Posted in food, Health, news

Can Diet Soda CAUSE Diabetes?

Another study suggests artificial sweeteners can increase one’s susceptibility to getting diabetes.

Research led by Dr. Brian Hoffman from the Medical College of Wisconsin and Marquette University, looked at rats who were fed artificial sweeteners and found they had changes in their fat and energy metabolism such that fat levels increased and protein was instead broken down to provide much-needed fuel.  Diabetes occurs when people cannot break down and utilize sugar correctly (more discussed below).

This isn’t the first time artificial sweeteners have been linked to a glucose metabolism disorder.  In October 2016, researchers at Karolinska Institute found two diet drinks a day DOUBLES one’s risk of diabetes.

These studies are concerning as many people prone to high blood sugar opt for the “sugar-free” beverages, thinking they are protecting their health, when in fact they could be hurting it.

Why would artificial sweeteners have such an effect?  One theory is our mouths and hence minds think something very sugary is coming down the pike.  Artificial sweeteners can be anywhere from 150-500 times sweeter than actual sugar. So the pancreas and other organs may ready the body for this huge anticipated “sugar load”.  When no sugar actually comes down the gullet and into the intestine to be absorbed, the body may eventually take a “boy who cried wolf” stance and not mount appropriate responses later.  Diet soda has been associated with weight gain, maybe due to the body’s metabolism slowing down as a result it feels it is “starving” when real food is not coming down the gut.

Another theory suggests sweeteners may alter the gut microbiome which has been discovered to be instrumental in a variety of physiological processes, including metabolism.  Another suggestion has been that sweeteners may interfere with the pancreas doing its optimal job by enhancing resistance to its main hormone in glucose metabolism, insulin.

A review of diabetes

Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly.  When we consume food, its broken down into proteins, nutrients, fats, water, and sugar. These components are necessary for cell growth and function.  They get absorbed in the small intestine and make it to the blood stream.   In order for a cell to utilize sugar, it needs the hormone insulin to help guide it in.  It’s similar to a key that fits in the keyhole of the “door” of the cell, opening it up so sugar can enter.  Insulin is produced in the pancreas, an organ that receives signals when one eats to release insulin in preparation of the sugar load coming down the pike.

Diabetes explained

So I imagine our mouth like a waiting room, the blood stream like a hallway, and the cells of the body the rooms along the hallway.  Insulin is the key to open the cells’ “doors” allowing sugar to enter.  If the sugar does not get in, it stays in the bloodstream “hallway” and doesn’t feed the cell.  Weight loss occurs, and individuals may become more thirsty as the sugar in the blood makes it fairly osmotic, something the body wants to neutralize, reduce.  The kidneys are going to want dump the excess sugar, so to do so, one would urinate more, again causing thirst.  So when a diabetic loses weight, urinates more frequently and becomes thirsty, you now understand why.

Type I vs. Type II vs. Type IIIc Diabetes

Type I Diabetes, previously called insulin dependent or Juvenile diabetes, occurs when the pancreas doesn’t produce insulin, possibly from the immune system destroying the cells that produce the hormone. When this occurs there is rapid weight loss and death could occur if the cells don’t get the sugar they need.  Insulin has to be administered regularly.

Type II Diabetes, previously called non-insulin dependent or adult-onset diabetes,  occurs in those who began with a fully functioning pancreas but as they age the pancreas produces less insulin, called insulin deficiency, or the insulin produced meets resistance.  This is the fastest growing type of diabetes in both children and adults.

Type IIIc diabetes may occur in individuals who suffered damage to their pancreas.  Inflammation/infection of the pancreas (pancreatitis), a pancreatic tumor, or surgery affecting the pancreas may destroy the beta cells that produce insulin.

Complications of Diabetes

Cardiovascular disease – Sugar is sticky, so it can easily add to atherosclerotic plaques.

Blindness – high sugar content draws in water to neutralize and small blood vessels in the eye can only take so much fluid before they burst.  Moreover, high blood sugar weakens blood vessels.

Kidney disease – the kidneys work overtime to eliminate the excess sugar. Moreover, sugar laden blood isn’t the healthiest when they themselves need nourishment.

Infections – pathogens love sugar. Its food for them.  Moreover blood laden with sugar doesn’t allow immune cells to work in the most opportune environment.

Neuropathy – nerves don’t receive adequate blood supply due to the diabetes-damaged blood flow and vessels, hence they become dull or hypersensitive causing diabetics to have numbness or pain.

