Mortality Archives

Dec

2018

Not Exercising Is More Risky For You Than Smoking

By Ray Schilling | Cancer, Cardiovascular disease, Diabetes, exercise, Fitness, heart attack, Mortality, Nutrition, Prevention, Smoking, Stroke

A new study showed that not exercising is more risky for you than smoking. We all know that smoking puts you at risk to get a heart attack or a stroke. It can also cause lung cancer and other cancers. So, hearing that not exercising is even more risky than smoking comes as a shocker.

The study

Dr. Wael Jaber, a cardiologist at the Cleveland Clinic was the senior cardiologist of this study. It was based on 122,007 patients who underwent tests using an exercise treadmill test at the Cleveland Clinic. This took place between the beginning of January 1991 and the end of December 2014. The end point in the study was all-cause mortality. The question in the study was whether exercise and fitness were lowering the risk of mortality. The result showed that 12% of the study group had the lowest exercise rate. This sedentary group had a mortality rate that was 500% higher than the top exercise performers. Compared to someone who exercises regularly the sedate group that hardly exercises still had a 390% higher death rate.

No ceiling of the benefit of exercise

What was astounding to the researchers was the fact that there was no ceiling of the benefit of exercise. The ultra fit group still had a super low mortality rate, lower than the next higher fitness group. Age did not matter either. Whether you were 40 or 80, the more you exercised, the lower your mortality rate was.

Comments about the study

Jaber said: “Being unfit on a treadmill or in an exercise stress test has a worse prognosis than being hypertensive, being diabetic or being a current smoker. We’ve never seen something as pronounced as this and as objective as this.” He went on to say: “If you compare the risk of sitting versus the highest performing on the exercise test, the risk is about three times higher than smoking.”

A sports medicine physician, Dr.Jordan Metzl who was not part of the study, said: “Cardiovascular disease and diabetes are the most expensive diseases in the United States. We spend more than $200 billion per year treating these diseases and their complications. Rather than pay huge sums for disease treatment, we should be encouraging our patients and communities to be active and exercise daily.”

Other studies showing that not exercising is associated with a high mortality rate

The STABILITY trial

This trial was based on 15,486 patients with heart disease and found that even 10 minutes of exercise per day reduced mortality. They compared the death rate of people engaging in 10 minutes of a brisk walk with a group who did not exercise at all. The brisk walkers had a 33% lower death rate than the group who was entirely sedentary.

A lack of exercise causes a lot of chronic diseases

This review article mentions that a number of chronic diseases were related to sedentary lifestyle. Major diseases like heart attacks, strokes, arthritis, depression and anxiety and others were clearly much more common in people who were more sedentary than those who were exercising regularly.

Poor lifestyle in general causes diseases

Lifestyle, in particular regular exercises, a healthy diet and NOT smoking has a profound positive effect on our health. In one study researchers showed that 79% of major diseases including heart attacks and strokes could be prevented with a healthy lifestyle. I reviewed this in this blog.

High blood pressure reduced by regular exercise

This 2017 study from Brazil has examined the effects of regular exercise on high blood pressure patients. They came to the conclusion that regular exercise can be as powerful as blood pressure lowering medication. Both bring down systolic and diastolic blood pressure. Even complications of previously untreated high blood pressure will be reversed with regular exercise while medication will not have this positive effect. Controlling high blood pressure with regular exercise will prevent diseases like heart attacks and strokes and the associated mortality.

Regular exercise and diet change to prevent type 2 diabetes

In this 2015 study the researchers noted that a combination of adopting a healthy diet and regular exercise could lead to weight loss. This was shown to prevent type 2 diabetes. The authors question why such a lifestyle change was not more widely taught to people to prevent cardiovascular diseases and diabetes.

Not Exercising Is More Risky For You Than Smoking

Conclusion

The medical profession knows for a long time that regular exercise is good for your health. But there always was a concern that perhaps too much exercise may be hazardous. A 2018 study from the Cleveland Clinic followed 122,007 patients for 14 years. All patients underwent an exercise treadmill test as a baseline. The end point was mortality during the 14 years of follow-up. The results made clear that there was no upper limit of exercise. Patients who were exercising the most still had a lower mortality than those who exercised less.

Sessile patients

But perhaps the most impressive result was that sessile patients who did hardly any or no exercise had the highest mortality. Their mortality was higher than that of smokers who exercised a little bit. If you want to avoid getting a heart attack, a stroke, diabetes or many types of cancer, exercise regularly, don’t smoke and eat a Mediterranean type diet. Regular exercise can reduce cardiovascular disease by 79%. And since the Cleveland study we know that more exercise is even better as the top athletes had the lowest mortality.

Nov

2018

Gut Bacteria Crucial To Healthy Aging

By Ray Schilling | Alzheimer’s disease, Anti-aging medicine, Cancer, lifestyle, Mortality, Parkinson’s disease

New research presented at the London Microbiome Meeting asked the question “are gut bacteria crucial to healthy aging?” Marina Ezcurra, is a Ph.D. is a researcher working at the Queen Mary University of London in the United Kingdom. She uses a nematode (round worm) model to investigate various aspects of aging. Nematodes like C. elegans provide a useful model not only for genetic work, but also for the human gut flora as well. Moreover, it allows making observations about the connection between bacterial genes and aging. Coupled with the fact that the worm has such a short lifespan, the researchers can test bacterial genes, the aging of the worm and get meaningful results in short order.

It seems like one of the research objectives was changing the nematode’s gut flora and observing life expectancy and age-related diseases.

Pathological versus healthy gut bacteria composition

Dr. Ezcurra did a couple of experiments with the nematode C. elegans as a model. She could show that the worm’s gut bacteria composition mattered. First of all, if there was a pathological composition of the gut flora, the worm did not turn as old and there were various age-related diseases that developed. Secondly, they were very comparable to human age-related degenerative diseases like Alzheimer’s disease.

Another senior author researched how genes of gut bacteria influence life expectancy

Meet Dr. Meng Wang, associate professor of molecular and human genetics, Baylor College of Medicine in Houston, TX. He did extensive genetic research on C. elegans. He used this model, because C. elegance lives only 2 to 3 weeks. This animal model is easy to manipulate. For instance, he studied the gut bacteria composition. This link explains that he tested about 4000 E.coli bacteria with various gene defects. 29 E.coli strains when deleted, increased the worms’ lifespan.12 bacterial mutants among those prevented cancer and amyloid-beta, found in Alzheimer’s disease. Some mutant bacteria caused longevity by acting on processes linked to aging.

Colanic acid is an important anti-aging factor in C.elegans

Dr. Wang joined Dr. Christophe Herman, associate professor of molecular and human genetics at Baylor, for further research. It turned out that one of the keys to longevity of the nematodes were the mutant bacteria in the gut over-producing the polysaccharide colanic acid. This allowed the nematodes to live much longer. The researchers could show further that fission and fusion processes with regard to mitochondria are important. Mitochondria are the energy packages in cells and these processes are regulated by the presence of colanic acid. As a result, if your gut has good bacteria you can grow old and escape Alzheimer’s disease and cancer.

Dr. Meng Wang said: “Of the nearly 4,000 bacterial genes we tested, 29, when deleted, increased the worms’ lifespan. Twelve of these bacterial mutants also protected the worms from tumor growth and accumulation of amyloid-beta, a characteristic of Alzheimer’s disease in humans.”

Creating longevity with metformin, a diabetic drug

Physicians have known for some time that metformin stimulates longevity genes. This is the reason why diabetics on metformin live longer than diabetics on insulin. Dr. Ezcurra mentioned on 24 October, 2018 in her talk at the London microbiome Meeting that she had done experiments with C. elegans and metformin. Metformin reduces the risk of cancer and increases longevity in C. elegans as well as in mice (other experiments). Currently there is a clinical trial going on that investigates anti-aging under the influence of metformin in older people.

Effects of metformin on anti-aging

Metformin has the potential to target diabetes, cancer and Alzheimer’s pathologies all at once.

The anti-aging effect in humans with metformin involves the gut bacteria. Dr. Ezcurra says that this is the reason why diabetics on metformin live longer than diabetics on insulin. Metformin influences the folate bacterial metabolism of the gut flora. Other research has shown that the Akkermansia bacteria in the gut, which are good, desirable bacteria, will increase from 3-5% to 12.44% of the gut flora under the influence of metformin. Here is the discussion in detail in the following link.

