We have known for a long time that exercise will help reduce blood sugar for type two diabetics. What is new is that both aerobic and strength training together can have a big impact on blood sugar reduction when both are done.

A recent study of diabetics that was conducted over 9 months took 245 diabetic patients and divided them into four groups. One group did aerobic exercise for 45 minutes three times a week. Another group did strength training with weights and a third group did both. The fourth group did stretching and relaxation exercises. Aerobic exercise was done using treadmills and strength training was done using machines both were supervised by trainers.

Forty-one percent of the combination group was able to decrease their blood sugar and/or medication. Twenty-nine percent of the aerobic exercise group, twenty-six percent of the weights only group and twenty-two percent of the non-exercise group were able to lower their blood sugars or reduce their medications.

This study emphasizes the importance for both strength and aerobic exercise in those with diabetes. It is also important for those without diabetes who want to remain fit.

A recent study has shown yet another unexpected benefit of getting enough sleep. In a well designed research study, a convincing relationship was shown between high blood cholesterol and short duration of sleep.* Although prior studies have suggested this association, this was the first longitudinal study on this topic.

We’ve already seen research suggesting an increased risk for diabetes associated with not getting enough sleep. And there has been in recent years convincing evidence of the association between lack of sleep and difficulty in losing weight leading to obesity.This last association came as a surprise to me, as I always assumed that the longer one stayed awake at night, the more calories one used up, and thus, the more weight one lost. In fact, when I was in college, my roommate and I always had a goal  – which we thought easily attainable – for exam week: we would study nonstop, purposely limiting our sleep in order to do that, and thus at the end of the week we would be “smart and skinny.” Now I understand why we always seemed to get smart (in the topics we studied of course) and never skinny!

So, during this Holiday weekend and the rest of the Holiday season, while you’re focusing on eating, drinking, and partying in moderation, let yourself go in three areas – all of which will be good for your health: laughter, enjoyment and sleep.

*Gangwisch JE et al. Short sleep duration as a risk factor for hypercholesterolemia: Analyses of the National Longitudinal Study of Adolescent Health. Sleep 2010 Jul 1; 33:956.

Do you ever wonder if the new modern technologies are rotting your brain? Are you dependent on your GPS to get you where you want to go? You may want to re-think that. Scientists have found that when you use your brain to navigate your route in your car or on foot that you use a map in your head or you find your way on autopilot. Either way you are using the hippocampus area of your brain. If you depend on the GPS you are not.

When scientists have examined the brains of taxi cab drivers in London where they are always looking for shortcuts, they found that their hippocampus was larger than those of non-taxi cab drivers. Older adults who do not use GPS and use maps to navigate have more grey matter than those who don’t.

It is possible by activating this part of the brain that we may be able to prevent dementia. This is one instance where it might make sense to do things the old fashioned way. If you need to find a new route to work or go to a place you have not been to in awhile, use a map and navigate on your own.

This is the time of year that I call The Danger Season. Why? Because it is often the season of “too much.” There is a tendency to party too much, spend too much, drink too much alcohol, smoke too many cigarettes, and of course, eat too much.  Although we’ll talk about those other excesses before this season is over, this particular blog is about overeating, and especially, overeating “sweets.”

From Halloween night until the morning of January 2, it’s one big food fest – from candy corn and caramel apples to cranberry sauce and pumpkin pie to peppermint sticks and fruitcake.  Do you notice a pattern here? Carbohydrates, or sugary foods or ”sweets” are in abundance.

(A clarification here: by “sweets” I mean simple carbohydrates only, or those foods that go directly into your bloodstream as sugar, such as cakes, candy, pastries, white breads and ice cream. This is as opposed to complex carbohydrates, which the body has to break down into sugar, and which are healthier. These include most fruits and vegetables.)

Too much sugar can be as dangerous as too much alcohol, too much partying, or too many cigarettes. Since the body uses just what it needs of the fuel we give it for immediate energy, sugar molecules in excess of what’s needed turn into fat. Gaining weight leads directly to many health problems, including osteoarthritis, sleep apnea, high blood pressure and heart disease, and Type 2 diabetes. The latter is not just about too much sugar in the blood, as your grandmother might’ve said. It’s the deadly disease that affects virtually every organ in the body, and can lead to kidney failure, heart attacks, blindness, poor healing, and painful nerve damage, among other complications.

