Posts Tagged ‘Risk Of Heart Disease’

Fortifying your knowledge of vitamins

By Tyrone M. Reyes, M.D.

Take a multivitamin for insurance.” Until recently, that was the usual advice from physicians, scientists, and other experts. Now, it’s under scrutiny: That’s because if you’re looking for hard evidence that a multivitamin will lower your risk of heart disease, cancer, cataracts, or other major disease, you may be disappointed. In 2006, the US National Institutes of Health held a State-of-the-Science Conference. Its conclusion: “Evidence is insufficient to prove the presence or absence of benefits.”

“Insufficient” is putting it mildly. By the time the scientists narrowed the field to trials that pitted a multivitamin against a placebo and excluded poorly done studies, they ended up with less than half a dozen — two of them done in China and two in France. The single US study looked only at vision. But it’s one thing to lack proof that multivitamins prevent disease. It’s quite another to find evidence that a multi might cause harm. After all, a handful of recent studies have suggested that people who take multivitamins — or a few of the nutrients they contain — might have a slightly higher risk of cancer. Here’s what to do until scientists sort out the confusion.

How To Read A Multivitamin Label

Please refer to the illustration of a made-up multivitamin label on this page. It lists how much of each vitamin and mineral we need to get every day (from food plus supplements), according to the US National Academy of Sciences’ Institute of Medicine (IOM). The IOM’s recommendations vary slightly by age and gender. In most cases, what is listed is the highest value for adults, excluding pregnant and breastfeeding women. The label also lists the Daily Value (DV) for each vitamin or mineral. It is the US Food and Drug Administration’s (FDA) advice on how much to shoot for each day (from food and supplements combined). The DVs, which haven’t been updated in decades, are still used on multivitamin labels. In some cases, the values date from 1968 and don’t reflect the recent research. Here is the current thinking on these nutrients (please refer to the values as indicated in the label):

• Vitamin A (retinol). The Daily Value (5,000 IU or International Units) is outdated. You need only 3,000 IU a day of vitamin A. Too much retinol (typically listed on labels as vitamin A palmitate or vitamin A acetate) may increase the risk of hip fractures, liver abnormalities, and birth defects. Beta-carotene, which the body converts to vitamin A, doesn’t cause those problems, but very high doses (33,000 to 50,000 IU a day) may increase the risk of lung cancer in smokers. Current advice: Don’t get more than 4,000 IU of retinol or 5,000 IU of beta-carotene from your multi (less retinol would even be better). Instead, load up on beta-carotene-rich fruits and vegetables like carrots, cantaloupes, sweet potatoes, and broccoli, which may help prevent some cancers.

• Vitamin C. The DV (60 mg) is lower than the IOM’s recommendations (75 mg a day for women and 90 mg a day for men). Roughly 250 to 500 mg saturates the body’s tissues, so more than that is probably excreted in urine. Taking more than 1,000 mg of vitamin C at one time in a supplement may cause diarrhea.

• Vitamin D. This vitamin helps you absorb calcium and may reduce the risk of cancer, diabetes, and falls. Some people may get too little vitamin D from sunshine or from their food. The IOM recommends 200 IU a day for adults 50 and under, 400 IU for people 51 to 70, and 600 IU for anyone over 70. Some vitamin D experts though say that everyone should get at least 1,000 IU a day. Those amounts include what you get from the sun, from salmon and other fatty fish, and from fortified foods like milk, breakfast cereals, and some brands of yogurt, margarine, and orange juice. They also include the vitamin D that’s added to many calcium supplements. Most multivitamins have 400 IU of vitamin D (the DV).

• Vitamin E. Doses of 30 to 800 IU a day haven’t protected against heart disease or stroke, and 400 IU a day or more may slightly raise the risk of dying. Studies are underway to see if 400 IU a day prevents prostate cancer. To play safe, stick to no more than 100 IU.

• Vitamin K. The IOM recommends 120 mcg/day, yet most multivitamins have much less than the DV (80 mcg). In recent studies, taking extra vitamin K doesn’t strengthen bones, as earlier studies had suggested. You can get K from leafy green, some calcium supplements, and vitamin K supplements. Vitamin K can interfere with blood-thinning drugs like Coumadin, so people who take them should check with their doctor before taking a multi with vitamin K.

