Monthly Archives: September 2011

Health Habits Top 10 List

'London to Brighton Bike Ride - British Heart Foundation' photo (c) 2010, Tilemahos Efthimiadis - license:

Every time we turn on the TV or pick up a magazine, I’m told to do this or don’t do that and, if I follow the guidance, it will decrease my risk of some horrible disease by 17% or 29%.

If I added up all the reductions in risk I would live to be 143. Kind of puts a whole new spin on the Social Security solvency issue. At the risk of ruffling a few feathers, I would like to suggest some order to the risk hierarchy. A logical starting place: if you plan to live a long time, and are actually doing something to facilitate it, start here:

1. Stop Smoking (or don’t start). This is the most researched and has absolute consensus in the medical community. Smoking cuts 5 or 10 years off your life. If you do only one thing to live longer, do this.

2. Diet – I am reserving the No. 2 slot for what you eat, not how much you eat.

If you want to live a long time, eat grains, fruits and vegetables and avoid meats of all kinds, especially red meat. This is also very well researched and causes a dramatic decrease in Cancer and Heart Disease – the No. 1 and No. 2 killers in this country. Your life expectancy will increase by 5 or more years from this.

3. Exercise every day. 20 minutes of some kind of exercise is the thing that will get you the most life for your time investment. Your life will be a few years longer, and perhaps more importantly you will be able to do more and feel better. The cancer and heart disease rates are lower in exercisers.

4. Treat lifestyle disease. We are talking hypertension, Type 2 diabetes and high cholesterol. Some of these are a result of excessive living, some just genetic roulette – blame your parents. Treating these illnesses almost completely neutralizes the dramatic decrease in lifespan they can cause. Treating these diseases can easily add a decade to you life.

5. Weight Control. The other shoe. Not what you eat, but how much. Excessive body weight contributes to hypertension, heart disease and cancer. This can easily take a decade off your life, and make the rest of it pretty unhappy.

6. Seat Belts. Protect yourself from an untimely death in a motor vehicle. There are about 40,000 deaths per year in the United States from motor vehicle accidents. Seat belts have added a bunch more years than vitamin C and the rest of the alphabet combined.

7. Deal with your depression. Depression measurably shortens life, but makes it feel way too long. The solution can be regular exercise, good friends or medications. The important thing is to do something about it. Living a long life takes the will to live – that means treat the depression.

8. Stay Married or Get Married. Married people have a measurably lower mortality rate then unmarried people. Sounds curious, but this is a well researched and reproducible fact. The subtype is a good marriage helps you live longer. Bad marriages do not. Make sure you know the difference (hint – if your spouse is your closest friend, you have a good one).

9. Sleep well. Insomnia and poor sleeping contribute to accidents, cardiovascular disease and poor health. Sleep apnea is one treatable culprit and can add years to your life.

10. Take Vitamins. This is No. 10 because vitamins have precious little good scientific evidence of extending your life. There are a couple of exceptions (like Niacin) but 98% are unproven.

So start at number 1 and go as far down the list as you can.

Take care

Dr B.

Marriage Tax Pay Off: Living a Longer Life

'Sanjeev's wedding' photo (c) 2006, Tom - license:’ve probably heard of the “marriage tax.” It amounts to something like $10,000 per year if filing jointly instead of individually. But what Uncle Sam “taketh away,” you perhaps make up thanks to a healthier lifestyle.

A significant reduction in “lifestyle disease” among married couples is no huge surprise. One just has to consider, perhaps wistfully, your single life for a few seconds to make this clear. Single people tend to live life at the extremes. There typically is more drinking, smoking, not sleeping or eating right, and in general fast-lane living among the unattached. We might want to blame this on youthful exuberance, but we also see this behavior rediscovered in divorced middle-aged people. Married folks tend to moderate each other’s behavior and consequently the lifestyle diseases such as hypertension, diabetes and heart disease are significantly reduced.

