Dr. Jane Explains

Open This Book & Say "Ahhh"

BMI not a good fit for our presidential candidates Or for you?

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Quite a bit of ruckus has been raised surround political candidates body mass index (BMI). Recently released personal medical records have suggested one of the candidates is overweight based on his BMI, while another may not have released her weight for comparative data. I think you know which one is which.

 

But really, how relevant is the BMI… (and should I have begun this sentence with “But”? My English teacher would have killed me).

 

BMI was developed by scientist, Lambert Adolphe Jacques Quetelet in the 1830’s. BMI estimates your healthy weight by dividing kilogram weight by height in meters squared. For those of us mathematically challenged: just look at the BMI chart (it’s far easier). Normal BMI is between 18.5-24.9.

 

Unfortunately, the measurements are less accurate for people with a lot of muscle like Arnold Schwarzenegger. In his younger years, his BMI was over 31 when he measured over six feet tall and weighed approximately 235 pounds. On the other hand, his waist circumference at prime, may have been around 34 inches (according to some historians). In context to recent guidelines, his waist circumference would have placed him in a normal body mass range.   Men are considered overweight if their waistlines are greater than 40inches. A healthy woman’s waist circumference should measure less than 35 inches

 

A high waist circumference in a strong predictor for increased risk for diabetes, high blood pressure and coronary heart disease. Accordingly, it should be the next “go to” for elevated BMI in men and women as a more sensitive measure for disease risks.

 

Let’s throw in more options for determining good health. Oxford Brookes University scientist found that taking a piece of string which measures the same length as your height, then folding it in half may be the answer. If the folded sting can easily fit around your middle (waist-line), then you are probably a healthy size. Try it out and let me know your thoughts!

 

For our presidential candidates, If obesity is a health concern and the circus-style political show continues, the simple string trick would be an ideal (and most dramatic) way to publicly demonstrate healthy weight on stage at the podium!

Drink responsibly! When too much water can’t be good

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buybooknowcoverThe excessively low sodium level caught my eye as I reviewed her outside labs. Is this correct? Is she ok? A normal blood sodium should range between 135-145 millequivalents per liter (mEq/L); subsequently, a sodium of 123 is deadly. I called my patient immediately.

 

“I feel fine, Dr. Sadler!”, my patient quickly reassured me. She had been on a diet that promoted drinking large quantities of water and she was drinking gup to 2 gallons daily! She denied nausea, vomiting, or dizziness. Most likely, her drop in blood sodium had been gradual and tolerated over time. Luckily, she had requested the diet center draw her blood levels and forward results to me for general review.  Her critically low levels were concerning.

 

Hyponatremia occurs when sodium in the blood is abnormally low. Sodium helps to regulate the amount of water in and around the body’s cells. Severe hyponatremia can cause swelling in the brain.  For most people, a similar drop in sodium similar to “Jenny’s”, could result in seizures, coma, and death.

 

 

However, Jenny was tolerating the dangerously low sodium level only because her levels had slowly dropped over a long course of time. Her body had somehow adapted, but she was teetering near death. The popular diet did not call for oversight by a medical provider.

 

Jenny reassured me she was doing well and that her diabetes was under much better control with her successful weight loss, and that her blood sugars were trending towards normal levels. “That is great!”, I told her as I IMMEDIATELY placed her on TIGHT fluid restrictions. She was told to have someone drive her to the clinic and follow up in a few days.

 

Success. With reasonable fluid restrictions, her sodium was up to 123 two days later, then 128 five days later. We will check my patient again next week, and I suspect she will have normal sodium levels. On the other hand, her sugars have returned to normal since her successful weight loss.

BOTTOM LINE: Water is the symbol of life in Egyptian culture, but water in over-abundance can be problematic. Drink water responsibly.

Spice up your wellness with turmeric!

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Turmeric is the hottest topic among patients suffering arthritis pain. “What do you think, Doc?” and “Is it safe?”, are reasonable questions to ask you medical provider about any new treatment that hits the market. Let’s quickly explore turmeric’s ability to fight joint inflammation and its safety.