Effect of gut bacteria on psychiatric diseases, obesity and diabetes

Dr. Ezcurra said that there are many studies showing that dysbiosis of the gut can lead to psychiatric diseases, Parkinson’s disease, obesity and diabetes etc.

We need to know more about whether a healthy gut flora will let us age without causing age-related diseases. Dr. Ezcurra stated: “By better understanding the links between nutrition, microbiome, and health, we can understand how the elderly can maintain their microbiome, and also help them directly by using pre- and probiotic strategies. This would help us age in a better way, maintaining health and quality of life in old age without drugs or surgery.”

Gut Bacteria Crucial To Healthy Aging

Conclusion

The composition of the gut microbiome appears to determine whether we age gracefully or not and whether we get sick as we age or not. Everything depends on the diversity of the gut flora. There are bacteria in the gut that are good for us and also bacteria that are bad for us. Metformin has been shown to stimulate the good gut bacteria to multiply. Dr. Ezcurra is continuing her research into this. She clearly stated that it should be possible for us to age in a better way and maintain health and quality of life in old age without drugs or surgery.

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colanic acid cosmetics

Nov

2018

When you are sleepless

By Ray Schilling | andropause, Anxiety, Drugs, Insomnia, Menopause, Mortality, sleep, stress, telomeres, testosterone

You are not alone when you are sleepless. Insomnia is a widespread problem in society.

Previous review of the topic of insomnia

I have reviewed the topic of insomnia before in a blog.

Briefly I pointed out that in some people there is a mutation of the gene that controls the circadian sleep rhythm. It is called the CRY1mutation. Some people have sleep disturbances from working night shifts. I mentioned the blue light of electronics that is produced by the TV screens or computer screens. The more you are exposed to it, the more it stimulates the brain to produce serotonin. This undermines the melatonin production, and as a result the person finds it extremely difficult to fall asleep. Children playing with i-phones, tablets or watching children’s programs on television can have sleep disturbances from the blue light. Blue has the frequency that over stimulates the brain and interferes with melatonin production. Drug and alcohol abuse can also interfere with the normal circadian sleep rhythm and cause insomnia.

Hormone factors of insomnia

For natural sleep to occur, we need melatonin which the pineal gland releases in the evening. It initiates and maintains sleep during the night. The natural opponent of melatonin is cortisol, the stress hormone, from the adrenal glands. Both hormones need to be in balance to allow you to sleep normally. Shortly before we wake up in the morning melatonin production goes down and cortisol production is up. Cortisol levels are low at night and high during the day. So it is cortisol that keeps us going throughout the day. But an excess of cortisol from chronic stress can also interfere with falling asleep and sleeping through the night.

Stress and insomnia

When we feel stressed, cortisol production goes way up. This has consequences regarding our sleep pattern. It can interfere with falling asleep, causes us to wake up from a deep sleep in the middle of the night and can give us problems falling asleep again. Chronic stress exposure leads to high cortisol production by the adrenal glands, which in turn will lower melatonin and cause sleep disturbances. Older people (above the age of 50) have very little melatonin production left, as there is an age-related decline of melatonin production. The melatonin production is highest in younger years and lowest in older age.

What to do when you are sleepless

There are several over-the-counter remedies, which in combination can be quite effective.

Melatonin for when you are sleepless

Melatonin (3 mg at bedtime) is a good start to see what it does for your sleeplessness. Taking a small amount of melatonin at bedtime we can re-establish the balance between cortisol and melatonin, which helps the circadian hormone rhythm and sleep pattern to come back. Some people wake up in the middle of the night and find it difficult to fall asleep again. If this happens at 3 AM, a good remedy at this time is to take another 3 mg of melatonin. Melatonin stays in the system for about 4 hours. Light during the day de-activates the effect, when light hits the retinas upon opening your eyes. You should not exceed 6 mg of total melatonin overnight. Otherwise it will interfere with the balance of cortisol and melatonin, lowering cortisol levels, which would rob you of energy during the day.

Phosphorylated serine (Seriphos)

A supplement that is freely available in the US (but not in Canada) consists of a simple amino acid. As this link shows (second item in the link) phosphorylated serine Seriphos) helps to down-regulate cortisol levels (lowering them). This means that melatonin gets the upper hand and you can sleep again.

The dosage for phosphorylated serine (Seriphos) varies from person to person, but will be in the range of 1000 mg to 3000 mg in the evening. After about 30 days the circadian rhythm may have recovered and you can stop the Seriphos. A one-day pause is required once a month for resetting the hormone receptors. Should you still have problems sleeping, you can continue with it for another month and pause again for a day. Seriphos has very few side effects.

Valerian root capsules

Another useful sleep aid is valerian root (as capsules). 500 mg to 1000 mg will help you to relax. It does not have the side effect of feeling groggy the next morning.

Other considerations when you are sleepless

Hormone problems like thyroid abnormalities (too much or too little thyroid hormones) are issues that your doctor has to investigate. Women in menopause often have sleep disturbances due to a lack of estrogen and progesterone. A knowledgeable healthcare professional is able to take care of that by prescribing bioidentical hormone creams.

When men approach andropause (the equivalent of menopause in women), they lose testosterone production. This can cause insomnia. The doctor can verify the hormone loss by a blood test. Replacement with either bioidentical testosterone cream or injections will rebalance testosterone levels. Insomnia may disappear. It is essential not to overdose testosterone, as this can also cause insomnia.

Sleep lab for when you are sleepless

When home remedies do not help, it may be time to check into one of the sleep labs to diagnose the kind of sleep disorder you are suffering from. Here is an overview what is happening there.

Essentially you get hooked up to monitors and are encouraged to just sleep as you would normally do. The physician in charge of the lab will later explain to you what the monitors showed, and tell you what type of sleep. According to the findings your doctor will recommend what measures are appropriate to remedy the situation.

Treatment for insomnia when over-the-counter remedies fail

Short acting benzodiazepams

When anxiety is not a problem, but only insomnia is (falling asleep or staying asleep) lorazepam 1 mg (Ativan) or temazepam 10 mg (Restoril) are shorter acting benzodiazepams that will help. It is not a permanent but a short “emergency break” for intermittent use, so that the GABA benzodiazepine receptors have time to recover. Otherwise, with continuous use tolerance would set in. This means higher and higher doses of the sleep medication would be necessary to achieve the same effect. Another non-benzodiazepine is Zolpidem 5 mg (Ambien). Even though this medication is not a benzodiazepine, it works on stimulating the same GABA benzodiazepine receptors.

Longer acting benzodiazepams combined with antidepressant Trazodone

For several years the combination of a small amount of the longer acting benzodiazepams, clonazepam (Rivotril) at 0.5 mg combined with a small amount of the anti-depressant trazodone (Oleptro or Desyrel) at 50 mg at bedtime has been has been in use quite successfully.

But there is a concern of drowsiness caused by Rivotril as this link shows.

Trazodone, which is an antidepressant has a sleep cycle restoring effect at low doses and has less side effects, because it is used at ¼ the dose for a full-blown depression. Males are often complaining that it reduces their sex drive, and it may cause erectile dysfunction.

Clonazepam side effects

Rivotril was originally in use to control epileptic seizures and anxiety. The combination therapy for sleep disorders uses Rivotril at ¼ of the regular dose. Although it is good as a sleep aid, it has a long half-life and stays in the system well into the next day. This may present as sleepiness and cause falls in elderly patients because of clouded attention. Replacement by one of the medium long acting benzodiazepams could be the solution. A drug pause for 1 day will help to reset the GABA benzodiazepine receptors and prevent tolerance from happening. Knowing all those effects and side effects it is wiser to reserve the use of these medication strictly when everything else has failed!

When you are sleepless

Conclusion

As I mentioned before, you are not alone when you are sleepless. Insomnia can present as having problems to fall asleep, but it may present in others as a problem in the middle of the night waking up and having problems going back to sleep again.

I described non-conventional methods to help you to sleep using melatonin, Seriphos and valerian root capsules. If this fails, a sleep lab investigation may be necessary to get to the bottom of your insomnia problem. Physicians often prescribe short acting benzodiazepams like lorazepam (Ativan) and temazepam 10 mg (Restoril).

