More women die of heart disease than men, yet research has long focused on the fellows. In this enlightening TEDxWomen talk from last November, C. Noel Bairey Merz, MD talks about how heart attack presents differently in women and why it’s harder to detect. Dr. Merz is director of the Women’s Heart Center at the Cedars-Sinai Heart Institute. As principal investigator for the WISE study (Women’s Ischemia Syndrome Evaluation) for Coronary Vascular Dysfunction, she has been researching what’s going on in female pattern heart attack for the last 15 years.

Some of the Dr. Merz’ key points are:

• Men and women store fatty plaque differently, leading to different causes of coronary artery disease: “men explode and women erode.”
• For women, an MRI helps find microvascular coronary obstructions better than an angiogram or EKG
• Female stem cells could be better for producing repairs to damaged areas

What’s needed now is an all-out effort to raise awareness, screening and treatment for this silent killer.

Thanks to Kit Leong for sharing this video.

Atrial fibrillation is a major risk factor, causing an estimated 1 in 4 strokes, yet many people do not realize they have it. For my latest post, I spoke with cardiologist Dr. John Alexander, lead researcher at Duke University Medical Center to learn about the exciting new class of anticoagulant drugs and their pros and cons vs. warfarin. Check out the full story at GE Healthy Outlook.

You may also like my story for the Make Death Wait campaign at Heartandstroke.ca, about a large Canadian study by Dr. David Gladstone at Sunnybrook Health Sciences Centre to test an innovative monitoring device to better detect atrial fibrillation.

Sleep is important for learning, memory consolidation, alertness, productivity and mood, whereas sleep deprivation is linked to many chronic diseases like diabetes, cardiovascular disease, obesity, depression and some cancers. Naps during the day can boost mood, memory, perception, stamina, motor skills, accuracy, enhance your sex life and make julienne French fries. Well, not the last one, but there sure are lots of benefits!

In my latest post for GE Healthy Outlook, ‘The Health Benefits of Napping‘, I share sleep expert Sara C. Mednick’s advice about how long you should nap and the best time to catch some Zs so you don’t wake up groggy. I was surprised to find out that right nap can be more restorative than reaching for a cup of coffee to push through an afternoon slump. Even better, a power nap of 20-30 minutes will not shortchange a solid night’s sleep.

If you want to read more about getting the most from your sleep at night, check out my story ‘Zeo Sleep Manager: The Science of a Sleep Lab at Home.‘ Zeo Sleep Manager lets you track your sleep cycles so you can make changes to your daytime lifestyle habits and improve the quality of restorative sleep you actually get. It even has a feature that wakes you at the optimal time in the lightest phase of sleep so you wake up alert.

In the study lab, tablet users checked emails, surfed the Internet, played a game or watched a movie while researchers measured their head and neck postures with an infrared three-dimensional motion analysis system. The study was conducted by the Occupational Biomechanics and Ergonomics Laboratory at HSPH and the results were recently published in Work: A Journal of Prevention, Assessment, and Rehabilitation. 

Four postures were tested:

• Lap-Hand: sitting on a chair with feet on a stool, device in lap
• Lap-Case: sitting on a chair with feet on the floor, device in lap
• Table-Case: sitting in a chair with device on a table at a low viewing angle
• Table-Movie: sitting in a chair with device on a table at a high viewing angle

You can see photos of the four postures here. But notice how in the Table-Movie position the person is not doing any typing? That’s great if you’re watching a movie, but how about if you need to type?

Here’s a solution I recently found at the Apple store: the Incase Origami Workstation. It’s a handy travel case for my wireless keyboard that flips into a workstation stand with a quick fold. It lets me take notes in client meetings or send out a live tweet stream during professional development seminars for PWAC Toronto Chapter without getting a stiff neck. Besides, I type faster on my usual keyboard rather than the iPad screen.

What works for you when you’re on the go with your mobile device and need to type?

Now, if I could only find standing desks when I’m not working from home.

Beyond pills and patches – new treatment options for chronic pain 

Chronic pain can arise from body injuries or health conditions such as migraines, diabetes, arthritis, shingles or cancer. But sometimes there is no obvious cause, which is frustrating for both patients and doctors. If the pain is not treated properly, pain signals can continue, leading to long-term changes in the central nervous system. Phillip Pizzo, M.D., Dean of the Stanford University School of Medicine says, “We see that for many patients, chronic pain becomes a disease in its own right.”

