Tag: health

Posted on

Is Coffee Bad or Good for You?

Millions of people around the world depend on a cup of coffee to start their day. We treat ourselves to a nice, hot, smooth cup and enjoy our vice even if it’s bad for you. Or… is it?
Is Coffee bad or good for you? Recent studies have evidence that coffee has potential health benefits. While more research is needed to validate the results, the evidence does show potential benefits to drinking coffee.

Lowers risk of Death

Several studies suggest an association between coffee consumption and a lower risk of death. A trial of 185,000 individuals who identified as African American, Latino, Native Hawaiian, white, or Japanese American, and aged 45-75, were followed over a period of 16.2 years. Coffee was associated with a lower risk of death even after adjusting for confounders. The association was found for both decaffeinated and caffeinated coffee, as well as anywhere from 1 cup per day to 4 cups per day.

In one cohort study, more than 500,000 individuals from 10 countries were followed over a mean period of 16.4 years. Compared to nondrinkers, men who drank the most coffee had a 12% lower risk of death (OR 0.88; 95% CI 0.82-0.95, P<0.001) and women had a 7% lower risk of death (OR 0.93; CI 0.87-0.98, P=0.009). Unfortunately, this study had potentials problems that made the evidence less cleared such as the authors noted that coffee drinking habits were only assessed once, and reverse causality might have affected the findings. However, the large numbers enrolled in the trial and exclusion of those who died within 8 years after the start of the trial certainly strengthen the findings.

Lower risk of developing Diabetes

The Nurses Health Study group had a combined follow-up for individuals of 1,663,319 years and found that those who drank coffee had a lower risk of developing diabetes. Those who decreased their coffee intake by more than 1 cup per day increased their risk for developing diabetes by 17%. They investigated tea drinking but found no association. Diet was reassessed every four years using a questionnaire.

Decrease Mortality in Chronic Kidney Disease (CKD)

Because the caffeine in coffee can transiently increase blood pressure, there are concerns that CKD or heart patients should not drink non-decaffeinated coffee. One group followed more than 2,300 patients with CKD and coffee drinking was associated with a decrease in mortality in that group, independent of many potential confounders (eGFR, smoking status, race, income, hypertension, BMI, and others). Those who drank the most coffee had a 24% lower risk of death compared to nondrinkers. This study at least demonstrates that coffee is safe in this population and that it might be beneficial. It would be interesting to see a similar design with a larger number of people to see if that same association holds true.

Lower risk of Colon cancer

A group studied the association between coffee consumption and colorectal cancer among 5,145 cases and 4,097 controls. In one of the strongest associations of any of these trials, coffee was associated with a 26% overall lower risk of developing colorectal cancer. Among the highest group of consumption (>2.5 servings per day), coffee was associated with a 54% lower risk (OR 0.46; 95% CI 0.39-0.54, P<0.001). Coffee data was collected using a validated questionnaire and the researchers controlled for race. The findings held true for both colon and rectal cancers.

Drink it black and don’t drink it scalding hot. Sugar is associated with numerous health problems and could be ruining the benefits you are receiving, while WHO’s International Agency for Research on Cancer issued a statement in 2016 that there is some limited evidence consuming drinks hotter than 200 degrees Fahrenheit might increase the risk for esophageal cancer.

 

Why do some think coffee is not good for you?

There have been some concerns that coffee might be bad for you, but these are based on limited evidence or taken out of context. For example, there is an ongoing court battle in California about whether coffee should be labeled a carcinogen due to trace amounts of acrylamide. This is based on the effect of acrylamide alone in animal studies. Other concern is cafestol, a compound removed by paper filters but not by other methods (French press, Turkish coffee), which increases cholesterol. Based on current evidence, the presence of this compound does not appear to negatively affect outcomes.
For people with borderline or high blood pressure, I would cautious and recommend limiting the number of coffee cups to two per day of noncaffeinated coffee. More research is needed to conclusively state some of the above benefits but for now the data is showing that there might be some benefit.

Posted on

Happy New Year

New year, new you! With the start of a new year we all feel like it is the start of a new you, that is why we make resolutions for the new year. Having had to deal with the illness of a family member and having to make tough decisions like palliative care; it has become increasingly clear to me that we have a finite amount of time and we should make the most out of it. Since we are here for a set amount of time, it should be clear that we should take care of our bodies so that we may have longer healthier life and enjoy more the world out there. As humans we are not perfect, and we can always improve, personally, health wise and improve relationships with family. Like many of you I find myself needing to lose weight and start exercising more. I will start an exercise program and eat healthier.

The first step is setting health goals that are realistic and obtainable, choose one to two goals instead of having too many which will make it hard to keep track of them, and break the larger goals into smaller steps that will be easier to do.  If loosing weight is one of your goals, you want to make sure to do it the right way and stay away from gimmicks. One way to lose weight is adjusting your calorie intake, this new online tool can help you figure out how to adjust your calorie intake.  Small changes can add up and make a big difference, so start small with changes you know you can stick with.

