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Can Exercise Ease Insomnia?
Tweet Share on Facebook March 3, 2009 CommentCan tiring myself out with exercise before bed be a helpful remedy for my insomnia, or is it likely to make matters worse? Nothing else seems to help.
Exercise is "nature's best tranquilizer," but vigorous exercise before bed may be more of a stimulant because of the endorphin effect. Instead, try taking an early evening walk, which may help you relax and help you sleep when followed by a warm bath. Also, keep in mind that vigorous exercise is not recommended for at least 90 minutes after a heavy meal since during that time blood tends to be shunted away from the brain—that is what makes you sleepy after a meal—and from the heart into the digestive system. Vigorous exercise too soon after a meal could cause heart problems. To help you control stress and even your body weight, I would encourage you to do vigorous exercise before, not after, your evening meal. -
Is Poor Sleep a Risk Factor for Heart Disease?
Tweet Share on Facebook March 3, 2009 Comment (2)
Defining poor sleep is challenging. A sufficient amount of sleep for one individual may be inadequate for another individual or even the same individual when confronted with an increase in physical or mental stress during the wakeful hours. Sleep deprivation can be acute—a drastic reduction in sleep for one to two nights—or chronic—a mild or moderate sleep deficiency over several nights. Long-term sleep deprivation can be bad for the heart because it can contribute to obesity (increased hunger) and increase stress levels.One problem called obstructive sleep apnea can have a direct negative effect on the cardiovascular system. This condition typically occurs from collapse of the throat during sleep, which leads to obstruction of the flow of air into the lungs until the lack of air arouses the individual to a semiconscious state. This then restores muscle tone in the throat, allowing the flow of air into the lungs. During the times of airflow obstruction, lung pressures increase and blood pressures may increase quite high before airflow is restored.
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Does Integrative Medicine Address Sleep Problems?
Tweet Share on Facebook March 3, 2009 Comment (2)I have chronic sleep problems, and nothing seems to help. I don't want to take prescription medications. Does integrative medicine address sleep problems? If so, what's the approach? Have any natural remedies been shown to be effective?
Sleep is such a crucial part of health and often not something medicine addresses until it is a significant problem. Medications can be helpful in breaking a sleepless cycle, but integrative approaches can be very helpful in the long run.First, of course, you should be certain you are practicing what is called good "sleep hygiene." Be sure to use your bed only for sleep (and sex!), but don't use your bed as your office, for example. You want crawling into bed to signal to your body that it is time to sleep. Go to sleep and wake up at approximately the same times every day, and don't exercise too close to bedtime. Once you've gone to bed, if you can't sleep after 20 to 30 minutes, get up and do something boring. This is often better than staying in bed and getting increasingly agitated that you are not sleeping.
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Is Stress a Risk Factor for Cancer?
Tweet Share on Facebook February 19, 2009 Comment (11)
Evidence from epidemiological studies suggests that chronic depression and/or a paucity of supportive personal relationships may be risk factors for the development and progression of some kinds of cancer. For example, one study of women with ovarian cancer suggests that stress and low social support may be related to certain growth factors in the tumor microenvironment—the place where cancer cells interact with surrounding cells. In some new studies from Eric Yang and Ron Glaser and others, melanoma, nasopharyngeal carcinoma, and multiple myeloma tumor cells have receptors for the stress hormones norepinephrine and epinephrine, and when cancer cells are exposed to these stress hormones in the laboratory, the cancer cells produce factors that favor the spread of the tumor cells; if this happens in the body, it could increase the risk for metastases. -
Good Carbs, Bad Carbs—Which Is Which?
Tweet Share on Facebook February 19, 2009 Comment (8)There seems to be a war against carbohydrates today, with the Atkins and similar diets. Do carbohydrates really pose health risks?
This is a war that has some justification, but we do need to distinguish between good and bad carbohydrates. The reality is that the vast majority of carbohydrates in the American diet are refined starches, sugar, and potatoes, and a war against these is justified. High-fructose corn sweetener should be considered the same as regular table sugar. These carbohydrates provide many empty calories (meaning that they contain few or no nutrients) and have multiple adverse metabolic effects, including the elevation of blood triglycerides and blood pressure and reduction of HDL (good) cholesterol. Reducing these carbohydrates should be a top nutritional priority.On the other hand, whole grains come with lots of fiber, minerals, and vitamins, and we do see that higher intakes of these carbohydrates are related to less weight gain and lower risks of diabetes and heart disease. Thus, replacing the huge amounts of refined starch and sugar in our diets with healthy forms of carbohydrates can have very positive benefits. If we are consuming healthy fats and healthy carbohydrates, the exact proportions don't make a major difference, which gives people many options for creating delicious and healthy meals.