• Thiamine (B-1), riboflavin (B-2), niacin (B-3), B-6. The higher-than-DV levels in many multivitamins are harmless. Two exceptions: More than 100 mg a day of vitamin B-6 can cause (reversible) neurologic damage. And as little as 50 mg a day of niacin can cause flushing. Super-high doses of niacin (3,000 mg a day or more) may cause liver damage, though you won’t find that much in a multivitamin.

• Folic acid. If you could become pregnant, look for a multi with the DV (400 mcg) to reduce the risk of birth defects. Others should probably take less until studies clarify whether high intakes (roughly 1,000 mcg a day or more from supplements and food combined) raise the risk of cancer. Since most multis have 400 mcg, one option is to take your “daily” multi every other day.

• Vitamin B-12. Most multivitamins have at least 6 mcg (the DV). That’s more than the 2.4 mcg the IOM recommends for adults, but it’s perfectly safe. (So are the higher doses — 600 to 800 mcg — that are found in a few multivitamins.) Ten to 30 percent of older people are unable to absorb the B-12 in the form that’s added to supplements and fortified foods. A B-12 deficiency can cause irreversible nerve damage and may masquerade as Alzheimer’s disease.

• Biotin, panthotenic acid. Ignore. You’d have to eat a bizarre diet to run short.

• Calcium. Calcium may help prevent colon cancer and (with vitamin D) may reduce the risk of osteoporosis. Shoot for 1,000 mg a day (if you’re 50 or younger) or 1,200 mg (if you’re over 50). But men should get no more than 200 mg from their multi, since 1,500 mg a day or more may raise prostate cancer risk.

• Iron. Many people, especially premenopausal women, are deficient. But taking too much can cause constipation or iron overload if you’re susceptible. Men and postmenopausal women should look for a multivitamin with no more than 10 mg of iron or should take a multi for premenopausal women every other day. The DV (18 mg) is fine for premenopausal women.

• Phosphorus. Unnecessary to take in a multi. Too much may impair calcium absorption, and we already get more than we need from our food.

• Magnesium. Many people get too little of magnesium from their food (among the best sources: whole grains and beans). A deficiency may increase the risk of diabetes and colon cancer. Look for a multi with at least 100 mg, just for insurance. The IOM recommends 320 mg a day for women and 420 mg for men. More than 350 mg a day from a supplement may cause diarrhea.

• Zinc, copper. Look for 8 mg (women) or 11 mg (men) of zinc and 0.9 mg of copper. There’s no harm in taking a multivitamin with the DVs (15 mg for zinc and 2 mg for copper), but don’t take more than 23 mg zinc. Getting more than 40 mg may make your body lose copper.

• Selenium. Many multis have less than the DV (70 mcg) or the IOM’s recommended level (55 mcg). A large study is under way to see if high doses (200 mcg) can lower the risk of prostate cancer. But a few studies have suggested that taking 200 mcg a day may raise the risk of skin cancer and diabetes, so it’s safest to take no more than about 100 mcg a day.

• Chromium. The IOM recommends only 20 to 25 mcg a day (women) or 30 to 35 mcg a day (men). Many brands have closer to 120 mcg (the DV), which is safe.

• Iodine, magnesium, molybdenum, chloride, boron. Ignore. There’s no evidence that people need more than what they get from their food.

• Potassium. Ignore. The amounts in multis are low. And while the potassium chloride that’s used in supplements may lower blood pressure and the risk of stroke, it won’t help prevent kidney stones and bone loss like the potassium citrate that’s found in fruits and vegetables.

• Nickel, silicon, tin, vanadium. Ignore. It’s not clear that they’re needed.

Source: Philstar

Why fat is belly bad and how to banish it

by Tyrone M. Reyes, M.D.

Having a large middle is not just a cosmetic issue — it’s a health threat. The excess fat tissue that makes it tough to tighten your belt also encases your abdominal organs, secreting hormones, inflammatory chemicals, and fatty acids that increase your risk of heart disease, high blood pressure, insulin resistance, type 2-diabetes, and possibly some cancers. Many scientists now believe that a wide waist circumference may be a better predictor of health risks than a battery of blood tests. But this is one risk factor you can do something about. Because abdominal or visceral fat (see figure) is more metabolically active than the fat that sits on your hips and thighs, it is easier to lose. The best way to trim it is a combination of diet and increased aerobic exercise.

