Sunday, December 8, 2019

Diabetes – A New form of Treatment and Reversal

In the U.S. today one in 8 adults have type 2 diabetes and one in 3 have prediabetes.  The number is much higher in those over 65.  (Type 1 diabetes is an auto-immune disease and is not being discussed here.)  News from England is exciting- they have found a way to reverse diabetes, with strict dieting and exercise to induce weight loss.  Patients are given a liquid diet of 800 calories – four daily servings of soup or vitamin rich shakes.  They report reduced hunger after the first few days.  They have a small salad of non-starchy vegetables like tomatoes and cucumbers.  They go off their insulin as the diet begins and are carefully watched by their doctor.  Type 2 diabetes is due to too much fat inside the liver and pancreas.  Losing weight reduces this fat and allows the pancreas to work again by producing insulin. In the English study,88% of those who last 33 pounds or more no longer had diabetes.  In the U.S., the English prescription of diet and exercise is being studied at the Gonda Diabetes Centers at UCLA Medical Center in Santa Monica and Westwood, California.  Anyone interested in trying to reverse their diabetes should work with their primary care doctor.  People stop their insulin when they start the low-calorie diet, which is why you must work with your doctor, who will advise you and monitor your blood sugar levels. Note that the diet and weight loss does not work for 100% of people – depending on how long you have had diabetes, and other factors.  

Scattering the Ashes of Someone who Died
I have had 3 experiences of this which may be helpful to others.  I scattered my mother’s ashes in 1992 in a small town in North Carolina. It was inside a circle.  There were spicules and small pieces, all of which stayed above the ground.  Her husband did not attend the ceremony.  He had started calling himself Charly Big Paw.  My mother did not want to become Mrs. Big Paw.  I afound the ceremony to be serious and meaningful.  I scattered the ashes of my long-time companion Alan Margolis at our home in Bolinas.  Alan had made a plaque when we buried our beloved dog Ladi – the plaque depicted stairs which she would walk to meet him on the other side.  Alan was not religious, but the idea had sad and serious meaning.   I dug a small circular 
trench around the plaque and buried his ashes in it.  I visit it whenever I go back to Bolinas.  Ferns and other native plants surround the site.  It’s good to be able to visit it.  Last week I went to San Francisco with my two sons and stepdaughter to scatter the ashes of their father, my ex, Bob Goldsmith.  Fortunately, Bob and I remained friends after the divorce. We walked up a steep trail to a site where he and his partner liked to look out at the city.  We said the 23rdpsalm and a Hebrew Kaddish.  It was very meaningful.  It is a place where the group can visit again. This is like returning to a grave.
Sadja Greenwood, MD, MPH

Saturday, November 23, 2019

Thanksgiving - how to make it Peaceful, Healthy and Happy

Thanksgiving is a time to give thanks to people who have made life better for you and the world.  Gratitude is powerful - here are my choices.  You will have good ones of your own.  I am grateful for my loving family.  I am grateful for Greta Thunberg, the 16 year old who has brought powerful awareness of the dangers of climate change to youth and adults throughout the world.  I am grateful to Boyan Slat, an inventor from the Netherlands, for the Ocean Cleanup.  They are developing technologies to extract plastic from the ocean and prevent rivers from adding more plastic.  I am grateful for Amory Lovins and The Rocky Mountain Institute for their work on battery technology and indoor cooling, which will be important worldwide.

Here are some suggestions for a peaceful Thanksgiving gathering.  If there is potential discord among  people, ignore politics!  Talk about sports if that will work, or about cooking, and how you made your favorite dish.  Follow the Six Precepts of Tilopa (988-1069) and say very little, letting other members talk while you beam on them.  Here are the precepts - No thought, no reflection, no analysis, no cultivation, no intention, let it settle itself.

When it comes to the Thanksgiving meal itself - more gratitude for the food.  If you want to make it healthy, don't show up extremely hungry. Have some nuts and/or yogurt in the morning ahead of time.  Fill your plate with vegetables and salad first.  If you are eating turkey, go easy on the amount you take.  Be moderate with mashed potatoes and sweet potatoes.  For desert, try small servings of pumpkin or apple pie and even discard some of the crust.  Notice when you are feeling satisfied and have had enough.  Drink water or sparkling water throughout the meal.  Don't drink alcohol if you are pregnant or taking medications that can be affected by alcohol, or if you have cancer.  Otherwise, limit yourself to one glass of wine or one serving of spirits.  At the end of the meal you will feel peaceful and glad not to be overstuffed.  Deal with leftovers the next day in the same way.  Always start with vegetables.
Sadja Greenwood, MD, MPH

