ASHLEY MALTZ, MD
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Yet another pill may shorten your life...

2/29/2012

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Per Journal Watch, here's the latest on sleeping pills. Although the relationship between these pills is only correlational (not thought to be an actual CAUSE of death), I would avoid taking them as much as possible. Most sleep medications approved by the FDA (ie, Tylenol PM, ambien, benadryl, etc) and alcohol suppress REM sleep (deep, restorative sleep) causing you to feel even more sleepy and get less of the much needed "dreaming" sleep you're trying to achieve. 

The higher mortality by people taking sleeping pills discussed in this paper may be due to the fact that people taking sleeping pills often suffer from multiple other medical problems. This, in turn, increases their risk of death and disease. Despite this possible explanation for the study's findings, I recommend erring on the side of caution.  

Try high-quality, evidence-based supplements like chamomile, melatonin and valerian root. Now If only insurance companies would reimburse doctors for teaching sleep hygeine and would cover the cost of these supplements...if only...

"Even Infrequent Use of Sleeping Pills Linked to Increased Mortality

Adults who take hypnotics for insomnia even less than 20 times a year might face increased mortality risk, according to a study in BMJ Open.

Using a rural health system database, researchers matched more than 10,000 adults who used hypnotics with nearly 24,000 nonusers. The most commonly used hypnotics were zolpidem (e.g., Ambien) and temazepam (e.g., Restoril). During 2.5 years of observation, 6% of hypnotic users and 1% of nonusers died.

After adjustment for comorbidities, hypnotic use was associated with an elevated risk for death, with risk increasing with the number of doses used. However, even adults who took just 0.4 to 18 pills per year had a significantly increased mortality risk compared with nonusers (hazard ratio, 3.6). In addition, use of more than 18 pills per year was associated with increased cancer risk.

Asked to comment, Dr. Peter Roy-Byrne, editor-in-chief of Journal Watch Psychiatry, said, "While a provocative finding, it is hard to conceive of a mechanism that would account for increases in mortality with just a handful of sleeping pills taken annually."

BM
J Open article (Free)"

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Cuts to the Prevention and Public Health Fund will affect us all

2/21/2012

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See how by Dr. Katz...

http://www.huffingtonpost.com/david-katz-md/preventive-medicine_b_1285063.html?utm_source=Alert-blogger&utm_medium=email&utm_campaign=Email%2BNotifications
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Diet Sodas and Death

2/16/2012

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I've posted about the health consequences of artificial sweeteners before but had to post this new information I read this morning. Dr. Weil writes...

"Drinking diet sodas daily is associated with an increased chance of suffering a heart attack, stroke, or of dying due to conditions that affect the circulatory system. This news follows an analysis of data gathered from more than 2,500 participants in New York City that looked at the relationship between drinking sodas (diet or regular) and cardiovascular disease risks. No association was found with consuming regular soft drinks or drinking diet sodas more moderately (between one a month and six a week), but the investigators found that compared to individuals who drink no diet sodas, those who drink them daily were 43 percent more likely to have a heart attack, stroke or other vascular event. The researchers said that the reasons for this association are unclear and that more research is needed. The study was published online on Jan. 27, 2012 in the Journal of General Internal Medicine."


Pretty crazy stuff. Quit the addiction and drink water flavored with your favorite fruit - raspberries, strawberries, peaches, etc. Jazz it up even more by using carbonated water - seltzer. These drinks are very refreshing, without any calories and 100% na-tu-ral! Enjoy!

Dr. M
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Air pollution tied to stroke risk (sorry guys!)

2/14/2012

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Hot off the presses from MedPage Today, an article that highlights the need to decrease pollution...for our HEALTH's sake (not just for preservation of the environment)!

Source -
http://www.medpagetoday.com/Cardiology/Strokes/31158


Airborne pollution can have serious consequences for the brain and the heart even at typical levels of exposure, according to the results of two studies published in the Feb. 13 issue of Archives of Internal Medicine.

In one analysis, researchers led by Gregory Wellenius, ScD, of Brown University in Providence, R.I., found that short-term exposure to fine particulate matter – even at levels allowed by the EPA – can increase the risk of ischemic stroke.

In the other study, a team led by Jennifer Weuve, ScD, of Rush University Medical Center in Chicago, and colleagues found that long-term exposure to particulate matter speeded up cognitive decline in older women.