Dementia – as with the heart and other organs, the brain needs healthy blood and flow.  Diabetes has been found to increase risk of Alzheimer’s as well.

 

What is insulin resistance?

Insulin resistance, if using our hallway and door analogy, is as if someone is pushing against the door the insulin is trying to unlock. As we know, those with obesity are at higher risk for diabetes, hence fat can increase insulin resistance.  It’s also been associated with an increase in heart disease.

Blood sugar numbers

If your fasting blood sugar (glucose) is greater than 126 mg/dl, or your non fasting blood sugar is greater than 200 mg/dl, you may be considered diabetic.  Pre-diabetes occurs when the fasting blood sugar is between 100 and 125 mg/dl.  If ignored, and the sugar rises, pre-diabetics may go on to develop diabetes.

 

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SOURCE DIABETESMEALPLANS.COM

Preventing/Controlling Diabetes

1/3 of American adults are currently pre-diabetic.  Experts predict 1/3 of US Adults will be diabetic by the year 2050.  Although genetics plays a big role, decreasing ones sugar intake and maintaining an active lifestyle can help ward of diabetes.

Foods high in sugar and carbohydrates increase one’s risk, so a diet rich in vegetables and lean meats is preferred.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

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Posted in Entertainment, Health, news

Verne Troyer, “Mini-Me”, Dies at Age 49

The 49-year-old iconic actor, known as “Mini-Me” in the Austin Power movies, has died at the age of 49.

Its been reported that he battled depression and alcoholism for years and was recently  admitted to a Los Angeles Hospital when he attempted suicide.

No immediate cause of death has been released but his Instagram page had the following message posted:

 

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The 2 foot 8 inch actor was a hit in multiple films and originally was working in the film industry as a stunt double.  Troyer had achondroplasia, in which cartilage cannot form into large bones resulting in dwarfism.  CNN reports his specific achondroplasia was cartilage-hair hypoplasia, which results in one having little to no hair.

A study in 2015 by Rodriguez-Gomez et al, when studying the medical and psychosocial conditions accompanying achondroplasia, found “31.8% of the sample reported at least one comorbid condition such as, hypertension, diabetes, rheumatoid arthritis, asthma, scoliosis, thyroid problems, neuropathy, psoriasis, gastritis and/or sleep apnea; 32% reported mild to severe depressive symptoms; 55% reported mild to severe symptoms associated to anxiety and 18% reported mild to severe symptoms associated with hopelessness.”

Last month Troyer had publically announced he was returning to rehab to fight his battle with alcohol.

This is a developing story.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news

“White Coat Hypertension” Should Not Be Ignored

Years ago I explained how a spike in blood pressure at the sight of a doctor’s “white coat” could be sign of poorly controlled blood pressure, putting one at risk of stroke, retinopathy, heart disease and kidney damage, but the medical consensus, at the time, felt it was “benign.”  My argument was if a white coat makes one’s blood pressure spike, so could a G-string, bank hold up, or call from a mother-in-law, suggesting one’s blood pressure may be spiking throughout the day. Catching this spike during a routine doctor’s visit could be lifesaving. Now a study agrees that “White Coat Hypertension”, which affects at least 30% of Americans, could signify significant disease.

“White Coat Hypertension” is believed to be a temporary spike in which blood pressure will rise either systolically (the pumping pressure) or diastolically (the filling pressure) or both.  Damage to brain tissue, heart, eyes, kidneys and other organs can occur during these spikes.

Study author, Dr. Raymond Townsend, director of the hypertension program at Penn Medicine, states, “We encourage our patients to do blood pressure readings at home. That is a good way to not only monitor blood pressure where you actually “live”, but it also provides a lot of insight for patients to understand how life’s little indiscretions, like take-out Chinese with extra soy sauce, can truly affect your blood pressure the next day,” reported in a piece by NBC News.

24 hour monitoring can be done at home or at work where one monitors their blood pressure throughout the day and night, allowing the medical provider to identify spikes that may be missed during a 15 minute office visit.

New Blood Pressure Guidelines Introduced Last Fall

High blood pressure has now been redefined as being greater than 130/80 mmHg, down from 140/90 mmHg.  This will mean close to 103 million more Americans will fall under the “hypertensive” category.

Multiple agencies, including the American Heart Association and American College of Cardiology, redefined the guidelines, in practice for the last 14 years, to lower the threshold for high blood pressure from 140/90 to 130/80.

Under the old guidelines, 1/3 of US Americans were considered to have high blood pressure.  Now 42% of Americans will be “hypertensive”.