Tuesday, November 12, 2019

Meditation

From the National Institutes of Health

Interesting article:

Meditation and Yoga can Modulate Brain Mechanisms that affect Behavior and Anxiety-A Modern Scientific Perspective


Please go to this link:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769029/


Sunday, October 13, 2019

Urban Farming in Washington D.C. – an exciting story

Urban Farming in Washington D.C. – an exciting story

You can read the whole article and see pictures of the land and people described here by going to civileats.com. Civil Eats is a constantly interesting website. Gail Taylor, an African American woman has set up the first organic farm with CSA (community supported agriculture) in Washington D.C. She currently has about 200 CSA members, and city farms in seven locations. Rooftop farms are being planned.

 Gail Taylor started out her work in Guatemala, promoting healing for women recovering from the trauma of civil war. Returning to the U.S., she began to share her passion for farming with other African Americans who recognized the power of food production to revitalize their communities. She approached the Oblates of Mary Immaculate, a Catholic order of missionaries with vacant land on their property.  They were able to set up the D.C. Urban Farming and Security Act that allows a 90% reduction in property taxes to owners of vacant lots who create partnerships with independent urban farmers. 

Gail Taylor and her group grow organic vegetables, herbs and flowers.  She plants a third of her farmed areas with oats, rye and crimson clover as cover crops between plantings.  Nearby orchards and farms run by women and farmers of color bring products like fruit, cheese, honey, rice, herbs and eggs.  They donate food to soup kitchens and food pantries.  Gail Taylor calls her CSA ‘Three Part Harmony’ because musicians in her family have created the music and the food together.  
Sadja Greenwood – past issues at sadjascolumns.blogspot.com
p.s. Deaths from vaping in the US have risen to 20.  The number was 6 when I last reported 2 weeks ago.  Do not vape.
 p.p.s. Melania Trump has continued to use and endorse the vegetable garden at the White House started by Michelle Obama.  She invites children to visit, plant and understand how food is grown.  The White House gardeners and kitchen tend to and serve the food daily.  How’s that for good news?


Sunday, September 22, 2019

The Dangers of Vaping

The use of electronic cigarettes – e-cigarettes – e-cigs – vape pens – has been increasing among high school students.  Vaping in high schools rose from 1.5% of students in 2011 to 20% in 2018.  Middle schools may also be affected.  This is a serious matter, because of the dangers of vaping. Juul is the brand name for e-cigarettes. Juul has flavored e-cigs that appeal to youth.

In September of 2019 the Centers for Disease Control and Prevention, and the US Food and Drug Administration sent out a warning – urging people to consider not using e-cigarettes and also to avoid buying them off the street.  Currently there have been at least 380 cases of severe lung illness reported from vaping, and 6 deaths.  Unfortunately, more deaths are expected.

Vaporizers heat and aerosolize the nicotine or nicotine plus marijuana meant to be inhaled.  Vaping solutions consist of particles associated with toxicity to the heart and lungs, such as formaldehyde.  Vaping can irritate the lungs and lead to damage. It increases lung inflammation and paralyzes cilia – the hair-like projections in airways that remove microbes and debris. This increases the risk of pneumonia. A new finding has been lipoid pneumonia – the presence of fat in the lungs as a result of vaping. This is a relatively new illness with long term consequences.  Articles in the British Medical Journal and the New England Journal of Medicine have cited cases of hospitalized patients with vomiting, chest pain, shortness of breath, fever, and weight loss.  Recovery can be slow, and complete recovery from lipoid pneumonia may not occur. Vaping has also been linked to seizures and damage to the endothelial cells that line the blood vessels. In one case, the e-cigarette exploded in the mouth of a user.

I think the lessons here are clear.  Do not vape. If you are a cigarette smoker and want to quit, talk to your health care provider about safe methods.  Go to the website of the Mayo Clinic for their suggestions.  You can do it – many have succeeded – be safe, and keep your children safe.  
Sadja Greenwood, MD, MPH

Sunday, September 15, 2019

Many Drugs have Dangerous Interactions with Alcohol – Be Aware

Information in this column is based on a newsletter called Worst Pills, Best Pills.  I suggest subscribing to this newsletter (800-289-3787) if you or members of your family take over-the- counter or prescription drugs. You do not need medical knowledge to understand the content of this newsletter, and it can be lifesaving.  

