Nutrition

Eat this, not that—and the “this” and the “that” change, almost daily. We’ll help sort out myths from facts and use evidence to do that. So, whether you’re interested in the Mediterranean diet or chia seeds muffins, we hope you find useful information!.

Fitness

Fitness is vital to good health from heart disease to cancer. So, get that 30 minutes, or is it 60 minutes of exercise daily 3 times a week or is it supposed to be every day? Again, let's simplify the rules and sort out facts..

General Health

After nutrition and fitness, that leaves a lot of territory from indoor air pollution to needed vaccinations to whether children always need antibiotics for ear infections. Let's look at the most recent evidence in simple terms.

   


From the Blog:

So good.. I have to share it…

Just did a new Jillian Michaels exercise video in my home gym (converted garage). After waking up at 5:30, running the vacuum, mopping the floors, cleaning the guest bathroom, running two loads of clothes, getting ready for a friend to come over (she is about 50% reliable and I’m used to that but wanted to be ready in case this was one of her reliable days)–then I went into the gym to do a pretty intense exercise period (probably 30 minutes and I do at least two intense exercise periods out of the 5 to 7 times I exercise each week— sometimes intervals, during the week ).

However, this is just me musing about life WITH exercise and what I wanted to share is something that Jillian said on the DVD that I love.

She was congratulating viewers for sticking with the program. Then she commented “You know some people never show up for life. They never get themselves in shape for their “A game”. By that, I doubt she just meant exercise. But think about how many of those folks there are in our lives. AND, for goodness sake, let’s make sure that WE are not one of those folks who never find their “A game”. How very sad.

The mammography debate as a mirror of our larger societal issues

The mammography debate continues with the publication of a new paper showing that mammograms increase the detection of tumors unlikely to have any impact on lifespan or quality of life BUT do not increase the detection of advanced tumors. A good screening study detects disease that is at a treatable point. The debate is that in an 80 year old woman, ductal carcinoma in situ is unlikely to do much harm. Advanced breast cancer on the other hand is not the stage that you want to detect because it cannot be cured. Opponents of mammography suggest that frequent mammograms result in useless overdiagnosis and no improvement in life span- thus not a good screening test. This was a study from Denmark and I’ll include a summary of the article in this post. Will this (yet another article challenging widespread, frequent screening in low risk women) change the minds of doctors or the demands of patients?

But it just brings to mind that, as a society, we are not ready to accept ANY limits to what we get in terms of treatment. Two things bring this to mind. A year or so ago during some medical discussion, my 93 year old mother-in-law made a comment about how she would feel if she needed a heart transplant. She is a totally mentally intact lady and I had to gasp that 93 year olds think a heart transplant made sense at age 93 (and surely, we hope, would not happen). And I’m working with a 79 year old friend with an aggressive cancer who seems to be willing to do whatever it takes, however much it costs the health care system, to try to capture another three months of life. When I faced the decision of whether to have chemotherapy for my breast cancer diagnosed over 5 years ago now, I looked at the benefit (maybe 3% of women benefited) and the risks (maybe 25% lived with serious side effects of chemo) and opted not to have chemo. Today, 5 years later, the data shows essentially no benefit to chemo for women with my type/stage of cancer. In retrospect, that was the right decision but even at the time, the benefits and risks were laid out based on what was known at the time with a very slight estimated benefit and the decision made sense.

So, as a society, do we just not understand that every test and every treatment comes with potential harm? At a time when we just do not have the resources to give every person another month or two or three of life regardless of age at a cost of $200,000 plus to the health care system and probably not alot of quality for them, how do we get that message across–or should we?

Study: Mammography Results in Overdiagnosis, No Reduction in Advanced Disease
News | January 09, 2017 | Screening, Breast Cancer
By Dave Levitan

Breast cancer screening was not associated with any reduction in the incidence of advanced cancer, and overdiagnosis of invasive tumors and ductal carcinoma in situ (DCIS) is a common problem, according to a new study conducted in Denmark.

“Effective breast cancer screening should reduce the incidence of advanced tumors,” wrote study authors led by Karsten Juhl Jørgensen, MD, of the Nordic Cochrane Centre in Copenhagen. “Screening mammography detects many small tumors that would not have become clinically evident in the remaining lifetime without screening.”

