10 Way to Live Longer and Healthier

Image by Cornell University Library

Exercise –

Exercising is a key to staying healthy and research shows that people who exercise age more slowly. This is perhaps due to the fact that exercise has been associated with preventing telomere shortening.  Telomeres are strands of DNA at the ends of each chromosome that shorten as we age.

Don’t Smoke –

Smoking causes the skin to wrinkle and wreaks havoc on our brains, heart and lungs.  The inflammation caused by smoking is thought to speed the aging process.

Eat a Healthy Diet –

You are what you eat.  A healthy diet provides antioxidants that gobble up free radicals that speed the aging process.  It also helps maintain a healthy weight which is important in preventing a host of diseases.

Stop Snoring –

Sleep apnea, a condition is which people stop breathing during sleep because tissues in your throat collapse blocking the airway, can cause high blood pressure, memory problems, weight gain, and depression.

Take Resveratrol –

Resveratrol is a powerful antioxidant found most prevalently in the skins of grapes. It provides the health benefits associated with red wine. Just like exercise, it slows telomere shortening. It is available in supplement form.

Manage Your Stress –

Excessive stress leads to the production of hormones in the body that are detrimental to long term health. High stress levels delays healing, increases fat deposition and suppresses the immune system.

Keep Your Insulin Levels In Check –

Insulin is a hormone in the body that is secreted in response to carbohydrate consumption.  An excessive level, due to excessive carbohydrate and sugar intake, is associated with increased cellular aging.  Keep grains and sugar to a low level in your diet.

Get Out in the Sun –

Being in the sun not only improves mood, but it produces vitamin D.  Vitamin D affects up to 10% of your genes and allows them to function optimally.  Vitamin D has also been shown to reduce the rate of many types of cancer.

Get Your Fats –

Eating a diet high in healthy fats, like omega-3, is essential for heart and brain health.  Good sources include fish and nuts.  To get optimal benefit, however, most people will likely have to supplement with fish oil.

Control Your Blood Pressure –

High blood pressure increases the risk of cardiovascular disease, stroke and a host of other diseases.  Controlling it will allow you to live longer.  It is best to control it by losing weight and exercising.

Common Pain Killers Increase Stroke Risk

The news on non-steroidal anti-inflammatory drugs just keeps getting worse and worse.  Just a month ago I posted about how this class of drugs was associated with an increased risk of heart problems.  Now a Danish study has found that these drugs are associated with an increased risk of stroke.

This class of drugs known as NSAIDs are used mainly as pain killers.  They are also used to effectively reduce fevers.  They are available over the counter and are used by millions upon millions of Americans every day.  This new

study finds that even short-term use of these drugs leads to an increased risk of having a stroke in the future.  What’s even scarier is that they studied a healthy population.

In many instances these types of studies are done on people with already existing conditions that make it difficult to assess whether the increased risk is associated with a person’s previously existing condition or the medication.  Not this time.

Over 500,000 healthy Danish people were included in this study.  The authors used a prescription registry to track which of these people were prescribed an NSAID.  About 45% of them took an NSAID from 1997-2005.  They then used stroke data from further hospitalization and death registries and estimated the risk of fatal and nonfatal stroke associated with the use of NSAIDs.

Results showed that NSAID use was associated with an increased risk of stroke. This increased risk ranged from about 30% with ibuprofen (Advil) and naproxen (Aleve) to 86% with diclofenac (Voltaren). The data were controlled for age, gender, and socioeconomic status.

They noted that there was a dose dependent relationship as well.  With doses over 200mg of ibuprofen the risk increased by a staggering 90%!  This is quite problematic as the base dose for over the counter ibuprofen is 200mg.  Millions of Americans take much more than that on a daily basis.

The authors of the study were not terribly surprised by the data considering the recent studies that have surfaced regarding the negative effects these medications seem to have on the cardiovascular system.  They did say it is hard to make absolute conclusions because no randomized controlled studies exist to date.  In light of this most recent evidence I doubt you will ever get an institutional review board to approve such a study because the risk seems to be too high.

The author also stated that in Denmark the availability of NSAIDs over the counter is relatively low compared to the United States. He stressed the need for closer monitoring of these drugs.