Other possibilities to treat insomnia

There are other possibilities to treat insomnia, with a combination of a low-dose antidepressant (trazodone, brand name Oleptro in the US) and low-dose anti-seizure and anti-anxiety drug clonazepam (Klonopin or Rivotril). Anxiety can often be a big component in insomnia and this treats both. On the other hand, anxiety is a separate problem, which needs professional treatment. There can be side effects of sleepiness from clonazepam and men complain of a lack of sex drive and erectile dysfunction from trazodone. Help is available when you are sleepless. But you need professional help to work on the problem and find the solution.

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Oct

2018

Four Diseases Cause Most Of The Deaths

By Ray Schilling | Angina, Cancer, Cardiovascular disease, Diabetes, Fitness, heart attack, Heart Disease, lifestyle, Lung Disease, Mortality, Nutrition, sugar

Four diseases cause most of the deaths around the world: cancer, cardiovascular disease, chronic respiratory diseases and diabetes. This story is the news right now. 50% of the 193 UN member states that signed a treaty in 2015 are falling short of their promise. They wanted to reduce premature deaths from these diseases by 2030. But this is not happening as this story shows.

I like to review these 4 key diseases and what we can do ourselves about eliminating them. We cannot afford to wait for things to happen on a national level. Rather we need to go to the grass roots of every country and change the risk factors that cause these 4 diseases.

Cancer

First, cancer is a disease of older people, unless strong genetic factors are present. In this case even children can get leukemia, brain tumors and osteogenic sarcoma. In older people DNA mutations and DNA breaks happen more often as we age. On the other hand, if we diagnose cancer in stage 1 or 2 (in the early stages), it is quite often curable.

Oncoblot test, a cancer screening test

Probably one of the less known new criteria is the fact that there is a very sensitive cancer blood test, called the Oncoblot test (released about 4 years ago by the FDA). The latest screening test that came out of the human genome project is called the Oncoblot test. It screens for 25 of the most common cancers. And it is screening for ENOX2 proteins from cancer cells. It is a 1000 USD test in the US that health plans will not cover, but it will screen for more than 25 different common cancers 6 to 8 years before they would otherwise become clinically manifest.

If you discover cancer with this early blood test and you treat it right away, you have a good chance to live a few years longer. You may come down with another cancer down the road, but treat it early again, and you will still have a better life expectancy. Remember: four diseases cause most of the deaths, cancer is one of them!

Cardiovascular disease

Furthermore, people develop cardiovascular disease from poor eating habits and a lack of regular exercise. There are a few percentage points of people with familiar high cholesterol. These people need to see their family doctor for a prescription to lower cholesterol. But the majority of people will do well by changing their diet into a Mediterranean diet; lose weight until their body mass index reaches a value of 21 to 24. With this diet it is important to cut out all refined sugar and starchy foods. Regular exercise in a gym will also prevent hardening of the arteries. Chelation therapy has been shown in this study to help reduce hardening of arteries.

Diabetes patients have accelerated hardening of the arteries

We know from diabetic patients who have accelerated hardening of the arteries how devastating cardiovascular disease can be. Heart attacks, strokes, kidney failure, amputations of the lower leg and blindness are just some examples. Even patients who do not have diabetes can get these complications at an older age. The key is to think preventatively, change the diet, exercise regularly and you will lower all those risks. Remember: four diseases cause most of the deaths; cardiovascular diseases belong to that group and are a major player.

Chronic respiratory diseases

There are different reasons why a person may develop chronic respiratory disease. A common disease is chronic obstructive pulmonary disease (COPD). COPD often has a link to smoking heavily as a younger person. This is where the damage to the lung tissue has started. Exposure to cigarette smoke leads to loss of elastic tissue in the bronchial tubes. The lungs have a difficult time to exhale to get rid of the CO2. The end result is that your breaths are shallow and you can’t get enough oxygen, because the lung is already filled with air.

Asthma and COPD

Another disease is asthma. Nowadays physicians can treat this condition well with a corticosteroid inhaler and salbutamol. Salbutamol dilates the airways by relaxing the muscles of the bronchial tubes. The corticosteroid keeps the lining of the bronchial tubes thin, so that the air can move in and out of the lung.

If asthma is not treated properly there can be permanent damage to the airways and the clinical picture would look similar to COPD.

With end-stage COPD patients the only therapy the physician can offer is continuous oxygen flow treatment. With power failures these machines that supply oxygen will stop working. People need to make provisions to have a back-up generator. Again, we need to remember: four diseases cause most of the deaths. Chronic respiratory diseases belong to them.

Diabetes

Patients with type-2 diabetes (Type 2 DM) are usually older than 30 years of age.

That’s why they are called “mature onset diabetes” or “adult onset diabetes”. For several decades a patient may “incubate” diabetes and have one or more of the diabetes risk factors, such as high blood pressure, obesity, high cholesterol or high triglycerides, but have normal blood sugars.

Physicians have followed patients like this for several decades in the well known Framingham Heart Study and found that a high percentage of them do come down with type-2 diabetes later in life. In the past this time of incubation was termed “pre-diabetes”. Now we call it “syndrome of insulin resistance” or “metabolic syndrome”. Diabetes belongs to the group of diseases that are associated with chronic inflammation in the body.

Causes of type-2 diabetes

Type-2 diabetes often associates with other endocrinological diseases such as Cushing’s syndrome (an adrenal gland hyperactivity) or acromegaly (increased growth hormone production). In these diseases other hormones are tilting the hormone balance by counteracting insulin thus leading to a relative shortfall of insulin, which is another cause for type-2 diabetes. There is confusion among scientists regarding possible genetic reasons for type-2 diabetes. The environment or weight gain may trigger various genetic loci that exist. The syndrome of insulin resistance has shown some connections between hypertension, obesity and type-2 diabetes.

Death in diabetics usually comes from a heart attack, a massive stroke, but it may also come from systemic infections, called sepsis. Dr. Taylor from Newcastle University showed on 30 volunteers that 43% of diabetics could be cured by a diet of 600-700 calories for 8 weeks. The medical literature also knows that regular exercise is beneficial for diabetics. It cannot be overstressed that four diseases cause most of the deaths; diabetes belongs to them and is a major player.

Four Diseases Cause Most Of The Deaths

Conclusion

Four diseases cause most of the deaths. They were the cause of death for several years. They are cancer, cardiovascular disease, chronic respiratory diseases and diabetes. The secret is to minimize the impact of each of these diseases. You can prevent chronic respiratory diseases by stopping to smoke and treating asthma properly. To treat cancer successfully one needs to diagnose it early and remove it surgically. With cardiovascular disease chelation therapy has shown a difference. Otherwise a regular exercise program and a Mediterranean diet, which has anti-inflammatory qualities, will help. Dr. Taylor from Newcastle University demonstrated that he can treat diabetes with a low calorie diet. Each one of us has a responsibility to do something about our diagnosed condition. We cannot wait for magic cures. We need to do what has known benefits. Hopefully with these short hints will help you to improve your health.

Oct

2018

Health Risks After Hurricanes

By Ray Schilling | Infectious Disease, Lung Disease, Mortality, Prevention

We hear a lot about the dangers of hurricanes when they are in a region, but very little regarding health risks after hurricanes. I thought it would be interesting to review all of the health risks in a blog.

Health risks during a hurricane

A lot of the health risks during a hurricane are directly related to the risks from the wind severity, the amount of rain per hour and the physical damage from the hurricane. The excessive wind can uproot trees and they may fall right onto a house. This happened in the beginning of hurricane Florence. The amount of rain that comes down in a short time frame can be astounding. It causes flooding, which together with the high wind speeds can make you lose your footing. There is flying debris, torn away pieces of wood and drywall that can become a hazard to any person. It is a hazard that could kill you right there. It is best to be out of the way of a hurricane, if you can at all. But you need to watch hurricane predictions on the Internet or the news, so you know what is going on long before the hurricane arrives. This gives you enough time to travel away from the danger zone. People who live on islands need to be particularly proactive, so that they get out of harms way in time.

