Medical Articles by Dr. Ray - Collection of health news, health articles and useful medical information you can use in everyday life.

Aug

2008

Lead Poisoning Down, But Watch For Mercury

The devastating results of lead poisoning in children have put consumers on alert. Lead in paint and in the glaze of ceramic products has gone unrecognized until the 1970’s. Since then stricter regulations have reduced or eliminated lead from paint products in North America. The additional move to unleaded gasoline has contributed to successful lead reduction. Consumers, however, should not let down their guard and be aware of the fact that there are still possibilities of lead exposure. Sources can be manifold. While most of lead exposure domes from old lead paint that was applied decades ago, especially in older homes, some exposure can come from imported toys, which just recently made headlines in the news. Some exposure can also come from medications and “nutritional products” imported from overseas. Imported cookware and other products have also been a significant source of lead contamination. The general awareness has paid off, as there is a significant reduction of lead levels since the ‘70’s. Public health warnings have been issued about mercury levels in fish, and this has led to concerns in consumer groups whether it is safe at all to consume fish. Blowing the warning whistle alone does not do a service to consumers. It is much more important to inform consumers to recognize, which of the fish species are averaging less than one tenth of Canada’s commercial mercury limit if 0.5 parts per million.

Lead Poisoning Down, But Watch For Mercury

Dr. Copes, director of environmental health at the B.C. Centre for Disease Control explained at a recent meeting that salmon, rainbow trout and tilapia fall into this group of fish that can be enjoyed more frequently, whereas other species, such as halibut, tuna and sablefish have levels of mercury that are five to ten times higher. They are still under the commercial limit, but it means that the consumer could enjoy 10 meals of salmon as opposed to one meal of halibut, tuna or sable fish. The recommendation is not total avoidance, but less frequent consumption.

Reference: The Medical Post, July 22, 2008, page 17

Comment on Nov. 17, 2012: The oceans are continuing to deteriorate with regard to mercury content. It is no longer safe to eat halibut, tuna or sable fish. Salmon, rainbow trout and tilapia should be limited to perhaps once per week. Avoid salmon that has migrated past Japan because of radioactive contamination of the coast region there (due to the earth quake in March 2011, the devastating tsunami and subsequent radiation crisis from the nuclear plant).

More information about toxins in the environment: https://www.askdrray.com/protecting-yourself-from-environmental-toxins/

Last edited November 4, 2014

Jul

2008

Genetic Difference Influences Sweet Tooth

By Ray Schilling | Diabetes, Nutrition, Obesity, Weight loss

Environmental factors and ethnic customs can influence us to have certain likes and dislikes of foods, but researcher Ahmed El-Sohemy has found in his studies that there is also a biological and genetic basis for some of our food preferences. Researchers from the University of Toronto have discovered a genetic difference in people who consume extra sugar in their diet. The specific genetic constellation which the researchers have called GLUT2 does not only work in the pancreas, but it also is responsible for turning on satiety signals in the brain. It seems to have an impaired ability to notice high blood sugar levels that ultimately send “stop eating” signals to the brain. The habit to eat more sweets has been researched in persons with diabetes, but Dr. El-Sohemy does not believe that diabetes is directly connected with gene GLUT2. On the other hand he does not suggest that the presence of the gene should be an excuse to overindulge in sugar high foods. He states that food habits in humans are often connected to the availability of foods: if there is a birthday party and birthday cake, the people with a liking of sweets will be the first to get a slice of cake. On the other hand, if there are no sweets available, they will not make an extra trip to the store just for a piece of cake. The most logical approach is to minimize the availability of foods that are high in sugar, which is especially important for individuals who have GLUT2, the ”sweet tooth gene”, so they are not tempted to overindulge.

