Thursday, December 13, 2012

Have a Seat. Relax.


In what is apparently an ongoing theme around here we have an article on sitting from the old grey lady.
It's not the sitting that is the theme.
It's the not moving.

Both The British Journal of Sports Medicine and  Diabetologia, a journal of the European Association for the Study of Diabetes found that sitting for long periods is unhealthy even when you are active at other times. That is, just because you work out at 5 a.m. each day before planting your bottom in that comfy task chair in cubieville, use the stairs, park in the next zip to increase walking time, then work out again after your day job, you still are going to feel the ill effects of the long sitting.

And what are these ill effects you know full well I'm going to tell you about?
Glucose metabolism lowered. Diabetes.
High density lipoprotein (hardly ever see that spelled out do we?) lowered. Heart disease.
Sit for an hour and your production of fat burning enzymes (lipases?) decline up to 90%.



See that workstation up there? The lady standing at her screen? If the Times article is to be believed that is how life in the land of cubes is going.

Sadly, I'm writing from a task chair in the corner of my small, private office with a laptop on my lap.
(They're "laptops", so they should darn well be on the lap, right?)
I used to use a drafting table a decade or so ago. Standing. It left me, love it though I did.
And so I'm not unused to standing and working on the keyboard.
I welcome this possible sea change in the nation's workstations.

You early adopters be sure to call me when the heel spurs and plantar fasciitis get unbearable.

Update: http://www.marketwatch.com/story/is-your-ergonomic-desk-trying-to-kill-you-2013-01-29







Tuesday, November 13, 2012

Killer Kitchens



We've probably all heard that the kitchen and bathroom are the most dangerous rooms in the house.
And we've all also likely heard that the greatest return on investment in a remodel comes from remodeling these ever so dangerous rooms.
Now consider that before the crash when money was cheap and plentiful, lenders were unscrupulous, and refi's ubiquitous, a lot of folks either went for high end materials in their new home kitchen or a remodel.

Enter the granite countertop.

It has come for your soul.

I'm years behind on this one. How could I not have heard?
Some granite countertops emit RADON, a radioactive gas.
Radon is listed as the second leading cause of lung cancer following cigarette smoking.

I previously only thought of radon as seeping into the home through the ground, collecting in the basement.

Not all granite will emit the gas and not all emitting granite will emit concerning amounts.
Whatever a concerning amount may be to you. There is no safe level of radon.
4 picocuries of radon per liter of air is the "Yes, we have a problem here level", according to EPA.

Testing kits can be purchased for under $50.
Abatement cost if the levels concern you?
Thousands?

Maybe you should have kept the harvest yellow formica.

Addition:

Just happened upon these factoids.

 The US Capitol Building in Washington DC:
                                                 Ship of Fools and you get to pick the crew!
"This building is so radioactive, due to the high uranium content in its granite walls, it could never be licensed as a nuclear power reactor site."

Thursday, November 8, 2012

FDA Watchlist Drug Two: Antibiotic

The second watch-listed medication that caught my attention are fluoroquinolones.
These are broad-spectrum antibiotics.
They are sold under brand names such as Cipro, Levaquin, and Floxin.

The current concern is over retinal detachment.
But that isn't the only eye-related secondary effect of the antibiotic.
Dim vision, double vision, cataracts, flashing lights, floaters.
Reversible blindness and irreversible blindness.
The laundry list of unwanted effects covers multiple body systems and is, indeed, long.
 

One interesting unwanted effect of flouroquinolone use is spontaneous tendon rupture.
Ruptures occurred hours to months after initiating treatment.
That must come as a shocking surprise. Especially when you are told (if you are told) that your antibiotic is to blame.

Four drugs within this class have been removed because of "unacceptably" high adverse reactions.

There have been class action suits.
There are consumer protection groups targeting these drugs.
What a nasty little mess they are.

I stand on the same position with fluoroquinolones as with other antibiotics.
Great tool for infection suppression/eradication. Great gift to mankind.
Misused, overused, and abused.

Traveling the Chilean countryside I asked my driver to stop at a pharmacia. The bad air in Santiago had taken its toll on me following the bad air on the Lan Chile flight from Kennedy.
I wanted a decongestant.
The pharmacist asked if I wanted an antibiotic as well.
No exam. Not even a single question about symptoms.
It was the common cold.
Any of 200+ strains of viruses.

And so our war on infection continues.
With us wasting our greatest weapons through sloth and ignorance.