All manner of traumatic death is also dramatically reduced in the married population. With a little more sleep, and less alcohol, motor vehicle fatalities are much lower among married people. I gave up skydiving once I got married, perhaps saving me a violent end. Other violent deaths like suicide are also much lower. Depression, perhaps not coincidentally, is lower in people with a soul mate.

If cancer is one of your big fears in life, marriage is one of your best defenses. The lifestyle cancers attributed to smoking and drinking are all understandably reduced, most notably lung cancer.

Interestingly enough, the cancers having no obvious connection to any specific human behavior are similarly reduced in the married population. Lymphoma, leukemia and pancreatic cancer are examples. In fact, the fatality rate from virtually any cancer you can name is lower among the married.

Most startling to me during my medical education was the lower death rate in married people goes across the vast spectrum of human disease and frailty. Pick the wildest thing you can think of – death by shark attack, getting hit by lightening – and you are less likely to die of that while you are married.

So let Uncle Sam take his cut, the pay off is married people have a better chance of living a longer, healthier life.

Take care.

Dr B

Food Storage: When in Doubt, Throw it Out

There are 70 to 80 million people each year in the United States who get food poisoning, resulting in more than 100,000 hospitalizations and numerous deaths. Only 20 percent are attributed to restaurants and food workers.

Many cases of food poisoning are somewhat self-inflicted by poor handling and storage of food in the home. Proper food handling and storage is critical to keeping your family safe.

Handling your food properly as soon as it’s purchased means prompt and proper storage until it is ready for consumption. Raw meat products are a common source of food poisoning, so it’s important to avoid cross contamination with other products.

Effective refrigerator temperature is 40 degrees and freezers should be at zero degrees to ensure safe storage. Carefully store meats in clean, leak-proof bags, double wrapped tightly with suitable freezer wrap or plastic. Storing on the bottom shelf of the refrigerator will avoid possible dripping on other foods.

Fresh meats or fish should be consumed within one to three days. Five days can still be satisfactory for some whole products such as a roast or chops. On average, frozen meat products should be consumed within six months, and even sooner for products like ground beef. Some whole roasts can be safely frozen for up to 10-12 months. Even if safe, this pushes the limits of food product integrity. Monitor the temperatures in your refrigerator and freezer to ensure no temperature fluctuations are occurring due to mechanical malfunctions or weather conditions.

Make sure to check “use-by” or “sell-by” dates on food packages. Remember, these dates do not apply once the package is open even if restored properly. Best-if-used-by dates provide the most reliable information. They take into account normal handling and use of the product.

Any package that is new or leftover can get lost in the refrigerator. You cannot safely judge a food product by the appearance, smell or taste. If in doubt, throw it out! It is not worth the risk of consuming tainted food.

Condiments often remain open in the refrigerator for long periods and are easily forgotten. Storage of condiments on the door is a suitable location in the refrigerator by design. Even the few acidic condiments that may be safe for longer storage will lose integrity of quality and taste; they still should be replaced after two months.

Fresh eggs should always be stored in a protective carton in a more consistently cool area. Do not store on the door where they are subject to temperature fluctuations and breakage.

Fresh produce should be kept in perforated bags that allow air circulation and evaporation of moisture. Do not wash them before storage, the moisture will speed decay and decrease shelf life dramatically.

Except for selected items like a hard-aged salami or cheese that contain natural mold that can be trimmed or even safely consumed, moldy or questionably appearing products should be discarded.

Cleaning the refrigerator/freezer more regularly is important to avoid excess build up of bacteria. Clean spills as soon as they occur with a weak cleaning solution that will sanitize. Bananas, potatoes and onions should be stored in a cool dry place, not refrigerated.

Store leftovers of any kind in a clean, airtight container. Food you prepare should be refrigerated within two hours after cooking to avoid spoilage and development of excess bacteria. Repeatedly warming and cooling leftovers can allow bacteria levels to get dangerously high.

To avoid the possibility of food poisoning at home, remember the golden rule – when it doubt, throw it out!

Dr. Bruce Kaler

Just How Many Heartbeats Do We Get?

Talking recently about exercise and the heart, a really weird question came up. Sometimes those are the best questions, aren’t they?

