Wednesday, April 7, 2010
Obesity drugs -- panacea or fool's paradise
Obesity in Canada is a growing health concern as it is one of the leading causes of preventable deaths. Canada ranks 35th on a 2008 list of fattest countries with a percentage of 61% of its citizens with an unhealthy weight.
In the last few weeks, three small American companies have completed clinical trials of the next wave of obesity drugs and will be considered for approval by the U.S. Food and Drug Administration. If approved, Canada will surely follow. These new drugs are called Contrave, Iorcaserin and Qnexa. In the last wave, when fen-phen drugs hit the market in 1994, prescriptions soared to 20 million in the U.S. alone, but by 1997 deadly side effects (to the heart) surfaced and the drugs were retired by their manufacturers in the face of huge lawsuits.
Clearly, both Canadians and Americans want a quick fix for losing weight. Is this possible? Will there soon be a free lunch?
Here's my take: The human body has evolved over hundreds of thousands of years in an environment somewhat different from the one in which we live today. Up until a hundred years ago, with the exception of pharaohs and kings, humans have had no alternative but to be physically active on a daily basis, just to survive. More recently, on the whole, we have become much more sedentary, and therefore many of us have thus become overweight, or so the statistics inform us.
But here's the problem with all drugs, including past obesity drugs and future ones, too. They introduce chemical formulations into the body that are foreign to us. Did you ever wonder why all drugs have side effects? It is because our bodies are very finely tuned organisms. While that foreign substance wrapped in a pill may result in one positive effect that we seek, it will surely affect something else inside us that may be dangerous or at least disruptive to our good health.
Let's look at the situation another way. After thousands of generations of unmitigated success as a species, our bodies expect the following ingredients to remain healthy, be strong to fight off germs and live a long life: Fresh air, pure water, natural fruits and vegetables, whole grains and nuts, and cooked fish, poultry and meat. Most everything else has the opposite effect: Robbing us of our good health and destroying our immune system.
In conclusion... there is no free lunch. Next month I will discuss a recent study which has surprising and counterintuitive conclusions that support my own beliefs: The only successful formula for losing weight and regaining strength is a change in lifestyle which promotes healthy habits, including physical activities, a proper diet and a positive mental attitude.
Friday, February 26, 2010
Fiber - The ins and outs
The results of a study in teenagers were recently reported in the American Journal of Clinical Nutrition: Over the two-year study period, about half of the participants had decreased their consumption of fiber by an average of about 6 grams per day, while the remainder increased their fiber intake by a similar amount. The investigators were looking at belly fat, which is the most dangerous type of fat; fatter waistlines increase the risk of diabetes and heart disease. Belly fat increased 21 percent for the study participants who were eating less fiber, but the adolescents who upped their fiber intake had a 4 percent reduction in belly fat.
Separately, it was earlier reported at the University of Leeds that pre-menopausal women who eat 30 grams or more of fiber a day cut their risk of breast cancer by 52 percent. This study involved nearly 36,000 women and lasted over eight years. I found these conclusions outstanding! So what's going on with fiber and our health? Exactly what is fiber anyway? What are the best sources of fiber and what are its health benefits?
Officially, fiber is a type of carbohydrate that the body can't digest. Great sources are whole fruits and vegetables, whole grain breads and breakfast cereals, and all manner of beans. The daily amount of fiber that is currently recommended depends on the number of calories that you consume each day. Most adult women should shoot for over 20 grams of fiber a day; teens and men should aim for over 30 grams.
Before discussing fiber's health benefits, let's first bust two myths:
1. All fiber is created equal. Not true. There are two basic types of fiber, with different functions. Insoluble fiber is found in wheat bran, nuts and many vegetables. Its structure is thick and rough, and it won't dissolve in water, so it zips through your digestive tract. Conversely, soluble fiber is found in oats, beans, barley and some fruits. It dissolves in water to form a gel-like material in your digestive tract. This allows it to slow the absorption of sugar into your bloodstream.
2. Fiber has no calories. Not true. Your small intestine can't break down soluble or insoluble fiber; both types just go right through you. That's why some experts say fiber doesn't provide any calories. However, this claim isn't entirely accurate. In your large intestine, soluble fiber's molecules are converted to short-chain fatty acids, which do provide four calories per gram, as with all carbohydrates. (Insoluble fiber has essentially zero calories.)
Finally, let's review a short list of fiber's health benefits and discuss the reasons for these benefits.
- Avoiding and relieving constipation. Fiber can absorb large amounts of water in the bowels, and this makes stools softer and easier to pass.
