KNIGHT WATCH

CAN'T HEALTH TOURISM START AT HOME?

Cardiovascular disease is the leading killer of men and women worldwide. The key preventions are smoking cessation; control of cholesterol, blood pressure and weight; and exercise. In fact, exercise helps to control cholesterol, blood pressure and weight. The Centers for Disease Control and Prevention recommends at least 150 minutes of moderate exercise weekly – but you don’t have to do it all at once. You can break that time into 10-minute segments and still benefit. To quote a spokesperson for the American Heart Association, “If you don’t find time for exercise, you will have to find time for disease”.

A study published in JAMA found women are likelier not to have chest pain when they have heart attacks. When data from 1.1 million heart attacks was analyzed, 42% of women didn’t have chest pain when they were admitted to the hospital compared to 31% of men. Also, 15% of women died in the hospital compared to 10% of men. Thus it’s especially important for women to know the other symptoms of heart attack – shortness of breath, nausea and pain in the jaw or back. However, as women age their symptoms are more like men’s - maybe another reason it’s called “menopause”.

Colon cancer is the second leading cancer killer of men and women in the U.S. and fourth worldwide. A study published in the New England Journal of Medicine found those who had precancerous growths removed during colonoscopies had 53% lower risk of colon cancer death than expected in the general public. In another Journal study participants were given colonoscopies or stool blood tests. Colonoscopies found advanced growths in twice as many participants and less serious growths in 10 times as many. Considering 143,000 new cases of colon cancer are expected in the U.S. in 2012, colonoscopies are the “bottom line”.

Thankfully, our pets make us healthier. A study published in 1980 found heart attack patients who owned pets lived longer than those who didn’t. Another early study showed petting one’s own dog reduced blood pressure. More recently studies done at the University of Missouri College of Veterinary Medicine found interacting with animals increased our level of the hormone oxytocin. Oxytocin helps us feel happy and trusting, but it also has long-term health benefits. Because it affects the body’s readiness to heal and to grow new cells, oxytocin predisposes our bodies to be healthier. So … reach out and pet something.

 

HAVE WE "WEIGHTED" TOO LONG?

Doctors overestimate our ability to lose weight. A study published in the journal Family Practice was based on openly recorded conversations between 40 doctors and 461 of their overweight or obese patients. The doctors predicted that 55% of their patients would be likely or very likely to follow their recommendations for losing weight, eating healthier or getting more exercise. However, 3 months later only 28% had lost at least 2 pounds, 34% were eating less fat and more fiber, and 6% were briskly walking an extra hour a week. It seems doctors aren’t good at playing the “weighting game”.

Downsizing is a good way to lose weight. In a study published in the journal Health Affairs, fast-food customers were asked if they wanted to downsize side-dish portions. One-third chose the smaller – and thus lower-calorie – side dishes. In another study also in Health Affairs, one group of customers was offered a 25-cent discount for smaller side dishes and two groups weren’t. When there was a discount, 33% of the people chose smaller portions as compared to 18% and 21% of the groups who didn’t get a discount. Obviously, we are likelier to downsize if we “put our money where our mouth is”.

Switching from soda to diet soda is a good way to lose weight. However, switching to water is better. A 6-month study of 318 overweight or obese participants published in the American Journal of Clinical Nutrition showed people who switched from sugary drinks to diet drinks or water lost about the same amount of weight, but those who switched to water had lower fasting glucose levels. Less weight and lower fasting glucose levels reduce the risk of obesity-related, chronic diseases like type 2 diabetes and heart disease. Hopefully, information from this study won’t be “water under the bridge”.

Being overweight is bad for our pets too. As with humans, excess weight can cause high blood pressure, arthritis, diabetes and some cancers. Also the animals’ lives are shortened by 2-2.5 years. According to a study by the Association for Pet Obesity Prevention, 53% of adult dogs and 55% of cats were classified by their veterinarians as overweight or obese. That translates into 41 million dogs and 47 million cats. Unfortunately, owners were unaware their pets were overweight. Twenty-two percent of dog owners and 15% of cat owners wrongfully thought their pets were normal weight. This could be a “dog-ged” “cat-astrophe”.

 

IS IT ALL ABOUT FEELING GOOD?