Genetic Difference Influences Sweet Tooth

Much was learnt from two separate studies that involved 100 older adults on the one hand who were overweight or obese and 587 healthy younger adults who were mostly lean. Foods and beverages that were consumed were carefully recorded. In both investigations blood was drawn for DNA analysis and the presence or absence of the variation of the GLUT2 gene was compared to the food intake data. The older obese group with the variant gene consumed 112 grams of sugar per day versus 86 Grams per day for the non-variant gene group (normal control). The younger population carrying the variant gene consumed 131 Grams of sugar per day, while the non-variant control of young people consumed 115 Grams of sugar per day. This illustrates how genetic influences have an effect on our eating habits and also that younger people ought to be careful that they do not overuse sugar containing foods.

It also points to the solution of controlling your weight, if you belong to the higher risk group with the GLUT2 gene: you must exercise more to burn up the extra calories you tend to eat. A brisk walk on a treadmill will consume about 300 or 350 Cal in 30 minutes depending on the slope and the miles per hour setting.

Reference: Medical Post Vol 44, No. 16, June 16, 2008: page 19 (based on May issue of Physiological Genomics)

Last edited December 4, 2012

Jul

2008

Have A Cup Of Coffee And Decrease Your Death Risk

By Ray Schilling | Health, Heart Disease, Nutrition

Coffee can be good for you, and this is one of the items, which even tastes good! There are some exceptions as discussed in previous articles: more than 2 cups per day can increase the risk for miscarriages in pregnant women. People who are anxious or nervous can find that coffee will aggravate anxiety. Patients with rheumatoid arthritis should also not indulge in the flavorful brew.

Aside from these exceptions researchers have found that coffee consumption can be beneficial. A recent study using the data from 41,736 male and 86,214 female subjects has evaluated data over a follow- up time of 18 years in the male group and 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% as compared to their counterparts with the lowest level of coffee consumption. Women with intermediate to high consumption had a relative risk reduction of 10% to 30 % as compared to the group that drank less than 1 cup of coffee per day.

Have A Cup Of Coffee And Decrease Your Death Risk

The limit of the study in this case was the self-reported nature of coffee consumption, but the researchers feel that the modest benefit of reduction of all-cause and CVD death warrants further investigation.

Reference: June 17, 2008 Annals of Internal Medicine

Last edited December 4, 2012

Jul

2008

Buprenorphine Prevents Relapses For Heroin Addicts

By Ray Schilling | Prevention, Substance abuse

It is a great challenge for persons who are suffering of drug addiction to quit. There is the difficult period of detoxification. Even though there is a lot of support, there will be intense withdrawal symptoms, and every drug free day is a hard won victory. It is a major milestone on the road to recovery to be discharged from a detox program, but the task to remain drug free and abstinent is anything but easy. For this reason it is of utmost importance that support to prevent a relapse is available in the form of counseling, support groups and a maintenance program which involves medication is accessible to the patient.

A standard treatment drug has been naltrexone which helped the recovering addict to remain abstinent. It has been largely used in patients who were recovering from heroin addiction. Dr. Richard Schottenfield from Yale University School of Medicine, New Haven, Ct. and colleagues led a randomized trial to compare the efficacy of the standard drug regimen of naltrexone with the medication Buprenorphine in patients who were in the process of receiving detoxification and drug counseling. A group of patients received placebo (sugar pills that contain no medication.) From the 126 detoxified heroin dependent patients 43 received the standard treatment of naltrexone, 44 received Buprenorphine and 39 took placebo pills.

Buprenorphine Prevents Relapses For Heroin Addicts

The researchers found that patients who received Buprenorphine lasted nearly twice as long till they experienced a relapse than those who were on naltrexone and more than twice as long as compared to those who took placebo pills.HIV risk reduction behaviors were significantly reduced in all three groups. Maintenance treatment with Buprenorphine is a significant public health approach to reduce problems that are connected with heroin dependence and can make a difference to the recovering heroin addict on the path of abstinence from the drug.

More information about opium and heroin addiction: http://nethealthbook.com/drug-addiction/opium-heroin/

Reference: Lancet (2008) vol.371, pages 2192-2200 and 2150-2151

Last edited November 4, 2014

Jul

2008

Chronic Kidney Disease Kills

By Ray Schilling | Diabetes, Heart Disease, High Blood Pressure

Chronic kidney disease (CKD) has been on the rise for several years and is responsible for premature deaths all over the world. Many different kidney diseases (glomerulonephritis, pyelonephritis, diabetic nephropathy, hypertensive nephropathy etc.) will lead to end stage kidney disease, called chronic kidney disease, and this in turn would require dialysis treatment or a kidney transplant. Often these patients will die prematurely.