Be safe from floodwaters

If you live in a low-lying area, it is safer for you to leave and go to a shelter before the hurricane hits. Otherwise you end up drowning. Being on top of your house in a hurricane is dangerous as the roof may fly off any minute from the force of the wind. You are also the target of flying debris, wood pieces and other flying objects.

Contaminated water is one of the major health risks after hurricanes

With hurricane Maria in 2018 it appeared in the first few days that only 16 to 18 people had died from the physical effects of the hurricane in Puerto Rico. But in the subsequent weeks and months people died en masse because of infections from contaminated drinking water. It is unbelievable that huge water supplies had been brought in by FEMA following the hurricane Maria, but it was not distributed to the people who needed it. The total death toll is now around the 3000 mark. FEMA calculated this by subtracting 13,000 deaths due to natural causes from the total deaths of 16,000. The difference is about 3,000 deaths, attributable to hurricane Maria.

Providing clean drinking water important

Providing clean drinking water should be the first priority following a hurricane. This will prevent that people get the typical water-born bacterial and viral illnesses following a hurricane.

One patient in Puerto Rico with chronic emphysema was on a breathing machine. The interruption of electricity as a result of hurricane Maria meant his death. Some people are so vulnerable that the interruption of electricity ends their life.

Communicable diseases from floodwaters

The WHO has brought out a fact sheet regarding communicable diseases from floodwaters. People need to be aware that floodwaters are contaminated and avoid them as much as possible. However, they also point out that unless you have bruises or cuts where bacteria from contaminated waters could grow the danger is smaller than generally believed.

Mold from water damage to houses

After hurricane Katrina in New Orleans 2005 there was a lot of mold growth in houses that were flooded. This caused an overwhelming odor that was difficult to cope with. Bleach water removes mold initially until a professional crew can clean it up at a later date. I mention this here because following a hurricane there will not be enough professional people around to help. Mold is particularly devastating for asthmatics and people with chronic respiratory conditions. These people need evacuation from such living environments until the house is clean from molds. Flare-ups of asthma and chronic obstructive pulmonary disease can be deadly. Under normal circumstances people with respiratory problems can manage, but these people are at a severe risk of dying from an aggravation of their underlying conditions. Hurricane Katrina will be remembered for this.

Living in destroyed homes

Often with a direct hit of hurricane the roofs of homes are missing. The hurricane ripped them off and they literally flew away. A home without a roof is prone to water damage from future precipitation. There is the danger of mouse and rat infestation. Birds can enter and partake in the leftover meals. Their droppings may contain contagious bacteria like salmonella causing typhoid fever. Builders work hard and long hours; it can take months or years before life is normal again. It may be wiser to live with a relative for a few months until the house is in livable condition again. When electricity is restored and the water lines are functioning again, there may still be an issue about getting safe drinking water and uncontaminated water to have showers and baths. Also, without proper shelter there are risks of mosquitoes transferring communicable diseases. This happened in the Dominican Republic.

Malaria in the Dominican Republic

In September 2004 Hurricane Jeanne struck the Dominican Republic. Subsequently there was more flooding from heavy rainfalls. The end result was a mini-epidemic of 17 cases of malaria, because the flooded areas gave the mosquitoes more breeding ground to multiply. Fortunately no one died, as all the malaria cases responded to chloroquine and primaquine. But some patients had to be treated in the Intensive Care Unit of a hospital. As already mentioned there are other water born illnesses that can cause diarrhea, vomiting and fever. These people need to get immediate access to a hospital where the medical staff will rehydrate them intravenously. Otherwise they could die.

Health Risks After Hurricanes

Conclusion

Hurricanes pose enormous problems for the communities where landfall occurs. Close to the eye of the hurricane are the worst structural damages to properties and trees. But even miles away from that there can be flooding due to excessive winds and rain. Most people are reasonable during the initial phase when the hurricane hits. This means they stay inside so they can protect themselves from the direct impact of the storm. But hurricanes can pull roofs off and people can get hurt.

Illnesses from contaminated water

Later there is a disruption of the electrical supply as well as the water supply. The restoration of the utilities may take days or weeks. Immediately you depend on fresh and clean water supply, and when you run out, there may not be enough fresh water available. Illnesses from contaminated water become a huge problem at that point. This is where a lot of mortality comes from in the aftermath of a hurricane.

If you can, it is wiser to escape this all by visiting a relative far away from the hurricane area. In this case you must leave well in time before the hurricane hits. You can check with the authorities when it would be safe to return home. At least you know that you have survived. Everything else can wait. You will gradually take care of it. But it may take a long time for things to return to normal.

Sep

2018

Moderate Carb Intake Has The Lowest Mortality

By Ray Schilling | diet, exercise, heart attack, lifestyle, Mortality, Nutrition, Stroke

A 25-year long study has shown that a moderate carb intake has the lowest mortality. A comprehensive study from the US has followed more than 15,000 men and women for 25 years. They were between 45-64 years when they entered the study and they were from diverse socioeconomic backgrounds. The authors chose mortality as an end point. Dr. Sara Seidelmann is a clinical and research fellow in cardiovascular medicine from Brigham and Women’s Hospital in Boston. She was the lead author of this study. The research group used food questionnaires and analyzed the carb content in the food. They also determined what percentage of the food composition was of animal origin or plant origin.

Research study finds moderate carb intake has the lowest mortality

The main findings of the study were that less than 40% of carbs in the diet led to an increased death rate with a mortality of between 1.4-fold and 1.8-fold. On the other hand, more than 70% of carbs in the diet also had increased mortality rates of 1.2-fold. The lowest mortality was in the group that consumed a diet where carbs were between 50% and 55%. Dr. Seidelmann explained that in terms of life expectancy the result of the study could be summarized as follows. A 50-year-old person had another 33 years to live when carb intake was in the moderate range. The low-carb person had only another 29 years to live (4 years less than the moderate carb person). The high-carb person lived another 32 years, 1 year less than the moderate carb person.

Plant-derived versus animal-derived fat and protein

The study showed that there was increased longevity when carbohydrates were exchanged for proteins and fats from plant sources. Mortality was 18% less for this group. Conversely, when carbs were replaced for animal-derived fat or protein mortality was 18% more!

Dr. Seidelmann noted that this study was coming from a US based population. In the case of an Asian group they would consume much more carbs on average, but they would replace a lot of the animal fat and protein with fish. Fish is a healthier source of protein and fat than beef or pork.

A moderate carb intake group that used protein and fat from animal sources was compared to plant sources. When protein and fat had the origin from lamb, beef, pork, and chicken the mortality over 25 years was higher. When protein and fat came from vegetables, such as nuts, peanut butter, seeds and whole-grain breads there was a lower mortality rate.

Other studies comparing the effect of animal protein versus plant protein

A 2016 study that had gone on for 49 years was involving 131,342 participants. Animal protein intake showed an association with higher mortality from heart attacks and strokes. 3% of energy from processed red meat was now substituted by an equivalent amount of plant protein. This reduced the all-cause mortality by 34%, for unprocessed red meat by 12% and for egg by 19%.

Red meat is cancer-producing. Several studies have shown this. When red meat is digested, cancer-causing substances are released that can be the cause of cancer in the lining of the stomach and the colon. The above link says we should limit red meat consumption to 65 grams (2oz.) per day or 2 servings (130 grams or 4 oz.) 3 to 4 times per week. We should avoid eating more than 455 grams (1 pound) of lean red meat per week.

Triglycerides are an independent risk factor for heart attacks

In this publication evidence is also present that triglycerides are an independent risk factor that can cause heart attacks.

When you eat too many carbs, the body produces the excess you don’t need into triglycerides, and it deposits its subsequently as fat in fatty tissue. Physical activity burns up some of the triglycerides. But when we eat too much refined sugar and starchy foods, there will be an excess of triglycerides putting our blood vessels and our hearts at risk.

Regular exercise prevents disease and premature deaths

Many studies have shown that regular exercise prevents heart attacks and premature deaths. We even know the mechanism of why this is so. Exercise releases nitric oxide ((NO) from our blood vessels, which widens the arteries. This also prevents high blood pressure. Exercise elevates the protective HDL cholesterol. When regular exercisers were compared to a non-active group they had a 41% lower risk of death. All-cause hospitalizations were down by 21% and cardiac hospitalizations were down 32%.