Sean Mackey, MD, Chief for the Division of Pain Management at Stanford University points out that the two most common pain treatments available, NSAIDs (non-steroidal anti-inflammatory drugs) and opioids (narcotic pain killers), “are agents we have been using for hundreds of years, in one form or another and we have not come up with new agents. We need to identify and research more alternative mechanisms for treating chronic pain that can attack where the injury and signal are processed.”

Here are five currently available alternatives for chronic pain treatment that go beyond pills and patches to target the locations where pain signals arise:

2. Spinal Cord Stimulation – A small pacemaker is implanted under the skin near the spinal cord with electrodes inserted into the epidural space, to treat chronic pain of the trunk or limbs. The patient delivers low-level electrical signals to their spinal cord using a handheld programmer, controlling the on or off switch as well as the intensity of the signals that are targeted at the precise pain area to block pain messages from reaching the brain. Up to 6 visits may be required to refine the stimulator settings. Available devices include the Medtronic Neurostimulation System and the recently FDA cleared St. Jude Medical’s Epiducer system, which allows placement of multiple neurostimulation leads through a single incision.

3. Spinal Cord Drug Pump – Also called an intrathecal drug delivery system, a drug pump is implanted under the skin to deliver pain medication directly to the fluid around the spinal cord. Because medication goes directly to the pain receptors near the spine rather than travelling throughout the circulatory system, pain relief can be achieved with a fraction of an oral medication dose and can reduce pain by 50% or more. The device is filled with medication and programmed by a doctor. Refilling the pump is done by a needle injection through the skin at follow-up appointments. A hand-held programmer option can permit the patient to deliver the dose.

4. Nerve Blocks – An injection of a local anesthetic can be an effective weapon to stop pain in its tracks in specific situations like a pinched nerve, where acute pain is localized in one part of the body. The nerve block can relieve pain so that the patient can participate in physiotherapy. A nerve block is most useful if used early to help prevent chronic pain from developing.

5. Radiofrequency Ablation – This technique is seen as a big advance among pain doctors because it is a very localized treatment that can make a big difference for some forms of pain such as low back, neck or arthritis joint pain. A small part of the nerve tissue is heated in an outpatient procedure, using an electrical current produced by a radio wave, carefully conducted under guided imaging. Radiofrequency ablation is done as an outpatient procedure using a local anesthetic. Relief from chronic pain can last from 6-12 months using this method.

CONNECT THE DOTS

Visit the American Chronic Pain Association to browse their online library of resources and pain management tools. Learn about the Chronic Pain Self-Management Program, a series of workshops developed by Stanford University that are offered in community settings. Read the Institute of Medicine’s report brief, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research to learn more about the scope of the burden of chronic pain or watch the webcast. You may also be interested in our earlier posts, Pain Patches Offer an Alternative to Pills and Biofeedback: A High-Tech Weapon Against Migraines.

Originally published on GE Healthy Outlook, October 18, 2011. Copyright Jane Langille.

Happy Valentine’s Day!

Check out my latest post on GE Healthy Outlook where I extol the virtues of eating sweets for a change, for their potential personality benefits! A new study suggests that people with a sweet tooth have sweeter dispositions and are more likely to volunteer and actually help others. I enjoyed interviewing Brian Meier, Ph.D. associate professor of psychology at Gettysburg College in Pennsylvania about the surprising findings about people who like to eat sweets.

I hope you are lucky enough to have people in your life who like to eat sweets.

We know that too much added sugar can sabotage a healthy diet and lead to obesity, higher triglycerides and lower HDL cholesterol, all primary risk factors for heart disease. So why is it so hard to cut back?

We are wired to overeat sugar, fat, and salt – especially in combination.One study by the National Institutes of Health found that when high-sugar, high-fat and high-salt foods were available in abundant supply, participants consumed an average of 150% of the calories required to maintain a stable weight.