Dr. Chi-Pang Wen and collegues from the National Health Research Institutes, Taiwan, have followed a total of 462,293 people with all stages of CKD since 1994. At the end of 2006 there were 14,436 deaths in this population. The two best screening tests to predict deterioration of kidney disease were the flow rate of fluid through the kidneys (medically termed “glomerular filtration rate”) and protein tests of urine. The glomerular filtration rate should stay constant and above a certain cut-off point, and protein should not leak into urine. When the medical researchers started to analyze the results of this study, they found that CKD was affecting about 12% of the general population (the figures are very similar to the US). The patients with CKD had an 83% higher general mortality and had a 100% higher mortality from cardiovascular diseases.

Chronic Kidney Disease Kills

After a 13 year observation period with a median follow-up of 7.5 years 10.3% of the deaths in the entire population were due to CKD. In the low socioeconomic status group this figure was 17.5%. About 40% of the deaths from CKD occurred before the age of 60. Those in the study who had been taking Chinese medicines had a 20% increased risk to develop CKD.

In most countries around the world regular yearly screening of glomerular filtration rates and testing for protein leakage into urine is not done on a large scale. But this is the only way to prevent early kidney disease from developing into chronic kidney disease. Once early kidney disease has been identified, preventative measures like salt restriction, treating diabetes and treating unrecognized high blood pressure etc. can be implemented. In many cases this will prevent the need for dialysis, kidney transplants and death from chronic kidney disease.

More information about pyelonephritis, one of the possible causes of kidney failure: http://nethealthbook.com/infectious-disease/urinary-tract-infection/pyelonephritis/

Reference: Lancet ( 2008), vol. 371, page 2173 to 2182 (June 28, 2008)

Last edited November 4, 2014

Jul

2008

High-protein, Low-refined carb diet useful in controlling diabetes

By Ray Schilling | Diabetes, Nutrition, Obesity, Weight loss

Diabetes type 2 is often associated with obesity (body mass index higher than 30.0 kg per meter squared). At the 16th European Congress on Obesity in Geneva Dr. Neil Mann presented a study of 99 patients. Half were put on a high protein diet, the other half on a high carbohydrate low glycemic index diet and followed for one year with periodic blood tests and examinations by their family doctors. The study population’s age ranged from 30 to 75 years and their body mass index varied from 27 to 40. The hemoglobin A1C level that is a measure of severity of the diabetic condition ranged from 6.5% to 10%.

The high-protein diet was structured so that 30% of calories came from protein, 40% came from carbohydrates and 30% came from fat. With the high-carbohydrate low glycemic index diet 15% of the calories came from protein, 55% from low glycemic index carbs and 30% from fat. In both groups the total calorie intake per day was restricted to 1500 calories and the carbohydrates were given as low glycemic index carbohydrates (less processed). In both groups the diabetes was better controlled with hemoglobin A1C, triglyceride levels and cholesterol levels normalizing. Both groups also showed an equal amount of weight loss that stayed down as long the patients adhered to the diet. However, the high-protein group was able to reduce diabetes pills (metformin) and insulin achieving the same results as the high-carbohydrate low glycemic index group that could not reduce their medications. The conventional approach is to use a low-fat, high-carbohydrate diet along with medication. However, this diet tends to lead to higher triglyceride levels, higher blood sugar levels and a reduction in the good cholesterol (HDL).