Turmeric, a member of the ginger family, is a spice from the root, Curcuma longa. For centuries Indian traditional medicine has used components of turmeric for various illnesses; and most recently, has been added to several health products from joint health to skincare. When you read or hear about curcuminoids, the information is pertaining to components of turmeric which is comprised primarily of curcumin.

 

In many studies, turmeric may benefit people with inflammatory bowel, heart, and autoimmune diseases. Many diabetic conditions have shown promising effects including diabetic kidney disease and small vessel disease.  Depression, Alzheimer’s disease, and skin infection and inflammation may also be improved with turmeric. But how safe is it?

The Journal of Alternative and Complement Medicine 2003 dissected thru six human trials in which the antioxidant, anti-inflammatory, antiviral and antifungal properties of curcuminoids were studied.

 

Between 1125-2500mg of curcumin per day were found to be safe. While higher doses (up to 12 grams per day) for shorter time periods may be considered safe, I recommend sticking with under 2500mg daily unless studies support higher dosing. Always use caution with supplements as mega- high doses of turmeric have been associated with cancer in mice.

 

More information to come as I learn more about turmeric’s medicinal properties. Right now, it is HOT and on the market everywhere; in fact, I found turmeric was one of the key ingredients in my weekly Kiehl’s  face mask. I love it and hope that turmeric lives up to all its touted promises!

Dr Jane Tip of the Day: Lose the bag, lose the weight…

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It is far too easy to eat chips, crackers, etc, out of the bag. Lose the bag! Pour a sensible portion on a small plate. A *blue salad plate seems to be the favorable for people seeking less portions and more weight loss (add blue utensils to magnify the effect!).

 

Good luck and happy, healthy eating!

 

*Boston University 2011 studyDSC_030413442644_10208540232559891_236641808584642566_o

The early bird gets less bugs when it comes to the flu shot!

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“I don’t want a shot!”, is a repetitive theme coming from the tiny cuties in the exam rooms. Trust me Kid, I don’t want to give you a shot, but between me and your parent, there is no running out that door.

For both children and adults, there is never a good time for a vaccination; but, if you had to choose when to get your shot, mornings are best when it comes to fighting the flu virus. Recent information has shown that a flu vaccine given between 9am and 11am increased antibody response four times the level of patients who received vaccines between 3pm and 5pm.

 

For some reason, the immune system generates more protection when the flu shot is given in the morning. A study out of Birmingham, England (Dr. Anna Phillips) studied three different strains of the flu virus in 276 adults age 65 and older and compared morning vaccination to afternoon vaccination times.  For the H1N1 (Swine flu) and B strain antibody responses, there was a significant effect of time of day. Not so much for the H3N2 viral flu strain.  Men and Women were equally likely to show these variations in immune effects and these results could be applied to other immunizations such as hepatitis shots.

Our immune system may simply be more awake to mount responses to vaccines in the early hours. We know there are diurnal (timing) variations of other body chemicals such as the stress hormone, cortisol. These steroid levels are higher in the morning and lower in the evening.

In the U.S. millions of people are sickened by the flu annually.  Several hundred thousands are hospitalized and tens of thousands will die from the flu every year. GET YOUR FLU SHOT ANNUALLY!

Do not expect much support for the kid-friendly nasal FluMist this 2016-2017 flu season. According to last year statistics, the FluMist had a poor performance record and did very little to protect our communities.  As for myself and my kids, we prefer to get our shots early in the morning; that way, the anticipatory flu-shot jitters are less likely to linger.

Put your heart into it! Why you may be “dying “to take a vacation!

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Making the break happen, can be difficult. Between kids schedules, work demands and deadlines, putting on the brakes and taking the summer “va-cay” can put you back on track to better health. Taking vacations could reduce your risk of premature death.

