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March 8th, 2012

Studies of interest to parents: Part 1

A good week for studies of relevance to lots of parents.

First one is a report published in the Canadian Medial Journal done right here in BC, a review of the records of over 900000 kids, and the researchers concluded that the younger a young child is in his grade, the greater his (way more boys are diagnosed with behaviour disorders than girls) of being diagnosed with ADHD.

The reason?

Probably because immature behaviour by younger kids is deemed to be disruptive by some of the adults caring for kids who are months older (at that point in life a few months represents a pretty substantial difference in how long kids have been alive and attuned to what’s expected).

The fallout?

This diagnosis follows that child for a long time, likely life, and many (probably most, these days) of these kids are put on behaviour-modifying medication to help them fit in, which they simply don’t need.

This study just screams at us – as I have been saying for many years - that we simply don’t have strict or exact enough criteria for the diagnosis of ADHD (indeed, for many behaviour problems) so that many kids are mis-labelled and over-diagnosed with a “behaviour problem” mostly because the adults taking care of that kid cannot amalgamate that end-of-the-bell-curve behavior into that setting.

I’m Dr Art Hister

March 2nd, 2012

Diabetes raises your risk of stroke - by a lot

The reason I think that it’s very important for me to keep mentioning Type 2 diabetes over and over again (as I tend to do in these items and on TV) is that Type 2 diabetes is most often a chronic, severe, progressive (you might even say relentless) condition that’s hard for a person to know they have (since the symptoms in the early stage are either nil or innocuous), and yet, from the time it starts with some disruption in insulin sensitivity (before it can even be detected via blood tests) diabetes is damaging both the large and small arteries in the body, a “killing” effect that gets worse the longer a person suffers with abnormal insulin sensitivity and abnormal blood sugar levels.

All of which means, in plainer English, that the longer you have Type 2 diabetes, the greater your risk of damage to many organ systems, which is why Type 2 diabetes is related to higher risks of amputations, severe infections, blindness, kidney failure, dementia, colon cancer, heart attacks, and strokes (and these are just the most prominent complications: there are a host of others).

The intimate connection between diabetes and stroke was illustrated in a recent study published in the journal, Stroke, which involved over 3000 individuals with diabetes followed for about 5 years.

For each year the patient had had diabetes, their risk of stroke went up by about 3 %.

A person who had had Type 2 diabetes for over 10 years had a three-fold increased risk of stroke.

And the really worrisome thing, I think, is that the rate of Type 2 diabetes is being diagnosed in sharply increasing numbers in much younger people than ever before because of the “epidemic” of obesity and sedentary lifestyle in the young and even the very young.

Bottom line: Type 2 diabetes is nearly totally preventable (at least 80 %, probably higher), so get moving, eat right, and watch your weight and you should have little to worry about.

And these days, this is especially important for kids and young adults to keep in mind:.

I’m Dr Art Hister

March 1st, 2012

Hearing loss increases the risk of falling

Hearing is one of those things in life that you pay attention to only when it’s going or worse, gone, and then you suddenly realize how much you regret having allowed that to occur.

Hearing loss not only diminishes the quality of life, but it has also been linked to several negative health consequences, such as a higher risk of dementia, which should be scary news for all those baby boomers who have gone to too many AC DC concerts and especially to the millions of young folks who walk around in their own planetary fog with an Ipod tuned up way too loud.

And as if that weren’t enough, a new study has linked hearing loss to a higher risk of falling, and the greater the hearing loss, the greater the risk of falling. Falling is, in turn linked to many negative health consequences such as head trauma, chronic pain from poorly healed fractures, and even a higher risk of death that lasts long beyond the period around the fall, since one study found that people who break a hip have a higher risk of dying for up to 10 years beyond that fracture.

So . . . best of course to prevent hearing loss in the first place.

But anyone who has hearing loss should own up to their deficit – surveys reveal that only roughly 15 % of people with hearing loss admit that they don’t hear well – and treat it: the rest of your brain will thank you for it, as will most people around you.

