Friday, January 9, 2015

Live Long and Prosper Newsletter December 2014

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP.

1.   Body-mass index and mortality among adults with incident type 2 diabetes.
   This study refutes the so-called "obesity paradox" for diabetics. A previous study suggested that for diabetics, it is healthier be overweight or obese. This study found that the optimal BMI for diabetics is in the upper limit of the "normal weight" bracket (BMI 22.5 to 24.9). Stay tuned for round 2, fans of diabetes-obesity controversy!
February 5, 2014

2.   Processing of meats and cardiovascular risk: time to focus on preservatives.
   Processed meats are strongly associated with heart disease and cancer. Most of the harm is due to extra sodium causing higher blood pressure. Unprocessed meats (all types considered together) have no such association. Fish, nuts, legumes, and vegetables are associated with lowered rate of heart disease.
February 5, 2014

3.   Dietary patterns and total mortality in a Mediterranean cohort: the SUN project.
   Bor-ing. Another study looked at Mediterranean Diet (in Mediterraneans of all people). Those who ate it had close to half the death rate relative to those who did not.
February 11, 2014

1.   Intake of Long-Chain ω-3 Fatty Acids From Diet and Supplements in Relation to Mortality.
   Should I take omega-3 supplements like fish oil? This is a question I hear a lot. This smaller study finds that those who consumed the most DHA and/or EPA (the 2 key essential omega-3 fatty acids), had an 18% reduction in overall mortality. The effect on cancer reduction (23%) was greater than the possible benefit for heart disease. Of course, in correlation-finding studies like this you cannot be sure the correlation implies causation! So here is some evidence that you want to at least be the kind of person who would consume more omega-3s.
February 6, 2014

2.   Lifestyle modification programmes for patients with coronary heart disease: a systematic review and meta-analysis of randomized controlled trials.
   For people with known coronary heart disease, do programs to modify lifestyle help? Yes! "Lifestyle modification programmes were associated with reduced all-cause mortality". Reduction was 34%.
February 14, 2014

3.   Do all health care professionals have a responsibility to prescribe and promote regular physical activity: or let us carry on doing nothing.
   The title says it all. This I believe is the direction we are headed with promotion of physical activity. In the near future, a sedentary lifestyle will be widely recognized to be almost as harmful as smoking.
February 20, 2014

1.   Dietary fiber intake and risk of type 2 diabetes: a dose–response analysis of prospective studies
   This is interesting. So the theory is that our highly refined, low-fiber American diet causes diabetes. The authors looked at all high quality studies to date on fiber and diabetes. Sure enough they found all types of fiber reduce diabetes significantly, like 20%. But interesting when they looked at the 5 studies that provided dosing data. They found that as your fiber intake goes from 0gm per day to about 20gm/day, we see not much reduction in diabetes. But as people's intake increases from about 20gm/day to 40gm/day, there is a steep reduction. So my takehome lesson is when we say fiber is important to help prevent diabetes, we mean you need to eat a lot of fiber. Shoot for 40 grams per day or more.
January 4, 2014

2.   Role of Bariatric Surgery in Diabetes
   Bariatric surgery (gastric banding, gastric bypass) may be our most effective treatment for diabetes. Studies have found that in 57% to 95% of cases, diabetes will reverse with such surgery. We have no nonsurgical treatment that is remotely as effective.
January 9, 2014

3.   Dairy products on metabolic health: Current research and clinical implications.
   Here is a study favorable toward dairy. They cite some evidence that dairy might reduce tendency to diabetes, obesity, or the metabolic syndrome which usually precedes diabetes. There is some research on each side of the issue, and it is not conclusive. But chalk 1 up in favor of dairy.
January 22, 2014

1.   Dietary dairy product intake and incident type 2 diabetes: a prospective study using dietary data from a 7-day food diary
   This trial found that top consumers of lowfat yogurt had 28% lower rate of diabetes compared with lowest consumers of lowfat dairy. Not clear what those who did not eat lowfat yogurt were eating instead. That's the key question.
February 7, 2014

2.   Adherence to the WCRF/AICR cancer prevention recommendations and cancer-specific mortality: results from the Vitamins and Lifestyle (VITAL) Study.
   6 major recommendations to prevent cancer were put to a 7 year test. The results? "Cancer-specific mortality was 61 % lower in respondents who met at least five recommendations compared to those who met none... Cancer-specific mortality was 10 % lower on an average with each additional recommendation met". What are the recommendations that might cut your risk of cancer by over half? (1) Stay as lean as possible without becoming underweight. (2) Be active for at least 30 minutes a day. (3) Limit consumption of calorie-dense foods and avoid sugary drinks. (4) Eat a plant-based diet that includes a variety of vegetables, fruits, whole grains and beans. (5) Limit intake of red meat (beef, pork, lamb) and avoid processed meat (ham, cold cuts, bacon, sausage). (6) If you consume alcohol, limit yourself to one drink/day for women, two drinks/day for men. Which of these had the biggest effect? #4, with an 18% reduction in cancer mortality risk.
February 24, 2014

