I was recently alerted to a great study (this time, a randomized controlled trial, which is the gold standard in medicine, featured below in Science Magazine) from 2009 illustrating the amazing effects of meditation on the body. African American men were randomized to 2 groups: a) usual care (medication and a cardiovascular health course...which is actually much more than usual care!) and b) usual care plus 15 to 20 minutes of transcendental meditation per day (which they were taught how to do). The men were followed for an average of 5 years and the number of heart attacks, strokes and deaths were tracked and compared. Needless to say, the results were impressive! 'Patients who practiced transcendental meditation on top of standard treatment experienced 47% fewer heart attacks, strokes, and deaths compared with the control group. For comparison, statin drugs, which reduce cholesterol levels, tend to lower the risk of life-threatening events by 30% to 40% relative to existing treatments. Common blood pressure drugs reduce these outcomes by 25% to 30%. In all, transcendental meditation has proved as powerful as any new class of heart disease medications entering the market.'
This strong decrease in heart attack, stroke and death rates is fascinating and VERY impressive! However, it comes as no surprise to me as I've learned quite a lot about meditation through both reading research and personal experience. Researchers believe that meditation fully decreases the action of body's sympathetic nervous system, which normally increases your blood pressure and keeps you on high alert for threats (stress response). By counteracting this system, blood pressure is lowered and your brain, heart and other organs (kidneys, lungs, eyes) stay in a state of calmness and tranquility. In doing so, you increase the oxygenation to your organs and tissues and decrease inflammation in the body. This is where we all need to stay in order to prevent heart attack, stroke and other diseases.
So, moving to the practicality of daily meditation. If you've never meditated before, I would recommend you buy a meditation or guided-imagery CD (can get them used for very cheap!) OR attend a few yoga classes that make time for relaxation (most do, but some more than others). You can start out with "sitting" for 10-15 minutes a day (or as much as you can tolerate) in a cool, dim room with your eyes closed and hands in your lap. You don't need to chant or hum or do anything weird, but just sit there and focus on breathing in through your nose and out through your mouth. When a thought enters your mind (like your shopping or to-do list), you acknowledge the thought and then let it go. It's pretty simple, yet takes a LOT of practice, so don't be discouraged when your mind wonders off or you feel like you can't focus.
Remember, we've been hard-wired to both increase and decrease stress; unfortunately, Western cultures are taught very well how to increase their stress response, but we are not taught how to counteract it. Meditation is one way of doing that. Others are exercise, yoga and tai chi; all of which
are wonderful, clinically proven, side-effect free and CHEAP ways to center your mind, focus your energy and rid yourself of unnecessary anxiety and obsessive thoughts. And, you'll be counteracting the negative effects of stress on your body! Trust me, I know this from personal experience! Enjoy!
Here's a link to the full article - http://news.sciencemag.org/sciencenow/2009/11/16-01.html
Are potatoes making you fat?
If so, you're not alone. In fact, potato chips were just named the number one culprit in gradual weight gain in a study conducted by researchers at Harvard Schools of Medicine and Public Health. Other food strongly associated with weight gain in the prospective longitudinal results reported in the June 23 issue of the New England Journal of Medicine included potatoes, sugar-sweetened beverages (ie, sodas, sweetened tea, lemonade, processed juices), unprocessed red meats (steak, hamburger, lamb, etc) and processed meats (hot dogs, cold cuts & sausage).
Four-year weight loss was most associated with intake of: yogurt, nuts, fruits, whole grains and vegetables (respectively, in order of greatest to least weight loss...yogurt was associated with the greatest amount of weight loss).
"'(These findings) reinforce the fact that even small changes can impact long-term weight maintenance,' noted Connie Diekman, MEd, RD, LD, a dietitian at Washington University in St. Louis and a past president of the American Dietetic Association.
Janet Kramer, RD, LD, a dietitian at University Hospitals Case Medical Center in Cleveland, saw few surprises in the breakdown of foods associated with weight gain and weight loss. 'It gives backbone to what dietitians have been saying for years,' she said in an interview.
The foods associated with weight loss fit with the emphasis on fruit, vegetables, and grains on the U.S. Department of Agriculture's plate graphic that recently replaced the food pyramid to guide food choices, Kramer pointed out.
But she cautioned against focusing too much on individual foods in the study rather than the overall picture of a healthy diet.
