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Calcium supplements tied to higher dementia risk for some women

Some older women who take calcium supplements commonly recommended to ward off age-related bone damage may face an increased risk of developing dementia, a small study suggests.

The heightened dementia risk appears limited to women who have had a stroke or suffer from other disorders that affect blood flow to the brain, researchers report in the journal Neurology.

“Our study is the first to show a relationship between calcium supplementation and increased risk for dementia in older women,” said lead author Dr. Silke Kern of the University of Gothenburg in Sweden.

Still, the findings from this observational study don’t prove calcium supplements directly cause dementia, Kern added by email. Even for women who have had a stroke, it’s too soon to say for sure whether it makes sense for them to avoid calcium supplements, Kern noted.

“These findings need to be replicated before any recommendations can be made,” Kern said.

Millions of women take calcium supplements to strengthen bones made brittle by osteoporosis, a bone-thinning disorder that typically develops starting during menopause when the body slows production of new bone tissue.

For the current study, Kern and colleagues examined data on 700 women between the ages of 70 and 92 who didn’t have dementia.

At the start of the study, and again five years later, women did a variety of psychiatric and cognitive tests including assessments of memory and reasoning skills. A subset of about 450 women also got brain scans.

When the study began, 98 women were taking calcium supplements and 54 participants had already experienced a stroke.

During the study, 54 more women had strokes, and 59 women developed dementia. Among the women who had brain scans, 71 percent had so-called white matter lesions, which are signs of mini-strokes and other disorders that affect blood flow to the brain.

Overall, women who took calcium supplements were twice as likely to develop dementia as their peers who didn’t, the study found.

But the increased risk appeared limited to people who had a stroke or other signs of existing cerebrovascular disease.

For women with a history of stroke, the dementia risk was almost seven times higher if they took calcium supplements than if they didn’t.

When women had white matter lesions that can be a precursor to strokes, the dementia risk was three times greater when they took calcium supplements.

Among women without a stroke history or white matter lesions, however, there wasn’t any increased dementia risk associated with calcium supplements.

Beyond its small size, other limitations of the study include the lack of follow-up brain scans at the end of the study, which made it impossible for researchers to assess how calcium supplements may have influenced the development of white matter lesions or silent strokes.

In addition, the study didn’t look at how much calcium women got in their diets, which can affect the body differently than supplements and is thought to be safe or even protective against blood flow problems, the authors note.

“Women and the public need to realize that when we talk about micronutrients –calcium included – and cognitive functioning, we need to consider that the combination of nutrients will be more predictive than one nutrient,” said Dr. Neelum Aggarwal, a researcher at Rush University Medical Center in Chicago who wasn’t involved in the study.

“For example, calcium, phosphorus and magnesium all are typically looked at for their effects on multiple organs, and cognitive functioning will be affected most likely by a combination of these nutrients,” Aggarwal added by email. “To say that only one nutrient increases the risk of dementia is premature and more studies need to look at a combination of nutrients.”

source: Reuters Health
http://www.reuters.com/article/us-health-women-calcium-dementia-idUSKCN10S26L

Know the right doctor for your illness

If you don’t feel well, do you know which doctor to go to? I know a lot of patients are confused as to what kind of doctor to visit for their symptoms.

As a general rule, you can first consult a family medicine practitioner or a general practitioner for your medical concerns. And if your case needs it, you will be directed to the right doctor.

Thus, I’m giving you a rundown of some specialties of doctors and a short description of what they do. This is just a partial list.

• Allergologist. If you have problems with allergy, constant runny nose, sneezing, coughing or rashes that just come and go, see an allergologist.

• Cardiologist or heart specialist. If you have chest pains, heart disease, high cholesterol or high blood pressure, you need to see a cardiologist. There are several kinds of cardiologists. A general cardiologist diagnoses and treats diseases of the heart and blood vessels in adults. A pediatric cardiologist treats heart disease in children. They are the experts in congenital heart diseases, like if a baby is born with a hole in the heart. If you need an angiogram or an angioplasty, you need to see an interventional cardiologist.

• Cosmetic surgeon. Well, this line of work needs no explanation. If you want to be beautiful, have your eye bags removed, and turn back the years, this is the doctor you need.

