Top 10 nutrition strategies for reducing heart disease

Here's a nice summary of sensible dietary recommendations, courtesy of the CBC News website and nutritionist Andrea Holwegner.

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Nutrition plays a major role in reducing many of the risk factors for heart disease. Making healthy eating choices is not only important to keep your blood cholesterol levels and blood pressure healthy, it greatly influences your ability to manage a healthy weight and protect against diabetes.

1. Boost your intake of omega-3 fats. These fats improve heart health by making the blood less "sticky", which reduces the risk of heart attack and stroke. Omega-3 fats also lower cholesterol. The best sources of omega-3 fats are fatty fish, ground flax seeds, walnuts, and canola oil.

2. Choose healthy unsaturated fats. Unsaturated fats found in olive oil, nuts, seeds, avocados and fish are healthy fats that are good for us. Be sure to include a moderate amount of these in your diet, as they lower your "bad" or LDL-cholesterol.

3. Increase fibre-rich foods. Fibre found in whole grain breads, bran cereals, beans/legumes, and fruits/veggies help to reduce cholesterol and keep you feeling full longer. Soluble fibre, which is especially high in bran cereals containing psyllium, can help to reduce cholesterol levels when you eat it regularly.

4. Slash trans fats. Trans fats (shortening, hydrogenated vegetable oils) are found in some margarines and many packaged foods such as cookies, cakes, frozen meals, deep fried foods, and fast foods. The food label can help you determine how much trans fats are in a particular food. Aim to reduce or even eliminate trans fats from your diet since they not only increase the "bad" LDL-cholesterol but they also reduce the "good" HDL-cholesterol in our body.

5. Reduce saturated fats. Saturated fats increase the "bad" LDL-cholesterol in our body which negatively affects our heart health. To reduce your intake of saturated fats limit heavily marbled meats, remove the skin on poultry, and consume less butter, margarine and high-fat dairy foods.

6. Eat less simple sugars & refined grains. Sweets, soda drinks, desserts and many refined foods such as white bread and low-fibre grains can increase your triglycerides, and contribute to extra calories and lead to weight gain. These foods can also contribute to higher blood sugars if you have diabetes.

7. Watch alcohol consumption. While 1-2 glasses of wine per day has been found to be beneficial for your heart, you should be aware that excessive alcohol can increase your triglyceride levels, contribute to high blood pressure and also increase your overall calorie level and lead to weight gain. If you choose to drink, do so in moderation.

8. Reduce your calories (if you are overweight). Reducing your calorie intake can help you to lose weight if you are overweight. Research suggests that many people see a drop in their cholesterol levels, blood pressure and blood sugars by even losing a few pounds.

9. Cut down on salt. I don't think it is any surprise that most of us eat much more salt than required for health. Most of our salt comes from ready-to-eat, processed/packed foods, eating out, canned foods, and condiments. Limiting dietary sodium intake to 1,500-2,300 mg per day is recommended if you have high blood pressure. Remove the salt shaker from your table and be sure to read labels and choose lower sodium foods.

10. Learn about the DASH diet. The DASH (dietary approaches to stop hypertension) diet has been shown in research to lower blood pressure significantly. This eating plan emphasizes plenty of fruits, veggies, low-fat dairy foods, and reduced saturated fat. The DASH diet also includes whole grains, fish, poultry, and nuts and is low in red meat, sweets, added sugars, and sweetened beverages typical in North American diets.

Yes - you really are turning into your mother!

You know that old saying, about how a young man should look at his prospective mother-in-law, to see how his wife-to-be might look in the future? Turns out, there's some scientific validity to it....but only if the mother and daughter have similar appearances to start with.

A recent study from Loma Linda University Medical Center found that mothers and daughters who have similar facial appearances age in similar patterns. The team used 3-D cameras and computer modeling to examine the faces of 40 mother-daughter pairs. They found that the signs of aging, particularly volume loss in the lower eyelid, are nearly identical for both moms and daughters. Lookalike mothers and daughters, they discovered, share the way their skin sags as it ages.