A major study of more than 27,000 people from 52 countries, drawn from diverse ethnic and racial groups, found that those people with the largest waist were 75 percent more likely to suffer a heart attack compared to those with the narrowest waistline. At the same time, this study, which was published in the November 2, 2005 issue of The Lancet found that a high body mass index (BMI) was a less accurate predictor of cardiovascular risk. Even among men of normal weight, heart disease risk was higher for those with big bellies. So all you may need to judge your future risk of a heart attack is a measuring tape! (more…)

Take heart: This gadget could save your life

by Ching M. Alano

While we probably can’t do anything about the high fuel prices and the high cost of living (except perhaps to swear to the high heavens), there’s one thing we can control: high blood pressure.

Did I see you raise your skeptical eyebrows sky-high? The lowdown on high blood pressure is, yes, you can monitor and chart it daily in the comforts of your home via the Omron blood pressure monitors.

But you ask, “Why is it a matter of life and death that we manage and prevent high blood pressure?”

High blood pressure is a primary risk factor for triggering heart disease, stroke, and diabetes. It is often called the silent killer because it does not usually cause symptoms, thus people brush it aside until it’s too late. Which brings us to another question: Is high blood pressure a disease?

Per se, having high blood pressure doesn’t mean you are sick. But it can make you sick because high blood pressure puts a strain on the blood vessels, eventually causing their inner walls to weaken and become more prone to damage. And then, if lipids, such as cholesterol and neutral fats, become attached to these damaged inner walls, thus producing thrombus, blood flow gradually becomes hampered. In medical lingo, this is called arteriosclerosis. This results in a higher risk of heart disease such as angina pectoris and myocardial infarct as well as cerebral hemorrhage, brain infarction, and even something more serious as renal (kidney) failure.

According to the Philippine Society for Hypertension (PSH), there are about seven to 10 million Filipinos with hypertension and two million suffering from diabetes. And there are about five million Filipinos with coronary artery disease.

But don’t lose heart. Research shows that we can lower our heart disease risk significantly — that is, by as much as 82 percent — by simply adopting sensible health habits. Even the older elderly population, aged 70 to 90, can reduce their chances of dying of heart disease by nearly two-thirds by leading a heart-healthy lifestyle.

For heart’s sake, we should take charge of our health. And the first step to a healthy heart is knowing our own risks for health diseases. But then again, while doing our darndest to lead a healthy lifestyle, we may need a little help, like regularly visiting our doctor and constantly monitoring blood-related data, so we can keep up-to-date records even at home and have accurate records to show our doctor when we go for a checkup.

In its hearty bid to promote heart health, Collins International Trading Corporation (CITC), exclusive distributor of Omron sensing devices, recently tied up with the Philippine Society for Hypertension.

Of course, the digital blood pressure monitors on the market today are a dime a dozen, but they don’t really guarantee accurate readings. Aware of the need of the growing legion of health-conscious individuals to get correct BP measurements, CITC sought the help of PSH in accrediting two models of Omron BPM: Omron Blood Pressure Monitor Arm type — SEM 1 and Omron Intellisense Blood Pressure Monitor Arm type — IA2. At least 15 units of each model were tested.

The board members of PSH, 10 doctors, and two observers (resident doctors or personal nurses) conducted a series of tests on Omron’s blood pressure monitors.

“At least 120 subjects/patients, 18 years old and up, were recruited from general medical and specialist clinics,” relates Omron marketing manager Julie Lee. “These patients were tested with our Omron BPM consecutively with a mercury sphygmomanometer in nine sequential readings at one-minute intervals.”

At simple rites held recently, the PSH formally accredited the two Omron blood pressure monitors. Lee asserts, “We want to elevate the understanding of every Filipino household that health monitoring should start in our own homes and we are fortunate that Japan’s leading brand of sensing technology has been in the country for many years now and it has been giving us accurate reading and measurement.”

To go to the heart of the matter, the Omron Intellisense blood pressure monitor (BPM) is designed for comfort and ease of use. It makes each measurement personalized, regardless of arm size, blood pressure fluctuations or time of measurement. It is also very useful even for people with arrhythmia or heart disease. Makes sense, doesn’t it?

