How to have an old age in good health: food for thought on the labour day

September 3, 2012 by Dr. Val Jones in the health, real stories

I spent the last two weeks make visits home "at risk" the elderly in rural areas of South Carolina. At the rate of approximately 7 House calls a day, I was able to make a few observations based on a respectable sample. I was surprised and intrigued by the conditions of life that I met, and I am pleased to announce that I did today my first physical examination in a careful review of a team of the cat, cock and hen (photo left). On another house call I I was offered a goat Pygmy as a thank-you for my efforts, and countless good-natured folk I was offered-the Ice House and these edible delectables such as fish and fishing honey cakes.

But what has me the most is that some elderly people were in much better health than others of their age, and the healthier who all had one thing in common: strict daily exercise regimens. I realize that this is not revolutionary News (which is good for us), but the contrast between those who exercised and those who could not have been more clear to me.

A particularly charming 85-year-old man gave me a tour of his vegetable garden and explains that he has bicycle in the city, six days a week to give friends and folk of the city churches of okra (and other vegetables). Growing vegetables and giving away them was the work of his current life, and although he lived in extremely modest circumstances, what he had was clean and tidy. He was happy, bright and had the physique of an athlete.

Contrast this man another patient in his 80's engaged in all and is smoking cigarettes inside most of the day. He was blind in one eye, almost deaf, difficult to breathe, had wounds on his skin. He was depressed, machines and bloated heart failure. I was sad to see his State and the relative squalor in which he lives. Smell of urine and smoke permeated the House, and I wondered how much more he would survive.

When I arrived at the House of a eighties, I noted that the garage was filled with watermelons of different sizes. After investigation, the man said that he has hand-picked the watermelons of a plot of land that it has 2 miles of his home.  He brought them home with a wheel barrow... and made many trips back and forth over the past week. There no medication and a normal physical examination.

And then my days - back to back tours with the elderly who either were involved in active, or have been weakening, plunged inside with progress of dementia and chronic disease. I realized that no medical treatment has the power to overcome damage implacable than inactivity, smoking and cause of deconditioning. The secret to old age in good health lies in the choice of life, not bottles of pills.

As we enjoy the last weekend of the summer day, consider the importance of this work is actually in our mental and physical well be. You are never too old to carry watermelons on the road, culture of okra to your neighbors or simply commit cessation and daily walks. If you do this regularly, your health will improve surely - and your quality of life will be immeasurably improved. Ultimately, adding life to years is what medicine is all about.

Tags: Exercise, health, home visits, life choices, SC, Secret of good health, the elderly, smoking cessation

Normal Blood Sugar Levels May Harm the Brain

Study Suggests Need to Reconsider What's Healthy

Sept. 4, 2012 -- Blood sugar levels at the high end of what is considered normal may put the brain at risk, according to a new Australian study.

Researchers in Canberra report a link between the shrinkage of two brain regions, the hippocampus and the amygdala, and normal blood sugar levels.

The hippocampus and amygdala are involved in memory, among other things, and researcher Nicolas Cherbuin, PhD, says shrinkage in these areas could worsen memory.

"It has been generally assumed that blood glucose in the normal range is not a risk factor for brain health in non-diabetics," Cherbuin says. "If the present results are replicated in other studies the definition of normal fasting blood glucose levels and of diabetes may need to be re-evaluated."

For the study, Cherbuin, a neuroscientist at Australian National University in Canberra, and his colleagues studied 249 people in their early 60s. Each of them had blood sugar levels in the normal range. At the beginning of the study, and again four years later, the researchers scanned their brains.

Comparing the before and after images, they found significant brain shrinkage among those whose blood sugar levels were high but still below the World Health Organization's threshold for pre-diabetes. The researchers report that those high levels may account for a 6% to 10% decrease in the volume of the hippocampus and amygdala.

Cherbuin and his team then excluded people who were overweight or obese, and substituted the American Diabetes Association's stricter normal range for that endorsed by the WHO. The results were virtually the same.

