heat summer

Beware the Danger of High Temperatures

May 30th is Heat Safety Awareness Day, so our concierge family doctors at MD 2.0 in Jupiter want to take this opportunity to acquaint you with this important health concern. The fact is, heat is a killer, and we here in south Florida need to pay particular attention to the danger high temperatures can present.

Heat exhaustion, heat stroke, and dehydration are some of the leading weather-related killers. For example:

  • A 1980 heat wave killed more than 1,250 people.
  • In 1995, a heat wave in Chicago took more than 700 people (the deadliest weather event in Chicago history).
  • In August 2003, a record heat wave in Europe claimed an estimated 50,000 lives.

 

Some people are more susceptible to negative effects from the heat. These include:

  • people 65 and older, who are less likely to sense and respond to changes in temperature;
  • people with chronic medical conditions, who may be taking medication that can worsen the impact of extreme heat;
  • infants and young children; and,
  • outdoor workers and athletes, who may be more likely to become dehydrated, particularly in extreme heat.

It’s vital to know the difference between heat exhaustion and heat stroke, the warning signs for each, and what to do in the event you or someone else experiences them. You should also know how to avoid these serious conditions.

 

Heat exhaustion

The Centers for Disease Control and Prevention (CDC) says muscle cramping might be the first sign of heat-related illness. It lists the warning signs of heat exhaustion as:

  • heavy sweating
  • weakness
  • cold, pale, clammy skin
  • fast, weak pulse
  • nausea or vomiting

If you or someone you’re with experiences these symptoms, you should move to a cooler location, lie down and loosen your clothing, apply cool, wet cloths to as much of your body as possible, and sip water. If you have vomited and it continues, seek medical attention immediately.

 

Heat stroke

The signs of heat stroke are:

  • high body temperature (above 103 degrees)
  • hot, red, dry, or moist skin
  • rapid and strong pulse
  • possible unconsciousness.

This is a medical emergency. Call 911 immediately. While waiting for the ambulance, move the person to a cooler environment, and try to reduce the person’s body temperature with cool cloths, or if possible, a cool bath. Do NOT try to give fluids.

 

Stay safe in the heat

Following are steps you can take to avoid experiencing either of these potentially deadly conditions.

Limit outdoor activity. The sun is hottest from 11 a.m. (D.S.T.) to 3 p.m., so try to stay indoors, or at least in shaded areas, during those times. If you must be outdoors, take frequent breaks, preferably in air-conditioned environments, and, if possible, take cool showers or baths to cool down.

Dress appropriately. Wear loose, lightweight, light-colored clothing. Wear a hat with wide brim.

Stay hydrated. Drink water frequently, from two to four cups of water every hour. Don’t wait until you’re thirsty to drink, because by then you’ve already started to dehydrate. Monitor urine color: If your urine is dark, you’re not drinking enough water. Urine should be light yellow or clear. And avoid alcoholic drinks, which can not only impair judgment regarding time spent in the heat but also dehydrate you.

Check the car. Despite all the awareness and warnings in the last few years, more children—51—died in hot cars in 2018 than any year on record. It happens to the most conscientious parents who simply have too many things on their minds. When transporting children, place something necessary—a purse or briefcase—next to the child. Keep car doors locked and never allow children to play in a car. And countless numbers of pets die when owners leave them alone in a hot car “just for a couple minutes.” Never leave pets alone in a closed car, even for a few minutes.

 

Check with us to see whether any medical conditions might make you more susceptible to heat.

Obesity Is a Little-Known Cancer Risk

When you think of ways to prevent cancer, you think of stopping smoking, avoiding the sun, getting regular screenings, and so on. But one way that might not occur to you is losing weight.

Therefore, our concierge family practice doctors in Jupiter thought you should know that there are 13 different types of cancer linked to overweight and obesity.

