Diet and Exercise keeps you healthy - not a surprise

Many studies have been published showing that proper diet and exercise programs not only keep you healthy, but can prolong life.

Some of you may have read about the recent increase rates of colon cancer in younger (under age 50) individuals in the United States. While rates have decreased in those over 50 (perhaps due to the colonoscopy screening removing pre-cancerous lesions), rates have increased by up to 3% for those in their 20's and 30's. (J Natl Cancer Inst (2017) 109 (8)). The authors speculate that diet and the increased rate of obesity, both of which have been shown to increase cancer risk are the cause.

In another study -JAMA 2017 Mar 7; 317:912 - researchers found that not eating healthy foods resulted in much higher risks of heart disease. Suboptimal intake of 10 dietary factors accounted for 45.4% of 702,308 cardiometabolic disease–related deaths in 2012; the largest contributors to these deaths were high sodium intake (9.5%), low consumption of nuts and seeds (8.5%), and high intake of processed meats (8.2%). Between 2002 and 2012, mortality fell by 25%, with the greatest effects coming from improved intakes of polyunsaturated fats and nuts and seeds and lower intake of sugar-sweetened beverages.

And finally, recent studies in the British Medical Journal of Sports Medicine have shown that interval training (95% of maximum capacity) improved many variables that are associated longevity - including better oxygen use and uptake. And the improvements were 50% better in those over the age of 50!

So eat well, exercise, and do those intervals if you want to have a long healthy life!!

Vitamin D - much a-Do about nothing?

Until about 10 years ago, we never considered Vitamin D deficiency as a common syndrome - only rare severe cases with bone disease was in the medical books.

As the test became more available, and more studies came out, it seemed that deficiency was associated with everything from cancer to emotional disorders. But is this real?

From a recent study in the British Medical Journal, the press headlined that Vitamin D prevents respiratory infections. In actuality, the study found, yes, it did seem to, but the incidence of acute respiratory tract infection was only lower with supplementation than with placebo by 1.9% (40.3% vs. 42.2%).

In an associated editorial (BMJ 2017;356:j456 ), Alison Avenell, one of the editorial’s authors, stated that there’s not enough evidence supporting taking vitamin D for disease prevention, even though low vitamin D levels have been associated with everything from cancer to Alzheimer’s. Avenell has also spent almost two decades studying whether vitamin D can prevent bone fractures and so far she’s found no evidence there, either.

Many of the studies are based on self reporting symptoms and vitamin use. So it seems that although slightly low levels of Vitamin D may occur commonly, we really don't know if taking supplements are worthwhile. If it is, it seems the effects are minimal.

I personally do not test myself for Vitamin D. If you decide to take Vitamin D, most recommendations are that you take no more than 2000U daily. This is probably safe. Oh, and sunshine does provide natural Vitamin D!

Is Colorado the new Amsterdam?

Since legalization of marijuana in Colorado, it has become a tourist state for cannibis. And apparently the tourists seem to be the ones who have the most problems.

After legalization in 2014, ER visits for cannibis doubled among non-residents but stayed constant with residents. The resaerchers They caution that intoxication from ingesting edible marijuana products can cause severe, unpredictable symptoms, including psychosis, and that novice users and children are particularly at risk; younger children can suffer significant central nervous system depression. This seems to be more likely in marijuana tourists.

Regardless of its legality, Marijuana is a drug with many side effects. and should be treated as such.

Kim HS and Monte AA., Ann Emerg Med 2016 Feb 24; 374:797

Is Acetaminophen (Tylenol) Dangerous during Pregnancy?

In a recent study (JAMA Pediatr 2016 Aug 15; ) reasearchers looked at the pre-natal use of acetominophen and the incidence of psychological behaviors in children.

They found up to a 20% increase in conduct problems at 18 and 32 weeks, hyperactivity problems at 18 and 32 weeks and emotional symptoms at 32 weeks.

This needs further research however; such as the reason the mothers took the medication. Furthermore fever and infection, common reasons for taking acetaminophen, can produce epigenetic and brain changes, as shown in an animal study (Biol Psychiatry 2016 Aug 12.

This is a bit of a conundrum. Avoid medications whenever possible during pregnancy, and don't run to pills unnecessarily. However if your physician suggests taking acetaminophen is worthwhile for your fever you probably should take it!

Toxins in baby Teething Products

Many people believe that "homeopathic" means natural and better. Really it just refers to the practice of medicine that embraces a holistic, natural approach to the treatment of the sick. There is no real regulation of products that are called homeopathic.

The FDA has confirmed that homeopathic teething tablets marketed by Hyland's contain elevated amounts of the toxic substance belladonna (deadly nightshade) and is warning consumers not to use them. Symptoms of belladonna toxicity include agitation, difficulty breathing, lethargy, muscle weakness, seizures, skin flushing, and constipation.

We should always remember that homeopathic products do not require approval by the FDA, nor have they been evaluated for safety. Three products containing belladonna were recalled by Rarity Pharmaceuticals this past November.

The manufacturer has not agreed to a recall, says the FDA, but a letter to consumers on the Hyland's website notes that their teething products are no longer being distributed in the U.S.

I would not use such products unless I can be assured of their safety and efficacy.

https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm538687.htm

Obamacare Version 2

Obamacare Part Two

After years of crying wolf, the new administration has "admitted" that the Affordable Care Act was a good thing. But, they must make dramatic changes to justify their years of crocodile tears.

The current bill, which is expected to have widespread opposition from both parties includes the following:

• There's no longer an individual mandate for coverage, but people who go without coverage for more than 2 months would face a 30% increase in premiums when they reenter the system. This might be a good way to get people to sign up.

• Older people could be charged up to five times the insurance rates paid by young people. Not so good; once again the insurance companies can charge such high fees for older individuals and those with pre-existing conditions as to make insurance unaffordable.

• Medicaid expansion would be reduced starting in 2020. This probably would mean millions uninsured again.

• Larger companies would not have to provide affordable insurance. Shifting the cost to those who cannot afford it.

• Money for Planned Parenthood clinics would be cut off for 1 year. This is clearly only political.

Among the things that would not change:

• Children could still remain on their parents' plans until age 26.

• The 10 essential health benefits mandated under ACA, including maternity care and preventive services.

• Coverage for "preexisting conditions."

As well, they want to allow selling of insurance across state lines. This might be a good thing.

Don't expect this to be the final answer as the special interests will undoubtedly get involved!

New York Times Article

Tea for You and your heart

In a recent study, researchers followed almost 7,000 subjects to see what could cahnge their risk for heart disease. In this analysis they found that coffee or caffeine had no effect, but tea drinkers actually seemed to lower their risk. They did not report the amount of cream or sugar; but iit seems that avoiding these should help.

Am J Med 2017 Feb 130:188