Update:  Probiotic versus bowel infection.
It was just this kind of research some years ago that turned me toward interest in gut health.
One month reports came out about 14 deaths in UK hospitals from Clostridium infection-- later found to have been introduced by nurses dirty fingernails.
The next month several internists at a US hospital co-authored a paper on probiotics preventing Clostridium infection in a hospital setting.

The disconnect used to infuriate me.
Now I see it as sad/pathetic.




Friday, October 26, 2012

Stay Sharp

Nice bit in Neurology here about exercise versus mental games in preserving mental function.
Unfortunately...no causation established.

But you have to keep moving.
If you're not moving you're dead.

Whether or not keeping on the move will allow you to remember where you put your keys is one thing.
But how about we narrow our view down a bit?
Way, way down.
Microscopic way down.

Ever seen an x-ray of a neck?
Did someone point out an area of degeneration?
Disc space is narrow or absent. Spurs. Messy looking anatomy.
 
How does this happen?
How about because you didn't keep moving.
 
See those spinal bones up there?
Between each one is (or in this case, was) a disc. A disc is a shock absorber between vertebrae. You know what happens when your car's shocks are shot. Now glance up at the radiograph and see what happens when your shocks are shot.
 
Our shock absorbers are always compared to a jelly donut. Gooey inside with hard tissue holding it in. The hard tissue is like a bias-ply tire. Basket weave strands of ligament make for a strong but pliable sack.
That's what your spine bounces around on.
 
Problem:  Ligaments and tendons are slow healers and poor healers, relative to, say, muscle. Muscle gets plenty of blood (read: nutrients). Muscle is able to shed it's cellular waste easily.
Ligaments, not so much. No blood supply (i.e., avascular. Strange words are fun!), they receive nourishment and shed metabolic waste as bulk fluid flow across the endplates of the bones where they are attached.
In the morning the discs are nice and plump having been slowly swollen during rest.
Move around all day and they pump out fluid, becoming smaller.
And with that pumping action the disc rids itself of waste.
 
When we think of body movement it usually is of the gross kind, eg. walking.
But focusing down to disc level you can see that spinal motion is necessary for disc survival.
Focus down further to cell level with me and watch the disc die.
 
When spinal motion is lost from, for instance, a car wreck, the vertebrae above and below a disc (the motor unit) may become fixed.
Since the disc is dependant upon motion to remove waste, and the motion is lost, waste accumulates in the disc.  Until motion is restored it can never properly or fully be cleansed of waste. The pH goes down within the disc (becomes acidic).  Oxygen is lacking (hypoxia). Cells are destroyed (apoptosis. Another fun word!).
Poisoned and asphyxiated, the disc dies.
And you get x-rays like the one above.
 
 
 
I hope you have enjoyed our brief foray into desmology.
 
Update:
Get Up, Stand Up: Sitting for Too Long Doubles Diabetes Risk. Medscape. Oct 15, 2012.         
 
 
Fat Chance
 
Reserch from the Mayo Clinic has shown that belly fat is a good indicator of potential cardiovascular death.  Even those with otherwise normal weight who had high belly fat-- fat around the body's organs-- had a 2.75 times greater chance of cardio death and a 2 times greater chance of death from all causes. 
"Normal Weight Individuals With Belly Fat at Highest CVD Risk", News release, presentation at European Society of Cardiology Congress, August 27, 2012, © European Society of Cardiology
 
The above study of 12,800 subjects used waist to hip ratio. You can measure this for yourself.
Measure your hips at the widest part and your waist at the narrowest, the smallest distance around between your lowest ribs and your belly button. Divide waist by hip and get the ratio.
Normal is 0.90 or less in males,  0.85 or below in females.
High is any number greater.
 

Weight, weight, weight.
I've often said, "You aren't healthy enough to lose weight". By that I mean I expect some physical/mental/chemical empediment to many person's weight loss.
 
When asked to assist in a weight loss program, around here we begin by assessing the diet and cutting out the garbage. We run blood chemistries to assess sugar handling, inflammation and infection, nutrient status, and hormone levels. We assess gastrointestinal, liver, and billiary (think: gallbladder) function. We determine what vitamins, minerals, enzymes, or amino acids the body is needing and tailor a regimen of supplementation to go with a sensible diet.
 
Then there's exercise. No way around it.
Doesn't mean training for an iron man event though.
So many people get glassy-eyed when they hear diet and exercise.
All I want to begin with is for them to get moving.
Butt off the couch or out of the task chair.
Going for walks several times per week? Lovely.
Trainer? Class? Gym? Great.
As you get healthier by not eating garbage, building the nutrient levels in your body, and moving, you can exercise more.
Or not. You decide.
 