Eating too much sugar drives up insulin levels, which can lead to obesity.Insulin is a hormone secreted by the pancreas to convert sugar into energy that can be used by cells in the body. When insulin is released, the sugar in your bloodstream is used in one of three ways: as an immediate fuel source for your brain and kidneys; storage as glycogen in the liver or muscles for short-term energy needs; or storage as fat for future energy. Therefore, when too much sugar is consumed, your body will store the unused glucose as fat. “Excess insulin tells your body to store fat and it blocks fat burning while it’s elevated,” says Natasha Turner, N.D. and author of The Hormone Diet and The Supercharged Hormone Diet.

Elevated insulin blocks the appetite-suppressing hormone leptin and cranks up your desire to eat more. Leptin is the hormone that produces a feeling of satiety and tells your brain you have eaten enough food. Excess insulin not only blocks leptin, it also causes a spike in dopamine, a hormone associated with reward pathways in the brain.

Chronic stress promotes consumption of added sugar as a form of self-medication. High-sugar foods can relieve pain or stress, stimulate or calm us down.

So how do you leave the sugar habit behind?

“The best way to kick the sugar habit is to go ‘cold turkey.’ Otherwise, if you eat sugar in small amounts here and there, all it’s going to do is perpetuate your cravings,” says Dr. Turner.

In her clinical practice, she recommends a two-week detoxification diet, cutting out all forms of added sugar while eating healthy foods like lean protein, carbohydrates from fruits and vegetables, adequate dietary fiber, and sufficient healthy fats. She finds that her patients have usually lost their sweet-tooth cravings by the end of the fourth day.

In order to resist backsliding to old habits, Dr. Turner recommends starting your day with a higher-protein breakfast such as eggs, a protein shake, or Greek yogurt and berries, to help prevent carbohydrate cravings in the middle of the afternoon. She also says, “Do not miss your afternoon snack, which should contain some protein, some carbohydrates and some healthy fats so you don’t binge at dinner time. Try 12-15 almonds with a piece of low fat cheese or hummus with veggie sticks.”

David Kessler, M.D., recommends four behaviors to reverse long-standing destructive eating habits in his book, The end of overeating: Taking control of the Insatiable North American Appetite:

1) Awareness. Does the smell of cookies baking make you want to eat them? Learn to recognize what sensory stimuli are creating your cravings for sweet foods so that you can decide whether to act on the urge or not.

2) Remove the temptation. Drive a different route to work to avoid seeing a fast-food outlet or purge your refrigerator and cupboards of sweets and treats so that they are not available.

3)  Form new thoughts to compete with the old ones. For example, instead of saying “I’ll just have one bite of that dessert,” say, “I’ll not have any because it will lead to eating too much.”

4)  Create a support network. Tell others about your healthy eating plan and you will sustain and reinforce your motivation. GE’s free My Diet Diary-Calorie Counter iPhone app allows users to track their food, exercise and weight goals and share their progress with friends on Facebook at MedHelp for support and encouragement.

What steps will you take to kick the added sugar habit?

CONNECT THE DOTS

Learn more about healthy eating to lose fat and balance your hormones at Clear Medicine, Natasha Turner’s wellness boutique in Toronto, Ontario. For further information about making good food choices at the grocery store, check out Marion Nestle’s book, What to Eat: An Aisle by Aisle Guide to Savvy Food Choices and Good Eating, or check out her blog, Food Politics. You may also enjoy reading our earlier Healthy Outlook Blog posts, “The Hidden Health Risks of Sweet Drinks,” “Is Too Much Sitting Putting Your Health at Risk?,” and “How the Mediterranean Diet Helps the Heart.”

Originally published on GE Healthy Outlook, December 15, 2011: “How to Kick the Added Sugar Habit“ Copyright Jane Langille.

Are you sitting down to read this? Perhaps you should be standing up. In a recent study, those who spent almost all of their time sitting had a 54% higher risk of mortality from all causes (except cancer) compared to those who hardly ever sat at all. Even more surprising, the increased risk of mortality was independent of whether they were meeting the recommended guidelines for leisure time physical activity.

Peter Katzmarzyk, PhD, Fellow of the American College of Sports Medicine and colleague at the Pennington Biomedical Research Center, found that the increased risk of mortality associated with sitting was independent of whether people were exercising at a moderate intensity for 30 minutes, 5 days per week or at a vigorous intensity for 20 minutes, 3 days per week. The study was published in Medicine & Science in Sports & Exercise, May 2009. It analyzed sitting activity data for more than 17,000 Canadians ages 18-90, and then compared mortality statistics over 12 years.

