Migraine: Not Just a Bad Headache
July 6, 2009 by Dr. Manny
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There are headaches, and then there are migraine headaches. Any headache can make you miserable, but a migraine can be excruciating. In fact, the most severe migraine headaches can just about bring you to your knees.
More than 28 million Americans suffer from migraine headaches. Their frequency and severity varies from person to person, but they strike women three times more often than men. And if there is a history of migraine in your family, there is an 80 percent chance you will have them as well.
Most people who suffer from migraines will have a first attack by the age of 30. Often they begin in childhood and then increase in frequency in adolescence. The condition usually continues through the thirties and forties, but attacks tend to decrease in frequency and severity with age, and they are rare after age 50.
Some people with these painful headaches will experience a variety of visual symptoms–such as flashing lights, blind spots, or zigzag patterns–either before or during the headaches themselves. Migraines make many people feel nauseous or light-headed. Vomiting and an extreme sensitivity to light and sound are other common symptoms. A migraine can incapacitate you for hours or even days.
While there is no cure for migraines and the exact cause of migraines is not known, they are now viewed as a vascular and inflammatory problem, so the new therapies being developed for migraine sufferers are focusing on these two pathways.
Not long ago, aspirin was the sole remedy for migraines, but today there are medications that can help reduce the frequency of migraine headaches and stop the pain once it has started. Severe cases are now treated with triptans, a class of drugs specifically developed to treat migraines. These drugs normally provide relief within 15 minutes to two hours in most people.
Preventive medication is available for serious migraine sufferers, though they do not eliminate the migraines completely. The beta-blockers used to treat high blood pressure and coronary artery disease can reduce the frequency and severity of migraines, and certain antidepressants can also help prevent migraines.
It’s important for migraine sufferers to avoid certain triggers, such as smoking, or certain foods or smells that may have triggered their headaches in the past. If you are a woman, birth control pills and other sources of estrogen may also trigger or make the headaches worse. Regular aerobic exercise is highly recommended to reduce tension and to help prevent migraines.
Dr. Manny’s Freedom Diet
One recent survey of Americans on body image found that more than half of all men and women would rather lose their job than gain an extra seventy-five pounds. And nearly 20 percent of the population would give up, or consider giving up, 20 IQ points to have the perfect body.
Obviously, weight and the way we are perceived is an important factor in our daily lives. It’s not surprising then that dieting is on the minds of so many people these days, particularly as people get on in their forties, when the metabolism begins to slow and the pounds begin to add up. So which diet is best? I’ll tell you.
First, let’s look at some of the big blockbuster diets that have appeared over the past decade or so—the South Beach Diet, the Atkins Diet, the Mediterranean Diet, and so on. Each one of these diets has simply incorporated a different method of teaching you about nutrition in order to get you to lose weight. Each one gives you something to focus on, a behavior to motivate you, which is great because, after all, to lose weight you have to change your thinking.
But if you look at the fundamentals, the underlying theme of each diet is calories. Whether you do Atkins, South Beach, or Dr. Phil, it’s really all about calories.
When reviewed carefully, most diets are really nothing more than low-calorie nutrition plans disguised by clever marketing gimmicks. Scientific-sounding “facts” and hocus-pocus “research” are just ornaments on the diet tree. Diet-plan marketers go to great lengths to explain how their diet can work for everyone, or claim that it is carbohydrate intake or fat intake—or whatever the bad intake of the day is—that’s the culprit.
However, the bottom line is that the only way to lose weight is to have a caloric deficit, which occurs only when you burn more calories than you consume.
The average American today consumes 300 more calories per day today than did the average American of 30 years ago. Today’s average American also burns 260 fewer calories each day due to increased automation, technology, and sedentary occupations. Put those numbers together, and it becomes rather obvious why America’s waistline is growing at an alarming rate.
Check Your BMI
The BMI can tell you if you are underweight, normal, overweight, or obese. Adults 20 years old and older can calculate their BMI with this formula:
BMI = your weight/pds divided by height/in x height/in x 703
You are UNDERWEIGHT, if your BMI is below 18.5.
You are of NORMAL WEIGHT, if your BMI is between 18.5 and 24.9.
You are OVERWEIGHT, if your BMI is between 25.0 and 29.9.
You are OBESE, if your BMI is 30.0 or more.
So here is Dr. Manny’s Freedom Diet. If you really want to lose weight, you have to do two things: eat fewer calories and burn more calories. This is not an optional “either/or” plan but an “and” plan. Of course, the calories you eat should be healthy calories. That’s all. Eat less. Exercise more. It really is that simple.
Fight obesity. Spread the word.
Exercise
People spend an enormous amount of time trying to find the perfect exercise, and while they’re doing that, their clock is ticking. Any physical activity is great, though the best kinds of exercise for you are those like walking, swimming, running, hiking, and skiing—all of which have a “global” impact on your body and mind.
