Saturday, August 30, 2008

How To Lower your Risk of Heart Disease

The leading cause of death right now is Cardiovascular Disease and statistics has shown that 1 in 3 will die from Cardiovascular Disease and it has also been the leading cause of death from China since the 1990's. In fact, cardiovascular disease is the number one killer among women and it kills more women each year than all cancers, tuberculosis, HIV/AIDS and malaria combined.

There are a number of factors for the increasing risk of cardiovascular disease, mainly:

  1. Obesity
  2. Smoking
  3. Lack of exercise
  4. Excessive drinking
  5. Lack of antioxidants

  6. Insufficient fiber intake
  7. High levels of total cholesterol


 

Cardiovascular disease, regardless of heart attack or stroke, is often a "silent killer" with little or no advance warning or symptoms. The first sign of a problem is often death by heart attack or stroke.

You can go HERE and calculate your risk of having a heart attack in the next 10 years.

According to the World Health Organization, cardiovascular disease causes 17.5 million deaths in the world each year. Cardiovascular disease is responsible for half of all deaths in the United States and other developed countries, and it is a main cause of death in many developing countries as well. Overall, it is the leading cause of death in adults.

In the United States, more than 80 million Americans have some form of cardiovascular disease. About 2400 people die every day of cardiovascular disease. Cancer, the second largest killer, accounts for a little more than half as many deaths.

Coronary artery disease, the most common form of cardiovascular disease, is the leading cause of death in America today. But thanks to many studies involving thousands of patients, researchers have found certain factors that play an important role in a person's chances of developing heart disease. These are called risk factors.

Risk factors are divided into two categories: major and contributing. Major risk factors are those that have been proven to increase your risk of heart disease. Contributing risk factors are those that doctors think can lead to an increased risk of heart disease, but their exact role has not been defined.

The more risk factors you have, the more likely you are to develop heart disease. Some risk factors can be changed, treated, or modified, and some cannot. But by controlling as many risk factors as possible through lifestyle changes, medicines, or both, you can reduce your risk of heart disease.

Major Risk Factors

High Blood Pressure (Hypertension). High blood pressure increases your risk of heart disease, heart attack, and stroke. Although other risk factors can lead to high blood pressure, you can have it without having other risk factors. If you are obese, smoke, or have high blood cholesterol levels along with high blood pressure, your risk of heart disease or stroke greatly increases.

Blood pressure can vary with activity and age, but a healthy adult who is resting should have a systolic pressure below 120 and a diastolic pressure below 80.


 

High Blood cho lesterol One of the major risk factors for heart disease is high blood cholesterol. Cholesterol, a fat-like substance carried in your blood, is found in all of your body's cells. Your liver produces all of the cholesterol your body needs to form cell membranes and to make certain hormones. Extra cholesterol enters your body when you eat foods that come from animals (meats, eggs, and dairy products).

Although we often blame the cholesterol found in foods that we eat for raising blood cholesterol, the main culprit is the saturated fat in food. (Be sure to read nutrition labels carefully, because even though a food does not contain cholesterol it may still have large amounts of saturated fat.) Foods rich in saturated fat include butter fat in milk products, fat from red meat, and tropical oils such as coconut oil.

Too much low-density lipoprotein (LDL or "bad cholesterol") in the blood causes plaque to form on artery walls, starting a disease process called atherosclerosis. When plaque builds up in the coronary arteries that supply blood to the heart, you are at greater risk of having a heart attack.

Diabetes. Heart problems are the leading cause of death among people with diabetes, especially in the case of adult-onset or Type 2 diabetes (also known as non-insulin-dependent diabetes). Certain racial and ethnic groups (African Americans, Hispanics, Asian and Pacific Islanders, and Native Americans) have a greater risk of developing diabetes. The American Heart Association estimates that 65% of patients with diabetes die of some form of cardiovascular disease. If you know that you have diabetes, you should already be under a doctor's care, because good control of blood sugar levels can reduce your risk. If you think you may have diabetes but are not sure, see your doctor for tests.


 


Obesity and Overweight
. Extra weight is thought to lead to increased total cholesterol levels, high blood pressure, and an increased risk of coronary artery disease. Obesity increases your chances of developing other risk factors for heart disease, especially high blood pressure, high blood cholesterol, and diabetes.

Smoking. Most people know that cigarette and tobacco smoking increases your risk of lung cancer, but few realize that it also greatly increases the risk of heart disease and peripheral vascular disease (disease in the vessels that supply blood to the arms and legs). According to the American Heart Association, more than 400,000 Americans die each year of smoking-related illnesses. Many of these deaths are because of the effects of smoking on the heart and blood vessels.