The study's authors feel that these similarities could help guide a plastic surgeon, by offering a reasonably accurate "preview" of what may happen to the daughter's appearance, and could be particularly helpful for women who are between their mid-30's and 50, who are considering non-invasive treatments like Botox and fillers.

So - how can you keep yourself looking young for as long as possible? Eat healthy, protect yourself from the sun, and don't smoke.

Human interest: the popularity of skin lightening creams in India

Great article from BBC News on a surprising topic - the popularity of over-the-counter skin lightening creams in India.

It turns out, that "fair and lovely" is the current fashion there, in addition to being the name of one of the most popular creams!

Click here for the link.

How to prepare for the changes in healthcare

Well, it was a very exciting weekend for political junkies.
The president's healthcare plan passed the House, by an oh-so-narrow 217-212 margin. So, the Senate-approved (initial) bill will become law as soon as the President signs it.

What does this mean for you & me?

Well, some of the details will depend on what happens with the upcoming reconciliation process. Some tax changes, like the 10% tax on indoor tanning treatments, begin immediately; others don't kick in until 2014.

Changes that would occur this year include:
- Dependent children could remain on their parents' health insurance plans until age 26.

- Some senior citizens would get more help paying for drugs in Medicare.

- People with health problems that left them uninsurable could qualify for coverage through a federal program.

Here are some other resources you can read to start digesting the many changes, and start thinking about how it will affect you and your family.
1) Wall Street Journal (link)
2) Kaiser Family Foundation comparison charts (link2)

If you don't yet have a family physician, you may want to work on establishing a relationship with one, before things get too crowded.

Another tax increase hidden in ObamaCare

I was just reading the text of the proposed changes to the Healthcare reform bill. Hidden in the middle of dozens of pages is this gem:

IN GENERAL.—There is hereby imposed on the sale of any taxable medical device by the manufacturer, producer, or importer a tax equal to 2.9 percent of the price for which so sold.

Well guess what, people - Mr. Obama & company may have backed off on the 10% cosmetic surgery tax, but he's still sticking it to you with a 2.9% tax on implants and surgical supplies.

That's in addition to the additional 3.9% tax you'll be paying for any investment income. So, if you invested and "saved your pennies" like an honest, hard-working American, you might be penalized up to 6.8% for your cosmetic surgery!

This tax also would apply to pacemakers, stents, heart valves, cataract lenses, artificial hip & knee implants, motorized wheelchairs, and implantable defibrillators. As if these things weren't expensive enough!

It's the "Son-of-Bo-tax". Boo!!!

Fat grafting to the breast

Here's a nice piece by ABC News discussing fat grafting to the breast. (link)

The ABC story doesn't introduce any new groundbreaking facts, but is a nice summary.

Fat grafting to the breasts is a "work in progress". New enhancements, such as pre-treatment with the BRAVA system and use of fat-derived stem cells, are being studied to see if they can make a higher percentage of the fat survive the move from the donor area to the breast. After all, it would be very disappointing if the majority of the fat got reabsorbed over 3-4 months! I should have some updates on this technology after the 2010 ASAPS meeting in April.

Although newer studies seem to show fewer issues regarding fat injections with mammograms, fat grafting - even in the best of hands - can be lumpy, irregular, and somewhat unpredictable. The volumes transferred to the breast also tend to be small, about 200 cc (= 1 cup size) so it's probably not a replacement for conventional breast implants quite yet.

Time will tell.

Fun: Juvederm simulator

Ever wonder how you might look with a Juvederm treatment?

Now you can, with a web-based photo manipulation tool from Allergan, the makers of Juvederm. You can even upload your own photo!

While the simulation is not 100% perfectly realistic, it's certainly fun to move the sliders around on the screen, and watch wrinkles come and go!

Click here for the link.

Vitamin D: the under-appreciated wonder-vitamin?

We all think of Vitamin D as "the sunshine vitamin", something that's good for your bones and as a supplement in milk. It turns out that this humble vitamin may have a whole lot more going for it.

