pancreas to produce more insulin .Examples include sitagliptin (Januvia), saxagliptin (Onglyza).
Alpha-glocosidase inhibitors: They work by inhibiting the absorption of carbohydrates. Examples are acarbose (Precose) and miglitol (Glyset).
GLP agonist: They are injectable and work by several methods. They slow glucose absorption from the gut, increase insulin secretion from the pancreas and decreases appetite. Examples are exenatide (Byetta) and liraglutide (Victoza).

A strict diet and exercise are critical for those with diabetes. Adult onset diabetes can often be managed without the need for medications if diet and weight are well controlled. If blood sugars are not controlled, many organs may be severly affected including the heart, kidneys and eyes.
     

Thursday, February 17, 2011

Grain Fed or Grass Fed?

Most people have heard the terms grain fed and grass fed, however they don't often know the difference between the two and the effect on your health. The most important factors include the added hormones, antibiotics and the ratio of essential fatty acids (the ones your body cannot make). Traditionally, most all livestock in the United States was grass fed, but  today what is commercially available is almost all feedlot (ie, corn fed) beef. Fifty years ago, steers were about 4 years old at processing, today, they are about 16 months. To bring a calf from birth to 1,000 pounds in a little more than a year requires enormous quantities of corn, supplements, antibiotics and  growth hormones. Grass fed beef not only is lower in overall and saturated fats, but it has the added advantage of providing more omega-3 fats. As a consequence, corn fed animals animals typically contains about 25 percent of the omega-3s as that from grass fed animals. In addition to being higher in healthy omega-3s, meat from pastured cattle is also up to four times higher in vitamin E. They are also generally free of antibiotics, supplements and hormones.

A healthy diet contains a balance of omega-3 and omega-6 fatty acids. Omega-3 fatty acids help reduce inflammation, and some omega-6 fatty acids tend to promote inflammation. The typical American diet tends to contain 20-25 times more omega-6 fatty acids than omega-3 fatty acids. The Mediterranean diet, on the other hand, has a much healthier balance between omega-3 and omega-6 fatty acids (around 3-1). This diet includes whole grains, fresh fruits and vegetables, fish, olive oil, garlic, as well as moderate wine consumption.  Many studies have shown that people who follow this diet are less likely to develop heart disease. Don't forget February is "Heart Health Month".

By contrast, sources of omega-6 fatty acids are numerous in modern diets. Omega-6 fatty acids are found in raw nuts, seeds, legumes, and in unsaturated vegetable oils including grape seed oil, primrose oil, sesame oil, and soybean oil. Refined vegetable oils, such as soy oil, are used in fast foods, most of the snack foods, cookies, crackers, and sweets in the American diet. Soybean oil alone is now so common in fast foods and processed foods that 20 percent of the calories in the American diet are estimated to come from this single source. The Mediterranean diet, on the other hand, has a healthier balance between omega-3 and omega-6 fatty acids. Many studies have shown that people who follow this diet are less likely to develop heart disease. The Mediterranean diet does not include much meat (which is high in omega-6 fatty acids) and emphasizes foods rich in omega-3 fatty acids, including whole grains, fresh fruits and vegetables, fish, olive oil, garlic, as well as moderate wine consumption.

This dietary imbalance between omega-3 and omega-6 fatty acids may explain the rise of such diseases as asthma, coronary heart disease, cancer, autoimmune and neurological diseases. The imbalance may also contribute to obesity, depression, hyperactivity and even a tendency toward violence. Studies have shown that adding omega 3s to prision foods reduced the amount of violence by 30%!

The FDA said antibiotics in meat pose a "serious public health threat" because the drugs create antibiotic-resistant bacteria that can infect humans who eat it.When beef cattle enter feedlots, hormone pellets are implanted behind the ear, a process that is also repeated at the midpoint of their fattening period. These hormones include natural estrogen, progesterone and testosterone, and synthetic zeranol, trenbolone, and melengesterol. The biggest concern is that girls may enter puberty and begin their menstration at a much younger age. 