Research has shown that smoking increases heart rate, tightens major arteries, and can create irregularities in the timing of heartbeats, all of which make your heart work harder. Smoking also raises blood pressure, which increases the risk of stroke in people who already have high blood pressure. Although nicotine is the main active agent in cigarette smoke, other chemicals and compounds like tar and carbon monoxide are also harmful to your heart in many ways. These chemicals lead to the buildup of fatty plaque in the arteries, possibly by injuring the vessel walls. And they also affect cholesterol and levels of fibrinogen, which is a blood-clotting material. This increases the risk of a blood clot that can lead to a heart attack.

Physical Inactivity. People who are not active have a greater risk of heart attack than do people who exercise regularly. Exercise burns calories, helps to control cholesterol levels and diabetes, and may lower blood pressure. Exercise also strengthens the heart muscle and makes the arteries more flexible. Those who actively burn 500 to 3500 calories per week, either at work or through exercise, can expect to live longer than people who do not exercise. Even moderate-intensity exercise is helpful if done regularly.

Gender. Overall, men have a higher risk of heart attack than women. But the difference narrows after women reach menopause. After the age of 65, the risk of heart disease is about the same between the sexes when other risk factors are similar.

Heredity. Heart disease tends to run in families. For example, if your parents or siblings had a heart or circulatory problem before age 55, then you are at greater risk for heart disease than someone who does not have that family history. Risk factors (including high blood pressure, diabetes, and obesity) may also be passed from one generation to another.

Also, researchers have found that some forms of cardiovascular disease are more common among certain racial and ethnic groups. For example, studies have shown that African Americans have more severe high blood pressure and a greater risk of heart disease than whites. The bulk of cardiovascular research for minorities has focused on African Americans and Hispanics, with the white population used as a comparison. Risk factors for cardiovascular disease in other minority groups are still being studied.

Age. Older age is a risk factor for heart disease. In fact, about 4 of every 5 deaths due to heart disease occur in people older than 65.

As we age, our hearts tend not to work as well. The heart's walls may thicken and arteries may stiffen and harden, making the heart less able to pump blood to the muscles of the body. Because of these changes, the risk of developing cardiovascular disease increases with age. Because of their sex hormones, women are usually protected from heart disease until menopause, and then their risk increases. Women 65 and older have about the same risk of cardiovascular disease as men of the same age.

Contributing Risk Factors

Stress. Stress is considered a contributing risk factor for heart disease because its effects on the heart are not completely understood. Also, the effects of emotional stress, behavior habits, and socioeconomic status on the risk of heart disease and heart attack have not been proven. That is because we all deal with stress differently: how much and in what way stress affects us varies from person to person.

Researchers have identified several reasons why stress may affect the heart.

Stress may also contribute to other risk factors. For example, people who are stressed may overeat for comfort, start smoking, or smoke more than they normally would.

Sex hormones. Sex hormones appear to play a role in heart disease. Among women younger than 40, heart disease is rare. But between the ages 40 and 65, around the time when most women go through menopause, the chances that a woman will have a heart attack greatly increase. From 65 onward, women make up about half of all heart attack victims.

Birth control pills. Early types of birth control pills contained high levels of estrogen and progestin, and taking these pills increased the risk of heart disease and stroke, especially in women older than 35 who smoked. But birth control pills today contain much lower doses of hormones and are considered safe for women younger than 35 who do not smoke or have high blood pressure.

But if you smoke or have other risk factors, birth control pills will increase your risk of heart disease and blood clots, especially if you are older than 35.  According to the American Heart Association, women who take birth control pills should have yearly check-ups that test blood pressure, triglyceride, and glucose levels.

Alcohol. Studies have shown that the risk of heart disease in people who drink moderate amounts of alcohol is lower than in nondrinkers. Experts say that moderate intake is an average of one to two drinks per day for men and one drink per day for women. One drink is defined as 1½ fluid ounces (fl oz) of 80-proof spirits (such as bourbon, Scotch, vodka, gin, etc.), 1 fl oz of 100-proof spirits, 4 fl oz of wine, or 12 fl oz of beer. But drinking more than a moderate amount of alcohol can cause heart-related problems such as high blood pressure, stroke, irregular heartbeats, and cardiomyopathy (disease of the heart muscle). And the average drink has between 100 and 200 calories. Calories from alcohol often add fat to the body, which may increase the risk of heart disease. It is not recommended that nondrinkers start using alcohol or that drinkers increase the amount that they drink.

It is never too late—or too early—to begin improving heart health. Some risk factors can be controlled, while others cannot. But, by eliminating risk factors that you can change and by properly managing those that you cannot control, you may greatly reduce your risk of heart disease.


 


 

Tuesday, August 26, 2008

Are You Depressed? How To Tell, What To Do


 

At any given time, it's estimated that five to seven percent of Americans suffer from depression. Yet, many of these people are too embarrassed to seek help. It is not uncommon for individuals suffering from depression to wonder just when it is necessary to seek help.

Many times, I hear comments like the following from depressed patients:
"I really thought this was something I could handle."
"I feel so weak, like I have failed."
"I should be able to control things so I don't get depressed."