Cherbuin says they did not take their conclusion "lightly," but the association between these higher blood sugar levels and brain shrinkage was "robust."

Next, he plans to study the impact that such brain changes may have.

Cherbuin's results suggest a need to reassess what's considered a healthy blood sugar level, but more research must be done before any changes to recommendations are made, says neurologist Marc Gordon, MD.

"The research is too preliminary, and the association shown here does not establish a cause or mechanism," says Gordon, chief of neurology at Zucker Hillside Hospital in Glen Oaks, N.Y., who describes the study as thoughtful and carefully considered. "To speak as a clinician and tell patients that they better cut out all candy because it will shrink their brain is a leap of faith."

Cherbuin says that we still do not fully understand all the factors involved in regulating blood sugar levels. We do know enough to say that poor diet, lack of exercise, and constant stress likely play a leading role in maintaining unhealthily high levels, he says.

"It is this chronic exposure to high glucose levels that is more likely to lead to poorer brain health," he says.

For Gordon, who says that there is good evidence that such factors all likely play some role in thinking and memory decline, the message is a simple one.

"It's just what all of our mothers told us: Eat well and exercise," says Gordon. "That's a principle we would all do well to live by."

Can Childhood Obesity Hinder the Brain?

Reading, Math Worse in Kids With Many Obesity-Related Risk Factors

Sept. 4, 2012 -- A new study shows that children who are overweight or obese may face problems with brain development, especially if they have risk factors for metabolic syndrome.

Metabolic syndrome is a cluster of problems that set the stage for diabetes and heart disease.

 The risks for metabolic syndrome include:

Belly fatHigh levels of blood fats called triglyceridesInsulin resistance or prediabetesHigh blood pressureLow level of "good" HDL cholesterol

Researcher Antonio Convit, MD, says the bottom line is, "We are seeing brain changes in kids with metabolic syndrome and we don't know if this is reversible."

Children with metabolic syndrome scored 10% lower on mental tasks that are important for learning, he says. The findings appear in Pediatrics.

In the new study, obese or overweight teens with metabolic syndrome could not read as well, scored worse on math tests, and took longer to complete tasks than children who did not have metabolic syndrome. What's more, their brains also had physical differences.

The new study included 49 teens with metabolic syndrome and 62 without it. The more metabolic syndrome risks that participants had, the more pronounced the brain changes were, the study shows.

Convit calls for testing for insulin resistance among at-risk children, particularly those who are very overweight and those who have a family history of diabetes or heart disease.

Other solutions include having physical education programs in school. "We should invest more in physical education so kids are fitter and less likely to have insulin resistance, which is the main driver of these brain changes."

Insulin is a hormone that helps the body turn sugar into energy. Insulin resistance occurs when the body does not use insulin properly.

Michele Mietus-Snyder, MD, says the new findings should serve as a wake-up call.

"Every cell in every organ system requires energy to live and insulin is the gatekeeper," she says. "Insulin resistance has reached beyond the traditional organ systems to the brain."

"We need to be very vigilant when children start to gain belly fat because we don't want children to fall behind the metabolic eight ball." If that occurs, it becomes a catch-22. "How can you expect someone to make healthy choices when they are [mentally] impaired?"

Scott Kahan, MD, MPH, is the director of the National Center for Weight and Wellness in Washington, D.C. "Metabolic syndrome was unheard of in kids until recently," he says. "It is striking that a significant number of kids have metabolic syndrome, but the fact that we can show further consequences in the brain is even more striking."

Prostate Cancer: Start-and-Stop Hormone Therapy Works

Sept. 5, 2012 -- "Start and stop" hormone therapy is as effective as continuous therapy in the treatment of some prostate cancer patients, a study shows.

Hormone therapy is also known as androgen deprivation. It is often used to treat prostate cancer if surgery or radiation fails.