“If you look at the overall human pattern of movement throughout the day, it doesn’t make sense to focus on 30 minutes of activity. What about the other 23.5 hours in the day? What you do for the rest of the day is also important. You need to look beyond small bumps of activity,” Katzmarzyk says.

The average American now spends 11 hours a day, 5 days a week, sitting. “When you sit for long periods of time,” Katzmarzyk added, “like working at your desk for 8 hours straight, or watching television for long stretches of time, your body shuts down, your metabolism just drops, the active muscle in your legs just go dormant. It’s hazardous to your health: you need to disrupt that sedentary behavior.”

Katzmarzyk and colleagues found in a recent U.S. study that since 1960, the estimated daily energy expenditure from work-related physical activity has dropped by more than 100 calories per day for both women and men. In the early 1960s, almost 50% of jobs required moderate activity whereas now, five decades later, less than 20% of jobs require moderate activity. That 100 calories per day may not seem like much, but over a year, the lost opportunity to burn 36,500 calories accounts for a significant part of the overall increase in U.S. body weights.

So what can we do to take a stand against so much sitting in our daily lives? James A. Levine, MD, PhD, has some compelling recommendations from his research at the NEAT Center at the Mayo Clinic. He calls our increasingly sedentary lifestyle a “sitting disease” and links it directly with the obesity epidemic. In his book, Move a Little, Lose a Lot, he notes that fifty years ago there were no gyms, people didn’t workout, and yet very few people struggled to maintain a healthy weight. Levine says we are plagued now with an obesity epidemic “because we are desk sentenced.”

NEAT, or non-exercise activity thermogenesis, represents the calories you burn doing regular daily activities like taking the stairs, walking to lunch or standing up to answer the phone. Incorporating NEAT activities throughout the day helps burn up to an additional 2,000 calories per day by boosting your metabolic rate. Additional benefits are lower blood pressure and increased mental clarity.

Some ideas to get you up out of your chair at frequent intervals:

* Take more steps in a day – Levine says when you walk, “your metabolism literally blasts off.” Add steps to your workday by taking public transit rather than driving to work, use the stairs, go for a walk at lunch, or try conducting a walking meeting. Get a pedometer and track your progress.

* Standup desks are gaining popularity in many workplaces. Levine’s research found that standing burns 3 times as many calories compared to sitting. There are also desks with integrated treadmills that allow you to walk at a slow but steady pace while working.

CONNECT THE DOTS

Download Morsel, GE healthymagination’s free mobile app to recommend easy, healthy activities to incorporate into your day. Check out Standupdesks.com and Trekdesk.com to learn about non-sitting desk alternatives for your workspace at home or the office. Watch a video featuring James Levine to see a presentation about NEAT science and the obesity epidemic.

Originally published on GE Healthy Outlook, September 2, 2011: “Is Too Much Sitting Putting Your Health at Risk?” Copyright Jane Langille.

I’m thrilled that this story was posted today for World AIDS Day. The evidence is clear: Treatment as Prevention reduces HIV transmission by almost 100% and the sooner we treat everyone globally who is infected, the sooner the AIDS epidemic will be eradicated for good. It was both a privilege and an honour to interview Dr. Julio Montaner, Director of the British Columbia Centre for Excellence in HIV/AIDS and Past-President of the International AIDS Society.

Check out my story on GE Healthy Outlook.

A closer look at the study abstract from the journal Injury Prevention revealed that the teens were indeed not blowing apart, but rather were found to have an anger problem associated with soft drink consumption. Here’s the scoop: a study among Boston teenagers found that those who drank more than five cans of soft drinks per week were significantly more likely to carry a weapon and to have been violent with peers, family members and dates. Frequent soda guzzling was associated with a 9-15% increase in the probability of engaging in aggressive actions, even after controlling for other factors like gender, race, body mass index, sleep patterns, tobacco and alcohol use and having family dinners.

At least the researchers were kind enough to point out that the association could be due to other factors that weren’t accounted for in the study and that a direct cause-and-effect relationship could not be proven. Yes! The survey’s major limitation was relying on self-reported data by the teens. Yes, again!

Bottom line: I suspect there is a group of teenagers in Boston somewhere having a good laugh about how they were able to skew this study’s results.