Upcoming presentations

Keeping your wits. Ten steps to prevent dementia and Alzheimer’s disease. Tuesday, September 18th, 6:00 p.m., Solana Beach Library.

Health benefits of wine and chocolate. Wednesday, September 19th 2:15 p.m. Rancho Penasquitos Library

In the news

Overdose on vitamin D? Not likely.

It’s rare to find an article about vitamin D that doesn’t mention the possibility of toxicity but that is extremely rare and should not be of concern to anyone taking a daily supplement. Even if one were to take ten times the recommended amount of 800 units per day it would take more than six months to show any signs of toxicity such as kidney damage.

A study of more than 70,000 patients at the University of Iowa Hospitals and Clinics revealed only four persons with symptoms, including abnormal calcium deposits and kidney injury that resulted from high doses of vitamin D. Two of these patients were children whose parents gave them a dropperful of liquid vitamin D instead of one drop.  The third patient was taking 50,000 units per day; the history of the fourth patient was not complete.

Of the more than 780 persons whose blood levels of vitamin D were above normal none had any symptoms and the blood levels of calcium were within the normal range among all but seven.

Some supplement manufacturers recommend 2,000 to 3,000 units of vitamin D per day, a dosage that is entirely safe.  For persons over the age of about 60 some experts recommend an intake of 1,000 units per day. Older persons who fear skin cancer tend to avoid sun exposure. That helps to explain why more than half of the senior population, especially in the northern half of the United States have abnormally low blood levels of this important vitamin.  In addition to its bone-building benefits vitamin D is necessary for a healthy immune system and appears to play a role in the prevention of heart disease and cancer.



Ten ways to prevent dementia and Preventing dementia and Alzheimer’s disease: step 2.

#2 – Keep your blood sugar normal

Type 2 diabetes is a lifestyle-destroying disease that now affects about eleven percent of the U.S. population.  It is characterized by frequent and prolonged high levels of blood sugar that cause distortion of blood vessels. The inevitable result is damage to those parts of the body that have a rich network of blood vessels: the kidneys, the eyes, the heart and the feet. Type 2 diabetes is the main cause of kidney failure and will soon become the major cause of blindness among seniors. Diabetics have high rates of heart disease and stroke. Defective blood vessels fail to bring nutrients to the brain and cannot remove waste products. Brain cells die, the brain shrinks and the result is dementia, deteriorating memory, loss of cognitive skills and the inability to care for oneself.

A high intake of refined (white) flour and refined sugar including high-fructose corn syrup produces elevated levels of sugar in the blood. Sugar molecules attach themselves to protein molecules that are the building blocks of blood vessels. Just as one cannot build a decent-looking wall with bricks of varying shapes and sizes, one cannot form healthy blood vessels with distorted protein molecules.

The solution: stay away from refined grains and sugars. Replace them with whole grain foods along with plenty of fruits and vegetables.

In the news

Is the price of legalized marijuana getting too high?         By the end of this decade it’s likely that nearly half of the states will have legalized the medical and/or recreational use of marijuana. It’s clear that it does have some medical benefits. What is also becoming clear is that frequent use of marijuana carries more risks than its supporters acknowledge, or may even be aware of. Three disturbing findings should make us pause for a moment.

We know that marijuana affects the brain. Otherwise, why bother? Colorado pediatricians, concerned about the future mental health of babies whose mothers smoke marijuana during pregnancy, monitor all newborn babies for the presence of the drug. Ten to fifteen percent of newborns in Colorado have marijuana in their systems. In one recent month in the city of Pueblo that figure was an astounding ninety percent!

In a study of more than 3600 children there was a more than 30 percent increased risk of “psychotic-like experiences” in the offspring of cannabis (marijuana) users when the children were evaluated at age ten years.

Canadian physicians are also concerned, and no wonder. The Canadian Psychiatric Association notes that “22 percent of youth aged 15 to 19 reported using cannabis during the past year.”  In a 2017 article they note that marijuana use in teenagers is “strongly linked” to other substance use disorders, depression, anxiety, psychosis, impaired neurological development, cognitive decline and diminished school performance.

Marijuana, like tobacco and alcohol, is here to stay.  If we could keep it from young people and pregnant women we could limit the ultimate damage.