The treatment works by blocking the production of the male hormones called androgens, which fuel prostate cancer growth. But there are serious side effects:

FatigueHot flashesMood swingsLoss of libidoErectile dysfunctionBone loss

In a new study from Canada, researchers compared men who went on and off hormone therapy with men who had continuous treatment. The researchers found the on-and-off treatment can be as effective as continuous treatment with fewer of these troubling side effects.

The study is published in The New England Journal of Medicine.

The study included about 1,400 prostate cancer patients whose cancer had not responded as hoped to radiation therapy. The researchers used a blood test called PSA to measure the cancer’s response to treatment. Rising PSA levels after treatment can mean the cancer did not respond well to treatment or has recurred.

Roughly half the men in the study were treated with continuous hormone therapy. The other half received the treatment for eight months, followed by observation. These men went back on treatment when PSA levels rose.

Over nearly seven years of follow-up, the average survival time in both groups was around nine years.

A total of 524 men died during this time, but most died from causes other than cancer. Just 18% of deaths in men receiving intermittent hormone therapy and 15% of deaths in the continuous-treatment group were due to the cancer.

Men who went on and off the hormone treatment reported fewer hot flashes, less loss of libido and erectile dysfunction, and fewer urinary issues. But the researchers say the difference in quality of life was not as profound as might be expected.

There was also no evidence that the start-and-stop treatment schedule prolonged the time in which hormone therapy worked, as the researchers had hoped.

Nevertheless, study researcher Juanita M. Crook, MD, calls the study "practice changing" for prostate cancer patients with rising PSA levels who need more treatment.

She says since many of these men remain on hormone therapy for the rest of their lives, a treatment strategy that can improve quality of life should be embraced.

"Intermittent therapy has been increasingly used over the past few decades, but we never knew if we were risking years of life to achieve a better quality of life," she says. "Now we know that this is not the case."

American Cancer Society Director of Prostate and Colorectal Cancers Durado Brooks, MD, says the findings confirm that on-and-off treatment is as effective as continuous treatment.

But Oliver Sartor, MD, who is medical director of the Tulane Cancer Center in New Orleans, says the study did not address an important unanswered question: "Do men with rising PSAs but no symptoms even need the hormone treatment?"

"The big debate in the field is whether to even treat patients with rising PSAs before there is evidence of [cancer spreading]," he says. "The answer is not clear."

Emma Roberts: Life On and Off the Set

The actress talks about her new film, "Celeste and Jesse Forever," young adulthood, and her charitable work with kids and teens.By Melanie D. G. Kaplan
WebMD the Magazine - Feature

When Emma Roberts won the role of a bratty pop star in Celeste and Jesse Forever (opening in August), she was thrilled. Of course she was delighted to be playing opposite Rashida Jones, known for her roles in NBC's Parks and Recreation and The Office. But Roberts was also pretty excited about playing dress-up.

"This character is the combination of every pop star we could think of, so my makeup, hair, and wardrobe were so much fun," Roberts says. "I wore a rainbow faux fur vest and super-long blonde extensions. That's why I wanted the part so bad. Because I knew I'd never be able to be like this in real life!"

In real life, the 21-year-old actor habitually hits snooze on her alarm clock, oversleeps, and rushes out of her Los Angeles apartment in the least time-consuming outfit possible. Today she's wearing polka-dot jeans, a T-shirt, and flip-flops (she's about to get a pedicure). But when she's on the red carpet, she's all girl. "I try to wear dresses," she says. "I feel like it's such a fairy tale."

It may seem that Roberts' life has been one big fairy tale. Her very first audition yielded the role of Johnny Depp and Penelope Cruz's daughter in Blow, she became a tween star as Addie Singer in Nickelodeon's Unfabulous, and she has polished her acting skills in a number of films, both independent (Lymelife) and blockbuster (Hotel for Dogs). This summer, she's been shooting Dito Montiel's heist drama, Empire State. Last but not least, she is the niece of actor Julia Roberts and daughter of actor Eric Roberts.