Exercise makes the heart beat faster, so why doesn’t exercise wear the heart out faster? Why don’t you run out of heartbeats sooner if you spend a lot of time exercising? After all, the heart has a lot of moving parts – heart valves, blood vessels and muscle. These presumably wear out, like anything else, kind of like the 100,000-mile power train warranty on your car. After the warranty expires, you’re on your own …

So you Exercisers watch out, you might just shake something loose. Actually the heart is an absolute wonder of durable construction and last an astounding number of beats. Let’s play with some numbers.
How many beats do we get in a lifetime? If an individual averages 80 beats per minute, that’s 4,800 beats per hour, 115,200 beats per day, and more than 42 million per year, which calculates to roughly 3 billion if you live to age 72. When you think about them that way, heartbeats are the most precious commodity on the planet. Hate to waste ‘em.

Assume a really compulsive 40-year-old exerciser does something strenuous and aerobic five days a week for 30 minutes. He will drive his heart rate up to 160 beats per minute (220 – your age is maximum heart rate and we like to exercise at 65 to 85 percent of that).

The math works out to an extra 2,400 heartbeats per day on your exercise days. That is a 2 percent increase in heartbeats per day for those who are keeping count.

But exercisers have slow heart rates — not in the first week, but after a month or two. Let’s assume exercise brings your resting pulse down from 80 to 60 beats a minute, a pretty reasonable goal. The 72-year-old at the 60-pulse rate uses only 2.2 billion heartbeats. To put it another way, to use up 3 billion heart beats, at a pulse rate of 60, you have to live to age 95. Startling, isn’t it?

But lower pulse rate isn’t the whole story because your heart is living tissue, not a car. That’s a subtle distinction I know, but one that comes up every day in medical practice. A mechanic comes in with a cut hand that requires sutures. He thanks me for fixing it and I usually say, “you’re doing the hard part, I just got it pushed together. You are healing it.” A mechanic has to fix your car engine 100 percent or it won’t run properly. Cars can’t heal themselves, but people can.

Using your heart’s muscle makes it strong. You don’t wear tissue out by using it; you wear it out by not using it. So invest as little as 15 minutes a day in exercise and you will extend your warranty for more trouble-free years of body ownership. Get that pulse down to 50 and it takes 105 years to use up 3 billion heartbeats.

Take care

Dr B

In Praise of the Mighty Blueberries

Guest Writer: Timi Gustafson, RD

Blueberries have long been popular for their tangy flavor and multiple uses in desserts, yogurts, juices and baked goods. They also rank among the healthiest foods you can possibly eat. In fact, the list of possible health benefits from blueberries grows longer every year, as more medical studies uncover their incredible healing power.

'Blueberries' photo (c) 2011, Robert Benner - license:

Here is a short list of the more recent findings:

• Blueberries have been shown to shrink cancerous tumors and prevent the development and growth of cancer cells.

• Blueberries can slow down and even reverse age-related memory loss.

• Blueberries can help improve physical coordination and balance at an advanced age.

• Blueberries reduce cholesterol levels.

• Blueberries prevent urinary tract infections.

• Blueberries are low in calories and high in fiber, vitamin C and antioxidants, all of which makes them extremely nutritionally beneficial.

This seems a lot of punch to pack for such a plain little berry, but all these claims are backed up by growing evidence.

For example, a study conducted at Ohio State University in 2009 found that when lab rats with blood vessel tumors were fed blueberry extract, their cancer growth was halted and even reversed. The blueberry-fed rats lived on average twice as long as those that were given none. Blood vessel tumor is among the most common cancer types affecting young children and occurs in about three percent of all infants. Researchers hope that the use of blueberries may some day be part of the treatment of these usually inoperable tumors.

A separate study that was conducted in 2007 at Rutgers University in cooperation with the U.S. Department of Agriculture (USDA) found that a specific compound in blueberries, named pterostilbene, was able to inhibit the spread of cancer cells in the colon of lab rats. And in 2005, researchers at the University of Illinois reported that antioxidants in wild blueberries, called anthocyanins, could prevent certain cancers from forming and proliferating in the prostate and the liver. “Blueberries seem to have “cancer-fighting properties at all stages: Initiation, promotion and proliferation,” said Dr. Mary Ann Lila, the lead author of the study report. “Wild blueberry compounds offer a multi-pronged attack against cancer,” she added.

