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Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.

Tuesday, November 14, 2017

REDUCE COLON CANCER RISK BY INCREASING INTAKE OF WHOLE GRAINS AND DECREASING MEAT

The American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF) recently updated information on diet, lifestyle and colon and rectal cancer risk.  Their extensive research review of over 100 studies found there is strong evidence of links between lifestyle and colorectal cancer risk.  An estimated 47% of American’s colorectal cancers, 63,700 cases, could be prevented each year with lifestyle changes. The 2017 report is the first by the AICR/WCRF to conclude there are substantial benefits to eating more whole grains (such as brown rice and 100% whole-grain bread) for reducing colon cancer risk.  Consistent with earlier reviews they found regular physical activity, healthy weight, and not smoking also lower one’s odds of bowel cancers.  Alcohol, meat, and particularly processed meats were found to increase risk of colon and rectal cancer.   

The AICR/WCRF found that three servings (a serving equals 1 slice of bread or ½ cup of cooked grains) a day of whole grains can lower colorectal cancer by 17%.  Other sources of dietary fiber including fruits, vegetables, beans, and nuts, as well as dairy products and calcium supplementation were also deemed beneficial for lowering colon cancer risk.  Besides their fiber, plant foods contain a wide variety of substances that have been linked to lower risk for cancer, including carotenoids, selenium, lycopene and many more.   Fruits and vegetables rich in vitamin C such as strawberries, oranges, and spinach appear to be especially beneficial. Interestingly, regular intake of garlic was also linked to reduced risk.  Exactly how garlic contributes to lower risk is not known but in many laboratory studies, garlic and its components such as allyl sulphur compounds, has shown the ability to slow and stop the formation of colon tumors.   The panel also recommended at least 30 minutes of daily physical activity.   

As for foods to decrease, AICR/WCRF experts advised limiting intake of all red meat, such as beef or pork, to no more than about 17 ounces (i.e. just over 1 pound) per week. The report also stated it is best to eat little or no processed meats such as ham, hot dogs and bacon because frequent intake of these significantly increases the risk of bowel cancer.  Nitrates are added to many processed meats; they contribute to the production of N-nitroso compounds that can damage the lining of the gut.

What to do:  Colorectal cancer is one of the most common cancers, yet this report demonstrates healthy diet and lifestyle substantially lowers risk.  Maintain a healthy weight with a diet rich in whole grains, fruits, and vegetables. Control portions of meat, opting for fish, chicken, or beans more often.  Stay away from processed meats, alcohol, and smoking.  Also get screened.  The USPSTF recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy beginning at age 50 and continuing until age 75 years. 

Adapted from articles available at: 

Source:

American Institute for Cancer Research and the World Cancer Research Fund International.  Continuous Update Project Report:  Diet, Nutrition, Physical Activity and Colorectal Cancer.  September 7, 2017.  Available at:  https://www.wcrf.org/colorectal-cancer-2017.

Saturday, November 11, 2017

UNTREATED OBSTRUCTIVE SLEEP APNEA HAS IMMEDIATE & LONG-TERM HEALTH CONSEQUENCES

A recent study underscores the importance of consistently treating obstructive sleep apnea (OSA).  The research trial revealed that when individuals with sleep apnea do not use their continuous positive airway pressure (CPAP) devices, even for just a couple of days, they experience marked increases in blood sugar, stress hormones, and blood pressure.  Another recent study concluded that over time untreated sleep apnea increases the build-up of amyloid beta, the plaque-building peptides associated with Alzheimer's disease. 

An estimated 25% of adults and 45% of obese adults have obstructive sleep apnea in which one's airway momentarily closes multiple times per hour during sleep. Treatment typically entails wearing a mask that provides air pressure into the throat to keep the airway open during sleep but there are also other less intrusive treatment options that can work in some cases.

"This is one of the first studies to show real-time effects of sleep apnea on metabolism during the night," said study senior author Dr. Jonathan Jun.  In the study, researchers monitored 31 obese individuals as they slept. All the subjects had moderate to severe obstructive sleep apnea and were monitored either while using a CPAP device or after not using it for two nights.  During the night, researchers measured levels blood fatty acids, insulin, glucose and the stress hormone cortisol. They found that having not worn the CPAP for two previous nights resulted in elevated heart rate and reduced blood oxygen. CPAP withdrawal also increased levels of free fatty acids, glucose, cortisol and blood pressure during sleep. The more severe the OSA, the more these parameters increased.