Many of these people also tell me that others have made especially cruel remarks to them concerning their depression, including:
"You don't have anything to be depressed about."
"You just need to make yourself get out (or get up -- or get over it)."
"I was depressed and I got over it -- so should you."

I don't think the people who made these remarks would say similar things to someone with a more traditional "medical" illness, such as cancer, diabetes or heart disease. Unfortunately, we still operate out of prejudice and ignorance when it comes to diseases of the brain, or as the more archaic name refers to it... mental illness.

It is important to realize that depression is a disease, a medical illness. It is the result of abnormalities in the brain that appear to be caused by extended periods of stress and duress, from which the brain is unable to re-establish its normal mood. It is actually a "multi-system" disease, meaning that since the brain controls multiple functions or systems when impacted by depression many of these other functions are affected.

The result is a disease with a variety of symptoms that can interfere with a wide range of daily activities and functions. Depression can also be genetically based. Like diabetes, heart disease and other chronic illnesses, it can run in families. Along with evidence of a relationship between alcoholism and depression, there are socioeconomic factors, including economic class and marital status, which seem to create an increased risk as well. The presence of concurrent physical illnesses serves as a stress factor that can precipitate a depressive episode. Given a combination of these risk factors and the presence of unremitting stress, it is not surprising that the development of a depressive episode becomes "an illness waiting to happen."

What then is this disease called depression, and when should someone seek treatment? There are well-established guidelines and criteria for making the diagnosis. This diagnosis is generally based on the presence of any combination of the following symptoms for at least 2 to 4 weeks:

  • Depressed mood most of the day, nearly every day
  • Decreased interest or pleasure in one's daily activities
  • Major changes in weight and/or appetite
  • Insomnia or hypersomnia
  • Agitated or slowed thinking
  • Fatigue, loss of energy -- all activities seem to require excessive effort to complete
  • Feelings of worthlessness, inappropriate or excessive guilt
  • Decreased ability to think or concentrate; indecisive thinking
  • Recurring thoughts of death or suicide; this does not always include a wish or plan to die but an acceptance of the belief that "others would be better off without me."

This list highlights the more prominent features of depression, but it is not all-inclusive. Many women complain of being easily frustrated, irritable or angered, worried about their "lack of patience with my children or my spouse." Others report not wanting to talk with friends, citing a lack of energy or interest in doing so. Their answering machine becomes a sentinel, screening their calls and limiting their interactions. Even their ability to function in the workplace is seriously compromised. There are complaints of problems with memory, concentration, attention and recall. Depressed workers may also experience reduced productivity. In severe cases, individuals who were outstanding employees begin to risk losing their jobs.

It takes incredible strength, courage and faith to seek treatment and commit oneself to it. Which brings us to the question of treatment -- what works and why? Treatment must be individualized. Medications for depression are safe, effective and must generally be continued for at least a year once the depression is controlled.

The patient and physician should then determine together whether it is time to discontinue medications and/or change the approach to treatment. The steps for achieving wellness begin with a personal inventory of one's life: eating habits, exercise patterns, the spiritual self, relationships (at work, home, with friends and family), and other aspects of one's lifestyle, which give pleasure, joy and satisfaction.

Addressing those factors that have gradually stressed the brain enough to make the person depressed will create an understanding of where one's efforts for change should be directed. However, such a necessary "journey" of understanding cannot be fully successful if one is struggling against severe depression. Therefore, I advise my patients to recognize that the healing process may take some time. There is no quick fix to the situation. However, once the medications have become effective, patients experience renewed strength as well as a return of the ability to establish a normal life. Patience and faith are critical factors in this healing process.

Sunday, August 24, 2008

blog test


Friday, August 8, 2008

Bone Density and FRAX Testing

What Is FRAX?

Old way to be responsible: Ask your doctor about a bone density test. New way: Find a doctor who knows her FRAX -- and if you've never heard of it, you're not alone.


 

FRAX is not a miracle pill or a fancy piece of equipment. Unveiled by the World Health Organization in February, it is an elegant patient assessment formula that works in a risk-calculating computer program. And though not yet widely known, it is rocking the osteo-establishment, pulling focus away from bone density -- doctors' long-trusted yardstick for measuring the strength of the skeleton as it ages -- to spotlight what many experts believe is the overriding concern: determining a person's risk of actually breaking a bone (in other words, fracture risk assessment, or FRAX). That assessment matters to millions of people; in the United States, half of all postmenopausal women and a substantial number of older men will suffer a potentially life-altering fracture.


 

The revelation behind FRAX: Bone density is not the single best indicator in determining the risk of those fractures. It's still crucial, but a short list of other key factors, such as having a parent who broke a hip, is now also considered significant. "FRAX gives us the capacity to quantify these risk factors and look at how they interact with each other. For people with low bone mass, it's a far more rational and reasonable way to assess fracture risk," says Robert Lindsay, MD, one of the authors of a guide that the National Osteoporosis Foundation published in conjunction with the debut of the new formula. The upshot for women? FRAX, rather than bone density testing alone, is the best way to determine who needs treatment.