Wednesday, February 16, 2011

February is Heart Health Month

Coronary artery disease is the leading cause of death in the United States and a major cause of disability. In 2010, an estimated 800,000 Americans had a new heart attack, and nearly 500,000 had a recurrent one. About every 30 seconds, an American will have a coronary event, and about one every minute will die from it. The chance of developing coronary heart disease can be significantly reduced by taking steps to prevent and control factors (ie, high blood pressure) that put people at higher risk. Additionally, knowing the signs and symptoms of heart disease are crucial to the prevention or treatment of a heart attack. The warning signs are often overlooked, ignored or misunderstood.

The most common symptom of coronary artery disease is angina, or chest pain. Angina can be described as a discomfort, heaviness, pressure, aching, burning, fullness, squeezing, or painful feeling in your chest. It can often be mistaken for indigestion or heartburn. Pain, tightness or discomfort may also be felt in the shoulders, arms (especially left) and neck.


Other symptoms of heart disease include:
 Trouble breathing (shortness of breath)
 Fatigue (especially in women)
 Sweating
 Nausea
 Rapid heartbeat (palpitations)


Preventable risk factors for heart disease:
 High Blood Pressure (untreated)
 Smoking (and second hand smoke)
 Obesity
 High Cholesterol (untreated)
 Untreated Diabetes
 Sedentary Lifestyle

A heart healthy diet:
Lean meats and poultry
Low-fat dairy products
High fiber (cholesterol-lowering)
Garlic (cholesterol-lowering) 
Avoid partially hydrogenated vegetable oils (saturated fats) 
Avoid high cholesterol foods (consume less than 300 mg daily)
Avoid foods with added sugar (and no "sweet tea") 
Low sodium (important)
Soy protein
Drink alcohol in moderation
Watch portion sizes
Green tea (antioxident, lowers inflammation, cholesterol) 



 

Monday, February 14, 2011

"Anti-cancer" Diet

The best diet for decreasing cancer risk is a predominantly plant-based diet that includes plenty of vegetables, fruits, and whole grains. Research shows that vegetarians are about fifty percent less likely to develop cancer than those who eat meat (ie, high 'saturated' fat diets). Also, depending on how it is prepared (ie, grilling), meat may develop carcinogenic compounds. High-fat foods should make up no more than 30 percent of your diet. Fats may also lead to more constipation, thus increasing the risk of colon cancer. Fiber plays a key role in keeping your digestive system clean and healthy as well as lowering cholesterol levels. You should consume about 30 grams of fiber per day which is half of the normal American diet. It helps keep food moving through your GI tract and hopefully eliminating any cancer-causing compounds.

Tips to add more plant-based foods to your diet:
Add fruit, seeds or nuts to a whole grain breakfast cereal or oatmeal. Eat a salad filled with beans, peas or other veggies. Use whole grain bread for sandwiches. Have a side of veggies or a piece of fruit instead of chips or fries. Try fresh fruit or vegetables for a snack. Raw veggies are great with a low-fat dip such as hummus. Keep a trail mix made with nuts, seeds on hand. Add fresh or frozen veggies to pasta  or rice dishes. Try baked potatoes with broccoli sauteed veggies or salsa instead of bacon and cheese. Avoid creamy pasta sauces; try a tomato sauce made with healthy olive oil. Consider a fruit or dark chocolate for dessert.

