Golf and Exercise

Do you think golf is “a good walk spoiled”? I do! But I am not Tiger Woods!

I like to golf. And I like to ride a power cart when I golf. There are many reasons for that. One of them has to do with the flight and landing of my golf ball. It has a tendency to land on areas that are not designated as fairways. Now for a guy who believes in exercise, I should relish the thought of walking to find my ball and find other peoples’ lost balls. But not me!

Why? I don’t golf for exercise. I golf for fun! But so far it has been anything but fun. So why make it more painful by walking? Besides, many golfers believe that due to the nature of the golf game (stop-and-go), walking while golfing is not counted as exercise. That’s what I thought. But, an article in the Golf Digest says golfing and walking is healthy.

An average player covers five miles or more during each 18-hole round. The article quotes a Swedish study that examined the physiological demands placed on middle-age golfers who walk the course. The researchers found that despite the short walking intervals, the golfers’ exercise intensity ranged from 40 to 70 percent of maximum aerobic power. They calculated that four hours of activity on a golf course is comparable to a 45-minute fitness class.

The article quotes another study done by a cardiologist, Dr. Edward A. Palank, which looks at the effect of walking on cholesterol levels. The study found that a group of middle-age men who played golf three times a week for four months had LDL (bad cholesterol) level decrease significantly compared to controls. There was no change in the HDL (good cholesterol) level.

Walking has many health benefits, whether you walk a golf course, a sidewalk, a park or a trade-mill in the warmth of your basement. It will keep you fit without the risk of serious injury. It is a very natural form of exercise and anyone can do it.

Walking improves cardio-vascular fitness, lowers cholesterol levels and blood pressure. Burns calories, improves muscle tone, relieves tension, improves digestion, and makes one feel good about one self. It also helps prevent osteoporosis.

Spring is here and the golfers are already out on the golf courses. I will be there one of these days. Am I going to walk the golf course or enjoy my trade mill (while watching Golf Channel) and continue to ride my power cart when golfing?

Well, I have so many excuses (its my plantar wart, its my ingrown toe-nail, its my knees, its my back, I am on-call, I don’t want to delay others, etc) to use a power cart that I may still find myself using one. I know I will need one as I tee-off at the first tee-box and my ball disappears from sight.

But don’t forget, walking is good for you and don’t do what I do on the golf course!

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Kidney Failure

Dr. B, why do kidneys fail?

Kidneys fail because their functioning capacity to get rid of body’s toxic substances is compromised by different kinds of diseases and injuries. Some of these are: diabetes, high blood pressure, polycystic kidneys, blockage of the urinary tract and certain type of medications.

Kidney failure, also called renal failure, can be partial or complete; acute or chronic. In acute renal failure, kidneys do recover function in six weeks or so. In chronic renal failure the damage is permanent. Chronically diseased kidneys can sustain life until about 90 percent of their functioning capacity has been lost.

What do kidneys do?

Kidneys remove wastes and toxic substances. They regulate water and electrolyte balance, and produce hormones that regulate blood pressure, the making of red blood cells, and uptake of calcium from the intestine.

Kidneys are essential to life. We are lucky that we have two kidneys compared to other essential organs like the brain, heart, and liver.

What happens if kidneys fail?

The body is unable to get rid of toxic substances from the blood. It has difficulty maintaining fluid and electrolyte balance and acid base balance. The blood pressure goes up. Certain parts of the body become puffy from fluid retention. There is change in the urinary output and in its content.

What is the long-term prognosis of chronic renal failure?

Without kidney dialysis and kidney transplant the prognosis is bad. Dialysis is life-prolonging process for patients with end stage kidney disease. Dialysis removes toxic materials from a patient’s blood. It also helps in maintaining body’s fluid, electrolyte and acid-base balance. But kidney transplantation is the most effective treatment.

Statistics show that as of 1998, there were 3434 patients waiting for an organ transplant in Canada. This is 88 percent increase since 1991! Eighty-one percent of patients listed for an organ transplant in 1998 were waiting for a kidney.

John Boksteyn, President of the Southern Alberta Branch and member of the National Board of Directors of The Kidney Foundation of Canada says that the Foundation is a national volunteer organization dedicated to improving the health and quality of life of people living with kidney disease.

Boksteyn adds, “March is Kidney Month and the volunteers have been working hard to collect funds for research and education. They also actively promote awareness of, and commitment to organ donation”.

How can we take care of our kidneys?

Maintain adequate hydration by drinking enough water. Have your blood pressure checked and treated if it is high. If you suffer from diabetes then follow your doctor’s advice and keep your blood sugar level under control. Have your urine checked for sugar, blood and protein as part of your physical examination. When you take any medications on regular basis, especially off the counter, then check for its effect on kidneys. Chronic urinary infection and kidney stone problems should be treated.

We are blessed with two kidneys to keep us healthy. Let us take care of them for our family and ourselves – you never know when a family member may need to borrow one!

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Diet and Cancer

“Doc, one more column on nutrition and I will throw up!” says Dave.

“Dr. B, just ignore him. Tell me, how can good nutrition prevent cancer?” asks Susan.

Susan, this question has been bothering me too. So, let us see if there is any scientific literature to prove that good nutrition can prevent cancer.