The Omron BPM has features that assure that its reading is accurate, such as the body movement indicator and irregular heartbeat detector. The body movement indicator helps the user detect any error in measurement due to body movement, thus ensuring more accurate blood pressure readings. On the other hand, the irregular heartbeat detector helps eliminate the frustrating “error” messages that are normally shown on other oscillometric BPMs when an irregular heartbeat occurs (the patient should consult a doctor if he sees the indicator frequently.

Don’t you think it’s high time you got yourself this sensible high blood pressure sensing device?

Source: Philippine Star

Can tea really ward off disease?

by Tyrone M. Reyes, M.D.

Tea is in. In the past few years, more and more Filipinos have developed a taste for tea.

That makes it now the country’s fourth most popular beverage, after water, soft drinks, and coffee.

And green tea extracts are the fastest growing dietary supplements.

There’s no doubt that tea is an invigorating drink – you can probably credit its caffeine for that (tea has about half the caffeine of coffee).

And the national waistline would be far better off if we replace some of that soda with tea (provided we sip it with little or no sugar).

But does tea lower the risk of cancer, heart disease, and obesity, as some manufacturers claim? Let’s check the tea leaves.

Heart Disease

“Tea drinking is associated with improved cardiovascular health,” says the Tea Association’s Web site. Yet the U.S. Food and Drug Administration (FDA) concluded in 2006 that “there is no credible scientific evidence” that green tea can reduce the risk of heart disease. (The evidence for black tea isn’t good, either.) Who’s right? “It’s confusing when you look across all the epidemiological studies,” says tea researcher David Maron of the Vanderbilt Heart Institute in Nashville, Tennessee. “Some studies find that drinking tea is linked to less cardiovascular disease, some do not, and some actually find an increased risk from drinking tea.”

Clearly, though, the Tea Association isn’t confused. According to the industry group’s Web site, a University of North Carolina analysis of more than a dozen published studies “found an average estimated 11 percent lower rate of heart attacks among study participants who drink three or more cups of tea per day.” The tea folks fail to disclose that the studies’ results were so contradictory that, statistically, the 11 percent reduction was no different from a zero reduction. But what if three cups a day aren’t enough? Apparently, neither are five cups, at least not in the most recent large studies that looked at the health of tea drinkers.

Among 40,000 healthy middle-aged and older Japanese men and women, those who drink five or more cups of green tea a day were just as likely to die of heart disease during an 11-year period as those who drank less than one cup a day. Unfortunately, clinical studies – which give people tea or a placebo and wait to see what happens – are scarce. “There really is not a lot of evidence from good clinical trials,” notes Maron. “None have looked at whether drinking tea or taking tea extracts prevent heart disease or strokes, and only a few have looked at whether it lessens any risk factors.”

In 2006, the FDA reviewed the evidence after a Japanese company asked for permission to say on its labels that its green tea could lower the risk of heart disease. In the seven good clinical studies submitted by the company, green tea or green tea extracts did nothing to lower cholesterol or blood pressure. The FDA denied the company’s petition.

However, a 2003 clinical study found that 114 men and women who took a tea extract called Teaflavin every day for three months ended up with LDL (“bad”) cholesterol levels that were 15% lower than those of 114 similar people who were given placebo. But the Teaflavin takers were getting the equivalent of 35 cups of tea a day. (Teaflavin combines the antioxidants theaflavin from black tea and catechins from green tea.) “It’s ridiculous to try to lower cholesterol levels by drinking tea because you would have to drink dozens of cups every day,” says David Maron, who conducted the study for Teaflavin’s manufacturer. “If someone can’t lower cholesterol by diet – or can’t or doesn’t want to use prescription statin drugs – then I would say he or she could try this extract to see if it helps.”

Bottom line: Drinking tea doesn’t appear to prevent heart disease. While one brand of tea extract lowered LDL (“bad”) cholesterol in one published study, that’s not enough to conclude it works.

Cancer

In the 1990s, tea seemed like a miracle cancer-fighter. “There’s no agent in the literature that has shown such remarkable effects in so many animal systems,” Hassan Mukhtar of Case Western Reserve University in Cleveland said in 1994. He was then hardly exaggerating. When researchers gave animals carcinogens, tea extracts reduced the number of tumors in the breast, colon, prostate, pancreas, skin, lung, esophagus, and small intestine. But what was missing 10 years ago is still missing today: evidence that tea also prevents cancer in people.