Tips to add fiber to your diet:
Use brown rice. Substitute a whole-grain bread for white bread. Try bran muffins instead of croissants. Have popcorn instead of chips. Eat fresh fruit and vegetables daily.
Examples of high fiber foods include: (from Family Doctor)
 Beans 
  navy (1/2 cup = 9.5 grams)
  kidney (1/2 cup = 8.2 grams)
  pinto (1/2 cup = 7.7 grams)
  black (1/2 cup = 7.5)
  lima (1/2 = 6.6 grams),
  white (1/2 cup = 6.3 grams)
  great northern (1/2 cup = 6.2 grams)
 Artichokes (1 artichoke = 6.5 grams)
 Sweet potatoes (1 medium sweet potato = 4.8 grams)
 Pears (I small pear = 4.4 grams)
 Green peas (1/2 cup = 4.4 grams)
 Berries such as raspberries or blackberries (1/2 cup = 4.0 grams)
 Prunes (1/2 cup = 3.8 grams)
 Figs and dates (1/4 cup = 3.6 grams)
 Spinach (1/2 cup = 3.5 grams)
 Apples (1 medium apple = 3.3 grams)
 Oranges (I medium orange = 3.1 grams)
 Bran muffins
 Oatmeal
 Bran or multiple-grain cereals, cooked or dry
 Brown rice
 Popcorn
 100% whole-wheat bread

Tips to reduce the bad fats (high saturated) :
Reduce red meats, whole milk and butter. Cook with olive oil or canola oil. Avoid anything with hydrogenated or partially hydrogenated oils (check the labels) which are usually found in margarines, shortenings, salad dressings, and packaged foods. Trim the fat off of meat and avoid eating the skin of the chicken. Choose nonfat dairy products and eggs that have been fortified with omega-3 fatty acids. Add walnuts, almonds, pumpkin seeds, hazelnuts, pecans, and sesame seeds. Use flaxseed oil in salad dressings, or mixed in snacks such as applesauce.Limit fast food, fried foods, and packaged foods, like potato chips, cookies, crackers, French fries, and doughnuts. Eat fish such as salmon, talapia, and cod. Don't fry it and  be aware of mercury levels.

Sunday, February 13, 2011

Breast Cancer

Breast cancer is the second leading cause of cancer deaths among women in the United States (lung cancer is first). About 1 in 8 women in the United States (12%) will develop invasive breast cancer over the course of her lifetime and the risk increases with age. A woman’s risk of breast cancer doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer. About 25% of women diagnosed with breast cancer have a family history of breast cancer and 8% of breast cancers can be linked to gene mutations (abnormal changes) of the BRCA1 and BRCA2 genes. Surprisingly, 75% of breast cancers occur in women who have no family history of breast cancer.

Percent of U.S. Women Who Develop Breast Cancer over 10-, 20- and 30-Year Intervals According to Their Current Age, (CDC) 
Current Age10 Years20 Years30 Years
30   0.43%   1.86%   4.13%
401.45 3.756.87
502.385.608.66
603.456.718.65

Types of breast cancer:
DCIS – Ductal Carcinoma In Situ
IDC – Invasive Ductal Carcinoma
LCIS – Lobular Carcinoma In Situ
ILC – Invasive Lobular Carcinoma
Inflammatory Breast Cancer
Paget's

Signs and symptoms of breast cancer:
A breast lump or thickening that feels different from the surrounding tissue
Bloody discharge from the nipple
Change in the size or shape of a breast
Changes to the skin over the breast, such as dimpling
Inverted nipple
Peeling or flaking of the nipple skin
Redness or pitting of the skin over your breast, like the skin of an orange

Prevention:
Breast self-exams
Mamograms
Drink alcohol in moderation
Exercise
Maintain a healthy weight
Limit synthetic hormone therapy (? natural hormones)

Japanese women have one-fifth (20%) the number of breast cancer cases as American women do. This diference is huge and is believed to be due to the following factors: a diet high in fruits, vegges and soy, low in fats and a much more active lifestyle.