 

Both the guide and the FRAX formula are currently available to physicians. If your doctor is forward-thinking, she may already be using these tools; if she isn't, you may need to prod her a little. The best way to start is by asking about FRAX and the National Osteoporosis Foundation guidelines at your next ob-gyn or primary care appointment. Meantime, here's what you should know.


 

Lindsay and others hope that FRAX will help clear up the confusion that's existed since 1994, when the World Health Organization first announced criteria for diagnosing osteoporosis. Before then, the disease -- characterized by porous and fragile bones -- was typically diagnosed when an elderly woman showed up at the emergency room after breaking her hip or wrist. But by the mid-1990s, after-the-fact diagnosis was no longer good enough. A new class of drugs, bisphosphonates, which reduce fracture risk, was soon to be introduced. The medications, which include Fosamax and Actonel, were expensive and not without side effects, including slow healing, difficulty swallowing, inflammation of the esophagus, gastric ulcer and, in rare cases, increased possibility of infection after dental surgery. There has also been concern that long-term use of these drugs may result in an accumulation of older bone in the skeleton (because the drugs slow down the activity of scavenger cells, which clear away older bone to make room for new). Right now this is more a theory than a finding, but the thinking is that over time these drugs might make the skeleton more, not less, brittle.


 

The World Health Organization hinged its 1994 criteria on the one measure of bone health then available: the bone mineral density scan. The organization's rating system involved T-scores, which compared a postmenopausal Caucasian woman's bones with those of a 30-year-old. A T-score of -1 (one standard deviation below normal) and above was considered normal bone density; below -2.5 was considered osteoporosis; and any score between -2.5 and -1 was considered osteopenia, itself not a disease but an indicator of borderline low density. The lower the score, the thinking went, the more porous and fragile the bone -- and the greater the risk of breaking it. Therefore, women with low T-scores were more likely to be treated with medication.


 

Nearly 15 years later, however, experts disagree on who truly needs a prescription. There's no controversy surrounding women whose T-scores scream osteoporosis. But a far greater number of scores register in the gray area of osteopenia, and there has been no clear guidance regarding whether they should prompt treatment. "Some doctors will take a 55-year-old woman with a -1.5 T-score and put her on medication. Others will have a 75-year-old woman with the same score and leave her alone," says Ethel S. Siris, MD, of Columbia University and president of the National Osteoporosis Foundation.


 

The net result: A considerable number of younger postmenopausal women whose risk of fracturing a bone in the near future is statistically minuscule are being treated prematurely or unnecessarily. Nelson B. Watts, MD, of the University of Cincinnati Bone Health and Osteoporosis Center, says that if 30-year-old women submitted themselves en masse to the World Health Organization's measurement criteria, fully 16 percent would be diagnosed with osteopenia.


 

The other, perhaps more troubling, side of this story: Under the current parameters, many older people who face immediate grave risk of fracture aren't getting treatment, simply because their T-scores don't demand it. At Oregon Health & Science University, a 2005 study of women age 65 and older found that, based on the World Health Organization's bone density criteria, more than half of the women who suffered hip fractures did not technically have osteoporosis.


 

To learn more and take a risk assesment test go

http://www.shef.ac.uk/FRAX/tool.jsp?locationValue=9

Thursday, July 31, 2008

Weight Loss Tips That Work

Weight Loss Tips That Work!


Weight management is all about health. In a culture that has produced Barbie and a media filled with waiflike images of male and female celebrities (who often look way too thin), what's needed is an accurate and realistic assessment of our body-image goals and the fortitude to carry out a healthy weight management plan.

There are 30 to 40 billion fat cells in your body. At times, they may seem like an army of enemies out to sabotage your appearance in a swimsuit, but they saved our ancestors from starving by storing fat to get them through lean times. Trouble is, we have more than enough food available in America in this day and age, and we're usually not trekking across frozen tundra or arid steppes in search of the next encampment.

Combine our hefty calorie intakes with generally sedentary lives -- sitting in front of the computer all day, driving from office to home, plopping down on the couch with the remote control to unwind -- and it's easy to see why too many Americans weigh more than they should.

Being overweight can damage much more than your ego. Overweight people have increased risks of developing high blood pressure, high triglycerides and low HDL ("good") cholesterol, type 2 diabetes mellitus, coronary artery disease, gallbladder disease, stroke, respiratory problems, osteoarthritis and various kinds of cancer. Due to these problems, overweight people may have a substandard quality of life and possibly die sooner than their healthy counterparts.

There is good news; however, if you are overweight. Even a five to 10 percent weight loss can lower your health risks. You may find your energy level and confidence increasing as the pounds come off, too. It's also true that genetics plays a role in how your body deals with calories. A family history of obesity increases your odds of ending up obese by 25 to 30 percent, but that just means you may have to work a little harder than those without such a history to achieve and maintain a healthy weight. You're not doomed. You can choose to adopt healthy habits.