I’m Dr Art Hister

February 28th, 2012

Sleeping pills raise the risk of dying - maybe

A study that’s receiving a lot attention involved over 10,00o people whose health was tracked for 3 years, and found that people who used even a small amount of sleeping pills – 18 doses a year – had a higher risk of dying than people who didn’t use any sleeping pills at all.

Further, in this study, the risk of death escalated with increasing doses of sleeping pills so that people who used sleeping pills roughly every 2nd night had about a fivefold higher risk of dying than non-users (there was also no difference apparently among the various types of pills used).

Which, if you’re like me and you have to resort to the occasional use of sleeping pills, would lead to a “Yikes!” conclusion.

However, before rushing out to order a grave with a good view, there are a host of factors you should well, factor in.

First, although the researchers tried very hard to account for such differences and claim they found none, there may still be several subtle, hard-to-detect differences between people who require sleeping pills and those who don’t, such as, for example, different rates of shift work, different hormonal imbalances, differing rates of anxiety and depression (many of these being factors that are hard to detect in these types of studies and all of which carry their own health consequences) and it’s actually those factors and not the sleeping meds that are the reason for the higher risk of dying in those who have to resort to the use of sleeping meds.

Second, the number of deaths in this study were not all that high (although even one death that’s avoidable is too high) so it’s not as if the next time you have to resort to using a sleeping pill, you should make sure to say your prayers fervently that night, too, just in case . . .

Also, several studies have linked lack of sleep itself to a higher risk of premature death so perhaps this study also reflects that factor, namely that people who don’t sleep well have a higher risk of dying whether they use sleeping pills or not.

All that said, no one should rely on sleeping pills if they can avoid their use.

Also, studies have consistently shown that cognitive behavioral therapy is a terrific tool to fight chronic insomnia, so that’s an avenue that should always be followed if a sleeping problem becomes persistent.

And finally, if you do have to use sleeping pills from time-to-time, don’t panic about that, but always make sure to use the lowest dose of the weakest preparation for the least length of time that you can.

I’m Dr Art Hister

February 27th, 2012

You don't have to have chest pain when suffering a heart attack - Part 2

As a follow-up to the item on chest pain – or lack of chest pain – during a heart attack, it’s also vital to know exactly what to do if you think you’re having a heart attack.

So, if you get any of the symptoms listed earlier and you think it may be due to something in your heart, you do NOT phone your family doctor, you do NOT email me, you do NOT contact your spouse for advice or someone who watches Oprah regularly and who is convinced that everything in life can be solved with the latest fad of coconut oil or some obscure berry that can only be grown in a South American rain forest.

What you do, though, and instantly, is swallow an Aspirin (full dose) and call 911.

Pretty easy to remember, even for someone like me who has a hard time remembering what he had for breakfast:

1)Take an ASA

2) Phone 9-1-1.

Hope you never need to use this info but if you do, it may save your heart.

I’m Dr Art Hister

February 24th, 2012

You don't have to have chest pain when suffering a heart attack - Part 1

The typical picture of a heart attack victim is a male, usually heavy, perhaps a smoker, generally looking about 60 or 65-years-old, suddenly clutching his chest and complaining of severe, crushing chest pain.

This picture is based on studies done years ago when they typical heart attack victim was indeed a middle-aged, heavy-set male smoker, so the symptoms that men like that were said to get were adopted as the common symptoms for everyone suffering a heart attack.

Which is nonsense, of course.

We now know that this “typical” picture varies in several vital ways:

1) Women suffer more heart attacks than men in part because women live so much longer than men on average.

2) Most heart attacks occur in elderly people.

3) However, young people are also increasingly being diagnosed with heart attacks, in part because of the changing risk profiles of so many younger people – they’re heavier, more sedentary, etc – and in part because we are so much better able to diagnose more “subtle” heart attacks than we were once able to.