Saturday, February 12, 2011

Salt in your diet

Hypertension (high blood pressure) has been nicknamed the "silent killer" due to its lack of symptoms. It affects approximately one out of every four adults (25%) in the U S, which isn't surprising with the amount of salt in the American diet. When left untreated, hypertension greatly increases the risk of heart disease and stroke. Your blood pressure should not be above 140/90 mmHg or preferably 135/85mmHg. 
A single teaspoon of salt (2000 mg) contains almost twice the minimum recommended amount of daily sodium for someone with elevated blood pressure. General recommendations are to not exceed 2,400 mg of sodium a day if you're a healthy adult and 1,400 mg of sodium a day if you have high blood pressure, kidney disease or diabetes. Your body does need some salt though to maintain the right balance of fluids, transmit nerve impulses and allow the contraction and relaxation of muscles.
Sodium in the diet is the single most important dietary factor for those with hypertension or prehypertension ("borderline"). Even a moderate reduction in dietary sodium can reduce blood pressure by 6-8 mm of mercury (mm Hg), according to the Mayo Clinic. If an individual continues to consume excess sodium on a daily basis, his or her blood pressure will continue to increase. Over a long period of time, this can lead to worsening health problems such as stroke, heart attack or kidney failure. Increasing potassium intake will also reduce the negative effects of sodium on blood pressure.

The DASH diet (Dietary Approaches to Stop Hypertension) is a diet promoted by the National Heart, Lung, and Blood Institute (part of the NIH) to control hypertension. This eating plan is rich in fruits, vegetables, whole grains, and low-fat dairy foods, lean meats, fish, poultry, nuts and beans. It is limited in sugar-sweetened foods canned beverages, red meat, and added fats.
Examples include: Try to eat homemade or specially prepared food. Ban any type of manufactured or canned product as they contain lots of salt and monosodium glutamate. Do not add any salt to the meal. Eat lots of vegetables, salads, fruits, etc. Consider adding boiled beans or chick peas to salads. Grill your fish or lean meats. Forget any soda or manufactured juices, even if they claim to be natural. The only natural juice is the one you prepare from fresh fruits. This diet reduced blood pressure by at least 11mmHg (systolic) and 6mmHg (diastolic) respectively in as short a time as two weeks.

The main sources of sodium in the average U.S. diet.
Cooking-5%
Adding-5%
Natural Sources-10%
Processed/Prepared foods-80%

Know your labels, here's what they mean:
Sodium-free or salt-free. Each serving in this product contains less than 5 mg of sodium.
Very low sodium. Each serving contains 35 mg of sodium or less.
Low sodium. Each serving contains 140 mg of sodium or less.
Reduced or less sodium. The product contains at least 25 percent less sodium than the regular version.
Lite or light sodium. The sodium content has been reduced by at least 50 percent from the regular version.
Unsalted or no salt added. No salt is added during processing of a food that normally contains salt (some foods with these labels may still be high in sodium).

Thursday, February 10, 2011

Asthma

Asthma is a common chronic inflammatory disease of the airways affecting 17 million Americans. Symptoms include wheezing, coughing, chest tightness, and shortness of breath. Asthma is caused by constriction and inflammation in the airways. The strongest risk factor for developing asthma is a history of atopic disease (eczema or atopic dermatitis) which can increase the risk by 3x. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages become inflamed and swell, reducing the amount of air that can pass. Asthma may become life threatening as their are more than 5000 deaths annually from this disease. It is imperative to recognize the signs and symptoms of asthma, especially in children.


Symptoms of asthma:
Wheezing
Coughing
Shortness of breath
Chest pain
Anxiety
Nasal flaring
Rapid heart rate

Common asthma triggers include:
Animals (pet hair or dander)
Dust
Cold weather
Chemicals in the air or in food
Exercise
Mold
Pollen
Respiratory infections
Stress
Tobacco smoke
Beta blockers (Metropolol, Atenolol)
Nonsteroidal anti-inflammatory drugs (Advil, Motrin)

Treatment:
Inhaled corticosteroids (such as Azmacort, Vanceril, AeroBid, Flovent)
Beta-agonist inhalers (Albuterol, Maxair)
Combination beta-agonist/corticisteroid (Serevent, Advir)
Leukotriene inhibitors (such as Singulair and Accolate)
Omalizumab, an immune system blocker(Xolair)
Cromolyn sodium (Intal)
Caffeine (often helpful) 

Wednesday, February 9, 2011

Healthy Skin

The skin is the largest organ of your body and reflects your overall health. Most of the tips to improve skin health revolve around healthy living. There are some things you should and should not do to maintain a healthy glow. Skin type also plays an important role in skin health as some types can be very sensitive to the sun or topical agents. There are six types of skin (I-VI) from very light to very dark depending on the amount of melanin. There are also different classifications of skin: dry, oily, sensitive or a combination of these.

