Monday, December 21, 2009
Dr Joes DIY Health Guide to Christmas
If I asked a group of year one school children the same questions all hands would go up the first time. The reason that some of us look forward to Christmas being over is of course stress.
It is a slightly sad reflection on society that so many people see Christmas as a stressful time. Yet as I have said before “stress is not about events themselves but what we make of them”
At one level Christmas is a day of the year like any other. At another it is a day of celebration of the birth of Jesus Christ. At a third level it is a secular celebration with gifts and get togethers. Finally there is the “festive season” which can start in mid November involving a series of events at which one may eat and drink.
The biggest stress issues around Christmas are weight gain from overindulging, bank balance loss from overspending and anxiety from interacting with those who you would prefer not too.
So this year rather than Survive Christmas why not enjoy Christmas. There is much that can be done to make sure you enjoy Christmas based on the 8 Pillars of DIY health.
1 Each day spend 30 seconds to take 3 slow deep breaths do this at least 4 times a day. This will reduce stress.
2 Drink water. Before you go to a function have a glass or two of water. Keep yourself hydrated. If at a party alternate water with alcoholic drinks.
3 Finger food is notoriously high in calories. Eat a carrot or other piece of vegetable before you go out. This way you will not be as hungry and hence you will eat less.
4 Keep active. Do some walking or other exercise everyday (or at least 3 times a week).
5 Don’t be the last to leave. You need your sleep.
6 Realize you have choices about whom you see and what you buy. Your stress levels will be a function of your choices not the “world out there”. Be honest with yourself and others about what you can and can’t reasonably do.
7 Buy your Christmas presents with cash. That way you know you can afford them and you won’t stress about the credit card bill in January
Only buy gifts for people you really want to give one to.
8 Christmas is a time for goodwill to all but if you really don’t like spending
time with certain people (even if they are your family) then it may still be better not to. Be polite but firm in declining invitations. Make sure you spend time with those you really care about If there is “no way out” then say to yourself “this too will pass” as often as needed. It will pass and by adopting this approach you will not stress.
9 Christmas day lunch is a meal. If you are having people around you don’t need more food than if they were coming any other day. If it’s a big gathering have everyone contribute a plate. You don’t have to eat till you feel like you will “explode”.
10 For some the preferred option is to “cancel” Christmas and just go to ground and emerge again on December 27.
11 Have fun. Children enjoy Christmas. There is no reason adults can’t do the same. Allow yourself to be a child again. Pop crackers enjoy unwrapping presents and playing with the wrapping paper.
12 Consider having some “purpose” around Christmas. Maybe do some volunteer work? Perhaps reflect on what you can do to be a better person or how you can contribute to your community.
For virtually everyone there was a tie when Christmas meant fun. Somewhere along the line this has been lost for some of us. This year ask yourself what needs to happen for me to enjoy Christmas as much as when I was six years old? Then go and have fun.
Wednesday, December 16, 2009
Cholesterol- a different view
So how did a molecule, which is actually essential for life, become public enemy number one? Good question. It basically goes back to the 1970s and various studies which looked at factors contributing to coronary artery (heart) disease. To cut a long story short, the idea took hold that cholesterol is bad therefore the levels in the bloodstream needed to be reduced. This was later modified to allow for lowering “bad” cholesterol (LDL) but not “good” or HDL cholesterol.
It wasn’t till the late 1980s when the first statin drugs appeared that the big push to lower cholesterol really took off. This of course was encouraged by the pharmaceutical industry, which makes billions of dollars from the sales of statin drugs.
However circulating cholesterol has never and will never be the problem. The problem is plaque (which may include cholesterol) building up on the artery (blood vessel) wall. This is why some people with high levels of cholesterol never have heart problems (including some French and Italian populations with very high levels) and as many as 40% of those with heart disease have none of the “official” risk factors including raised cholesterol.
The real cause of vascular disease (including heart disease) is slow inflammation. In this setting cholesterol may contribute to plaque on the vessel walls, which narrows the bloods vessel restricting (or stopping) blood flow but is not the primary cause.
Recent studies have now shown that lowering cholesterol does not equate to lowering heart disease. Two drugs were compared. What was shown was that whilst one group of people had their cholesterol lowered more than the other there was no difference in rates of heart disease.
Lets get back to our original question about cholesterol as public enemy number one. In the 1970s it was observed that LDL (bad) cholesterol was raised by saturated fat. It was (and still is) assumed that saturated fat is bad because it raises LDL and in turn LDL is bad because it is raised by saturated fat. This is a circular rather than cause and effect argument.