Here are some things that can help.

Before you set any weight loss goals, be realistic. The goal isn't necessarily to look like a super model. A good way to assess your weight health is to measure your Body Mass Index, or BMI. This method is better at estimating body fat and health risks than other methods... including the bathroom scale. If your BMI is 19 to 24, there's probably not a health advantage to losing weight. Keep up healthy habits to stay in this ideal range. If your BMI is 25 or more, losing weight might improve your health. If your BMI is under 19, you're most likely underweight.

STOCK THE PANTRY WITH HEALTHY FOODS

Instead of jumping on the diet-of-the-week bandwagon, experts advise eating a diet with 50 to 65 percent carbohydrate (emphasizing whole grains, legumes, fruits and veggies); 20 to 25 percent protein; and the remainder from mostly unsaturated fat (olive oil over butter or meat fat, for example). High-fiber foods will fill you up and are not very calorie-dense. They also take a while to chew, giving your body time to signal you that it's time to put your fork down after you've had enough. Instead of potato chips or crackers containing hydrogenated oils, opt for almonds, peanuts, soy nuts, air-popped popcorn sprinkled with nutritional yeast or mixed seasonings, carrots, grapes, pretzels or other non-fried snacks.

EAT WITH INTENTION
This one seems easy, yet few of us do it in our multi-tasking frenzy. For many people, eating while driving, watching TV or working at the computer is practically second nature. But these distractions take away from our enjoyment and awareness of what we're eating, often contributing to eating too fast and overeating. Make a point of sitting at the table, turning off the TV and computer and setting aside your work for mealtimes. In addition many overweight people feel they have to sneak their food or that they don't deserve to enjoy their food. It's better to sit and really enjoy some of what you really want than to sneak it or end up depriving yourself until you end up bingeing out of frustration.

GIVE UP YOUR MEMBERSHIP TO THE CLEAN PLATE CLUB
As a child, you may have been encouraged to finish every last morsel of food on your plate. While we certainly don't want kids in India to go hungry, stuffing yourself to the brink of exploding won't help anyone, including you. Get used to pushing your plate aside when you've had enough.

PORTIONS
In this age of super-size everything, it's easy to lose sight of what a portion of food actually looks like. To keep portion sizes in check, use small dishes to serve meals and desserts. Instead of a cereal bowl, use a dessert dish for ice cream. Put your pasta in a cereal bowl instead of loading it onto a gargantuan plate.

PLAN AHEAD
The amount of planning you do for the week ahead can make or break healthy eating patterns. Have healthy snacks on hand and bring sandwiches if you'll be away from home at lunch or staying late at the office. Determine whether you'll be walking by a store, where you can buy yogurt and/or fruit during a snack or lunch break.

LOOK FORWARD TO YOUR WORKOUT
It's not always easy to drag yourself out of bed for a morning jog. If that's the case, find some other aerobic activity that you enjoy enough to keep doing. Walking is one easy option.
Take a dance or yoga class, or sign up at a gym and ask a trainer to help you use the weights. Find out if there's a local indoor pool for lap swimmers; it's easy on the joints and a darn good workout. Aim for 30 minutes of cardiovascular exercise most days of the week-getting your heart pumping is important. (If you have health problems, be sure to ask your doctor to help you devise an exercise program that is safe, and before beginning an exercise program, become familiar with your maximum heart rate so you don't put unnecessary stress on your heart.)

Why Stress Makes You Eat

Stress is any change in your normal routine or health. Stress occurs when bad things happen, as well as happy things. Getting a raise or promotion is stress, just as getting fired from your job is stress. Speculative changes cause just as much stress as veritable changes. Pensiveness or anguish about whether you will get that new job is stress the same as being offered a new position is stress.

Often people use food to comfort themselves, relieve stress and have something to do when they're bored or sad. Many people mistakenly use food to accommodate certain basic needs, such as getting rest, expressing feelings, being intellectually stimulated and receiving comfort. Food isn't going to supply any of that. While many people use food in response to emotions like anger, frustration, loneliness and sadness, stress is felt to be the main cause of emotional eating.

Imagine that it is mid-morning and you encounter unexpected stress. Your boss e-mails you about a huge accounting error you've made, or your pediatrician calls to tell you your 6-year-old's lab results are abnormal. Your body goes into fight-or-flight mode. During a fight-or-flight reaction, your cells demand sugar for fuel -- and quickly. Unfortunately, on this particular morning, you skipped breakfast, and supper the night before was ice cream and a diet Coke.

You have a minimal amount of circulating blood sugar available to handle your stressful event. So, your liver releases part of its stockpile of stored blood sugar. When the stressful event is over, your blood sugar is low and depleted. Low blood sugar, known as hypoglycemia, causes weakness, anxiety, nervousness, shakiness and confusion. You feel weak, tremulous and irritable. You reach for a doughnut or a candy bar because your body craves sugar.