We already know the Mediterranean Diet is good because it lowers risk of heart disease, stroke and dementia. Now maybe we know why. In a study published in the Archives of Neurology, researchers compared brain scans and diets of 966 adults – average age 72. Those who most closely followed the Mediterranean Diet (fruits, vegetables, fish, whole grains, legumes, olive oil and moderate alcohol) had the least small blood vessel damage in their brain. Because this damage increases with age and predicts higher risks of stroke and dementia, perhaps in this case the word diet should be changed to “livet”.

Massage does more than feel good. Researchers put 11 men through a hard exercise routine. After the workout each man got a 10-minute, Swedish-type massage on one leg. Using gene-profiling techniques, muscle samples from both legs were compared before and after the workout. The gene profiling showed massage had activated genes that decrease inflammation and genes that promote the creation of mitochondria – structures that are like energy factories inside cells. The fitter a muscle, the more mitochondria it has. According to this study, massage helps both muscle recovery and muscle growth. That’s information that can’t “rub someone the wrong way”.

Knee replacements make us feel good … again. In 2009 the number of those surgeries topped 600,000 – having doubled in 10 years. In 2012 there were 4.5 million Americans who had had knee replacement surgery. That’s according to a report presented to the American Academy of Orthopedic Surgeons. Because the surgery becomes more common with age, part of the increase in knee replacements was due to people age 80 and over. Another part was due to obese baby boomers. However, the majority of the increase was due to injuries in active middle-agers – who had decided they didn’t “kneed” the pain.

Finally, marijuana may feel good; but it almost doubles the risk of vehicle collisions. In a study published in the British Medical Journal, researchers reviewed 9 marijuana/driving studies that included approximately 50,000 people. Alcohol affects drivers’ speed and reaction time; marijuana affects spatial location. Drivers may follow cars too closely and swerve in and out of lanes. People impaired by alcohol often realize they are impaired; those impaired by marijuana often don’t. If drivers are 35 or younger, there’s a higher likelihood of marijuana causing collisions than previously thought. Those driving after smoking pot within 3-4 hours aren’t using their “potheads”.

 

HOW LONG CAN WE REMEMBER THIS?

Keeping your brain active throughout life helps prevent Alzheimer’s. A study published in JAMA Archives of Neurology included 65 healthy adults ages 60 and older, 10 adults with Alzheimer’s and 11 adults ages 20-30. All the participants completed mental tests, answered questions about mentally challenging activities and had brain scans. Older adults with the highest cognitive activity over a lifetime – reading, writing, puzzles – had ofbeta-amyloid levels (a protein linked to Alzheimer’s) comparable to the younger adults. Older adults with the least cognitive activity had ofbeta-amyloid levels comparable to those with Alzheimer’s. Hmmm, let’s think of crossword puzzles and “happyword” puzzles.

Overeating may increase the risk of memory loss in the elderly. A Mayo Clinic study included 1,200 seniors – ages 70-89 – of which 163 had mild cognitive impairment. MCI is the intermediate stage between normal cognitive decline and dementia and it increases the risk of dementia. In the study seniors were questioned about their daily caloric intake and then divided into 3 caloric groups: 600-1,526; 1,526-2,143; and 2,143-6,000 calories daily. The risk of MCI was more than double for those in the highest caloric group. It seems remembering not to overeat now will help us to remember that and more when we’re seniors.

Mild memory problems are more common in men. Symptoms include difficulty remembering recent events and/or new information, as well as problems with language, thinking or judgment. The 1,450 study participants ages 70-89 were dementia free. They took mental tests every 15 months for 3 years and were interviewed about their memory. The rate of developing mild cognitive impairment was higher among men. It was also higher in the less educated and singles. Some of the strongest risk factors for MCI are high blood pressure, diabetes and obesity – which occur earlier in men – and may explain the “men” in dementia.

Smoking may cause earlier mental decline in men. According to a study published in the Archives of General Psychiatry, the mental function of a 50-year-old, male smoker can decline as quickly as that of a 60-year-old non-smoker. This was true even when educational level and overall health were considered. Also, this finding didn’t apply to just pack-a-day smokers. Intermittent smokers showed the same cognitive decline as persistent smokers. Surprisingly, the same cognitive decline wasn’t seen in female smokers. However, this finding was attributed to gender differences in smoking and health patterns – not because female brains received different “smoke signals”.