Hence it became case closed that cholesterol was bad and anything, which raised it, was bad and hence lowering it was good. A bit like in George Orwell’s animal farm “for legs good two legs bad”.
Now what is interesting is that statins seem to be associated with lower rates of heart disease. However these new trials, which used non-statin medications, might be suggesting that the primary benefit of statins may not be lowering cholesterol but some other effect.
There are many scientific studies, which raise questions over the widespread use of statin medications. This is from the perspective of side effects and costs but mainly questioning the assumed benefits. Not surprisingly the manufacturers fund most of the studies supporting statins. Like many pharmaceuticals, there is a role but not as big a one as they end up with.
So what is the bottom line here? Essentially cholesterol has been made into an ogre, which it is not. In the process billions of dollars worth of drugs have been sold for far less benefit to many of those taking them than the pharmaceutical companies would have you believe.
For the individual interested in their own health the solution as usual is simple. Eat mainly food which till recently was growing or moving around. Make water your main beverage. Minimize processed and packaged foods.
This together with the other 7 pillars is your best way of staying healthy and in turn not getting sick.
Wednesday, December 9, 2009
Medical Screening- More Not Allways Better
Now I am not entering into a discussion about aliens but the real point is that our knowledge changes. This mainly happens through trial and error and also through creative genius. The medicine man in the seventeenth century applying leeches didn’t think he was doing the wrong thing. He was going with the knowledge of the day.
Today science is able to make greater progress than in centuries gone by. However it remains an extension of trial and error. The simple reason for that is that science is an extension of our senses and capacity to interpret what we find. Before the invention of microscopes we couldn’t see bacteria-it didn’t mean they weren’t there. Before the electron microscope we couldn’t see our genes (DNA) –again it didn’t mean it wasn’t there.
Science then is limited by the five senses and an assortment of aids such as microscopes. More importantly scientific discovery is a reflection of our capacity to “understand and interpret” what we find. Ultimately what we “know” today may be found to be totally wrong tomorrow. This is how knowledge advances.
The recent furor over cancer screening fits into the above scenario. In the USA new guidelines for mammograms now recommend that it be done two yearly starting at age 50 rather than annually starting at 40(this now matches Australian guidelines) .The new guidelines comes from looking at the actual results of the screening program. New guidelines are also being considered for cervical cancer screening. Prostate cancer screening remains highly controversial as to what is best.
It is easy to paint all cancer screening as “saving lives” and dismiss the problems. However screening can lead to unnecessary procedures (including surgery) and stress for people who have false positive results (results which show an abnormality but where the person has no disease). Also we are seeing that some very early “cancers” might not actually develop and some resolve themselves.
Now none of this is to say that screening is not helpful. It is to say that what we “knew” ten years ago may no longer be relevant. It is also important to note that the loudest arguments against change usually come from those who are doing the screening. They necessarily have a vested interest, which may be financial or reputational. The medical industrial complex has spawned industries around screening and follow up treatment.
Sadly this debate may get tied up in arguments about payments and “rationing”. More tests have been seen as being only positive. The reality is that indiscriminate testing has downside. Whilst it is easy for a person to say “my cancer was found and I don’t care how many other people had needless tests and stress to allow this”, that is only one side of the issue, albeit the only side that gets much airtime. Furthermore real questions can now be asked as to whether all these cancers would have progressed anyway. In other words it may not be the screening that “saved all the lives.”
As our knowledge grows and more importantly our capacity to understand what we “see” grows there will be changes in what is regarded as best medical practice. These should always “challenge “ current ideas and generate debate. Clinging to what has been done before when new knowledge supersedes it is the modern equivalent of insisting the earth is flat.
Monday, November 30, 2009
A weighty issue- time to think differently
There is no question that carrying excess weight is not healthy for a number of reasons. The question is what constitutes overweight? This article (see link) looks at some of the politics of obesity. It describes the background to the Body Mass Index (BMI), which derives from work done in the 1940s by insurance actuaries and work on “normal “ weight from the 1830s. The arbitrary cutoffs came from the International Obesity Task Force. All this seems a bit out of date and perhaps of questionable relevance today.
What is so special about a BMI of 25 as against 27? Many sports people are classed as overweight because they are muscle bound. Arnold Schwarzenegger was “obese” when he won Mr. Olympia. Many football players would also be technically overweight. The BMI also does not include a differentiator for men and women.
A recent study has followed over 11,000 people for 12 years and found those who were technically overweight (BMI 25-29.9) had lower death rates than those with a “normal” BMI (18.5-24.9). Now I am always suspicious of studies but whenever there is one, which challenges conventional wisdom, I am more interested. Whilst research is presented as “scientific “, to publish findings, which are against the herd, mentality is difficult.