That was not the best choice. Eating simple sugars and junk foods will indeed raise your blood sugar, but only for a short time. As soon as that ingested burst of sugar is metabolized, your circulating levels of blood sugar drops back precipitously low. And, the cycle of irritability and poor mental performance continues.

So, What can you do?

1. Understand the Stress Response. When faced with a stressful situation, your brain signals the adrenal glands to release a hormone called cortisol. Cortisol, in turn, releases glucose and fatty acids into the bloodstream to provide energy to the muscles. High cortisol levels result in increased appetite and fat deposits, typically in the cervical area, trunk and abdomen.
Why Stress Makes You Eat ?

2. Learn How Stress Impacts Eating. Stress can increase your appetite and make you crave foods that contain high calories and few nutrients. Unfortunately, researchers have not yet determined why stress-eaters tend to gravitate toward certain types of food.

3. Don't Worry, Be Happy. So, what can you do to decrease stress? Instead of seeking comfort in food, engage in a pleasurable activity that doesn't involve calories! You might get a massage, visit a friend, read a book, watch an old movie or play games with your child.

4. Take Charge. When faced with a stressful event, ask yourself what you can change to minimize the pressure. Elect to take charge of the situation instead of being victimized by it. In the process, your body will reduce the amount of cortisol it produces, which can minimize the harmful effects of prolonged hormone release.

5. Eat a Variety of Foods. Because stress affects blood sugar, it is important to eat healthy meals throughout the day to maintain blood sugar levels. Stress-eaters tend to reach for sugary carbohydrates, so be sure also to include the recommended amounts of protein and fat in each meal.

6. Eat Breakfast. A well-balanced breakfast provides protein, carbohydrate and fat that helps keep blood sugar levels steady throughout the day, reducing the tendency to reach for a candy bar or soft drink.

7. Replenish Vitamin and Mineral Stores. Stress causes the body to "burn" more vitamins and minerals, specifically vitamin B complex, magnesium and zinc; these nutrients are needed for blood sugar balance. When their levels drop, stress levels increase. Also, the adrenal glands require more vitamin C and pantothenic acid (part of the vitamin B complex) during stressful times. To offset these needs, eat fresh vegetables and fruits daily.

8. Get Physical. Moderate exercise can help reduce the body's production of cortisol during stressful times. Numerous studies have shown that moderate physical activity helps modulate mood, reduce stress, improve self-esteem and program the brain for optimism instead of pessimism. Do aerobic and anaerobic training on a regular basis, but don't overdo it. Taking your frustration out during a vigorous workout will further increase cortisol production.

9. Get Plenty of Rest. Sleep deprivation affects blood sugar levels, increases cortisol and reduces the production of leptin (a hormone that signals that you are full). Go to bed a little earlier each night during trying times and aim for eight hours of sleep.

How do you know if you're really hungry or if it's stress induced?

There are several differences between emotional hunger and physical hunger. Emotional hunger tends to come on suddenly, while physical hunger occurs more gradually. When you're eating for emotional reasons, you tend to crave a specific food like ice cream, candy or pizza, and only that food will meet your need. When you're actually hungry, you're more open to options. Eating for emotional reasons tends to leave us feeling guilty when eating for physical hunger does not.

Since stress is here to stay, everyone needs to develop methods for invoking the relaxation response -- the natural unwinding of the stress response. Relaxation lowers blood pressure, improves respiration, lowers pulse rates, releases muscle tension and eases emotional strains. This response is highly individualized, but there are certain approaches that seem to work, including: exercise, deep breathing, muscle relaxation, meditation and having a good network of social support.


Posted by Dr. Nancy Tice, 10:31 AM, Permalink

  

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Weight Loss Tips That Work!


Weight management is all about health. In a culture that has produced Barbie and a media filled with waiflike images of male and female celebrities (who often look way too thin), what's needed is an accurate and realistic assessment of our body-image goals and the fortitude to carry out a healthy weight management plan.

There are 30 to 40 billion fat cells in your body. At times, they may seem like an army of enemies out to sabotage your appearance in a swimsuit, but they saved our ancestors from starving by storing fat to get them through lean times. Trouble is, we have more than enough food available in America in this day and age, and we're usually not trekking across frozen tundra or arid steppes in search of the next encampment.

Combine our hefty calorie intakes with generally sedentary lives -- sitting in front of the computer all day, driving from office to home, plopping down on the couch with the remote control to unwind -- and it's easy to see why too many Americans weigh more than they should.

Being overweight can damage much more than your ego. Overweight people have increased risks of developing high blood pressure, high triglycerides and low HDL ("good") cholesterol, type 2 diabetes mellitus, coronary artery disease, gallbladder disease, stroke, respiratory problems, osteoarthritis and various kinds of cancer. Due to these problems, overweight people may have a substandard quality of life and possibly die sooner than their healthy counterparts.

