New Year's Resolution: Don't Just Sit

"Even if you're on the right track, you'll get run over if you just sit there." 
-- Will Rogers



"If everything is under control, you're going too slow."  
-- Mario Andretti

Inner Beauty: A Healthy Colon

Does your colon really need cleansing?  Few issues divide the worlds of conventional and alternative medicine quite so starkly.

According to a profusion of Web sites, clinics and wellness spas, the typical American diet of  processed foods, pharmaceuticals, stress and lack of exercise is clogging up our lower intestinal tracts, leaving them inflamed and lined with waste-and leaking toxins into the body that cause problems ranging from headaches and chronic fatigue to arthritis and cellulite. All that "stubborn fecal matter" also contributes to bulging bellies and expanding waistlines, cleansing proponents claim. Eliminating the buildup, either with supplements or laxatives, or by flushing the colon with warm water-a practice known as "hydrotherapy" or "colonics"-can dramatically improve a person's health and well-being, proponents claim. "Colonics help people get rid of what's in there, so they have a sense of 'Wow! That's what I should feel like,' " says Kim Dupre, who is owner of Wellville Healing Arts Center in Durham, N.C., and certified by an international organization of colon hydrotherapists.

Gastroenterologists pooh-pooh many of those claims. Healthy colons are self-cleaning, they say, and evacuating the colon via other means can do serious harm, even causing the sluggishness the cleansing purports to fix. "I've seen a lot of colons and the notion that people have pounds of feces and evil toxins built up in there is pure fantasy," says John I. Allen, a Minnesota gastroenterologist who has performed more than 20,000 colonoscopies, including many in patients who haven't drunk the traditional medical cleansing preparation  beforehand. Claims for colonics and other forms of cleansing, Dr. Allen says, "just play to people's fears and desire to lose weight."

The notion of emptying the intestines to cure illness was common in many ancient cultures, too. Egyptians performed enemas in rivers using hollow reeds. Colonic irrigation was been a staple of European spas for centuries, and it was all the rage in 17th-century Paris to have several enemas a day.

In the U.S., colon cleansing was common until the early 19th century, when conventional physicians began to challenge the lack of scientific evidence and condemn some practitioners as quacks.

In recent decades, colon cleansing has ridden a wave of interest in alternative medicines. Hydrotherapy spas-from storefront clinics to luxury resorts-have sprung up, especially in the South and West. And the Internet has fueled a boom in sales of at-home cleansing products.  Generally combinations of fiber, herbs, vitamins and stimulants, they often make enticing claims ("Ever wonder how the stars lose weight so quickly?" "Flush out up to 30 pounds!"). Some Web sites feature photos of long strands of rubbery-looking goo that customers claim they have expelled. ("I have lost some of the most horrific things you could imagine, and I have proof!")

Some Web purveyors even suggest that cleansing can cut one's risk of colon cancer; there is no such evidence, medical experts say. Attorneys for Oprah Winfrey and Mehmet Oz, a cardiologist and author, filed a suit last month in federal court in Manhattan accusing 40 Internet marketers of implying that their colon cleansers and dietary supplements have received the celebrities' endorsements. The U.S. Food and Drug Administration has warned some makers of colon cleansers about unsubstantiated claims, and some consumers have complained about being lured in by "free" trial offers for products, only to find themselves
charged $80 or more per month for shipments that are difficult to cancel.

Even within the colon-cleansing community, there is a wide spectrum of practices and competing claims. Steven Horne, a past president of the American Herbalist Guild, says use of home-cleansing products can result in startling results. But the expelled goo shown in online photos is most likely the mucilaginous fiber in the purging products themselves, combined with black bile from the liver, he says. "People do pass this stuff, but it's a myth that it's coming off the lining of their colon." Still, Mr. Horne says modern diets can irritate the lining of the GI tract and allow toxins to invade the body and cause illness-what he and others call the "leaky gut syndrome"-and that cleansing can help eliminate many health problems. He advocates a combination of natural fiber, digestive enzymes and herbal supplements.

"Not everybody needs to do this," Mr. Horne says, "but people who have chronic sinus problems or weak immune systems or general aches and pains seem to benefit a lot." He concedes there are few scientific studies to support the practice but adds, "I'm comfortable with that, because I've seen it in clinical experience."

Dr. Allen, who is on the American Gastroenterological Association's board of governors, says there is some scientific basis for leaky gut syndrome, but the problem is rare and primarily affects the small intestine. "If you biopsy a normal colon, there is no inflammation," he says. And there are illnesses, like inflammatory bowel disease and liver failure, in which toxins do affect the whole body. But cleansing proponents, he says, "have taken literature on disease states and tried to extend it to normal people."

Practitioners of colonics say their procedure is natural, because it avoids the use of laxatives and exercises colon muscles. A therapist inserts a rubber tube into the rectum and infuses up to 20 gallons of warm water into the colon (a traditional enema uses far less water and  involves only the last few inches of the colon). When the water is drained out, it brings fecal matter with it. The procedure often includes an abdominal massage.

