Healthy Aging: Why genes from our mothers are not enough

shutterstock_593434751.jpgFor Mother’s Day

It’s that time of year when we think of our mothers and reflect upon the gift of life we’ve been given. Indeed, it is the very reason we are on this earth. What makes us unique and one of a kind is in our genes or genetic make up.

It is why family members look alike. It is also why some diseases such as diabetes, cancer or heart disease run in certain families.  These genes are the ones we are born with and cannot change. As a physician, when we assess an individual’s risk for chronic diseases, we take that genetic makeup, that family history into account.

Our genetic make up is a gift from our mothers (and dad’s too), it is not modifiable. There is a no return policy! However, it is often the modifiable risks, the ones we can change, that will make the biggest difference in our lives. For we all want not only to live longer, but also, to live those years in an active and healthy lifestyle, independent and with all our cognitive abilities.

While you may feel those years are some time down the road, it is never too late or too early to start thinking about healthy aging and what that means. It is time to make adjustments in your lifestyle so that you can live a longer and healthier life and act as a role model to your family.

Here are a few healthy aging strategies I counsel my patients to practice

  1. Eat a healthy diet of calcium rich foods such as leafy greens and dairy products or soy-based products if you are averse to dairy. Calcium from food products is ideal and we aim for 1200 mg per day from all sources. If you are eating well, you may be getting enough calcium in your diet and supplements are not needed.  Generally speaking, we all need Vitamin D supplements as we get little direct sunlight in North America and that is the common source of Vitamin D. Take Vitamin D daily–400-1000 IU’s for adults under 50 and 800-2000 IU for adults over 50.  That is a must!
  2. Eat Healthy. Follow the Mediterranean Diet that is rich in vegetables, fruits legumes and lean meats.   Women who eat more vegetables experience less risk of cognitive decline than their peers who eat fewer vegetables. The rate of cognitive declines the lowest in women who eat the most cruciferous vegetables and dark leafy greens. And there is a positive correlation between BMI (body mass index) and the rate of cognitive decline
  3. Exercise.  Use weight-bearing exercises that use your body weight such as walking, running, weight lifting to help to strengthen both bones and muscles, as well as improving your balance. Exercise with purpose. Running up and down the stairs doing laundry is not the same. You need to exercise to raise your heart rate a minimum of three to five times a week for at least thirty minutes to get the most benefit.
  4. Stay Socially Connected. It is important to stay socially active and connected with your friends and family. Doing Sudoku at home alone might be a good brain exercise, but it is not the same as being with people. Research shows that individuals who are socially connected live longer have stimulation to protect brain aging and overall have a better quality of life.
  5. Reduce Stress—Practice Mindful Meditation. While some stress can be a good thing and helps the brain cope with life- threatening situations, too much stress is harmful. If the stress is long term, it can raise the levels of cortisol, leading to weight gain. Chronic unrelenting stress, ages our telomeres, those caps that protect our cells. Mindful meditation and other activities that reduce stress has shown benefits such as an increase in the flow of oxygen rich blood to your brain. It is not only helpful to reduce stress for your emotional well being, it actually has a measurable physical impact.

So on this Mother’s Day and throughout the year, make a promise to yourself and your loved ones to stay healthy and follow the strategies I’ve outlined above. Taking care of yourself is not selfish, it is selfless as you will be there to take care of the ones you love…..and that’s the best gift of all.

Disclaimer

The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

 

 

 

Top Trends in Preventative Health Care – Personalized Medicine

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2016-Science and Technology Increasingly Converge
Part 2

In my previous blog, I have been discussing some of the technological and scientific opportunities in preventative health care. So what does personalized medicine mean?

PERSONALIZED MEDICINE AND GENETIC PROFILING ON THE RISE

Personalized medicine is an emerging practice that uses an individual’s genetic profile to guide decisions about the prevention, diagnosis, and treatment of disease. Knowing a patient’s genetic profile can help doctors select and administer the proper medication or therapy in the correct dose or regimen.
A report by PricewaterhouseCoopers (PwC) highlights that medical science and technological advancements have converged with the growing emphasis on health, wellness and prevention to push personalized medicine to a tipping point. We are now seeing a blurring of the lines between traditional healthcare offerings and consumer-oriented wellness products and services.
I think we need only be open-minded about innovations but also vigilant about expectations and about medical evidence in evaluating these products.

INCREASING USE OF GENOMICS AND OTHER DIAGNOSTICSbigstock-Test-Tubes-in-Science-Research-5143772

What this means is that with the help of genomics and other diagnostics we will increasingly be able to target medical care and identify an individual’s susceptibility to disease to predict how a given patient will respond to a particular drug.

Genetic testing, helping us understand personal risk, may be a wonderful starting point.