The first report "adds to the already strong
evidence linking (particulate matter) to cardiovascular effects," wrote Rajiv Bhatia, MD, of the San Francisco Department of Public Health, in an accompanying commentary.

And, he added, the cognition study suggests that "we may not fully understand the breadth of (particulate matter) health burdens."

Bhatia concluded that controlling particulate matter is technically feasible, but needs "increased efforts to assess exposure at the community level, more stringent and creative regulatory initiatives, and political support."

Wellenius and colleagues studied links between daily variation in fine particulate matter – particles less than 2.5 micrometers in diameter – and stroke incidence in the Boston area.

They drew data from medical records of 1,705 patients admitted to a single institution with neurologist-confirmed ischemic stroke between April 1, 1999, and Oct. 31, 2008.

Fine matter concentrations were measured at a central monitoring station, using EPA guidelines that define moderate air quality as between 15 and 40 micrograms per cubic meter of air and good air quality as 15 micrograms or lower.

The study period included only days in which the air quality was good or moderate; the researchers excluded 11 days in which it exceeded 40 micrograms per cubic meter.

They found that the estimated odds ratio of ischemic stroke onset was 1.34 (95% CI 1.13 to 1.58) following a 24-hour period classified as moderate, compared with a period in which the air quality was good. The risk increase was significant at P<0.001.

They also found that the relationship between higher particulate levels and increased risk of stroke was linear, strongest within 12 hours of exposure, and was seen among patients with strokes caused by large-artery atherosclerosis or small-vessel occlusion but not cardioembolism.

The risk was more strongly associated with markers of traffic pollution – such as black carbon and NO2 – than with particles linked to nontraffic sources, they reported.

Although the findings add to the evidence linking stroke and air pollution, there are some "unique" aspects, according to Robert Brook, MD, of the University of Michigan Ann Arbor, and Sanjay Rajagopalan, MD, of the Ohio State University Medical Center in Columbus.

Specifically, they noted in an accompanying commentary, "the extremely rapid increase in stroke risk is an important novel insight" that suggests that current regulatory focus on daily and yearly average concentrations may be missing the boat.

For the cognition study, Weuve and colleagues turned to the long-running
Nurses' Health Study, which began in 1976 with more than 121,000 participants.

Between 1995 and 2001, participants 70 or older with no history of stroke were asked to take part in a study of cognition and 19,049 agreed. Cognitive testing was done by telephone three times, with about two years between interviews.

The researchers tracked changes in cognition, looking for associations between both fine and coarse particulate matter, defined, respectively, as smaller than 2.5 micrometers in diameter and between 2.5 and 10 micrometers.

Particulate matter was measured using EPA monitoring data, adjusted to estimate local exposure for each participant.

Analysis showed that higher levels of long-term exposure to both grades of pollution were associated with "significantly faster cognitive decline," the researchers found. Specifically:

  • The two-year decline on a global score was 0.020 units worse for every increase of 10 micrograms per cubic meter in long-term exposure to coarse particles.
  • Similarly, the two-year decline was 0.018 units worse for every increase of 10 micrograms per cubic meter in long-term fine particle exposure.

The differences, Weuve and colleagues reported, were similar to those between women in the study who were approximately two years apart in age.

The associations, they reported, were found at pollution levels typical in many areas, suggesting that pollution control might be a way to reduce the "future population burden of age-related cognitive decline, and, eventually, dementia."

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Mindfulness is the key to weight loss

2/12/2012

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This is key for those struggling with weight loss. My mentor teaches a program called Mindfulness Based Eating Awareness Training (MB-EAT) that I will eventually become certified to teach. She believes it is the missing link for those who yo-yo diet. You have to change your RELATIONSHIP to food in order to change you WEIGHT! Check it out!

http://www.nytimes.com/2012/02/08/dining/mindful-eating-as-food-for-thought.html?pagewanted=2&smid=fb-share
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Friday's Food For Thought

2/10/2012

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Ever wonder what happens to the foods you eat once you chew and swallow them?? Well, scientists at Harvard have uncovered some of the truth using a Pillcam (a tiny camera that is swallowed before eating and sends images of the digestive process to a computer by Bluetooth technology). The differences that occur in this process between freshly made food and store-bought processed noodles is astounding.

Take a look inside...but be warned, it's a little nasty (but not that bad!)!
http://www.youtube.com/watch?feature=player_detailpage&v=zi_DaJKsCLo


Happy Friday,
Dr. M
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Watch your sodium...I mean bread...intake!