Research from the National Institute on Alcohol Abuse and Alcoholism has shown that many people, especially those over 65, may be incurring a risk by using alcohol when taking prescription drugs.  Alcohol, itself a drug, becomes more intoxicating if the drug taken will block the stomach’s ability to metabolize alcohol.  This is true of commonly used drugs for treating gastrointestinal ulcers such as ranitidine (Zantac and Tagamet), and also true for the smoking cessation drug Chantix.  

People combining alcohol and sedatives, including benzodiazepines (such as Valium or Ativan) and sleeping pills of all kinds, can experience increased sedation, impaired breathing, and be more likely to fall or have serious accidents.  Respiratory arrest can occur.  

Alcohol can impair the metabolism of drugs, resulting in risk of drug overdose.  This could happen with the drug warfarin (Coumadin), used as a blood thinner, and could result in an increased risk of bleeding. Conversely, long term heavy drinking could increase the metabolism of warfarin and increase the risk of blood clots. It is clear that people on warfarin should not drink heavily and be aware of their levels of the blood thinner.

Alcohol can interact with antibiotics, anti-fungal drugs, antidepressants, antihistamines, diabetes drugs, opioids, nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen (Advil and Aleve), and Tylenol.  

People who are used to having a glass of wine with dinner may not experience problems with medications. However, heavier drinking can cause serious problems.  Therefore, the following advice is very important: check with your pharmacist and your health care provider before using alcohol with any prescription or over-the-counter drug. Read the warning labels on the bottle or package.  If it says not to drink alcohol – don’t drink it! 

Sadja Greenwood, MD, MPH




Monday, September 9, 2019

Sunday, September 8, 2019

What YOU can do about Global Warming

Speak up – to your friends, neighbors and elected officials. Tell California officials you are proud of their policies on fuel economy standards. A pushback is coming immediately from the Trump administration.  Stay tuned.

Follow Swedish teenager Greta Lundberg as she mobilizes youth to fight climate change. They want to inhabit a livable world.  She is currently at the U.N. in NYC.  I have her on Google Alert, so I can read about her every day.  

What would happen if everybody in the United States cut back on driving?It turns out that even driving just 10 percent less — if everyone did it — would have a big impact on greenhouse gas emissions. That’s because Americans drive trillions of miles every year, helping to make transportation the biggest contributor to United States greenhouse gas emissions. In 2017, light-duty vehicles in the United States (including cars, S.U.V.s, pickups and most of the vehicles used for everyday life) produced 1,098 million metric tons of carbon dioxide equivalents.  That’s about one fifth of the country's total emissions footprint. A 10 percent cut, therefore, would be roughly 110 million metric tons of carbon dioxide, or the same as taking about 28 coal-fired power plants offline for a year.  While not easy, that target is realistic for most people, said Tony Dutzik, a senior policy analyst at the Frontier Group, a nonprofit research organization. Walk, bike or take public transit when possible. Car-pool, and work from home when you can. Emissions from a full bus or train are vastly lower than a car.  Fly less – take a train or bus instead.  

Weatherize your dwelling – make sure to seal drafts and have good insulation.  There may be federal tax breaks for some of this.  Invest in energy efficient appliances – look for the Energy Star label on them.  Find power plug-in devices that are rarely used and turn them off – I found two immediately in my apartment.  

It takes energy to heat your water and make it clean.  Take shorter showers, turn off the tap when you brush your teeth, wash your clothes in cold water. 75 to 90% of the energy used by your washing machine goes to warming the water.   Set a timer to run your dishwasher at night, to save on electricity, gas and water costs.  If you have time, dry your clothes on a bamboo clothes drying rack.  

Eat less meat – there are large energy and water costs in producing meat and cleaning animal refuse.  Eat vegetable protein such as nuts, and organic soy.  Combined with wholegrains, you will get a complete protein. Consider drinking nut milk instead of milk and cream.  Follow the Monterey Bay Aquarium Guide for advice on sustainable seafood.  

Buy LED lightbulbs – they use 90% less power than incandescent bulbs and are much longer lasting. They will cost you more up-front but save money and power.  

Find a way to plant trees in your community – either on your property if feasible, or possibly through a local school where the children participate.  Contact the Arbor Day Foundation to find suitable trees for your area.  
Keep at it!   Sadja Greenwood, MD, MPH

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Monday, August 26, 2019

Eggs – Good or Bad For You?