Another recent report finds that OSA puts elderly at greater risk of developing Alzheimer's disease.  Researchers from this study report that biomarkers for amyloid beta, the plaque-building peptides associated with Alzheimer's disease, increase over time in elderly adults with OSA in proportion to OSA severity. Thus, individuals with more apneas per hour had greater accumulation of brain amyloid over time.

What to do:  These studies emphasize the importance of treating OSA to prevent its metabolic, cardiovascular, and neurological consequences.  Indications one is at increased risk for OSA include obesity, particularly in the upper body and neck, daytime sleepiness, snoring, and waking at night feeling like one cannot breath.  Maintain a healthy weight or work on weight loss to minimize your risk for OSA.  Screening with a sleep study can reliably diagnose OSA but  many diagnosed individuals find it difficult to tolerate wearing their CPAP device. In this case work with a sleep specialist with whom you can explore the various CPAP mask options and potential alternative OSA therapies including implanted devices, dental appliances, and positional therapy. 

Adapted from articles available at:
https://www.medlineplus.gov/news/fullstory_168254.html
https://www.sciencedaily.com/releases/2017/08/170831101454.htm
https://www.sciencedaily.com/releases/2017/11/171110084325.htm

Sources
Chopra S, Rathore A, Younas H et al. Obstructive sleep apnea dynamically increases nocturnal plasma free fatty acids, glucose, and cortisol during sleep. The Journal of Clinical Endocrinology & Metabolism, 2017; DOI: 10.1210/jc.2017-00619


Sharma RA, Varga AW, Bubu OM et alObstructive sleep apnea severity affects amyloid burden in cognitively normal elderly: A longitudinal study.  American Journal of Respiratory and Critical Care Medicine, 2017; DOI: 10.1164/rccm.201704-0704OC

Tuesday, June 6, 2017

RIBOFLAVIN SUPPLEMENTATION HELPS REDUCE MIGRAINES

A recent review of existing experimental studies found that daily supplementation with riboflavin can significantly reduce migraine frequency.    Migraine headaches are a common but debilitating neurological disorder.  Approximately 12% of Americans suffer from migraines and it is estimated the condition costs our healthcare system over 78 billion dollars annually. Migraine symptoms are typically characterized by intense pulsing or throbbing pain in one area of the head and are often accompanied by visual disturbances, nausea, vomiting, dizziness, sensitivity to light and sound, and/or tingling in the extremities and face. 

The pathophysiology of migraine headaches is complex and involves many diverse dysfunctional areas in the brain. One of the major genetic disorders that has been linked to migraine headaches is dysfunctional mitochondria (the powerhouses of our cells).  Riboflavin, also known as B2, catalyzes the activity of flavoenzymes in mitochondria and it is via this mechanism that riboflavin is believed to aid in better functioning of neural cell metabolism and migraine relief.  Previous research suggests a high percentage of migraine sufferers have at least mild deficiencies in riboflavin.

What to do:  Riboflavin supplementation will not help all sufferers of this diverse condition but it does appear remarkably effective for some and, unlike most migraine medications, it has the benefits of being very safe and inexpensive.  So, if you suffer from migraines consider supplementing with 300-400mg of riboflavin daily for 2-3 months.  Foods that are especially rich in riboflavin include eggs, meat, and dairy. In the U.S. flour is also fortified with riboflavin.

Adapted from article available at:
https://ods.od.nih.gov/factsheets/Riboflavin-HealthProfessional/

Source:

Thompson DF, Saluja HS. Prophylaxis of migraine headaches with riboflavin: A systematic review. Journal of Clinical Pharmacy & Theraputics 2017;00:1–10.  Published online ahead of print May 8, 2017. https://doi.org/10.1111/jcpt.12548

Thursday, April 13, 2017

OLDER ADULTS' BONES BENEFIT FROM CALCIUM RICH DIET WHEN SUPPLEMENTING WITH VITAMIN D

A recent analysis of a prospective cohort study including over 600 older adults found that a diet rich in calcium was only associated with better bone health outcomes when participants were also supplementing with vitamin D.  Dietary intake of calcium rich foods did not appear to support bone health among individuals who did not supplement with vitamin D.  Study participants were drawn from those enrolled in the long-running Framingham Study, which began in 1948 and has followed the health and habits of a cohort Framingham, Massachusetts residents over time.