3.   Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study.
   What's better - exercise or drugs? This study looked at the available evidence, and concluded that "exercise and many drug interventions are often potentially similar in terms of their mortality benefits in the secondary prevention of coronary heart disease, rehabilitation after stroke, treatment of heart failure, and prevention of diabetes". In other words, exercise is about the same as effective as drugs for the diseases listed. And yes, typically the benefits are additive when you combine them both.
February 25, 2014

Thursday, January 1, 2015

Saturday, December 6, 2014

Phone System Down Saturday December 6, 2014

We are transitioning our phone system to Verizon Fios today.  If you need to reach the on-call doctor, please call 302-319-3414

Thursday, December 4, 2014

Knee or Shoulder Arthritis?

Having some knee pain that is limiting your exercise program?  Dr Zarek and our Physician Assistants, Abbe Jackson, PA-C and Ashley Kontra, PA-C, are skilled at joint injections.  We have helped patients with knee or shoulder pain by a simple injection in our office.  Please call for an appointment if you need to get moving again. 

Friday, November 21, 2014

Live Long & Prosper Newsletter November 2014

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP.

1.   Lack of health insurance increases all cause and all cancer mortality in adults: an analysis of National Health and Nutrition Examination Survey (NHANES III) data.
   "There was a 70% increase in risk of all cause death and almost 300% of all cancer death for people without any health insurance coverage". We need to be mindful that those who lack health insurance are in that unfortunate state because of some root causes, which also impact mortality rate. Namely, they tend to be of lower socioeconomic status, and they tend to be sicker. Because that is how the health insurers earn large bonuses - keep sicker, more expensive patients off the books. Let's hope this improves with the Affordable Care Act.
October 23, 2013

2.   Meat consumption and diet quality and mortality in NHANES III.
   This large study found no association between consumption of red or processed meat with mortality. Men who ate more white meat were in a category that had lower overall mortality. For women, white meat was not correlated with mortality.
October 24, 2013

3.   Calcium intake and serum concentration in relation to risk of cardiovascular death in NHANES III.
   You might have read that calcium pills might increase your risk of a heart attack. This study, looking at 1 particular large data set, found no association. However it did find that women with highest levels of calcium (upper 5%) have almost double the risk of heart disease.
October 25, 2013

1.   High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis.
   High-intensity interval training "significantly increases CRF [Cardio-Respiratory Fitness] by almost double that of MICT [moderate-intensity continuous training] in patients with lifestyle-induced chronic diseases." So if you have high blood pressure, pre-diabetes, heart disease, then you might consider asking your doctor about switching from the occasional grind on the treadmill, to a program involving periods of high intensitiy activity. You will likely need to have a screening test to make sure your heart is up to it first though.
October 23, 2013

2.   Effect of increased fruit and vegetable consumption on physical function and muscle strength in older adults
   Since fruits and veggies are not protein sources, they might divert your diet from important protein sources (meat and dairy), right? This randomized trial showed that eating more fruits and veggies for 12 weeks actually increased grip strength, though the finding was not quite statistically significant. So we can infer at least that fruits and veggies do not make you weaker.
November 30, 2013

3.   Exercise: Putting Action into Our Epigenome.
   How do we prevent age-causing methylation of your genome? Exercise! "Six months of aerobic exercise alters whole-genome DNA methylation in skeletal muscle and adipose tissue"
October 29, 2013

1.   Moderate Physical Activity as Predictor of Weight Loss After Bariatric Surgery
September 30, 2013

2.   Changes in fish consumption in midlife and the risk of coronary heart disease in men and women.
   "Our results suggest that increasing fish consumption to at least 2 servings per week in mid- or later life may lower CHD risk in women but not in men."
September 27, 2013

3.   Mortality among African American women with sarcoidosis: data from the Black Women's Health Study.
   Sarcoidosis kills. African American women with this disease have a 2.4 x risk of death compared with those who do not.
September 29, 2013

Thursday, November 13, 2014

Small Dermatology Procedures done in our Office!

Have a mole you're worried about?  Our physician assistants can take a look at it and remove it for you, if necessary.  Abbe Jackson, PA-C & Ashley Kontra, PA-C both had experience training in a dermatology office before starting at Progressive Health of Delaware.   Call us today if you have a mole you wanted checked!

Monday, November 3, 2014

High Dose Flu Vaccines Back in Stock

Our office did received some high dose flu vaccine last week and it's been going fast.  If you are over 65 years old, please come in soon for your high dose vaccine.  We have plenty of regular flu vaccines as well.  Stay healthy!

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