Sunday, June 28, 2009

Go to Health - Moving Right Along

Go to Health: Moving right along
Our bodies have magnificently evolved to move, but life can get in the way: computers, sedentary work, commuting, television, child-care, fatigue. Here are two ways for busy people to vary the 30 minutes of dedicated daily exercise that has been shown to reduce cardiovascular risk and keep us fit.

The Treadmill Desk—aka iPLod
Dr James Levine at the Mayo clinic disliked visiting the gym after a long workday. In his lab he is studying ‘Non-exercise Activity Thermogenesis’. He has devised a way for office workers to walk slowly on a treadmill while working on their computers or talking on the phone. His lab also has a two lane walking track that serves as a meeting room. He puts the treadmill on a very slow speed (as slow as 1 mph), which is fast enough to burn an extra 100 calories per hour, and up to 1,000 extra per day on his average 10-hour workday. Levine placed 15 obese workers on treadmills in front of computers and found they burned an extra 119 calories an hour walking at their own pace. During the course of a year, those workers could lose close to 50 pounds if they practiced healthy eating, the researchers said.
Some companies, such as Mutual of Omaha and Humana, are trying out ‘walkstations’, and finding that some employees cannot get used to them, but others find it helps their ability to focus on work. While commercially produced walkstations are expensive, some people with home offices can build their own tray holding a laptop over a treadmill. Another message from this research is that staying on your feet as much as possible during the day – even with slow walking – is beneficial for weight loss or maintaining a healthy weight. Keep moving! Here are two good websites that illustrate these strategies.

Interval Training
Interval training is alternating bursts of intense activity with intervals of lighter activity. Researchers at McMaster University in Ontario are studying whether humans can increase endurance with only a few minutes of strenuous exercise, instead of hours. They had a group of healthy college students, not athletes, ride a stationary bike at a sustainable pace for between 90 and 120 minutes. Another set of students grunted through a series of short, strenuous intervals: 20 to 30 seconds of cycling at the highest intensity the riders could stand. After resting for four minutes, the students pedaled hard again for another 20 to 30 seconds, repeating the cycle four to six times. Each of the two groups exercised three times a week. After two weeks, both groups showed almost identical increases in their endurance, even though the one group had exercised for six to nine minutes per week, and the other about five hours. Additionally, molecular changes that signal increased fitness were evident equally in both groups. People who have a chronic health condition or who haven't been exercising regularly should consult a doctor before trying interval training, and overuse injury of muscles and tendons can also be a problem. Here’ a recent website on interval training:

Sadja Greenwood, MD –back issues on this blog, leave a message! no column on 7/6/09; celery & purslane on 7/13/09

Sunday, June 21, 2009

Go to Health - Omega-3 fatty acids

Go to Health – Omega-3 fatty acids
Humans have been eating aquatic animals since the beginning of our evolution. We depended on the rivers, lakes, and marshes to survive in the African heat. Some anthropologists believe we were only able to become large-brained because we regularly included fish and other aquatic animals in our diet. The beneficial fats in fish and shellfish are known as EPA and DHA (also called omega-3 fatty acids); they are made by microalgae in seawater, consumed by fish and accumulated in their fat and organs.. When we eat fish, shellfish or fish oil capsules, we experience some of the following benefits:
*Heart - a current review of 15 large studies, published in the American Journal of Nutrition, states that EPA and DHA consumption markedly reduces the risk of cardiac death. The scientists recommended establishment of a Dietary Reference Intake for EPA and DHA (250-500 mg/day) to reduce the risk of heart disease – the leading cause of death of men and women in the US and other developed countries. The mechanisms by which omega-3 fatty acids work is thought to be by suppressing irregular heart beats, decreasing clotting and inflammation, and lowering triglycerides.
*Brain - the human brain is composed of about 60% fat; studies show that omega-3 fatty acids are essential for nervous tissue growth and function. In 1996, the Journal of the American Medical Association published a study comparing the prevalence of depression across ten nations. The survey showed how the lifetime and annual rates for depression vary widely from country to country. (1.5 in every 100 adults in Taiwan experience depression in their lifetimes while the figure is 19 for every 100 adults in Beirut). A 1998 study published in The Lancet compared this data with fish consumption, finding the higher consuming populations had less depression. A 2003 study published in the American Journal of Psychiatry compared similar cross-national data, involving bipolar disorder, again finding a strong correlation between this illness and seafood consumption. Dr.Andrew Stoll, a Harvard psychiatrist, uses fish oil capsules to treat depression, bipolar disease, and anxiety, in addition to standard treatment in serious cases. His book ‘The Omega-3 Connection’ explains the use of fish oil capsules for mood stabilization in many illnesses, including post-partum depression. Pediatricians are aware that improving maternal DHA/EPA nutrition decreases the risk of poor infant and child visual and neural development. Pregnant and breast feeding mothers are often advised to include (very low mercury) fish or fish oil in their diet, and some infant formulas are now available with added omega-3s.
*Vegetarians – Vegan omega-3 capsules made from microalgae are sold in natural food stores. Walnuts, flax, pumpkin seed and purslane contain a type of fat similar to fish oil, called alpha linolenic acid. This compound is converted to EPA in the body, but the conversion is not complete. Both EPA and DHA are found in fish oil, which makes it the most desirable nutrient for omega-3s. Concern about mercury in fish makes it important to eat wisely, avoiding large fish like swordfish and shark. Look for the words ‘molecularly distilled’ on fish oil caps. Here’s a good website for avoiding both mercury and endangered species of fish:
Sadja Greenwood, MD

Monday, June 15, 2009

Go to Health - Chewing Gum – some surprising benefits

Chewing gum is prohibited in many schools because it can be noisy, distracting and tends to be stuck under chairs and tables. Chewing gum has been considered impolite and ugly, especially bubble gum. Most commercial gum is made with sugar or questionable substitutes such as saccharin and aspartame. Gum chewers can develop pain in their temporomandibular joints (TMJ), especially if they chew on one side of their mouth for too long. That’s the down side. Here are some interesting benefits.