For years I've listened to people who thought that all their problems stemmed from being "fat".
They seem to think if they reach some self-visualized, idealized weight/body image that flowers will bloom as they pass, rainbows appear on every horizon, and  magical unicorns prance around their yard.
You and I will never look like supermodels. (Unless, of course, you happen to already be a supermodel).
Doesn't matter.
Health matters.
Want the sun to shine in your backdoor?
Get healthy.
 
 

Thursday, October 25, 2012




A few paragraphs about beer. Kind of.

 
"Probiotic drink prevents diarrhea linked to antibiotic use"

Yet another journal publishes an article saying take probiotics (friendly bacteria, the kind that a healthy person has living with them at all times) to prevent that oh, so unpleasant stool viscosity caused by killing off all your beneficial bacteria.

Those happy little bugs do a lot more than save on TP. They keep bad bugs from taking over, participate in digestion, and provide essential nutrients.

Annoyingly, this has been known for as long as antibiotics have been in use.

Still makes me happy to see it in print, though.
BMJ. Published online 6/29/07

 I have taken a very effective approach to both preventing the two-step and maintaining bowel ecology.

Antibiotics, of course, do not kill yeast. Do kill friendly bacteria (normal flora) This is why following a course of antibiotic treatment can lead to a yeast (Candida) overgrowth. The good bacteria that keep the bad bacteria-- and yeast-- in check are wiped out. So Candida albicans, those joyous white curds, explode in population.

Now here is where the beer comes in.

Beer was once an important food stuff. Water couldn’t be trusted for purity. But beer could. As long as it didn’t have any off flavors you knew you weren’t going to get sick as you might getting a drink from the local lake.

The water for the beer is boiled. Kills any nasty bacteria.

Then, when the sugars from the malted grains have been extracted in the water, the temperature is dropped to the point where it won’t kill the yeast (Saccharomyces cerevisiae) that converts the sugar to alcohol.

The big point here is the brewer gets that yeast into the beer as soon as possible and in high quantities because his beer is vulnerable to infection by wild yeast and bacteria until the desirable, protective yeast is established in the beer. Once the good yeast takes off, the bad guys have no chance of infecting the beer.

This is exactly like the situation in your gut. Mine. Everybody’s after antibiotic therapy.

So what I do is recommend taking a friendly yeast (Saccharomyces boulardii) while on therapy to prevent Candida overgrowth, and overgrowth of any resistant bacteria for that matter (Heard of Methicillin Resistant Staph. Aureus?) then towards the end of the drug therapy begin taking friendly bacteria to inoculate the gut and re-establish normal bowel ecology.

Update:

The crisis is ongoing.
In a JAMA
article published 10/24/12, hospital acquired infections (nosocomial infections) and resultant deaths are discussed.
Time to put normal flora to work in our hospitals and nursing homes.


Update 2:
 
Probiotic versus bowel infection.
It was just this kind of research some years ago that turned me toward interest in gut health.
One month reports came out about 14 deaths in UK hospitals from Clostridium infection-- later found to have been introduced by nurses' dirty fingernails.
The next month several internists at a US hospital co-authored a paper on probiotics preventing Clostridium infection in a hospital setting.

The disconnect used to infuriate me.
Now I see it as sad/pathetic.



An always timely look back to 2007.



Can’t Possibly Be True Department

England’s hospital docs so rarely wash their hands between patients while on rounds that the UK’s Chief Medical Officer is recommending patients encourage them with hand cleanser at the ready bedside.

The Chief, Sir Liam Donaldson, is attempting to reduce the number of hospital acquired infections (nosocomial infections for you philology fans).

One patient every two minutes is infected, and one dies every two hours from nosocomial infection in UK hospitals.

Less than 60% are washing their hands between patients. Daily Telegraph, 7/19/07

I have so many snide comments to make here. But I’m going leave off.

This is simply too pathetic.

More encouragingly, from www.health.harvard.edu/LLLB we have:



“7 Simple Steps to Fend Off Harmful Inflammation”



Inflammation is an essential part of the immune response.
However, chronic low-grade infection is involved in vascular disease, diabetes-- take your pick of chronic diseases, really.

The big offenders are smoking, lack of exercise, hi-fat/hi-cal meals, and processed foods.

The good folks at Harvard recommend you not wait for big pharma to pull your chestnuts out of the fire. (They even mention side-effects of drugs-- GASP)

“Simple changes

What you eat may fan the fires of inflammation. With some small changes — no crazy new foods involved — you can douse them.”

“Get an oil change”

Animal fat/saturated fat/trans fat promotes inflammation. Polyunsaturated fats decrease inflammation. Learn to love olive oil. Devour essential fatty acids.