Denmark provides an ideal setting for testing overdiagnosis and screening efficacy, because only 20% of the population aged 50 to 69 years was invited to participate in a mammography screening program over a 17-year period. The researchers compared breast cancer rates and estimated overdiagnosis in this large population; the results were published in Annals of Oncology.

Overall, they found that the incidence of nonadvanced tumors increased in screening periods compared with prescreening periods, with an incidence rate ratio of 1.49 (95% CI, 1.43–1.54). Instituting screening was not, however, associated with any decrease in the incidence of advanced tumors.

They estimated that in 2010, 271 invasive breast tumors and 180 DCIS cases were overdiagnosed each year. When DCIS was included, they found an overdiagnosis rate of 24.4%, compared with the incidence observed in 50- to 69-year-old women in non–screening areas of the country; without DCIS, the rate was 14.7%. In other words, approximately one in every five women in that age group diagnosed with breast cancer was overdiagnosed in areas where screening was used.

A secondary estimation approach that accounted for regional differences in women younger than screening age found an overdiagnosis rate of 48.3% including DCIS, and 38.6% excluding DCIS.

“Seventeen years of organized breast screening in Denmark has not measurably reduced the incidence of advanced tumors, but has markedly increased the incidence of nonadvanced tumors and DCIS,” the authors wrote. “These findings support that screening has not accomplished the promise of a reduction in invasive therapy or disease-specific mortality.”

In an accompanying editorial, Otis W. Brawley, MD, of the American Cancer Society in Atlanta, wrote that “acknowledging the existence of breast cancer overdiagnosis challenges the value of screening: it means that the benefits of breast screening have been overstated, and that some women who have been ‘cured’ were harmed because they received unnecessary treatment.” He noted that routine mammography should be advocated for women at significant risk, and that in the future it may become easier to separate those at very low or very high risk in order to stratify for screening purposes.
Oncology Journal
ONCOLOGY Journal

There are some germ loaded public places out there…

There are some germy public places out there and a friend’s trip to DC got me thinking about it. He is headed to DC for the inauguration (which I would not do for a million bucks but short of supplying him with Kevlar, I decided sharing some of the tips in this posting from WebMD n the germiest public places could be useful to him and we’ll talk about that on this Thursday’s radio show). I do feel compelled to make one political comment (without disclosing too much, I will say that as a kid I worked in Humphrey’s campaign, was President of the Young Democrats at my university as an undergrad and do have a Hilary for President tshirt from her first attempt. Hopefully, when I say I have become more conservative with age, those past credentials put me in the middle of the road and an issues person, not an ideolog. However, these whiners have got to stop sometime (as Joe Biden, says, “It’s Over”). We are one country of different persuasions and we are not two year olds in a sandbox. Working together is how we will get better not by kicking sand in each other’s faces and fighting over who has the red or blue sandbucket!

But if you are more interested in germs instead of whining two year olds, you might check out this post. If you are actually more interested in whining two year olds, just watch almost all the election coverage.

http://www.webmd.com/cold-and-flu/ss/slideshow-public-germs?ecd=wnl_spr_010717&ctr=wnl-spr-010717_nsl-ld-stry_1&mb=Lh473%2fr3RjZn6NT7Qq3h%2fhXFE73IOX1cZm7yzvHhDzc%3d

Next week, we’ll get back to what I had planned to talk about this week- the health mistakes that men make–and how we can fix them.

However, if I have you thinking about germs, there is another great slide show on WebMd which is about germs in the home. Unfortunately, the cat woke me up at 4:30 am one day (not unusual) and I got up and started reading neat things on the web including this piece. That was okay but by 5:30 AM, I was cleaning the Keurig, sterilizing dog dishes, etc.

So, for germy places in the home, brace yourself and read the following.

http://www.webmd.com/cold-and-flu/ss/slideshow-house-gross-things?ecd=wnl_spr_010717&ctr=wnl-spr-010717_nsl-promo-v_4&mb=Lh473%2fr3RjZn6NT7Qq3h%2fhXFE73IOX1cZm7yzvHhDzc%3d