 

WHAT'S DANGEROUS TO OUR HEALTH NOW?

Middle age can be dangerous to your health. According to a study published in the New England Journal of Medicine, men age 45 who have 2 or more or the following risk factors – high blood pressure, high cholesterol, diabetes or smoking – have a 50% chance of heart attack or stroke during the remainder of their lives. Women age 45 with 2 risk factors have a 30% chance. However, even 1 risk factor dramatically increases the risk of heart disease. Considering 95% of middle-aged Americans (ages 45-55) have at least 1 risk factor, only 5% don’t have to “take this information to heart”.

Working long hours can be dangerous to your health. A study published in the journal PLoS ONE followed 2,123 civil servants for 6 years and found those who worked an average of at least 11 hours a day at the office had about 2.5 times the risk of depression than employees who worked 7-8 hours. This was true even when job strain, workplace support, alcohol use, smoking and chronic physical disease were considered. However, the length of workdays didn’t have a perceptible effect on the mental health of higher-paid, top-level employees – unless it interfered with golf.

Lack of sun can be dangerous to your health. A study presented at the American Stroke Association’s International Conference combined data from a long-term stroke study of more than 30,000 Caucasians and African Americans age 45 and older with NASA satellite and ground monitor data. Researchers were thus able to determine how sunlight and temperature exposure corresponded with stroke risk. In addition to confirming that hot and cold temperatures are associated with higher stroke risk, the findings showed that people who had less than average sun exposure had a 60% increased stroke risk. As opposed to sunstroke, this is “lack-of-sunstroke”.

Finally, high heels can be dangerous to your health. They force toes to be constantly pointed. A study published in the Journal of Applied Physiology compared the walk of 9 women who had worn 2-inch plus heels 40 hours weekly for at least 2 years with the walk of 10 women who’d worn heels less than 10 hours weekly. The heel lovers tended to walk with a flexed foot even when they walked barefoot. Fibers in their calf muscles had shortened and their Achilles tendons were stiff. Both conditions contribute to muscle fatigue and potential injury. Obviously, heels aren’t a “natural high”.

 

WHAT CAN WE DO BESIDES JUST SIT THERE?

Exercising to maintain a healthy weight reduces breast cancer risk. According to the Women’s Health Initiative, postmenopausal women who walked 30 minutes daily reduced breast cancer risk 20%. According to an American Cancer Society study, women gaining 21-30 pounds after age 18 were 40% likelier to develop breast cancer than women who stayed within 5 pounds of their youthful weight. Those gaining more than 70 pounds doubled their risk. Overall, obese women were 30%-50% likelier to develop the disease than women who maintained a healthy weight. Exercise is important. The only but about it is … a bigger “butt”.

Exercise and a healthy diet reduce risk of dementia, which is important to know because a study published in the British Medical Journal found signs of age-related cognitive decline in people 45 years old. Researchers tracked 7,400 people ages 45-70 for 10 years. They were repeatedly tested for memory and vocabulary, as well as auditory and visual learning. Mental abilities declined in everything except vocabulary. Specifically, there was a 3.6% decline in mental abilities for people ages 45-49. However, because the youngest people in the study were 45, mental decline may start earlier. It may be already later than we think.

Both yoga and stretching relieve back pain. A study published in the Archives of Internal Medicine randomly assigned 228 adults with moderate chronic back pain to weekly yoga classes, weekly stretching classes or gave them a book about back pain. The yoga and stretching groups were also given instructional videos and encouraged to practice 20 minutes daily. Three months later 40% of the yoga and stretching groups had reduced their mediation compared to 20% of the book group. It seems beginner yoga or stretching classes that focus on the back and legs can provide a “leg-up” on back pain.

Frequent dental cleanings reduce heart disease and stroke risk. Research presented to the American Heart Association followed more than 100,000 patients for 7 years – only half of whom had ever had their teeth cleaned. Those who had dental cleanings had 24% lower risk of heart attack and 13% lower risk of stroke. Those who had dental cleanings at least yearly had even lower risk. It seems oral bacteria can enter the bloodstream, grow into plaque and clog arteries. Because it’s foreign material, bacteria can also cause inflammation and swelling that narrows blood vessels. Obviously, not even bacteria from teeth are “toothsome”.