There is good news; however, if you are overweight. Even a five to 10 percent weight loss can lower your health risks. You may find your energy level and confidence increasing as the pounds come off, too. It's also true that genetics plays a role in how your body deals with calories. A family history of obesity increases your odds of ending up obese by 25 to 30 percent, but that just means you may have to work a little harder than those without such a history to achieve and maintain a healthy weight. You're not doomed. You can choose to adopt healthy habits.

Here are some things that can help.

Before you set any weight loss goals, be realistic. The goal isn't necessarily to look like a super model. A good way to assess your weight health is to measure your Body Mass Index, or BMI. This method is better at estimating body fat and health risks than other methods... including the bathroom scale. If your BMI is 19 to 24, there's probably not a health advantage to losing weight. Keep up healthy habits to stay in this ideal range. If your BMI is 25 or more, losing weight might improve your health. If your BMI is under 19, you're most likely underweight.

STOCK THE PANTRY WITH HEALTHY FOODS

Instead of jumping on the diet-of-the-week bandwagon, experts advise eating a diet with 50 to 65 percent carbohydrate (emphasizing whole grains, legumes, fruits and veggies); 20 to 25 percent protein; and the remainder from mostly unsaturated fat (olive oil over butter or meat fat, for example). High-fiber foods will fill you up and are not very calorie-dense. They also take a while to chew, giving your body time to signal you that it's time to put your fork down after you've had enough. Instead of potato chips or crackers containing hydrogenated oils, opt for almonds, peanuts, soy nuts, air-popped popcorn sprinkled with nutritional yeast or mixed seasonings, carrots, grapes, pretzels or other non-fried snacks.

EAT WITH INTENTION
This one seems easy, yet few of us do it in our multi-tasking frenzy. For many people, eating while driving, watching TV or working at the computer is practically second nature. But these distractions take away from our enjoyment and awareness of what we're eating, often contributing to eating too fast and overeating. Make a point of sitting at the table, turning off the TV and computer and setting aside your work for mealtimes. In addition many overweight people feel they have to sneak their food or that they don't deserve to enjoy their food. It's better to sit and really enjoy some of what you really want than to sneak it or end up depriving yourself until you end up bingeing out of frustration.

GIVE UP YOUR MEMBERSHIP TO THE CLEAN PLATE CLUB
As a child, you may have been encouraged to finish every last morsel of food on your plate. While we certainly don't want kids in India to go hungry, stuffing yourself to the brink of exploding won't help anyone, including you. Get used to pushing your plate aside when you've had enough.

PORTIONS
In this age of super-size everything, it's easy to lose sight of what a portion of food actually looks like. To keep portion sizes in check, use small dishes to serve meals and desserts. Instead of a cereal bowl, use a dessert dish for ice cream. Put your pasta in a cereal bowl instead of loading it onto a gargantuan plate.

PLAN AHEAD
The amount of planning you do for the week ahead can make or break healthy eating patterns. Have healthy snacks on hand and bring sandwiches if you'll be away from home at lunch or staying late at the office. Determine whether you'll be walking by a store, where you can buy yogurt and/or fruit during a snack or lunch break.

LOOK FORWARD TO YOUR WORKOUT
It's not always easy to drag yourself out of bed for a morning jog. If that's the case, find some other aerobic activity that you enjoy enough to keep doing. Walking is one easy option.
Take a dance or yoga class, or sign up at a gym and ask a trainer to help you use the weights. Find out if there's a local indoor pool for lap swimmers; it's easy on the joints and a darn good workout. Aim for 30 minutes of cardiovascular exercise most days of the week-getting your heart pumping is important. (If you have health problems, be sure to ask your doctor to help you devise an exercise program that is safe, and before beginning an exercise program, become familiar with your maximum heart rate so you don't put unnecessary stress on your heart.)

Sunday, July 13, 2008

Halt The Hurt: Coping With Pain

At least 34 million Americans suffer from chronic pain caused by conditions including arthritis, lower back problems, neuralgia, or migraine headaches. Some 15 million working Americans have pain on a chronic basis.

Having injured my back this summer, I have come to learn a lot about pain firsthand. Pain can be hard to define. It means different things to different people and your own perception of pain can change over time. For some people, acknowledging pain is a sign of weakness. What most people don't realize is that pain is a medical problem -- and that it can be treated.

How do you measure your pain?

It is difficult. No lab tests or X-rays can convey to your doctor what you are feeling. But even when pain is intense, many people struggle to find the words to describe it to the doctor. It is important to understand whether you suffer from acute or chronic pain.

Acute pain is not related to an ongoing condition and declines when you recover from the illness, injury, or surgery that initially caused the pain. Acute pain usually lasts for no longer than it takes to heal.

Chronic pain is constant or recurrent and is caused by a long-term condition (arthritis) or a progressive illness (cancer). Chronic pain lasts for months -- and it may last a lifetime. Chronic pain takes a psychological as well as a physical toll. It can lead to anxiety, anger, depression, and insomnia. Chronic pain sufferers may find it difficult or impossible to work and hard to do the things they once enjoyed. Chronic pain can even disrupt a person's relationships with family and friends.