The risk

A recent article in The Washington Post reported that, although smoking is the number one preventable cause of cancer, killing more than 500,000 people in this country every year, “obesity is poised to take the top spot, as Americans’ waistlines continue to expand while tobacco use plummets.” It also appears that the more overweight a person is, the higher the cancer risk.

According to the National Institutes of Health (NIH), the types of cancer that may be influenced by overweight include:

  • esophageal
  • thyroid
  • colon
  • renal
  • liver
  • melanoma
  • multiple myeloma
  • rectal
  • gallbladder
  • leukemia
  • lymphoma
  • prostate in men
  • post-menopausal breast and endometrial in women

Being overweight also makes it more difficult to survive once a cancer is diagnosed.

The American Cancer Society (ACS) says that excess body weight is thought to be responsible for about eight percent of all cancers in the United States, as well as about seven percent of all cancer deaths. In addition, having too much belly fat, regardless of body weight, is linked with an increased risk of colon and rectal cancer, and is probably linked to a higher risk of cancers of the pancreas, endometrium, and breast cancer in post-menopausal women.

The reasons

Despite the apparent links, researchers are not certain of the reason that increased weight raises the risk of cancer. But they do have some theories. The ACS believes that timing of weight gain plays a role.

“Being overweight during childhood and young adulthood might be more of a risk factor than gaining weight later in life for some cancers,” the ACS says. “For example, some research suggests that women who are overweight as teenagers (but not those who gain weight as adults) may be at higher risk for developing ovarian cancer before menopause.”

The Post reports that researchers are homing in on the “visceral” fat that surrounds internal organs as the culprit.

“Rather than being a harmless glob, this fat is a ‘metabolically active organ’ that produces hormones such as estrogen, which is associated with a higher risk of breast and some other cancers, according to the American Institute for Cancer Research. . . . The fat also secretes proteins that drive insulin levels higher, which may spur cell growth and increase the possibility of cancer. And it can cause chronic inflammation, another risk factor for the disease, according to the group.”

“It’s a complex interplay of metabolism, inflammation, and immunity,” Jennifer Ligibel, a breast oncologist at the Dana-Farber Cancer Institute, told the paper. “It creates an environment that is more permissive for cancer.”

It’s also possible that lifestyle choices which cause overweight—poor diet and lack of exercise—are themselves contributing factors.

The upshot

While the effect of losing weight on reducing cancer risk is still uncertain, the ACS believes reducing body weight is a good move.

“Some body changes that occur as a result of weight loss suggest it may, indeed, reduce cancer risk. For example, overweight or obese people who intentionally lose weight have reduced levels of certain hormones that are related to cancer risk, such as insulin, estrogens, and androgens.”

To improve cancer odds, Ligibel of Dana-Farber told The Post that even a five percent reduction in body weight produces a beneficial result on blood sugar and inflammation.

We know dieting is difficult, but the results are well worth it, not only in reducing the risk of cancers and heart disease, but in improved quality of life overall. If you are overweight, please see us for tips and advice on simple ways to slim down.

unhealthy food

Our Diets Are Killing Us

Question: What causes more deaths worldwide than smoking?

Answer: Food. And it’s not tainted food; it’s the unhealthy food we put on our plates every day.

Our concierge primary care doctors in Jupiter have told you many times about the importance of a healthy diet. Now a new study published this month in the journal Lancet warns that as a species, we don’t eat properly, and we’re paying for it.

“In many countries, poor diet now causes more deaths than tobacco smoking and high blood pressure,” Ashkan Afshin, lead study author, told CNN.

Afshin is an assistant professor at the Institute for Health Metrics Sciences at the University of Washington.

And it’s not just the bad things we eat—salt, red meat, sugar—that are contributing to premature deaths around the world; it’s the good things we don’t get enough of: fruits, vegetables, nuts and seeds, and so forth.

“Poor dietary habits . . . overall cause more deaths than any other risk factors globally,” Afshin told CBS News.