- Heart disease. Foods containing soluble fiber can have a positive influence on cholesterol, triglycerides, and other particles in the blood that affect the development of heart disease.
- Gallstones and kidney stones. Rapid digestion leads to a rapid release of glucose (sugar) into the bloodstream. To cope with this, the body has to release large amounts of insulin into the bloodstream, and this can make a person more likely to develop gallstones and kidney stones (in addition to diabetes and high cholesterol).
- Keeping Weight Under Control. Foods containing plenty of fiber have more bulk than low-fiber foods. Therefore, fiber can sometimes slow the onset of hunger because the contents of the stomach are bulkier and are retained longer. Here's a tip: avoid foods that have been made easier to eat by the removal of fiber, such as fruit juices. You would be far better off to eat an apple and then drink a glass of water, rather than having a glass of apple juice (which contains no fiber).
Indeed, the list of the health benefits of dietary fiber is much longer. It is safe to conclude that paying more attention to fiber may go a long way to improving your health and avoiding disease.
Wednesday, January 20, 2010
I've been trying for some time to develop a lifestyle that doesn't require my presence
My belief has always been that the lifestyle that we choose does indeed determine our state of health and our chances of living a long life full of zest and joy.
In a recent edition of the Proceedings of the National Academy of Sciences, researchers from the University of Michigan reported some very counterintuitive findings: They looked at death rates during the Great Depression, the worst economic slump of the 20th century. From the stock market crash of 1929 through the early 1930s, economic activity fell sharply, dropping 14 per cent in 1932 alone.
Black and white images from the era of bread lines and migrant farmers make it easy to assume the economic misery would have affected public health. But when the researchers looked at mortality rates among men, women and children from 1920 to 1940, they found death rates declined during years of falling economic activity and rose when times were better.
And so it is with no surprise to the researchers that the same conclusions have already been drawn during the recent worldwide recession: When the economy gets sick, people get healthier. What's going on? How is this possible?
It seems that people adopt smarter lifestyles in recessions. People have less money to spend on alcohol and cigarettes. And less economic activity means people are working less, or not at all. Thus, they have more free time to go to the gym, or even for a walk. Exercise leads to weight loss, which in turn cuts down on the incidence of many maladies, particularly cardiovascular diseases. There's more time for sleep, which improves health. And with less money to spend, people drive less, which reduces pollution. Recent studies have linked particulate matter from cars and trucks and carbon monoxide with heart attacks and strokes.
A University of North Carolina study has found that a one-percentage-point rise in the unemployment rate reduces the death rate by 0.5%. Those are U.S. results, but other studies show the same effect in the 23 OECD countries in aggregate.
The recent downturn in dead people is a reminder that the No. 1 culprit for sickness and disease is lifestyle.
So, why wait for an economic downturn to become healthier? These statistics and studies support my very own enduring belief that the choices we make in how we live our lives determine our own health.
I am often asked for my opinion from friends on which foods are healthier, or which exercises give the quickest results, or how to lose weight and keep it off permanently. It is apparent that old habits are difficult to break and new behaviours are not easy to integrate into our daily routine. Ostensibly, most of us want to improve our health and happiness, but without a change in lifestyle, it doesn't seem to me possible. My response invariably is to choose one modification in behaviour, perhaps going for a half-hour walk every evening, learning a new sport, or attending a weekly lecture and then discover the enjoyment in this simple pleasure. Why not start 2010 off with a new commitment to enhancing your own lifestyle?
Jet lag... can we elude it?
Most of us have the pleasure (or obligation) of flying overseas for vacations, family visits or work. The more time zones that we cross in one journey, the greater the likelihood of suffering from jet lag. Some people may require several days or even a week or more to adjust to a new time zone, while others experience little disruption. How do we know in which group we fall? Here are the typical symptoms for most of us:
- Fatigue, temporary insomnia
- Disorientation, irritability, anxiety
- Headache, nausea
- Digestive problems
Why do people get jet lag? Since the dawn of jet travel we have learned that when traveling across a number of time zones, the body clock will be out of synchronization with the destination time, as it experiences daylight and darkness contrary to the rhythms to which it has grown accustomed: the body's natural pattern of eating, sleeping and hormone regulation is upset!
There are many home remedies that purport to reduce jet lag. How many of these have you tried?
Melatonin. Melatonin is a hormone secreted by the pineal gland in the brain. One of melatonin's key jobs is controlling the body's circadian rhythm--our internal clock that plays an important role in when we fall asleep and when we wake up.
Adjusting sleep and wake time. Involves adjusting a person's bedtime and wake time to the destination time prior to traveling.