"We are like personal trainers for the colon-we help re-educate those muscles about how they should be moving," says Ms. Dupre, who adds that many of her clients are constipated and need to change their diets.  "Otherwise, colonics are just a band-aid." She usually recommends a series of three to five weekly sessions (at $85 each), and monthly after
that. Gastroenterologists say that about 15% of the population suffers from constipation at some point, and some conditions and medications increase it. The best remedies are to increase dietary fiber, ideally from whole grains, fruits and vegetables, and to consult a  physician before trying other measures.

Some gastroenterologists worry that colonics can wash out beneficial bacteria and create infections, abscesses and electrolyte imbalances; there have been cases of rectal perforations. That is one reason that some hydrotherapists are pushing states to have formal licensing procedures. As of now, only Florida licenses colon hydrotherapists.  Texas requires patients to have a doctor's prescription; Rhode Island prohibits the practice.

Brian Landzberg, a Manhattan gastroenterologist, says people's notion that they have pounds of backed-up stool in their colons is helping to feed distorted body images. He says he frequently sees patients who have abused laxatives in an effort to lose weight or flatten their stomachs. "Those are some of my toughest patients to treat," he says, because overuse of some bowel stimulants can damage the nerves and walls of the colon and prevent it from functioning properly.

Some patients, he says, are so convinced they are constipated that only transit marker studies-which follow the passage of small markers through the intestine via X-ray-can persuade them that their "transit time" is normal. "There is a degree of obsession that goes along with this," says Dr. Landzberg. "You can't just accept a patient's report that they are
constipated."

Even "natural" laxatives, such as the plants senna and cascara, can harm the bowel, Dr. Landzberg says, adding, "The public has grown increasingly wary of the side effects of pharmaceuticals. I would like to see people bring that same degree of healthy skepticism to 'natural' products."

Where practitioners of conventional and alternative medicine do agree is in recommending improvements in the average American diet, to avoid gastrointestinal problems and lower the risk of colon cancer. 

"We do see a lot of constipation in Western civilization," says Dr. Landzberg. "We don't drink enough fluids. We are too sedentary, we have weakened abdominal muscles, and we don't take enough fiber in our diets.  But the answer to that is not artificial colon cleansing.  A
well-balanced diet with a good portion of soluble fiber-with lower fat and a calcium  supplement-makes a happy colon."

From The Wall Street Journal, by Melinda Beck
Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP

H1N1 Vaccine Update

We have received our supply of H1N1 vaccine from the State of Texas.  We'll contact member patients over the next week or so to arrange vaccination.  In the interim, feel free to call if you've questions or concerns.

Quotes from Soldiers

"You've never been lost until you've been lost at Mach 3."
-- Paul F. Crickmore (SR71 test pilot)


"'Whoever said the pen is mightier than the sword, obviously never encountered automatic weapons."
-- General Douglas MacArthur


"You, you, and you ... Panic.     The rest of you, come with me."
-- US Marine Corps Gunnery Sgt

MacArthur Genius Award: Reducing Falls in the Elderly

For a 75-year-old with high blood pressure, the risk of death or serious
disability resulting from a fall is just as high as the risk of death or
serious disability caused by a stroke. But a generation ago, doctors
thought of falling as an inevitable risk, not something they could do
anything to prevent as part of caring for patients.

That's how Mary Tinetti, a geriatrician at Yale med school, laid things
out for us when we got her on the phone to chat about the MacArthur
genius grant she just won. (Here's a complete list of this year's
winners, including several health-care geniuses.)

In the decades since Tinetti did her first research on the subject, she
and her colleagues have gone on to show that there are clear factors
that increase the risk of falls - things like muscle weakness, balance
problems and taking multiple medications. What's more, they found, by
addressing these issues, doctors can reduce seniors' risk of falls by
about 30%.

Still, not all patients get screened for these risk factors. Doctors
don't get paid much for spending time diagnosing and treating these risk
factors. And they don't fit into the disease/specialist model of health
care, which tends to focus on things like heart attacks and strokes.
"What needs to be done is very simple," she told us. "Figuring out how
to do it is the complex piece."

As a MacArthur Fellow, Tinetti gets $500,000 with no strings attached.
She says she plans to use the money to look more broadly at how to look
beyond single diseases to try use broader measures of well-being to
guide treatment of the elderly.

"What became obvious to me as I was doing the work on falls is the big
problem with older people is they don't have a single disease, they have
multiple diseases," she said. "All of our decision-making is based on
what's best for a single disease, not what's best for an individual
patient. What I'm interested in is how we can figure out what's best for
patients with multiple diseases so we can maximize benefits and minimize
harms."

From: The Wall Street Journal, by Jacob Goldstein
Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP

Dallas Providence Homes

Dr. Yates,


I appreciate the opportunity to share with you our work at Dallas Providence Homes and appreciate your personal involvement with our women and children.


Our Mission is to break the cycle of domestic violence for women and their children through long term transformational care that seeks to restore faith, hope and health. We accomplish this through our unique "transformational housing ministry" whereby we make a two-year commitment to our women and children.


We are NOT a shelter, which typically allows women to stay for 30, 60 or 90 days; we are a transformational housing ministry: we are the BRIDGE from the shelter back into the community. It is  during the 24 months that we provide acontinuum of care, counseling, housing and life skill training that will enable our women to become self sufficient.