Dietary risk factors

The study took place over 27 years in 195 countries. Israel had the lowest number of diet-related deaths, followed by France, Spain, Japan, and the principality of Andorra. Uzbekistan had the highest, with the U.S. ranking 43rd out of 195.

The study results attributed one in five deaths (about 11 million people) annually around the world to the following dietary risk factors:

  • high sodium
  • low whole grains
  • low fruit
  • low nuts and seeds
  • low vegetables
  • low fiber
  • high trans fats
  • high sweetened beverages
  • low legumes
  • high red meat
  • high processed meat
  • low calcium
  • low milk
  • low omega-3s
  • low polyunsaturated fatty acids

Note: Omega-3 fatty acids are found in seafood. Polyunsaturated fatty acids are found in some nuts and seeds, salmon, and vegetable oils.

Healthy beats unhealthy

In their analysis of the 15 dietary factors, researchers found that the lack of healthy foods was worse than consumption of unhealthy foods. In other words, not eating fruits, vegetables and so forth was responsible for more deaths than eating red meat, processed foods, and the like.

As a result, Afshin recommended that policy makers should not just focus on what not to eat, but what to replace those foods with. The study estimated that three million deaths globally could be attributed to high sodium intake, but another three million were caused by lack of whole grains, with two million more caused by inadequate fruit intake.

They estimated that cardiovascular disease (CVD) was the leading cause of diet-related deaths around the world, followed by various cancers and diabetes, all of which were attributed to diet. Of course, other factors—including physical inactivity, environmental, economic, and social factors—contribute as well, according to Bruce Lee, associate professor of international health at Johns Hopkins Bloomberg School of Public Health.

“Diet can contribute to noncommunicable disease (NCDs) via increased body weight and obesity, elevated blood pressure, hyperlipidemia or high levels of fat in the blood, and conditions that lead to high blood sugar levels,” he told The Washington Post. Lee, who is also executive director of the Global Obesity Prevention Center, added that another problem is that “unhealthy foods such as those that are highly processed with artificial ingredients are often cheaper to make, store, ship, and prepare. Therefore, such foods have replaced more natural and healthy foods in foods systems around the world.”

Another factor is the profit motive.

“Refining grains is highly profitable,” Corinna Hawkes, director of the Centre for Food Policy at the University of London, told CNN. “Take corn, for example. You can refine it into different ingredients: animal feed, refined flours, and high-fructose corn syrup, to name three. So manufacturers are generating multiple value streams from this refining process.”

What you can do

As much as possible, try to adhere to a Mediterranean-style diet: abundant amounts of nuts, seeds, fresh fruits and vegetables, use of olive oil in cooking, moderate portions of fish and poultry, and little red meat.

Also beware of marketing claims that a product is “whole grain,” because often a whole grain has been stripped of one or more of its components: the bran, the germ, or the endosperm. Look for the stamp provided by the Whole Grains Council that certifies a product actually contains all three of these components.

And as always, check with us for any questions or concerns you may have about the food your family eats.

New Findings Change Aspirin-a-Day Guidelines

Our concierge family practice doctors in Jupiter understand the temptation to pop a pill—whether a prescription medication or a supplement—to stay healthy, instead of following more difficult suggestions regarding exercise and diet.

And to be sure, the long-standing belief that taking a daily low-dose aspirin can prevent heart attacks has some scientific basis for those who’ve already suffered a heart attack. In addition, some earlier research did seem to support daily aspirin use for reducing the risk of numerous cancers as well as Alzheimer’s disease.

Latest findings

But the good thing about science in general and medical research in particular is that researchers are constantly reviewing and refining established knowledge. In the case of the aspirin-a-day approach, for example, several new studies in the last year have challenged the practice of taking a low-dose (81 mg.) aspirin to prevent cardiovascular disease (CVD). And this month the American College of Cardiology (ACC) and the American Heart Association (AHA) released new guidelines recommending against the use of daily low-dose aspirin, based on these studies.

