Stress is a part of life, and cortisol is one of the results of stress. You may have heard of cortisol, but not understand how too much of it can impact your health. So our concierge family doctors at MD 2.0 in Jupiter want to explain what it is, and offer ways to help control it.
We’re not even halfway through summer yet, and we’ve already seen record-high temperatures here in south Florida, which can bring dangerous health impacts. The two most serious are heat exhaustion and heat stroke. Our concierge doctors in Jupiter want to remind you of ways you can keep your family safe as temperatures soar.
What to watch for
The Red Cross warns that some people are more at risk of developing a heat-related illness. These include: people aged 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.
When keeping an eye on the weather forecast, here’s what the various warning terms mean:
Consequences of extreme heat exposure
Such excessive heat as we’ve been experiencing recently can lead to life-threating heat exhaustion and heat stroke. Most people have heard these terms, but may not fully understand what they mean. We want to explain the differences between the two, because the treatments for each are different.
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:
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:
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.
Staying safe in the heat
Here are steps you can take to avoid experiencing either of these serious conditions.
Keep these safety tips in mind as you enjoy the outdoor fun in summer, and check with us if you feel more bothered than usual by the heat. This could be a sign of a medical condition that warrants investigation.
Sausages. Mayonnaise. Pizza. Potato chips. Bacon. Even whiskey, gin, and rum. All these foods and many more share two common traits: All were “processed” into their familiar form by humans, and all have been implicated in an increased risk for early death.
Our concierge primary doctors in Jupiter want to make you aware of the latest studies on the dangers of consuming these foods as the primary part of your diet.
The difference in these studies is that they don’t just address so-called “junk” foods like cookies and fast foods, but many of the items that all of us have in our kitchens and rely on as staples of our diet.
The studies
Published last month in the journal BMJ, one study followed more than 100,000 adults in France for five years. They found that those who ate the most processed foods were 23 percent more likely to experience a heart condition or stroke than those who consumed the lowest amounts.
The second study, also published in BMJ, tracked 20,000 Spanish adults over 20 years. Those who ate the most processed foods were 62 percent more likely to die during the study period than those who ate the lowest.
“High consumption” was defined as four or more servings of ultra-processed foods daily, with health risks rising 18 percent for each additional daily serving.
While researchers cautioned that correlation doesn’t prove causation, both studies controlled for such other possible risk factors as lifestyle, demographics, physical activity, weight, and overall health in drawing their conclusions. They also noted that their findings correspond to other earlier studies showing an association between highly processed foods and higher risks of obesity, high blood pressure, high cholesterol, and some cancers.
The cause
Researchers classified foods into roughly three categories:
They also created a separate category called “processed ingredients,” which included salt, sugar, honey, olive oil, butter, and lard.
The problem seems to stem from the processing, which changes foods from their natural state into something that will last longer on our shelves. These tend to be high in poor-quality fats, additional sugar, salt, and preservative chemicals, and low in vitamins and fiber. The common factor can be summed up in the phrase “convenience foods”; that is, foods that are quick and easy to prepare at home.
Dr. Andrew Freeman, a cardiologist who was not involved in the study, told CBS News, “I like to say: The longer the shelf life, the shorter your life.” Freeman directs cardiovascular prevention and wellness at National Jewish Health in Denver.
The solution
The takeaway in both these studies, as well as preceding ones is, the closer to a food’s natural state that you can eat, the better the effect on your overall health.
Freeman told CBS News that the most heart-healthy diet is one rich in whole foods, particularly plant-based foods like fruits and vegetables, legumes, whole grains, and nuts. He added that, for affordability and convenience, fresh-frozen vegetables were perfectly acceptable.
Simply switching from sodas to water is another good choice, as well as substituting fresh fruit for sweets. Options for quick snack foods include such treats as homemade sweet potato chips, and oven-“fried” vegetables like cauliflower and broccoli, as well as celery and carrot sticks cut up and stored in water.
If you have any questions about a healthy eating plan, please let us know. We can help you substitute a healthy diet for foods likely to negatively impact your health.
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:
Some people are more susceptible to negative effects from the heat. These include:
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:
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:
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.
Because May is Skin Cancer Awareness Month, our concierge family doctors in Jupiter want to share some facts with you about this often deadly, yet preventable, disease.
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.
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:
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.
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.
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.
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
“Poor dietary habits . . . overall cause more deaths than any other risk factors globally,” Afshin told CBS News.
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:
Note: Omega-3 fatty acids are found in seafood. Polyunsaturated fatty acids are found in some nuts and seeds, salmon, and vegetable oils.
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.”
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.
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.
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.
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.
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.
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.
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:
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:
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.