But we know all that. And still we can’t stay away from the dessert table during this season. Why? Because sweets are associated with childhood, pleasure,  and holidays. So we don’t tend to see them as dangerous, as we see alcohol. As a result, we’re not as careful with the amount of sweets we take in as we are (or should be) with alcohol.

And even though we may think we’re only going to have a “taste” of the goodies, it’s never just a taste. There’s a physiologic reason for this. When sugar enters the body, it immediately stimulates the release of insulin to push the sugar from the bloodstream into the cells. This results in a lower blood sugar level which makes the body want more fuel, resulting in your appetite being stimulated again, especially to want more carbs.

Here are suggestions that may help to avoid those sweets next week at Thanksgiving dinner (and thereafter).

• Don’t go to a holiday event with an empty stomach. Drink a warm beverage before you go, and eat something filling like an apple.
• Fill your plate quickly with nutritious foods: turkey, chicken, fish, veggies, fruits, nuts and cheese.
• Avoid the dessert table like the plague. Don’t even look at it.
• Limit your alcohol intake. The more you drink alcohol, the more uninhibited you become and the more you’ll eat.
• Keep yourself well hydrated with nonalcoholic beverages. This will also make you feel full.
• Watch out for hidden carbs such as the dressing/stuffing inside the turkey and those delicious holiday punches.
• Be mindful of what you’re eating.
• Enjoy being healthy!

Probiotics can help prevent colds in children and now a new study has found that they may reduce the number of bellyaches in children with irritable bowel syndrome (IBS). In 2009, a study of Chinese children between the ages of 3 and 5 found that those children who drank milk with Lactobacillus and Bifidobacterium animalis added had 59 percent fewer runny noses, 62 percent fewer coughing episodes, and 72 percent fewer fevers.

A recent study of Italian children with IBS between the ages of 5 and 14 found that those who were treated with Lactobacillus rhamnosus strain GG daily for 8 weeks when compared to placebo had a significant reduction in their belly pain episodes. Those given probiotics only had one pain episode weekly as opposed to an average of 4 per week. The placebo group had 2 episodes a week. The intensity of the symptoms dropped significantly in the treated group as well. The treatment remained effective up until 8 weeks after the trial was finished.

Probiotics are healthy bacteria that seem to help children as well as adults. If you want to keep your children healthy you might want to consider using them especially if you want to prevent colds in the winter and if you have children with chronic belly pain due to IBS.

One of the big buzz phrases in recent years is “giving yourself permission,” as in giving yourself permission to take care of yourself first, giving yourself permission to take a break from work, giving yourself permission to admit that all is not well in your life rather than always being strong and pretending otherwise.  These are all positive things, and letting yourself do these – and other things you’ve been too afraid/uptight/busy to allow yourself to do – is important.  But giving yourself permission may not always be such a good thing.

Just before my yoga class began earlier this week, my classmates and I got into a discussion about food. More specifically, those foods that we used to love, but since changing our eating habits, no longer liked. And the conversation turned toward pizza. One woman said that the tomato sauce now tasted too “manufactured” now that she had started eating only fresh vegetables. Another said that the entire taste of pizza was way too greasy. And on and on. Then the woman on the mat next to mine said, “But you have to give yourself permission to have pizza once in awhile if you like it. You can’t deprive yourself of everything you like.”

All well and good, I thought.

Then she went on to say, “I’m very good about giving myself permission. For instance, when I don’t feel like exercising, I give myself permission to skip my workouts. And since I hate seeing doctors, this year I gave myself permission to skip my yearly Gyn exam and mammogram. I think it’s healthy to break my routine occasionally when I feel like it.”

Whoa…

I looked around at the others in the class and they looked as surprised as I was feeling. Obviously because giving oneself permission can go too far, just as our classmate had demonstrated. Once you give yourself permission to break your routine once, it’s a slippery slope to not having a healthy routine at all.

No, it’s not a great idea to hold all your emotions in – so it’s healthy once in awhile to “give yourself permission” to let them out. By the same token, it’s not a good idea to give yourself permission whenever you feel like it to do unhealthy things.

So, moral of the story: be selective about what you give yourself permission to do. Put another way, if you’re going to give yourself permission to do something, make sure that it isn’t harmful. (And yes – this does apply to giving yourself permission to eat your way through the holidays with no limitations!)