4) Very crucially, heart attacks can be – and very often are - accompanied by many varied symptoms, not just crushing sub-sternal chest pain.

5) In fact, you don’t even have to have chest pain when suffering a heart attack.

That was the rather stunning conclusion of a just-released study published in the which followed and concluded that a rather large number of men (31 %) didn’t complain of chest pain when suffering their heart attack nor did a stunning 42 % of women.

And the younger the women were, the less likely they were to complain of chest pain during a heart attack, so that women under 45 mostly did not have any chest pain in their heart attacks (and yes, women under 45 can get heart attacks).

So it’s important to note the other symptoms that may accompany a heart attack, the most common being (in no particular order:

Shortness of breath
Indigestion
Intense fatigue
Chest discomfort
Pain in other areas of the upper body such as the neck and jaw
Pain in the abdomen

Happily, most people who get such symptoms (some of which are all too common, of course) will not be having a heart attack. But if there’s any doubt at all, a person with such symptoms – especially someone who’s higher-risk - with should be checked out immediately.

More on this in next blog.

I’m Dr Art Hister

February 23rd, 2012

Just how common is gluten intolerance anyway?

As a person who has known for over 40 years that he has celiac disease – an auto-immune condition that’s set off by ingesting gluten which is a protein present in wheat, rye, and barley – it has greatly warmed my heart (and my innards) to welcome so many more people into my heretofore lonely tent because a self-diagnosed sensitivity to gluten has become a very, very common condition.

And speaking completely selfishly, the benefit for me has been an explosion of gluten-free products (I mean who had ever even heard of quinoa 10 years ago?), so going out to eat is a pleasure and not a chore these days.

But of those people who claim that they are sensitive to or intolerant of or react to (take your pick), how many really are? And equally important, how many truly have celiac disease, which can lead to some pretty awful complications if not treated with a very strict gluten-free diet?

According to a very good review article in the Annals of Internal Medicine, no one really knows the answers to those questions, so while it’s assumed that true celiac disease has remained pretty steady at around one North American in 133, no one can be sure that the rate of celiac disease has not been creeping up because the “god standard” tests used to diagnose celiac disease are not readily available or easily done.

That said, it’s also generally agreed that the vast majority of people self-diagnosing themselves to be sensitive to gluten are not celiacs, so what’s happening in them?

Again, no one knows, although the best bet is that these people respond with uncomfortable symptoms to ingestion of gluten (or perhaps some other protein in those 3 gluten-containing grains).

The bottom line is pretty simple, though: aside from kids who really should not be given a restrictive diet (which in theory they must follow for life) without confirmatory testing, in everyone else, avoiding gluten-containing products does not compromise health (aside from turning you into a neurotic label-reader) , and might even have some health benefits since once you start reading labels carefully, you become amazed – and appalled - at some of the stuff you’ve been eating.

I’m Dr Art Hister

February 16th, 2012

Sleep on it - or not

Experts never like to admit that they don’t have the answers you seek but that doesn’t stop them from issuing guidelines and advice.

And for no part of medicine is that more true, I’d say, than the matter of sleep because really, when push comes to shove, we don’t know very much at all about sleep – even why it’s so necessary – and we certainly don’t know enough as we need to know about how to judge if you need more sleep or what to do about it if you do think you need more.

So it was pretty neat to see a study that sort of put an emphatic point to that, namely that even when it comes to kids, we don’t really know how much sleep they need.

In this lovely study from Australia, the researchers looked at advice about sleep dating back over 100 years and found that even back then, when kids were averaging about 1 ½ hours more sleep than they seem to average these days, the experts of the day and the parents back then were still worried that kids were not getting as much sleep as they needed, which can only lead one to conclude that some parents clearly aren’t happy unless their kids are asleep the entire time they’re home.

Bottom line: there is really only one way to judge – and it’s a poor one, at that – whether a kid (or even an adult) needs to do something about their sleep, and that’s by how tired they are during their waking hours.

