New Guidelines for Zika Virus & Travel

Zika Florida inforgraphic 1200x628Canada’s Public Health Agency issued a travel health notice recommending that pregnant women avoid traveling to countries or areas where the mosquito-borne Zika virus has been found which includes popular destinations for Canadians, including Cuba, Mexico, the Bahamas, and Jamaica.

http://https://www.facebook.com/CTVNewsChannel/videos/1325413534186641/

My New Year’s Resolution– Is NO New Year’s Resolutions!

ChrisKornackiI will be honest; my issue is not wanting to exercise or take the time to work out. I have a very busy schedule and find it hard to fit in.   Although I know and talk about the importance of exercise and healthy aging, internally I find it hard to schedule.  I tell myself that’s because of work. However, enough is enough. I need to make this a priority.

So before the holidays,  I decided to make a commitment, set a reasonable goal and act on it.  For me, creating the challenge and then living up to it is always satisfying and I feel energized by the effort. This led to rearranging my work schedule, book with a trainer and just do it!  No more excuses.So my journey has begun.  I am meeting weekly with Chris, a young, bright,

So my journey has begun.  I am meeting weekly with Chris (pictured above), a young, bright, well-educated trainer in charge of TOTUM, the fitness facility in the Medisys location where I work on Thursdays.  I, therefore, changed from business attire to workout clothes and walked into a beautiful new facility for my assessment. Intimidating? YES. Important? YES. Part of my routine, well, I am trying to keep that focus and have booked a month of appointments, even pre-paying for them so I am less likely to cancel.

How am I doing? So far, less intimidated and starting to feel more positive. Not yet stronger or healthier, but it is early. I will let you know how it goes.

So, whether your goal is healthy eating, exercise or getting more sleep, don’t make a New Year’s resolution. Instead, dig deep within yourself for the answers and take responsibility. Be honest with yourself and you may just find the best resolution 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.

Pneumonia deaths are increasing. Protect yourself and your family.

shutterstock_561346174.jpg1500 adults die from pneumonia in Canada every year. We are in the midst of a rough flu season similar to 2014-2015, where many outbreaks occurred and are likely to continue throughout the winter.   So I would like to remind you of the importance of immunization and flu shots and adult pneumonia. Pneumonia is an infection of the lungs and needlessly affects millions of people worldwide each year that can cause mild to severe illness in people of all ages. Common signs of pneumonia can include a cough, fever, and trouble breathing.

We are in the midst of a rough flu season and I can’t emphasize enough how important it is to get a flu shot.  I also want to talk about immunization and pneumonia.  In Canada, only 16.7% adults with chronic medical conditions are immunized against Streptococcus pneumonia. That’s right –only a small percentage of Canadians are immunized. As a result, there is a dramatic increase in the number of people who get the disease and about 1500 Canadian adults die from it every year.

Who Is At Risk for Pneumonia?

People who are more likely to become ill with pneumonia:

  • Adults 65 years or older
  • Children younger than 5 years old
  • Those  who have underlying medical conditions (like asthma, diabetes or heart disease)
  • People who smoke cigarettes
  • People with immune suppression diseases, such as HIV, leukemia, and other cancers

However, Pneumonia can often be prevented and can usually be treated. Many of these deaths——could be prevented with vaccines and appropriate treatment (like antibiotics and antivirals).

Vaccination is the best way to prevent the disease or lower your risk while reducing the risk of the general population coming down with pneumonia.

Pneumococcal Recommendations for Older Adults
There are two different types of pneumococcal vaccines for adults and guidelines are NOT the same in the US and Canada.

  • US Guidelines: One dose of PCV13 is recommended for all adults 65 years of age or older who have not previously received the vaccine. A dose of PPSV23 should be given at a later date (anytime after 8 weeks from the initial vaccine)
  • Canadian Guidelines: Currently differ for those of us that are 65 and healthy, or those with significant underlying disease. Healthy 65 year old adults are advised to simply take PPSV23. Those with higher risk would follow the guidelines of both vaccines
  • Recently the Canadian government included vaccinations for individuals that required medical attention for asthma in the past 12 months.

Pneumococcal Recommendations for Children

  • Children with asthma younger than 18 years should receive both vaccines

What you can do

  • Encourage friends and loved ones with certain health conditions, like diabetes and asthma, to get vaccinated.
  • Make sure children get vaccinated
  • Practice good hygiene; wash your hands regularly or use alcohol based hand sanitizers
  • Don’t some
  • Keep your immune system strong-get enough sleep, exercise regularly, and health a healthy diet

 

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.

 

Exercises that Help To Maintain or Build Strong Bones

shutterstock_451265800Osteoporosis can strike at any age and affects both men and women.

Osteoporosis is often known as “the silent thief” because bone loss occurs without symptoms.  It is sometimes confused with osteoarthritis because the names are similar. Osteoporosis is a bone disorder, with a loss of the normal strength and quality of the bone, as well as a decrease in bone mass. Osteoarthritis is a disease of the joints and surrounding tissue, often described as wear and tear of a previously normal, smooth joint.  *

Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the removal of old bone.  The bones become weak and brittle making them more fragile and at risk of a fracture. (broken bones) Even a minor fall can have a significant impact –leading to a broken hip, spine, wrist or shoulder (the most common areas at risk)

Exercise is part of a healthy bone strategy

Weight bearing

We all know and understand how important exercise is for heart health. But it can’t be emphasized enough how important regular weight-bearing exercise is for bone health, too.  Weight bearing exercise is when you use your body weight in activities such as walking, running and weight lifting. The result is that weight bearing exercises help to develop more bone mass.   Brisk walking, dancing, tennis, and yoga have all been shown to help your bones become denser.  It will also improve your balance and strength, which could help to prevent falls.   But what about biking?   It’s good for your heart and lungs but is not considered weight-bearing, when you are seated.

Look at it this way.

It is recommended that you walk between three to five miles a week to help build or maintain healthy bones.  If we assume it takes between fifteen or twenty minutes to walk a mile, then spending between seventy-five to one hundred minutes a week (out of ten thousand and eighty minutes in a week) is minuscule compared to the enormous benefits you will reap.

Resistance Training

Resistance means you’re working against the weight of another object. Resistance exercise includes free weights or weight machines, water exercises that make your muscles work harder and resistance tubes— incorporated into your regular exercise regime two to three times a week will help build or maintain bone mass.

Stretching and Flexibility

Having flexible joints is another important aspect of help to keep osteoporosis at bay. Regular stretching, yoga, and Pilates are some of the ways you can ensure your joints stay lubricated and flexible.

There are of course other aspects to maintaining good bone health such as eating a healthy diet and ensuring you get enough calcium and vitamin D, but that’s a subject for another blog.

The important thing to keep in mind is that staying active, exercising and stretching are very effective strategies to help prevent osteoporosis.  And even if you have osteoporosis you can still make improvements by exercising.

Disclaimer

The material contained in this blog is for informational and educational purposes. Considerable 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.

 

 

* Source Osteoporosis Canada. Speaking of Bones. 2006.

 

 

Caution: Calcium Supplements Might Hurt Your Heart!

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I have long been an advocate of getting your vitamins and minerals from food rather than relying totally on vitamin and mineral supplements.  For instance, a 3-ounce serving of salmon is 208 milligrams of calcium, a glass of orange juice fortified with Calcium and Vitamin D is 320 milligrams—the daily requirement, for menopausal women, according to Osteoporosis Canada is 1,200 mgs per day.

While it’s desirable to eat a balanced diet, for many in this fast paced world, it is just not possible. And that’s where supplements come into play. Canadians are huge buyers of supplements paying an estimated $374 million a year.

 However, some supplements may actually be harmful, especially calcium.  A recent study, released by the Journal of the American Heart Association, backs up what many experts already claim about calcium supplements.  That too much calcium from supplements rather than from food can lead to plaque buildup in arteries which will affect your heart.

It’s not clear why.  According to a nutrition professor at the University of North Carolina, that worked on the study, “there is clearly something different in how the body uses and responds to supplements versus intake through diet that makes it riskier.”

The study team looked at 2,700 people taking part in a larger survey. They had filled out questionnaires in 2000 and got CT scans— in 2000 and again in 2010. These CT scans can assess and visualize whether calcium-heavy deposits are building up in the arteries.

Those who ate more than 1,400 milligrams of calcium a day were 27 percent less likely to this buildup than the others, the study found.

But when they looked at the source of calcium, they found those who took supplements were more likely to develop the blockages.

People who took calcium pills were about 22 percent more likely to develop dangerous buildups called plaque in their arteries than people who did not take them, according to the research.

But people who also ate a lot of calcium in food seemed to be protected, according to the team at Johns Hopkins University

The daily recommended intake of calcium is 1,000 -1500 milligrams a day.  What I do, is total up the amount of calcium I have in a day, whether it’s from a latte, yogurt or hard cheese and then top it up with a calcium supplement, only if needed, to reach my daily requirement. That way I am assured I am not overdoing it and creating a problem where none should exist.

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.

 

 

 

 

 

 

 

 

Five simple ways to help you fall back into a healthy routine

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Dr. Stacy Irvine, Bsc. Kin, M.Sc., D.C., C.S.C.S is a Health and Exercise Specialist and Chiropractor in Toronto and owner of Totum Life Sciences a leader in fitness and rehabilitation in Toronto.   Totum will be opening a fitness centre at our Medisys Toronto Offices on the 15th floor of 333 Bay Street in October.

I asked Stacy to suggest ways now that summer is over, to help us get back into a healthy routine. Here are her top suggestions.

That’s it! Summer is officially over. As sad as this sounds, for most of us, there is a small part of our brain that will welcome the return to a more structured routine. We will all miss the wonderful freedoms of summer, but those late nights, delicious cocktails, dockside burgers, and adventure-filled travel can disrupt many of our healthy habits. During the summer months, our sleep patterns are often altered, we usually eat a bit more and drink a bit more, and we skip our usual workouts because we are travelling. All of these changes to our routine may even add to our emotional stress.

The time has come to get back on track and set ourselves up for the success that comes with starting out the fall on a great plan. Here are five simple steps to get you started on the right path.

  1. This fall, make your exercise time a priority by booking it into your schedule now and putting it on repeat. Too often we book all of our family and work activities first and then leave our workouts to last. This is not as effective. Carve out the time and the activities right now and let everyone know that you are booked during these times.
  1. Set up your training program to get you the BEST results possible. A great exercise program contains areas that develop your physical strength, your cardiovascular fitness, and your overall mobility. Too often we find one activity we like and then we just repeat that activity over and over and over and over. Then we get an “overuse” injury and wonder why that happened! This fall I want you to include a variety of activities that help you work on all of these areas. Lifting weights is a wonderful way to build your strength.   Cardiovascular activity is usually easy to figure out because any sport or movement that elevates your heart rate for approximately 45 minutes will qualify. Mobility training can be a challenge for many people. You could sign up for a class that focuses on mobility such as Yoga, Pilates or the new trend of Kin Stretch. Another option for mobility would be to spend approximately 15 to 20 minutes working on this after your cardio workout. However, you want to sort this out, do it now and make it a priority in your schedule.
  1. Eliminate two unhealthy foods from your regular diet and add two new healthy items. Small changes to our usual eating patterns are easier to manage and will result in long-term successful changes. If you are unsure about how to do this or if you do not feel comfortable making these types of choices, fall is a great time to book a session with a nutritionist to see what you can improve.
  1. Make sleep a priority. Get back on a regular sleep schedule and practice the best sleep hygiene you can. This means getting your screens out of your bedroom, making sure your sleeping area is dark and cool, and giving yourself enough time to regularly get 8 hours of sleep per night. Without proper sleep, you will have an extremely difficult time meeting your other health goals.
  1. Pick your top three health related goals and write them down in an email and send them to yourself. You should re-visit and re-read these goals often. This is easily done by hitting forward on that email and sending it to your mailbox again and again. You could also add an inspirational quote or photograph to this email. Whenever you are feeling frustrated about a lack of time for training, or a bad night of sleep, search up this email and re-read it to get back on track.

These five steps are so simple and they do not require a ton of time. Do them now before your fall schedule gets completely out of hand and you find yourself preparing for Christmas.

Thank you, Stacy, all useful and practical suggestions.

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.

Exercise & Brain Health

shutterstock_492750550.jpgExercise is an important component of health aging especially when it comes to brain health. While there are no guarantees a healthy lifestyle will prevent dementia or Alzheimer’s, exercise will absolutely improve blood flow to the brain. Because as we age, the brain shrinks! It happens to everyone. As we age, our blood supply to the brain is reduced, which causes the volume of the brain to shrink. If you exercise, the blood supply to your brain will improve blood flow and increase your brain volume, which can slow the brain aging process.

Studies show that exercise, meaning exercising with purpose, increases the level of Brain -Derived Neuro-Tropic factor (BDNF), which is critical for neuroplasticity. (The ability for the brain to adapt) Exercise is also associated with the growth and creation of new brain cells which helps increase the volume of your brain.

Sustained aerobic exercise is not to be taken lightly or put off for another day, as brain function and cognition are essential in maintaining an independent and healthy life.

So what exercises are the best?
Studies indicate that thirty minutes of sustained aerobic exercise such as running every day will increase brain health, neural plasticity, brain function and cognition. That’s the BDNF factor I was referring to earlier.   For most of us, seven days a week is a big commitment and may not be practical or achievable. However, one can set a reasonable weekly goal. The objective here is to circulate more blood to the brain that will, in turn, increase the volume of the brain to prevent early dementia.
What about weight training or interval training? Both are good for you and other parts of your body such as your muscles, but there is no indication that it positively affects your brain the way aerobic exercise does.

 Proof that Exercise is good for the brain
Take a look at the  diagram below. The brain on the right lights up after activity.

brain-benefits-exercise
Lots of women say to me, “ Yes, I know Dr. Brown exercise is really important but I just don’t have the time. “ What they are really saying to me is ‘exercise is not my priority’. I understand that. Exercise may not be your priority as you run from the carpool to take care of elderly parents and to finish your work. But if exercise is never your priority, if you are always last on your list and you will pay a huge price.

So my advice is that you allow yourself to be your priority at least part of the time.Let’s remember, when the flight attendance explains that when the oxygen comes down, put the mask on yourself first and then on the child beside you. If you don’t take care of you, you won’t be here to take care of the others you care about!!

 

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.

 

 

 

Osteoarthritis: A rising epidemic as baby boomers age. Signs, Symptoms and Solutions.

shutterstock_274164731Arthritis consists of more than 100 different conditions, which range from relatively mild forms of tendonitis and bursitis to crippling systemic forms, such as rheumatoid arthritis. The common denominator for all these conditions is joint and musculoskeletal pain, often as a result of an inflammation of the joint lining.
Critical to the outcome of the disease is an early diagnosis as it only gets progressively worse.  And therapies work best when started as soon as possible.

Consider this:
• Over four million Canadian adults have arthritis, and the numbers continue to grow.
• By 2036 it’s estimated that almost one in five Canadian adults will have arthritis, an irreversible degeneration of the bone.
• Two out of three Canadians affected by arthritis are women
WHAT CAUSES OSTEOARTHRITIS?
Osteoarthritis starts when the cartilage, that tough elastic material that covers and protects the ends of bones that act as a cushion-like shock absorber, starts to break down and wear away. Joints become bigger as the body tries to heal itself, and bones begin to rub together, leading to pain, stiffness, and swelling. As we get older, our risk of developing osteoarthritis increases. Other risk factors include obesity, a previous joint injury and a genetic predisposition that researchers believe may have something to do with the shape of your bones and the way they fit together.

SIGNS AND SYMPTOMS
Understanding the signs and symptoms as well as treatment options can help to slow the progression of the disease which is an important step in living with Osteoarthritis:

Common signs and symptoms
• PAIN
• STIFFNESS
• JOINT DEFORMITY
• JOINT INSTABILITY
• LIMITED RANGE OF MOTION

TREATMENTS
Treatments are divided into non-medical therapies such as physiotherapy, occupational therapy, bracing and splinting, education, weight loss and exercise. All of which can lead to improving function and biomechanics. Dietary supplements including chondroitin sulfate and glucosamine can be taken up to three times daily in doses of 400 mg and 500 mg respectively. While the medical evidence for these products is inconclusive, most rheumatologists do not feel they do harm and may, indeed, be helpful.
Depending on the severity, medical treatments may involve the use of acetaminophen anti-inflammatories (NAISD’s), topical non-steroidal naproxen, opioid analgesics such as codeine or morphine under careful doctor supervision. Joint injections with corticosteroids or hyaluronic acid for knee osteoarthritis can also be used. The most invasive option is joint replacement involves surgery.
Whatever your condition and treatment goals, it is important to heed the signs and symptoms and take action as soon as possible because osteoarthritis while not curable, is manageable, with the goal of keeping you active, engaged in activity, and pain free.

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.

The Sleep Revolution

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I just reviewed Arianna Huffington’s important book on Sleep, The Sleep Revolution. Transforming your life, One Night at a Time. Let’s take a look at what she has to say. According to Ms. Huffington, the co-founder and editor in chief of The Huffington Post, we are in the midst of a sleep deprivation crisis. She says that sleep deprivation is having profound consequences – on our health, our job performance, our relationships, and our happiness. What is needed, she boldly asserts, is nothing short of a sleep revolution.  Only by renewing our relationship with sleep can we take back control of our lives. (1)

A report by The World Sleep Association bears this out. The report claims sleep deprivation is a worldwide epidemic. This is also true in Canada, where the majority of Canadians –60% of us only get an average of 6.9 hours of sleep per night. — The experts recommend an average of 8 hours.

WHY IS SLEEP IMPORTANT
Sleep is necessary for our nervous systems to work properly. Too little sleep leaves us drowsy and unable to concentrate the next day. It also leads to impaired memory and physical performance. Without sleep, neurons may become so depleted in energy or so polluted with byproducts of normal cellular activities that they begin to malfunction. Sleep also may give the brain a chance to exercise important neuronal connections that might otherwise deteriorate from lack of activity. (2)
Why then, when it has been conclusively shown that sleep is an absolute necessity in keeping ups healthy and happy do we continue to discount sleep as a priority?
Ms. Huffington’s extensive research concludes that as a culture “we tend to dismiss sleep as time wasted—and a badge of honor—even though it compromises our health and our decision-making and undermines our work lives, our personal lives — and even our sex lives.”
Her book explores all the latest science on what exactly is going on while we sleep and dream.  She takes on the dangerous sleeping pill industry, and all the ways our addiction to technology disrupts our sleep. She also offers a range of recommendations and tips from leading scientists on how we can get better and more restorative sleep, and harness its incredible power.

Here are Ms. Huffington’s twelve tips for getting a good night’s sleep. Doctors refer to this as sleep hygiene.

  1. Create a bedroom environment that’s dark, quiet, and cool (between 60 and 67 degrees).
  2. Turn off electronic devices at least 30 minutes before bedtime.
  3. Don’t charge your phone next to your bed. Even better: Gently escort all devices completely out of your room.
  4. Stop drinking caffeine after 2 p.m.
  5. Use your bed for sleep and sex only—no work!
  6. Keep pets off the bed (sorry, Mr. Snuffles).
  7. Take a hot bath with Epsom salts in the evening to help calm your mind and body.
  8. Wear pajamas, nightgowns or even a special T-shirt—it’ll send a sleep-friendly message to your body. If you wore it to the gym, don’t wear it to bed.
  9. Do some light stretching, deep breathing, yoga, or meditation to help your body and your mind transition to sleep.
  10. Choose a real book or an e-reader that does not emit blue light, if you like to read in bed. And make sure it’s not work-related: novels, poetry, philosophy—anything but work.
  11. Sip chamomile or lavender tea to ease yourself into sleep mode.
  12. Write down a list of what you’re grateful for before bed. It’s a great way to make sure your blessings get the closing scene of the night.

I try to keep to a regular sleep schedule- going to bed at the same time every night or close to it and waking up in the morning, generally at the same time. It helps my body and mind ready itself for sleep the same time every night. As with anything else establishing a new health pattern takes time, so don’t be discouraged.

Sources

  1. The Sleep Revolution. Transforming Your Life, One Night at a Time by Arianna Huffington. Harmony Books, an imprint of Crown Publishing Group, a Division of Random House LLC, New York.
  2. Source- Mental Health Canada

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.

 

 

Is Life Expectancy Heading Downward?


shutterstock_309649415 (1)Have we reached the tipping point?

An interesting article recently appeared in the prestigious Journal of American Medicine Association (JAMA) about life expectancy and death rates in the US. The Centres for Disease Control and Prevention in the US (CDC) noted that death rates for the first nine months of 2015 increased significantly most notably due to obesity. Leading some to predict that life expectancy would decline in the United States by the middle of the 21st century.
The CDC report suggests that a “tipping point may have been reached beyond which technological advances may no longer compensate.” The article goes on to point out that between l961 and l983, life expectancy increased in a relatively consistent fashion throughout the United States. However, between 1983 and 1991 life expectancy decreased significantly for men in 11 US counties and 180 counties for women. The counties were those most severely affected by the obesity epidemic.
Some experts like David S. Ludwig, MD, PhD, of the New Balance Foundation Obesity Prevention Centre in Boston predict that the downward trend will almost certainly accelerate as the current generation of children- with high body weights earlier in life than ever before—reaches adulthood.

You might be aware that death rates have been dropping. This is largely due to modern medical care that may be able to prevent premature deaths among adults who develop obesity at a young age, by prescribing blood pressure and cholesterol lowering medications, heart bypass surgery, and various other medical interventions.

But over time, some experts are predicting that obesity-related chronic diseases might outstrip the ability for technology to counteract the rise in obesity and its consequences.

As a physician, I can tell you that the most important step you can do for yourself and your family is to choose to live a healthy lifestyle and make healthy choices.That means getting regular exercise of at least thirty minutes a day, five days a week,eating fresh fruit and vegetables, legumes and nuts while eliminating high fat, processed foods and added sugars in your diet.

Read labels on packaged food and educate yourself and your family on the value of eating nutritional foods and not to be swayed by advertising.

A few actions today may forestall the predictions that children of today and tomorrow will lead a shorter less healthy life than their parents.

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.