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Monday, February 28, 2011

@drportnay, 2/28/11 11:31 AM

Dr Ted Portnay (@drportnay)
2/28/11 11:31 AM
The Dr Ted Portnay Daily is out! http://bit.ly/eyo6B9 ▸ Top stories today via @drdavidkatz @doctorwes @drsharma @yourhealthnut

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Friday, February 25, 2011

@drportnay, 2/25/11 11:30 AM

Dr Ted Portnay (@drportnay)
2/25/11 11:30 AM
The Dr Ted Portnay Daily is out! http://bit.ly/eyo6B9 ▸ Top stories today via @hearthub @missfitness33 @healthyamerica1 @scrippshealth

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Thursday, February 24, 2011

@drportnay, 2/24/11 11:40 AM

Dr Ted Portnay (@drportnay)
2/24/11 11:40 AM
The Dr Ted Portnay Daily is out! http://bit.ly/eyo6B9 ▸ Top stories today via @flheartgroup @healthtoheart @yonifreedhoff @yourhealthnut

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Wednesday, February 23, 2011

Recent tweets

  1. Aspirin, Cost-Effective Heart Disease Preventionhttp://mnt.to/f/3Rvr
  2. Drinking Reduces Heart Problems, But Beware Of Alcholismhttp://mnt.to/f/3Rxb
  3. BMI-death link is same for Asians as Europeanshttp://feedproxy.google.com/~r/Theheartorg/~3/1bImDHCH9aQ/1188959.do
  4. The Dr Ted Portnay Daily is out! http://bit.ly/eyo6B9 ▸ Top stories today via @publichealth @tuftsmedicalctr @shmlive
  5. ?Ideal' CV health extremely low among the middle-agedhttp://bit.ly/dEYGzv via Cardiology Today iPhone App
  6. Study Finds Nitroglycerin Improves Bone Densityhttp://cardiobrief.org/2011/02/22/study-finds-nitroglycerin-improves-bone-density/
  7. A good well written piece on the recent cell phone-brain connection @nprnews: Cell Phone Radio Waves Excite Brain Cells http://t.co/dyIZKTZ
  8. CDC survey: Statin use increased 23% over past two decadeshttp://tinyurl.com/4e4hnkz
  9. Reducing Medication Errors using an iPod Touch #HIMSS11http://tinyurl.com/4sbncmx
  10. Physicians Replace Diseased Heart Valve Through Small Hole In The Leg http://tinyurl.com/4e72jtp
  11. Gender Does Not Increase Risk Of Death From Heart Attackhttp://tinyurl.com/4wfgyt3
  12. Clot Risk Higher in Patients With IBDhttp://tinyurl.com/4cbztj7

Preventing Heart Disease in Women

The American Heart Association just recently updated its recommendations for preventing heart disease in women

While not a dramatic update, it does change the criteria for high risk from those women with a 20% 10-year risk to those with a 10% 10-year risk.

The authors also added some new criteria for at-risk status, including lupus, rheumatoid arthritis, and three pregnancy complications -- preeclampsia, gestational diabetes, and pregnancy-induced hypertension.

So what are the risk factors for heart disease. I like to think of them as those that are "controllable" and those that are "non-controllable".

Non-controllable Risk Factors
- You have a family history of premature coronary artery disease or stroke (occurring in male family members less than 55 years old, or in women family members less than 65 years old).
- You are age 55 or older
- You are post-menopausal, or have had your ovaries removed
- During pregnancy, you have had preeclampsia (significant hypertension) or gestational diabetes, or you delivered a low-birth-weight baby.

Controllable Risk Factors
- You are overweight or obese
- You have a sedentary lifestyle
- You are a smoker
- You have hypertension
- You have high total cholesterol, and/or reduced HDL cholesterol
- You have diabetes
- You have metabolic syndrome
- You have increased C-reactive protein (CRP) levels
- You use birth control pills, especially if you are also a smoker

If you have any of these risk factors, this should be discussed with your doctor to better understand your individualized risk for heart disease and steps that can be taken to help reduce this risk.

Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-based guidelines for the prevention of CVD in women—2011 update. A guideline from the American Heart Association. Circulation 2011; DOI:10.1161/CIR.0b013e31820faaf8.

BMI - Death correlation exists - irrespective of your race

A new study was just published exploring the association of body-mass index (BMI) and risk of death.

This study showed that in an Asian population, there exists the same U-shaped curve that exists in individuals of European decent. This U-shaped curve reveals that there is higher rates of death the more extreme deviation from "normal" weight - both on the high side and the low side. Individuals with very low weight and very high weight have much increased risk of death compared with "normal" weight individuals.

This study also showed that the same BMI criteria for overweight (BMI >25 kg/m2) and obese (BMI >30 kg/m2) could be applied to an Asian population as is applied to a population of European decent.