Homeopathy. The usual remedies include some or all of these ingredients: Arnica, bellis perennis, chamomilla, ipecacuanha, lycopodium
Valerian. An herb used as a natural sleep aid.
Avoiding alcohol and caffeine. Both can cause dehydration and disrupt sleeping schedules.
To date, with the exception of melatonin, there are no scientific studies to support or reject these remedies.
If you suffer from jet lag, here's my advice for your next trip: The focus of your efforts to minimize, even eliminate, jet lag must be on sleep. As soon as you get a good night's sleep (of eight hours) at your destination, your jet lag is essentially over. If you can at all accomplish this goal on the first night, you may not even get jet lagged at all.
Let's work backwards from that first night's sleep.
If you arrive at your destination in the morning or afternoon, the best advice for sleeping well will be to stay awake all day. This will be challenging if you failed to sleep on the plane, but anything more than a one-hour nap at your destination will probably interfere with your ability to fall asleep at night. Spending the afternoon outside in the daylight and fresh air will help the body to adjust to the new time zone and guarantees that you will be exhausted at bedtime.
If you arrive at your destination in the evening, then you will want to go to bed soon after your arrival. In this case the best advice for sleeping well will be to try not to sleep on the airplane during the flight. This will ensure that you arrive at your destination a little sleep deprived and eager to go to bed.
If you follow my suggestions on your next trip, let me know your conclusions. I will report the results in a future article.
Wednesday, October 7, 2009
How sweet it is! Why sugar may be killing us slowly.
So why is this important to you and me? Are excess refined sugar and sweeteners bad for our health?
The answer is clear when we look at an abbreviated list of how sugar and sweeteners can harm the human body; they can:
- Suppress the immune system
- Contribute to hyperactivity, anxiety, depression
- Produce a significant rise in triglycerides
- Contribute to weight gain and obesity
- Reduce helpful high density cholesterol (HDL)
- Promote an elevation of harmful cholesterol (LDL)
- Increase the risk of cardiovascular disease
An influx of sugar into the bloodstream upsets the body's blood-sugar balance, triggering the release of insulin, which the body uses to keep blood-sugar at a constant and safe level. Insulin also promotes the storage of fat, so that when you eat foods high in sugar, you're making way for rapid weight gain and elevated triglyceride levels, both of which have been linked to cardiovascular disease.
I can guess that you've always wanted to know how to make sense of this, so let's have a look at the chain of events that I have summarized above:
Step 1: The blood vessel's lining (endothelium) is damaged by unhealthy conditions such as high blood levels of cholesterol or glucose (sugar), high blood pressure, or smoking. For example, excessive blood glucose can result in an excessive amount of glucose adhering to and infiltrating the vessel surface, which also activates the inflammatory response.
Step 2: The intima is the innermost muscular layer of the blood vessel wall. The inflammatory response causing the formation of vascular plaque lesions results in thickenings of the intima.
Step 3: The immune system sends platelets (blood cells that are involved in clotting) and other specialized blood cells to the site of the plaque deposit in the intima.
Step 4: As blood cells and other substances continue to accumulate, the plaque deposit grows bigger and digs deeper into the layers of the vessel wall. More immune cells are drawn to the injured vessel, fueling the inflammation process.
Step 5: Increasing inflammation can cause the plaque deposit to break apart, or rupture.
Step 6: Blood clots form on the ruptured plaque and can block blood flow to or within the heart (causing a heart attack) or brain (causing a stroke).
Now that we understand the process better, what can we do avoid this sometimes fatal chain of events? Just how much sugar is safe to consume?
Nobody really knows, however most nutritionists use 10 - 12% as a rough guide of the maximum percentage of your daily calories coming from sugars and sweeteners. This is roughly half the amount that the average Canadian consumes today.
One simple way of reducing the amount of sugars and sweeteners in your diet is to follow one rule: Avoid eating processed foods. Instead, concentrate on eating lots of fruits, vegetables, legumes, lean meats, fishes and dairy products. You just may discover that healthy foods are naturally very tasty and do not need to be sweetened at all!
Friday, August 21, 2009
You are my sunshine
According to the Canadian Cancer Society, skin cancer is the most common form of cancer in Canada.
What exactly is skin cancer and what can we do to avoid joining these gruesome statistics?
In brief, skin cancer is a malignant growth on the skin. There are a variety of different skin cancer symptoms. These include changes in the skin that do not heal, ulcering in the skin, discoloured skin, and changes in existing moles. In Canada, the major cause is overexposure to radiation from the sun or from artificial UV light such as tanning beds or sun lamps.