He also said, “If half the population takes these drugs, even on an occasional basis, then this could be responsible for a 50% to 100% increase in stroke risk. It is an enormous effect.”

In my opinion, we need to regulate these drugs as closely as possible.  If one were to watch the evening news you would see these drugs being advertised as health food practically.  It is studies like these that make it abundantly clear  they are not without risk.

Options abound for people who take these on a regular basis for mild to moderate pain.  Exercise and diet are a great start.  Reducing the use of NSAIDs would likely have a very positive effect on the cost of health care in the U.S. We need all the help we can get in that department.

Solving Childhood Obesity – Part I

Recently released this month was an interesting piece on childhood obesity.  It is part of the Let’s Move campaign that is headed by First Lady Michelle Obama.  The report entitled Solving the Problem of Childhood Obesity within a Generation is full of good information (full report available at www.letsmove.gov).  I am usually skeptical of such reports because they seem to just recycle to same old information that has gotten us into the problem in the first place.  This report seems to be different.  Over the next couple of weeks, I am going to try and break down most of the recommendations that were put forth in this new report. Some of the recommendations I find very refreshing.  They are often things chiropractors, naturopaths and nutritionists have been recommending for years.  I’m glad to see traditional medicine catching up.

I have spoken many times on this blog about childhood obesity and what a large problem it is in the US.  The numbers are staggering.

• One in every three children (31.7%) ages 2-19 is overweight or obese.
• Obesity is estimated to cause 112,000 deaths per year in the United States, and one third of all children born in the year 2000 are expected to develop diabetes during their lifetime.
• The current generation may even be on track to have a shorter lifespan than their parents.

Also, this takes a massive toll on our health care system.  As health care costs continue to rise many economists say that they could eventually bankrupt the country.  Each year, obese adults incur an estimated $1,429 more in medical expenses than their normal-weight peers.  Overall from 1998 to 2008 medical costs related directly to obesity in adults increased by almost four fold from $40 billion to over $147 billion.  Childhood obesity now contributes to $3 billion in medical costs.

Unfortunately the trends of obesity are continuing to rise and have risen substantially in the last 30-40 years.  In particular, the levels of obesity have increased significantly since 1980.  Obesity has more than doubled among adults (rising from 15% to 34%), and more than tripled among children and adolescents (rising from 5% to 17%) since 1980.

While most people know that being overweight increases the likelihood of heart disease, there are other problems associated with it as well.  Obesity increases the risk of cancer, diabetes, arthritis, depression and osteoporosis to name a few.  Quality of life is also affected.  Children who are obese report a lower health-related quality of life (a measure of their physical, emotional, educational, and social well-being). One study actually found that children who are obese have similar quality of life as children with cancer!

So the question is how do we solve the problem?  The first part of the solution might surprise you.

Breastfeeding

Children who are breastfed are at reduced risk of obesity.77 Studies have found that the likelihood of obesity is 22% lower among children who were breastfed. This effect was noted all the way into adolescence suggesting that breastfeeding your child has very long lasting effects.  Other studies have shown that for every month a child is breastfed up to 9 months, a 4% reduction in the risk of being obese is observed.

In my practice I recommend that my patients breastfeed up to 12 months if possible.  Routinely I hear from expectant or new mothers that their doctors ‘recommend’ breast feeding but that they won’t lose out on anything if they choose formula.  This may stem from the years when women were being told that breast milk was no match in terms of nutrients to what could be concocted in a lab.  It is clear now that breastfeeding is an important part of the early life of a child.

Even though the research clearly points out that breastfeeding is critical most children (67%) do not breastfeed after three months.  The protection offered by breast milk is from several factors.   First, synthetic formulas contain twice as much protein as breast milk.  This stimulates insulin to be secreted in amounts that are too high.  This leads to excess fat storage.

Second, the biological response to breast milk differs from that of formula. When feeding a baby, the mother’s milk prompts the baby’s liver to release a protein that helps regulate metabolism.  This is not produced with formula.  Also,  giving formula is associated with unfavorable concentrations of leptin, a hormone that inhibits appetite and controls body fatness.

