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.

 

 

 

 

 

Top Trends in Preventative Healthcare

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Science and Technology Converge
Part I

As a passionate advocate of preventative healthcare and wellness, I am glad to see that there will be an increased focus on prevention, because many older people continue to have chronic diseases which overwhelm their daily activities and are not enjoying a good quality of life in their later years. It is worth emphasizing that while most of us will face some sort of illness in our later years, it is important to live a healthy lifestyle; get enough exercise, eat a healthy diet, avoid smoking, excessive drinking, sugar, salts and unhealthy fats and processed foods. That way we will cope with illness, aging and any disability in a strong and independent manner.

Advances in technology and science are making it easier for people to focus on preventative healthcare. In order to maintain a healthy lifestyle and for a more health conscious society, let’s look at some of the possibilities and opportunities.

 Wearable Technology will continue to grow! And why do I love it?

It seems we need to quantify every step, every workout, every morsel of food and every waking and sleeping minute of the day and as a result there is an ever-expanding range of technologies to support our need to chronicle our daily lives. Interest in mobile apps such as activity trackers like Fitbit will continue to capture consumer interest. According to a report by international consulting firm, PwC, “Adoption of health-related smartphone apps doubled in two years, from 16 percent in 2013 to 32 percent in 2014 and will continue. There are many fitness and activity trackers on the market today, it can be confusing.   PcMagazine, has an excellent article comparing various trackers and recommends you try them out before you buy. Once you’ve bought a fitness tracker, the next step is to integrate it into your daily routine, which I recently wrote about. “You’ve bought a fitness tracker—Now what!

What has worked for me is the challenge of maintaining my commitment by using my Fitbit, trying really hard to maintain that 10,000.00 steps per day. I appreciate a measurable outcome. And yup, I have learned once again, that “hectic does NOT equal aerobic”.

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.

Brain Drain and Menopause: Reality or Myth ?

shutterstock_57740512Is there such a thing as Brain Drain and Menopause?
Research shows that the female sex hormone, estrogen, plays a key role in brain function. Estrogen declines during menopause, but that doesn’t mean your brain function will decline along with it. Although estrogen produced by our bodies helps the brain function, there’s no clear clinical evidence to support the notion that the brains of women after menopause don’t work as well as they did in the past.  What we are learning is the difference between changes with menopause and normal age-related changes in function.
Often, postmenopausal women do have memory slips or difficulty concentrating. However, research suggests a variety of potential underlying causes. These include disturbed sleep, extra stress, or depression. If you’re awakened by night sweats several times during the night, that’s often enough to interfere with your ability to concentrate or remember details for the next days’ meeting.

Should hot flashes be the reason for your insomnia and the fuzzy thinking and memory glitches that follow a sleepless night, try reducing their hold on you with some lifestyle changes. Exercising daily is linked to a lower incidence of hot flashes. And some products designed to lower your temperature, such as the menopod, may be helpful. And if you’re a smoker, this may be the motivation you need to finally quit: Women who smoke have more intense and more frequent hot flashes than nonsmoking women.
If you think you might be depressed, which can cause difficulty concentrating, make an appointment with your doctor. Menopausal hormone fluctuations can be linked to depression in some women. Feeling occasional sadness isn’t the same as being depressed.
If your stress level is noticeably high, you may be able to control and reframe your intensity by practicing some form of relaxation. One of the simplest ways to combat stress is deep breathing. Meditation, yoga, tai chi, or gentle stretching are also good ways to reduce stress. If stress, memory slips, or other menopausal symptoms continue to bother you, consult your doctor. The key is to take action that will let you feel more in control.
Now what was I saying?

#woman #brainhealth #healthy #menopause

Chilling hot flashes? You might want to check out the Menopod. (www.menopod.com)- It contains a cooling technology inside the device. There are no fans or moving parts. When you turn the power on, it instantly drops to a cool temperature) so that you can discreetly place it on the back of your neck to stop the hot flash.

 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.