Recent statistics for our ministry:

-1 in 4 residents who enter our program will graduate

-64% of our residents overcame their addiction before leaving

-100% of residents increased self esteem

-70% of residents did not know Christ when they entered, yet over 50% of them became believers before leaving

-Average wage earnings increased 77% upon leaving our program

-We reach our residents at a cost of less than $40 per day


One of our most recent success stories was a lady and her 8 year old son who came to us after having stayed at theSamaritan Inn, McKinney for almost 4 months.  When she entered our program, she had an interest in the nursing profession, but no formal training, and her son was failing in school. After completing our program which provided stability as well as education for her and her son, she accepted a job at M.D. Anderson in Houston and her son has been selected to attend two gifted classes, one in math and one in science.


There are a lot of good causes, however, If you have some interest in learning more about our ministry or how you can get involved in helping change the life of a woman or a child, please visit our website at www.dallasprovidence.org email Lori Conley, Executive Director, at execdirector@dallasprovidencehomes.org. or me at mw.hagan@tx.rr.com

Thanks so much for your interest in our ministry as it is through community that we are able to truly impact the lives of our residents.

Sincerely,

Mark Hagan

Founder, Dallas Providence Homes, Inc.

Link Between Successful Weight Loss And Vitamin D Levels

Vitamin D levels in the body at the start of a low-calorie diet predict weight loss success, a new study found. The results, which suggest a possible role for vitamin D in weight loss, were presented at The Endocrine Society's 91st Annual Meeting in Washington, D.C.

"Vitamin D deficiency is associated with obesity, but it is not clear if inadequate vitamin D causes obesity or the other way around," said the study's lead author, Shalamar Sibley, MD, MPH, an assistant professor of medicine at the University of Minnesota.

In this study, the authors attempted to determine whether baseline vitamin D levels before calorie restriction affect subsequent weight loss. They measured circulating blood levels of vitamin D in 38 overweight men and women before and after the subjects followed a diet plan for 11 weeks consisting of 750 calories a day fewer than their estimated total needs. Subjects also had their fat distribution measured with DXA (bone densitometry) scans.

On average, subjects had vitamin D levels that many experts would consider to be in the insufficient range, according to Sibley. However, the authors found that baseline, or pre-diet, vitamin D levels predicted weight loss in a linear relationship. For every increase of 1 ng/mL in level of 25-hydroxycholecalciferol - the precursor form of vitamin D and a commonly used indicator of vitamin D status - subjects ended up losing almost a half pound (0.196 kg) more on their calorie-restricted diet. For each 1-ng/mL increase in the active or "hormonal" form of vitamin D (1,25-dihydroxycholecalciferol), subjects lost nearly one-quarter pound (0.107 kg) more.

Additionally, higher baseline vitamin D levels (both the precursor and active forms) predicted greater loss of abdominal fat.

"Our results suggest the possibility that the addition of vitamin D to a reduced-calorie diet will lead to better weight loss," Sibley said.

She cautioned, however, that more research is needed. "Our findings," she said, "need to be followed up by the right kind of controlled clinical trial to determine if there is a role for vitamin D supplementation in helping people lose weight when they attempt to cut back on what they eat."

The National Institutes of Health, the University of Minnesota, and the Pennock Family Endowment at the University of Minnesota funded this study.

Source: Aaron Lohr, The Endocrine Society

Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP

Don't Cancel Your Mammogram Yet

As you’ve certainly heard or read, the USPSTF (United States Preventive Services Task Force) has issued updated guidelines for breast cancer screening. Here’s a summary of those recommendations and our comments.

Summary of USPSTF Recommendations

• The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms. The USPSTF recommends against routinely providing the service. There may be considerations that support providing the service in an individual patient. There is at least moderate certainty that the net benefit is small.

• The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.

• The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.

• The USPSTF recommends against teaching breast self-examination (BSE). The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.

• The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.

• The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.

Summary of American Cancer Society Recommendations

• Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.

• Clinical breast exam (CBE) should be part of a periodic health exam, about every 3 years for women in their 20s and 30s and every year for women 40 and over.

• Women should know how their breasts normally feel and report any breast change promptly to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s.

• Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.

Phil Evans, a professor of radiology at the University of Texas Southwestern Medical Center and president of the Society for Breast Imaging, says he was "shocked" by the changes. "There's a ton of scientific data in this country and others on screening that shows a significant benefit for women between 40 and 49 to be screened," he says. (Quoted in the Wall Street Journal)

It is important to note that the American Cancer Society and other groups have not changed their recommendations (which uniformly include teaching breast self examination and routine mammography). Dr. Schrader, Dr. Bond and I will review the evidence supporting these changes as it becomes available, but for now we believe that it is premature to change screening procedures.

Comments / Posted by Scott W. Yates, MD, MBA, MS, FACP

ADHD - The Positive Side

The three major symptoms of ADHD: hyperactivity, impulsiveness and inattention can create many problems in people’s lives. They can interfere with relationships, school and work. But there are also many positive characteristics of adult ADD/ADHD.