So why don’t more women breast feed? It is a complicated answer that has physical, social and cultural factors.  However, in this country we don’t make it easy for new mothers.  In the hospital a newborn is often taken from their mother and necessarily given formula.  This makes it difficult for the baby and the mother to learn how to properly breastfeed.  Part of the solution is to designate hospitals as “baby friendly” as determined by an independent group appointed by the government.  A hospital is given this baby friendly designation if they meet certain criteria for breastfeeding.  Currently, only 3% of births occur in baby friendly hospitals.

My advice to patients is always to breastfeed.  Do everything you can to make sure it happens.  If any doctor tells you that formula is ‘just as good’ as breast milk, find another doctor.  If you cannot breastfeed directly, try and pump your breast milk.  The advantages of breast milk over formula are huge.  After all a million years or so of evolution can’t be wrong.  In my next blog we will talk about chemical exposure and screen time and how it relates to childhood obesity.  I hope you’ll continue to read.

Can What You Eat Cause Infertility?

Apparently, the answer is yes.  Recent research has shown that women who have celiac disease are much more likely to have trouble getting pregnant than women who are not gluten sensitive.

Celiac disease is a genetic disorder in which gluten, the main protein found in wheat, is not properly processed.  It causes an autoimmune reaction in the body leading to ulceration and inflammation in the gut.  Symptoms include diarrhea, gas, bloating and fatigue.  A person with celiac disease may be asymptomatic or may have very severe symptoms.  Although wheat is the main offender, gluten is also found in rye, barley and oats.

The reaction the body forms to gluten causes the lining of the small intestine to atrophy.  This problematic because this is the portion of the digestive tract that is most responsible for absorbing nutrients.  If you cannot absorb nutrients your body cannot thrive.

Women with untreated celiac disease are more likely to have problems getting pregnant.  They also will have higher incidences of miscarriage and premature births.  Believe it or not, men will also have issues with fertility if they have celiac disease.  There are also other problems associated with untreated celiac disease for women.  Dr. Sheila Crowe, a professor in the division of gastroenterology and hepatology in the department of medicine at the University of Virginia lists the following problems.

• Later onset of menstruation
• Earlier menopause
• Secondary amenorrhea (a condition in which menses starts but then stops)

These menstrual problems cause a woman to ovulate less which results in a smaller chance of getting pregnant.  Men may also have trouble with fertility as mentioned above.

• Abnormal sperm (reduced sperm count, altered shape, and reduced function)
• Reduced testosterone levels

Dr. Crowe recommends that if you and your partner are having trouble getting pregnant, you should both be screened to see if celiac plays a role.  Remember, you may not have symptoms and still have celiac disease.  The test is a relatively simple blood test.  Be sure to continue to eat gluten throughout because if you go gluten free before the blood test it may not show up.  If the blood test comes back positive, a tissue biopsy may be performed to confirm the diagnosis.  The pathologist will look at the cellular lining of the small intestine to confirm that there is in fact atrophy.

Treatment for celiac is relatively simple.  Avoid gluten.  This is becoming more and more common place and grocery store chains are starting to carry more foods that are gluten free.  A simple diet change is enough to solve this problem.

Low Carb is Still the Way to Go

A large portion of carbohydrate products are made from grain.  The most common grain used is wheat and wheat contains large amounts of gluten.  I am huge proponent of low carbohydrate diets for overall health.  While celiac disease might cause auto-immune reactions that disrupt fertility, obesity is also a known risk factor for infertility.  Women who are obese are 43% less likely to conceive a child than normal weight or even overweight people. If you think about this in terms of evolution it makes sense.  A woman who is obese is less likely to survive child birth because of the strain it puts on the body.  It is not unreasonable to assume that the lower rates of pregnancy in obese women is some sort of protective measure, evolutionarily speaking.

Research has shown that low carbohydrate diets are more effective for losing weight and improving measurable health outcomes over the traditional low fat diet.  See our old post. If you are having trouble conceiving a child and you are significantly overweight you should try losing weight and possibly think about getting tested for celiac disease.  These are efforts you should undertake before considering fertility treatments.