 

The rules for healthy skin:

1.Stay out of the sun.
2.Don't smoke.
3.Manage stress.
4.Be good to your skin.
5.Eat healthy.

What protects the skin?
A thin fluid layer, called the acid mantle, maintains and protects the overall health of skin. Secretions formed by sebaceous and sweat glands comprise this layer. Sebum (the oily substance produced by the sebaceous glands) and sweat blend and are further acidified by secretions from the normal flora of the skin. The normal acid mantle for skin averages a pH of 5. The term pH, the abbreviation for potential of hydrogen, is a measure of the acidity or alkalinity (acid or base) of a solution. Chemists long ago established a scale from 1 to 14 to assess these properties. Neutral  was assigned the midway point on the scale: 7. The further the pH shifts from 7 in either direction, the more irritating the solution to your skin.

Basic skincare regimen:
1. Cleansing- Purpose Gentle Cleansing Wash. (popular, inexpensive and gentle)
2. Exfoliate- Clinique Seven Day Scrub. (popular)
3. Moisturize-Olay Regenerist Micro-Sculpting Cream (popular)
4. Sunscreen- La Roche-Posay Anthelios XL (popular)

Tips for healthy skin:
One the most important components of skin health is vitamin A. The best places to get it are low-fat dairy products, carrots, spinach and liver. Berries are extremely good for your skin due to their high antioxidant content. Salmon, Walnuts, Canola Oil, and Flax Seed all deliver essential fatty acids, and thus are also key foods for healthy skin. Green Tea has many anti-inflammatory properties and it's protective to the skin cell membranes. Lastly, our skin and body needs a lot of water, eight glasses every day.
Washing the skin with moderately or highly alkaline soap or detergent (cleansers that foam) is one of the most common mistakes made that strips away the acid mantle. Limit bath time as it will also wash away the acid mantle. Many toners are pH inappropriate and lacking in hydrators, choose carefully. Use of a cleansing agent that contains a buffered glycolic acid or other alpha hydroxy acid (AHA) is a great way to keep the skin glowing. However, if you already have parched, irritated skin, avoid AHA products until you have soothed the skin with a moisturizing cream. After which, go into the preventative mode using moisturizers with AHAs to prevent dehydration and maintain the acid mantle.

Monday, February 7, 2011

Signs of Heart Disease

Heart disease is the leading cause of death in the United States and much of the world. It accounts for more than 20 % of the total annual deaths in the U S (500,000+). According to the American Heart Association, a heart attack occurs about every 30 seconds. Estimates are that ten million people in the United States suffer from chest pain due to heart disease (angina).  Heart disease is projected to cost an estimated $250 billion or more in direct and indirect costs this year. The warning signs are often overlooked, ignored or misunderstood. Please take a minute to increase your awareness of heart disease. If these symptoms (below) are persistent, then an evaluation should be done to make sure you are not at risk for coronary artery disease.  

Feel free to check out the American Heart Association heart risk calculator at: https://www.americanheart.org/gglRisk/locale/en_US/index.html?gtype=health

The most common symptom of coronary artery disease is angina, or chest pain. Angina can be described as a discomfort, heaviness, pressure, aching, burning, fullness, squeezing, or painful feeling in your chest. It can often be mistaken for indigestion or heartburn. Pain, tightness or discomfort may also be felt in the shoulders, arms (especially left) and neck.

Other symptoms of heart disease include:
 Trouble breathing (shortness of breath)
 Fatigue (especially in women)
 Sweating
 Nausea
 Rapid heartbeat (palpitations)

Preventable risk factors for heart disease:
 High Blood Pressure (untreated)
 Smoking
 Obesity
 High Cholesterol
 Untreated Diabetes
 Sedentary Lifestyle

Hypertension is the most common cause for heart disease. Prevention and treatment are the keys to good health and longevity. People with high blood pressure should monitor their BP regularly, avoid salt and caffeine, not stop their medications and exercise regularly (with proper medical supervision). Those with a strong family history should be very aware of their own risk for developing high blood pressure or heart disease.
 