Discussion

Barry Sears is the inventor of the Zone Diet. I attended a lecture in 2001 at an Anti-Aging Conference in San Diego. Dr. Sears was the keynote speaker at this conference. He stressed that a diet with 55% of complex carbs would be the best diet. It is interesting that Dr. Seidelmann in the study mentioned in beginning of this blog found the same thing. The lowest mortality was in the group that consumed a diet where carbs were between 50% and 55%.
The second point that is important to note is that it matters whether we eat protein derived from animals or from plants. Even small steps help. When we reduce our animal protein intake by only 3% of the energy intake, and replace it by plant protein, there is a significant reduction in mortality.
Exercise is rarely mentioned in relation to diets. But exercise needs to be included every day and you will experience a reduction of cardiac hospitalizations of 32% as mentioned above.

Moderate Carb Intake Has The Lowest Mortality

Conclusion

A moderate carb intake, as is the case in the Mediterranean diet and in the Zone Diet of Barry Sears, has the lowest mortality rate. Complex carbs (in vegetables) are absorbed much slower. As a result the risk for heart attacks is much lower. The opposite is true for refined carbs from sugar. They cause heart attacks and strokes with premature mortality. Dr. Sara Seidelmann led a study at the Brigham and Women’s Hospital in Boston that lasted 25 years. Less than 40% of carbs in the diet led to an increased death rate with a mortality of between 1.4-fold and 1.8-fold. These diets are paleo-type diets, the Atkins diet and the ketogenic diet. More than 70% of carbs in the diet also had increased mortality rates of 1.2-fold.

The healthiest diet

People who consumed a diet where carbs were between 50% and 55% had the lowest mortality rate (Zone Diet). Another finding of this study, which was confirmed by others is that animal-based protein is unhealthier than plant-based protein. Even replacing 3% of energy from an animal-based diet with plant-derived protein delayed mortality significantly.

If you want to live longer and stay healthy you need to critically evaluate what you eat.

Incoming search terms:

carbs and life expectancy

Aug

2018

The Downside Of Living To 100

By Ray Schilling | Alzheimer’s disease, Arthritis, back pain, Cancer, Cardiovascular disease, chronic pain, Dementia, depression, Diabetes, diet, Drugs, exercise, Fitness, fractures, heart attack, High Blood Pressure, Infectious Disease, mitochondria, Mortality, Obesity, osteoarthritis, Osteoporosis

A review article has examined longevity and reviewed the downside of living to 100. In their 80’s about 10% of the population live in nursing homes, but among centenarians 55% are residing in nursing homes. They are often very lonely, as their social circles have shrunk as they aged.

Common diseases of older people

Osteoarthritis makes it difficult for people to get around, it causes chronic pain and it can also be the reason for falls. In 1990 there were 213.4 cases of osteoarthritis per 100,000. 26 years later, in 2016 there were 232.1 cases of osteoarthritis per 100,000 people.

Chronic obstructive pulmonary disease (COPD) has been falling, because less people smoke cigarettes now. Statistics show 1667 cases of COPD per 100,000 in 1990, but only 945 cases of COPD per 100,000 in 2016.

Diarrhea and common infections have dropped sharply from 8951 per 100,000 in 1990 to 3276 per 100,000 in 2016.

What other common diseases do older people get?

There are a number of common diseases that affect the elderly.

Osteoarthritis

Osteoarthritis of the hips and the knees are common, but it can affect every joint in the body. In the end stage knee replacements or hip replacements may be necessary. But before a total knee replacement or total hip replacement can even come into consideration, the person’s heart needs a thorough checkup to ensure that it is safe for the patient to undergo surgery under a general anesthetic.

Heart disease

Older people often have heart disease.

When coronary arteries are narrowed, heart attacks occur. Cardiologists can place stents, so that previously narrowed coronary arteries receive normal blood flow. Following such a procedure the patient may live for another 10 to 15 years.

There are also heart valve calcifications. The aortic valve is particularly endangered. A heart surgeon may be able to replace a diseased aortic valve by a porcine valve.

The nervous system of the heart transmits electrical signals from the sinus node to the muscle fibers, which can get diseased. Heart rhythm problems may necessitate the insertion of a pacemaker.

Finally, the heart may enlarge, but pump less blood than before. This condition is congestive heart failure. The 5-year survival for this condition is only 50.4%. Unfortunately there is very little the doctor can do for patients like this.

Cancer

The older we get, the more DNA mutations we accumulate. At one point cancer develops. If the diagnosis happens at an early stage there is a good chance that surgery can remove a cancerous growth, and the patient survives. But there are cancers that are notoriously difficult to recognize in the early stages. These are: cancer of the pancreas, kidney cancer, stomach cancer and certain types of leukemias.

Respiratory diseases

Those who smoked earlier in life may develop chronic obstructive pulmonary disease (COPD). It is a chronically disabling lung disorder. Often these individuals have to carry an oxygen tank with them wherever they go. The 5-year survival rate for people with COPD is 40 to 70%.

Osteoporosis

Osteoporosis is a disease where the bone is brittle. Spontaneous bone fractures can occur at the wrists, the upper thigh bone (femoral fractures) or in the vertebral bones. Women in menopause are hormone deficient and this contributes to calcium depletion of the bones. Lately research has shown that vitamin K2 and vitamin D3 are necessary for a normal calcium metabolism. Briefly, 200 micrograms of vitamin K2 and 5000 IU of vitamin D3 every day are the necessary dosage that the body can absorb calcium from the gut, eliminate it from the blood vessels and deposit it into the bone. Calcium is present in milk products and milk. If a person does not consume enough milk products a supplement of 1000 mg of calcium daily does make sense.

Alzheimer’s

The older we get, the more likely it is an onset of Alzheimer’s or dementia. Between the ages of 90 to 94 there is a yearly increase of Alzheimer’s of 12.7% per year. The group from age 95 to 99 years has a yearly increase of Alzheimer’s of 21.2% per year. Persons aged 100 years and older have an increase of Alzheimer’s by 40.7% per year. What this means is that essentially there is a doubling of Alzheimer’s every 5.5 years. We do not have all of the answers why this is happening and why Alzheimer’s develops. But we do know that diabetics are more likely to develop Alzheimer’s. High blood sugar levels and high insulin levels seem to lead to the precipitation of the tau protein in the brain, which causes Alzheimer’s.

Diabetes

When diabetes is not well controlled, there is accelerated hardening of the arteries. This can cause heart attacks and strokes. Longstanding diabetes can affect the kidneys (diabetic nephropathy, kidney damage) and can lead to hardening of the leg arteries. Often the only treatment left is a below knee amputation. Blindness from uncontrolled diabetes is common and pain from diabetic neuropathy as well.

Diabetics have an average life expectancy of 77 to 81 years. However, if they pay attention to their blood sugars and manage their diabetes closely they can live past the age of 85.

Falls and balance problems

As people age, their balance organ is not functioning as well. Also, people with high blood pressure medication may have postural hypotensive episodes that can lead to falls.

There may be a lack of cognitive functioning and misjudging of steps, ledges and irregularities in the floor. When a person has brittle bones from osteoporosis and they fall, a hip fracture is very common. At a higher age surgery for a hip fracture is dangerous. It can have a mortality of 50%.

Obesity

A person with obesity has a life expectancy that is 10 years less than a person without obesity. The reason for this is that with obesity This is so, because the risk of heart attacks, strokes, cancer, arthritis and diabetes is increased.

Depression

Older people often get depressed. It even has its own name: involutional depression. People can get into a state of mind, where they think negatively. Depressed people feel that they have nothing to live for. They lost friends; they are shut in because they can’t drive a car any more. This type of depression needs treatment by a psychologist or psychiatrist. The danger of leaving depression untreated is that the person may get suicidal. In older people depression is often precipitated by physical health problems.

Oral health

When teeth are not looked after, gingivitis and periodontitis can develop. Infected gums can shed bacteria into the blood and this can affect the heart valves. Endocarditis, the infection of heart valves, is a cardiological emergency. Prolonged antibiotic therapy is necessary to overcome this condition.

Poverty

Poverty has real consequences. The aging person may not have access to the optimal medical care facility because of a lack of funds. But even at a younger age there is evidence that people are healthier when they are wealthier.