In lowering the guidelines, task force members hope to reduce complications associated with high blood pressure and start treatment earlier in those who have not been treated.

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What do the blood pressure numbers mean?

The top number, or systolic pressure, is the pressure the heart exudes during a beat or pumping of the blood.

Diastolic pressure is the pressure in your arteries between beats while the heart is “filling”.

Both numbers are equally important as elevation of either can increase one’s risk of cardiovascular disease.

What can long term high blood pressure do?

Chronic high blood pressure can be dangerous.  It may cause:

Heart attacks

Heart failure

Stroke

Kidney disease

Dementia

Eye damage – vision loss

Erectile dysfunction…to name a few.

How do we treat high blood pressure?

The stages of blood pressure are defined in the chart above.  At the elevated or early stages of high blood pressure the following lifestyle changes will be recommended:

Weight loss

Low salt diet

Low fat diet

Good sleep habits

Regular exercise

Avoiding tobacco products

Limiting alcohol consumption

As a family physician I would also screen for diabetes, high cholesterol, low thyroid, kidney disease and sleep apnea.

If blood pressure cannot be controlled and continues to rise, medications may be prescribed to decrease blood volume, or lower the heart rate, or relax the blood vessels.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news

Showering Daily Could CAUSE Illness

For years we’ve been warned of bacteria, some of them drug-resistant, lurking on our cell phones, desks, computer keyboards, toilet seats, and as a result have increased our bathing rituals to include longer showers, more soaps, or stronger water pressure.

Now a study from Columbia University suggests to wash much less often as it could strip our skin of healthy protective microbes.  Dr. Elaine Larson states, “Bathing will remove odor if you’re stinky or have been to the gym,” but should focus more on washing hands regularly and clothes to help reduce illness.

Assistant Professor of Dermatology at George Washington University, Dr. C. Brandon Mitchell suggested to TIME that once or twice a week bathing is sufficient suggesting, “a daily shower isn’t necessary.”

Skin contains countless microbes that keep other pathogens at bay.  Frequent scrubbing or altering this environment with soap and other chemicals may alter the balance allowing bad bugs to enter our bodies’ greatest defense system, the skin.

In Roman times baths were used to help fight illness an in modern-day, many of us after a long day in a medical clinic/hospital, will take a hot shower to help “flush out” microbes that could have landed in our respiratory tree or on our person.

However, its been suggested that oils on or skin and scalp are protective and should not be wasted with multiple cleanings if we don’t need to.  Experts suggest cleaning our “stinky” areas more frequently but sparing our skin and scalp if we can.

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

Posted in Entertainment, Health, news

Full Metal Jacket’s R. Lee Ermey dies at age 74

Actor, Golden Globe nominee, and famous sergeant, R. Lee Ermey passed away Sunday from complications of pneumonia.  He was 74.

According to a statement from R. Lee Ermey’s long time manager, Bill Rogin:

It is with deep sadness that I regret to inform you all that R. Lee Ermey (“The Gunny”) passed away this morning from complications of pneumonia. He will be greatly missed by all of us.

Semper Fi, Gunny. Godspeed.

Prior to acting in iconic roles in movies such as “Mississippi Burning”, the remake of “Texas Chainsaw Massacre” and the “Toy Story” series, Ermey served in the US Marine Corps for 11 years.

He joined the Marines in 1961, served in the aviation support field, before later becoming a drill instructor, eventually earning the rank of Gunnery Sergeant.  He served in Vietnam and served two tours in Okinawa, Japan. He was medically discharged in 1972. He then enrolled in the University of Manila, where he studied Criminology and Drama, according to IMDb.

 

This is a developing story.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, marijuana, news

Marijuana Medical Benefits are Strain Specific

Cannabis users need to be aware that benefits may be unique and specific to certain strains.

Cannabis plants produce cannabinoids, or chemicals that can induce an effect on the body. When cannabinoids are produced by a plant they are called phytocannabinoids.  Humans produce their own cannabinoids, called endogenous cannabinoids.  Laboratory  or synthetically produced cannabinoids are called synthetic cannabinoids.

The human body has a very intricate endocannabinoid (endogenous cannabinoid) system, with receptors throughout our brain, organs, glands, and immune system. Hence a wide variety of physiological responses, occur when these receptors are stimulated by cannabinoids.  These include responses to sleep, memory, appetite, pain, immune response, mood, and cell damage repair and death, Research is currently investigating what endogenous chemicals the human body produces, but the majority of medical discussions surrounding cannabinoids includes the phytocannabinoids.