Sunday, February 6, 2011

Spot Reducing (or Zeltiq?)

The term spot reducing refers to lowering fat stores in a specific area of the body such as the abdomen or hips. Unfortunately, the only way you can truly get rid of a trouble spot is by losing weight all around as you have no real control over where the body takes fat from. The only technology that will remove specific fat deposits from any part of the body is liposuction and possibly "CoolSculpting" (Zeltiq).

Zeltiq uses precisely controlled targeted cold therapy in a treatment that lasts about one hour. Though it is referred to as "cryolipolysis", this procedure does not actually freeze the fat. Rather, it crystallizes the fat cells causing them to die. The skin to be treated is suctioned between two cooling plates which modify the fat's temperature to just above freezing. The procedure targets only fat cells in the superficial fat layer close to the skin. The body then carries off the dead cells over the course of two to three months for a more natural result. The average fat reduction is about 20 percent. Additional CoolSculpting procedures can be performed after two to four months, resulting in another 20 percent reduction. Because the treated fat cells are eliminated, the results are considered long term. Temporary side effects include redness, minor bruising, cramping, tingling or numbness in the treated area. The cost of CoolSculpting for fat cell reduction averages about $600 to $800 per treatment.

Abdominal exercises will improve the area around the waist in several ways. First, these exercises require a lot of effort and burn a lot of calories. Blood flow and fat breakdown is usually greatest around the working muscles. Secondly, fat reduction appears more effective in these areas because exercise generates more heat in the muscles triggers a higher release of catecholamines. Lastly, when additional muscle is built, it takes up more space which can compress fat against the skin until the skin adapts. At the same time there will be a loss of fluid that contributes to both weight loss and slimming. This can also give the illusion of fat being reduced when it actually has not. The result is that toning and strengthening those muscles definitely helps to restore that youthful look. 

The way fat is shed is different from person to person. It tends to go first from the most recent place it appeared. If your hips started gaining first - this will be the very last place for the fat to disappear from. A woman may complain of a smaller bust while the hips may have barely moved in inch. This is further compounded by cellulite. With cellulite tissue, the fat is contained in a net of fibrous connective tissue. As fat loss occurs the net becomes compressed, making it difficult for the blood supply to readily remove the fat from these stubborn areas. 

A program of daily exercise and a proper diet is the key to long-term health, weight loss and fat reduction. You'll feel better, look better and your health will be optimized. Even though you may not be truly spot reducing, diet and exercise will help reduce those undesired fat deposits.

Wednesday, February 2, 2011

Is Red Dye 40 Bad For You?

Allura Red AC is a red food coloring dye that goes by several names including: Allura Red, Food Red 17, C.I. 16035, FD&C Red 40. A lot of research has been done on Red 40 and other food coloring dyes. The findings seem somewhat shocking. Children who have been diagnosed with ADHD (Attention Deficit Hyperactivity Disorder) or Tourette's and Tic disorders generally have significant improvements in their behavior and ability to concentrate when artificial additives such as Red 40 are removed from their diet. Red 40 may also trigger migraine headaches. After researching this dye and removing it from our home, we have noticed a significant improvement in one of our own children. I was skeptical at first, like many people, but now I am just glad to be aware. I also find it ironic that we have taken Red 40 out of most hummingbird foods, but not our children's foods. 