Blueberries have also been praised for their ability to reduce age-related deterioration of brain functions and memory. A research team from England concluded in 2008 that eating blueberries can actually reverse problems with memory and other cognitive functions. Almost ten years earlier, a USDA-sponsored study found that blueberries improved the physical coordination and balance in aging lab rats.

USDA researchers also reported findings of cholesterol-lowering properties in blueberries, based on animal studies they conducted in 2004. In fact, their experimentation showed that blueberries were more effective in lowering cholesterol levels than many widely prescribed cholesterol medications.

A 2004 study from Rutgers University confirmed that blueberries, like cranberries, can be helpful in preventing and healing urinary tract infections. A compound, called epicatechin, keeps infectious bacteria from attaching themselves to the bladder wall.

Besides these astounding health benefits, blueberries are also nutritional powerhouses. They are low in calories – one cup is 82 calories – high in fiber and loaded with vitamins, especially vitamin C. They rank among the top providers of antioxidants, which are essential to nutritional health. Antioxidants like anthocyanin, vitamin C, vitamin A, vitamin E and mineral selenium, and also copper (a highly effective anti-bacterial agent), zinc and iron (which raises hemoglobin and the concentration of oxygen in the blood), among other important micronutrients, boost the immune system and help to prevent infections.

In addition to its rich nutritional qualities, blueberries have the ability to neutralize so-called “free radicals,” which are unstable molecules that can cause many diseases and accelerate the aging process. This is mainly due to the concentrated presence of anthocyanin, the pigment that gives these berries their dark bluish color.

Some believers in the multiple powers of this “superfruit” think of blueberries also as an effective anti-depressant, although, to my knowledge, no conclusive research has yet been done in this regard. But it wouldn’t surprise me at all. I personally eat a bowl of blueberries every morning as part of my breakfast – and I haven’t had a bad day in a very long time. Maybe it’s the berries.

Timi Gustafson RD, LDN. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (, and at You can follow Timi on Twitter and on Facebook.

Coffee and Kids: Wonder Beverage or Devil’s Brew?

There has recently been a lot of talk about a very old beverage, coffee.

The occasion for this has been the admission by seemingly responsible parents that they actually give their young child a cup of coffee with breakfast. Egads – what is the world coming to?

With some guilt, I admit my 8-year-old had a cup with her Fruit Loops this morning, as she does most mornings. (Please don’t report me to CPS).

So is coffee bad for kids? The old cup-a-joe has a long and somewhat sordid history. Going back to the days of dirt and plague, coffee was associated with all manner of dark things, like most of what went on in the Middle Ages, with no scientific basis.

Yet coffee is one of the most studied beverages on the planet, not surprisingly as there are nearly 1000 organic chemicals in a cup of brew. Caffeine is the one that everyone talks about. This is an interesting chemical, a mild stimulant in the methyl xanthene family. This is closely related to adrenalin and medications that are used to treat asthma. Coffee is a well known bronchodilator. So coffee certainly isn’t bad for kids with asthma.

One of the other effects of coffee is to mildly raise dopamine levels in the brain. You’ve heard of raising dopamine in talking about antidepressants, like Prozac. In fact kids who drink a cup of coffee with milk per day have a significantly lower rate of depression. So coffee isn’t bad for sad kids.

Caffeine is a stimulant and recently parents of kids with attention deficit disorder have been experimenting on their kids.

The thought goes something like this: if the stimulant amphetamine helps kid with ADHD focus and concentrate, maybe a good cup of coffee will do the same. Funny thing is, it does seem to help. We don’t have any huge definitive studies to quote, but limited research shows coffee helps kids with ADHD focus and concentrate. It doesn’t help as much as Adderall, but it does help. For some kids, coffee is all they need. For other kids who don’t get enough benefit from medications, adding a cup of coffee helps. So coffee isn’t bad for kids with attention deficit disorder.