High-protein, Low-refined carb diet useful in controlling diabetes

Dr. Mann who is a professor and head of the department of nutrition and food science at RMIT University, Melbourne, explained the people get confused when they hear the term high-protein diet as they think of the Atkins diet where the protein component was much higher. The diet that was investigated here is a more natural diet consisting of slightly higher protein and less processed carbohydrates. By containing more fat than in the conventional diabetic diet the patient is not getting hungry and finds it easy to stick to the diet, which leads to weight loss and improvement of the metabolism. Many patients can normalize their blood values and often even get off their diabetic medication (under careful supervision by their treating physician). The physician will address the three components of diabetic control (energy balance, glycemic control, and vascular complications) by recommending to the patient this high-protein/low-carb diet. This likely will replace the conventional approach of using a low-fat, high-carbohydrate diet.

More information about a Mediterranean type diet in firefighter’s, which is very similar to this study: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

Reference: 16th European Congress on Obesity, Geneva June 23, 2008

Last edited November 4, 2014

Jun

2008

Diabetes Onset Can be Delayed

By Ray Schilling | Diabetes, Fitness, Nutrition, Prevention

Diabetes delayed by diet and exercise

Prevention is the buzzword in healthcare, but often medicine has to embark on the curative avenues. With the onset of a health problem patients are often tempted to throw in the towel: it’s too late now anyways. There is nothing I can do. It’s up to medication, pills or shots to get a handle on my problem. Nothing could be further from the truth, as major clinical trials have shown, when it comes to intervention to prevent the onset of diabetes. There is a stage where lab tests show that a patient has impaired glucose tolerance. He or she is”pre-diabetic”. Without intervention the development of diabetes is more or less imminent. But this does not mean that “it is too late “. It is exactly at that point, where lifestyle intervention can make a difference. How long do these post-intervention studies remain effective? Professor Guangwei Li at the China-Japan Friendship Hospital in Beijing, China and Dr. Ping Zhang from Centers for Disease Control and Prevention followed up patients 20 years after enrolment. In 1986, 577 adults from 33 clinics in China were randomly assigned to a control group or one of three lifestyle intervention groups (diet, exercise or diet and exercise combined).

Diabetes Onset Can be Delayed

All of the patients had impaired glucose tolerance. There was an active intervention program until 1992, and in 2006 participants were assessed for the long-term effect of the interventions. The results showed that the combined lifestyle interventions reduced the incidence of diabetes by about half during the active intervention period of 6 years. Over the 20 year duration the reduction was 43 %. At the end of the 20 year period 80% of the intervention group had developed diabetes, whereas 93% of the control group that had not followed a lifestyle intervention program were diabetic. The researchers reported that lifestyle intervention programs for patients with impaired glucose tolerance can indeed make a difference. A six year intervention program can delay the onset of diabetes by 14 years.

More information about diabetes: http://nethealthbook.com/hormones/diabetes/

Reference: Lancet 2008;371:1783-1789; 1731-1733.

Last edited November 3, 2014

Jun

2008

Boost Babies’ Health with Mom’s Diet

By Ray Schilling | Allergies, Asthma, Health, Nutrition, obstetrics, Prevention, Vitamins and supplements

Prenatal supplements and good advice on proper nutrition during pregnancy have long been included in proper prenatal care. Importance has been placed on folic acid to prevent neural tube defects in the fetal development. Calcium is recommended, often in the form of dairy products, but it does not end there: just swallowing the supplement and adding some more milk may be helpful but not quite enough. Certain dietary habits have been found more beneficial, such as the eating habits in the Mediterranean countries. A research team from the University of Crete in Heraclion, Greece included women who were involved in antenatal care at all general practices in Menorca, Spain. The study took place in the time frame of 12 month starting in 1997. After six and a half years 460 children were also included in the analysis.

Dietary habits were studied and assessed by food questionnaires and the children were assessed for the development of allergies and asthma.

Boost Babies’ Health with Mom’s Diet

The children of mothers who consumed the most vegetables, fish and legumes were almost 80% less likely to have persistent wheeze and more than 40 % less likely to have allergies. The results are consistent with the fact that a high level of adherence to the Mediterranean diet during pregnancy is protective not only to the mother but also to the child.