Some other risk factors include
· light skin, eyes or hair
· skin that burns or freckles easily
· a strong family history of skin cancer
· having many moles
Why do cancer rates continue to increase despite the fact that sales of sunscreen are climbing by 2.5 percent each year, reaching over $100 million in Canada alone last year?
The answer is straightforward: Skin cancer generally has a 20- to 30-year latency period. Many instances of skin cancer in older individuals today can be traced to their behaviours as young adults in the 1970s and early 1980s. Deep tans at that time were routinely regarded as "healthy." Sunburns represented an inconvenient rite of spring or an awkward preliminary stage in the process of acquiring a "healthy" tan. Severe burns were commonplace. Today we know this approach to be reckless. The incidence rates of skin cancer today in persons over 50 years of age reflect that day's popular ignorance.
Interestingly, there are reports coming out of Australia of infants developing rickets, most often caused by a lack of exposure to sunshine due, perhaps, to their overprotective parents.
So then, how much sunshine is the right amount? There is no precise answer, but, I have always used the rule that 10-15 minutes per day is all that is needed to keep our bodies healthy. If you plan to stay outdoors longer, then simply apply a natural sunscreen on all exposed skin. The longer you plan to stay in the sun, the higher the SPF that you need to use. Because it is impractical to apply sunscreen to your head, it is wise to wear a hat or cap to protect your scalp. There is a lot of controversy about sunscreen use, but I will save that discussion for a future article.
What should you do if you do get a sunburn? Treat your skin immediately with a natural cream or gel that should contain one or more of the following ingredients: lavender oil, aloe vera, chamomile or rosehip. These are natural antiseptics, analgesics or are anti-inflammatory and moisturizing.
If you overdid it in the sun, you hopefully only have a mild sunburn. However, if you have a fever or chills or if you feel nauseous, dizzy or faint, it's probably a good idea to call your physician, as these are signs of heat exhaustion and require medical attention.
The summers in Canada are short and it's fun to be outdoors to play or relax, but we all need to have a healthy respect for getting too much of a good thing!
Sunday, August 2, 2009
What would you give for a good night's sleep?
Furthermore, the National Sleep Foundation recently reported that 20 percent of Americans, up from 13 percent just eight years ago, sleep fewer than six hours a night. It said the lucky few who sleep a full eight hours or more dropped to 28 percent, from 38 percent. There is no reason to believe that Canadians are any different from Americans when it comes to our sleep habits.
Is this news really important to you and me? Are we walking zombies during the day, craving a mid-day snooze?
Here's my take: Would you believe scientists aren't yet really certain why we need sleep at all? One recent and controversial conclusion is that our immune system is being recharged while we sleep. If this were true, it is reason enough why a good night's sleep, however elusive, is most important to maintaining good health.
But we do all agree what happens when we do not get enough sleep. We have low energy, a lack of motivation, concentration problems, daytime drowsiness, headaches and/or mood changes.
What are the causes of sleeplessness or insomnia? Some of the more frequent causes are anxiety, depression, various diseases, excitement, grief, stress and stimulants such as alcohol, nicotine, caffeine and food.
So, what can we do to ensure that we sleep deeply and wake up refreshed and rested every day? Eliminating the root cause of the problem is a good start. But in the meantime, I have some ideas for you that have proved successful for others:
Avoid stressful situations before bedtime.
Exercise regularly, but not in the last three hours before going to bed.
Relax by reading, taking a bath, or listening to soothing music before going to bed.
Remove your TV or computer from your bedroom. Otherwise, your brain becomes used to the stimulation and starts to expect it when you are there. This makes it harder for you to fall asleep.
Establish a regular bedtime, but do not go to bed if you feel wide awake.
Avoid using alcohol in the evening. Avoid caffeine for at least four hours before bedtime. Give up smoking, because nicotine is a stimulant.
If you can't fall asleep after 20 minutes, get out of bed and do a quiet activity such as reading or listening to music. When you feel sleepy, get back in bed and try again. If not successful in 20 minutes, repeat.
If you do wake up in the middle of the night, do not let that worry you. Some sleep researchers feel that waking up in the middle of the night is normal, even expected. You can decide to read or have a glass of milk to become sleepy again. Milk? Yes, that old tale of a drinking a glass of milk to help you sleep has some scientific merit after all. Milk contains a natural sleep inducer called L-tryptophan. This may help explain why babies sleep so much.
Tonight would be a good time to begin reading that book you've been meaning to start, so relax, enjoy the slower pace before bedtime, and you, too, should be able to "sleep like a baby!"