What about other kids? My daughter had a cup this morning. She isn’t challenged by ADD, or depression, thankfully. She just likes a cup in the morning like I do. Coffee doesn’t stunt your growth or hurt your development in any way we have found. It actually does some good stuff. Parkinson’s disease is reduced in coffee drinkers as is colon cancer, liver disease and Type 2 diabetes. All well proven. Early research on Alzheimer’s disease suggests its occurrence is reduced in coffee drinkers.

For those still thinking coffee is an adult only vice, I invite you to consider normal kid breakfast drink alternatives. What do your kids drink for breakfast? Popular orange drinks have many times the sugar of coffee. Other beverage choices have higher fat or cholesterol content. In this epidemic of obesity, nobody ever got fat on coffee.

So tomorrow morning when I pour my cup, I will cheerfully give some to my 8-year-old; she gets her own cup because I don’t like to share.

Take care

Dr B

The Quiet Revolution In Lighting

There has been little notice of the planned phase out in the United States of most incandescent light bulbs in the next two years. We are actually behind several other countries that are already well along in the process of replacing regular incandescent bulbs for LED and Compact Fluorescent lights.

The impetus behind this change is energy efficiency.

Florescent and LED lights are 4 to 10 times more efficient than incandescent bulbs. They also last much longer than incandescent bulbs. Most common incandescent bulbs – 40 watt through 100 watt – will be unavailable by 2014.

Thomas Edison is perhaps rolling over in his grave.

This change has been visible when we make semi-regular pilgrimages to the local hardware store. More and more shelves are filled with these funny looking spiral shaped bulbs (at 2-3 times the price).

Just the other day a company nurse asked me about the health effects to expect from increased exposure to florescent lighting. Health effects from florescent lighting, I asked nervously, looking over my shoulder at my office lighting. Perhaps a little research is in order.

It doesn’t take long on the Internet to find some ominous sounding quasi-scientific concerns regard fluorescent lightening. Let’s explore some.

Seizure risk: Fluorescent lights traditionally are driven by magnetic ballasts and flicker at 100 to 120 times per second. Like movies, which are a series of still pictures flashed on the screen at 24 times per second, almost all people are unable to perceive the flickering of the light (anything over 16 flashes per second is seen as continuous light). Theoretically the light flickering could trigger a seizure. This is more of a theoretical concern, than something neurologists are treating. Since compact florescent lights use electrical ballast, there is no flickering, thus no seizure risk.

Ultraviolet radiation: Ultraviolet radiation is often raised as a concern with fluorescent lights. UV light is emitted from some fluorescent lights in relatively greater amounts. There are a handful of rare dermatological conditions that have been suggested to be worsened by high UV emitting florescent lights. Even a few that are improved. The florescent bulbs can be constructed to emit various light frequencies for different applications. High output UV lights are used to simulate sunlight in aquariums, terrariums and tanning beds. The UV exposure approximates sunshine, perhaps useful for the “winter blues.” Florescent lights can be manufactured with double walls to eliminate almost all UV light. The color of the light is also becoming more of a choice; gone are the days of harsh blue-white light showing every skin imperfection. Florescent lights now are designed to emit a more amber glow, longer wavelengths, a light that flatters people and interiors.

Aside from UV radiation, which is completely manageable with light design, there is little evidence they will otherwise cause you injury.

After looking at risk from UV radiation, we quickly travel into so-called “emerging science.” That is a euphemism for information that is not explained by conventional scientific thinking. Not surprisingly, the diseases mentioned as having some possible connection to florescent lighting are among the least understood diseases. Autism and Lupus are examples of such diseases. There is no scientific support for such claims.

The wholesale change to florescent lightening may provide a few surprises, but not health ones.

So, I am not buying cases of incandescent bulbs to horde or sell on eBay. Florescent lights are well researched and improved in design every year. Your house and job will be a little more efficient for the change – and you might ultimately have a little more jingle in your pocket.

Take care,

Dr B