Infertility issues affect one in six couples in the US. Half of the problems are due to the male member of the couple. One of the things that is known to cause a decreased sperm count is exposure to heat in a hot tub. When the scrotal temperature is raised by one degree Celsius there is damage to sperm.

There is now a whole new issue with laptop computers. A recent study has found that if men use them on their lap, after an hour, the heat from the computer can raise their scrotum temperature by as much as 2.5 degrees Celsius. The scary part is that the men had no idea that their scrotal area was getting overheated.

Whether this increase in temperature will impact fertility over time is not clear. What we do know is that cooling pads are ineffective when it comes to keeping the lap temperature down. The best way to avoid problems is to use the laptop on a desk.

If you are part of a couple with fertility problems, keeping the laptop off your lap may be one factor in improving your odds of getting pregnant. Keep cool, step away from the computer and place it on the desk.

It seems like we’ve been talking a lot about vaccinations in this blog lately. You need the shingles shot if you’re 60 or older; you need the pneumonia shot if you’re 65 or older, or if you have a chronic disease; and of course it’s flu season, so you need a yearly flu shot. You also need a tetanus shot every ten years. And of course, if you haven’t had the shots against Hepatitis A or Hepatitis B or measles/mumps/rubella or meningitis or chicken pox, you should discuss these with your doctor.*

Here comes another one. The Advisory Committee on Immunization Practices (ACIP), in a report to the CDC last week, made new recommendations on the vaccine against pertussis, or whooping cough. Prior recommendations had called for a single vaccination against pertussis – or whooping cough – for people ages 11- 64, with the preferred time for receiving this vaccine being at age 11 or 12.  (This booster is given, of course, after the series of pertussis vaccinations given in early childhood.) Because of recent outbreaks of pertussis in the US, the ACIP broadened its advice regarding this shot. These recommendations should be made official soon.

Before going over the new recommendations, you should know that the vaccine against pertussis is given as one shot in combination with the vaccines for tetanus and diphtheria; this shot is known as Tdap.  There is another formulation that includes only tetanus and diphtheria vaccines, without pertussis; this is known as Td, and is the immunization that has been commonly used when you’ve needed the tetanus booster required every ten years.  

The new recommendations state that the following people should get a booster pertussis shot:

·        Everyone between the ages of 11-64

·        Adults who do not know their immunization history

·        Adults who have had the “plain” tetanus shot (the one without the pertussis vaccine included, or Td)  within the past five years

Three things to note:

1) It is especially important if you have, or will have, close contact with infants under the age of one year, that you get Tdap in order to prevent whooping cough in infants.

2) Even if you’ve had the plain tetanus shot(Td) within the past five years or so, it is safe to get Tdap.

3) If you’re not sure which type of tetanus vaccine you received – the one with pertussis or the one without – be sure to ask your doctor.

So, what’s the big whoop? (Sorry about that pun) If you haven’t been getting a regular tetanus shot every ten years, then this new recommendation will actually mean NO extra shot for you. Just go get a Tdap shot, and you’ll be covered for whooping cough indefinitely, and for tetanus for the next ten years.

But then I guess that also means that if you have been good about your preventive health care, and have been getting regular tetanus shots, then you will need to take an extra shot – one of the few times that taking care of yourself didn’t pay off. But of course this doesn’t mean that in the future you shouldn’t take care of yourself.  Oh dear, maybe this is a big whoop.

*For the CDC’s recommendations on adult immunizations, go to:

http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm

For an easy-to-read schedule of shots you should get, go to:

http://www.immunize.org/catg.d/p4030.pdf

As the obesity epidemic in our country continues to grow, there are many new weight loss programs that are in the process of being evaluated. In Rhode Island researchers studied 179 people with an average BMI (Body Mass Index) of 34. They were part of a 12-week weight loss competition online. One group did the standard online program that helped with diet and exercise. Another group was given video lessons on weight loss in addition to the standard program. A third group was given the online program, videos and daily self-monitoring for exercise and diet, and computer generated feedback.

With education and videos the average weight loss was 3.1 pounds. With the addition of feedback the group lost an average of 7.7 pounds. Feedback is a valuable tool for weight loss. Personal feedback rather than on the computer may be even more effective. When you consider the massive scale of the obesity epidemic, personal interaction may not always be possible. Computer generated feedback programs therefore may be a very effective tool for the future.