That doesn’t address of course whether a tired person needs more sleep or better quality sleep (after all, if you get 8 hours a night but wake up every few minutes, you really need to address how you’re sleeping and not how much time you’re spending in bed), but it’s a start.

I’m Dr Art Hister

February 15th, 2012

Move and you can sit (or something like that)

Recently, there have been several studies claiming to show that sitting is a toxic activity (well, more like a non-activity) on its own.

That is, the more you sit, the worse your health outcomes, whether or not – and this is the highly debatable point – you do any exercise.

In other words, if you sit for many hours regularly, you will die sooner compared to your non-sedentary bro, even if you do a fair bit of exercise to try to compensate for all that sitting.

Well, maybe not.

In a nice study involving 20,000 kids, these researchers claim to have found that kids who did just a bit of vigorous exercise regularly (average of about 35 minutes/day) had much better health profiles – lower cholesterol levels, better blood pressure, less insulin resistance, slimmer waists, and several others – compared to kids who didn’t do even that minimal level of exercise.

And this held true even for kids who spent most of their time sitting.

And there is no reason that the same doesn’t hold true for adults.

In other words, and although no one suggests that lots of daily sitting is the best way to live (although it’s unavoidable for many of us, of course) doing some exercise compensates to a large extent for sitting for long periods.

I’m Dr Art Hister

February 14th, 2012

Happy Valentines Day

Easy to love this day because it not only gives everyone a chance to remember that heart disease is still a main killer of Canadians yet one that is nearly entirely preventable (that’s the naggy bit) but also that there are very pleasant ways to lower the risk of heart disease, ways that this day is synonymous with.

So, sending a valentine to (some of) the people you love not only likely lowers your (and their) stress levels but also keeps you social contacts going, and quite clearly, the richer the social life, especially in old age, the lower the risk of all sorts of negative health outcomes including deaths from heart attacks and strokes.

Also, this is a day when people go out for a good time, which for most people is accompanied by drinking some alcohol, and again that’s not an important social contact and stress-reducing thing to do (so long as you can afford it cuz if you can’t, that increases stress, I suppose) but wine in moderate quantities is also good for the heart.

Remember that admonition about “moderate” because binging tonight probably out does all the other good things for your heart that you may be doing today.

And finally, there’s that favorite Valentine’s Day gift of chocolate, which is also a heart healthy treat, although again, only if you do it right so that the darker the chocolate, usually the better, and also in moderation because too much chocolate is not only fattening but will probably also make you sick and that would be a poor way to finish the day, right?

I’m Dr Art Hister

February 13th, 2012

A possible new treatment for Dementia? Maybe

I hate to hype studies about new treatments because nearly all of them turn out to be far less effective in the real world than they were in studies, so please take that into account when reading about a potential new treatment for dementia.

In this study from the US published in the journal Science, researchers from Case Western Reserve University School of Medicine in Cleveland, Ohio, claim that a drug they used to treat a mouse equivalent of Alzheimer’s disease had some truly amazing results in reducing, indeed virtually eliminating, the plaque that is a hallmark of AD, and even more amazingly, they claim to have seen beneficial results within six hours of administering the drug, all of which led to “rapid improvement in a range of observable behaviors in the three different types of mouse model of Alzheimer's that were used.”

The good news is that the drug used in this study done in mice, bexarotene, has been around for about a decade as a treatment for cancer so we know a fair bit about how it works in humans.

The much more iffy news is that when something smells this good, it usually turns out to be mostly smell, so no one should get their hopes very high yet.

However, it’s nice to have hopes up just a bit for what is after all, currently, a very poorly treatable condition.

I’m Dr Art Hister

February 10th, 2012

If you're reading this, chances are you're healthier than the people not reading this

TV gets a very bad rap when it comes to assigning blame for our evident problems with obesity and study after study has concluded that people who watch TV weigh way more than non-TV watchers, the former do less exercise, and they also tend to have much worse diets.