• Dermatologist. For skin problems, removing unsightly blemishes and warts or hair removal, you need to see a dermatologist.

• Ear, nose, throat specialist. For ringing ears, dizziness, deafness and, sometimes, objects stuck inside the ear, see an ENT specialist. ENT doctors are experts, too, in nose bleeding, polyps, mouth sores, and tonsillitis.

• Endocrinologist. Think diabetes, fatty foods, and obesity. Also add problems like goiter and hyperactive thyroid. You need the diabetes experts, the endocrinologists.

• Gastroenterologist. I guess you know that gastro doctors treat ulcers, abdominal pains, and constipation. But they’re experts in problems of the liver (like hepatitis), gallbladder, and pancreas, too. Gastroenterologists are the ones who perform a proctosigmoidoscopy and colonoscopy to rule out colon cancer.

• Infectious disease specialist (IDS). For prolonged fever and difficult-to-treat infections, ranging from dengue, swine flu and typhoid to sexually-transmitted diseases, you need the IDS experts.

• Nephrologist or kidney specialist. If you have urinary problems or swelling of the feet, you should see a nephrologist. Nephrologists handle all matters related to kidney diseases, including kidney failure, dialysis, and kidney transplants.

• Neurologist or brain specialist. If you have persistent headache, dizziness, or tingling of the hands and feet, you should see a neurologist. They’re the experts in diseases of the nervous system, the brain, spinal cord, and nerves.

• Obstetrician and gynecologist. They provide care during pregnancy, childbirth, and also treat conditions of the female reproductive system. There are some doctors who train in oncology and gynecology combined (the gyne-onco), which makes them the experts in treating masses and cancers of the uterus, cervix, and ovaries.

• Oncologist or cancer specialist. This line needs no explanation. They’re the cancer experts.

• Ophthalmologist or eye specialist. Is this article blurry or foggy? For any problem related to the eyes, see your ophthalmologists who are the experts in cataract, glaucoma, and red eyes.

• Pediatrician. These kid specialists take care of patients from birth through their teenage years, maybe until they’re 15-16 years old. Everyone needs a pediatrician, at one time in their lives, for vaccines and check-ups.

• Psychiatrist. A psychiatrist treats depression, anxiety disorders, and mental illness. They handle drug addiction problems, alcoholism, and relationship/emotional problems, too. And don’t worry, majority of their patients are not mentally ill. They’re really a pleasure to talk to.

• Pulmonologist or lung specialist. Have difficulty breathing? Coughing out phlegm? Smoking every day? Losing weight? See a lung specialist before it’s too late. Pulmonologists also treat asthma, allergies, and those with sleep apnea.

• Rheumatologist: A rheumatologist specializes in arthritis problems. Any joint, bone, and muscle pain is within his field of expertise, too.

Here are the surgical specialties:

• Cardiothoracic surgeon. A heart bypass, fixing an aortic aneurysm, and removing a mass in the lung are jobs that belong to cardiothoracic surgeons who perform these delicate and difficult operations within the heart and chest area.

• General surgeon. A general surgeon diagnoses and removes diseased organs such as the appendix, gallbladder, thyroid, breast masses and other cysts.

• Neurosurgeon. Brain tumors, brain aneurysms, spinal nerve problems are all delicate operations reserved for the steady, deft hands of our neurosurgeons.

• Orthopedic surgeon. For bone problems like fractures, osteoporosis, and various bone-related aches and pains, see your orthopedic surgeon. They also handle hip and knee problems, especially those injuries related to sports.

• Plastic surgeon. This miracle worker repairs the physical defects of our skin, muscles, face, extremities, breast and external genitalia.

• Urologist. Here’s the favorite doctor of guys above 50. They’re the experts in impotence, prostate problems, and sex concerns. All your secrets are safe in the office of your favorite urologist.

There are many more important specialties and fields in medicine (such as rehabilitation medicine, geriatric medicine, anesthesia, colorectal surgery, bariatric surgery, alternative medicine, public health medicine, and many more). Maybe in the future, I could write a second part to this article.

