Cardiovascular AND Dementia Risk Factors

As a family doctor I tell people regularly that changing their lifestyle will decrease their risk of a heart attack or stroke. Turns out the same risk factors for cardiovascular disease are also dementia risk factors.

There are few things more heartbreaking than watching a parent or spouse slowly lose their memory and ability to care for themselves. Many people are rightly afraid of developing dementia, especially if their parent was affected.

A new study was published recently that looked at structural changes in the brain that are associated with dementia. The authors found that vascular risk factors like smoking, high blood pressure, diabetes, high cholesterol, body mass index, and waist–hip ratio were associated with more brain changes.

This study wasn’t designed to prove causation – that these risk factors CAUSE the brain abnormalities. However, they did see that the more risk factors the patient had the more likely they were to have these changes.

Smoking, high blood pressure and diabetes had the strongest association. What’s most interesting is that middle-aged people with these risk factors had measurable changes in their brains. This was long BEFORE the memory loss started. The seeds of dementia are being planted, the damage is being done, long before the patient starts showing signs.

If you are a smoker, do whatever you need to do to quit. Now. Not tomorrow, next week, next month or next year. Smoking is not only hurting your heart and vascular system, it is hurting your brain too.

If you have high blood pressure or diabetes, work with your doctor to control them. Work on your diet and add some daily exercise. Add more fresh whole colorful plant foods and cut back on animal foods, fast food, junk food and added sugars. Take your medication as prescribed.

Smoking, obesity (especially around your middle), high blood pressure, high cholesterol and diabetes aren’t just bad for your cardiovascular system. They are bad for you brain and significantly increase your risk of dementia as you age. Get serious, and stay healthy and sharp!

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Screening Children For Cardiovascular Risk

I’m a family doctor. I take care of children. When I think of patients with high blood pressure, cholesterol and diabetes, I think of my ADULT patients, not my kids.

But there’s a good reason for screening children for cardiovascular risk. A new study published in Pediatrics showed up to 40% of children may have high blood pressure, high cholesterol, and even diabetes.

We’ve known for a long time that kids are having more and more problems with overweight and obesity. Poor food choices (and limited availability of fresh whole plant foods, in many cases), decreasing levels of physical activity and increasing time spent in front of computers both in school and at home have contributed to this trend.

Researchers went to Norwood, Ohio (very close to where I grew up, actually) and studied kids in middle school. With parental permission they checked height, weight, blood pressure, cholesterol and blood sugar. 42% of the children were overweight or obese, and 34% had blood sugar or cholesterol out of the normal range.

The American Academy of Pediatrics recommends screening children for blood pressure, blood sugar and cholesterol at age 9-11, and again at age 17-21. It is more urgent if children are overweight or obese, or if they have a family history of high cholesterol.

If you have children, make sure to model good habits for them. Don’t tell them to eat their veggies while you are eating pizza and wings. Don’t tell them to exercise while you sit on the couch. Make fitness a family affair by choosing activities all family members can enjoy. Some examples are hiking, cycling, swimming, martial arts, dance, sports, etc.

As your children are growing, ask their doctor whether they need to be screened for heart risk factors. Especially ask about screening if their doctor expresses concern about their weight. Also ask if there is a family history of high cholesterol or early heart attacks. “Early” means before age 55 in men and age 65 in women).

There is an epidemic of overweight and obesity happening in the US and around the world. We must be alert and start screening children for cardiovascular risk factors earlier than we might think.

QUESTION: Do you have kids? Have they had their cholesterol and blood sugar checked?

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Multivitamin Benefits: Are They Good For You?

What do YOU think?

Anyone who knows me knows what my opinion is, but it’s been awhile since I sat down to review what the scientific research says about multivitamin benefits.

Many people believe that if they just eat healthy they will get all the nutrition they need.  Worse, health professionals like doctors and dietitians perpetuate this myth.  The research is very clear that people do NOT get all the nutrition they need from the food they eat.  Whether or not they SHOULD, they DON’T.