“Don’t be so refined”

White flour/rice and sugar promote inflammation. It’s whole grains for you. No corn syrup.

Make it simple: Food pre-packaged with a shelf-life enabling a legacy to your grandchildren…do you really think you should be eating this stuff?

“Produce”

Fruits and veggies are anti-inflammatory. How often do we need to hear the eat-your-veggies mantra? Apparently daily, ‘cause we’re not getting our veg every day.

“Go Nuts”

Nuts and seeds are recommended anti-inflammatory foods.

Number six is a bad idea. Follow the link if you are desperate to know Harvard’s #6.

“Alcohol in Moderation”

Or not at all. Not like it is an important foodstuff anymore. In ages past when water supplies were suspect and B vitamins hard to come by, sure. Now its mostly trouble.

However: Drink ‘a day seems to lower inflammation. Several per day increases inflammation.

Probably should have skipped that one too. Added a couple of my own. But this is Harvard’s show, so, lastly--

“Spice it up”

Many herbs and spices are anti-inflammatory (and some inhibit bacteria and viruses). Salt is neither herb nor spice.

So there you have it (most of it).

This is partly the foundational dietary recommendations I’ve been giving to diabetics for a long time.

 

Loved this paragraph from a nutritionist.

“The average American’s diet is really dismal. With this in mind, I am surprised when any nutritional supplement study shows a beneficial outcome. How can giving a few milligrams of policosanol or allicin function to counteract 2,500 calories worth of disease promotion?”

Thursday, September 13, 2012

Mayor Mike Set to Improve New Yorker's Diets, or
Bloomberg to Save New Yorker's from Themselves, or
Big Apple Honcho Knows Better Than You What You Should Do.

Take your pick. Whatever your perspective...
http://www.nytimes.com/2012/09/14/nyregion/health-board-approves-bloombergs-soda-ban.html

Truly love this article from nutritionist Judith Valentine printed back in '02.
http://www.westonaprice.org/modern-foods/soft-drinks-americas-other-drinking-problem

"Beverage Digest estimates that per-capita American consumption of carbonated soft drinks in 2009 fell to 736 eight-ounce servings, down from 760 servings in 2008. (Per capita consumption peaked in 1998 at 864 eight-ounce servings.) But even at current rates, which are nearly 15 percent lower than the peak, the U.S. still has the highest per capita consumption of carbonated soft drinks in the world, Beverage Digest said."
http://www.adweek.com/news/advertising-branding/soft-drink-consumption-continues-decline-107218

864 eight ounce servings!
But hey, now we're down to only 736.
Progress.

Now, I have maybe one or two sodas per month.
Not smug. Not holier than thou.
Just don't like (enjoy) all that sugar.
So...lucky for me.
But if I'm only downing 288 ounces per year tops,  somebody else is picking up the slack to the tune of five thousand, six hundred ounces.  Or more. Per year.

Obviously I'm no great fan of soda.
Still wonder where King Mike gets off enforcing his whim on the paesantry.

For giggles department:
Here's an uplifting site to determine the number of caffeinated drinks necessary to kill you.
http://www.energyfiend.com/death-by-caffeine
I know. Not very sciency.

How about a real case of death by soda from a couple years ago?
http://news.yahoo.com/blogs/sideshow/woman-coca-cola-habit-cited-death-161323721.html

And, yes, excess water consumption can be a killer too.
http://abcnews.go.com/GMA/jury-rules-radio-station-jennifer-strange-water-drinking/story?id=8970712
The name of the contest?
"Hold Your Pee for a Wii"





Big D eal
Vitamin D versus Tuberculosis
Been prattling on about Vitamin D for quite some time. Years even.
But that is only because the dozen or so research article titles I scan every morning keeping popping up D.

Sweet, sweet, nugget:
"ScienceDaily (Sep. 3, 2012) — For decades before antibiotics became generally available, sunshine was used to treat tuberculosis, with patients often being sent to Swiss clinics to soak up the sun's healing rays. Now, for the first time scientists have shown how and why heliotherapy might, indeed, have made a difference."

Do visit the Science Daily folks for this one, here: http://www.sciencedaily.com/releases/2012/09/120903154008.htm

With progressive antibiotic resistance it encourages me to see a combination therapy with a health promoting component.

Trying. Very hard. Not to. Rant. About. Antibiotic resistance.

This is a vitD post and this is the fascinating story that put me heads-up to vitD research: http://www.medicalnewstoday.com/releases/51913.php

For everything vitamin D, you can visit Dr. Cannell's group at:
 http://www.vitamindcouncil.org/