One study published last month in the Journal of the American Medical Association (JAMA), for example, found that people without heart trouble who took a daily dose of aspirin had a lower risk of heart attack, stroke, and death. These benefits, however, were canceled out by the increased risk of bleeding in the intestinal tract or the brain, which can often be deadly.

Researchers in that study performed a meta-analysis of 13 studies that included 164,225 participants, none of whom had CVD when the studies began.

“For every 256 patients treated with aspirin for five years, one heart attack, stroke or death from cardiovascular disease would be prevented,” Dr. Sean Zheng, lead author of the study and and academic clinical fellow in cardiology at King’s College Hospital in London, told CNN. “On the other hand, for every 210 patients treated with an aspirin over the same period, one would have a serious bleeding event.”

“This calls into question the net benefit of taking aspirin, and whether people who have not previously had cardiovascular disease should take aspirin,” Zheng said.

Another study published last fall in the New England Journal of Medicine (NEJM) reported similar results, even finding that older patients experienced no health benefits at all from daily aspirin use. These and other recent studies are what led to this month’s revised recommendations from the AHA/ACC.

“We knew there would be an increased risk of bleeding with aspirin, because there has always been,” recommendations co-author Dr. Anne Murray told NBC News. “But not only did it not decrease risk of disability or death, it did not decrease the risk of heart attack and stroke, and there was an increase in the rate of death.” Murray is also a geriatrician and epidemiologist at the Hennepin Healthcare Research Institute and the University of Minnesota, Minneapolis.

In their statement, the AHA/ACC advised against taking a preventive aspirin a day, saying it may actually cause more harm than good.

“We’re talking about healthy people who don’t have known heart disease or stroke, who might have been considering or [are] already taking an aspirin to prevent that heart attack or stroke in the first place,” said Dr. Erin Michos, another of the authors of the new AHA/ACC guidelines.

The AHA stressed that the new recommendations do not apply to people who have already had a heart attack or stroke, or who have undergone such procedures as receiving a coronary artery stent or bypass surgery. But for the elderly (people over 70) and those with a high risk of internal bleeding, the AHA cautioned that “aspirin may do more harm than good, but there are no absolutes, so these decisions need to be tailored to individuals.”

Another co-author of the revised recommendations suggested that doctors might advise their patients who have a strong family history of heart disease to take a daily aspirin. This could also apply to those whose tests reveal considerable plaque build-up in their arteries. But for those with a low or moderate risk, lifestyle changes could have a more salient effect.

“Eat a heart-healthy diet, get regular physical activity, control blood pressure and control cholesterol,” Michos said. “If [people] need a statin, take it. Those are much more important when compared to recommending aspirin.”

As with so many other over-the-counter remedies, we always recommend you check with us before taking them. Each person is different and their needs and sensitivities are also different. We can help determine the best course for you.

Take Sleep Seriously – World Sleep Day

Our concierge family practice doctors at MD 2.0 in Jupiter know that sleep is often the best medicine for any illness or injury. Conversely, lack of adequate sleep can not only interfere with recovery, but it can also trigger a host of diseases.

This Friday, March 15th, is World Sleep Day, designed to highlight the critical role sleep plays in maintaining health. World Sleep Day is hosted by the non-profit World Sleep Society (WSS) and was created because “Time and time again, sleep medicine professionals and researchers came up against the belief that sleep was not important enough in personal health and well-being to be a priority,” the WSS explains. It added that “society’s 24/7 flow” exacerbates what some medical professionals and researchers have called a national health crisis.

Several causes

The health issues associated with lack of sufficient sleep are myriad: obesity, type 2 diabetes, cancer, cardiovascular disease, dementia, depression . . . even a shorter lifespan overall.

How does poor sleep impact health? In short, the time we spend sleeping is time the body uses to repair itself, which it can’t do when we’re eating, working, playing, active, or stressed. From a medical standpoint, during sleep the immune system releases cytokines, which are a type of protein the body needs not only to sleep, but to fight the effects of stress, illness, or injury.