Data for these reports come from the Tufts University Friedman School of Nutrition Science and Policy.  I consider their publications to be extremely well researched.

Eggs: the protein in eggs provides all the essential amino acids your body needs as well as essential nutrients such as biotin, selenium, vitamins B12, A and D, iodine, potassium and phosphorus.  Egg yolks are high in lutein and zeaxanthin that may help to protect against age-related macular degeneration.

The controversy about eggs comes from the cholesterol in the yolk.  Too much LDL cholesterol in the blood can lead to a build-up of plaque in the arteries, increasing the risk for heart attack and stroke. Recent research has shown that for most people dietary cholesterol is not significantly related to LDL cholesterol in the body.  Saturated fat in the diet is more of a problem. 

Studies published in the last year have shown data on both sides of the subject of eggs in the diet.  Here is a prudent way to look at it.  If you have diabetes, have had a heart attack or are at high risk for heart disease, talk to your doctor about avoiding eggs altogether.  Enjoy an egg white omelet.  Get tested for diabetes if you are overweight or obese – many people have diabetes without knowing it.  

If you are not in the high risk category, eat eggs in moderation.  The American Heart Association suggests no more than one egg a day. Avoid unhealthy sides with your egg, such as bacon, ham, sausage, white bread or other refined grains, or fried white potatoes.  Eat eggs with vegetables, beans and whole grains instead. Store eggs in the refrigerator. Cook them until the yolk is firm to decrease the risk of salmonella infection.
Saturated fat is found in butter, lard, cheese, meats, chicken with the skin, and many baked good such as doughnuts, piecrusts, frozen pizza and cookies.   Fast food restaurants use trans-fats for frying because the oil can be used over and over again. Avoid when possible. Read the label on processed foods and margarine to look for partially hydrogenated oil. Avoid it.  Coconut oil is a saturated fat that many people enjoy because of its distinctive taste.  According the Dr. Walter Willett of the Harvard School of Public Health – “for now, I’d use coconut oil sparingly.  Most of the research so far has consisted of short-term studies to examine its effect on cholesterol levels.  We really don’t know how coconut oil affects heart disease.  And I don’t think coconut oil is as healthful as vegetable oils like olive oil and soybean oil, which are mainly unsaturated fat and therefore both lower LDL and increase HDL.  Coconut oil’s special HDL boosting effect may make it ‘less bad’ than the high saturated fat content would indicate, but it’s still probably not the best choice among the many available oils to reduce the risk of heart disease.”
Sadja Greenwood, MD, MPH

  

Sunday, August 18, 2019

Breath Meditation – A Way to Relieve Stress


This entry is based on an article in Health.Harvard.edu

Psychological stress is bad for your health, increasing the risk of heart disease and cancer.  Stress can bring memory problems and bodily aches and pains.  Reducing stress helps sleep and may bring down blood pressure.  Focusing attention on breathing can help to make you relaxed, and is a gateway to ‘mindfulness’ – which means that you accept what comes in life, and its challenges.  Dr. Ronald Siegel, an assistant professor of psychology at Harvard Medical School, has written a book on meditation and mindfulness – The Mindfulness Solution: Everyday practices for everyday problems

Find a comfortable place with minimal distractions – sit, stand or walk.  Many people find sitting the most helpful.  Repeat a sound, phrase or movement – allowing thoughts to come and go as you focus on repetition.  You can silently count inhalations and exhalations, going from one to four for example, or silently say ‘in and out’ to yourself, or say peace/love, or here/now as you breathe.

Do your meditation at the same time every day, starting with 10 minutes in the morning and evening and working up to 20 minutes or more as it becomes easier.  Mindfulness came from Buddhism originally but is shared by many spiritual traditions and religions.  It means focusing on the present moment and accepting it without judgment.  Embrace life as it is. Much stress comes from fighting reality.

In summary: sit with your spine erect in a comfortable position.
Focus on your breath - it doesn’t matter if it’s long or short.
Allow your thoughts to come and go, returning your attention to your breath.

Get the book by Dr. Siegel mentioned above, or find a meditation site such as Insight Timer. 

Stay tuned for exciting new treatments for the Ebola Virus in Africa and drug resistant tuberculosis in the U.S. and throughout the world.  

Mindfulness does not mean that you abdicate working against injustice and the many problems in the world. It means that you accept your personal stressful situation for a short time every day to achieve a sense of well-being. 

Sadja Greenwood, MD, MPH