Cannabis plants produce many phytocannabinoids, but the most well known and studied include CBD (cannabidiol) and THC (Tetrahydrocannabinol).  The latter is psychoactive, meaning it can give the user a feeling of euphoria.   The former, CBD, in non-psychoactive and researched more than others for its medicinal benefits.

Now plants, just like animals, are classified from Kingdom (Plantae) down to Genius and species.  Cannabis comes in a variety of species, including the major ones:  C. sativa, C. indica and C. ruderalis. 

 

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C. ruderalis is less popular as it has a lower THC content. However it has “autoflowering” qualities, making them useful to cultivators, and if bred with C. sativa or C. indica could enhance the new hybrid in its reproduction.

C. sativa has a higher THC/CBD ratio, hence can provide more euphoria.  It reportedly helps decrease anxiety, treat depression and increase appetite.  It’s been touted to increase energy and boost creativity.  Its also used to help manage attention deficit disorder.  Although not approved yet in the US, an oral spray, nabiximol, has been developed and sold in multiple countries to treat neuropathic cancer pain.  Its brand name is sold, by prescription, as Sativex® .

C. indica has a higher CBD content and has been used for its sedative properties.  Its also used to help anxiety and induce appetite, but will additionally be used to treat pain and muscle spasms.

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Epidiolex has received FDA approval to treat some seizures.  Its high CBD component is credited for its anti-seizure activity.

There are multiple other strains, each touted to have their own unique properties.  420medbook.com provides the below table.

 

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The challenge, however, is the lack of medical research in each of the different strains.  And when a study does come out discussing the medical advantages or disadvantages to using cannabis medicinally, the specific strain may not be mentioned or easily found in the report.

I believe that various strains do have unique properties and there is an art to the field of medical marijuana but more research needs to be done and quickly to avoid random use of cannabis products for treatment of medical conditions.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news

Vaping Now an Epidemic Among Middle and High School Students

Once hailed as a hero to curbing our deadly tobacco epidemic, vaping has now become more popular than smoking cigarettes among middle and high school students.

Last month the CDC reported that 4.3 percent of middle school students and 11.3 percent of high school students vape e-cigarettes. This week, results from a 2016 National Youth Tobacco Survey cite a 900% jump in use among teens from the years 2011-2015, with half a million middle school students and 1.7 million high schoolers having vaped within the last 30 days.

As more studies finalize, we’re anticipating these numbers to rise even higher.

Although electronic cigarette products are not to be purchased or used by those under 18, teen use of Juul and other vaping products have gone viral.

“RJ”, who asked to remain anonymous, is a senior at a local Las Vegas high school and states, “Almost everyone vapes.  No one smokes anymore due to the health risks.  They think vaping is safer and cooler. Smoking’s out, vaping definitely in.”

Students who were never destined to pick up a stick of tobacco have become new recruits to the inhaling industry, being duped by the flavors and image of a “safe way to look cool”.

The Juul casing is particularly attractive.  It looks like a flash drive so its sleek, smooth and easy to hide.

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The flavored nicotines, e-juices, are a huge draw to those who would never tolerate the smokey taste of tobacco.  These can include almost any taste preference such as chocolate, vanilla custard, strawberry, bananas foster and even margarita flavor.

 

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Image from  novelecig.com

 

Vaping is addictive

At the start of the year a landmark study found teens who start vaping were 2.5 times  likely to become tobacco smokers within a year, suggesting vaping is a gateway drug to later smoking cigarettes.  The nicotine introduced in the e-cig can get children hooked fairly quickly such that they may be drawn to unfiltered cigarettes when vaping isn’t enough.

 

Vaping is risky

Vaping is not without its risks.  Last month a study from Johns Hopkins Bloomberg School of Public Health revealed toxic levels of lead from the heating coil element leak into the vaporized fluid that is inhaled.  The month before, a study from New York University found vaping to increase risk of heart disease and cancer.  In 2015 a University of Minnesota study found e-cig vapor to include chemicals such as formaldehyde and various metals that are linked to bladder cancer. For more on these studies read  here.

Even handling the e-juice has its risks.  In March, John Conway, Assistant Principal of Jamestown High School in North Dakota, fell ill after confiscating a device and its juice from two high school students.  He became nauseous, dizzy, had huge emotional swings and suffered from an intense headache, highlighting the danger e-juice could pose to young kids and pets.

As parents and schools try to combat the growing vaping epidemic, care needs to be taken with the handling and disposing of the concentrated nicotine liquid.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician