Presidential Healthcare center

We provide the same Preventive Executive Physical Program as received by the President of the United States.


Leave a comment

Can Compression Clothing Enhance Your Workout?

clothes 2In recent years, many people who exercise have begun wearing compression clothes. These snug-fitting socks, shorts, tights or shirts, which squeeze muscles as tightly as sausage casings, are reputed to improve performance during exercise and speed recovery afterward.

But a new study and several reviews of relevant research raise interesting questions about whether the garments really function as expected and help people to exercise better and, if they do, whether it is the clothing or people’s expectations doing most of the work.

The rationales for wearing compression clothing are logical enough. “The garments supposedly increase blood circulation and thus oxygen delivery for improved sport performance,”clothes 3 said Abigail Stickford, a postdoctoral researcher at the Institute for Exercise and Environmental Medicine at the University of Texas Southwestern Medical Center in Dallas, who led the new study of compression clothes.

The clothes also are thought to refine proprioception, which is someone’s sense of how the body is positioned in space. Better proprioception should, in theory at least, clothes 5improve the efficiency of movement and reduce the number of muscles that need to be activated, making exercise less tiring.

Meanwhile, the clothes also are believed to reduce fatigue and soreness after exercise by literally squeezing the muscles with a kind of no-hands massage and, by increasing blood flow to muscles, help to flush out unwanted exercise-related biochemical.

 

Source: The New York Times


Leave a comment

Off the Lifestyle Hook with Statins? Study Shows Weight Gain, More Calories Consumed

statins

Individuals prescribed statin therapy for high cholesterol levels have increased their caloric intake by nearly 10% and their intake of fat by 14% over a recent 10-year period, while no changes in eating habits have been observed among statin nonusers, a new study shows.

In addition, researchers report that individuals prescribed a statin had a larger increase in body-mass index (BMI) than those who weren’t taking the lipid-lowering medication.

Presenting their findings April 24, 2014 here at the Society of General Internal Medicine Meeting , the researchers say the study showed that statin users were consuming an extra 192 kcal per day in 2009–2010 than they were in 1999–2000, and this could have contributed to the increase in BMI, which was the equivalent of a 3- to 5-kg weight gain.

“Since the guideline recommends that patients should prevent weight gain, the observed increase in caloric intake and more rapid increase in BMI among statin users are of concern,” write Dr Takehiro Sugiyama (University of Tokyo, Japan) and colleagues in JAMA: Internal Medicine, where the study was published to coincide with the presentation. “According to the guidelines, people who receive statin therapy also should take steps to reduce fat intake, but we did not observe a pattern of combining statin use with dietary control.”

Dr Rita Redberg (University of California, San Francisco), the editor of JAMA: Internal Medicine, said she has treated many patients with statins over the years and has observed a “false reassurance” among those who receive the cholesterol-lowering medications. There is a perception, she writes, that “statins can compensate for poor dietary choices and a sedentary life.” The new data raise concerns of a potential hazard with statins, where the focus on “cholesterol levels can be distracting from the more beneficial focus on healthy lifestyle to reduce heart-disease risk,” suggests Redberg.

Using data from the National Health and Nutrition Examination Survey (NHANES), Sugiyama and colleagues examined the temporal trend in food intake among statin users and nonstatin users between 1999 and 2010. During this time period, the proportion of patients taking statins increased from 7.5% in 1999 to 16.5% in 2010. Statin users tended to be older, male, and white and have less education, a diagnosis of diabetes, and a higher BMI than their counterparts not taking statins.

In 1999–2000, statin users consumed 2000 kcal/day and ate 71.7 g/day of fat, both of which were significantly less than that consumed by individuals not taking statins. By 2009–2010, however, there was a significant increase in the number of calories consumed and the amount of fat eaten by statin users, whereas dietary habits were unchanged among those not taking the cholesterol-lowering medications. In 2009–2010, there was no significant difference in the amount of food consumed by statin users and nonusers, nor was there any difference in the amount of fat consumed. Similar findings were observed when the researchers restricted the analysis to saturated fat and cholesterol intake.

Regarding obesity, there was a 1.3-kg/m2 increase in BMI from 1999–2000 to 2009–2010 in the statin users and a 0.4-kg/m2 increase among statin nonusers.

