Category Archives: health prevention

Breast Cancer..Not Every Woman Needs to Follow Angelina Jolie

angelina-jolie

Ever since the much-publicised double mastectomy by the famous Hollywood star in May 2013, there has been quite a bit of confusion by women as to whether removing both breasts surgically is the only answer to avoid getting breast cancer. Even today, my colleagues are still being asked this question frequently.

Here are some facts regarding this:

  • Most breast cancers (90%) are not inherited.
  • The inherited form, due to alteration in the BRCA genes, account for 5-10% of cases.
  •  Routine screening by BRCA testing is not recommended. The blood test is expensive, costing anywhere between USD 1000-4000 and takes about three weeks before results are known.
  • BRCA testing is usually done where there is a related history of breast cancer. Indeed, there are specific indications for doing this test, e.g for women with two first-degree relatives with breast cancer below 50. For a full list of indications, see here.
BRAC and cancer

This graph shows how the risk of cancer is much higher in those tested positive for BRCA.

What happens if the BRCA test is positive? As such people have a very high chance of getting cancer of the ovaries and breasts, there are a few options available. It does not necessarily mean that double mastectomy is the only way out. Other options include taking medications, more intensive and regular breast cancer screening and having both ovaries removed before the age of 40. The right decision involves the patient being fully informed and playing an active role in the decision-making process.

Whatever the decision, its important to execute it immediately as procrastination is the worst enemy. Jolie’s case highlights the importance of knowing one’s family history and learning one’s cancer risks in order to address them proactively.

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Coffee Causes Cancer…No!

coffee

Around one in 10 British adults mistakenly think coffee causes cancer,so says a survey carried out by the World Cancer Research Fund (see here). Nothing can be  further from the truth – repeat, drinking coffee does not cause cancer. In fact, the benefits of coffee have been largely understated. Among the benefits include:

1. It contains powerful anti-oxidants, like chlorogenic acid and melanoidins (especially in roasted coffee beans), both of which confer proven health benefits.

2.Reducing the incidence of Parkinson’s Disease and Alzheimer’s. Read “A Cup of Coffee a Day will Keep Alzheimer’s Away”.

3.Protecting against diabetes. Moderate consumption  may lower the risk of type 2 diabetes in younger and middle aged women.

4.Preventing liver disease and the formation of liver and kidney stones.

5. Promoting alertness, attentiveness, and wakefulness.

But its not all good and no bad. Drinking excessive amounts (more than four cups a day) has been shown to accelerate osteoporosis as well as increase blood pressure, palpitations and even increase the risk of hardening of the arteries (a process called atherosclerosis). In some, coffee can cause heartburn, or GERD(gastro -esophageal reflux disease).

An important point to note is that there seems to be a health hazard in drinking unfiltered coffee (as in Turkish coffee and kahawa) as it raises blood cholesterol. Filtered coffee, as in instant coffee, does not do so, as diterpenes, responsible for raising cholesterol, are removed by filtration.

What about heart disease? The verdict’s not in just yet..on one hand, diterpenes cause a rise in cholesterol and homocysteine but this seems balanced by the beneficial anti-oxidant properties. As of now, there is no convincing evidence that coffee leads to heart disease.

latte

Latte, a combination of coffee,steamed milk and sugar) can set you back by 260 calories per cup.

Bear in mind that this discussion is based on just pure plain coffee. The scenario changes quite a bit with additives like milk, cream and sugar. For one thing, a cup of latte at Starbucks can contribute about 260 calories (as opposed to 0 calories in plain coffee). This is not to mention the health risks of added fats (and cholesterol) and sugar.

Strike Away Stroke..FAST

Its World Stroke Day..so it might be timely to reiterate what I consider the most important point in handling someone who is suspected of suffering from ‘brain attack‘ – acting FAST.

stroke_prevention2Of the four points, perhaps the last is most crucial in determining the chances of survival and the probability of recovery. Every second delayed in receiving treatment means more brain cells die . The thing about the brain is once cells die, they do not get replaced, unlike other organs in the body like the liver.

Nowadays, its possible to dissolve the clot causing the stroke (the ischemic variety, not the bleeding form) by injecting a clot-dissolving medicine into the veins; but to re-emphasize, time is of utmost importance.

One might wonder – how do you prevent stroke in the first place?