Shingles

Older people often get shingles, even if they had chickenpox or shingles as a child. This is evidence that the immune system is getting weaker. Shingles in an older person should alarm the treating physician that there could be an underlying cancer. Due to that knowledge a cancer-screening tests should be part of the medical exam. In addition, a varicella vaccine should be offered to the patient to build up immunity.

The Downside Of Living To 100

Conclusion

Living to 100 is often glorified in the press. Maybe you have seen a 90-year old jogger completing a marathon, or you saw an 85-year old couple ballroom dancing. But what they don’t show you is what I summarized here, the less glamorous things about living to 100. You may get a heart attack or a stroke. Osteoarthritis may affect you how you walk. Congestive heart failure may make you get short of breath when you walk upstairs. Then there are various cancer types that are difficult to diagnose early.

If you have smoked in the past, you may suffer from chronic obstructive pulmonary disease (COPD), which leaves you breathless.

Other illnesses

Osteoporosis can lead to spontaneous fractures. Because the bone has a lack of calcium, this is difficult to treat and takes a long time to heal.

Alzheimer’s is ever so much more common when you approach the year 100. There are other medical conditions you can get: obesity, diabetes and depression. When you get shingles for the second time, it may mean that your immune system is getting weak and a cancer-screening test should be done.

There are some downsides when you approach the age of 100.

Know your risks and be vigilant

You may keep your physician busy checking out various age-related illnesses, but more importantly, get regular check-ups and tests. Any condition is easier to treat with an earlier diagnosis! The message for anybody reading this is very simple. Prevention through healthy living is something you can actively pursue. Keep your body and your mind busy. Enjoy time with friends and family instead of living a solitary existence. See the glass that is half full instead of viewing it as half empty. Stick to a healthy diet. Knowing all the risks is not a scare but a call to being vigilant. Knowledge is powerful and will help you to enjoy your golden years feeling well and happy.

Jun

2018

Writing A Medical Book

By Ray Schilling | Anti-aging medicine, Cancer, Cardiovascular disease, Hormones, lifestyle, Medical Condition, Mental Health, Mortality, Nutrition, Prevention

In my 40’s when I was practicing medicine, I was dreaming about writing a medical book. This was in the mid 1980’s and I was busy seeing 30 to 40 patients a day. I would never have found the time to write a medical book at that time. I thought, perhaps I could show how patients could stay younger for longer by adopting the right life style in order to stay well. Fast forward 3 decades, and the medical book writing began. But instead of one book the project turned into 4 books. There were too many topics to cover to fit them all in one book.

Prior to writing a medical book

First of all, in 2002 I published a large website. Its structure is like a book on the Internet: Net Health Book . It contains descriptions of the major diseases, mental and physical, and their current treatment modalities. I still maintain this work. Furthermore, I started another website in 2003, a weekly blog, called “Ask Dr. Ray” . This is a compilation of interesting research. Some medical research papers can get too scientific. For this reason I translated it into easier language. The topics tend to be anti-aging topics. This blog comes out Saturdays.

Retirement hobby

When I retired in 2010 I revamped my websites. In the process the web developer suggested I should add to Net Health Book a blog (nethealthbook.com/news) where I review current health news that I find interesting. This is a weekly blog, which I publish on Wednesdays. All of this is still going on, and it gave me lots of opportunities to write and publish on a smaller scale. In addition, I finally started publishing books.

A Survivor’s Guide To Successful Aging

My first book came out with Amazon in 2014. I had joined the A4M (American Academy of Anti-Aging Medicine) in the early 2000’s. The lectures at their conferences were very open-minded and pointed out details of what one could do to delay aging and avoid premature deaths. My own experience with changing our diet in 2001, starting bioidentical hormone replacement and changing my lifestyle became topics that were part of this book. I dedicated this book “to those who are willing to work on prevention in order to achieve a longer life without disabilities”. This is still the basis of prolonging your life.

Lifestyles can be deleterious

I start out in this book describing the obesity wave and how this changes the metabolism (metabolic syndrome). I used statistics from the Framingham Heart Study to show the detrimental effects of various lifestyles on mortality. Subsequent chapters deal with food, exercise, stress and missing hormones as life-shortening factors. There is a separate chapter on vitamins and supplements. They as a group can create 5.1% longer telomeres, which translated into 9.8 years of longer life expectancy (see also a study by Dr. Xu in the book). Subsequently it describes how a change of your lifestyle can have a positive impact. Changing your eating habits and exercise activity will make a tremendous positive difference on the long term.

Successful Aging in the Kitchen

The book ends with an appendix, written by my wife: “Successful Aging in the Kitchen”. You are presented with recipes for 7 breakfasts, 7 lunches and 7 dinners. In addition she has provided 7 healthy desserts for you. Bon Appétit!

Healing Gone Wrong, Healing Done Right

In another book, which got appeared in 2016 I gave a few examples of how famous people were failed by medicine. It started already in the past: Ludwig van Beethoven’s physicians did harm instead of healing their patient. However, this is happening now as well: physicians mismanaged the health care of Elvis Presley, Churchill, Michael Jackson and JF Kennedy. The physicians treated symptoms, but they never properly attended to the causes of the ailments of their patients. The end result was premature death in all of them. Churchill who had good genetics made it to age 90, but during his last 15 years he suffered of severe disabilities.

Treatment of symptoms will fail, treatment of causes succeed

These examples of famous people’s health problems resemble to what happens to today’s patients in various office settings. Their symptoms are mostly being treated, but their causes often not. Simply treating symptoms will not work on the long term. It did not work in the past, and it does not work now.

Other chapters in this book

Other chapters in this book deal with preventing disease, keeping a healthy brain and keeping a healthy heart. Next I discuss why food matters, followed by the health of limbs and joints. Subsequently I am discussing how to keep toxins out. The next chapter deals with how to reduce the impact of cancer. It is always important to diagnose cancer as early as possible as removal by surgery has the highest success rate at an early cancer stage. The next chapter is entitled: “Stable hormones key to health”. If any of your hormones are missing (particularly around the age of menopause and/or andropause) it is time for nature identical hormone replacement. The next chapter gives you general thoughts on anti-aging. This is followed by “supplements yes, but do not overdo it”.

Alternative treatment for ADHD

A final chapter gives you an example of an alternative treatment for ADHD, where the idea of not just treating symptomatically, but treating causes is included. References and an index are also provided for the book.

Prostate Cancer Unmasked

Furthermore, I did not intend to write this book. But in early 2016 my PSA (prostate specific antigen) level jumped from 3 to 8.6. For years it had been in the 1.5 areas, then slowly increased to 3. But 8.6 was too high for comfort! I had an MRI scan done, which showed one lesion in my left prostate, which was suspicious for prostate cancer. I was referred to a urologist at the Vancouver Prostate Centre, one of the top clinics in Canada. But I had already researched the literature and came across research by Dr. Gary Onik from Ft. Lauderdale who warned me about the pitfalls of “standard therapy”.

The conservative urologist in Vancouver

The urologist in Vancouver told me that without a positive biopsy he cannot accept that the shadow on my MRI scan would be prostate cancer. And the only way they do a prostate biopsy was by random trans-rectal biopsies. He also wanted to include me in a random clinical trial where they would compare active intervention with active surveillance. I politely declined the trans-rectal prostate biopsy and the inclusion into a trial.

Assessment by Dr. Onik

I booked a flight to see Dr. Onik in Ft. Lauderdale. His method is well researched and orchestrated.

Initial assessment

He assesses you with a rectal ultrasound and he sees the prostate on a TV screen. He said right away that I had three separate lesions, one in the left as shown on the MRI scan and two in the right lobe, which was missed by the MRI scan. False negative lesions are common on MRI scans, which can become a source of cancer recurrence.

3-dimensional prostate biopsy

The following day he booked me for a 3-dimensional prostate biopsy via the perineal approach. The perineum is easy to sterilize, so there is no risk of septicemia. A metal grid with holes for biopsy needles was used to get 96 biopsies of my enlarged prostate. For a normal size prostate, Dr. Onik said about 60 biopsy needles are normal. You don’t feel anything, because you are asleep.