Most important, you should stick to the exercise of your choice and do it regularly. If you adhere to those two principles, you’re going to burn calories, feel better, improve your metabolism, and benefit your health.
Any activity you do during the day—from climbing stairs, to housecleaning, to watching TV—will, of course, burn calories. But those activities don’t provide the necessary continuity, and I think the essence of getting into shape and having a good metabolism has to do with a continuity of exercise.
In other words, it’s better to burn 120 calories a day, seven days a week, doing your favorite exercise, for example, than to burn 800 calories doing the housework once a week. It’s the exercise regimen that has an impact on your health, not necessarily the intensity.
Burn, Baby, Burn
Estimated number of calories burned per minute based on an individual weighing about 150 pounds:
Sitting: 1
Talking on phone: 1
Sleeping: 1
Driving: 2
Housework: 3
Cooking: 3
Washing dishes: 3
Stretching: 4
Sex (active): 5
Walking (3 mph): 5
Calisthenics (moderate): 5
Ballroom dancing (fast): 6
Gardening: 6
Swimming (moderate): 7
Aerobics (low impact): 7
Hiking: 7
Jogging: 8
Stair step machine: 8
Bicycling (12 to 14 mph): 10
Basketball (full court): 12
Running (10 mph): 20
To easily calculate how many calories you burn in a day, go to www.healthstatus.com and click on “Calculators” then “Calories Burned.”
It is also very important to drink adequate amounts of fluid when you exercise. You need to drink about a half cup of water for every fifteen minutes of vigorous exercise. People think that muscle cramps during exercise are caused by a shortage of electrolytes, but that’s not true. You get muscle cramps because of water loss and dehydration. Drink that water!
Hypertension: The Silent Killer
June 23, 2009 by Dr. Manny
Filed under Articles, Featured, Men's Health
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Hypertension is known as the silent killer for good reason. Some 50 million Americans have high blood pressure and one-third of those don’t even know it, despite the fact that it’s very easy to diagnose.
Hypertension kills some 40,000 Americans each year, and another 200,000 die annually of a high-blood-pressure-related illness. People with hypertension are seven times more likely to have a stroke, six times more likely to have congestive heart failure, and three times more likely to develop a heart attack.
In all, hypertension claims more lives per year in the United States than cancer. Those numbers are doubly sad: first, because they are so high, and second, because they could easily be so much lower. More than half of the people with hypertension are not receiving treatment at all, and one-quarter of them are being inadequately treated. Only about one-fifth are receiving the proper treatment to control their blood pressure.
There are two types of hypertension. More than 90 percent of all cases of hypertension involve what is known as essential hypertension, which is high blood pressure without a definite cause. The rest, fewer than 10 percent of the cases, have a known cause; this is known as organic hypertension, or secondary hypertension. Organic hypertension occurs when a specific disease, such as a tumor of the kidneys, vascular disease, or hormonal disease, causes your blood pressure to be elevated.
When we talk about blood pressure, we are referring to a comparison of the blood pressure when the heart is beating versus the pressure when the heart is resting. A blood pressure reading is represented as the systolic (or beating pressure) over the diastolic (or resting) pressure. A normal blood pressure is anything lower than 120 over 80. But if you are 140 over 90 or above, you have high blood pressure. Anything in between the two sets of numbers is considered prehypertensive.
How can you tell you have high blood pressure? Certainly not by your symptoms; most people with hypertension don’t have any. But any qualified health professional can measure your blood pressure in a very non-evasive way using a blood pressure machine. Of course, if your blood pressure is very high, you will have symptoms like nose bleeds, irregular heartbeats, headaches, and dizziness.
Hypertension affects more males than females and more blacks and Latinos than whites. The lifestyle characteristics that can put you at risk of developing hypertension include obesity, lack of exercise, a diet rich in sodium, and excessive alcohol consumption. Smoking raises blood pressure as well. Genetic factors may be involved, too, as some individuals have a family history of hypertension.
In younger women, hypertension is sometimes associated with birth control pills. Other medications that can give you high blood pressure include some nonsteroid anti-inflammatories, cold remedies, decongestants, and appetite-suppressant pills.
Your diet plays a very significant role in blood pressure. Foods high in cholesterol thicken the blood with fat, and that forces the heart to work harder, thereby raising your blood pressure. As the heart works harder to push that blood through, the heart becomes larger because it has to expand more to grab enough volume in order to squeeze the blood out of its chambers. If the heart has to work harder, the heart and the arteries come under tremendous pressure and stress, and this, of course, weakens the heart. It also means that organs like the kidneys and eyes and liver don’t get enough oxygenated blood, which causes cell damage to those organs that ultimately damages them.