A study conducted in England by four researchers, one of whom came from Malaysia and was a classmate of mine, showed quite conclusively that one could reduce the chances of getting stroke by 50% if one adopted the following measures:

  • not smoking
  • being physically active
  • limiting their alcohol intake to not more than 14 units a week
  • fruit and vegetable intake of at least five servings a day.

Apart from the above, it is well-known that the presence of the following risk-factors also predispose to stroke: high blood pressure, diabetes, high cholesterol, atrial fibrillation (irregular heart-beats), heart disease and certain blood diseases which cause clotting.

As they say, prevention is better than cure.

 

Housework Is NOT Exercise

housework2

The age-old concept is now being challenged

People who count housework as exercise could be fooling themselves, research has suggested. Until now, studies have suggested housework counts towards a weekly round-up of moderate exercise activity.Such housework activities included gardening, DIY, vacuuming or cleaning.

In a study published in the journal BMC Public Health, experts found that those who counted housework as exercise were actually heavier than people choosing other forms of exercise. The study, published in more detail here went on to say that such activity may not be sufficient to provide all of the benefits normally associated with meeting the physical activity guidelines. In other words, the energy expended during housework was insufficient to burn off enough calories to make one maintain or lose their weight.

Personally, I’ve maintained for a long time that when it comes to exercise, in particular heart (cardiovascular) fitness, the intensity and duration should be any form of continuous strenuous physical activity which should be at least 25 minutes duration three times a week. Even the so-called weekend ‘jogging’ does not meet this criteria if there is no midweek activity put in place.

housework

This does not count..

exercise

..but this does.

Strike Away Stroke FAST

Some readers of this blog asked what they can do to prevent  a stroke from hitting them. Plenty!

A very recent research study just released  stroke_prevention2in the British Medical Journal by 4 authors, one of whom is a Malaysian classmate who now works in the UK, reveals 4 things that people can do to reduce the chances of getting a stroke by half.

The study, conducted in England involving 20,000 people over 11 years, showed that they could reduce the chances of getting stroke by 50% if they did all the following life-style measures:

  • not smoking
  • being physically active
  • limiting their alcohol intake to not more than 14 units a week
  • fruit and vegetable intake of at least five servings a day.

Apart from the above, it is well-known that the presence of the following risk-factors also predispose to stroke: high blood pressure, diabetes, high cholesterol, atrial fibrillation (irregular heart-beats), heart disease and certain blood diseases which cause clotting.

One does need to realise, however, that some risk-factors cannot be changed or eliminated. Try changing your age (the chance of having a stroke approximately doubles for each decade of life after age 55), sex (more common in men), your relatives( your stroke risk is greater if a parent, grandparent, sister or brother has had a stroke) or the fact that you have had a previous stroke or transient ischemic attack (TIA, or warning strokes)!

The whole idea of getting away from stroke is to eliminate as many of the above risk-factors as possible and to lead a healthy lifestyle.

See my related article “Mending A Stroke In Time”.

If You Must Mask, Mask Correctly

Face-masks come in many shapes and sizes. One normally associates  them with surgical masks, which is meant to prevent germs from the wearer contaminating the environment. However, the haze which is affecting Southeast Asia is another story..

facemask2

Facemasks come in different shapes and sizes..see if you can spot the two wearing the N95.

The Southeast Asian haze event is caused by continued uncontrolled burning from “slash and burn” cultivation in Indonesia, and affects several countries in the Southeast Asian region because the prevailing southwesterly winds carry the pollutants across the water – see below.

haze map

What are haze particles composed of? Haze particles are predominantly made up of fine particles that are 2.5 micrometers or smaller. This means using an ordinary facemask, whether single-ply, 2 ply or 3 ply, hardly protects the wearer effectively from the haze particles Its designed to keep the germs in and should be worn by those having viral illnesses like flu. Nevertheless, ordinary surgical masks will reduce the inhalation of haze particles but NOT eliminate them completely.

N95_Mask

A properly fitting N95 mask/respirator is effective in keeping out haze particles

To eliminate haze particles completely, one needs to wear a N95 mask (so-called because these masks eliminate 95% of particles as small as 0.1 micrometers (or microns). It must be tight-fitting and is rather uncomfortable to wear over long periods as extra effort is sometimes needed to inhale.

For this reason, the N95 mask is a must for those with lung problems, those with reduced immunity and those who have to be in the open for prolonged periods (like traffic cops).