Participants averaged 75 years age.  Their patterns of food intake were assessed with detailed food frequency questionnaires and their bone density assessed with bone scans. The analysis found that absolute spinal bone mineral density levels as well as the change in hip bone mineral density over four years was significantly better among those who both consumed diets rich in calcium and who supplemented with vitamin D.  In contrast, higher dietary calcium intake was not protective among those who were not supplementing in vitamin D.  These results are consistent with the fact that vitamin D stimulates calcium absorption, which aids in bone building and prevention of bone loss. 

Bone health problems are a widespread health concern.  An estimated 44 million Americans have low bone density and 10 million Americans have more severe osteoporosis, a disease marked by low bone mass and progressive deterioration of bone tissue. Osteoporosis increases the risk of fractures, loss of physical function, decreased quality of life, and even death. 

What to do:  These findings underscore that the benefits of calcium rich diet to older person’s bones may be dependent on vitamin D intake.  As we age, all individuals lose bone mass but those who lose mass more quickly as well as those who did not accumulate adequate bone mass in adolescence are at risk for osteoporosis.  While the efficacy of calcium supplements remains debated there is generally consensus that individuals' bone health benefits from diets rich in calcium.  An estimated 80% of Americans’ diets are insufficient in calcium.  Some of the foods richest in calcium include dairy such as milk, yogurt, and cheese, fish with bones such canned salmon and sardines, and dark leafy vegetable such as Chinese cabbage, kale, and broccoli.  Our bodies make vitamin D when our skin is exposed to the sun but persons who are older, obese, have darker skin, and/or get little sun exposure are at high risk for low vitamin D levels.  If your bloodwork indicates you are low in vitamin D, supplementation as well as a calcium rich diet may be integral to maintaining bone health into old age.   

Source:
Sahni S, Mangano KM, et al.  Dairy intake is protective against bone loss in older vitamin D supplement users: The Framingham Study. Journal of Nutrition.  First published online March 1, 2017. DOI:10.3945/jn.116.240390

Adapted from articles available at:

Tuesday, March 28, 2017

EATING HOME-COOKED MEALS and Keeping the TV off during meals both LINKED TO HEALTHIER WEIGHT

A recent study of more than 12,000 low-income Ohio residents found eating food cooked at home, rather than out, and without the television on, was tied to lower rates of obesity.

To determine how meal practices affect obesity risk, the study team analyzed data from the 2012 Ohio Medicaid Assessment Survey on for 12,842 adults.  The participants answered questions about how often they ate meals at home and how often they watched TV while eating and how many of their meals were home-cooked.  The researchers used self-reported height and weight data to calculate each participant’s body mass index (BMI), a ratio of weight to height.  Approximately one-third of participants were obese.

They found that overall about a third of adults watched TV during most or all meals, while another 36% did not watch any TV or videos during meals. For 62% of adults, all of the meals they ate were cooked at home.  Adults who cooked all of their meals at home were 26% less likely to be obese, compared with those who ate some or no home-cooked meals.  And, individuals who never watched TV during meals had 37%  lower odds of being obese than those who always or usually watched TV or videos during meals.

These findings are consistent with previous research that has found adults and children tend to eat more food, eat more quickly, and feel less satiated when they eat while watching TV.  Trials have found focusing on the food and the experience of eating can help to slow down the rate of consumption, reduce the total calories consumed, and increase perceived fullness and satisfaction with the meal.  There is also strong evidence that meals purchased outside the home are on average higher in total calories, sodium, and unhealthy fat than the average home cooked meal. One recent study that included many cities across the U.S. found that average restaurant/takeout entrĂ©e was over 1200 calories and that there was little difference in the nutritional breakdown of meals from chains and non-chains. 

What to do: Prepare food at home when possible.  Menu planning, weekend prepping, batch cooking, utilizing devices such as rice cookers and slow cookers and drawing on healthy convenience items such as frozen vegetables, pre-washed greens, and unsalted canned beans and fish can help to minimize the time needed to prepare meals.  And, regardless of whether you are eating a meal prepared at a restaurant or at home, turning off the TV and avoiding other device screens while eating can help with portion control and meal satiety.  If it feels empty without visual media at the meal, try playing music, or using the meal time as an opportunity to catch up with family members.   

Source:
Tumin R & Anderson SE.  Television, Home-Cooked Meals, and Family Meal Frequency: Associations with Adult Obesity.  Journal of the Academy of Nutrition and Dietetics.  Published online February 24, 2017.  Available at DOI: http://dx.doi.org/10.1016/j.jand.2017.01.009

Adapted from article available at:
http://www.reuters.com/article/us-health-obesity-meals-tv-idUSKBN16928E

Tuesday, February 28, 2017

LIVE LONGER WITH 10 DAILY SERVINGS OF FRUITS AND VEGGIES

If you want to add years to your life, a new review of existing research indicates 10 daily servings of fruits and vegetables may be the best recipe you can follow.  Researchers pooled the results of 95 studies that included more than 2 million subjects to assess the relationship between dietary intake of fruits and vegetables and longevity.  They found that a plant-rich diet lowers rates of heart attack, stroke, cancer and early death. Researchers estimate that if everyone found a way to get 10 daily servings of produce, 7.8 million premature deaths could be avoided each year.

A serving of fruit or veggies is roughly defined as one small fruit, 1 cup of raw fruit or veggies, or ½ cup of cooked fruits or veggies.  In the recent study, researchers found getting 10 servings of produce daily was associated with a 24% reduction in heart disease, a 33% reduction in stroke, a 28% reduction in cardiovascular disease, a 13% reduction in cancer, and a 31% reduction in premature death risk.  If you are a long way off from 10 daily servings of produce, do not despair.  Even just 2.5 servings daily yields substantial health benefits.  Researchers found eating 2.5 servings of produce daily was associated with a 16% reduction in heart disease, an 18% reduction in stroke, a 13% reduction in cardiovascular disease, a 4% reduction in cancer, and a 15% reduction in premature death.   

Why are fruits and vegetables so beneficial to our health?  They contain a complex array of vitamins, minerals, phytonutrients, antioxidants, and fiber that have diverse benefits to our health and the health of our gut bacteria.  They also can replace intake of foods known to be harmful to our health.   
Which produce offers the most benefit?  Researchers found apples, pears, citrus fruits, green leafy vegetables, cruciferous vegetables (such as broccoli, cabbage and cauliflower), and green and yellow vegetables (such as green beans, spinach, carrots and peppers) emerged as some of the most beneficial to reducing risk of health problems.

Another recent research paper found that intake of antioxidant-rich produce is especially helpful to current and former smokers.  Smoking exposes the lungs and body to increased oxidation and DNA damage.  The 13-year study involved 44,000 Swedish men between the ages of 45 and 79. Nearly two-thirds had smoked at some point. Roughly one-quarter still smoked.  The men filled out food questionnaires and answered questions about smoking and other behaviors.  Analyzing the data, the study team determined that regardless of smoking history those who ate five or more servings of certain fruits and vegetables a day were 35% less likely to develop serious airway diseases (known as chronic obstructive pulmonary disease (COPD) which includes emphysema) than those who consumed just two servings daily.  Among former smokers, each additional produce serving produced a 4% lower risk of COPD. In current smokers, each extra serving was linked to an 8% lower risk.  Researchers theorized that antioxidants found in fruits and vegetables may play a role in reducing tissue stress and inflammation that is central to the onset of COPD.  Intake of apples, pears, green leafy vegetables and peppers appeared to be most protective against COPD.

What to do:  For overall health and longevity, incorporate a variety of fruits and vegetables into your regular meals and snacks.  Aim for 10 servings a day.  This is not as hard as you might think.  Remember a “serving” is approximately 1 cup of raw or ½ cup of cooked produce, so, for example, your portion of salad might be 3 servings of veggies.   Start by trying to include a fruit and/or veggie in each meal or snack.  Frozen options are nutritious and easy to keep on hand and quickly add to your menu selections.  As for preventing COPD, your best bet is not to smoke or quit if you do, but, if you won’t quit, making your diet rich in produce can likely help to blunt some of the increased risk to your health.

Adapted from articles available at:
https://medlineplus.gov/news/fullstory_163748.html

Sources:
Varraso R, Shaheen SO.  Could a healthy diet attenuate COPD risk in smokers?  Thorax 2017. Published online ahead of print February 22, 2017 DOI:  10.1136/thoraxjnl-2016-209608

Kaluza J, Larsson SC, Orsini N, et al.  Fruit and vegetable consumption and risk of COPD: a prospective cohort study of men.  Thorax 2017. Published online ahead of print February 22, 2017.  DOI: 10.1136/thoraxjnl-2015-207851

Dagfinn A, Giovannucci D, et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality–a systematic review and dose-response meta-analysis of prospective studies. International  Journal of Epidemiology 2017. DOI: 10.1093/ije/dyw319 

Thursday, January 26, 2017

YOGA MAY IMPROVE BLOOD PRESSURE

Yoga is a mind-body therapy based on movement, breathing, and mindfulness. Over the last few years, many small studies have found that practicing yoga is good for heart health as well as mental health.  A recent small study adds to findings that regularly practicing yoga can significantly improve blood pressure. 

The new study included 60 people who had pre-hypertension but were otherwise healthy.  Blood pressure is made up of two numbers. The top number, the systolic pressure measures the pressure in the arteries when blood is pumped from the heart.  The bottom number, the diastolic pressure, measures the pressure between heartbeats. Persons with pre-hypertension have a systolic blood pressure of 120-139 millimeters of mercury (mmHg) and/or a diastolic reading of 80-89 mmHg.  Pre-hypertensives are at high risk for developing full-blown hypertension which is defined as having a systolic pressure of 140 mmHg or higher and/or a diastolic pressure of 90 mmHg or greater.  Both pre-hypertension and hypertension increase the risk of heart attack, stroke, and heart failure.  In the U.S. approximately 1 out of 3 adults have pre-hypertension and nearly 75 million have hypertension.

To investigate the impact of hatha yoga on blood pressure, researchers assigned half of their participants to practice hatha yoga for 1 hour daily while the other half did not take up yoga.  Both groups were advised on standard measures to lower blood pressure including increasing cardiovascular activity, reducing salt intake, and quitting smoking.  The yoga treatment group received yoga instruction for a month and then did the activity at home. The yoga practice included breathing control exercises,  physical poses that involved stretching and strengthening components, and meditation.

After three months, those in the yoga group had notable decreases in blood pressure, while those in the control group did not.  Participants in the yoga group had 24-hour diastolic blood pressure and night diastolic blood pressure decreases of about 4.5 mm Hg, and 24-hour average arterial pressure decreases of about 4.9 mm Hg.  These were clinically significant results as it is estimated that among pre-hypertensives, every 2 mm Hg decrease in diastolic blood pressure decreases the risk of coronary heart disease by 6% and the risk of stroke by 15%.

What to do:  Consider adding some yoga into your life.  Hatha yoga, the type of yoga in this study is a more gentle form of yoga with more emphasis on breathing and mindfulness.  It is appropriate for persons at all fitness levels.  If making it to a yoga studio is not practical for you, there are many yoga DVD’s and resources online for streaming yoga.  Also, cable television providers often offer exercise-on-demand or feature regular yoga programming.  Many area senior centers and recreational centers offer very affordable class options.  Also, studios often offer a “community class” midday at reduced rates.

Information adapted from articles available at:
http://www.heart.org/HEARTORG/HealthyLiving/PhysicalActivity/FitnessBasics/Yoga-and-Heart-Health_UCM_434966_Article.jsp#.WFmDT_krLIU

Source

Manchanda SC, Narang R, Reddy KS, Sachdeva U, Prabhakaran D, Dharmanand S, Rajani M, Bijlani R. Retardation of coronary atherosclerosis with yoga lifestyle intervention. J Assoc Physicians India. 2000 Jul; 48(7):687–694.  Abstract available at:  https://www.ncbi.nlm.nih.gov/pubmed/11273502