A 2007 study from Southampton University questioned the safety of Azo food dyes in children. Professor Stevenson, a co-author said: "This has been a major study investigating an important area of research. The results suggest that consumption of certain mixtures of artificial food colours and sodium benzoate preservative are associated with increases in hyperactive behavior in children. However, parents should not think that simply taking these additives out of food will prevent hyperactive disorders. We know that many other influences are at work but this at least is one a child can avoid."
The following additives were tested in the research:
  • Sunset yellow (E110) (FD&C Yellow #6) - Coloring found in soft drinks
  • Carmoisine (E122) - Red coloring in gelatin foods
  • Tartrazine (E102) (FD&C Yellow #5) - Yellow coloring
  • Ponceau 4R (E124) - Red coloring
  • Sodium benzoate (E211) - Preservative
  • Quinoline yellow (E104) - Food coloring
  • Allura red AC (E129) (FD&C Red #40) - Orange / red food dye
The study found that increased levels of hyperactivity and attention deficit hyperactivity disorder (ADHD) and lower IQs were observed in children. In Europe, Red 40 is not recommended for consumption by children. It is banned in Denmark, Belgium, France, Switzerland, and Sweden. 


Dr. Alison Schonwald, MD, FAAP, an expert in developmental and behavioral pediatrics at Children's Hospital in Boston writes the following review for the 2008 American Acadamy of Pediatrics Grand Rounds:
 
  Despite increasing data supporting the efficacy of stimulants in preschoolers with attention deficit hyperactivity disorder (ADHD), parents and providers understandably seek safe and effective interventions that require no prescription. A recent metaanalysis of 15 trials concludes that there is “accumulating evidence that neurobehavioral toxicity may characterize a variety of widely distributed chemicals.” Some children may be more sensitive to the effects of these chemicals, and the authors suggest there is a need to better identify responders. In real life, practitioners faced with hyperactive preschoolers have a reasonable option to offer parents. For the child without a medical, emotional, or environmental etiology of ADHD behaviors, a trial of a preservative-free, food coloring–free diet is a reasonable intervention.

Dr. Schonwald also writes:

  Although quite complicated, this was a carefully conducted study [the Southhampton study] in which the investigators went to great lengths to eliminate bias and to rigorously measure outcomes. The results are hard to follow and somewhat inconsistent. For many of the assessments there were small but statistically significant differences of measured behaviors in children who consumed the food additives compared with those who did not. In each case increased hyperactive behaviors were associated with consuming the additives. For those comparisons in which no statistically significant differences were found, there was a trend for more hyperactive behaviors associated with the food additive drink in virtually every assessment. Thus, the overall findings of the study are clear and require that even we skeptics, who have long doubted parental claims of the effects of various foods on the behavior of their children, admit we might have been wrong.

Dr. Schonwald's full report may be found at : http://www.feingold.org/Research/PDFstudies/AAP08.pdf

Tuesday, February 1, 2011

ADHD Part 2-Treatment

Treatment consists of medications (often stimulants) and behavioral modification. ADHD treatment should be tailored to meet the unique needs of the child or adult as well as the needs of the family and especially siblings. Probably the single most important factor in dealing with those who have ADHD is consistency. This post will outline the more common therapies and is primarily directed towards children and adolescents.

Behavioral modification for young children ( 6 or younger):
1.Provide a consistent routine and structure in the environment. Let them know in advance when the routine is changing.
2.Give your child clear boundaries and expectations. These instructions and guidelines are best given right before any activity or situation.
3.Devise an appropriate reward system for good behavior or for completing certain activities; such as a merit point or gold star program with a specific reward, such as a favorite activity. Avoid using food and especially candy for rewards.
4.Try to engage your child in constructive and mind-building activities, such as reading, games, and puzzles by participating in the activities yourself.

Behavior management strategies for older children (7-12):
1.As much as possible, give clear instructions and explanations for tasks throughout the day. If a task is complex or lengthy, break it down into steps that are more manageable.
2.Reward the child appropriately for good behavior and tasks completed. Set up a clear system of rewards  so that the child knows what to expect when they complete a task or improve their behavior.
3.It is important to have a plan for appropriate discipline for misbehaving that does not require carrying it out in front of others. Setting up a specific consequence for a certain behavior is probably the best method of providing consistency and fairness for your child.
4.Communicate regularly with your child's teachers so that behavior patterns can be dealt with before they become a major problem.
5.Always set a good example for your child. Children with ADHD need role models for behavior more than other children. Adult role models are extremely important in their lives.