“While most of the animal studies that have been reported have been positive, the epidemiological data are not clear in finding a benefit for tea on cancer in humans,” says researcher Joshua Lambert of Rutgers University in New Jersey. For example, in that study of 40,000 healthy middle aged and older Japanese men and women, those who drank five or more cups of green tea a day were just as likely to die of cancer during an 11-year period as those who drank less than one cup a day. As for specific cancers:

• Colon. In 28 studies on three continents, people who drink the most black or green tea were just as likely to get colon cancer as those who drank the least.

• Prostate. In the most recent study, which looked at 19,000 Japanese men, those who drank five or more cups of green tea a day were as likely to die of prostate cancer as those who drank less than one cup a day. “The epidemiological evidence for black or green tea protecting against prostate cancer is not very strong,” says Anna Wu of UCLA.

• Breast. “Studies show that drinking black tea has no effect on breast cancer,” says Wu. In 13 studies in eight countries involving more than 160,000 women, those who drank the most black tea, usually four or more cups a day, were just as likely to be diagnosed with breast cancer as those who drank the least. For green tea, “the evidence isn’t very strong, either,” says Wu. In three studies that tracked nearly 70,000 Japanese women for seven to 24 years, those who drank at least five cups of green tea daily were just as likely to be diagnosed with breast cancer as those who drank little or none. But, says Wu, “We need additional human studies that carefully document the intake in order to draw strong conclusions about green tea and breast cancer.”

Why is the evidence that tea prevents cancer so strong in animals and test tubes, yet so weak in humans? “How much tea people consume versus how much is used in the animal experiments has always been a key issue,” says Rutgers’ Joshua Lambert. As a result, the concentration of those ingredients in the animals’ tissues may be 10 times higher than in the tissues of people who drink tea.

“When you look at the animal studies that use levels of tea more comparable to the concentrates found in human tissues, you don’t see an anti-cancer effect,” says Nurulain Zaveri of SRI International, a nonprofit institute in Menlo Park, California, that conducts research for industry and the government. “I think the value of the research we’re doing will be identifying how tea prevents cancer in animals and test tubes, and then developing drugs to do the same thing,” she says.

Bottom line: Tea prevents cancer in animals but in human studies, people who drank five more cups a day have no lower risk. Few studies have tested tea extracts on cancer in people.

Weight

In late 2006, two companies in the US marketed a carbonated diet green tea fortified with 100 mg of caffeine and 90 mg of epigallocatechin gallete (EGCG), an antioxidant that occurs naturally in tea. The companies claim that you can burn an additional 60 to 100 calories every 24 hours if you drink three 24-ounce cans daily.

So, does tea – or EGCG in tea – have any impact on weight? The evidence is pretty thin. In a handful of small studies that lasted only one to three days, people who took EGCG plus caffeine burned slightly more calories than those who were given placebo. But what happens after a few days? Do people eat more to compensate for the extra calories they’re burning, or perhaps stop burning extra calories? The results of the studies showed there was no difference between those who drank tea and those who took placebo after 12 weeks.

Bottom line: In a few very-short-term studies, people burned slightly more calories when given EGCG plus caffeine. But in longer-term studies, the combination had no consistent impact on weight.

While there may be other health benefits for tea, there is currently no concrete scientific evidence that drinking tea is beneficial for heart disease, cancer, or weight loss.

Source: Philippine Star

Coffee also rich in antioxidants

While the body naturally produces antioxidants, it needs additional amounts of these molecules for it to remain in a constant state of wellness.

Antioxidants help neutralize the body’s free radicals as they attack cell membranes and cause what is collectively known as oxidative stress, which has been suggested to cause premature aging and degenerative diseases of the cardiovascular, immune and nervous systems as well as cancer and cataracts.

This is why doctors advice that antioxidant-rich beverages be part of the diet. Regular consumption of fruit-made drinks as well as coffee, tea, and red wine, for example, are highly recommended.

Antioxidant-rich beverages include those made from banana, cranberries, blueberries, blackberries, strawberries, apples, peaches, mangos, and melons. But while these fruits are readily available, not many people take them on a regular basis. (more…)

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