CAFFEINE-THE UPS AND DOWNS. HOW MUCH IS TOO MUCH?

shutterstock_433348924 (1)Millions of us rely on coffee to wake us up, keep us going and improve concentration and focus. But how much is too much and what is the difference between caffeine and coffee. Caffeine is a naturally occurring chemical found in more than 60 plants including coffee beans, tea leaves, kola nuts and as we know used to flavour soft drink colas. It is also found in cacao pods used to make chocolate products. Man-made caffeine is sometimes added to foods, drinks and medicines. So caffeine is not just found in coffee.
Up to 400 milligrams of caffeine a day appears to be safe for most healthy adults.
That’s roughly the amount of caffeine in four cups of brewed coffee. For children, 100 milligrams a day is the most a child should be allowed, although I would not recommend that children drink coffee.
Caffeine and Medications
Heavy caffeine use among adults can cause unpleasant side effects and may not be a good choice for people who are highly sensitive to its effects or take certain medications.
For instance, caffeine is used in painkillers such as aspirin and acetaminophen and for simple headaches. It’s also used in drugs such as 222’s because caffeine helps absorb the codeine – so certain medications include caffeine.
Some people are more sensitive to caffeine than are others. If you’re susceptible to the effects of caffeine, just small amounts — even one cup of coffee or tea — may prompt unwanted effects, such as restlessness and sleep problems. Here are some of the side effects. How you react to caffeine may be determined in part by how much caffeine you’re used to drinking. People who don’t regularly drink caffeine tend to be more sensitive to its negative effects. Other factors may include body mass, age, medication use and health conditions such as anxiety disorders. Research also suggests that men may be more susceptible to the effects of caffeine than are women.

  • Nervousness
  • Restlessness
  • Irritability
  • Stomach upset
  • Fast Heartbeat
  • Insomnia

So I would say yes to a cup or two but no to a pot!

 #coffee #caffeine #healthy #breakfast 

DISCLAIMER
T
he 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.

Life-saving vaccine school program gets boost from Toronto Board of Health.

shutterstock_526821535.jpgEach year the diagnosis and treatment of HPV-related infections (Human Papillomaviruses (HPV)) cost the Canadian health care system more than $300 million.  HPV are the cause of almost all cervical cancers, are a leading cause of other genital cancers, anal cancers, and warts, and contribute to cancers of the head and neck.  Three out of every four Canadians will have at least one HPV infection in their lifetime. Not every infection leads to cancer, but medicine still is unclear as to why some people clear this virus, while others have persistent virus that then does become more aggressive.

In 2007, the National Advisory Committee on Immunization (NACI) recommended the use of the HPV vaccine for females between nine and 26 years of age to prevent cervical cancer, as well as other infections such as genital warts.  That year, the Ontario Ministry of Health and Long-Term Care (MOHLTC) made the HPV vaccine publicly available, free of charge, to all grade 8 girls (13-14 years of age).  In September 2012 the MOHLTC also funded a “catch-up” program to vaccinate females born between 1993 and 1998 that had not received all three HPV shots while in grade 8.

In January 2012, NACI added a recommendation for all males aged nine to 26 to receive HPV vaccine to prevent anal and genital cancers and genital warts.  It also recommended HPV vaccine for all males who have sex with males since they have a disproportionately higher burden of HPV infections.  Vaccinating males with HPV vaccine will also reduce the spread of HPV infection to females.  

To date, the Ontario’s MOHLTC has not acted on this recommendation, and the HPV publicly funded vaccination program remains available only to females in grades 8-12.  In other provinces, PEI and Alberta, the program is being funded for boys as well.  Ontario needs to step up to the plate.

As a family physician and member of the Federation of Medical Women of Canada I cannot stress enough how crucial it is to expand this program to include boys!!!   This is a contagious infection that has serious potential to spread and we have the tools to stop it!  This is what we mean by primary prevention, stopping infection and disease, before it starts.

Currently, I am meeting with all 3 parties at Queen’s Park to discuss these issues and to encourage equitable access for all young Ontarians.  It is only fair. 

 

 

 

 

 

HPV- Not just for girls & women. HPV can also cause cancer in boys & men

shutterstock_566860909.jpgThe Human Papillomavirus  (HPV) is among the most common sexually transmitted viruses in the world with some strains leading to various cancers as well as external genital warts

What this  really means is that we now understand what is causing cancer in these regions.   It’s very exciting, because if we understand what causes a cancer, we can begin to prevent it. 

According to Health Canada,  as many as 75% of sexually active men and women will have at least one HPV infection in their lifetime, with the highest rate found in people under 25.  What
we don’t fully understand is why some people clear the infection and never get cancer while others have persistent infections, which leads to abnormalities.
  Cervical cancer is the most common HPV- associated cancer worldwide, so the majority of HPV research has
been focused on understanding the role of HPV and cervical disease.
Therefore the first trials involved girls and women. As a result, when the
vaccine was introduced in 2006 in Canada, it was launched as an immunization programme for school aged girls. However, as research continued, much more is now known about the role of HPV in causing cancers and disease in males.  Therefore in 2012, the
National Advisory Committee on Immunization reviewed its’ recommendations and now recommends the HPV vaccine not only for girls and women but also for boys and
men. It is so exciting that we now have a vaccine that will reduce the risk of cancers in
both sexes.  How do we know this? In my next blog, I will take a look at some of the published
research findings, which show how effective vaccination really is!

 

Vaginal atrophy affects more than 2 million post-menopausal Canadian women

shutterstock_84108826But intimacy does not need to be sacrificed

Vaginal atrophy (VA) is a common but treatable condition affecting post -menopausal women.  VA is where the vaginal walls become thin, fragile and inflamed due to the reduction of estrogen that naturally occurs during menopause***.

Symptoms of vaginal atrophy include: burning, itching, dryness, irritation and painful intercourse.

According to a recent study, not only is VA causing physical discomfort, but it’s also causing emotional distance between couples because of the difficulty women are having discussing it with their partners.

 

The CLOSER study *,  a study that surveyed more than 1,000 Canadian post-menopausal women and male partners of post-menopausal women, and showed couples are feeling the impact.

 

·       Sixty-six per cent of post-menopausal women avoid sexual intimacy fearing it is too painful

·       Sixty-three per cent of women avoid sexual intimacy due to a general loss of libido

·       Canadian women are among the most likely to agree that due to VA sex is less satisfying

·       One fifth of women feel VA has made them emotionally distant from their partner

·       Forty-four per cent of women say VA makes them feel old

·       Sixty-eight per cent of men surveyed say they have sex less often because of VA

·       Thirty per cent of men say sex is less satisfying for them personally

·       Twenty-six per cent of Canadian men say they have stopped having sex altogether

Fortunately today there are treatment options

Treating the symptoms:
Many women self-treat using over-the-counter lubricants and moisturizers, which may provide temporary relief of symptoms but do not treat the underlying condition.

Treating the underlying condition
Local Estrogen Therapy (LET) treats the underlying condition.As a result of LET, one third of Canadian women according to the CLOSER Study ** agreed their sex life had improved and that they felt more optimistic about the future of their sex life.

According to the Society of Obstetricians and Gynecologists of Canada (SOGC), effective treatment options are available for VA, with local estrogen therapy being a standard of care.

LET comes in several forms, we have several options in Canada

Vaginal estrogen tablet. Vaginal estrogen cream. Vaginal estrogen ring. Which one is right for you? There are different advantages, ease of use and decisions for women…so talk to your doctor! Healthcare professionals are a primary source of information and together with women, their partners and their doctors can find a solution.

** Clarifying vaginal atrophy’s impact On SEX and Relationships (CLOSER). European Menopause and Andropause Society (EMAS) Annual Congress, March 2012.

***Mayo Clinic: Vaginal Atrophy Definition. Available at: http://www.mayoclinic.com/health/vaginal-atrophy/DS00770. Last accessed June 2013

No Bones about it: Protect Yourself From Osteoporosis

Fitness Assessment (2)

Part # 1

A ninety-four year old woman has had two major falls in the past twenty years. Upon falling down a flight of stairs, she fractured her arm. More recently, when this tiny woman was picked up by a gust of wind and then dropped on the parking lot pavement one icy winter day, she fractured her elbow.  In both situations she could have also easily broken her hip or spine yet she didn’t. She recovered fully, continues to drive, live independently and most importantly enjoys a healthy and active life.

At ninety-four she most certainly has lost bone mass which peaks at the age of 16-20 for girls and 20-25 in men.  As women approach menopause they lose bone mass at the rate of 2-3% a year. Yet it would seem that a healthy diet, regular weight-bearing exercise and preventative medication are able to decrease the risk of fractures and the advance of osteoporosis.  And in a healthy, fit, active person, even when there is a fracture, there is better healing and recovery.

What is osteoporosis? 

Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue. This leads to increased bone fragility and risk of fracture (broken bones), particularly of the hip, spine, wrist and shoulder. Osteoporosis is often known as “the silent thief” because bone loss occurs without symptoms. Osteoporosis is sometimes confused with osteoarthritis, because the names are similar. Osteoporosis is a bone disorder, with loss of the normal strength and quality of the bone, as well as a decrease in the amount of bone. Osteoarthritis is a disease of the joints and surrounding tissue, often described as wear and tear of a previously normal, smooth joint.  *

Consider this:

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

The most common sites of fractures are the hips, wrist, spine and  shoulder.

At least 1 in 3 women and 1 in 5 men will suffer from an osteoporotic fracture during their lifetime.

Twenty-eight per cent of women and 37% of men who suffer a hip fracture will die within the following year.

Over 80% of all fractures in people 50+ are caused by osteoporosis.

How can you protect yourself?

Fortunately, there are a variety of ways an individual can protect or improve their bone health.

Have your physician conduct a fracture risk assessment! This may include a bone mineral density test, (BMD) which determines the amount of healthy bone you maintain.  Risk assessment is also evaluating your personal risk, your family history, your age and other complicating factors.  The average age for a BMD is 65 according to Osteoporosis Canada, but a risk assessment begins at age 50!

The two main issues I try to look at with every patient over the age of 50 is significant height loss, yes that’s why we measure your height, and if you have had a fracture since I last saw you–that way I quickly have an idea if there is an increased risk of osteoporosis in that patient.

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.

Take Calcium & Vitamin D. 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.

For those over 50, Canada’s Food Guide recommends 3 servings of milk and alternatives – yogurt, cheese, calcium-fortified beverages, puddings, custards, etc.

This essentially means that, if you are over 50, you need the equivalent of one good serving of dairy at each meal or 1200 units a day of calcium supplements.

I have yogurt each day and at least one latte, so I often decide at night if I have had that 3rd serving of dairy that day.  If not, I take 500mg of Calcium.  If I have had 3 servings, then the third calcium is not needed and NOT advised. More is not better. So you can decide day by day, depending on your diet as it is normal for this to vary a bit every day.

Vitamin D a day –400-1000 IU’s for adults under 50 and 800-2000 IU for adults over 50.  That is a must!

Exercise.  Use weight-bearing exercises that uses your body weight such as walking, running, weight lifting to help to strengthen both bones and muscles, as well as improving your balance.

Consider taking medications that build bone density and prevent bone loss if your risk assessment is significant and you are at risk for fracture. We know that low risk individuals have less than a 10% risk of fracture in the next year and can do well with diet and exercise.  High-risk folks have a greater than 20% risk and should be on medications. And for those of us between 10 and 20%, the moderate risk patients, the decision is individualized, as there are more issues to consider this is the art of medicine and warrants a discussion with your physician.
*Osteoporosis Canada  WWW.osteoporosis.ca