'There's no particular one food that is going to help a person lose weight," Kramer cautioned in the interview. 'There are a number of foods that contribute to weight gain, but overall it seems to support that calories in do make a difference.'
But identifying particular culprits in long-term weight gain may help with targeting interventions, noted Rena Wing, PhD, director of Brown University's Weight Control and Diabetes Research Center in Providence, R.I.
'We often tell people that if they want to avoid gaining weight they need to eat less and exercise more. That sounds easy but it's hard for people to do,' she said in an interview. "Being very specific and giving them specific targets to focus on may be easier for individuals."
The analysis pooled results from the Nurses' Health Study I and II and Health Professionals Follow-up Study for a total of 120,877 women and men free of chronic diseases and obesity at baseline who were followed for weight gain from 1986 to 2006, 1991 to 2003, and 1986 to 2006, respectively.
Weight gain averaged 3.35 lb across the cohorts during each four-year period, representing 2.4% of body weight, and added up to an average 16.8 lb over 20 years.
The researchers looked for links between changes in lifestyle factors and weight at four-year intervals after multivariable adjustment for age, baseline body mass index in each period, and all lifestyle factors simultaneously.
Other lifestyle factors also played a role in longer-term weight change (P<0.001).
Weight gain was linked to alcohol use (0.41 lb per drink per day), smoking cessation (new quitters gained 5.17 lb, former smokers gained 0.14 lb), and television watching (0.31 lb per hour per day).
Not surprisingly, physical activity was associated with 1.76 lb of weight loss over four years for the top versus bottom quintiles.
The researchers cautioned that the lifestyle changes seen in the cohorts were self-selected participants with the possibility of residual confounding and even reverse causality if those who were gaining weight shifted to healthier foods.
Although the three cohorts largely comprised white, well-educated American adults, the similarity in findings across the cohorts support similar effects in other populations, Mozaffarian's group noted."
Source: "Potato Chips a Top Culprit in Gradual Weight Gain"
By Crystal Phend, Senior Staff Writer, MedPage Today
Published: June 22, 2011
I'm trying to respond to your comments as you highlight some great points, however, my website won't let me respond for some reason (quirk!). As you have already discovered (evidenced by your second comment), we are in WAY over our heads in terms of carcinogens in our environment. Here's one great reference to start to answer your "environmental causes of cancer" question:
You can find the full report at: http://deainfo.nci.nih.gov/advisory/pcp/annualReports/pcp08-09rpt/PCP_Report_08-09_508.pdf.
I have also blogged on that report a few times - See "Repost: Because It's So Important" from November 2010.
Other resources on the toxins implicated in causing cancer in children can be found on the Mount Sinai Children's Environmental Health Center website at http://www.mountsinai.org/patient-care/service-areas/children/areas-of-care/childrens-environmental-health-center
Their research can be found at:
As for your first question, it is possible that unfunded patients may die without a diagnosis, but that is generally not the case. They usually die because they do not get adequate screening and preventive care as they tend to present too late in the disease process for treatment. I can tell you from firsthand experience, that I have diagnosed multiple patients in the hospital with cancer for which they cannot receive treatment either due to lack of funding or to late progression of the disease process. That being said, American citizens can apply for emergency Medicaid/Medicare status with the hopes that they recieve approval. Also, there are great non-profits working their butts off to obtain funds for some of them.
And yes, New Yorkers have been noted to live longer than other Americans (likely secondary to walking so much). I do agree this goes against my argument today, however, there are SOO many factors involved, ranging from socioeconomic status and education level to the droves of young people flocking to the live in Manhattan every year. Let's be honest, NYC is no place to grow old!
I hope this has been helpful in answering some of your questions. Let me know if you have any more. Happy Father's Day to all the Dads out there! : D
Here's an interesting article I just stumbled upon that leads to some interesting discussion. The main idea is that US cancer death rates are on the decline, but those most vulnerable (ie, the Uninsured and Underinsured) are achieving fewer cure rates due to limited resources. Putting the political "health care for all' debate aside, I had some thoughts on the simple fact that cancer death rates are declining.
First, this article highlights decreasing DEATH rates in the US, NOT (a) incidence or (b) prevelance rates [(a) the number of new cases of cancer diagnosed divided by the total population in a given amount of time, usually per year; and (b) the number of total cancer cases (anyone with an active cancer diagnosis) divided by the total population in a given amount of time (also, usually a year)]. This is an important distinction because it highlights the advantage of multiple preventive medicine themes: 1) early detection and 2) early treatment.