Here are two articles. First one, a review article titled “Diet and the prevention of cancer” in the British Medical Journal. Second one, “Diet and cancer” in the Encyclopaedia Britannica. This is what they have to say.

There are three ways in which a person’s usual diet may lead to cancer: (1) A cancer producing substance, in food or drink, can come in contact with the lining of the mouth, throat, oesophagus, stomach, intestines, liver, or urinary bladder and trigger changes leading to cancer. (2) A person is little overfed or a little underfed may influence the incidence of hormone-dependent cancers in the breast, uterus or prostate by altering the hormone secretion or metabolism. (3) Some nutrients may influence the susceptibility of other sites to cancer producing substances.

It has been estimated that diet may be responsible for around 38 percent of cancer deaths. About 80 percent of cancers of the large bowel, breast and prostate may be related to diet. One of the articles says: While there is strong but indirect epidemiological evidence that most of the common cancers could be made less common by suitable modifications of food habits, there is still no precise and reliable evidence as to exactly what dietary changes would be of major importance.

For people like you and me this creates a significant dilemma. We need to know exactly what to eat and what to avoid to prevent cancer. Just like the “heart smart” diets where we know the type of foods that will keep our heart and blood vessels healthy.

Colon and rectal cancer is one for which the evidence that diet is involved is probably strongest. Constipation is known to be a risk factor because of the increased time the cancer inducing substances in the stool spend against the lining of the colon and rectum. Increased intake of fibre and vegetables can hasten the transit time and reduce the risk.

Red meat , processed meat, and canned meat increase the risk of colon and rectal cancer.

When it comes to breast cancer, overweight postmenopausal women have up to a twofold greater risk. In premenopausal women, the effect of weight is inconsistent. Meat and alcohol are associated with increased risk. Low intake of vegetables and fibre may have the same effect.

Other cancers where nutrition is important are: cancer of the prostate, stomach, oesophagus, pancreas, lung, and uterus. The common theme is – excessive use of cigarettes, alcohol, meat, and fat. Not enough intake of fruits, vegetables, fibre, and certain types of vitamins.

Role of vitamins in cancer is controversial. Some experts believe that caution should be used with high doses of purified supplements of vitamins and minerals. But all experts believe that vegetables and fruits have strong protective effect and red meat and processed meat is linked to high risk of many cancers.

So next time you buy a burger, don’t ask: Where is the beef?


This series of articles explore the health problems of Dave and his family. They are composite characters of a typical family with health problems.

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Cholesterol

Doc, what is cholesterol? Where does it come from? What does it do?

These are not uncommon questions. Most adults, who have a regular physical examination, undergo routine blood tests to check for cholesterol level. Some are normal. Others are abnormal. Some have to go on a diet. Some have to take pills. Is this necessary?

Cholesterol is normally present in blood and all animal tissues. It is odourless and tasteless. It is essential to life. It is an important component of the membrane that surrounds each cell. Cholesterol is required when body synthesises substances like bile acids, steroid hormones, and vitamin D.

Where does it come from?

The liver and many other organs synthesize cholesterol. We also consume considerable amount of it in our diet.

How does it do the damage?

Cholesterol is not soluble in the blood. In order for it to be transported to different sites in the body, it has to attach itself to certain type of protein called lipoprotein. This transportation occurs through the bloodstream.

LDL (low density lipoprotein), also known as bad cholesterol, picks up the cholesterol from the liver and transports it to various tissues and body cells. Here the cholesterol gets separated from the lipoprotein and is used by the cells. This includes the deposition of cholesterol and other fatty substances circulating in the blood stream in the interior walls of the blood vessels. These deposits (atherosclerosis) narrow the blood vessels causing heart attacks and strokes. Higher levels of blood cholesterol cause more damage and increased narrowing of the blood vessels.

HDL (high density lipoprotein), also known as good cholesterol, transports excess or unused cholesterol from the tissues back to the liver, where it is broken down to bile acids and then removed from the body.

How can we avoid high cholesterol levels in the blood?

Mainly by improved nutrition (remember March is nutrition month!). Susan White, Clinical Dietician at the Medicine Hat Regional Hospital has a very informative hand out for the Cardiac Rehab Program patients. It is called: Nutrition – For Your Heart. It has five titles: 1.Eat more fibre 2. Meats and Alternatives 3. Choose lower fat Milk Products 4. Reduce all sources of dietary fat 5. Reduce salt, caffeine and alcohol intake.

Avoid lard, butter, cheese, whole milk, red meat, candy and baked goods containing shortening. Egg-yolks and shrimps are high in cholesterol. If you love cheese then eat in small amounts. Pick varieties with less than 20 percent M.F. (milk fat), and products made with skim milk or partly skim milk.

Chips, deep-fried items (who does not love French fries?), and commercially baked goods should be avoided. Same goes for ice cream, whipping or cereal cream, coffee whitener or regular puddings.

So, it is not easy. Careful thinking and strong motivation helps.

Those who fail to control their cholesterol level by diet and exercise end up on pills. There are several in the market and your doctor should be well versed in this area as it is such a common problem. Heart disease is the number one killer.

In the last few days you have had your plate full with items on nutrition. Hopefully, it has not given you indigestion. If you decide to make changes in how and what you eat then do it slowly. Sometimes it is the smallest changes that can pretty well change your life.

Good luck and happy eating!

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