Don’t forget exercise as it is one of the best things you can do to keep you healthy and loose weight. Logging what you eat can help you see how much you are eating and keep track of calories. There are many apps for your smart phone that you can use. There are also apps that can help you exercise such as the 7-minute workout. Writing down goals and letting your friends and family know can help you stay on track. Lastly, don’t for get to schedule time for exercise, if can’t do it daily start with three days per week. What ever your goals, the most important thing is to get started.

Posted on

Is Eating Vegan Healthy?

A few years ago, one of my patients asked me if I knew anything about Forks over knives. She reported she saw a cardiologist to get cleared for surgery, he told her he would not clear her but encouraged her to see the documentary Forks over Knives and to follow the diet. The patient was very stressing over the fact she could not get the surgery, she told me that the cardiologist encouraged her to eat a vegan diet. Vegans abstain from eating any animal products while vegetarians do not eat animal meat but still eat eggs, cheese, milk.  The Forks over Knife documentary and book explores the claim that all deteriorating diseases can be control, even reverse by not eating animal based and processed foods.

Most people become vegan to avoid animal cruelty products and wanting to be healthier. But is a vegan diet Healthy? Around 2.5 percent of people in the United States (U.S.) are vegans, according to a 2016 poll. Here are some facts about the vegan diet:

The vegan diet contains only plant-based foods. All protein, vitamins, and minerals must come from non-animal sources, so food choice and preparation are important. Tofu, tempeh, and mushrooms are three of the many alternatives than can provide the nutrients found in meat. A vegan diet can help to protect bone and heart health, and lower the risk of cancer.  Supplements are recommended to replace levels of certain nutrients abundant in meat, such as vitamin B12.

Animal fats have been linked to various cancers, diabetes, rheumatoid arthritis, hypertension, heart disease, and a range of illnesses and conditions. Animal sources are likely to account for 13 of the top 15 sources of cholesterol-raising fats in the U.S.  Not eating meat reduces the overall risk of mortality.

The following are likely to be in short supply on a vegan diet, but alternatives are available.

  • Vitamin B12: Vitamin-B12 fortified plant foods, such as fortified soy, seaweed, cereals, and nutritional yeast can supplement intake.
  • Iron: Dried beans and dark leafy greens may be better sources of iron than meat on a per-calorie basis. Using a cast-iron skillet to prepare a meal is a good way to absorb more iron into the food.
  • Calcium: Eat more tofu, tahini, and green, leafy vegetables.
  • Vitamin D: Regularly consuming more vitamin-D fortified foods and spending time in the sun can boost vitamin D levels.
  • Omega-3 fatty acids such as DHA and ALA: Omega-3 fatty acids, such as fish oil, are vital for cardiovascular health, eye function, and brain function. Though EPA, another type of omega-3, can’t be obtained with a vegan diet, ALA and DHA can be found in ground flaxseed, walnuts, canola oil, soy products, and hemp beverages.
  • Zinc: Whole grains, legumes, and soy products are rich in zinc.

My patient followed the diet and lost around 20 lbs., reported feeling better, got off most of her medications and could get her surgery. The patient was not able to stick with the diet for more than 18 months, and has since started to eat meat again. While eating vegan can be healthy, making sure to get vitamin B12, iron, calcium, vitamin D, omega 3 acids and zinc; is important.

Posted on

Even a little bit of movement matters

The take-home message from a mountain of data is that less sitting and more exercise is the goal, and even a little bit of improvement helps. For those who have a desk job, taking short movement breaks throughout the day is protective.

Scientific evidence strongly suggests that the more time a person spends sitting, the higher their risk of death from any cause. Multiple large studies and high-quality data analyses show that regardless of age or health issues, the hours we spend in our office chairs, cars, or on the sofa watching television can literally kill us.

A well-conducted study published in July 2016 in The Lancet looked at a massive amount of data from 16 large studies and including over a million subjects. What they found was that 60 to 75 minutes of moderate physical activity (The CDC has published a table describing many activities ) like walking to work, walking the dog, riding a stationary bike, line dancing, golf or softball, doubles tennis, or coaching sports eliminates the risk of death related to sitting, even from sitting for more than eight hours per day.

Can’t get in an hour of these types of activities per day? Just 25 minutes of moderate activity is somewhat protective, even for people who sit for eight or more hours per day. Other studies have suggested that exercise can be broken up and spread out throughout the day and still be beneficial. One study found that even hourly breaks of light activity decreased measurable damage to our arteries.

Time spent sitting was analyzed separately from time spent sitting and watching television. TV time is associated with even greater risk of death, and exercise was not as protective. Even more than an hour per day of moderate activity did not eliminate the risks associated with five or more hours per day of zoning in front of the tube. Why the extra negative effect of TV watching? The authors hypothesize that people are more likely to get up and walk around at work than they are while watching TV. In addition, people tend to watch TV in the evening after eating dinner, which may have negative effects on our blood sugars and fat metabolism. Or, perhaps people are prompted to snack on unhealthy foods during those commercials breaks. Watching large number of hours of television? Consider an exercise bike or a treadmill, place it in front of the screen.

Whether it’s sitting in an office chair or watching TV, those who get less than five minutes of moderate activity per day fare the worst, and the longer they sit, the higher their risk of death from any cause – be it heart disease or cancer.

For more information see: exercise recommendations for patients with diabetes.