Hyperactivity is most often described as “feeling as if driven by a motor.” It creates the inability to sit still for long periods. Children with hyperactivity are in constant motion, usually running or “bouncing” from one activity to another. Many times this will subside in adolescence and adulthood, but for most people, hyperactivity is still present. Maybe it has decreased to a feeling of restlessness or being fidgety. Or maybe adults have better learned to manage it in daily life. Hyperactivity, however, is also seen as a positive for adults. Some indicate they enjoy the endless energy and the ability to accomplish more and work longer hours. They prefer getting up and doing things rather than sitting in front of a television.

Impulsiveness is acting without thinking. It is rushing ahead without slowing down to think about the consequences of our actions. Children and teens often get into much trouble for their impulsive actions. Impulsiveness is also seen in blurting out answers or interrupting others while they are talking. Adding structure to our lives, and the daily lives of our children, help to reign in our carelessness. But spontaneity is also important. Allowing ourselves to be unpredictable adds variety to life. As adults, sometimes our lives become too structured. We often leave for work early in the morning and once we arrive home our evenings are filled with making dinner, helping with homework, household chores. We sometimes forget the pleasure of having the unexpected happen. Giving in to impulsiveness, at times, can create a more exciting and adventurous life. It can provide us with a different perspective on our problems and allow our minds to find creative solutions to what may have seemed impossible before. Impulsiveness can help to foster creativity.

Inattention, being easily distracted and not completing tasks are often some of the major complaints of both children and adults with ADD/ADHD. Many times these traits lead to uncompleted homework, lost items, and half finished projects. In life, we must learn to finish what we have started. We need to be able to focus on the task at hand to accomplish our goals. But having the ability to move from one task to another also has benefits. Allowing ourselves to experience many things adds to our perspective on life. It allows us to find what we do enjoy. It allows us to search for our interests and our passions. Although I do not condone teaching children to stop what they are doing as soon as their interest wanes, providing them with varied activities may help them determine what direction they want their lives to take. Allowing ourselves to experience many different things will increase our awareness of who we are and what we want to accomplish.

In addition to the main symptoms, some other positive traits of ADD/ADHD are included below. Several years ago, I took an informal survey of 50 adults, asking what their favorite ADD/ADHD characteristic was. Their top ten answers are as follows (in no particular order):

• Endless Energy
• Hyperfocus
• Energy and hyperfocus combined
• Great imagination
• Creativity
• Humor
• Ahead of “establishment” thinking
• Creative thinking and problem solving
• Spontaneity
• Great passion for interests

So go ahead, enjoy your life, enjoy your ADHD and live life to it’s fullest.

By Eileen Bailey on ADHDCentral.com

Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP

The Benefits of Flax Seed

Some call it one of the most powerful plant foods on the planet. There’s some evidence it can help reduce your risk of heart disease, cancer, stroke, and diabetes. That’s quite a tall order for a tiny seed that’s been around for centuries: flaxseed.

Flaxseed was cultivated in Babylon as early as 3000 BC, according to the Flax Council of Canada. By the 8th century, King Charlemagne believed so strongly in the health benefits of flaxseed that he passed laws requiring his subjects to consume it. Fast-forward 13 centuries, and some experts would say we have preliminary research to back up what Charlemagne suspected all those years ago.

These days, flaxseed is found in all kinds of foods, from crackers to frozen waffles to oatmeal. In the first 11 months of 2006, 75 new products were launched that listed flax or flaxseed as an ingredient. Not only has consumer demand for flaxseed gone up, agricultural use has also increased -- to feed all those chickens laying eggs that are higher in omega-3 fatty acids.

Although flaxseed contains all sorts of healthy components, it owes its healthy reputation primarily to three ingredients:

Omega-3 essential fatty acids, "good" fats that have been shown to have heart-healthy effects. Each tablespoon of ground flaxseed contains about 1.8 grams of plant omega-3s.

Lignans, which have both plant estrogen and antioxidant qualities. Flaxseed contains 75- 800 times more lignans than other plant foods.

Fiber. Flaxseed contains both the soluble and insoluble types.

The Health Benefits of Flax

Although Lilian Thompson, PhD, an internationally known flaxseed researcher from the University of Toronto, says she wouldn’t call any of the health benefits of flax "well established," research indicates that flax’s possible health benefits include reducing the risks of certain cancers as well as cardiovascular disease and lung disease. Here are more details:

Cancer

Recent studies have suggested that flaxseed may have a protective effect against cancer, particularly breast cancer, prostate cancer, and colon cancer. At least two of the components in flaxseed seem to contribute, says Kelley C. Fitzpatrick, M.Sc., director of health and nutrition with the Flax Council of Canada.

In animal studies, the plant omega-3 fatty acid found in flaxseed, called ALA, inhibited tumor incidence and growth.

Further, the lignans in flaxseed may provide some protection against cancers that are sensitive to hormones. Some studies have suggested that exposure to lignans during adolescence helps reduce the risk of breast cancer, Thompson says.

Lignans may help protect against cancer by:

Blocking enzymes that are involved in hormone metabolism.

Interfering with the growth and spread of tumor cells.

Some of the other components in flaxseed also have antioxidant properties, which may contribute to protection against cancer and heart disease.

Cardiovascular Disease

Research suggests that plant omega-3s help the cardiovascular system via several different mechanisms, including anti-inflammatory action and normalizing the heartbeat, Fitzpatrick says.