More information about prenatal visits (where nutritional habits are checked as well): http://nethealthbook.com/womens-health-gynecology-and-obstetrics/pregnancy-labor-delivery-2/prenatal-visits/

Reference: The Medical Post, April 22, 2008, page 25

Last edited December 18, 2014

Jun

2008

You Are What You Sleep

By Ray Schilling | Obesity, Stress management

Lack of sleep can lead to childhood obesity

Stressful lifestyles often contribute to physical disorders and psychological difficulties, but little has been known about the fact that unbalanced sleep patterns also dysbalance a healthy body weight. Jean-Philippe Chaput of Laval University, Quebec City presented some facts at the 16 th European Congress on Obesity in Geneva, that emphasizes the importance of a balanced sleep pattern. There can be not only too little sleep but also too much sleep, as Dr. Chaput found out by studying 276 adults. Those who had a pattern of short duration sleep (5 to 6 hours) and those individuals who slept 9 to 10 hours were 35% and 25% more likely, respectively to show weight gains of 5 kg compared to the group that slept for 7 to 8 hours. The most likely reason is an alteration of certain hormones: short sleepers had high leptin levels and low ghrelin levels. In a previous study on children it also became obvious that to little sleep increases the risk of overweight and obesity in children. It was also possible to establish the type of weight gain.

You Are What You Sleep

Short sleep duration in kids lead to abdominal fat rather than to overall body fat deposits. Too little sleep in children seems to have more health consequences than previously thought, as it is the most important risk factor for overweight in this group. The most important risk factor was sleep duration that is too short, followed by parental obesity, watching TV and lack of physical activity.

More information about sleep apnea: http://nethealthbook.com/ear-nose-and-throat-diseases-otolaryngology-ent/nose-problems/sleep-apnea/

Reference: From the 16th European Congress on Obesity, May 2008

Last edited November 3, 2014

Jun

2008

New Modified Carrots and Food from Cloned Animals

By Ray Schilling | Nutrition

Researchers from Texas A&M AgriLife’s Vegetable and Fruit improvement Center and a research group from Baylor College of Medicine reported about their work earlier this year. They developed a new variety of super carrots that contain 41% more calcium than the regular garden varieties. In a study 15 men and 15 women ate regular carrots for a week. At the end of the week urine samples were taken to examine the amount of calcium absorbed. The test persons ate the modified carrots for a week, and more urine tests were taken. The result showed a higher intake of calcium from the modified carrots. The head of the study, Dr. Jay Morris, PhD made a statement that fruit and vegetables are beneficial for many reasons, but they have never been a good food source for calcium. He states that if the new technology is applied to a number of different fruit and vegetables, it could have a significant impact on preventing osteoporosis. This research may sound like a futuristic concept, but bioengineering and food from bioengineered animals may soon be a reality for consumers in the United States and in Europe. The FDA has reported that, for the most part, milk and meat from cloned animals is safe to eat. The European Food Safety Authority has also concluded at the same time that milk and meat from healthy cloned cattle and pigs are suitable for human consumption. At this point there was not enough information for the agency to come to a conclusion on the safety of food from other animal clones, such as sheep. The European agency noted that death and disease rates are higher in cloned as compared to conventionally reproduced animals, and it would be of essence that unhealthy clones will not enter the food supply.

New Modified Carrots and Food from Cloned Animals: BUY ORGANIC!

The European Group on Ethics in Science and New Technologies (EGE) advises against food production from cloned animals due to the current level of suffering and health problems in surrogate dams and animal clones. Cloning remains fraught with perinatal and postnatal disease of cloned animals. Abnormalities are also common in the form of malformations, increased weight, respiratory problems, enlarged fetal liver and kidney abnormalities. Ultimately the old adage is as valid as ever, even if it comes to the mundane task of shopping for dinner. It is called “buyer beware”!

More information about the safety of our food: https://www.askdrray.com/our-endangered-food/

Reference: The Medical Post, April 22, 2008, page 25

Addendum on Nov. 16, 2012: Buy 100% organic food. It is freightening to see how superficial the FDA testing methods have become with respect to cloned foods, genetically modified foods etc. Your only recourse is to buy 100% organic food!

Last edited November 3, 2014

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