A number of scientific studies have been looking at the links between Vitamin D deficiency and various disease states, and the results are quite startling.

Low or deficient Vitamin D levels have been found in association with:
- obesity & pre-diabetes,
- heart disease and stroke,
- metabolic syndrome,
- high blood pressure,
- elevated cholesterol,
- neurodegenerative diseases, such as MS and Parkinson's
- certain forms of cancer,
- seasonal affective disorder (SAD),
- some autoimmune diseases.


Now, before you get too excited, association is not the same as "the cause". It's like saying red paint is found in association with fast Italian sports cars...it doesn't mean that the paint makes the car go faster, right? Similarly, taking supplements has not yet been proven to bestow these health benefits...but the linkage is extremely interesting. Many experts now feel that the recommended daily dose of vitamin D should be increased, but opinions vary on what the new level should be.

Studies are now underway, however, to investigate this very point - and in particular, whether vitamin D supplementation (2000 units per day) can result in measurable health benefits.

If there is a causal connection, Vitamin D supplements, which are cheap, widely available, and have few side effects, could be a big player in health optimization.

Nice write-up also in the New York Times (link)

Six New Jersey Women get Industrial Silicone Injections...and big problems.

Here's a story from CBS News - it belongs in the "You've got to be kidding me " file. These women had buttock injections from a bogus MD in a hotel room. With bathroom-type silicone caulking. In large volumes. This story did not end well.

Astute (no pun intended) readers of this blog should recognize several "red-flags" already.....


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Women Hospitalized After Fake Silicone Injections: 6 Individuals Thought They Were Improving Their Curves But Ended Up Getting Tumor-Like Infections Instead


J-Lo and Kim Kardashian have curves women would kill for. This may have been the shapely image six New Jersey women were trying to achieve when they got injections from bogus medical providers to enhance their behinds, but instead ended up in hospitals with severe tumor-like infections.

"The product used was, first of all, not manufactured with the intention to inject into the body," Dr. Steven Marcus of NJ Poison Control told CBS station WCBS-TV.

Health officials believe bathroom caulk may have been used in the injections. It's made from silicone and used to seal cracks in tubs and tiles in bathrooms.

Poison control officials said the women were lucky to be alive. "You could inject this into a vein, and then that substance floating in your bloodstream could damage your heart, your brain, you could have a stroke from it," Marcus said.

The women, five of them from Essex County, apparently got the injections in motel and hotel rooms. The Board of Medical Examiners was investigating to see if they all got it from the same unlicensed provider.

"I was thinking about doing that," for a more plump buttocks, said Joan Sorbino of Newark, but she's thankful she didn't. "Very scary," she said.

"If you have somebody whose entire buttock is injected with this material, you occasionally will need to do a fairly radical incision as if it were a cancer," said Dr. Mark Granick, chief plastic surgeon at University Hospital. "Plastic surgeons don't inject large volumes of anything in anybody. It's just not safe. You can have a buttock implant put in. Some doctors will do that, and buttock implants are also well-tested and relatively safe, although they do have a separate set of complications," Granick said.

With any kind of procedure, you should always check with the American Society of Plastic Surgeons to make sure your surgeon is legitimate.

(Dr. Fiala's note: In addition, only FDA-approved, medical-grade products should ever be used for any kind of injection. In general, for buttock augmentation procedures, I recommend fat grafting techniques or appropriately designed and approved buttock implants.)

WSJ: Plastic Surgery decreased in 2009

Nice summary of 2009 plastic surgery trends in the Wall Street Journal, showing the effect of hard economic times on elective plastic surgery volume.

I've reproduced it, below. I've added some editorial comments in parentheses.

In addition, you can see the latest ASAPS statistics on plastic surgery, by clicking the link here.

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By ANJALI ATHAVALEY, Wall Street Journal

The number of cosmetic-surgery procedures in the U.S. sagged for the second year in a row in 2009, according to an annual survey released Tuesday by a plastic surgeons' association.