Several studies have suggested that diets rich in flaxseed omega-3s help prevent hardening of the arteries and keep plaque from being deposited in the arteries, partly by keeping white blood cells from sticking to the blood vessels’ inner linings.

"Lignans in flaxseed have been shown to reduce atherosclerotic plaque buildup by up to 75%," Fitzpatrick says.

Because plant omega-3s may also play a role in maintaining the heart’s natural rhythm, they may be useful in treating arrhythmia (irregular heartbeat) and heart failure, although more research is needed on this.

Eating flaxseed daily may help your cholesterol levels, too. Small particles of LDL or "bad" cholesterol in the bloodstream have been linked to an increased risk of heart disease, obesity, diabetes, and metabolic syndrome. A French-Canadian study in menopausal women reported a decrease in these small LDL particles after the women ate 4 tablespoons of ground flaxseed daily for a year. Fitzpatrick says the cholesterol-lowering effects of flaxseed are the result of the synergistic benefits of omega 3 ALA; fiber and lignans.

Diabetes

Preliminary research also suggests that daily intake of the lignans in flax may modestly improve blood sugar (as measured by hemoglobin A1c blood tests in adults with type 2 diabetes).

Inflammation

Two components in flaxseed, ALA and lignans, may reduce the inflammation that accompanies certain illnesses (such as Parkinson's disease and asthma) by helping to block the release of certain pro-inflammatory agents, Fitzpatrick says.

The plant omega-3 ALA has been shown to decrease inflammatory reactions in humans. And studies in animals have found that lignans can decrease levels of several pro-inflammatory agents.

Reducing inflammatory reactions associated with plaque buildup in the arteries may be another way flaxseed helps prevent heart attack and strokes.

Hot Flashes

One preliminary study on menopausal women, published in 2007, reported that 2 tablespoons of ground flaxseed (taken twice each day) cut the women's hot flashes in half. And, the intensity of their hot flashes dropped by 57%. The women noticed a difference after talking the daily flaxseed for just one week, and achieved the maximum benefit within two weeks.

Who Shouldn’t Use Flaxseed?

Until more is known, Thompson says pregnant women and possibly breastfeeding mothers should not supplement their diets with ground flaxseed.

"Our own animal studies showed that flaxseed exposure during these stages may be protective against breast cancer in the offspring, but a study of another investigator showed the opposite effect," Thompson says.

Tips for Using Flaxseed

Many experts believe it's better to consume flaxseed than flax oil (which contains just part of the seed) so you get all the components. But stay tuned as researchers continue to investigate.

"Ground flaxseed, in general, is a great first choice but there may be specific situations where flax oil or the lignans (taken in amounts naturally found in flaxseed) might be as good," Thompson says.

And how much flaxseed do you need? The optimum dose to obtain health benefits is not yet known. But 1-2 tablespoons of ground flaxseed a day is currently the suggested dose, according to the Flax Council of Canada.

Here are more tips for using, buying, and storing flaxseed:

Buy it ground or grind it yourself. Flaxseed, when eaten whole, is more likely to pass through the intestinal tract undigested, which means your body doesn't get all the healthful components. If you want to grind flaxseed yourself, those little electric coffee grinders seem to work best.

Milled = ground = flax meal. Don’t be confused by the different product names for ground flaxseed. Milled or ground flaxseed is the same thing as flax meal. Buy either brown or golden flaxseed. Golden flaxseed is easier on the eyes, but brown flaxseed is easier to find in most supermarkets. There is very little difference nutritionally between the two, so the choice is up to you. Find it in stores or on the Internet. Many supermarket chains now carry ground flaxseed (or flaxmeal). It’s usually in the flour or "grain" aisle or the whole-grain cereal section, often sold in 1-pound bags. You can also find it in health food stores, or order it through various web sites. Check the product label. When buying products containing flaxseed, check the label to make sure ground flaxseed, not whole flaxseed, was added. Flaxseed is a featured ingredient in cereals, pasta, whole grain breads and crackers, energy bars, meatless meal products, and snack foods. Add flaxseed to a food you habitually eat. Every time you have a certain food, like oatmeal, smoothies, soup, or yogurt, stir in a couple tablespoons of ground flaxseed. Soon it will be a habit and you won’t have to think about it, you’ll just do it. Hide flaxseed in dark, moist dishes. The dishes that hide flaxseed the best usually have a darkly colored sauces or meat mixtures. No one tends to notice flaxseed when it's stirred into enchilada casserole, chicken Parmesan, chili, beef stew, meatloaf or meatballs. For a 4-serving casserole, you can usually get away with adding 2-4 tablespoons of ground flaxseed. For a dish serving 6-8, use 4-8 tablespoons. Use it in baking. Substitute ground flaxseed for part of the flour in recipes for quick breads, muffins, rolls, bread, bagels, pancakes, and waffles. Try replacing 1/4 to 1/2 cup of the flour with ground flaxseed if the recipe calls for 2 or more cups of flour. Keep it in the freezer. The best place to store ground flaxseed is the freezer. Freeze pre-ground flaxseed in the bag you bought it in, or in a plastic sealable bag if you ground it yourself. The freezer will keep the ground flax from oxidizing and losing its nutritional potency. Whole flaxseed keeps longer. The outside shell in whole flaxseed appears to keep the fatty acids inside well protected. It’s a good idea to keep your whole flaxseed in a dark, cool place until you grind it. But as long as it is dry and of good quality, whole flaxseed can be stored at room temperature for up to a year.