We now have the knowledge and tools to detect it earlier and treat it earlier.
According to CDC (Center for Disease Control) statistics (SEER data), some forms of cancer (including lung, breast and colon cancer) are on the decline in terms of new cases, Kidney cancer and melanoma cases are definitely on the rise, however. One caveat though, the decline in the aforementioned cancers does not, in general, apply to many minorities and other vulnerable populations, ie, children, elderly and the un/under-insured.
Given the fact that cancer is occurring more frequently among certain populations and remains at very high rates among the majority of the population, I'd like you all to consider what it would be like to actually HAVE cancer. First imagine the stress of being diagnosed, the stress of multiple doctor visits, biopsies and blood work. Then, consider the stress of being told multiple opinions in regards to treatment and then finally, consider the actual treatment - being painfully poked and prodded for venous access, having a to take a pill every day or sit through long IV chemo infusions or radiation sessions. And then, the waiting, praying and hoping, all while you could have been enjoying your life! Not to mention, the medical bills that pile up and days of nausea, vomiting, pain, extreme fatigue and hair loss, etc. Very inconvenient!!! In addition, many of these effects can be long lasting depending on the drugs or radiation doses used.
Now imagine a world with less cancer, less stress and more happiness. This is the world that Preventive Medicine specialists such as myself are trying to achieve. But we need YOUR HELP! Read up on your products and use ones that are paraben and phalate-free, get to the gym 150 minutes per week, eat more fruits and veggies that contain natural anti-cancer vitamins and minerals, buy organic, use less pollution-causing fossil fuels, write or call your Congressperson and GET INVOLVED! Don't wait for the government or private industry to clean up this mess. Do something NOW!
This is YOUR HEALTH and YOUR LIFE and unfortunately, you only get one! Please help us change the current carcinogenic lifestyle we live in. Not only will you be doing good things for others, but you'll also help yourself...and that in itself, makes it all worth it.
Here's the article that stemmed this blog entry:
NPR: US Cancer Death Rates Decline, But Disparities Persist Published: June 17, 2011 by National Public Radio (US)
by Scott Hensley
The rate at which Americans die from cancer continues to fall, according to the latest estimates from the American Cancer Society. As a result, nearly 900,000 cancer deaths were avoided between 1990 and 2007, the group figures. Survival gains have come as mortality rates have declined for some of the most common malignancies, including colorectal cancer, breast cancer in women and prostate cancer.
Still, the ACS estimates there will nearly 1.6 million new cancers diagnosed this year, and about 572,000 deaths from the disease. The incidence of cancers hasn't budged much for men in recent years, after falling quite a bit during the first half of the last decade. Cancer incidence for women has been falling since 1998.
Lung cancer remains the biggest killer for both men and women. All told, about 160,000 people in the U.S. are expected to die from it this year. Starting in 1987, more women have died from lung cancer each year than breast cancer.
One section of the report focuses on a persistent and, in some cases, widening gap in cancer death rates between people with the least education and those with the most. Educational attainment is often used in research as a proxy for socioeconomic status.
American Cancer Society epidemiologist Elizabeth Ward, one of the report's authors, tells Shots, "People of a lower socioeconomic status are more likely to smoke and less likely to get access to care where they can get screened for early detection."
Then there's issue of health coverage, which can make a big difference in treatment. "People with higher income jobs usually work for employers who offer better insurance," Ward says.
The report was just published online by CA: A Cancer Journal for Clinicians.
Have a great weekend!
Meditation Eases Hot Flashes
This is one of the techniques I'll be learning in my Integrative Medicine Fellowship starting in July. I will mostly be using it for stress reduction and weight loss, but now, maybe for menopausal symptoms too. Here's what Dr. Weil has to say...
"It takes some training, but practicing mindfulness meditation does seem to help ease hot flashes, night sweats and insomnia in menopausal women, according to study results from the University of Massachusetts. Researchers there taught mindfulness meditation to 55 women between the ages of 47 and 69. A comparable group of 55 women of the same age who had the same symptoms were placed on a "waiting list" for training. The women in the first group attended classes once a week for eight weeks and also had a full day of training in mindfulness meditation, which involves focusing on the present. When the study began, the women reported five or more moderate to severe hot flashes or night sweats daily. After nearly two years of practice, the meditating women reported their symptoms bothered them about 15 percent less than they had at the outset, compared to a decrease of only 7 percent in the women who were on the waiting list. The study was published in the June 2011 issue of Menopause.