But two very key questions that remain unanswered by most of these studies are these: is it the TV watching that leads to the poorer health habits? Or do people with poor health habits choose to watch more TV

And second, are all TV watchers equally at risk?

Well, seems to me that if there were no TV around, people who want to sit and eat fatty snacks would find other ways to fulfill their needs so I have long tended to absolve TV of much of the blame for why we’re fat and lazy (and yes, perhaps my views are coloured by the fact that I work on TV).

But there is a bit of evidence now to point to in order to back up what I believe: A European study has concluded that “news junkies” (mostly from TV, but also those who follow news on radio and in the press), tend to have healthier diets (specifically, they adhere more closely to a Mediterranean diet) than do people who are not avid news followers.

In other words, TV viewing can actually improve health outcomes, which is why if you’re not doing it already, you should make a resolution to never – never, never – miss another episode of Health Headlines with Dr. Art Hister on Global TV.

Just suggesting this for your health, of course.

I’m Dr Art Hister

February 9th, 2012

Immunizations are not just for kids

An outbreak of whooping cough in the Fraser Valley should remind everyone of 2 important things about immunizations.

First, none of the diseases that we immunize kids against are “gone”, so they are always lurking in the community, waiting for immunization levels to go down, and then these potentially very serious conditions – German measles, measles, mumps, whooping cough – will spike again, and produce potentially deadly consequences.

And although whooping cough is most dangerous, indeed it’s life-threatening to the very young and usually only a mild problem in adults – even in adults it can produce serious problems such as broken ribs and even broken blood vessels in the brain from the heavy persistent coughing.

Second, the need for immunization does not disappear magically when someone enters adulthood.

Rather, all adults need to keep up with certain booster shots, and there are several immunization specific for adults as well.

Bottom line: next time you see your doctor, ask about which shots you need to get.

Chances are very good that nearly all of you are missing at least some if not many of these important vaccinations.

I’m Dr Art Hister

February 8th, 2012

How to prevent a blood clot on a long flight

A group of experts have come down with important new guidelines on how to prevent a deep vein clot in the legs while flying, what doctors refer to as a deep vein thrombosis or DVT, and although this group of experts are very firm in stating that this is a low risk for most travellers, they are also very clear in stating that there are some people who are at especially high risk (see previous blog item )and who should therefore take some precautions when confining themselves for long periods in a cramped space, such as a long flight or even a long car ride.

Among the precautions they suggest are these:

Getting up regularly to take a short walk (as an aside, every time I mention this strategy on-air to my audience, I get a testy email from at least one flight attendant who will point out that this advice can be very disruptive if too many people do it during a flight, to which the only answer is “yes, but . . . “)

Doing leg muscle stretching exercises regularly while seated

Avoiding a window seat (and probably a middle seat as well) which really translates as trying to get an aisle seat whenever possible

Wearing below-knee compression stockings

What they don’t recommend (and a lot of this is quite debatable) is
1) taking ASA as a clot preventive, 2) for low-risk people to take any of the preceding preventive measures, and 3) relying on good hydration to make any difference in lowering the risk of getting a DVT, meaning, as I have long loved to point out, that there is absolutely no proof that drinking lots of water or avoiding a reasonable amount of alcohol on a flight makes any difference in terms of lowering the risks of suffering a DVT (in fact, I can’t think of any normal situation in which drinking lots of water makes any difference in health outcome).

I’m Dr Art Hister

February 7th, 2012

News for people at risk of blood clots from flying

An expert panel has just released new guidelines to help people who may be at risk of suffering a blood clot in a deep vein in the legs, what doctors call a deep vein thrombosis or DVT, during or after a long flight (usually determined as one of 4 hours or more, although this can happen even on shorter flights).