2/8/2012

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Wow, a surprising find in regards to the highest source of America's sodium intake is highlighted below. It's BREAD (although potato chips and other salty snacks are definitely still major contributors!)!!! So now we have multiple reasons to watch our bread intake (starch equals fat when not burned, gluten sensitivity for those who are sensitive and now sodium levels). Interesting!


"CDC survey finds bread is top source of sodium in US diet.

ABC World News (2/7, story 7, 0:35, Sawyer) reported that "the Center for Diseases Control said nine out of ten adults eat too much salt. And the number one source of their salt is a surprise -- bread and rolls."
        The CBS Evening News (2/7, story 9, 0:20, Pelley) reported, "The Centers for Disease Control said today that salty snacks like potato chips are not our biggest source of sodium."
        NBC Nightly News (2/7, story 8, 2:25, Williams) reported that CDC Director Thomas Frieden, MD, said, "We're eating more food made by others, in restaurants or prepared food from grocery stores. And when other people make food for us, they put a lot more salt in it." NBC's Costello added, "More fruits, veggies and home cooking are the solution, says the CDC."
        The AP (2/8, Stobbe) reports, "Bread and rolls are the No. 1 source of salt in the American diet, accounting for more than twice as much sodium as salty junk food like potato chips. That surprising finding comes in a government report released Tuesday that includes a list of the top 10 sources of sodium." CDC officials "are encouraging consumers to read labels and, for example, buy brands of bread that have lower sodium." CDC Director Frieden noted, "Potato chips, pretzels, and popcorn -- which we think of as the saltiest foods in our diet -- are only No. 10."
        "Most sodium in the US diet comes from bread, lunch meat, pizza, chicken, soup, and burgers, the CDC found," according to the National Journal (2/8, Fox, Subscription Publication). In a statement, CDC Director Frieden said, "We're encouraged that some food manufacturers are already taking steps to reduce sodium," noting that manufacturers such as Kraft and Leprino Foods are "actively working on providing customers and consumers with healthier options."
        The NPR (2/8, Barclay) "The Salt" blog reports, "According to the CDC, the average American consumes about 3,300 milligrams of sodium per day, not including any salt that may be added during a meal. ... The US Dietary Guidelines recommend no more than 2,300 mg a day, except if you're over 51 years or African American or have high blood pressure, diabetes or chronic kidney disease."
        The Atlanta Journal-Constitution (2/8, Jeffries) lists the "10 types of foods are responsible for more than 40 percent of people's sodium intake," according to the CDC list. The foods are "breads and rolls; luncheon meat, such as deli ham or turkey; pizza; poultry; soups; cheeseburgers and other sandwiches; cheese; pasta dishes; meat dishes such as meat loaf; and snack foods such as potato chips, pretzels and popcorn." The Journal-Constitution points out that "breads and rolls aren't saltier than many of the other foods on the CDC list, but people tend to eat a lot of them," which makes them the cop source of salt in the diet.
        MedPage Today (2/8, Fiore) notes, "The data come from the 'What We Eat in America' portion of the National Health and Nutrition Examination Survey (NHANES) 2007-2008. NHANES is a survey that relies on self-reported data, a fact that may introduce bias and also raises questions about the generalizability of its findings." The study is published in the CDC's Morbidity and Mortality Weekly Report. CQ (2/8, Subscription Publication) and the Los Angeles Times (2/8, Muskal) "Nation Now" blog also cover the story."

Source: AMA Morning Rounds Newsletter
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    Dr. Maltz earned a Medical Degree and Master in Public Health from the University of Texas Medical Branch (UTMB) in Galveston, TX. She completed a combined Internal and Preventive Medicine Residency at UTMB in June, 2011. She then completed a 2-year Integrative Medicine Fellowship at Stamford Hospital in Stamford, CT, during which she simultaneously underwent an intensive 1000-hour curriculum created by The University of Arizona Integrative Medicine Program founded by Dr. Andrew Weil.  

    Dr. Maltz's specific interests include helping her patients and populations improve their health through lifestyle interventions including, but not limited to, natural pain relief, nutrition, mind-body techniques and decreasing environmental exposures. She spent the last year of her four-year medical residency participating in health policy, cancer prevention and environmental health rotations and enjoys guiding people through the overwhelming amount of health information available on the web.

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