My take? Mindfulness is the technique of bringing all of our awareness to the here and now, to the sensations in our bodies and our breathing, for example, rather than letting much of it slip away in contemplation of the past and future or of other subjects that are not in the present. The assumption is that when we act with full awareness, our actions are more likely to achieve what we intend. These study results offer further evidence that mindfulness meditation can have a positive effect on health. Other than hormone replacement therapy, women have few options that they can count on to address menopausal symptoms. Mindfulness meditation is a risk-free method that is certainly worth trying."
From the Mount Sinai Children's Environmental Health Center website:
"New data show that, despite previous efforts to curb their use, toxic chemicals have a major impact on health care costs and childhood morbidity.
NEW YORK, NY – May 4, 2011 /Press Release/ –– In three new studies published in the May issue of the journal Health Affairs, Mount Sinai School of Medicine researchers reveal the staggering economic impact of toxic chemicals and air pollutants in the environment, and propose new legislation to mandate testing of new chemicals and also those already on the market.
Leonardo Trasande, MD, Associate Professor of Preventive Medicine and Pediatrics at Mount Sinai School of Medicine, analyzed the costs of conditions – including lead poisoning, childhood cancer, asthma, autism, and attention deficit hyperactivity disorder (ADHD) – associated with exposure to toxic chemicals. Dr. Trasande and his team calculated the annual cost for direct medical care and the indirect costs, such as parents’ lost work days, and lost economic productivity caring for their children, of these diseases in children.
The researchers found the annual cost in the United States to be an estimated $76.6 billion, representing 3.5 percent of all U.S. health care costs in 2008. The breakdown includes: lead poisoning ($50.9 billion), autism ($7.9 billion), intellectual disability ($5.4 billion), exposure to mercury pollution ($5.1 billion), ADHD ($5 billion), asthma ($2.2 billion), and childhood cancer ($95 million).
"Our findings show that, despite previous efforts to curb their use, toxic chemicals have a major impact on health care costs and childhood morbidity," said Dr. Trasande. "New policy mandates are necessary to reduce the burden of disease associated with environmental toxins. The prevalence of chronic childhood conditions and costs associated with them may continue to rise if this issue is not addressed."
Dr. Trasande also reviewed an earlier study of 1997 data, which was conducted by Philip J. Landrigan, MD, and documented $54.9 billion in annual costs forchildhood diseases associated with environmental toxins in the United States. Reviewing this prior analysis, Dr. Trasande found that while exposure to lead and costs associated with asthma had diminished, new chemicals and new environmentally-induced diseases, like ADHD, have increased the overall burden of disease. Dr. Landrigan is currently Dean for Global Health, and Professor and Chair of Preventive Medicine, and Professor of Pediatrics, at Mount Sinai School of Medicine.
In a related article also in the current issue of Health Affairs, Dr. Landrigan and Lynn R. Goldman, MD, Dean of the School of Public Health at George Washington University, propose a three-pronged approach to reduce the burden of disease and rein in the effects of toxic chemicals in the environment:
In a separate article in Health Affairs, Perry Sheffield, MD, Assistant Professor of Preventive Medicine at Mount Sinai School of Medicine, evaluated the little-studied correlation between air pollution and infectious respiratory illness in children, and the resultant health care costs.
Dr. Sheffield and her team analyzed hospitalization data between 1999 and 2007 for children aged one month to one year who had bronchiolitis – a type of viral lung infection with symptoms similar to asthma – and monitored the air quality surrounding in the hospitals where the patients were treated. They found a statistically significant association between levels of fine particulate matter pollutant surrounding the hospitals, and total charges and costs for infant bronchiolitis hospitalizations.
Her team revealed that as the amount of air pollutants increased, infant bronchiolitis hospitalization costs increased by an average of $127 per patient. As a result, they concluded that reducing the average level of fine particulate pollutant by just seven percent below the current annual standard could save $15 million annually in U.S. health care costs.
"While more research is required to understand the full effect of air pollutants on infectious disease severity and health care costs, our findings are indicative of the tremendous impact new legislation on air quality control standards could have on the health of our children," said Dr. Sheffield.
To access these three articles in Health Affairs, please visit http://www.healthaffairs.org."
We are learning that lifestyle changes, including healthy diets and exercise, can actually turn on or off the expression of genes related to cancer. Read on for more info.
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.