Category: Medicine Hat News

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There is a Price to Pay for Physical Inactivity

An overweight man sitting on a bench with take-out food. (Digital Vision/Thinkstock)
An overweight man sitting on a bench with take-out food. (Digital Vision/Thinkstock)

An article in the Lancet (July 21 2012) says worldwide mortality rate of inactivity is about one per cent which is same as mortality from smoking.

It says exercise has been called a miracle drug that can benefit every part of the body and substantially extend lifespan. Yet it receives little respect from doctors or society. This passive attitude towards inactivity, where exercise is viewed as a personal choice, is anachronistic, and is reminiscent of the battles still being fought over smoking.

Inactivity in our society is reaching pandemic proportion and has far reaching health, economic, environmental and social consequences, says the Lancet paper.

Is it too difficult to exercise two hours and thirty minutes a week? That is the recommended amount of time we should be physically active each week. Would you be surprised if I say only 15 per cent of the Canadians meet this goal? Yes, that is true. Only 15 per cent of us are physically active for two-and-half hours each week.

An average Canadian spends more than two hours watching television every day. Come to think of it, physical activity can be as easy as watching television. You can incorporate physical activity in your daily routine – going shopping, walking your children to school, delivering newspapers and visiting a friend. These are just a few examples. You can do more if you can. The more you do the better it is.

In 2005, Time magazine did a survey to see what kind of physical activity Americans like to do. The survey revealed 69 per cent take a brisk walk, 35 per cent use exercise machine, 32 per cent lift weights, 30 per cent ride a bike, 27 per cent jog or run, 22 per cent do aerobic exercise, 21 per cent swim, 19 per cent dance, 18 per cent play some kind of sport like soccer, 18 per cent go hiking, eight per cent play golf, seven per cent do yoga and seven per cent bowl.

Physical activity has many benefits. We know that. Smoking is harmful. We know that too. Yet we continue to be couch potatoes and we continue to smoke. What is the solution? Let us keep moving and stop smoking. Isn’t that easy?

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How much vitamin D do you need daily to prevent fractures?

A vitamin capsule. (iStockphoto/Thinkstock)
A vitamin capsule. (iStockphoto/Thinkstock)

Basking in the sun is one way to obtain vitamin D

Basking in the sun is one way to obtain vitamin D although the risk of skin cancer increases. Other sources of vitamin D are fortified dairy products, fatty fish and egg yolks.

Answer to this question appears in an article in the New England Journal of Medicine (NEJM) published in July, 2012. The authors examined the relationship between vitamin D supplementation and fracture reduction.

They looked at 11 double-blind, randomized, controlled trials of oral vitamin D supplementation (daily, weekly, or every 4 months), with or without calcium, in persons 65 years of age or older. The goal was to look for the incidence of hip and any nonspinal fractures.

The study included 31,022 persons (mean age, 76 years; 91 per cent women) with 1111 incident hip fractures and 3770 nonspinal fractures.

When they looked at a subgroup of participants by actual intake of vitamin D, they found reduction in the risk of fracture was shown only at the highest intake level (median, 800 IU daily; range, 792 to 2000), with a 30 per cent reduction in the risk of hip fracture and a 14 per cent reduction in the risk of any nonspinal fracture.

“Benefits at the highest level of vitamin D intake were fairly consistent across subgroups defined by age group, type of dwelling, baseline 25-hydroxyvitamin D level, and additional calcium intake,” says the NEJM paper.

The conclusion of the study was that high-dose vitamin D supplementation (≥800 IU daily) was somewhat favorable in the prevention of hip fracture and any nonspinal fracture in persons 65 years of age or older.

As we know, vitamin D is a nutrient that helps the body use calcium and phosphorous to build and maintain strong bones and teeth. Vitamin D is unique in that it can be synthesized by the body after exposure to ultraviolet rays from sunlight.

Too much vitamin D can cause too much calcium to be deposited in the body, which can lead to calcification of the kidney and other soft tissues including the heart, lungs and blood vessels. But it is hard to define what is too much. Some expert recommend daily intake of 1000 to 2000 IU of vitamin D to prevent certain types of cancers.

Health Canada’s recommendation for daily dietary intake of vitamin D in adults age 70 and over is 800 IU (20 mcg). This is based on the assumption that there is minimum of exposure to sunlight. The major sources of vitamin D are fortified foods. In Canada, cow’s milk and margarine must be fortified with vitamin D. The only natural sources of vitamin D in the Canadian food supply are fatty fish and egg yolks.

Many people meet at least some of their vitamin D needs through exposure to sunlight. Although there is some risk of skin cancer. But you never know how much vitamin D you are getting through sun exposure. It all depends on the season, time of day, cloud cover, smog, skin pigmentation, and sunscreen use.

Daily intake of vitamin D recommendation depends on a person’s age. Talk to your doctor or see Health Canada website for more details. But do not forget to drink your milk everyday.

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There is Hope for People with Egg Allergy

A broken egg. (iStockphoto/Thinkstock)
A broken egg. (iStockphoto/Thinkstock)

Millions of people around the world suffer from egg allergy. It is a hypersensitivity to dietary substances from the yolk or whites of eggs, causing an overreaction of the immune system which may lead to severe physical symptoms.