There has been a whole industry set up to deal with the obesity “epidemic”. This includes countless jobs for health officials to set up taskforces and attend meetings. The pharmaceutical industry has tried to get on board, although with limited success as some “weight loss” pills had to be taken off the market. More recently weight loss surgery has been a winner for surgeons.
To get a drug to market requires years of development including trials to establish that the drug works and that the side effect profile is acceptable. New surgical procedures are not subject to this. The long-term effects of weight loss surgery may be only just becoming visible. Two recent reports show
increased rates of fractures and kidney stones for people in the years after surgery.
It does not surprise me that when you interfere with the absorption of food that there will eventually be consequences. Belatedly a study is being done to see if there actually are long-term benefits from weight loss surgery.
The central question in all this is what constitutes overweight and obesity. We can probably all spot it when we see it but can we define it? More importantly can one measure be applied to all people in all circumstances – the answer to that one is no.
Like most things with the body there is a “right” level above and below which there are health issues. With weight there is a level, which will impact on your health. That level may not be a BMI of 25. The likelihood is that the “correct “ BMI for most people is somewhere between 20 and 30.The other likelihood is that there are much better markers for health issues than the BMI.
As I say in my book, Dr Joes DIY Health-Putting you in charge of your health, focus on eating food that until recently was moving around or growing somewhere, food that your ancestors from 100 years ago would recognize as food, food that if not eaten would have to be thrown out next week. Following these simple guidelines will make it far more likely that your weight will be in the zone that is right for you.
http://www.ipa.org.au/publications/1409/big-fat-beat-up
Saturday, November 21, 2009
Swine flu-Chicken Little Rides Again
The moral of the story is don’t believe everything you hear. Chicken little jumps to a conclusion, whips up others into fear and hysteria, which plays right into the hands of the fox that uses the hysteria to his advantage.
Whipping up fear, which can be used to advantage is sadly seen in health matters. Some expert has a view that the sky is falling and countless deaths will occur. In most instances the people running the scare have a “solution” of sorts, which either involves them, making money or wielding influence/power.
In the book Scared to Death by Christopher Booker and Richard North health scares are brilliantly defined as having four components:
1 The source of danger must be universal so anyone can be affected.
2 The danger must not have appeared in the current form before (even though it may have appeared previously.)
3 Whilst the scientific basis of the scare must be plausible there must also be an element of uncertainty to allow for alarmist speculation.
4 Societies response must be disproportionate.
Ladies and gentlemen I give you swine flu, a classic health scare where alarmist speculation about a virus has led to a massive over reaction. A lot has been written and said about H1N1 virus over the past 7 months.
However this article from the New York Times (see link) perhaps best sum up the situation. We have two polarized groups. There are those who desperately want a vaccine, as they are fearful of the H1N1 virus and those who are fearful of the vaccine itself. In amongst this are conspiracy theories with a fair amount of disinformation and a thriving industry.
Of course there is also a silent majority who wonder what all the fuss is about.
Yes there have been deaths associated with the H1N1 virus. There are deaths every year associated with the flu. Yes some previously healthy people for unknown reasons will succumb to overwhelming illness. The vast majority either has a mild illness or no illness at all.
Through all this I am yet to hear anyone in officialdom suggest that a healthy immune system is the best way not to get ill. I am yet to hear about the ways to strengthen your immune system.
Advice like put the right foods into your body, a balanced diet with adequate fruit and vegetables as well as sources of essential fatty acids such as fish, olives (or olive oil), linseed or nuts. Advice like taking vitamin supplements, particularly antioxidants such as vitamins A, C and E, D. Folate and zinc which help the immune system.
Advice to get enough sleep, as this is the bodies recharge the battery time and drink 35ml/kilo of water each day. Advice to lower your stress. This will significantly help the immune system.
No, we get a diet of fear, which increases people’s stress, and a line that there is nothing you as an individual can do, only a vaccine can save you. In turn you are encouraged to look to the medical industrial complex and government to save you in your hour of need. This is not the way to go if you want to be in charge of your own health.
Here is the bottom line. The sky is not falling. The H1N1 virus is a mild strain at absolute worst and there is no need for mass panic or the mass over reaction we have been subjected to.
