Health Topics


Closing Down and Signing Off


This website,, is closing down in a few weeks.  As editor I have found myself repeating the advice I've given regarding good health habits as you (and I) get older.  If you are thinking of looking elsewhere on the internet for health information, please consider WebMD, Mayo Clinic, and the National Institutes of Health websites as reliable sources; you should beware of any site that offers treatment advice without giving a link to trustworthy supportive data. 


Here's a message to some patients with left bundle branch block (LBBB).  Over the years you have developed a useful online support group in the Medical Questions section.  It would be a great pity if this conversation couldn't be continued on the internet. Would one of you with a Facebook account care to create a group where LBBB patients can go for practical information, advice, and encouragement? If that's possible, let me know and I shall try to email the link to other potential contributors.


Eating Right Can Reduce Your Risk of Dementia

You know what a healthy diet is and what’s unhealthy: vegetables, berries and fruits, fish, and unsaturated fats from milk products and spreads are all healthy, and sausages, eggs, sweet deserts, sugary drinks, salty fish, and saturated fats from milk products and spreads are unhealthy.  It’s hard (and more expensive) to stick to the good things, without going over to the Dark Side.  But it’s well worth it, as shown by a study from Finland, which is reported in detail in a published PhD thesis

The work attempts to analyze the role of diet in the development of dementia and cognitive impairment.  The idea was that a healthy diet at midlife might reduce the risk of mild cognitive impairment (MCI) and dementia (including Alzheimer’s disease) later in life.  Data were obtained from persons taking part in a large Finnish study on cardiovascular risk factors, aging and the incidence of dementia.  A series of analyses were made on different aspects of the topic.

Two thousand participants were selected from random population samples studied in 1972, 1977, 1982 or 1987 (for the midlife/baseline examination), when they were on average 50 (the range was 39-64 years).  Food frequency questionnaires were used to collect dietary information at this baseline.  Re-examination visits were carried out in 1998, with altogether 1,449 people (73%) aged 65-79 participating.

Using the healthy diet index, the researchers found that those who ate the healthiest diets at baseline had an almost 90% lower risk for dementia during the 14-year follow-up, compared with those whose diets were least healthy. 

In a separate analysis, a high midlife intake of saturated fats (from milk products and spreads) was associated with lower cognitive and memory functions and an increased risk of being diagnosed with MCI in a 21-year follow-up; whereas diets favoring vegetable oils, oil-based spreads, and fatty fish were protective, being associated with better global mental functioning and memory, and higher reaction and decision-taking speed.

Finally, the researchers found that drinking 3-5 cups of coffee daily was linked with a lower risk for dementia compared with consumption of more or less cups daily – an excellent example of a J-shaped curve effect.

It’s claimed that this study is the first in the world to investigate the relationship between a healthy diet in midlife and the risk of developing dementia in later life.  If confirmed in other studies, it should have a big impact on our middle-aged way of life.


Eating Grapes Regularly to Treat Knee Arthritis Pain?

I’m naturally suspicious of a publication that describes the effectiveness of a foodstuff when the research conducted is funded by a consortium of the foodstuff’s growers.  However, this post concerns the possible pain-relieving benefit of adding grapes to the diet to relieve pain in knee osteoarthritis sufferers, which is intriguing.  The information comes from a presentation at the recent Experimental Biology conference in San Diego, California, based on a study conducted by researchers from Texas Woman’s University.

A 16-week study was done in 72 men and women with knee osteoarthritis.  They were given a powder derived from whole grapes, or a similar-looking placebo powder, as a dietary supplement.  During the study serum samples were taken for biomarkers measuring inflammation (IL-1β) and cartilage metabolism (IGF-1).

Both men and women taking the grape-enriched diet had a significant decrease in self-reported pain in association with physical activity, and an overall decrease in total knee symptoms, compared with those taking the placebo powder. This beneficial effect was more pronounced in women. 

In participants under 65, those taking the grape powder had a 70% increase in their ability to undertake moderately strenuous activity, whereas those taking the placebo had a significant decrease in this ability over the 16-week period.  In those over 65 both groups – those taking grape powder or placebo - reported a decline in moderate to strenuous activities.

The marker for inflammation (IL-1β) was increased in both the grape powder and placebo groups, but the increase was less in the grape group.  Higher levels of an important cartilage growth factor (IGF-1) were seen in men, but not in women, consuming the grape-enriched diet compared with those in the placebo group. 

Osteoarthritis is a condition where the natural cushioning between joints – the cartilage – wears away.  This trial, together with lab experiments, suggests that the polyphenols in grapes may have a protective effect on cartilage cells. However, further well-controlled studies will need to be reported before too much importance can be attributed to these findings.  No matter - grapes are a pleasant, healthy fruit, and deserve a place in anyone’s diet.  If you’ve got knee pain, grapes won’t do harm, and might even help with the pain.


Lack of Exercise Is a Woman’s Biggest Risk Factor for Heart Disease

It’s estimated that smoking, high blood pressure, physical inactivity, and a high body mass index (BMI) are the leading risk factors for ill-health in Australia, and in most developed countries. To narrow this list down a bit, Australian researchers examined the relative importance of specific risk factors for heart disease in women.  They published their results in the British Journal of Sports Medicine.  Here’s a summary.

Data came from the Australian Longitudinal Study on Women's Health, where 32,000 participants were classified into 15 separate age groups, ranging from 22–27 (9,608 women) to 85–90 (3,901 women). The frequency of smoking was highest in the 22-27 age group, at 28%, and lowest in the 73-78 year-olds, at 5%.  Inactivity and high blood pressure increased steadily throughout, from 22 to 90 years; overweight (represented by BMI) showed the lowest overall increase – 46% in the youngest women, rising to 79% at 59-64, and then sinking to 62% at 85-90.

The scientists used a formula called the population attributable risk, or PAR, that indicates the percentage reduction in disease that would be achieved in a given population if exposure to a specific risk were eliminated.  Up to age 30, smoking was the greatest contributor to heart disease, with a PAR of 59%, but its contribution dropped to only 5.3% in women aged 73-78 (when smoking was uncommon).  On the other hand, low or no physical activity had a PAR of 47% in women aged 22-27, rising to 51% at age 31-36, and then declined gradually to 23.5% in women aged 85-90.  The greatest PAR for a high BMI was 33% in women aged 31-36, while the highest for high blood pressure was 11% in women 56-64.

Looked at another way, the data showed that, in Australia, if every woman between 30 and 90 were to exercise 150 minutes weekly at a moderate intensity, 2,000 middle-aged and older women would be saved from a cardiac death.  Just imagine how many US women could be saved if they started exercising.  Get moving!


You Should Eat More Fiber after a Heart Attack

After a heart attack, patients are urges to adapt a healthy lifestyle, and also exercise, reduce stress, and often take a variety of medications.  One simple change is to increase the dietary intake of fiber.  Increased fiber intake lessens the risk of cholesterol disorders, high blood pressure, obesity, diabetes, peripheral vascular disease, coronary heart disease, and stroke.  Physicians often urge their patients to increase their fiber consumption, but they may omit this simple lifestyle change in their post-heart attack recommendations. However, a study published in the British Medical Journal may change their minds.     

Data were obtained from the Nurses’ Health Study (121,700 US registered female nurses enrolled 1976), and the Health Professional Follow-up Study (51, 500 US male health professionals enrolled in 1986; in both, the participants answered detailed questionnaires on lifestyle and medical history every two years.  The 4,000-odd participants (2,258 women and 1,840 men) who had a heart attack (myocardial infarction, or MI) were analyzed with respect to their dietary fiber intake and mortality.  These subjects were classified into 5 groups, or quintiles, based on their post-MI fiber intake, and mortality was estimated for each quartile.

The highest quintile of fiber consumption had a 25% lower risk for cardiovascular or all-cause mortality; on average, 9 years after an MI the top quintile fiber eaters had a 25% lower risk of all-cause mortality than the lower quintile.  Overall, there was a 15% reduction in mortality risk associated with every 10-g/day increase in fiber intake.  The strongest association was observed for those consuming fiber derived from cereals and grains.  A strong benefit was also seen in people with the largest increases in fiber consumption after their MI.

These results were not unexpected, in view of the known benefits of fiber consumption.  But, as noted by the authors of the report, less than 5% of people in the U.S. consume the minimum recommended amount of fiber (25 grams a day for women and 38 grams a day for men).  You can find a list of the best sources of fiber, here.


Avoid Obesity by Living in the Mountains? 

The US Army and Air Force have provided good subjects to test the possible influence of high altitude on the likelihood of overweight people developing obesity.  In a study reported in the journal PLOS One, military scientists report the findings of a comparison of the effects of living at high altitude (more than 6,400 feet above sea level) vs. living below 3,200 feet.

Between January 2006 and December 2012 data were derived from all medical records of overweight enlisted service members in the US Army or Air Force stationed in the United States.  The focus of interest was on the number of subjects who progressed from ‘overweight’ (a body mass index or BMI of 25.0 kg/m2 or above) to ‘obese’ (a BMI of 30.0 kg/m2 or more).

After adjustment for BMI at enlistment, gender, race, age, and other factors, it was found that service members living at high altitudes had a 41% lower risk of progressing from overweight to obesity than those living a low altitude.    

Not surprisingly, the military scientists suggest further studies to determine the likely mechanism for this effect.  Hypoxia – low oxygen levels – is known to reduce food intake in rats and, possibly, in humans.  It’s probable that leptin, the appetite-control hormone, which is also increased by hypoxia, is involved.  It certainly appears, therefore, that living at high altitude, all other things being equal, is linked with a decreased appetite.  However, this is not a reason for overweight people to move to the mountains.  A possible decreased risk in obesity might be counteracted by the known increased likelihood of suicide in mountain-dwellers.


Can a Daily Glass of Milk Slow Knee Osteoarthritis?

It can, according to investigators at Boston’s Brigham & Women’s Hospital, writing in the journal Arthritis Care & Research.

The Osteoarthritis Initiative is a nationwide observational study of men and women, sponsored by the National Institutes of Health. It’s concerned with the prevention and treatment of knee osteoarthritis, and has already amassed a large amount of clinical data.  The Boston researchers examined 2,148 participants who had radiographic knee osteoarthritis, with 3,064 affected knees between them.  Dietary data, based on the Block Brief Food Frequency Questionnaire, was available at baseline. Using plain radiographs, the joint space width between the femur and tibia was measured. (This space becomes narrower as the disease progresses.)   The participants were followed up after 12, 24, 36 and 48 months.  After making allowances for possible disturbing factors, such difference in baseline disease activity or body mass index (BMI), the possible relationship between fat-free or low-fat milk intake and joint space narrowing was determined.

The participants were classified into 4 groups according to their weekly milk intake: none, 3 or fewer glasses, 4 – 6 glasses, and 7 or more glasses/week.  The average decreases of joint space in women for these 4 groups were 0.38mm, 0.29mm, 0.29mm and 0.26mm, respectively.  Interestingly, there was no such association between milk consumption and joint space decrease in the men participants. 

The investigators conclude that frequent milk consumption may be associated with reduced progression of osteoarthritis in women.  An editorialist for the journal points out that women are “particularly burdened by osteoarthritis of the knee which can lead to functional disability” and this may explain why the effect is seen in women, but not in men.  This not a very satisfactory explanation, but the findings in women are sufficiently interesting to spark further studies to confirm and try to explain the effect.  In the meantime, note that the milk used here was either fat-free or low-fat, and that cheese won’t work!


Laugh Your Way to a Better Memory

Researchers at Loma Linda University have studied the relationship between stress and memory, including the possible role of laughter in reducing stress.  Their findings were reported at the April FASEB meeting (Federation of American Societies for Experimental Biology).  Excess cortisol in the blood is a marker of stress, and causes a decrease in the number of neurons (brain cells) in the hippocampus that are associated with memory.  Since it’s well known that laughter can be a stress reliever, the study wanted to see whether humor could reduce cortisol-induced brain damage, and hence improve memory.. 

The study was designed to see the effects of humor on short-term memory tests of learning, recall, and visual recognition.  A 20-minute laugh-inducing video was shown to a group of healthy elderly individuals and a group of elderly people with diabetes.  A third similarly-aged group of volunteers was selected, but shown no video.  All the participants, who had an average age of 68, provided saliva samples for cortical determinations at the beginning and end of the study.  They also undertook before-and-after standardized neuropsychological memory assessments, using the Rey Auditory Verbal Learning Test (RAVLT).

The salivary cortisol levels showed borderline-significant reductions in the healthy elderly/video group, significant reductions in the diabetic/video group, and no changes in the control group.  The results for learning ability improved by 38%, 33%, and 24% in the first (healthy elderly/video), second (diabetic/video), and control (no video) groups, respectively.  Delayed recall improved by 44%, 48%, and 20% in the elderly, diabetic, and control groups, respectively; and visual recognition increased by 13%, 17%, and 8% in these groups, respectively.

These results suggest that the less stress someone has, the better their memory will perform, and humor may be a way to reducing stress levels.  A daily half-hour of TV’s “Big Bang Theory” (my personal favorite) might work wonders; it will certainly put you in a good humor.