Let's consider some of the more devastating psychological effects of chronic pain:

  1. Loss of mobility. Chronic pain and suicide ideation have been shown to be strongly related. However, recent research shows that chronic pain is usually a secondary cause of suicide ideation. One of the chief intermediary factors is the severe effect that chronic pain has on limiting mobility. Being unable to move around comfortably, constantly being constrained by pain, being unable to enjoy normal sexual relations with one's spouse or carrying one's children without fear of injury leaves a damaging mark on the sufferer's emotions.
  2. Depression. Patients with depression are also heightened in their perception of pain, and will very often be reluctant to carry out treatment modules provided to them for fear of encountering more pain. The combination of immobility and depression leads to irritability, nervousness (or anxiety) and an unhealthy desire for isolation. Marital conflicts develop and escalate. As depression sets in, chronic pain patients tend to become angrier, easily frustrated, often moody, and plagued with feelings of hopelessness.
  3. Sleep Disturbances. Chronic pain also influences the amount of sleep the patient is able to get. Difficulty falling asleep and early night awakenings both contribute to progressive depression, lethargy, and poor memory (especially vigilance tasks). The last effect, that is, the decline in vigilance due to sleep loss often presents other problems, such as proneness to accidents.
  4. Medications. Medications that limit the effect of pain may also produce nagging side effects such as gastro-intestinal problems or excessive sleepiness that create further irritation. In addition, some patients become dependent on painkillers to sleep or function throughout the day. Although there is evidence that narcotic drugs prescribed to chronic pain patients do not produce physical dependencies, these dependencies are often not biochemical but psychological. In addition, the patient may develop a tolerance to pain medications that are consistently prescribed.
  5. Anxiety. Pain may also include anxiety disorders because of increased muscle tension or spasms. Tension headaches, post heart attack pain and other pain syndromes affecting the musculoskeletal system may occur. Patients injured in motor-vehicle accidents often suffer flashbacks of the accident, frequent nightmares, fear of driving or crossing the street, and extreme anxiety when returning to the site of the accident.

What do you need to tell your doctor?

  • Where is the pain and how long have you had it?
  • How bad is your pain? Use descriptive words to explain it to your doctor: is the pain a throb, an ache, a burning sensation, or a tingle? Is it constant or does it come and go? What triggers it?
  • What do you think caused your pain? Tell your doctor about any injuries, illnesses, or activities that you believe are related to the onset of the pain.
  • What medications or other pain-relief methods (including alternative or herbal therapy) have you tried? How effective have they been?
  • Besides this pain, what other medical conditions do you have? Are you taking medications for any of these conditions?
  • How has the pain affected your daily life? Be sure to describe the emotional changes in your life as well as the physical ones.

Pain patients often encounter numerous obstacles in their attempts to find a healthcare professional educated on current clinical thinking in pain management, pain assessment, and pain treatment. What should frustrated patients do? Be aggressive and, above all, educate yourself so you know the right questions to ask.

Some suggestions:

Become an effective advocate

  • Learn what concerns your doctor. One pain specialist advises patients to open a dialogue with the physician -- without getting confrontational. Say, "I get the idea that you're not comfortable about managing my pain." If he or she acknowledges discomfort, ask to be referred to someone else.
  • Describe your pain in ways a doctor can understand. Put a 1 to 10 number on it. Use descriptions such as sharp, stabbing, dull, aching, burning, shock-like, tingling, throbbing, deep, pressing.
    Find a doctor who can help
  • Think of pain as a specialized problem which requires a doctor focused specifically on pain issues. In this type of scenario, your primary care doctor may refer you to a pain specialist for specific treatment -- but you will then go back to your primary care doctor once the situation is under control.
  • Some pain advocates advise changing doctors if your pain remains uncontrolled even after you've tried to discuss or explain the situation to your physician. Advocates suggest networking with other patients to learn which doctors are up-to-date on pain management. Learn about local pain clinics or pain specialty practices. Many larger medical centers have professionals who specialize in pain.

Know your rights

  • Having your pain adequately relieved is now an official patient right in many healthcare settings. The Joint Commission on Accreditation of Healthcare Organizations, a body that reviews standards of care, has started a process that requires all hospitals and nursing homes to specifically ask patients about their pain, assess it and make a plan to treat it, or risk losing accreditation.

Educate yourself

  • Learn about your disorder and then start to network by joining a support group for people with your condition. Or learn through organizations' websites and chat rooms.

Make a pain-relief plan

  • Work with a doctor to create a specific plan for you and set realistic goals.
  • Explore non-drug, non-surgical relief, such as massage, relaxation, meditation, exercise, omega XL, cold and heat treatments. They may not take away your pain completely, but can often lessen the effects.

These articles are not intended as Medical advice, and the author assumes no responsibility for actions taken based on the information contained in this article. If Medical advice or other expert assistance is required, the services of a competent professional should be sought.