How does one calculate their BMI? Its easy, just use one of the readily available online calculators. Or use a BMI chart.

As the researchers state "The main message is that people must be encouraged to maintain a normal weight: too low and too high are both unhealthy. To do this, people must eat healthily, do more exercise, and not smoke."

Monday, February 21, 2011

Aerobic Exercise May Improve Memory In Seniors

I found the following story on the NPR iPhone App:

Aerobic Exercise May Improve Memory In Seniors
by Michelle Trudeau

- February 21, 2011

There's a very small structure deep in the center of our brains called the hippocampus. It's smaller than your pinkie, but it plays an absolutely essential role in learning and memory. The hippocampus encodes new information so that we can recall it later. Without a hippocampus, we would be unable to form new memories; we'd only be able to remember the old ones.

As part of normal aging, the hippocampus shrinks. And this shrinkage speeds up as we grow older, foreshadowing memory problems and dementias like Alzheimer's disease.

But there's been some good news in the past decade: Scientists have discovered that in certain areas of the aging brain, new cells are born and grow throughout through life. Neuroscientist Peter Snyder, a researcher at Brown University's Alpert Medical School and Rhode Island Hospital, says the hippocampus is one of those brain areas that continue to form new cells and make new connections between cells.

"What we're finding is that of all of these noninvasive ways of intervening, it is exercise that seems to have the most efficacy at this point — more so than nutritional supplements, vitamins and cognitive interventions," says Snyder, who studies what we can do to maintain memory as our brains age.

Power Of Exercise

Snyder says several studies have been published recently on the power of exercise on the aging brain.

"The literature on exercise is just tremendous," he says. "What we find is that with exercise — with aerobic exercise, a moderate amount on a regular basis — there are chemical changes that occur in the brain that promote the growth of new neurons in [the hippocampus]."

The major chemical change in the hippocampus during aerobic exercise is an increase in a brain protein called BDNF, which acts like a fertilizer during the birth of new brain cells by nourishing new connections between neurons.

Some of the most provocative evidence on the power of exercise on the brain comes from a study just published in the Proceedings of the National Academy of Sciences by neuroscientist Art Kramer at the University of Illinois, Urbana-Champaign. Kramer and his colleagues have documented the impact of exercise on the growth of the hippocampus in a small group of elderly people over the course of one year.

"The participants in our study were 120 very sedentary people," Kramer says.

He adds none had dementia or memory problems when they entered the study. "They were relatively healthy, but certainly 'couch potatoes' would fit as a label."

Getting Couch Potatoes Moving

One of those "couch potatoes" who volunteered for the study was Gregory Stanton, a 66-year-old semi-retired college professor. He admits to not exercising regularly but counters that he was physically quite active remodeling his home. So he refers to himself as "a semi-couch potato."

Stanton and the other 120 men and women in the study ranged from 60 to 80 years old. When they entered the study, they were randomly divided into two groups.

"One was the aerobic exercise group," Kramer says. "Those were people who walked further and faster as time went on. And the others in our control group were in a toning, stretching and light-strengthening group."

Stanton was randomly assigned to the aerobic exercise group.

"Basically, it's walking a track in one of the gym facilities," Stanton says. He and the others in the aerobic group walked the track for about 40 minutes three times a week for a year. Stanton says he averaged about 3 miles each session. After each session, he was breathing hard and had worked up a sweat, he says.

The idea was for each participant to walk fast enough to reach aerobic exercise level, Kramer explains, which is generally considered to be 70 percent of one's maximum heart rate.

Walkers Fared Better

All the participants in the study had MRI brain scans done before the study began and again a year later when the study ended. Then the researchers analyzed the MRI data.

"What we found," Kramer says, "is that individuals in the aerobic group showed increases in the volume of their hippocampus."

The increase in volume — again for the aerobic but not for the non-aerobic group — was about 2 percent.

"The 2 percent increase we can think of as turning back the clock about two years," Kramer says.

The increased volume was found in the anterior, or front part, of the hippocampus. That's the area of the hippocampus that has been shown to grow as a function of exercise in several animal studies.

By comparison, "the individuals in the control group — in the toning and stretching group — lost about 1.5 percent [of their hippocampal volume]," Kramer says. "So we can think of it as about a 3.5 percent difference compared to those individuals who didn't benefit aerobically."

The results are small but suggestive. This finding shows that not only did the aerobic exercise protect against normal shrinkage, but also that new cells were added to the hippocampus. The researchers also saw a significant increase in that important brain-fertilizing chemical BDNF in the plasma of those in the aerobic exercise group — but not in the control group.