So if people are going around deficient in one or more nutrient every day, does supplementation help?  Can you get the nutrition you need from pills?

vitaminbottlesIn a word, no.  You can’t get all the nutrition you need from pills.  You need to eat healthy.  This is basically because we need to know that you need a nutrient before we can put it into a pill.  And whole-foods supplements (where they basically juice a food and dehydrate it and package what’s left into a pill) aren’t adequate because you’d have to take huge numbers of pills daily in order to get the content of a single piece of fruit or a vegetable.  You still need to eat healthy balanced meals and sensible portions of food.

So what’s a person to do?  The short answer is to eat healthy AND take a high-quality supplement.  I did a literature review and here are five studies from the 1980s to today.

1.  In 1985, a study was published examining blood nutrient levels in female college students living on-campus and eating a diet specifically designed for them by the college dietician.  These young women’s blood nutrient levels were significantly improved by taking a multivitamin.

2.  A study of healthy adults over age 60 showed that those who took a multivitamin-mineral supplement spent one-third as many days sick with infection-related illness as those who did not take the supplement.  (My friend Amanda knows this is true.  Her kids don’t share nearly as many colds with her since she started taking Shaklee supplements!)

3.  Calcium and vitamin D supplementation have been shown to decrease the rate of bone loss in postmenopausal women (many studies demonstrate this).

4.  Use of an herbal supplement (marketed by the Shaklee Corporation under the trade name NutriFeron) was associated with  significantly decreased menopausal symptoms, systolic and diastolic blood pressure, and plasma triglycerides and LDL-cholesterol.  Researchers also found lower plasma hepatitis C viral levels in patients with chronic active hepatitis C and improved symptoms as well in study participants who used NutriFeron.

5.  Long-term users of a number of supplements produced by the Shaklee Corporation were shown to have lower blood pressure, better cholesterol profiles, lower levels of certain inflammatory markers, lower risk of diabetes and were more likely to rate their health as “good” or “excellent.”  Here is the study link.

There are many more studies I can cite, but I think you’ll agree that the evidence is clear that taking a carefully designed program of supplements including a high-quality multivitamin is an important ingredient in a healthy lifestyle.

I should add that all the research I discussed above was supported and published by Shaklee.  There are over 100 research studies published in peer-reviewed journals supported by Shaklee, which you can check out at the Shaklee Health Resource.  How many studies has your supplement company published?

If you’d like more information about what supplements would be appropriate for you, please fill out a HealthPrint assessment or email me at drjen@jenniferwurstmd.com.

Question:  Do you take a multivitamin?  Do you think it makes you healthier?

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Suicide Games And Social Media

If you have children, have you heard of the Momo challenge? This was a supposed series of social media posts targeting children and teens. The challenge asks children to perform an escalating series of dangerous actions ending by telling the child to hurt or kill themselves.

This is just the latest in a series of supposed “suicide games” making the rounds on social media. The Momo challenge itself turned out to be a hoax, but there definitely have been instances of kids and teens being challenged to do dangerous things (like eating Tide Pods) during social media suicide games.

We as adults see social media as a way to share information, keep up with what’s going on with our friends and families, raise awareness, argue about politics and engage in other activities. Sometimes these activities are very beneficial. Think of the ALS ice water challenge that raised awareness and funds for ALS research several years ago.

Our kids, however, are very vulnerable online. Even more than in person, children are susceptible to grooming by predators, bullying and other dangerous influences via social media.

It’s been said many times before but bears repeating. Our children need us to be vigilant in protecting them. They have a hard time knowing whether someone is trustworthy in the best of times. When you take away the body language clues, social media interactions are even harder for them to judge.

Kids are impulsive. Many times they don’t stop to think through the consequences of their actions. Couple that with kids’ natural risk-taking behavior and the anonymous nature of online interaction, and you make it very easy to coax a child or teen into doing something very dangerous.