Ten ways to prevent dementia and Alzheimer’s disease

       “Alzheimer’s disease is no longer considered an inevitable consequence of the aging process.” M. Folstein, M.D.

          This should be not only a reassurance but an incentive to take advantage of the several means of avoiding or at least postponing the onset of one of the most feared illnesses of our generation. In the biweekly blogs that follow we will present each of the steps – there are actually more than ten – that anyone can do without a massive change in lifestyle.

Alzheimer’s disease is only one type of dementia and is not actually a single condition. However all the steps described here will not only help to prevent these dementias, they will also lower your risk of heart disease, stroke, cancer, osteoporosis and type 2 diabetes.

#1 – Busy body, better brain

Regular, moderately intense exercise is the single most important factor in preventing not only dementia but the major chronic diseases that are (incorrectly) blamed on aging.

Exercise helps to grow new brains cells, makes existing cells last longer and forms more connections between brain cells. Thus with an extra reserve of brain cells and the connections between them, loss of some of these structures due to the accumulation of abnormal protein such as that which occurs in Alzheimer’s disease is less crippling.

Persons who exercise regularly (that means at least 4 times a week and for about one hour) are found to have faster thinking speed and better memory. Exercise almost entirely eliminates one form of dementia, that caused by damage to blood vessels.









Upcoming presentations

Friday, August 3, 2:30 LIFE program at Mira Costa College, Oceanside. Baby Boomer blindness. Details at  http://www.miracosta.edu/life.

Tuesday, August 28, 1:00 Mission Valley library, A day in the life of a Renaissance physician. Learn how it impacts what your physician is doing today.

In the news

Exercise more, feel better

Physical activity – another term for exercise – has lots of benefits that go beyond helping you to keep from gaining weight. Besides making your heart and lungs perform better, moderately intense physical activity can completely prevent type 2 diabetes (which now affects 12 percent of the adult population!) and lowers the risk of osteoporosis and Alzheimer’s disease.

Research from Finland shows that it also improves psychological well-being.  A group of couch potatoes was instructed in the use of weights and resistance bands and they were observed for nine months. Compared to non-exercisers the gym rats reported improved quality of life and fewer depressive symptoms.

Those of you who exercise regularly probably could have predicted that. Better circulation, especially to the brain, improved appetite, more flexibility, more restful sleep and greater physical endurance are all benefits of regular exercise.

Although even those who (by study design) exercised only once a week showed significant improvement those who exercised three days a week showed the most improvement.

Try it. You’ll like it!



Shingles vaccine update

About side effects – I received the second (and final) dose of the new shingles vaccine, called Shingrix a couple of weeks ago. There was some soreness at the injection site, which is typical for most vaccines and it wasn’t very bothersome. However, I felt crummy for two days. That was it! It didn’t keep me from my usual activities except that I took a holiday from the gym for about five days because of the sore arm.

About a quarter of Americans will have had at least one episode of shingles – known as herpes zoster – and if you’re lucky enough to live past 85 the risk is about 50 percent.

Even an “ordinary” case of shingles will include a painful rash that lasts about three weeks. In some cases the pain lasts forever! The worst side effects of the Shingrix vaccine aren’t nearly as bad as that.

Older age carries an even greater risk, that of depressed immune function resulting from leukemia or chemotherapy, in which case the disease can be really severe.

The bottom line: everyone over the age of 50 should have the vaccine, even those who have had shingles in the past or have had the older vaccine (Zostavax). Are the side effects a problem? Nah!







In the news

Thanks for (Ouch!) saving my life

Perhaps you saw the recent news article about how Senator Joe Manchin saved the life of another senator – Claire McCaskill – by performing the Heimlich maneuver/abdominal thrust. The story didn’t describe the details of what caused the airway obstruction but the big news was that Rescuer Joe cracked one of Ms. McCaskill’s ribs. Bad form but a good outcome.

There’s a teaching point here: if the abdominal thrust – the Washington Post called it the Heimlich maneuver – is performed correctly you shouldn’t crack a rib. The good senator obviously placed his hands too high on Ms. McCaskill’s abdomen. The best place is just above the bellybutton. Not only will that avoid vulnerable ribs, it will also avoid the xiphoid process, the arrowhead-shaped bone that points downward (and right at the liver!).

I’m willing to bet that by now Senator Manchin has received dozens of e-mails and tweets to let him know how to improve his technique.



Dieting Guidelines

Spot reducing sounds like a great idea. Too bad it doesn’t work for thighs, chins or upper arms. Categorically, using a vibrating “fat-reduction” tool on any part of your body or exercising one area (like your thighs) will have little effect on the fat there.

Having said that, all fat is not the same. The stuff around a woman’s hips and thighs is hard to get rid of because nature has programmed it to be one of the last stores to melt away during food scarcity in case the owner of the fat happens to be pregnant. Fat around the middle – which is usually an indicator that there is too much heart-damaging fat around the abdominal organs, intestines, etc. – usually starts coming off first when you lower calorie intake and exercise more. Be aware, however, that doing lots of abdominal exercises won’t make that fat go away any faster, it will just give you stronger abs underneath the fat.

That dangling fat at the back part of the upper arms won’t go away any faster if you do lots of arm exercises but the muscles there will get bigger and more firm. Eventually you’ll lose those “angel’s wings” along with the excess fat everywhere else.








Upcoming presentations

Thursday, July 19, 1:00 p.m. Ramona Library The True Mediterranean Diet, (Hint: It’s not what you get at the local pizza parlor but it’s a proven life-extender.)

Tuesday, July 24, 1:00 p.m. Mission Valley Library, Keeping your wits; ten ways to prevent dementia and Alzheimer’s disease.

In the news

Hearing loss on the horizon

Physicians have known for decades that chronic exposure to loud noise leads to hearing loss. Maybe we should be concerned about noise that may not seem to be loud but that is piped directly into our ears via headphones or ear buds.

A study among Dutch children revealed that 14 percent had high frequency hearing loss. High frequency loss matters because it includes conversational tones. In a study in the U.S., 90 percent of pre-teens and teens used a portable music player. Although these two studies are not entirely consistent with each other they reveal a trend – widespread use of music devices and evidence of hearing loss among persons who are likely to be using them for several more decades.

The genie is out of the bottle; it’s unlikely that either trend will reverse itself. When today’s kids reach Medicare age they might have to start learning sign language.

Two recommendations that we should be passing on to our kids (and using ourselves): if someone else can hear what you’re listening to with ear buds or headphones the volume is too high. Second, make a habit of keeping the volume low enough so that you can hear another conversation.

The most commonly used word in the English language today (according to Siri) is “the.” In the future it might be “Huh?.”


Exercise Tips

Should you push yourself? That depends on what you mean by “push.” Very long (greater than one hour) workouts are unnecessary, counterproductive and invite injury.

For those who run, keep in mind that running is a sport, not an exercise. You can hurt yourself in a sport like running but not in an exercise like walking. (I know that I’ll get some flak on this!) Unless you are a competition runner there is only a marginal benefit toward fitness in running versus walking.

If you lift weights you are probably aware that the greatest benefits come with lifting enough so that the final repetition is barely doable. That’s what makes a muscle grow. If you develop pain during an exercise, stop immediately. It is not possible to “work through” an injury. Shoulder injuries are among the most common and they take very long to heal.

Instead of lifting heavier weights, make each repetition last several seconds but decrease the weight by at least a third. The results will be the same and the risk much less.







In the news

Is it time to test your telomeres?

For a few hundred dollars and a small blood sample you can learn how long your telomeres are. These are DNA structures that form caps on the ends of the chromosomes that carry genetic material, protecting them from deteriorating and keeping them from getting stuck to their neighbors. With each cell division some telomere material disappears. When the shortening reaches a critical stage the cell can no longer divide and eventually dies. The shorter your telomeres, the shorter your remaining lifespan will be. Do you really want to know?

Many age-related diseases appear to be linked to the shortening of telomeres, including coronary artery disease and several types of cancer. There is no clear consensus on the role of telomere shortening in the aging process or disease. That hasn’t kept marketers from latching onto the idea that it is helpful to know how your telomere length compares with that of the average person. Some companies provide you with your age in telomere years for comparison with your chronologic age.

Those who promote testing claim that bad news, like showing that your telomere age is a decade or two older than your chronologic age, is an incentive to change your lifestyle. Studies in humans are sparse but exposure to toxic chemicals, a sedentary lifestyle, a diet that is high in animal products and low in plant foods all appear to shorten telomeres. Stress reduction, exercise and foods high in antioxidants appear to make them longer.