For those who are otherwise healthy and stay indoors most of the time, ordinary surgical masks may be adequate. In all cases, adequate hydration is important mainly to facilitate the removal of the haze particles which have lodged in the lungs.

 

So, Is Coffee OK, Doc?

Some patients asked recently whether coffee was good for one’s health. They had apparently noticed that there has been the shift in marketing strategy by coffee-makers  in promoting it as a rich source of anti-oxidants, and therefore beneficial to health.

coffeePour

 

YES,  coffee is a rich source of anti-oxidants, like chlorogenic acid and melanoidins, the latter being the most important component of roasted coffee. Some of the other beneficial effect of drinking coffee include:

  1. Reducing the incidence of Parkinson’s Disease and Alzheimer’s. Read “A Cup of Coffee a Day will Keep Alzheimer’s Away”.
  2. Protecting against diabetes. Moderate consumption  may lower the risk of type 2 diabetes in younger and middle aged women.
  3. Preventing liver disease and the formation of liver and kidney stones.
  4. The beneficial effects of caffeine in coffee on alertness, attentiveness, and wakefulness.

NO,  among other things:

  1. Unfiltered coffee (as in Turkish coffee and kahawa) raises blood cholesterol. Filtered coffee, as in instant coffee, does not do so as diterpenes, responsible for raising cholesterol, are removed by filtration.
  2. Coffee consumption is also associated with an increase of plasma homocysteine, a risk factor for coronary heart disease.
  3. Caffeine in coffee can increase the risk of elevated blood pressure and hardening of the arteries, as well as palpitations.
  4. 4 cups or more will hasten osteoporosis, especially in those with low calcium intake in the diet.
  5. Coffee increases heartburn, aka gastro-eosophageal reflux disease (GERD).

What about heart disease? The verdict’s not in just yet..on one hand, diterpenes cause a rise in cholesterol and homocysteine but this seems balanced by the beneficial anti-oxidant properties. As of now, there is no convincing evidence that coffee leads to heart disease, period.

I ought to clarify here that we are talking about coffee, just plain coffee. The pendulum swings the other way when we consume coffee with additives, like milk and sugar. The latte at the local Starbucks will add on quite a substantial amount of fats, sugars and calories (260 to be precise, see here). Compare that to the ZERO calories of plain black coffee!

This Is What 2000 Calories Look Like..

2000 calories..that’s what an average-sized man requires in one day. I found this interesting video and it helps explain why there is so much obesity around.

 

Does Increasing Taxes Reduce Smoking?

In recent months, there has been a renewed initiative by most governments to make it costlier to light up a cigarette. In Australia, not only has excise duties increased, cigarettes can only be sold at designated areas and, since December 2011, they have to come in plain packaging, forcing all cigarette manufacturers to present their goods in khaki boxes with shrunken logos and a graphic health message.

The argument whether increasing taxes do significantly reduce the incidence of smoking has been with us for ages. Some have not been convinced, but irrefutable data has just been released  which showed that in the US, when President Obama signed the tax hike — the biggest to take effect in his first term — on his 16th day in office, reversing two vetoes by the previous President Bush (causing the federal cigarette tax to jump from 39 cents to $1.01 per pack on April 1, 2009) the net result was, as reported by USA Today, a historic drop in smoking, especially among teens, poor people and those dependent on government health insurance.

Most impressively, about 3 million fewer people smoked last year than in 2009, despite a larger population, according to surveys by the Centers for Disease Control and Prevention.

These data are most certainly going to spur more countries to implement this form of social engineering via taxation, what with the economic recession resulting in declining revenues for the tax-man.

Counterfeits and black-markets account for one-quarter of cigarette sales in the UK,Australia and Malaysia

However, while most of us acknowledge the health hazards of smoking, increasing taxes may lead to newer problems. Increased smuggling, tax evasion, counterfeiting are challenges that law enforcement agencies have to handle effectively so that the ultimate objective is achieved. The tendency for smokers to downgrade to cigars (not necessarily more cost-efficient!) or cheaper brands will not reduce the incidence of smoking. Hence the necessity of concurrent health education campaigns.

A unique print advert from Saudi Arabia

The last-mentioned is an often under-estimated weapon, particularly when the stand of most cigarette companies is “We don’t build our business on persuading people to smoke or trying to stop people from quitting. We believe that if you want to quit, you should.”

The Ideal Plate of Food

For more info, go to Healthy Eating Plate.

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