A high salt intake also makes you retain more water in your vascular system, and that, too, increases your blood pressure. To reduce your risk of high blood pressure, the American Heart Association (AHA) suggests that you ingest no more than 2,400 milligrams of sodium a day. That’s just one and a quarter teaspoons of salt per day, and it mounts up faster than you think; many foods, especially prepared foods, contain large amounts of sodium. And then there is all the salt we actually add to our food.
Being overweight is also a fundamental factor in developing high blood pressure. Conversely, losing weight is one of the essential ways of improving your blood pressure. Lack of exercise and physical inactivity is another risk factor for heart disease. This means that exercising will improve your cardiac performance, making your heart work better, thus lowering your blood pressure.
Stress has also been linked to hypertension: it narrows the blood vessels, thereby causing high blood pressure, so it is vital for people who have high blood pressure to learn how to manage their stress.
The treatment of high blood pressure involves making dietary changes, losing weight, lowering cholesterol, practicing relaxation and meditation techniques, and getting some exercise. If these don’t work, there are medications that can specifically target the kind of hypertension you have.
So how do we prevent high blood pressure?
Number one, watch your weight. If you are 30 percent above your ideal body weight, you’ve got a problem and are more likely to develop high blood pressure.
Second, if you’re drinking excessively—more than three hard drinks a day—this also is a problem.
Third, watch your salt intake; eat fewer processed foods. If you go out to eat, ask your wait person if the kitchen can reduce the amount of salt in your order. Eat a balanced diet. Consume foods that can help lower your cholesterol, like vegetables and grains.
Don’t smoke; nicotine is a major vasoconstrictor.
Exercise regularly; try to do 30 minutes’ worth of aerobic activities three to four times a week.
The bottom line on hypertension is to do your best to prevent it. If you can’t, identify it, and then treat it. Whatever you do, don’t become a statistic like so many other Americans.
You Are What You Eat
June 23, 2009 by Dr. Manny
Filed under Articles, Eating Healthy, Healthy Living, Men's Health
I think Americans generally pay more attention to the gasoline they put in their cars than to the food they put in their mouths. We are a society of excess, and one of our more impressive excesses is the way in which we eat and what we choose to put in our mouths.
We are the leading country in the world in almost everything, yet our mortality rates, our cancer rates, and our neonatal death rates don’t rank among the best in the world. We lead in research, we lead in academic training, we lead in freedom of information, yet we don’t lead in taking care of our health.
We have all the knowledge in the world about everything in life, but that has made no impact on our health. Why? I think nutrition is part of the reason, and I think I know why.
No one is ever taught about nutrition. We certainly don’t teach the subject in grammar school, and it’s rarely taught in high school. Some colleges may offer it as an elective. But our parents certainly don’t talk to us about carbohydrates and proteins the way they do about the birds and the bees. If you combine this lack of knowledge with our appetite for diversity, taste, and presentation, what you have is a lot of people who know nothing about the food on their plate.
It’s never too late to learn about nutrition. The fundamental issue with nutrition is learning how to balance your caloric intake with the number of calories you burn. Everything we eat has a caloric value. If you take in more nutrients that contain a lot of calories and you don’t burn them up, the excess caloric energy is going to be stored as fat, and you’re going to gain weight. That weight and that fat will then interfere with all the normal functions of your body.
On the other hand, if you consume too few calories, say fewer than 1,200 calories a day, then your body doesn’t have sufficient energy to maintain adequate functioning. The caloric intake for a normal adult should range between 1,500 and 2,000 calories a day.
The body requires certain nutrients in order to work properly. Nutrients are the chemicals our body gets from food. These nutrients are used to build muscles, improve cell-to-cell transmission, and manufacture hormones. In describing nutrients, the word “essential” means that the body must consume them; it cannot produce them on its own. The nutrients we need include:
Essential amino acids.
The body requires amino acids to produce new body proteins and replace damaged proteins to build and maintain the body.
Vitamins and minerals.
These are recognized as essential nutrients that are specifically linked to the functionality of cells. If we’re deficient in vitamins and minerals, we develop a weak immune system, cell metabolism disorders, premature aging, scurvy, goiters, and bone loss.
Fatty acids.
Also essential, fatty acids are crucial for maintaining the body’s normal health. They are responsible for the normal formation of hormones and creation of some of the biological pathways responsible for dealing with inflammation and cell repair.
Sugars.
They are essential because they provide the fuel our cells need to function adequately, which allows the other nutrients to be utilized properly. If cells don’t have the sugar molecule necessary to generate the energy required for repairing, functioning, transmitting, and utilizing nutrients, then cellular damage and disease will result.
Each nutrient carries out one or more unique tasks your body needs to function. And because you need many nutrients to stay healthy—protein, fat, carbohydrates, vitamins, minerals—you have to eat a wide variety of foods to get them all.
It’s when we don’t recognize the necessity of all those elements that we begin getting into trouble. It’s like filling your gas tank with gasoline and forgetting to change the oil every 3,500 miles, or forgetting to put water in the radiator. The car needs the gasoline, the oil and the water, all in the proper proportions, in order to function properly. The same is true of the human body.
The problem, as I’ve mentioned before, is that about one-third of all American meals are prepared foods. And the problem with prepared foods is that their contents are not nutritionally balanced.
Our lack of knowledge of nutrition, combined with our obsession with processed foods, is really damaging our health. So we have to get back to fundamentals, a good example of which is the diet of people who live in the Mediterranean. Their diet is well balanced with vegetables and fruit, fish and lean meat, and the good unsaturated fats like olive oil.
Today, many people think that if they stick to low-fat or nonfat foods, they won’t gain weight. That’s a myth, because gaining weight has to do with calorie intake. If you take a salad and you add cheese and eggs and everything else in the book, even if you select low-fat ingredients, you’re still consuming a tremendous load of calories. And size matters, too; the size of your portions does make a difference in terms of the total amount of calories consumed. It’s just a plain mathematical calculation.
There are no magical foods that are going to help you burn calories or increase your cell metabolism either. There is no such a thing as a food that is more active in the body than others. People think that eating a grapefruit each day or having cabbage soup for lunch is going to burn off their fat. But that’s a myth. There is only one way to burn off those extra calories: exercise, any exercise at all.
How to Eat
It’s not just what or how much we are eating that’s the problem these days, it’s the way most of us eat. Many people skip breakfast, gulp down a quick lunch at noon, and then consume a large meal at seven o’clock at night.
Trouble is, they don’t need all that fuel at night. They need a little bit throughout the day when they are active—either moving, thinking, or both.
So what happens in the middle of the day if this is the way we eat? Without a supply of energy, our metabolism gets altered. Our blood sugar level is erratic. Our hormones go haywire trying to figure out where to obtain the fuel we need. People are always telling me, “I don’t eat, so how come I’m not losing weight?”
That’s the answer. Their metabolism is out of whack, and they need to get it back in order.
Supplements
If you eat a balanced diet with fruits, vegetables, grains, fish, and all the rest, you don’t need to take supplements. But how many of us really eat such a balanced diet?
And even if we do, because we are all predisposed for certain diseases and the aging processes, being proactive and adding certain supplements to our diet may be a good idea. But before popping supplements like candies from a bag of M&M’s, check with your doctor about what’s best for you. Some supplements can be toxic. Others may cause allergies or cross reactions with medications you may be taking. But there is no doubt that certain supplements can have specific health benefits and can lower the cost of health care at the same time.
An Important Word About Supplements
Many supplements contain active ingredients that can have strong effects on your body, and some supplements can interfere with prescription medicines. Always consult with your doctor or pharmacist before taking supplements.
I am particularly bullish on five supplements that have been well studied and are proven to support optimal health.
Omega-3 Fatty Acids
I love the omega-3 fatty acids. They are an important contributor to the improvement of human health. Some studies have shown that omega 3s are good for the prevention of heart disease, as well as for depression, rheumatoid arthritis, and asthma. You can get omega 3s by eating leafy greens and fish or by taking a fish oil tablet. Omega 3s assist with fat metabolism and help maintain a balance of good and bad cholesterol.
Calcium
Calcium is another very good supplement, specifically calcium with vitamin D. Calcium intake is an important factor in bone health and may play a role in the prevention of colon cancer, though it doesn’t appear to be the silver bullet that everyone hoped it would be. Research has shown that calcium supplements can significantly lower the occurrence of hip fractures among those aged 65 and older.
Folic Acid
Folic acid and folate are forms of a water-soluble vitamin B that occur naturally in leafy vegetables such as spinach and turnip greens, dry beans and peas, fortified cereal products, and some other fruits and vegetables. Folic acid supplements have been a lifesaver in the prevention of neural tube defects in children. They are also very beneficial for cell function and the prevention of heart disease.
Glucosamine
I also like glucosamine. It has good anti-inflammatory effects, especially for individuals with arthritis. It doesn’t prevent arthritis, and it doesn’t repair or rejuvenate cartilage, but I think it’s a very good supplement because it helps promote joint function and relieves the symptoms of inflammation and pain.
Other supplements that are thought to make a positive contribution to health include saw palmetto, the fruit of the fan palm, for men. Native Americans consumed it as food and used it to treat urinary and genital problems. Some research has shown that it could be effective for the treatment of an enlarged prostate in men. It increases urinary flow and has no known safety hazards.