From WebMD by Elaine Magee, MPH, RD

Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP

Adequate Vitamin D Levels May Aid Weight Loss in Obese Patients

Adequate plasma levels of vitamin D, both the precursor and active
forms, may play a role in promotion of weight loss in obese patients,
perhaps through effects on adipose metabolism, according to research
reported Thursday at The Endocrine Society's annual meeting in
Washington, D.C.

While vitamin D deficiency is associated with obesity, "there are
limited data on the temporal relationship between vitamin D and weight
loss -- an important step in establishing a cause-effect link between
vitamin D deficiency and obesity," Dr. Shalamar Sibley from the
University of Minnesota in Minneapolis told the conference.

She and colleagues investigated the temporal relationship between
baseline vitamin D levels and subsequent weight loss success in 38
overweight and obese men and women.

They measured plasma vitamin D (25-hydroxyvitamin D and
1,25-dihydroxyvitamin D) concentrations before and after an 11-week
weight loss intervention consisting of a 750 calorie per day deficit
from estimated total daily calorie needs. They used dual-energy X-ray
absorptiometry and computed tomography to measure body composition and
fat distribution.

On average, vitamin D levels in study subjects were in the insufficient
range.

According to the investigators, in separate models adjusted for gender,
baseline (pre-diet) 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D
levels predicted subsequent weight loss success (p = 0.020 and p =
0.015, respectively) on a reduced calorie diet.

For each 1-ng/mL increase in level of 25-hydroxyvitamin D, obese
patients lost almost half a pound (0.196 kg) more on their
calorie-restricted diet. For each 1-ng/mL increase in
1,25-dihydroxyvitamin D, subjects lost nearly one-quarter pound (0.107
kg) more.

"Abdominal fat loss, in particular, tended to be related to baseline
vitamin D concentrations, with the effect being stronger with the active
form of vitamin D," Dr. Sibley reported. "Vitamin D status did not
predict lean body mass changes, so there was relative preservation of
lean tissue."

The researchers say studies are needed to confirm these findings and
define underlying mechanisms.

"If it is established," Dr. Sibley said, "that vitamin D does indeed
synergistically contribute to standard weight loss approaches, such as a
reduced calorie diet, then identification and treatment of inadequate
vitamin D status could ultimately have a large public health impact on
the obesity epidemic. Our findings suggest that vitamin D may play an
important role in promoting optimal weight management," she concluded.

From Reuters Health, by Megan Rauscher

Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP

Preventing Flu: What Works

From Airborne to vitamin D, the truth behind preventative measures and treatments.

In 2004, People magazine interviewed Dr. Peter Katona, an associate clinical professor of infectious diseases at the David Geffen School of Medicine at UCLA, about a money-making dietary supplement called Airborne.

The small tablets, then being marketed as a handy cold prevention and treatment remedy, are chock-full of vitamins, herbs and minerals and fizz once placed in water.

Katona gave a frank opinion, calling the over-the-counter supplement a "waste of money." The actor Kevin Costner, on the other hand, gave a brief but glowing review and confessed to stashing them on his private plane.

"Who do you think readers listened to?" says Katona, with a laugh.

In Depth: Cold/Flu Products To Try, And Toss

Katona's assessment was reinforced last December when Airborne agreed to pay up to $30 million to settle a class-action lawsuit. The Federal Trade Commission, which announced the settlement, said Airborne lacked "competent and reliable scientific evidence to support the claims."

Airborne is still on the shelves--with a slightly different marketing claim that it supports the immune system--but that doesn't make the product any more effective.

Though Americans spent $4.6 billion on cough, cold and sore throat remedies in 2008, in fact there are only a handful of scientifically proven preventions and treatments for viruses that cause the cold and flu, and none of them involve excess doses of vitamins. Instead, public health officials and physicians have a more common-sense approach, including avoiding sick people, getting vaccinated for the seasonal and H1N1 flues, managing symptoms with reliable medications like an anti-inflammatory or decongestant, and seeking treatment for the flu within the first 48 hours of flu symptom onset.

Prevention and Treatment Myths

Still, this doesn't stop sufferers from relying on a host of ineffective treatments. Like Dr. Katona, emergency physician Dr. Frank McGeorge often deals with patients who rely on remedies that lack scientific proof until their symptoms worsen and they have to see a health care professional.

McGeorge, a Detroit-Mich.-based spokesman for the American College of Emergency Physicians, says a lot of patients often take vitamins like echinacea, zinc and vitamin C once they get sick. While research on the use of the herb echinacea to treat colds and flues is still ongoing, many studies--including two funded by the government--have found no benefit.

Similarly, there's not enough scientific evidence to demonstrate that zinc and vitamin C are powerful weapons against the cold and flu. On the contrary, both can be harmful in excessive doses. Earlier this year, the Food and Drug Administration warned consumers that the homeopathic cold-treatment nasal spray Zicam, which contains the mineral zinc, had been linked to a loss of smell in more than 100 people since 1999. McGeorge also advises against regularly taking more than 500 milligrams of vitamin C per day. Doing so over a long period of time may be harmful; excess vitamin C can cause severe diarrhea.