Finally, for your medical problems, my advice is to look for PRC-board certified doctors and you can’t go wrong. More power to all our Filipino doctors!

source: Philippine Star
http://www.philstar.com/health-and-family/2016/08/16/1613748/know-right-doctor-your-illness

If you want to lose weight, don’t diet

I do not advocate crash dieting as a weight reduction strategy because—as you yourself can attest to—it is fairly easy to lose as much as 25 to 30 lbs. in a rather short time by severely limiting ones food intake, but it is hard to keep the weight off. This is because dieters revert to their old eating habits soon after they stop their “crash diet.” Sooner or later, people like you who keep trying to reduce by crash dieting acquire the vicious habit of yo-yo dieting, i.e., cyclical loss and gain of weight by crash dieting.

What yo-yo dieting does to your body

Each time you go on a crash diet, you are at risk of developing fluid and electrolyte imbalance and protein, calorie, and micronutrient deficiency, which could compromise and irreparably damage your vital organs. Furthermore, some studies suggestthat yo-yo dieting may increase your risk for certain health problems including high blood pressure, high cholesterol, and gallbladder disease.

What you need to do to lose excess weight permanently

If you wish to lose weight permanently, do not crash diet. Instead, adopt these two lifestyle measures: shift to a maintenance diet and increase your physical activity level. Remember, however, that the key to a desirable body weight is discipline—the ability to practice these suggested lifestyle changes religiously.

Determining your maintenance diet without counting calories

Your maintenance diet refers to the food regimen that will bring your weight down to your desirable level then keep it there. If you are overweight, how do you determine your maintenance diet?

Very simple, first find out the percentage of body weight you want to eventually lose. For example, if you are 150 lbs. now and would like to go down to 120 lbs. you need to lose 30 lbs. or about 15 percent of your body weight. Hence, your maintenance diet equals your current diet minus 15 percent. This simply means that every meal time, you must set aside, for all food items, what you think is about 15 percent of what you used to take. If you are able to religiously do this, you will notice that you will gradually lose weight and that over a period of a several months you will go down to 120 lbs. Why? Because your maintenance diet can only sustain a 120-pound body and consequently, the fat cells that are responsible for you excess weight will gradually shrink. By the way, whenever you get hungry during the first few days to weeks of your maintenance diet, you can eat as much boiled leafy vegetables as you want. Once you have attained your desirable body weight there is no need to change your diet, because you are already on your maintenance diet in the first place.

Why you should exercise

To give some flexibility to your “maintenance” diet, you need to increase your physical activity. This will enable you to occasionally indulge yourself with your favorite dessert.

A regular exercise program that has aerobic value will go a long way in maintaining your desirable body weight because aside from increasing your energy expenditureit will also increase your basal metabolic rate. An exercise program has other benefits too—it will keep your muscles and cardiovascular system in shape. There are many exercise activities with high aerobic value (jogging, swimming, aerobic dancing, etc.) but I suggest you choose one that you find enjoyable so you don’t get bored doing the activity day in and day out.

source: Manila Bulletin
http://www.mb.com.ph/if-you-want-to-lose-weight-dont-diet/

Senior drivers taking opioid painkillers have higher crash risk

Seniors who get behind the wheel soon after starting to use narcotic pain relievers have twice the risk of getting into a serious car crash as their peers who use non-opioid painkillers, Swedish researchers say.

Senior drivers who’d been using opioid painkillers regularly for several months also had higher odds of getting into accidents, but not as high as the new users did, according to Joel Monarrez-Espino of Karolinska Institute in Stockholm and colleagues.

Their study included 4,445 drivers between the ages of 50 and 80 who had been involved in a single car crash between 2005 and 2009 in which at least one person suffered an injury that required medical care, plus more than 17,000 similar drivers who had not been in crashes.

As reported in the journal Age and Aging, study participants were considered new to opioid painkillers if they had been given a prescription within one month before the crash. Regular users were those given at least three prescriptions in the last six months, with at least one prescription within a month of the crash.

“New, but also frequent opioid analgesic use, resulted in an increased probability of single vehicle crashes,” the research team wrote.

Specifically, the risk was 100 percent higher for the new opioid users, and 60 to 70 percent higher for the regular users, compared to the risk in people of the same age taking one or two non-opioid painkillers.

“While more epidemiologic evidence is needed, patients could be advised to refrain from driving when using opioid analgesics,” the authors wrote.

They did not respond to a request for comment.

Whether the “regular users” in this study had a lower risk because their bodies were accustomed to the opioids is hard to know, said Dr. Thomas Meuser, a specialist in aging at the University of Missouri who was not involved with the study.

“The study doesn’t show if the participants took their medications consistently,” Meuser told Reuters Health by phone.

“Another reason for the drop in risk (among regular users) could be that some stopped or reduced taking their medications due to side effects, even though they continued being prescribed,” said Meuser.

Paul Atchley, who studies the human brain, vision and attention to driving at the University of Kansas, told Reuters Health the findings should serve as a wake-up call for doctors to have better conversations with their patients about the true risks of taking these medications.

“Driving is the riskiest thing we do on a daily basis,” said Atchley, who wasn’t involved in the study.

“We need to understand what’s at risk, so that we as drivers can make better choices,” he said.

“What’s unique about this study isn’t just painkiller use, but the pattern of use,” Atchley pointed out.

The risk of being injured or killed in a car crash increases with age, according to the Centers for Disease Control and Prevention (CDC).

Meuser noted that older adults generally have more diagnoses and take more medications than younger adults. “There’s always a risk for side effects for someone taking five or more medications,” he said. “Side effects that affect the brain and nervous system are especially worrisome for older drivers.”

source: Reuters Health
http://www.reuters.com/article/us-health-seniors-driving-idUSKCN10N28E

Briefly standing, or being active, reduces blood sugar across the day

For obese people who sit for most of the day, replacing some sitting time with standing, slow walking or slow cycling reduces average blood sugar across the day and into the night, a small study finds.

“Anything you can do to bring down glucose readings throughout the day is a good thing,” said senior author Glenn Gaesser of the School of Nutrition and Health Promotion at Arizona State University in Phoenix. 

“We chose a typical workday because a large number of Americans spend a lot of time sitting at an office desk, and a number of (studies) indicate sitting is a health hazard, so we reckoned that trying to alleviate that by either standing or walking or cycling would help,” Gaesser told Reuters Health.

The researchers studied nine overweight or obese adults who wore continuous blood sugar monitors and blood pressure monitors during their regular, mostly-sitting eight-hour workday. One week later, participants gradually replaced some of that sitting time with standing, in intervals of 10 to 30 minutes for a total of two and half hours per day.

The following week, the same amount of sitting time was replaced with walking at a treadmill desk at a pace of one mile per hour. In the fourth week, the intervals were spent cycling on a stationary bike retrofitted to a workstation, also at an extremely slow pace with low energy expenditure.

Average 24-hour glucose was lower for standing and walking than for sitting, and was lowest on the cycling days, the researchers report in Medicine and Science in Sports and Exercise.

There was a similar pattern during the hours right after eating and even during overnight hours, with people having sustained lower blood sugar overnight after days they had cycled.

This is “not wholly surprising," because other research in the last few years has shown that breaking up prolonged sitting has benefits on glucose over the course of a day, said Dr. Daniel Bailey of the University of Bedforshire in the U.K., who was not part of the study.

It’s uncertain if the difference in blood sugar would have clinical significance or reduce metabolic risk, but that would be more likely for walking and cycling than for standing, which only resulted in a small reduction, Bailey told Reuters Health by email.

“Studies with larger groups would be needed before we could say these findings would apply to overweight people in general,” he said. But it’s likely that overweight or prediabetic people may benefit more from breaking up periods of sitting than healthy-weight people, he said.

“We found that the overall reduction in blood sugar throughout the 24-hour day was typically 5 percent to 12 percent, with the greatest effect being in cycling,” Gaesser said.

After a meal of carbohydrates, most blood sugar is disposed of in skeletal muscle, and muscle contractions increase insulin activity and glucose uptake, which helps to lower blood sugar, he said.

“For low-level activity throughout the workday, the effect lasts well after the last exercise bout at 4:30 or 5:00 in the afternoon,” continuing into sleep, he said.

Breaks in sedentary time are good, even if you don’t have access to a walking or cycling workstation, Gaesser said.

source: Reuters Health
http://www.reuters.com/article/us-health-activity-glucose-sitting-idUSKCN10N21R