The best way not to get sick is to be healthy.
http://www.nytimes.com/2009/11/10/health/10klas.html?th&emc=th
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Monday, November 16, 2009
Getting real about our children
The figures from Greece are the most interesting as they reveal one of the key reasons we have this problem. Between 1982 and 2002 there had been a trebling in the number of overweight Greek 12 year olds. During this time there had been a move away from the “traditional” Mediterranean diet and an embracing of processed high sugar foods. The traditional diet was based on vegetables fruit, unrefined grains olive oil for cooking with a bit of fish nuts poultry and eggs thrown in. There was not a lot of red meat consumed and virtually no refined sugars. This diet provides lots of nutrition and is not calorie dense.
Contrast this with a diet of hamburgers, soft drinks, biscuits and other processed foods which make up, a “typical” western diet. This is the exact opposite - calorie dense with not much nutrition. If you then add into the mix that many children are not physically active, spending hours in front of screens, we can see why children like adults are getting heavier.
There is much hand wringing going on about childhood obesity. There is no shortage of opinions on how to “manage the crisis”. As is usually the case, calls are made to ban advertising of “junk foods” and for government to provide “funding” for various programs. Of course this funding goes mainly to program providers, often the same people who are arguing for funding for such programs.
Then there are the ridiculous suggestions like banning children under two from watching TV. Not only is this pointless but how on earth would it be implemented? The most bizarre one recently was for lap banding surgery for children. Not only is this completely the wrong approach to take with children but no one has considered the long term effects on their growth if one interferes with food absorption.(It is emerging that long term issues with bones and kidneys may follow lap band surgery but this takes years to appear).
In amongst the nonsense, there is a shining light. A school in Queensland (Australia) has won an award for teaching children how to grow and cook fresh food. Angela Skerman,the teacher in charge of this was quoted as saying "There's a lot of benefit of getting children to go back to the basics and being able to grow their own food and see the relevance and importance of eating seasonal produce rather than things that have been held in a fridge for eight months “
In my view this sums it up. Rather than berate children and parents about all the wrong things they are supposedly doing or treat them like imbeciles who will do anything just because it was on an ad, teach useful skills and provide useful information. This is best done at a grass roots level.
The two key ways to help our children with their eating is to teach them the basics and the connections between nature, what we eat and our health. The other key is to lead by and set a good example.
Thursday, November 5, 2009
A giraffe in a plane
It is amazing how new learning’s come at the most unexpected times. Last Saturday I had a new lesson in relaxation, pillar 6 of DIY Health, at the local markets. Now Saturday can be fairly busy in our house.
There are two and sometimes three sports and most weeks it is the day for food shopping (unfortunately in Perth we are very restricted in when we can go shopping), as there is no time during the week.
Anyway we were due to start at 9am with basketball for my son. We arrived a bit before 9 and by the designated start time there were only three of our team and none of the other team and no referee.
This seemed odd. At five past I felt it was time to ask the question at the reception desk. Apparently the other team had forfeited at the last moment and the rest of our team who had arrived two minutes before us had been “headed off at the pass” and had gone off for a refreshment.
There are two choices one has in this situation. One is to get stressed, the other is to accept what is and move on to the next thing. We chose the latter.By late morning it was time for the weekly food run. We go to the local supermarket for non-perishables and to the local markets for fruit and veggies, bread and produce from the continental grocer. Now the markets are not flash (as my daughter reminds me) but the produce is good, fresh and actually cheaper than in the supermarkets.
Our last stop was to be the continental grocer as it was on the way back to the car. On the way we noticed the face painting for children was set up next to the grocer (it is usually at the other end) and you can guess what became the added stop.
Despite it being a busy lunchtime there were no takers for face painting. My daughter wanted a swan. One of the painters was trying to “sell” the idea of a painted giraffe in a plane. She had been practicing this but had no takers. “Dad “ she asked “would you like a small giraffe on a plane on your arm?” With a bit of encouragement I agreed.
On sitting down the painter said to me this is a good thing to relieve stress. This seemed an odd description of an adult having a picture painted on his arm. Then as I sat watching her paint, the penny dropped. I had been pretty much on the go all week and through Saturday. This was a chance to not only sit down but also watch an artist in action.
As the aviator giraffe formed on my forearm, I was relaxing as just watching her paint absorbed me and I stopped thinking about the other things that still needed to be done that day. It was also just “fun”. At what age did I become too old to have a fun painting on my arm? It was cute and colorful.
Watching a giraffe in a plane being painted on my arm had brought me into the present moment, allowed me to sit down and to be a kid for a while. I got up more relaxed than when I sat down. The opportunity to relax may present itself in unexpected ways. Be open to them and when they arise take the opportunity to do something that a serious adult would reject but a child would see as fun.
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