There were 10 million surgical and nonsurgical procedures last year, down 2% from 2008, according to a survey of 928 board-certified physicians by the American Society for Aesthetic Plastic Surgery, a Garden Grove, Calif., group of plastic surgeons specializing in cosmetic surgery. (ASAPS is the largest, most important group of cosmetically-oriented plastic surgeons.)

Driving the decline was a 17% drop in surgical procedures, to 1.5 million surgeries. "People just couldn't go for the big items," said Renato Saltz, the association's president.

Tummy tucks, rhinosplasty and other surgical procedures can cost thousands of dollars more than nonsurgical measures, and they require a longer recovery. (But of course, the surgeries do much more than any non-surgical alternative.)

Indeed, fear of job loss is the main reason people are putting off their surgeries, says Phil Haeck, president-elect of the American Society of Plastic Surgeons, a separate group that has yet to release its annual survey. Dr. Haeck, a plastic surgeon in Seattle, said that marks a shift from last year when consumers cited cost as a primary hurdle. This year, "job priority is number one, cosmetic surgery is number two," he said.

Breast augmentation beat out liposuction as the most popular surgical procedure for the second year in a row. Dr. Saltz attributes renewed popularity of breast augmentation to the 2006 Food and Drug Administration decision to lift the ban on cosmetic use of silicone breast implants. Breast augmentations numbered 311,957 last year, down 12% from 2008; liposuctions numbered 283,735, down 17%.

Nonsurgical procedures, such as injections of Botox or hyaluronic acid to fill facial wrinkles, were flat, inching up 0.6% to 8.5 million.

Two surgeries are surging in popularity. Buttock lifts, which involve reshaping of the bottom, increased 25% to 3,024 procedures, and buttock augmentations increased 37%, to 4,996. Increasingly, people want to reshape their rears after losing weight, Dr. Saltz said.

The procedures, costing from $4,000 to $5,000, are fairly new, with both benefiting from recent technique improvements, he added. As the economy recovers, more baby boomers are expected to seek procedures, and more physicians will likely offer nonsurgical options. Surgical procedures have increased by 50% since 1997, while non-surgical procedures grew 231%. Places like health clubs and spas are already offering minimally invasive procedures. (Not recommended!) Cosmetic-surgery associations recommend that consumers seek out procedures that are conducted under the supervision of a board-certified physician.

They should also do research before going overseas for cheaper rates for surgical procedures, which physicians say is a growing trend. "Right now, there is not an association that verifies that the physician is appropriately trained to do what they are doing," said Dr. Haeck. "Very few of the countries where these are being offered have anything that approximates the rigorous boards in the United States." (Canada is one exception - their training standards are equivalent to the U.S.)

New Dysport promotion: save up to $150

Dysport, as most readers of the Plastic Surgery Blog know, is the new competitor to Botox. Like David taking on Goliath, they have announced an exciting new marketing promotion, called the "Dysport Challenge". It just started March 1, and runs until April 30, 2010.

It's actually quite a deal, especially if you are someone who likes the wrinkle-fighting effects of either Botox or Dysport.

Within 14 days after your first Dysport treatment, you must sign up for the Dysport Challenge, download your Dysport Coupon Rebate Form from dysportusa.com (link) and mail the rebate form and itemized receipt.

If you love it, you can get another $75 rebate on your second treatment of Dysport. Even if you didn't like Dysport for some reason, and prefer the effect of Botox, you can still get a $75 Rebate Check from Medicis, the makers of Dysport, on your Botox treatment!

Technicalities:
You must wait a minimum of 3 months between your first and second treatments.
First treatment must occur between March 1 and April 30, 2010.
Your second treatment must occur between June 1 and September 30, 2010.
Itemized receipts must be submitted with forms.

Study Shows Women Are More Prone to Facial Wrinkles Than Men

Findings from a study published in the November/December issue of Aesthetic Surgery Journal (ASJ) suggest that gender-specific differences in the perioral skin (skin surrounding the mouth) account for more and deeper skin wrinkling in women than in men.