Behavior management strategies for teenagers:
1.As your child matures, it is important to involve them in setting expectations, rewards, and consequences. Empowering them in this manner will improve their self-esteem and reinforce the concept that they are ultimately the masters of their own behavior.
2.Teenagers are often very sensitive of how they appear to others and may overreact when they are disciplined in front of others.
3.As adolescents they are experiencing hormonal changes and sexual development which brings up a whole host of new issues. Teenage years can be tough enough without ADHD, so be gentle and understanding.
4.Continue to communicate regularly with your child's teachers so that behavior patterns can be dealt with before they become a major problem and before the teachers get overly frustrated with the situation.
5.Continue to be consistent and fair in your own behavior. A predictable, reasonable parent is always an asset for children with ADHD.
6.Continue to set a good example for your child. Teens with ADHD need role models for behavior more than other kids.

Medical therapy for ADHD: (Stimulant drugs to treat ADHD)
Adderall
Concerta
Desoxyn
Dexedrine
Focalin 
Metadate 
Methylin
Ritalin 
Vyvanse

(Non-stimulant drugs)
Intuniv
Strattera


Non medical therapies: include removing all food dyes and preservatives, if possible.
Next, remove "sugary" foods (sweets, high fructose corn syrup, ...). Then add, on a daily basis, a good source of omega-3s such as krill and a supplement called magnesium tartrate.

ADHD Part 1- Overview

ADHD, otherwise known as attention deficit hyperactivity disorder or sometimes attention deficit disorder (ADD), is a chronic condition that affects between 5 and 10 percent of children and adults. ADHD has no known cause. Some environmental factors may include toxin exposure during pregnancy (ie, smoking), food additives or food allergies, sugar, and food coloring ( ie, red dye #40). ADHD is diagnosed two to four times more frequent in boys as it is in girls. This disorder is generally divided into three types: hyperactivity, inattention or a combination of both (most common). Children with this disorder can be particularly difficult and require special attention as well as a lot of patience. This disorder can be a stressful problem both in school and at home.
There are number of symptoms (see below) associated with ADHD including difficulty sitting still, paying attention or remembering simple things after only a short period of time. Children with ADHD will often make careless mistakes in their schoolwork or fail to finish their assignments. They may seem to not listen even when spoken directly to or have difficulty following instructions. They will also frequently lose small items such as pencils, books or small toys. Children with ADHD may also struggle with low self-esteem and poor performance in school. Early diagnosis and treatment will often significantly improve both school performance and issues in the home.

Inattentive type symptoms may include:
Being easily distracted, missing details, forgetting things, and frequently switching from one activity to another.
Have difficulty maintaining focus on one task.
Become bored with a task after only a few minutes (unless doing something enjoyable).
Have difficulty focusing attention on organizing and completing a task or learning something new.
Having trouble completing or turning in homework assignments.
Often losing things (e.g., pencils, toys, assignments).
Not seeming to listen when spoken to.
Daydream or become easily confused.
Have difficulty processing information as quickly and accurately as others.
Struggle to follow instructions.

Hyperactive-impulsive type symptoms may include:
Fidgeting and squirming in their seats.
Talking nonstop.
Dash around, touching or playing with anything and everything in sight.
Have trouble sitting still during dinner, school, and story time.
Being constantly in motion.
Have difficulty doing quiet tasks or activities. 
Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences.
Have difficulty waiting for things they want or waiting their turns in games (impatient).

ADHD is often found associated with other disorders including defiance and temper tantrums (33%), conduct or antisocial problems (25%), borderline personality disorder, bipolar disorder (25%) as well as obsessive compulsive disorder (OCD) and anxiety.

Realizing that a child may have ADHD and seeking treatment early may be the most important thing to prevent a decline in school performance and improve conditions in the home. In part two, I will discuss the types of therapy including behavioral modification and medications.