 

WHY IS OBESITY STILL BIG NEWS?

Night shift workers have an increased risk of obesity. An editorial in PLoS Medicine, an online medical journal, attributed this in part to diet. Options for eating at 3 am seem to be limited to convenience stores and fast food restaurants. Night shift workers who don’t bring food from home and who don’t have time to leave the building are stuck with vending machine food. Night shift workers also tend to exercise and sleep less because of their schedules. For the 15 million Americans who work the night shift, a healthy diet could make a “night and day” difference.

Obesity may change the brain. In a study published in the Journal of Clinical Investigation, rodents were fed a typical, high-fat, American diet. In just one day inflammation was found in their hypothalamus – the part of the brain that helps regulate body weight and hunger. Within a week the animals’ brains activated brain cells that repair and protect damaged neurons. Then researchers looked at brain scans of 34 humans and found obese people had more repair activity in the hypothalamus. Because researchers think this may explain why it’s hard to keep weight off, this information should be “weightlisted”.

Obese or overweight - if people eat too much, decreasing or increasing protein won’t cause weight loss. A study published in the Journal of the American Medical Association put 25 normal-weight people – ages 18-35 – on a low-protein diet (5%), a normal diet (15%) or a high-protein diet (25%) for 12 weeks. For the last 8 weeks everyone ate 1,000 extra calories. Although the low-protein dieters gained only half as much weight, it was because they lost muscle. They actually stored a higher percentage of calories as fat. The high-protein dieters had the opposite results. That decreasing or increasing protein can cause weight loss is a big, “fat” lie.

Weight loss surgery does more than reduce risk of obesity and type 2 diabetes. It also reduces risk of heart attack and stroke. Another study published in JAMA included about 2,000 weight-loss surgery patients and a similar number of obese people. Most were in their 40’s and 50’s and all were followed for an average of 14 years. Weight-loss surgery was associated with 33% fewer heart attacks and stokes and 53% fewer deaths from both. About 200,000 weight-reduction surgeries are performed yearly in the U.S. That’s a lot of heart attack and stroke reduction too. 

 

WHAT'S BEEN FOUND ABOUT MEMORY LOSS?

Memory loss can be caused by silent strokes. These strokes don’t always cause noticeable symptoms, but they result in small pockets of dead brain cells and are found in about 25% of seniors. A study published in the journal Neurology included 658 adults age 65 and older – all without dementia. They had brain scans and were tested for memory, language skills, thinking speed and visual perception. The brain scans showed 174 of the participants had experienced silent strokes and those participants didn’t perform as well on the memory tests. Research into stroke prevention continues – with the exception of “strokes of genius”.

A fat hormone can increase the risk of dementia and Alzheimer’s. That’s according to a study published in the Archives of Neurology. Adiponectin is a hormone produced by fat cells. It helps regulate the body’s response to insulin and metabolism. Although higher levels help lower the risk of Type 2 Diabetes, higher levels were found in older women with dementia. Higher levels increased the likelihood of dementia 60% and Alzheimer’s 90%. However, older women who were fatter had lower levels of adiponectin and dementia. Although no men were in the study, they have a “fat chance” of not being similarly affected.

However, slow response times aren’t necessarily a sign of early dementia. A study done at Ohio State University asked 300 volunteers to watch asterisks flash on a computer screen. Then they were told to quickly decide whether they had been shown 31 to 50 asterisks or 51 to 70. Response times and accuracy improved with age up to a point. Accuracy remained good among seniors, but response times got slower as people got older. Because of failing memories, older people are more careful when deliberating; and this carefulness slows their decision making to “slow but sure”.

More good news – in the future a spinal tap may predict Alzheimer’s. A study published in the Archives of General Psychiatry suggests 2 biomarkers found in cerebrospinal fluid (the fluid that surrounds and protects the spinal cord and brain) could predict when mild cognitive impairment will become Alzheimer’s. Both biomarkers are proteins. An increase in “tau” is associated with neurofibrillary tangles in the brain. A decrease in “beta-amyloid” is associated with plaque formation in the brain and is an earlier predictor. Alzheimer’s treatment is thought to be more effective the earlier it’s diagnosed and this study has “tapped into” an early diagnosis.

 

HOW CAN WE AVOID ALZHEIMER'S?