The reason a DVT can be dangerous, even life-threatening, is that if a piece of that clot breaks off, it travels upwards in the venous system and then can lodge in the lungs, where it’s known as a pulmonary embolus, which has a substantial mortality rate associated with it.

The other term for this condition, the one used by most lay people, is economy class syndrome, but these experts point out that there is nothing special about sitting in economy seats on a flight that raise the risk of a DVT.

Rather, it’s the long period of sitting in a confined space without getting up or moving the legs that raises the risk of a DVT which means that anyone confined in such a space and situation – even in business class or first class but also on a bus or in a car – is at risk of a DVT.

So this is something everyone wants to prevent, but some of us are more at risk than others.

According to these just-released guidelines, among the more important risk factors are these:

• Previous DVT or known blood clotting disorder
• Malignancy
• Recent surgery or trauma
• Immobility
• Estrogen use, including the use of oral contraceptives
• Pregnancy
• Sitting in a window seat
• Obesity

Bottom line, though: everyone wants to prevent this, whether you have risk factors or not, so pay attention to what you need to do to lower your risk (in the next blog).

I’m Dr Art Hister

February 6th, 2012

News about risk factors for premature strokes

2 studies about strokes that will be important news for some of you were presented at the just-completed annual meeting of the American Stroke Association.

First, a study showing that people who had a parent who suffered a stroke before the age of 65 have a higher than average risk of having a premature stroke themselves.

In this study, when subjected to fancy MRI brain scans, such people under the age of 65 – those with a parent who suffered a stroke early in life – already had some damage to their brains, even if they had no symptoms, and they also had a diminution in certain cognitive abilities, although again, none of them had noticed those changes as yet.

Bottom line: a parent with a stroke means you’re at higher risk than average so do everything else you can to lower your risk.

The second study showed similar early “silent stroke” changes in the brains of people who suffer from sleep apnea, and the worse the apnea, the more changes that were found.

Same bottom line, of course, for such people, too.

I’m Dr Art Hister

February 5th, 2012

Massage is good for you in more ways than you think

For many and variable reasons nearly everyone likes a good massage.

And now there’s some good proof from a terrific little study that massage is also good for what ails you, so long as what ails you is some kind of muscle pain or discomfort.

In this study, done at McMaster University in Hamilton and published in the journal Science Translational Medicine, researchers studied the effects of massage therapy on leg muscles in 11 young active men by taking samples from those muscles after exercise on both legs, only one of which was massaged.

They conclude that massage not only had an anti-inflammatory effect, which means it helps the muscle tissue recover more rapidly after exercise and likely with less discomfort, but there was also a huge potential long-term benefit from massage in that the massage stimulated the muscle cells to develop more mitochondria, which are usually referred to as the engines of cells.

If that’s true and it can be confirmed in larger, more elaborate studies, especially ones done on non-athletes, it opens up a huge potential area for treatment of all sorts of muscle-related problems, particularly, one would hope, in the elderly.

I’m Dr Art Hister

February 2nd, 2012

Testosterone

Something all women have known, well, since at least the woman who came right after Eve: most men don’t tend to co-operate in tasks as well as most women do, and the answer likely lies in biology.

That is, it’s most likely that hormone differences account for the differences between the two genders in the ability to co-operate, and most researchers would put their bets on the higher levels of testosterone that men have which makes many men – take your pick here - more aggressive, more assertive, more confident in their own abilities, bigger jerks when it comes to working with others, etc.

So, here’s the deal: in some ingenious research involving 17 pairs of women, on one day, researchers gave the women a placebo pill before making them do an experiment that involved co-operating to solve properly.

With a placebo pill, the women were quite able to co-operate and solve that problem.

On another day, however, the researchers gave those same women some testosterone instead of placebo, and on that day, the women’s level of co-operation needed to solve the problem dropped dramatically.

The studies appear in the journal Proceedings of the Royal Society .

I’m Dr Art Hister




Just another indication
that no one is immune to this potentially serious infection...

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