 

A study from Psychosomatic Medicine (2000) studied 13,000 middle-age men over a period of several years. The men with more frequent vacations had decreased all-cause mortality, most notably, heart disease. Among men at higher risk for heart disease, those who missed out on vacations for five consecutive years were 30 percent more likely to suffer heart attacks.

 

Non-vacationing women are  equally  (or more!) at risk for heart disease. But, how much vacation is heart healthy? Two retreats annually may be the lucky number of work “time-outs” for the ladies. Women were eight times more likely to develop heart disease or have a heart attack if they took less than one vacation every six years.

 

Whether it is a stay-cation or a way-away vacation, any time off can be good. Studies find that regular vacationers are less stressed, depressed, and tired; in addition, marital relationships are strengthened with frequent get-away breaks. Be sure to schedule leisure events such as golf, hiking, or other purposeful events (as proven by a study of 900 lawyers). As opposed to just lying on the beach, travel excursions are more likely to result in decreased work stress.

 

Get to your calendar now, schedule time out, and get to our happy and healthy place! Be wary that a stay-cation does not lead to a housework honey-do list. This doctor recommends you get out of town; otherwise your home-place could become your work-place!

I better not sleep thru Better Sleep Month!

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I am sleeping standing up. The dog took up most of my feet space and my husband inched over to the rest of the “me” space. Not that I mind a good snuggle…but can a girl get some sleep around here?  It takes me a while, but then as soon as my sleep-deprived body awakens, Become more clear in my morning thoughts and I remember…I was supposed to blog about Better Sleep Month!  Now that it is May 31st, the month is almost over. But not quite enough over to review the incredible importance of healthy sleep.

According to Dr. Larry Altshuler, director of Sleep Medicine at Cancer Treatment Centers of America, I am not alone in suffering sleep deprivation. Approximately 1/3 of Americans have chronic insomnia and about 74% of people will experience sleep problems intermittently in their lifetime.

A common sleep disorder, sleep apnea is a condition where you may take several pauses or shallow breaths while you sleep. Approximately 90% of people with sleep apnea do not know they have problems with getting enough night time oxygen and therefore do not reach healthy sleep levels.  People with sleep apnea have a 5X increased risk of cancer-related deaths!

If you or your partner are concerned about the quality of your sleep, then a sleep study is a good idea. For mild sleep apnea, an oral device may suffice; however, specific oropharyngeal exercises (taught by a licensed speech therapist) may improve sleep apnea by up to 50%.

Good sleep is NOT over-rated! Sleep deprivation whether due to decreased sleep hours or sleep quality (i.e. apnea) causes decreased alertness, creativity, and overall performance according to Dr. Altshuler.  Adults are not the only ones who suffer sleep disorders. Children with poor sleep habits are crankier and less adaptive to their environments; and, along with adults, are more likely to experience attention deficit. For most adults seven to nine hours (for children) a night is enough sleep.

Quality of sleep may be disrupted by stress and blue-light (electronics) exposure close to bed time. Dr. Altshuler recommends not to use our electronic tablets up to one hour prior to sleep. However, he does agree that the purple or red filters can help negate some of the blue light mal-effects on our sleep (look for these specialized programs available on the App Store).

Conquering poor sleep with a cat nap can be a good idea. NASA scientists found that a quick nap can increase alertness by 100% and improve performance by up to 34%. A 10-20minute power nap is most effective explains Dr. Altshuler. After approximately 30 minutes, people may experience sleep inertia; a sense of grogginess and difficulty overcoming their sleepy state.

Studying in Spain, my daughter is learning all about the siesta. Here, they take nap time seriously but unfortunately they also stay up very late into the evening and therefore do not exude the ultimate sleep health. NPR reports that  the Spanish have some of the highest incidence of work-related accidents in the world and (for many reasons) the siesta may be going the way of the dinosaur.

Not feeling rested in the morning? Turn off electronics, go to bed earlier, consider a sleep study if needed. Still feeling tired? Sleep on it: A short nap could do all of us a world of good!