Cryoablation prostate surgery

Next was the cryoablation surgery of the 3 prostate cancer lesions. This happened one month after the biopsy. I was seen at the hospital in Ft. Lauderdale. The same grid from the biopsy was used to relocate exactly where the cancer lesions were. The pathologist had confirmed them as Gleason 6 and 7 prostate cancers. This was treated with Argon sounds and frozen twice. I felt nothing, because I was under a general anesthetic. But Dr. Onik told me that everything went very well. Some cancer was too close to the neurovascular bundle, so he used the NanoKnife, an invention where nano-size holes get blasted into cancer cells, but it leaves normal tissue intact.

I needed to do self-catheterization for about one month to empty my bladder, as there was a lot of swelling from the prostate hypertrophy and the surgery. But eventually my normal water works returned.

Follow-up blood work

My follow-up PSA blood work 3 months after the surgery was down to 1.0. Prior to the surgery the Oncoblot test was positive for prostate cancer. A repeat Oncoblot test 3 months after the surgery was now negative for prostate cancer. I realize that not every physician accepts this new cancer-screening test, but I felt a lot better to know that all the cancer markers were now gone.

9 cancer treatments reviewed

In my book I described a total of 9 prostate cancer treatments and their 10-year survival statistics. None of the other treatment methods were as good as Dr. Onik’s statistics. I believe it is linked to the precision of the 3-dimensional biopsy and the surgery being done through the same grid. If you do not perform the surgery this way, you miss cancer lesions and this becomes the source of failure 10 years down the road. My book details all these alternative treatments. It also has a section on lifestyle modifying factors. I needed to write this book as a service to any man who suddenly is faced with a possible diagnosis of prostate cancer.

Unmasking prostate cancer

Like me he needs to unmask the cancer. Is it really there? How far advanced is it? Which way to safely biopsy it (definitely NOT through the rectum for fear of blood poisoning=septicemia)? What is the best method to remove it? I came to the conclusion that Dr. Onik’s method was best for me. But with the information in this book you can decide what is best for you.

Medical Questions Answered

Finally I wrote my 4th book. From more than 4400 medical questions that I have answered on the site Quora.com I selected the most popular questions for this book. The editorial board of Quora said that I own the publishing rights for my answers. The questions were rephrased without changing the meaning. I selected more than 120 questions under 44 different headings.

Here are some of the areas that are covered: Acne, the best home remedies. Aging: can it be reversed? What is the limit for a human? Alcohol: how does it affect your body? Alzheimer’s disease: which foods promote brain health? Arthritis: what can you do about osteoarthritis? Back pain: what can I do about it? Cancer: why can cancer still not be cured? There are as well 15 other answers about cancer. Depression: will my depression ever go away? Diabetes: will a 600-calorie diet help diabetes control?

Further topics discussed

Diet: I want to get rid of sugar in my diet. How can I do this long-term? Other answers about diet are included. Exercise: How useful is cardiovascular exercise? Gut disease: Is “gluten free” food healthy? Heart disease: What can I do to clean out my arteries and reduce my risk for heart disease? Hormones: Is estrogen present in the male body? Life Expectancy: What is the theoretical life expectancy of humans? Lifestyle Habits: Can good habits change your life completely? Pain: Pain relief for a headache or other pain: Aleve, Advil or Tylenol? Pregnancy: Best age for a successful pregnancy? Prostate Cancer: How dangerous is prostate cancer? Does it kill you? Schizophrenia: What complementary approach may help a patient with schizophrenia? Sleep: What happens when you go to bed late every night? And many other answers under this topic.

And the book finishes with these topics

Sugar: will I be OK living without sugar? Vaccinations: Is there a connection between vaccinations and autism? Vitamins and supplements: Are taking vitamins and supplements healthy or are they harmful? Weight loss: I am working out every day, but I am not loosing weight. What should I do? There are many more answers under this topic. Younger for longer: What are three things I can do every day to stay younger for longer?

These are only a few selections of all of the topics dealt with in this book.

Writing A Medical Book

Conclusion

I have reviewed briefly why I published the books mentioned above. My prostate cancer book developed out of the necessity that I had to deal with my newly diagnosed prostate cancer in 2016. I felt that the review process I went through would be good for those men who have to face a similar situation. The anti-aging book comes from my interest in anti-aging medicine. “Healing Gone Wrong, Healing Done Right” developed from the observation that physicians in the past and often even now tend to only treat symptoms. But if a cause can be found, this should be treated, as this often leads to a permanent cure.

Treating symptoms only will not improve the patient’s condition

Treating symptoms only will not improve the patient’s condition. “Medical Questions Answered” is a collection of medical topics where I answered various medical questions. It was a way for me to cover a vast array of medical topics. Some of the topics are dealt with in depth (acne for instance); others are very short. I have also two medical blogs that come out on Wednesdays and Saturdays. I hope that some of that medical information will be useful to you.

Apr

2018

3 Cups Of Coffee Stop Clogged Arteries

By Ray Schilling | coffee, heart attack, Heart Disease, Mortality, Stroke

There is a new coffee study that says 3 cups of coffee stop clogged arteries. The study appeared in the Journal of the American Heart Association on March 24, 2018. It was part of the cross sectional Brazilian Longitudinal Study of Adult Health. This study took place from August 2008 to December 2010. It followed 15,105 civil servants, aged 35 to 74 years. They were living in 6 Brazilian cities (Belo Horizonte, Porto Alegre, Rio de Janeiro, Salvador, São Paulo, and Vitoria). The final study sample comprised 4426 individuals who underwent CAC measurements.

CAC score

CAC stands for “coronary artery calcium”. Other tests in the past have shown that CAC is a very sensitive test that quantitates the calcification status of coronary arteries. The CAC score is also known as Agatston score. It also predicts how likely it is that a person with a high CAC count will develop a heart attack down the road. A score of 100 or less is considered to be a low risk for developing a heart attack later in life. If the score is between 100 and 400, it is a moderate risk. A score of more than 400 ranks as a high risk to develop a heart attack.

Study design

Upon entering the study the participants had an extensive entrance exam and interview. Part of this was a nutritional and lifestyle questionnaire. This told the examiners whether the patients were smokers or not. Their age ranged between 35 and 74 years. Participants took a CAC test. 4426 individuals who underwent CAC measurements became part of the study. The participants’ blood pressure and body weight were additional measurements.

Results of the study

There was a negative correlation between the amount of coffee consumed on a daily basis and the CAC score. Specifically, the following observation emerged regarding daily coffee consumption and the risk of a higher than 100 CAC score.

Less than 1 cup per day: odds ratio 0.85
1 to 3 cups per day: odds ratio 0.73
More than 3 cups per day: odds ratio 0.33

These results show clearly that there is an inverse relationship between coffee consumption and risk of developing coronary artery hardening. Those who consume 3 or more cups of coffee have a lower coronary artery disease risk.

The risk to develop coronary artery calcification in coffee drinkers (3 or more cups) is 67% lower. The comparison group are non-coffee drinkers.

Discussion of the results

The research paper from Brazil compares their results with many other research facilities and concludes that others had very similar conclusions. For instance, a 2014 publication pointed out that consuming more than 5 cups of coffee per day had no association with heart disease and did not cause any increased mortality.

The 2015–2020 Dietary Guidelines for Americans recommends consuming 3 to 5 cups of coffee per day, which reduces the risk of getting diabetes type 2 or cardiovascular disease.

Korean study using CAC scores

One other relevant Korean study that involved 25,138 participants is also of note. The participants consumed 3 to 5 cups of coffee per day. They also underwent CAC tests. The coffee drinkers had a 41% lesser prevalence of CAC score in comparison to non-coffee consuming controls. The authors of the present study said that the Korean study was comparable to their own findings.

Comparison of study to previous literature

Mortality data and coffee consumption

In a large Harvard study that I discussed on Nov. 18, 2017 the end point was mortality data. There too, was a dose response curve. With 3 to 5 cups of decaffeinated or regular coffee there was a reduction of death rates by 15%. Less coffee consumption produced less reduction of mortality.