If you allow your child or teen to have a smartphone or online access, make sure you supervise them. Privacy online should NOT exist when it comes to children. You are not their friend – you are there to protect them, whether they like it or not. You should have all their passwords and the right to inspect their accounts at any time, with no warning, or they are not online.

Many of our children do have access online while at school. Make sure to check with your child’s school to understand their security procedures. Children shouldn’t be able to access forbidden content while at school.

So-called suicide games are only one of the dangers our kids face online. If your child’s behavior changes or they act secretive, be suspicious and investigate their online accounts. Our kids need us to protect us online the way we protect them offline. You insist your child buckle up in the car and wear a helmet when riding their bike, right? You should be as vigilant to make sure they are safe when they are online.

QUESTION: What steps do you take to monitor your child’s online activity?

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How To Get Quality Sleep

One of the most common problems we see in primary care is complaints about not getting quality sleep. People can’t fall asleep. Once they’re asleep they keep waking up. They wake up unrested. They’re tired and sleepy during the day.

Sleep disturbances have huge impact on our quality of life. Fatigue and sleepiness decrease our enjoyment of our hobbies and activities with family. In extreme cases, severe fatigue can be fatal in the case of people who fall asleep behind the wheel.

The good news is that sleep problems are very responsive to treatment even without medications. Changes in behavior related to sleep make a huge difference in quality of sleep. Continuing bad sleep habits (called poor sleep hygiene) make it very difficult for even sleeping pills to produce good results.

The absolute first thing to do is to have a consistent wake-up time every morning, 7 days per week. This sets your “biological clock” and helps improve sleep onset. And don’t nap. If you absolutely must nap every once in a while, set an alarm so you only sleep 20-30 minutes, and nap early in the day.

Can’t Fall Asleep

This actually is one of the easier problems to correct. Why can’t you fall asleep? Usually it’s because you’re worrying about something, or because you have trained yourself to be awake in bed.

The first thing to do is to make a commitment that the ONLY things you’re going to do in bed are sleep and have sex. Everything else happens somewhere else. No watching TV, no reading, no eating, no nothing. Often just taking this one step is enough to help gradually improve your ability to fall asleep.

If you are a light sleeper and use the TV to block out outside noise, change to a white-noise machine. TV noise (and light) actually makes it hard to sleep because of the change in pitch and volume from show to show and with commercial breaks.

If you have trouble getting to sleep because you’re worrying about something, take a week and try scheduling time earlier in each day to make a plan for dealing with whatever is worrying you. If you lie down and then remember something, get up and take care of it right away or make yourself a note so you don’t forget to deal with it in the morning. Oh, and don’t check work emails right before bed!

Can’t Stay Asleep

Many people fall asleep just fine but wake up before they need to get up, and then have trouble going back to sleep. This is often stress related and responds to stress reduction, meditation, and exercise.

This may sound weird, but it is important to only sleep as much as you need to feel refreshed the next day. Not everyone needs 8 hours, and spending excess time in bed can increase broken sleep and make it hard to get deep, restful sleep.

One important thing to do is STOP watching the clock. This makes it even harder to go to sleep. Set your alarm for your wake-up time and turn the clock towards the wall. Turn your phone over or plug it in in a place where you can’t reach it without getting out of bed.

Also, make sure you have a comfortable bed and bedroom. Cooler temperatures usually make it easier to sleep. It should be quiet and dark. As I said earlier, a white noise machine and blackout curtains can help if you are a light sleeper.

Substance use can interfere with quality sleep too. Caffeine, alcohol and nicotine all interfere with quality sleep. Caffeine should be avoided after noon, alcohol should be avoided after dinner and nicotine should be avoided altogether 😉

What Next?

If you have tried these measures and still find yourself unable to fall asleep, unable to stay asleep, and feeling sleepy during the day, it’s time to see the doctor. Sleep trouble is potentially dangerous and treatment can significantly improve your quality of life.

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