Growing up, Roberts visited Aunt Julia on shoots and, she says, was so dazzled by the behind-the-scenes magic that her parents had to drag her away at night. Even now, she says, she cherishes every moment on the set, where she is endlessly inspired by experienced actors and directors. After working with Jones, who not only starred as Celeste but also wrote the script for the new film, Roberts started thinking about writing and producing. 

Earlier this year while shooting the comedy Adult World, in which she co-stars with John Cusack, she got to know director Scott Coffey really well and is now eager to do more comedy -- maybe something of Bridesmaids'  ilk, she says. And her onetime dream of starting a girl band was reignited when she got to sing in her Celeste and Jesse Forever pop star role. "The acting part is fun," she says, "but there's so much more to explore."

Meanwhile, Roberts is exploring her own adult world -- maintaining an apartment, keeping her room clean without being asked, and staying fit with yoga and SoulCycle, an intense indoor cycling workout. Although she decided to take a break from school after attending Sarah Lawrence College last fall, she says she constantly reads on the set to help pass time.

Dirty Secret: Trying on Makeup

There aren't germs in that communal makeup at the cosmetics counter -– or are there?By Shelley Levitt
WebMD the Magazine - Feature

Q: I love trying on makeup, but I don't use those tiny plastic swabs at beauty counters. Am I going to bring home something besides a great new shade of gloss?

A: It's quite possible. To a dermatologist, that's like strolling through a public restroom. Those tubes and jars resemble petri dishes, teeming with microbes and bacteria. The viruses that cause herpes and pink eye thrive on moist, inanimate objects -- making a pot of lip gloss, foundation, or eye shadow a perfect breeding ground.

Even if the salespeople are careful about wiping off testers after customers use them, they may not be aware of all the passing shoppers who dipped a finger into a product or swept it onto their lips, cheeks, or hands.

So, a disposable tester is a good defense against contamination. Just make sure that lipstick tube or blush brush is wiped with alcohol and dried before you try.

--Joshua Zeichner, MD, director of cosmetic and clinical research, Department of Dermatology, Mount Sinai Hospital, N.Y.

Find more articles, browse back issues, and read the current issue of "WebMD the Magazine." 

NFL Players at Higher Risk of Brain Diseases

Sept. 5, 2012 -- Former National Football League (NFL) players may have a higher risk of dying from diseases that damage brain cells.

Research has raised red flags about the health risks associated with cumulative blows to the head. Now a new study finds that pro football players are four times more likely to die with Alzheimer's or Lou Gehrig's disease (amyotrophic lateral sclerosis or ALS), compared to the general population.

The study looked at nearly 3,500 football players with five or more years in the NFL, playing from 1959-1988. There were a total of 334 deaths, including seven with Alzheimer’s and seven with ALS listed on their death certificates.

The new findings appear in the journal Neurology.

At greatest risk were NFL players who held “speed” positions, such as quarterback, running back, halfback, fullback, and tight end. These players were three times more likely to die from a brain-related disease than their teammates who played non-speed positions, such as defensive and offensive lineman.

Still, there's a lot of information the study can’t provide. For example, researchers did not have information on head injuries or concussions sustained by the players or knowledge about any other risks for these diseases.

The study also did not look at why football players may be at higher risk for dying from these brain diseases. The theory is that repeated blows to the head may start a process that results in one or more brain-damaging disorders in some people.

Past research has linked concussions to chronic traumatic encephalopathy (CTE), a disorder that has symptoms similar to those of ALS, Alzheimer’s, or Parkinson’s disease. But it is not yet known if CTE develops independently or is the beginning signs of these diseases.

“There are probably other factors involved, such as other environmental exposures or genetic factors, but we are in the very early stages of knowing how those may be involved,” says researcher Everett Lehman, of the CDC’s National Institute for Occupational Safety and Health in Cincinnati.