 Lifestyle changes can delay or prevent late-life Alzheimer’s, which affects people in their 80’s and 90’s – especially if the changes begin in midlife. Being physically fit is the most important factor in keeping the brain young. Being socially active and mentally engaged in new and challenging ways are two other factors. Moderate exercise increases the size of the shrinking hippocampus – the part of the brain responsible for forming memories. Exercise also maintains healthy blood flow to the brain – important because blood vessels make up one-third of the brain’s volume. It seems you can’t start to early to avoid late-life Alzheimer’s.

Nutrition also helps prevent Alzheimer’s. Because brain and heart health are very closely related, a heart-healthy diet is essential. Safflower and sunflower oils plus nuts and green vegetables are good sources of anti-oxidant-rich vitamin E, which significantly lowers Alzheimer’s risk. Four ounces of fatty fish (lake trout, salmon, sardines, tuna) – eaten at least twice weekly - increase Omega-3 fatty acids, which aid mental function. Finally, the spice turmeric protects the brain and is thought partly responsible for the much lower rate of Alzheimer’s in India. Considering Alzheimer’s is the sixth-leading cause of death in the U.S., think “newtrition”.

A study published in the journal Neurology shows how nutrition affects our brain. The blood of 104 elderly volunteers was tested for a variety of nutrients. The volunteers were also given tests to measure memory and thinking abilities and 42 of them had MRI scans to measure brain size. Those who tested high in omega-3 fatty acids and vitamin D (fish) plus vitamins C, E and B (vegetables) were less likely to have brain shrinkage and more likely to test well than those eating trans fats (margarine, packaged foods, baked goods, fast food). According to this, trans fats are a “brain drain”.

However, flu shots don’t increase Alzheimer’s risk. There is no research showing an additive in the shot is responsible for difficulties with thought, memory and language. In fact, a Canadian study of more than 4,000 adults showed past exposure to several vaccines – including flu vaccine – was linked to reduced risk of Alzheimer’s. Other research has shown getting an annual flu vaccine was linked to lower risk of death in the elderly. Annual flu vaccine is recommended for everyone 6 months and older – but especially for those under 5 and over 50. Obviously, we should let our doctors “call the shots”.

 

WHY DOES OUR HEALTH HAVE SO MANY IF'S?

If your nose runs when you are exercising, you’re one of the 10%-20% of Americans with “exercise induced rhinitis”. EIR is much like allergic rhinitis, also called hay fever or nasal allergies; and the symptoms are similar – congestion, sneezing, itchiness and runny nose. It is more common in people who have allergies and in people who exercise outdoors. It’s also more common in winter. Although the exact cause of this condition isn’t known, medical research is pointing to pollution, specifically nitrogen dioxide found in car exhaust. When cars run, so do EIR noses.

If you have acid reflux, you’re one of the 60 million Americans who experience it at least monthly. However, 15 million experience it daily. A Norwegian study conducted from 1995 to 2009 found the number of people who frequently experienced symptoms almost doubled in the past decade. More women have acid reflux, but it’s more common in both sexes toward middle age. Too much stomach acid can scar the esophagus and the acid can increase the risk of esophageal cancer if chronic and untreated. Although many researchers attribute the increase in acid reflux to the increase in obesity, that explanation “wears thin” with some Americans.

If you get a cat, your risk for cat allergy almost doubles. An Italian study included 6,300 people ages 20-44 who weren’t allergic to cats. Nine years later they were tested again. Although 231 had become sensitized to cats, those who got a cat during the study were 1.8 times likelier to develop cat allergy. Those who already had allergies or asthma were 3-4 times likelier to develop cat allergy. However, 89 people who had a cat or got one during the study didn’t let their cat into their bedroom. None of them developed cat allergy. None of them “catnapped”.

If you are a woman, clogged arteries present different dangers than to men. A study presented to the Radiological Society of North America included 480 patients – average age 55 – with acute chest pain. By combining CT angiographies with 13 months of follow-up, scientists discovered the risk of major cardiac events were significantly higher in women with large amounts of plaque buildup and extensive hardening of the arteries. Men had greater risk of heart attack or coronary bypass surgery when their arteries contained “non-calcified plaque” – fatty deposits that accumulate deep in artery walls. Doctors wanting to customize care will find this information “heartening”.