Although the paper is limited by its cross-sectional design, Sugiyama and colleagues state that it is reasonable to conclude the average American treated with statins is eating more calories and more fat than the average American taking statins was doing a decade ago. At present, they can only speculate as to the reasons for this.

“One possibility is that statin use may have undermined the perceived need to follow dietary recommendations. Patients who recognized that their LDL-cholesterol levels were lowered drastically by statins may have lost the incentive to pursue dietary modifications,” write the researchers. “Physicians might have contributed to this process by shifting the focus of consultations from diet to statin regimen adherence once statin treatment had begun.”

Dr Mahesh Patel (Duke University School of Medicine, Durham, NC), who was not affiliated with the study, said the new analysis is interesting because it explores something that is rarely studied in medicine, that being the interaction between medication and lifestyle habits. However, he is cautious about making firm conclusions based on the data.

“It is tempting to conclude that patients prescribed statins adopted a more liberal diet than the individuals who were not taking the drugs, but the study only reflects population averages” and does not track the same patients over the 10-year period, he told heartwire .

Dr Sekar Kathiresan (Massachusetts General Hospital Heart Center, Boston) agreed with the need for caution. The analysis, which is based on a somewhat “sexy hypothesis,” tends to fit with people’s preconceived notions about the ill effects of medication use. The lament often heard is that people will simply abandon moderation when it comes to diet because they are now being treated with a statin.

“The flaw is that this is a nonrandomized, observational study, and the statin use might simply be marking a subset of patients who ate more over a 10-year period,” Kathiresan told heartwire . As such, the observational nature of the NHANES analysis makes it impossible to imply causality, whereby taking a statin had the unintended effect of people eating more. Like Patel, Kathiresan noted that the researchers did not follow the same group of patients from 1999 to 2010, a major limitation of the data.

Previous studies have shown that the use of statins is associated with a modestly increased risk of diabetes. Kathiresan said that an increased BMI might be one of the possible reasons for this association but again urged restraint about reading too much into the data.

Both Patel and Kathiresan agreed that physicians need to be vigilant in getting patients to understand their risk factors. To heartwire , Patel said that patients should be reminded “they are not off the hook because they’re on a statin and their LDL-cholesterol levels are better” and that physicians should not “let off the gas” once their patients are treated with a moderate- or high-dose statin as recommended by the clinical guidelines.

Source: Medscape


Leave a comment

Vegetarian Diet May Lower Your Blood Pressure

1352522323_6893_sweetpotsalad

Nearly a third of American adults have high blood pressure, also known as hypertension. Often called the “silent killer” because it provides few warning signs, hypertension increases a patient’s risk for heart attack and stroke. New research suggests eating a vegetarian diet could help combat this deadly disease. A healthy blood pressure is 120/80 mm HG. Previous studies have shown that each increase of 20/10 mm Hg in that number doubles the patient’s risk of cardiovascular disease. But lowering that top number just 5 mm HG can reduce your chances of dying from cardiovascular disease by about 7%. And eating more fruits and vegetables may be a good way to do that, according to the new study, published Monday in the scientific journal JAMA Internal Medicine.

In seven clinical trials, participants following a vegetarian diet had a systolic blood pressure that was 4.8 mm Hg lower on average than their omnivore counterparts’. The vegetarians’ diastolic blood pressure was lower by an average of 2.2 mm Hg. In observational studies, the difference was slightly bigger. A vegetarian diet was associated with an average decrease of 6.9 mm Hg for systolic blood pressure and 4.7 mm HG for diastolic blood pressure. Many factors could be affecting the vegetarians’ blood pressure. Vegetarian diets are often lower in sodium and saturated fats, while being higher in fiber and potassium.

vegetables

Vegetarians also tend to have lower body mass indexes because fruits and vegetables are less energy dense – meaning you can eat more of them for fewer calories. The definition of a “vegetarian diet” differs from person to person, so the researchers can’t tell you how much meat is too much. Some of the observational studies also did not adjust for lifestyle factors such as exercise or alcohol intake that could have affected the results. Eating more fruits and vegetables as part of an overall healthy diet could help lower your blood pressure, says study author Dr. Neal Barnard. You should also try to limit your sodium intake, exercise regularly and avoid drinking alcohol excessively.

Source: CNN