Egg allergy appears mainly in children although some adults are affected by it as well. It is the second most common food allergy in children, the most common is cow’s milk allergy.

The most severe food allergy reaction is called anaphylaxis and is an emergency situation requiring immediate attention and treatment with epinephrine. The Asthma and Allergy Foundation of America estimates that most children outgrow egg allergy by the age of five, but some people remain allergic for a lifetime.

It is estimated that one in every 13 Canadian suffers from a significant food allergy. Besides egg and milk, other common food allergies are to peanut, fish and sesame. Research indicates that peanut and nut allergies were much more common in children than adults and the opposite was true with fish and shellfish allergy.

Here is the good news now. A study published in The New England Journal of Medicine (July 19, 2012) provides hope for children with egg allergy. It says egg allergy can be substantially reduced and in some cases can be cured.

The research was conducted by feeding children with severe egg allergies with tiny amounts of egg protein (oral immunotherapy). Over time, the dose was steadily increased. The idea was to allow the body to gradually learn to tolerate exposure to the substance.

Results:

-After 10 months of therapy, 55 per cent of those who received oral immunotherapy passed the oral food challenge and were considered to be desensitized.

-After 22 months, 75 per cent of children in the oral immunotherapy group were desensitized.

-At 30 months and 36 months, all children who had passed the oral food challenge at 24 months were consuming egg.

About 25 per cent of the children who did not respond to oral immunotherapy suggests that some patients will need treatment on a regular basis for a longer time. The researchers believe even if it doesn’t provide a complete cure for everyone, the treatment may be able to reduce the severity of allergic reactions in many patients.

Parents are cautioned not to try this kind of treatment (oral immunotherapy) at home without medical supervision. A lot more research needs to be done before the therapy is ready for the general public. Oral immunotherapy is still considered experimental and should not be attempted outside a research trial. For now, this research paper provides hope for millions of people who have food allergies.

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We Ultimately Define What is Possible in Our Own Lives

Mount Kilimanjaro Summit, Uhuru Peak (iStockphoto/Thinkstock)
Mount Kilimanjaro Summit, Uhuru Peak (iStockphoto/Thinkstock)

Here is a story of courage from the Globe and Mail (June 23, 2012). It is the story of 31-year-old Spencer West, who lost both his legs when he was just five-years-old. He was told he will never walk again. But he did more than that. He climbed Africa’s highest mountain, Mount Kilimanjaro in Tanzania, partly by wheelchair but for the most part by walking on only his hands to reach the summit. He did this for charity and make a point that you don’t need legs to overcome adversity in life.

He told the Globe reporter, “We ultimately define what is possible in our own lives.”

The summit of Mount Kilimanjaro (the world’s fourth-highest peak) is about 20,000 ft. The summit of Mount Everest is about 30,000 ft. About 25,000 people from all over the world try to climb Mount Kilimanjaro each year but one-third never make it up to the summit due to various reasons.

One of them was Martina Navratilova, the tennis superstar. In December, 2010, just months after completing six weeks of radiation treatment for noninvasive breast cancer, attempted to climb Mount Kilimanjaro for a charity. On the fifth day of a planned six-day journey, she became ill and was taken off the mountain. Navratilova, 54, was flown to a hospital, where it was determined she had high altitude pulmonary edema.

Altitude sickness kills 10 to 20 people each year attempting Kilimanjaro. More people die trying to climb Mount Everest each year. One of them was a Toronto resident. “They say the mountain took her, but not before she conquered it,” says Toronto Sun. Shriya Shah-Klorfine, 33, who made her dream come true when she reached the summit of Mount Everest. This was in May, 2012. She died while descending from the peak.

What is the secret of survival for mountaineers?

For Himalayan mountain climbers, neither personal experience nor participating in a traditional versus commercial expedition affects the chances of survival, reports a study in the June 30, 2012, British Medical Journal.

Mountaineering is a dangerous sport with a significant risk of death. The researchers conclude, “… that cumulative, collective knowledge and general innovation are more important than individual experience in improving the odds of survival.”

Factors like good health, courage, determination and training are important. Good preparation in any endeavour does bring success. Many young and old have set records climbing Kilimanjaro.

Seven-year-old Keats Boyd of Sherman Oaks, California is thought to be the youngest to have summited Kilimanjaro, he did so on January 21, 2008.

In the summer of 2010, granddad George Solt, a retired professor from Olney in Buckinghamshire, became the oldest man to reach the summit of Kilimanjaro, at the age of 82. In September, 2010, 83-year-old Bernice Buum managed to climb to the top of Kilimanjaro and became probably the oldest woman to get to the summit.

So, age or sex is not a determining factor. I know quite a few people from Medicine Hat have climbed Kilimanjaro. But my dream, since I was in high school in Tanzania, to climb Kilimanjaro has taken a back seat over the years. I don’t know why. Like anything else in life, the more you delay your venture, more difficult it gets to accomplish. Although it is never impossible.

So, there is hope for me and many others who have dreams and bucket lists. Just keep working hard and keep trying. Success will follow.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!