Genetic testing will also help eliminate unnecessary treatments, reduce reactions to drugs and increase the efficacy of treatments and, ultimately, improve health outcomes.
In the field of oncology, we do tests on tumors for receptors, as a means of understanding the likelihood of a response to a certain drug. This has become standard for example in breast cancer, learning whether a tumor is hormone sensitive or not, to then decide to treat with a hormone- blocking agent. This is not new. What is new is the arena of testing for prevention, not only for treatment options.

We are also now also seeing the growth of in-home testing of genetic products that are giving consumers information to will enable them to predict better medical risks, detect health issues sooner to manage their health. This early trend will no doubt continue in 2016 and beyond. So let’s welcome new options, but be careful as to medical evidence and expectations.

Disclaimer
The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

 

 

 

 

 

 

Pharmacogenomics: Determining the most effective drug for your genetic makeup.

shutterstock_437357662.jpgGenetic Testing & Drugs
Each person is unique and so is his or her response to certain medications.  Since the mapping of the Human Genome Project was completed in 2003, a new area of study and research has opened up called, Pharmacogenomics, the technology that analyses how genetic makeup affects an individual’s response to drugs—will a drug be helpful for a specific treatment or will it be toxic? Will it help or hinder? Will you be at increased risk for certain side affects or will genetic testing help to avoid a serious adverse drug reaction.

 

Such approaches promise the advent of personalized medicine in which drugs and drug combinations are optimized for each individual’s unique genetic makeup. There are two areas  pharmacogenomics is being applied.  One is in the area of cancer treatment and the other is using genetic testing to determine response to certain medications. In the area of cancer treatment, oncologists may order certain tests that will look at the genetic features of a tumor to assess how the cancer will respond to certain types of treatment and what form of therapy would be best for a particular patient.  This is the only area today that may be covered by health insurance in Ontario.

 

The other use for genetic testing is in the area determining the effectiveness of certain drugs for treatments related to heart disease such Plavix or Warfarin. We have learned that the uniqueness of our genetic makeup means that not all drugs work in the same way for all individuals or it may be hard to get the dose right.   It is not yet common practice in Canada or covered under OHIP, but genetic testing in this area can be carried out privately if your doctor determines it is warranted.  Ideally, Medisys genetic counselor, Katherine Hodson, suggests the test be carried out before a drug such as Warfarin or Plavix is prescribed to avoid adverse reactions and ensure the right dosage.

 

Genetic testing may also be used to determine whether certain pain relievers such as codeine will work well for a given patient.  An individual suffering from chronic pain may not respond to codeine as genetically, that person may metabolize the drug too quickly.  In this case, the patient would need a different medication and of course, given concerns about narcotics and drug seeking, how reassuring it is to have a clear medical answer about different or higher dosing requirements.

 

We are on the cusp of understanding more about genetics, medications, reactions, both good and bad, and that will make prescribing drugs much more personalized, with predictable and better outcomes.

 

#medicine #healthcare #healthy

Disclaimer
The material contained in this blog is for informational and educational purposes. Great efforts have been made to maintain the quality of the content.  However, it is strongly recommended that the treatment/management of any medical conditions mentioned here, should not be used by an individual/visitor of this blog, on their own, without consulting competent persons such as your doctor, or health care provider.   As always we encourage your comments on this blog or any others and hope you will join discussions.

Personalized Medicine –When should you consider genetic testing?

Since the Human Genome project made it possible to map the entire DNA of a human in the 1990’s, it has become a powerful information tool. Learning an individual’s personal genetic make up can lead to improved diagnosis of certain illnesses. We also can advise you, if you are at higher risk because of a disease or condition that runs in your family.  It can help physicians like me make more informed decisions when prescribing medicines.  It is truly miraculous and a continually emerging and exciting field.
Breast cancer, heart disease, type II diabetes, prostate cancer are just a few of the diseases and conditions that can be tested.
However, before you begin the process, I would suggest you discuss your concerns with a qualified genetic counselor.  And that counselor should be certified by the Canadian Association of Genetic Counselors. (
www.cagc-accg.ca)
Sometimes, the first and only step you may need to take, is knowing your family history for a medical condition to be flagged with your counselor.
 For instance, the vast majority of breast cancer cases occur by chance and are not as the result of genetic factors.  Genetic counseling can be incredibly reassuring. Although rare, inherited changes in the BRCA1 and BRCA2 genes, which was the case for actress Angelina Jolie, are linked to a high lifetime risk of breast, ovarian and other specific cancers.  In that case, preventative measures were taken.  And that too is reassuring.
Once you and your counselor decide genetic testing is right for you, all that is needed is a saliva sample to begin the process.
In a future blog, I will discuss genetic testing and medication responses. We are learning how genetic testing can help in prescribing the best medication to treat a condition or disease. And we can tailor medication to specifically treat an individual…. for we all know, it is NOT one size fits all.