“The aim of this study is to obtain new insight into the perception that women wrinkle earlier and more severely than men,” said the study’s lead author, Emma C. Paes, M.D., from the Department of Plastic, Reconstructive and Hand Surgery at the University Medical Center in Utrecht, Netherlands. “If we understood the reasons for differences in wrinkling between women and men, then we might be able to develop better strategies for the treatment of perioral wrinkles.”

The study found that all of the following could explain the presence of more and deeper perioral wrinkles in women:

Women’s perioral skin contains fewer sweat glands and sebaceous glands (microscopic glands in the skin that secrete an oily/waxy matter, called sebum, to lubricate skin and hair), which could influence the natural filling of the dermis (skin).

Women’s perioral skin contains fewer blood vessels and, therefore, is less vascularized compared to men, which could accelerate the development of wrinkles.

In women, the closer attachment of the muscular fibers surrounding the mouth to the dermis may cause an inward traction, thereby creating deeper wrinkles.

Current treatments for perioral wrinkles include the use of lasers & chemical peels, Botox injections, and injectable or implantable wrinkle fillers. Despite these many options, the effective treatment of wrinkles in the perioral region still remains a challenging problem.

“We think it's important to consider the reasons why a particular treatment may or may not be effective,“ said Dr. Paes. “Sometimes one has to go back to the basics... In the end, having more basic knowledge about a problem can speed up the process of finding the right solution.”

Source: ASAPS

Pick the best diet based on a genetic test?

Now that the Vancouver Olympics are over, it's time for me to get back to blogging! Here's an interesting story from ABC News about a new genetic test that may help people decide which sort of weight loss approach best fits their individual needs. While the testing is exciting, these results are still very preliminary, and further large-scale testing needs to be completed before I can endorse this approach.

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WASHINGTON (Reuters) - Can't lose weight on a low-fat diet? Maybe you need to cut carbs instead, and a new genetic test may point the way, maker Interleukin Genetics Inc reported on Wednesday.

The small study of about 140 overweight or obese women showed that those on diets "appropriate" for their genetic makeup lost more weight than those on less appropriate diets, researchers told an American Heart Association meeting.

"The potential of using genetic information to achieve this magnitude of weight loss without pharmaceutical intervention would be important in helping to solve the pervasive problem of excessive weight in our society," Christopher Gardner at Stanford University in California, who worked on the study, said in a statement.

Massachusetts-based Interleukin's $149 test looks for mutations in three genes, known as FABP2, PPARG and ADRB2.

The company says 39 percent of white Americans have the low-fat genotype, 45 percent have the type that responds best to a diet low in processed carbohydrates and an unlucky 16 percent have gene mutations that mean they have to watch both fat and processed carbohydrates.

The researchers randomly assigned around 140 women to one of four diets -- the low-carb Atkins diet, the ultra low-fat Ornish diet, the very low-fat LEARN diet or the more balanced Zone diet.

Interleukin went back and tested about 100 of the women for their DNA by using a cheek swab and then looked to see if the women on the "right" diets lost more weight.

MOST EFFECTIVE MATCHES

Over a year, people on diets appropriate to their genetic makeup, as determined by the test, lost 5.3 percent of body weight. People on mismatched diets lost 2.3 percent, the Stanford researchers told the meeting.

Cholesterol levels improved in line with weight loss, they said.

The company said the test looks for genes that affect metabolism.

"One of the gene variations affects absorption of fats from the intestine," Ken Kornman, chief scientific officer at Interleukin, said in a telephone interview. He said people with that particular mutation absorb more fat from their food and thus should avoid fat if they want to lose weight.

Another of the variations affects insulin response -- the body's production of insulin to metabolize sugar, he said. Simple carbohydrates such as sugar and processed flour stimulate people with that particular gene type to store more of the energy as fat.

Ten percent to 16 percent of people have both mutations, and must watch both carbs and fat, Kornman said.

"What we don't know is if they are on the right diet for their genotype whether it affects satiety or feeling full," he said. He said the company planned broader studies to ask these questions.

Interleukin markets the test under the brand name Inherent Health. It also can test who might best lose weight in response to exercise.