Research has shown that lack of sleep also reduces the number of certain antibodies used to fight infections. In addition, Japanese researchers found that losing six hours of sleep over a single night resulted in significantly elevated blood glucose and triglyceride levels, warning signs for increased risk of heart disease and diabetes.

Effects of poor sleep

According to the National Institutes of Health (NIH), here are some of the effects of insufficient sleep on adults, as well as children and teens.

Brain and emotions

Sleep helps form new pathways to enhance learning, memory, problem-solving, decision-making, and creativity. Sleep deficiency has been linked to anxiety, depression, suicide, risky behavior, and inability to cope with change. The loss of even a single night of sleep has been shown to increase formation of the proteins associated with Alzheimer’s disease. In addition, children who are sleep deficient may feel angry and impulsive, have difficulty paying attention, and get lower grades.

Physical health

Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke in adults. It also increases the risk of obesity in all age groups. In addition, insufficient sleep hinders the body’s ability to repair itself, including hampering the immune system. Sleep also supports healthy growth and development in children and teens, helping to boost muscle mass.

Performance and Safety

A loss of even one to two hours of sleep a night over several nights has the same effect as if you haven’t slept at all for a day or two. Sleep deficiency not only interferes with the ability to drive a car, it can affect people in all lines of work, including health care workers, pilots, students, lawyers, mechanics, and assembly-line workers. So insufficient sleep is not only affecting those who experience it, but can impact others, as well. The NIH estimates that driver sleepiness is a factor in approximately 100,000 auto accidents each year, resulting in about 1,500 deaths.

What Is Healthy Sleep?

The Centers for Disease Control and Prevention (CDC) estimates that up to a third of Americans do not get the recommended seven hours of sleep a night. If you’re sleeping well, you:

  • will fall asleep within 15 to 20 minutes of going to bed;
  • will sleep between seven and nine hours per night (longer than that is also unhealthy);
  • will remain asleep for the entire night;
  • will awaken feeling refreshed, and will remain alert and productive during the day; and,
  • will not snore, gasp for breath, or feel restless while you’re trying to sleep.

If you typically skimp on sleep during the week and try to catch up by sleeping in on the weekends, a new study published last month in the journal Current Biology has some bad news for you. Researchers found that so-called “recovery sleep” has no benefit to the body in the long term. As reported in The Washington Post, participants in a sleep laboratory who we limited to five hours of sleep on weekdays then allowed to “binge sleep” on weekends still gained nearly three pounds over two weeks and also experienced metabolic disruption that would increase the risk of diabetes later in life.

To help you obtain the proper amount of sleep, you should:

  • go to bed at the same time every night
  • don’t try to sleep on a full stomach
  • refrain from using caffeine or alcohol after dinner
  • turn off “blue-light” devices (TVs, computers, smartphones) at least an hour before bedtime; and,
  • restrict activity in the bed to sex and sleep (i.e., no working, reading, TV, etc.)

Because healthy sleep is so crucial to your health, please let us know if you have any difficulty falling asleep or staying asleep so we can help uncover the cause and provide solutions.

The Downside of Diet Soda

Our concierge family practice doctors in Jupiter, applaud any effort by our patients to avoid, or at least reduce, their dietary intake of sugar whenever possible. But one of the solutions many people turn to instead may not be an improvement. Diet soda and other drinks replace sugar with the artificial sweetener aspartame, which seems to be implicated in several health issues associated with diet soda consumption as noted in several recent studies.

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Dietary_Supplements

Think Twice About Dietary Supplements

Because dietary supplements are a $40-billion-a-year business in this country, our concierge family practice doctors in Jupiter, want to make you aware of the latest research on these popular products. Numerous studies have found little benefit to taking any of the thousands of dietary supplements available on the market. And the U.S. Food and Drug Administration (FDA) has recently taken action regarding some of the health claims made by their manufacturers.

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