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Are Mono and Hodgkin's Lymphoma Linked?
Tweet Share on Facebook February 19, 2009 Comment (3)I read that there is a link between mono and Hodgkin's lymphoma. If my child gets mono, should I panic?
No, you should not panic. For many young people, mono is a tough disease that knocks the socks out of them just as they are in the most active and productive parts of high school or college. Mono is caused by the Epstein Barr virus. Its symptoms are swollen glands, sometimes a swollen spleen, and almost always a profound level of fatigue lasting from a few days to many months. Mono is quite a common disease affecting as many as 1 in 100 people ages 15 to 25.What you have probably read is that Epstein Barr virus may also be implicated in Hodgkin's lymphoma, which is a cancer of the lymph glands. Scientists believe there is some sort of association, although it is still unclear exactly how the association works. If you read about Hodgkins, you will read that one risk factor for getting it is a past history of mono.
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When Should I Consider a Statin?
Tweet Share on Facebook February 5, 2009 Comment (1)My cholesterol is a little high, and my doctor says I might benefit from a cholesterol-lowering statin. What else should I look at to help make this decision?
There's no black or white answer about whether to take a statin if your "bad" LDL cholesterol level is moderately high—between 160 mg/dL and 190 mg/dL—and you've got no other heart-attack risk factors like diabetes or established heart disease. The first step is to work harder on improving your dietary and exercise habits. If you are over age 50, most doctors such as myself would favor treatment to reduce your risk of developing progressive hardening of the arteries. Ask your doctor to calculate your Framingham risk score to estimate your risk of heart attack over the next 10 years.There are a few additional tests you might want to consider having if you're on the fence.
A routine blood test called high-sensitivity C-reactive protein can help determine whether you've got inflammation, which promotes plaque formation in your arteries. Statins can be additionally helpful if you have elevated hsCRP since they lower inflammation along with LDL.
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Is There a Link Between Birth Control Pills and HPV?
Tweet Share on Facebook January 29, 2009 Comment (4)
Studies have associated long-term use of birth control pills (more than five years) with an increased risk of cervical cancer. Since cervical cancer is caused by HPV, which is sexually transmitted, the association of HPV with birth control use may be related to sexual activity, not the pills themselves. We know that the risk of infection with HPV is increased with younger age at first intercourse, more frequent intercourse, and more partners.The good news today is that the HPV vaccine given several years before first intercourse provides excellent protection against HPV infection. I encourage all parents to immunize their children against HPV before the teen years so that immunity develops well before first intercourse. Currently the HPV vaccine is approved only for females, but it is clear that males also develop HPV-related cancers and I hope it will be approved for males soon as well.
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My Mother Had Breast Cancer. Should I Get Tested for the Breast Cancer Gene?
Tweet Share on Facebook January 29, 2009 Comment (3) Most breast cancer is not associated with an inherited predisposition, but it is normal to worry about your risk if your mother had the disease. Families with genetic, or inherited, breast cancer are usually characterized by multiple cases of early onset breast cancer occurring before age 50 and spanning multiple generations. If there are cases of male breast cancer, women with cancer in both breasts, or ovarian cancer in the family, the suspicion for a genetic cause of breast cancer increases. If a family meets these criteria, genetic counseling and testing are reasonable. When possible, we begin testing with a family member who has been affected with cancer. -
Will Americans Ever Change Their Diet?
Tweet Share on Facebook January 26, 2009 CommentI am optimistic that Americans will change their diets for the better, but such changes don't happen overnight. For example, we have seen that saturated fat has declined from about 18 percent of calories to 11 percent over the last 40 years, and egg consumption has decreased by about half over that time. Also, some important changes can happen quickly by modification of the manufacturing process; in this way we have cut trans fat intake by about 2/3 over the past five years. This was virtually invisible to consumers but has been a tremendous change for the better. We now need to do the same with salt, which primarily comes from processed foods.
