Newsletters Archive

January 2008

Exercise - The Universal Life Preserver

  According to a powerful new study - the largest such study ever, middle aged to elderly men can slash their risk of premature death from all causes in half simply by taking a brisk, 30 minute walk at least 4 to 6 days a week.  The investigators calculated the fitness levels of over 15,000 adult males through treadmill exercise testing sometime between 1983-2006 and assigned them depending on their results from "low fit" to "very high fit."  By tracking fatalities through June 2007, the scientists found that a study subject's fitness level was more predictive of their future risk of death than blood pressure, body weight, or age.  The most fit study subjects cut their risk of early death by a whopping 70%! (Circulation, February2007)

   A second compelling study, unique in that it included the effects of physical activity for several subgroups of the general population reported similarly remarkable findings.  This study involved over 252,000 men and women ages 50 to 71 and found the risk of death was reduced by 50% in people who engaged in moderate activity (like brisk walking) 30 minutes at least five days a week or vigorous activity (enough to break a sweat) 20 minutes at least 3 times a week.  Even those that did a little bit of moderate activity during the week were 19% less likely to die than those who were sedentary - in other words, some is always better than none at all (Archives of Internal Medicine, December 2007). 

   These two new studies are further confirmation of one of my favorite wellness soundbites - namely, "exercise is the magic bullet!" There is simply nothing else available to you - not nuts, not berries, nor any combination of foods, nor prescription drugs, nor meditation -- NOTHING! -- that can provide to your body what regular physical activity can.  And it's free (yet priceless). So as they say in the Nike ads - just do it! (Those with chronic disease or cardiovascular risk factors check with your healthcare provider before embarking on an exercise program.)

Know Your Blood Sugar Level

    When I was in clinical practice a few years back, normal fasting blood sugar (glucose) levels were values less than 110.  However, based on new, solid evidence that any level of fasting blood glucose above 99 imparts significant health risks, normal is now defined as less than 100, pre-diabetic as 100-125, and diabetic greater than 125.  As a result of these new parameters, a huge portion of our population now falls into the pre-diabetic range, some estimates as high as 40% of the population older than 40 and 62% of the population older than 65.  A provocative new study from The Journal of the American College of Cardiology (January 2008) hammers home the urgency of knowing exactly where your fasting blood sugar levels fall, especially for women.  Researchers followed 4,058 men and women over a period of 4 years to monitor the association of blood glucose levels taken at the start of the study to the subsequent development of heart disease. Across the board, the higher the blood sugar level, the greater the risk of developing heart disease.  The adverse effects of high blood sugar appear to be exacerbated in females.  In this study for any level of blood sugar, women had a higher risk than men.  In fact, women whose blood sugar was between 110 and 125 had the same level of heart disease risk as a woman with full-fledged diabetes.  Dr. John Buse, president for medicine and science at the American Diabetes Association (also a Charleston native and former high school mate) made the following statement based on this and former studies, "Women who don't have diabetes, usually don't have heart attacks.  Women with diabetes, basically, all have heart attacks."

    Rates of diabetes continue to soar in all segments of the population according to a report out just today in the Archives of Internal Medicine.  Between 1994 and 2004, we experienced a 62% increase in those living with the disease.  It affects 20 million Americans and 1/3^rd of them do not even know they have it.  One-third of the entire Medicare budget is spent treating diabetes, even though 90% is preventable through maintaining a healthy body weight, diet, and exercise.  Despite our enormous investment in treating diabetes, we are doing a lousy job in managing it effectively as complication rates, especially for kidney disease, have continued to increase.  I consider the growing scourge of type 2 diabetes the single greatest public health threat we have faced in modern medical times.  Know your fasting blood sugar level and click here to find out what you can do to prevent type 2 diabetes, reverse pre-diabetes, or manage it more effectively if you already have it.

Get Your Beauty Rest (and make sure your kids do too)!

    There were several new studies from the past few weeks supporting the importance of sleep for both general health and body weight.  According to a study in the Journal of Clinical Sleep Medicine (December, 2007), adults with chronic health problems like heart disease and diabetes reporting less than 7 hours of sleep each night were 3 times more likely to be obese than those who got 8 or 9 hours of sleep.  Prior studies have found that sleep deprivation boosts levels of the appetite-stimulating hormone ghrelin, while lowering levels of the appetite-suppressing hormone leptin, additionally promoting a sluggish metabolism by decreasing insulin's effectiveness.  A second, startling report from the Proceedings of The National Academy of Sciences (December, 2007) found that poor sleep quality in young adults, specifically failing to sleep deeply for just 3 nights in a row, had the same negative impact on the hormone insulin's effectiveness as gaining 20 to 30 pounds! (Poor insulin activity a.k.a insulin resistance turns your fat cells into fat magnets while dramatically increasing your risk of heart disease and type 2 diabetes.)  Stated another way - 3 nights of disrupted sleep gave the young adults in this study the metabolism of people 3 times their age.  This was the first study to link poor sleep quality with an increased risk of diabetes, having huge implications for public health as sleep duration and quality are at an all-time reported low and type 2 diabetes has become the proverbial "runaway train."