*Aid in weight loss: chewing gum vigorously (100 chews a minute) has been shown to slightly increase metabolic rate. Gum can also be an appetite suppressant. A study found that chewing gum before an afternoon snack caused people to consume 25 less snack calories. While that is not a high number, even a slight reduction in caloric intake can have significant effects in the long term. Gum can be an alternative to mindless munching. Dieters who crave sweets can chew xylitol sweetened gum after a meal to signal the end of eating. Xylitol is a form of sugar found in plants, trees, fruits and vegetables It has 40% less calories than sugar, and tastes as sweet, with no aftertaste. It may be safe for some with diabetes - check with your doctor.

*Abdominal surgery
A new study has shown that chewing gum after abdominal surgery may help in recovery. Chewing gum reduces the time for the gut to become active, lowering the incidence of obstruction of the bowel and stimulating the release of gut hormones. Furthermore, gum chewers have better chances of avoiding nausea and vomiting after the operation.

*Dental benefits: ingredients such as Xylitol and Peelu in gum may help cleaning your teeth, decreasing tooth decay and dental plaque.. The US Army puts xylitol gum in its MRE (meals ready to eat) because it blocks bacteria from producing the acids that cause tooth decay,. Xylitol also increases saliva flow, which helps neutralize any acids and provides calcium to repair any weakened areas of the teeth. Soldiers returning from combat had been showing serious amounts of dental decay. Now they are advised to chew xylitol gum for 5 minutes 3x daily.

*Memory Aid!: An English study of gum chewing showed that chewers scores were 24% -36% higher than controls on immediate and delayed word recall, and also more accurate on tests of spatial memory. Explanations for the link between recall and chewing gum are varied: Chewing gum raises the heart beat by around 3 beats per minute, increasing blood flow in the cerebral area, which could explain the improvement in such brain activity. Chewing gum while taking in information, and chewing again at the time it needs to be recalled, such as in an exam, may aid in a memory association between the action or taste of chewing gum and the information being remembered. Based on these suppositions, a Stanford student has developed a product called Think Gum, popular on campus at exam time. It contains peppermint, rosemary, ginkgo biloba, vinpocetine from periwinkle plants, the Indian herb bacopa, and guarana, a source of caffeine (10 mg per piece). Since simpler may be safer,
My advice is– try xylitol gum – found in natural food and vitamin stores..
Sadja Greenwood, MD – back issues on my blog

Sunday, June 7, 2009

Mifepristone (RU486), the medical abortion pill

Go to Health – Mifepristone – the Medical Abortion pill – RU486
Women have been using herbs, poisons, soap solutions, sticks and pointed roots for millennia to try to get rid of an unwanted pregnancy. Illegal, unsafe abortion is a nightmare for women and their health-care providers. Surgical abortion, legal in the US since 1973 (since 1969 in California) has made the process safe, effective and much less traumatic.

In the 1980’s, French doctors began to work on a pill that would induce abortion – it was licensed there in 1988 and called RU486, or mifepristone (Mfp). In the US, it underwent clinical trials in the 1990’s and was approved in 2000. It is legal and available in all 50 states, Washington D.C., Guam and Puerto Rico.

Medical abortion with Mfp can be used as soon as a woman confirms that she is pregnant, and up to 8-9 weeks from the beginning of her last menstrual period. It is most effective if done early. The pills are effective about 95% of the time. In 3% to 5% of cases women will need a suction abortion due to continued pregnancy, prolonged or excessive bleeding.

Mfp works by blocking the action of progesterone, a hormone needed for the continuation of pregnancy. After taking the Mfp pills, in a clinic or doctor’s office, the woman is given a medicine called misoprostol (MSP) to use in a few days. MSP is taken by mouth or inserted into the vagina – clinics differ in their instructions on this. It causes the uterus to contract and expel the pregnancy, often with bleeding that resembles a heavy, crampy period. Infection is a rare side effect of medical and surgical abortions. Women should always be under the care of their clinic or doctor while undergoing an abortion and should follow instructions carefully.

The University of California San Francisco has a helpful website explaining the procedure and comparing medical and surgical abortions:

Medical Abortion with Mfp is legal throughout Europe (not in Ireland and Poland), and in many Asian countries including India, China, Vietnam and Japan. In Africa, only South Africa and Tunisia allow abortions. In Latin America abortion is legal only in Cuba and Mexico City. The World Health Organization estimates that 21% of all pregnancies in Latin America end in unsafe abortions. MSP, which causes strong uterine contractions, is available over the counter in many areas, sold as Cytotec, a drug designed for preventing stomach ulcers. It is widely used – without Mfp - by women seeking abortion, with very little information on how to use it or handle problems of heavy bleeding, cramping or infection.

The recent murder of Dr George Tiller, a doctor who performed late abortions in Kansas, is a terrible reminder of the passions on both sides of the abortion debate. I had an abortion when it was illegal in this country; I took care of women after illegal abortions, and I performed many thousands of legal procedures. My conclusions – keep it safe and legal; remember contraception.
Sadja Greenwood, MD