Stroke data and coffee consumption

In another review on March 4, 2013 I reviewed a 10-yer study that looked at the effect of 1 to 2 cups of coffee per day in 32,600 women. There was a 25-32% reduction of strokes compared to non-coffee or tea consuming controls. I also reviewed a Finnish study that consisted of 29,133 smokers (smoking 5 cigarettes a day) aged 50 to 69 who were stroke free when entering the study. It ended in 1993 and the study had lasted for at least 5 years. Drinking two cups of black tea or 8 cups of coffee reduced the stroke risk by 21 to 23%.

Stroke mortality and coffee consumption

In the Annals of Internal Medicine (June 17, 2008) researchers have found that coffee consumption can be beneficial to reduce stroke mortality. A study using the data from 41,736 male and 86,214 female subjects is quite informative. Researchers followed these people over 18 years in the male group and over 24 years in the female group. The risk of all-cause mortality decreased significantly with increasing coffee consumption in the male as well as in the female group. Men had a relative risk reduction of 20% in comparison to those with the lowest level of coffee consumption. Women with intermediate to high consumption of coffee had a relative risk reduction of 10% to 30 % when compared to the group that drank less than 1 cup of coffee per day. The end point here was risk of death from stroke.

3 Cups Of Coffee Stop Clogged Arteries

Conclusion

Coffee has a number of anti-oxidant bioflavonoids that help increase survival. The main study reviewed measured the effects of coffee consumption by calcium scores of the coronary arteries. This is a specific way to look at the relative risk to come down with a heart attack in the future. Other ways to measure the beneficial effect of coffee are mortality as the end point, stroke or stroke mortality. I have reviewed some studies that used all of these end points. It is interesting to observe that consumption of 3 to 5 cups of coffee has such a beneficial effect. It does not matter whether it is regular or decaffeinated coffee. Both have the identical effect. This has been shown by a recent Harvard study.

Coffee and tea make you live longer

Coffee keeps the arteries open for longer, if we consume 3 to 5 cups of coffee per day. This allows our brain to think longer and allows our heart to beat for many more years. It is time to stop the research and to apply what was found: 3 to 5 cups of coffee per day. If tea is what you prefer, you are in luck. Everything I said about coffee also applies for green and black tea. There is one word of caution. Using copious amounts of sugar in your coffee or tea will most likely cancel some or all of the benefits. Cream and sugar-laced Frappuccino or Chai Lattes are calorie bombs and not conducive to good health. I use stevia instead of sugar to sweeten my coffee.

Mar

2018

Prevent Plugged Arteries

By Ray Schilling | Cardiovascular disease, cholesterol, Diabetes, diet, exercise, fish oil, Fitness, food, heart attack, High Blood Pressure, Inflammation, lifestyle, Mortality, Nutrition, Obesity, olive oil, omega-3 fatty acids, Prevention, Processed food, Stroke, sugar

There are several ways to prevent plugged arteries, which will translate into less heart attacks and strokes. The message is simple: if you get less heart attacks and strokes, you will live longer. Below I am examining ways to prolong life by various ways to prevent plugged arteries.

You probably heard of plaque formation in the arteries. This is the process where a combination of fat, calcium, cholesterol and cell waste forms a deposit (plaque) under the lining of the arteries.

The end result is that the blood won’t be flowing freely through the affected arteries. This can cause a heart attack or a stroke. Essentially, this is the point where a clot forms in the narrowed passage of the artery. It is also the point, when the clinicians make a diagnosis of a heart attack or a stroke.

Let’s examine what leads to plaque formation in the arteries.

Trans fats

Trans fats are contained in fried foods like French fries, in margarines and other butter substitutes. As margarine is a common ingredient of cakes, cookies, pastries and pies, these are all bad news for our heart health. I consider them off limits. If you eat those foods, you build up plaque in your arteries, which leads to premature heart attacks and strokes.

Lack of exercise

It has been common knowledge for a long time that being sessile leads to premature hardening of the arteries. In the late 1800s to the early 1900s physical exercise was promoted in various countries around the world.

The latter part of the 20^th century saw a renaissance of the fitness movement. It was trendy to go running, cycling, and swimming or working out at a gym. It is not only trendy but healthy: cardiologists support all of these sports to help people stay healthy and keep the arteries free from plaque formation.

Too many refined carbs

Sugar and processed foods, especially those with added sugar to improve flavor, have a direct relationship to heart attacks and strokes. It is known that sugar causes high LDL cholesterol and high triglycerides. In addition sugar also causes inflammation of the arterial walls, which causes plugged arteries. However, sugar is only part of the problem. Starchy foods like rice, noodles, cakes, cookies and other foods made with flour get broken down into sugar. Both lead to insulin production. And both lead to changes of the lining of the arterial walls.

In the 1980s and 1990s there was a school of thought that a low fat diet would be healthy in terms of heart attack and stroke prevention (the low fat/high carb diet). This turned out to be a nutritional disaster: the high carb content of such a diet was the problem. It led to weight gain, obesity and death.

Red meat is a problem

Several studies have documented that saturated fat from red meat is only part of the problem. The other part is carnitine, which is abundantly present in beef, pork, lamb and venison. But mortality of people eating unprocessed red meat is only marginally elevated. It is when people eat processed red meat that there is a significant rise in mortality from heart attacks and strokes. This study examined this. They found that gut bacteria were stimulated by red meat to produce substances that stimulate bacteria in your gut to secrete TMA and TMAO, which makes your platelets more sticky and contributes to plugging your arteries. This research paper from the Cleveland Clinic explains it in more detail.

What must I do to prevent plugged arteries?

Eat the right food

A Mediterranean diet is anti-inflammatory. It contains lots of vegetables, but little red meat. Fish and chicken that contain much less L-carnitine are more dominant in Mediterranean food. As mentioned above, you want to avoid trans fats. And you also want to avoid sugar and too many starchy foods. This includes sugar-sweetened beverages. Making these changes will keep your insulin levels in the normal range eliminating inflammation in your arteries. Avoid eating processed foods, because they contain food preservatives and lots of sugar that we want to avoid. Eat more unsaturated fats like avocados, walnuts, olives, trout, herring, and salmon. The last three contain marine-derived omega-3 fatty acids that are particularly helpful in preventing heart attacks and strokes by being anti-inflammatory and by elevating the protective HDL cholesterol. Drink lots of green or black tea, rooibos tea, or ginger tea. They contain antioxidants and bioflavonoids that prevent plugged arteries.

Regular exercise

Many publications have shown that regular physical exercise will lower blood pressure, condition your muscles including your heart and lower mortality.

Only 10 minutes of brisk walking every day reduced the death rate by 33% compared to those who did not exercise at all.

Regular physical exercise does not only prevent heart attacks and strokes, it also reduces the risk of getting another 35 chronic diseases, as the link shows.

Here are some common exercises: jogging, cycling, running, brisk walking, swimming, playing tennis and doing aerobics. All of them will strengthen your muscles and condition your heart and lungs.

Other ways to prevent plugged arteries

Smokers must quit smoking, as smoking has been identified as a major risk factor for heart attacks and strokes.

Exposure to prolonged stress is a factor that leads to hardening of arteries. Stress management is possible by counseling, by self-hypnosis, yoga, tai chi and other relaxation methods.

Risk factors associated with plugged arteries

We already have mentioned the risk factors that are associated with clogged arteries. But for clarity I would like to repeat the major risk factors here.

Smoking
High blood pressure
Elevated LDL cholesterol (the bad cholesterol)
Reduced HDL cholesterol (HDL is increasing with exercise)
Obesity (often associated by ingestion of too many carbs)
Insulin resistance and diabetes
Lack of exercise (too much sitting in front of the TV or doing computer work)
Unhealthy diet (Standard American diet instead of Mediterranean diet)

Prevent Plugged Arteries

Conclusion

We often think that we have no input whether or not we get a heart attack or a stroke. This is completely wrong. If you adopt the solutions I have listed here, you can change things for the better. You will reduce your risk to get a heart attack or a stroke. Treat high blood pressure. Stop smoking. Cut out sugar and starchy foods to reduce triglycerides and LDL cholesterol. Exercise regularly and your HDL will protect you from heart attacks and strokes. Shed pounds, if you are obese by starting a Mediterranean diet and cutting out sugar. This will also improve your insulin resistance or diabetes. Start daily exercise as this reduces your risk of a heart attack or a stroke. In addition exercise reduces the risk of 35 chronic diseases that have also been mentioned in one of the links.