    Consistently, studies have found that 7-8 hours of sleep a night for adults is optimal.  Both too little and too much can boost your risk of death.  A recent Dutch study of 8000 adults ages 35-55 followed for several years found that those who reduced their nightly sleep below 6-8 hours per night from the start of the study experienced a 110% excess risk of cardiovascular-related death.  Those who increased their sleep duration beyond 7-8 hours from the start of the study had a 110% excess rate of non-cardiovascular death (Sleep, December 2007)

    Kids are susceptible too when it comes to poor sleep and poor health.  The journal Pediatrics (November 2007) reported that 6^th graders who averaged less than 8.5 hours of sleep a night had a 2-fold greater obesity rate than their counterparts who slept more than 9.25 hours a night.  Investigators reporting in the journal Sleep (January 2008) found that amongst 591 seven year olds, those who got the least sleep had a three fold higher risk of being overweight or obese in addition to more emotional volatility.  As in adults, adequate sleep is required for both a child's physical and emotional health.  The American Academy of Sleep Medicine recommends that preschool children get 11-13 hours of sleep a night and that school-aged children get 10 to 11 hours per night.

In Praise of Legumes

    I am highly enthusiastic about this wonderful category of plant foods which include beans, peas, lentils, soybeans, and peanuts - In fact, I consider this humble group the most underutilized and economical of all the "superfoods" nature has to offer.  Beans are cheap, convenient, versatile, satisfying, and power-packed full of healthful nutrients including lots of fiber, B vitamins, protein, minerals, and antioxidant polyphenols.  Knowing that several of their nutritional attributes are especially valuable for guarding against insulin resistance and type 2 diabetes, it was not surprising that the first prospective, large-scale study undertaken to assess the impact of legumes on the incidence of type 2 diabetes declared positive results.  As part of the Shanghai Women's Health Study, over 64,000 middle-aged Asian women were followed over an average of 5.6 years to examine the relationship of legume intake to the incidence of type 2 diabetes.  Women that consumed the most legumes were 38% less likely to develop type 2 diabetes.  Those enjoying the most soybeans had a 47% lower risk (The American Journal of Clinical Nutrition, January 2008).

    My recommendation is to strive to include a serving of legumes each day.  Fresh, frozen, dried, canned - In your dips, soups, stews, burritos, salads, or all on their own - Any delicious way you can.

New "Skinny" on Olive Oil

   I consider extra virgin olive oil the healthiest oil available and a fascinating, novel study gives us an additional reason to make this delicious fat a regular guest at mealtime, namely better appetite control.  Reporting in Gastroenterology (November, 2007) scientists found that oleic acid, the primary fatty acid found in olive oil, delayed stomach emptying more effectively than the fatty acid that predominates in vegetable oils(ie. kept study subject fuller longer).  Additionally, the oleic acid led to an earlier and more dramatic increase in the hormones CCK and PYY - both "power players" in reining in appetite.

  The most healthful way to include extra virgin olive oil (EVOO) in your diet is in foods prepared cold, at room temperature or with low heat like pan sautéing.  Enjoy EVOO in your salad dressings, dip your whole grain bread in it, or drizzle onto your vegetables and pasta dishes after cooking.

More Bad News for Red Meat

    The largest study ever to look at the effects of red and processed meat on a broad range of cancers found that those consuming the most red meat, equivalent to a quarter pound hamburger or a pork chop per day were at higher risk of a number of cancers including colo-rectal, esophageal, liver, and lung (PLoS Medicine, December 2007).  There are a number of biologically plausible reasons by which red and processed meats can increase cancer risk including exposure to potent carcinogens (HCA's, PAH's, nitrosamines) in addition to providing large amounts of saturated fats and iron, both linked to cancer.  New guidelines issued as a result of the most definitive review to date of diet and cancer risk recommend that we "limit the intakes of red meat and avoid processed meat" (Food, Nutrition, Physical Activity, and the Prevention of Cancer, 2007).  My advice is to limit red meat to 2 servings (3 ounces each) per week and to rarely eat processed meats.  And there is no need to fret over this when there are so many other healthy and delicious proteins to choose from like poultry, fish, shellfish, low-fat dairy products, beans, etc.

Chat Yourself Smarter

   Of the 100+ studies I reviewed over the past several weeks, this one brought the biggest smile to my face.  Intriguing new research by a team of U.S. experts found that simply engaging in a brief social conversation for as little as ten minutes a day can enhance memory and boost test scores.  The University of Michigan psychologist that headed up the report said that "socializing was just as effective as more traditional kinds of mental exercise in boosting memory and intellectual performance."  After analyzing over 3,000 adults they found the greater the social interaction among participants, to include gatherings and phone communications, the better their intellectual functioning.  In one experiment with college students, the group who discussed a social issue for 10 minutes prior to a test performed significantly better than the control group who watched a 10 minute clip of Seinfeld. (Personality and Social Psychology Bulletin, November 2007)  So be smart and chat it up!