"There are very intelligent, well-grounded people who swear by this stuff," says McGeorge, referring to vitamin supplements and homeopathic remedies. "My problem is that people taking these [products] sometimes ignore things that will really help them and instead choose voodoo medicine."

Getting Smart About the Cold and Flu

Instead, McGeorge would prefer patients to practice cold and flu prevention by washing their hands, avoiding sick people, staying healthy and, for the flu, getting vaccinated. This year that means obtaining both the seasonal flu vaccine and the H1N1 vaccine. The second vaccine is particularly important for high-risk patients like pregnant women and young children.

Controlling uncomfortable symptoms of either the cold or flu can be done with over-the-counter medications like ibuprofen, an anti-inflammatory that reduces fever and pain; a decongestant, which relieves swollen tissue in the nose; or an antihistamine, which minimizes sneezing, runny nose and coughing. And staying hydrated, which helps keep mucus moist and easy to clear from the nose, will do more to help the body heal than any alternative or homeopathic remedy.

Dr. Norman Edelman, chief medical officer at the American Lung Association, says an effective cold and flu prevention strategy should also include a healthy diet, exercise and plenty of sleep. Following these guidelines will help support the immune system, though Edelman stresses that minor slip-ups, like missing an hour or two of exercise during the week, won't severely compromise one's natural defenses.

And if you've been unfortunate enough to catch a cold or flu, Edelman has a final recommendation: be considerate of others.

"Cancel that trip to grandma's or don't go to work," he says. "If you're sick and spread it to someone else, that's an impolite thing to do."

Cold/Flu Products To Try, And Toss

Echinacea

Some who use this herb to shorten the duration of a cold or treat its symptoms say that it's effective, and at least one study of 95 people made a similar observation. Yet many studies, including two funded by the government, have found no benefit. The National Center for Complimentary and Alternative Health, a division of the National Institutes of Health, is continuing to study the use of Echinacea in treating upper respiratory infections and in supporting the immune system.

Vitamin C

There is no conclusive evidence to support vitamin C as a cold prevention or treatment remedy, according to the National Institute of Allergy and Infectious Diseases. Several controlled studies have been conducted, but the data on whether or not vitamin C reduces the severity or duration of symptoms is unclear. In fact, taking more than 500 milligrams of vitamin C daily over a long period of time may be harmful; excess vitamin C can cause severe diarrhea.

Consider Vitamin D

If there is a supplement you might consider taking this winter, says Dr. Edelman, it is vitamin D. Recent research has demonstrated an association between vitamin D deficiency and cardiovascular disease and increased risk of the common cold. It's easy to get sufficient levels of vitamin D--which the body processes when it's exposed to the sun's UV-B rays--during the summer months but more difficult throughout winter. Research on the use of vitamin D to protect against the cold is still ongoing; discuss the appropriate dose with your physician.

Tamiflu and Relenza

Practicing prevention doesn't guarantee immunity; for those who do come down with the flu, McGeorge recommends seeing a health care professional within the first 48 hours. That's a critical window of time during which a doctor can prescribe the antiviral medications Tamiflu or Relenza, both of which have been shown to shorten the course of the flu.

From Yahoo Health by Rebecca Ruiz

Reviewed/Posted by: M Keith Schrader, MD

6 Daily Habits That May Make You Sick

They say that home is where the heart is. But what you may not know is
that it's also where 65% of colds and more than half of food-borne
illnesses are contracted. The things we do around the house every day
have a big impact on both our long- and short-term health. Here are six
common household activities that may be making you sick.

1. Using a Sponge

The dirtiest room in everybody's home is the kitchen, says Phillip
Tierno, PhD, director of clinical microbiology and diagnostic immunology
at the New York University Langone Medical Center and author of The
Secret Life of Germs. "That's because we deal with dead animal carcasses
on our countertops and in the sink." Raw meat can carry E. coli and
salmonella, among other viruses and bacteria.

Most people clean their countertops and table after a meal with the one
tool found in almost all kitchens: the sponge. In addition to sopping up
liquids and other messes, the kitchen sponge commonly carries E. coli
and fecal bacteria, as well as many other microbes. "It's the single
dirtiest thing in your kitchen, along with a dishrag," says Tierno.

Ironically, the more you attempt to clean your countertops with a
sponge, the more germs you're spreading around. "People leave [the
sponge] growing and it becomes teaming with [millions of] bacteria, and
that can make you sick and become a reservoir of other organisms that
you cross-contaminate your countertops with, your refrigerator, and
other appliances in the kitchen," Tierno explains.

Solution: Tierno suggests dipping sponges into a solution of bleach and
water before wiping down surfaces. "That is the best and cheapest
germicide money can buy -- less than a penny to make the solution -- so
that you can clean your countertops, cutting boards, dishrags, or
sponges after each meal preparation."

In addition, once you've used your sponge, be sure to let it air-dry.
Dryness kills off organisms. Another way to keep bacteria from building
up in your sponge is to microwave it for one to two minutes each week.
"Put a little water in a dish and put the sponge in that," Tierno
advises. "That will boil and distribute the heat evenly [throughout the
sponge] and kill the bacteria."