Impact On Memory

But did the growth in the hippocampus translate into improvements in memory? Both groups were given memory tests before and after the yearlong exercise program. Kramer says these tests looked specifically at a type of memory called "spatial memory," which records information about our environment, like the layout of the neighborhood or the interior of the grocery store.

At the start of the study, both the aerobic and the non-aerobic group scored similarly on the spatial memory test. But after the yearlong program, the group that did aerobic exercises had improved significantly on its spatial memory tests, bettering its own scores from a year earlier. The non-aerobic group had not improved in memory after a year of stretching, toning and lightweight lifting.

As for "semi-couch potato" Stanton, who'd been in the aerobic group, he says he didn't notice any improvement in his memory. He still has problems remembering people's names. But he did notice he had more physical stamina after the yearlong aerobic walking program.

In spite of this, Stanton says he still doesn't maintain a regular exercise regimen. He says while he knows it's good for him, he, like many of us, can't find the time. He's just too busy. [Copyright 2011 National Public Radio]

To learn more about the NPR iPhone app, go to http://iphone.npr.org/recommendnprnews

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Monday, February 14, 2011

Automatic referral to Cardiac Rehab

Feb. 14 (HealthDay News) -- Heart disease patients are far more likely to undergo cardiac rehabilitation if they are given an automatic referral after discussing the matter with their doctor, a new study finds.

Evidence shows that cardiac rehabilitation reduces illness and death by about 25 percent over one to two years. However, 70 percent to 80 percent of eligible heart disease patients in Canada, the United States and United Kingdom do not receive cardiac rehabilitation after hospital discharge, according to background information in the study.

Researchers surveyed more than 2,600 patients with coronary artery disease who were treated at 11 Canadian hospitals that used one of four referral strategies for cardiac rehabilitation: an automatic referral using electronic patient records or standard discharge orders; liaison referral, in which the referral occurs after a discussion with a doctor; a combination of both automatic and liaison strategies; or usual referral, in which certain patients are referred at the discretion of a doctor.

Patients who were automatically referred after talking with their doctors were the most likely to enroll in rehab, according to the study.

More than 70 percent of patients who received the combined automatic/liaison referral enrolled in rehabilitation compared to 60 percent with automatic referral alone, nearly 51 percent with liaison alone and 29 percent when referral was left up to the doctor's discretion.

The combined automatic/liaison method may be most effective because it relies on both the automatic referral and because patients and doctors are involved. The discussion allows patients to get their questions answered and may make them more willing to try cardiac rehabilitation, according to study author Sherry Grace of York University in Toronto and her colleagues.

"Implementation [of the combined strategy] could potentially raise cardiac rehabilitation use 45 percent, suggesting that major public health gains could be achieved in the population being treated for cardiac disease," the authors concluded.

The study is published in the Feb. 14 issue of the Archives of Internal Medicine.

More information

The U.S. National Heart, Lung, and Blood Institute has more about cardiac rehabilitation.


Wednesday, February 9, 2011

Best Route To Heart May Be Through Your Wrist

I found the following story on the NPR iPhone App:

Best Route To Heart May Be Through Your Wrist
by Scott Hensley

- February 8, 2011

Let's be clear, this isn't a post about Valentine's Day, or anything else romantic.

Just the opposite. If you've got real, honest-to-goodness heartache caused by medical problems, there's a pretty good chance you'll get a catheter snaked into the arteries feeding your heart to check for a blockage and maybe put in some stents. More than one million Americans a year get these cardiac catheterizations.

Usually the doctor gets started with an incision in your groin and pushes the catheter through a femoral artery. Not fun. But, as the Wall Street Journal's Ron Winslow reports, some cardiologists are pushing an alternate route.

They say going through an artery in the wrist, though a little more demanding on the doctors, has safety advantages for the patients. Snaking the catheter through a radial artery lowers a patient's risk of bleeding.

In the U.S., only about 8 percent of catheterizations are done through the wrist, though that's about quadruple the rate of of four years ago. In some European countries more than half the procedures are done through the wrist.

As one patient who'd had catheterizations both ways told Winslow about the newer method, "It was like going from something caveman archaic to modern medicine."

Poor circulation can mean the wrist approach isn't a good idea. Ask your doctor about the alternatives, if you're interested.

And don't be bashful about asking if the procedure is really necessary. A big study published last year found that about 200,000 Americans who undergo angiograms each year don't get very useful information from the tests. The problem is, it's hard to know ahead of time who will benefit and who won't. [Copyright 2011 National Public Radio]

To learn more about the NPR iPhone app, go to http://iphone.npr.org/recommendnprnews

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Checking Up On Michelle Obama's Anti-Obesity Effort

I found the following story on the NPR iPhone App:

Checking Up On Michelle Obama's Anti-Obesity Effort
by Ari Shapiro

- February 9, 2011

First lady Michelle Obama is spending the week promoting the first anniversary of her Let's Move! initiative. Her goal is to solve the problem of childhood obesity within a generation.

The idea of a sustained project for the first lady started in the early 1960s.

"It was Jacqueline Kennedy's work on refurbishing the White House, and that sort of set a bar early on," says Myra Gutin of Rider University in New Jersey, who studies the history of first ladies. "First ladies generally are dealing with less controversial or uncontroversial issues, but those which tend to benefit many people in the country."

Lady Bird Johnson focused on highway beautification. Rosalynn Carter addressed mental health. Barbara Bush took on literacy. And in that respect, Gutin says, the Let's Move! initiative is right in line with what others have done.

But Gutin says Michelle Obama goes further than her predecessors: "She has partners from Major League Baseball to Wal-Mart, and no other first lady initiative that I can think of had that kind of support from the corporate world."

Last month, the first lady said she was "thrilled" as she joined Wal-Mart executives to announce that the grocery chain will reduce sugar, sodium and trans fats in thousands of its products. The month before that, she persuaded Congress to pass a $4.5 billion child nutrition bill.

At the signing ceremony, the president credited his wife with giving the bill the urgency it needed to become a law.

"Had I not been able to get this passed," President Obama said, "I would be sleeping on the couch."

Into The Mainstream

Marion Nestle, a professor of nutrition, food studies and public health at New York University, says the first lady has moved what used to be a niche movement into the mainstream.

"There's no question that there are enormous changes taking place in school lunches," Nestle says. "You can see that all over the country, where schools everywhere are trying to do something to improve the quality of the food that they're serving to children. So this is having an immediate impact."

The first lady rarely misses an opportunity to plug the program. Guests who are invited to the White House for a meal will often read that ingredients on the menu come from the White House garden. Even the president's Super Bowl party included — on top of the kielbasa and buffalo wings — White House honey ale.

Michelle Obama held conference calls Tuesday to thank mayors, school officials and medical professionals who have been involved in the program.

"It's pretty amazing, for me at least, to look back and see how far we've come," she said.

Surgeon General Regina Benjamin said there is no greater challenge to the country's health than obesity. "Since 1980," she said, "obesity rates have doubled in adults and more than tripled in children, and the problem is even worse among black, Hispanic and Native American children."

An Overreach?

It helps that kids' nutrition has historically been a bipartisan issue. Five years ago, Democrat Bill Clinton and Republican Mike Huckabee teamed up on a childhood obesity program.

But now that the White House is steering the ship, some Republicans have jumped overboard.

Glenn Beck, Rush Limbaugh and Sarah Palin have all attacked Michelle Obama's program directly.

"Instead of a government thinking that they need to take over [and] make decisions for us according to some politician or politician's wife's priorities — just leave us alone. Get off our back," Palin has said.

During the Super Bowl telecast, viewers in Washington, D.C., saw an ad against a proposed soda tax that struck a similar tone — without mentioning Obama's program specifically.

"Give me a break. I can decide what to buy without government help," the woman in the ad says. "The government is just getting too involved in our personal lives."

While critics accuse the program of being too heavy-handed, many of these changes come from agreements, rather than regulations. No surprise: The first lady favors carrots over sticks — and also carrots over Twinkies.

Now that her team has made advances getting healthier foods into public schools and grocery stores, they are working on the next frontier: more nutritious options in restaurants. [Copyright 2011 National Public Radio]

To learn more about the NPR iPhone app, go to http://iphone.npr.org/recommendnprnews

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Tuesday, February 1, 2011

Tips to Get Motivated

From celebrity fitness expert Mandy Ingber in the Jan 10th, 2011 issue of People Magazine

Yes - I read People magazine. Great health and fitness advice can be found all over the place. When I find it, I like to share it.

  1. Stay Hydrated
    1. Water regulates body temperature and helps convert food to energy
    2. Divide you body weight by 2 for your daily intake
    3. So, if you are 120lbs, you should be drinking 60oz of water per day
  2. Move your body
    1. For one hour a day, that's it. Just move it! Dance, walk, cycle, jump, play sports, do yoga, but whatever you chosse, keep it moving
  3. Sleep
    1. Sleep is one of the greatest things you can do for your health
    2. Make sleep a ritual and try and wind down beforehand
    3. Eat meals early enough so that your body has at least 3 hours to digest and completely let go when it is time
  4. Eat all day long
    1. When you eat 5-6 small meals a day, you can increase your metabolism so that your body is burning fuel all day long
    2. Choosing healthy, clean, non-sugary whole foods will regenerate you blood sugar throughout the day, so that you are always satiated
  5. Smile
    1. Smiling is one of the best ways to change your attitude
    2. It can connect you with others, and give real physical benefits to your body