No matter how long or short your telomeres may be, adopting a prudent lifestyle will help you to avoid the common diseases of aging. Instead of purchasing a test kit that might or might not predict how many years you have left it makes sense to follow some simple steps: regular, moderately intense exercise, a diet that is rich in plant foods and low in saturated fat, refined grains, sugar and red meat and avoidance of stress. Resveratrol, an ingredient in red wine, has also been found to increase telomere length. A glass or two will also keep you from worrying about them.


Mosquitoes love beer

       In our mid-April blog we offered some thoughts about the importance of avoiding mosquitoes and eliminating their breeding sites.  Now that summer is officially just a few days away here are some more tips that will make you a less attractive target.

Sorry to bring bad news but mosquitoes are attracted to beer drinkers and it only takes one glass to turn them on. A study from Japan seems to have nailed down that theory, which is supported by a mosquito expert at the University of Kentucky. The reasons aren’t clear but it might be the scent of CO2 that is released when you open that can or bottle. (Soda has the same effect.) You also exhale more CO2 when you are more active.

If you are sweating – and who doesn’t in the summer? – you’re adding another attractant. In fact, mosquito researchers use human sweat to entice the critters into their traps.

Dress defensively. Mosquitoes prefer victims wearing dark clothing.











Upcoming presentations

Wednesday, June 6, 1:00 Supermarket suicide and restaurant roulette. Escondido Senior Center. OASIS – see their website http://www.oasisnet.org.

Friday, June 15, 1:00 Emerging infectious diseases and safe travel guidelines, Temecula Higher Education Learning Center. Osher – see their website http://www.csusm.edu/el/olli.

Wednesday, June 20, 2:00 All about Shingrix, the new shingles vaccine, Escondido Senior Center http://www.oasisnet.org

Tuesday, June 26, 9:30 a.m. How wars changed medicine, Oceanside Senior Center, 455 Country Club Lane. Osher – see their website http://www.csusm.edu/el/olli.

Friday, June 29, 1:00 p.m. Emerging infectious diseases and safe travel guidelines, Carlsbad Library Learning Center. Osher – see their website http://www.csusm.edu/el/olli.

In the news

Trans fats are going away – finally!

Trans fats are vegetable oils that have been treated to keep them from becoming rancid. When they are used in baked goods they prolong their shelf life. That’s good for food manufacturers but bad for the heart. Trans fats raise LDL (bad) cholesterol, lower the levels of HDL (good) cholesterol, make blood more likely to clot in vessels of the heart and brain and increase inflammation, which plays a large role in heart disease, stroke, diabetes, cancer, osteoporosis and other diseases.

By June 18 – only days away – the FDA has ruled that food manufacturers must remove trans fats from processed foods. Health experts predict that this will prevent several thousand heart attacks per year.

If you are a label reader you have probably seen some nutrition facts labels that state that the trans fat content of the item is zero. Government folks aren’t very good at math: “zero trans fat” on a food label means that it can have up to 0.5 grams of trans fat. Maybe that helps to explain why the U.S. is a financial mess – the people that make the rules can’t do simple math!



Dieting Guidelines

Your mother was right! Eating slowly is better for you but not for the reasons I heard when I was a kid: “Don’t eat so fast! You’ll choke on your food.” “It’ll make you sick..” Well, that second part was right but the sickness would take years, even decades to develop.

When we eat fast we eat more. That’s because it takes about 15 or 20 minutes for our hard-wired appetite-control mechanism to let us know that we’ve eaten enough. It was once thought that this was a simple mechanism brought into play by a hormone called cholecystokinin that was released when the stomach was full. We should have known! Nothing is really that simple in matters of biology. Scientists now know that there are several mechanisms, some regulated by hormone-like chemicals, that control appetite.

Some of this came to light after lots of people had a part of the stomach removed to lose weight. They didn’t get as hungry as they should have when portion sizes were limited to something about the size of a golf ball. The part of the stomach that had been removed contained cells that produced one of the hunger-causing hormones.

The bottom line: follow Mom’s advice and eat slowly. You’ll end up eating less, especially if your meals consist largely of fiber-rich vegetables.