2. Vacuuming

Conventional vacuum cleaners are intended to pick up and retain big
pieces of dirt, like the dust bunnies we see floating about on our
floors. But it's the tiny dust particles that pass right through the
porous vacuum bags and up into the air. So, while our floors may look
cleaner after running a vacuum over them, plenty of dust, which can
exacerbate allergies and asthma, remains.

Pet allergens and indoor dust, which contains the highest concentrations
of hazardous materials like heavy metals, lead, pesticides, and other
chemicals, are found in higher concentrations in the smallest particles
of the dust, explains David MacIntosh, MD. He is principal scientist at
Environmental Health & Engineering (EH&E), an environmental consulting
and engineering services firm based in Needham, Mass.

"The everyday habit of cleaning with a conventional vacuum cleaner
results in a burst of particles in the air and then they settle back
down over the course of hours," says MacIntosh.

Solution: Look for a vacuum cleaner with a high efficiency particulate
air (HEPA) filter. Unlike those in conventional vacuums, HEPA filters
are able to retain the small particles and prevent them from passing
through and contaminating the air you breathe in your home.

3. Sleeping With Pillows and a Mattress

The average person sheds about 1.5 million skin cells per hour and
perspires one quart every day even while doing nothing, says Tierno. The
skin cells accumulate in our pillows and mattresses and dust mites grow
and settle.

If that's not gross enough for you, Tierno explains that a mattress
doubles in weight every 10 years because of the accumulation of human
hair, bodily secretions, animal hair and dander, fungal mold and spores,
bacteria, chemicals, dust, lint, fibers, dust mites, insect parts, and a
variety of particulates, including dust mite feces. After five years,
10% of the weight of a pillow is dust mites. This is what you're
inhaling while you sleep.

"What you're sleeping on can exacerbate your allergies or your asthma,"
says Tierno.

Solution: Cover your mattress, box springs, and pillows with impervious
outer covers.

"Allergy-proof coverings seal the mattress and pillow, preventing
anything from getting in or out, which protects you," Tierno says. He
also suggests that you wash your sheets weekly in hot water. Make sure
the temperature range of the water is between 130 to 150 degrees
Fahrenheit.

4. Grilling Meat

So much for the summertime staple: Barbecuing meat creates the
cancer-causing compounds polycyclic aromatic hydrocarbons (PAHs) and
heterocyclic amines (HCAs). When fat drips from the meat onto the hot
grill, catches fire, and produces smoke, PAHs form. That's what's
contained in that delicious-looking charred mark we all look for on our
burger. HCAs form when meat is cooked at a high temperature, which can
occur during an indoor cooking process as well.

Solution: "Limiting your outdoor cooking, using tin foil, or microwaving
the meat first is a sensible precaution," says Michael Thun, MD. He is
emeritus vice president for epidemiology and surveillance research with
the American Cancer Society.

Wrapping meat in foil with holes poked in it allows fat to drip off, but
limits the amount of fat that hits the flames and comes back onto the
meat, Thun tells WebMD. Some of the excess fat can also be eliminated by
first microwaving meat and choosing cuts of meat that are leaner.

5. Opening Your Windows

When the weather turns nice, many of us throw open our windows to breath
in the fresh spring air. But that may be an unhealthy move, considering
the combination of seasonal allergies and poor air quality of many
cities throughout the U.S. According to a recent report by the American
Lung Association, 60% of Americans are breathing unhealthy air. And the
pollution inside our homes may be worse than outdoors. The Environmental
Protection Agency lists poor indoor air quality as the fourth largest
environmental threat to our country. Bacteria, molds, mildew, tobacco
smoke, viruses, animal dander, house dust mites, and pollen are among
the most common household pollutants.

Solution: Shut the windows and run the air conditioner. All
air-conditioning systems have a filter that protects the mechanical
equipment and keeps them clean of debris.

"Pollen and mold spores that have made their way indoors will be run
through the air-conditioning system and taken out of the air as they go
through the duct work," MacIntosh says.

But much like with the vacuum cleaner, these filters can only capture
the largest particles. "The conventional filters just pick up big
things, such as hair or cob webs," says MacIntosh. "Filters intended to
remove the inhalable particles, which are very small, exist on the
market and some are very effective."

They may also be worth the investment. A recent study published in The
New England Journal of Medicine showed that cleaner air might add as
much as five months to a person's life.

Tierno says that air purification systems are important, particularly in
a bedroom where bacteria are teaming.

6. Sitting in Front of the TV

Sitting in front of the television has become a national pastime and one
of our least healthy behaviors, particularly because we often do it
while snacking on food that is high in calories.

"When you're sitting there in a trance, you can really pack on some
calories," says Thun. "Today, more than one-third of the U.S. population
qualifies as obese and one-third qualifies as overweight. Thirteen
million Americans are morbidly obese."

Excess body weight puts us at greater risk for heart disease, cancer,
arthritis, and a host of other diseases, Thun says. "That poses a
greater health risk than the toxic cleansers under our sinks."

Solution: Turn off the TV, put away the bag of chips, and go for a walk.

From WebMD by Lisa Zamosky

Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP