Hypertension: The Silent Killer

Killer with gun
In clinic, a 45 year old man comes in for an office visit and his blood pressure was 150/90. He states he feels fine and is not worried about his blood pressure. He admits to working a high demanding job, always stressed about finances, eating processed foods on the go and finding himself staying up after a few drinks on the couch every evening. How many of you agree, he is young, without symptoms, so he shouldn’t worry?
Well, I said “Let’s talk high blood pressure!”.

High Blood Pressure is A Silent Killer

 
WHEN: You Wait Too Long
This silent killer sneaks into your body.  Insidiously, causes insult to the endothelial layer of the artery causing chronic inflammation and oxidative stress. Like a garden hose in the sun, your arteries get thickened, stiff and cracked. Now imagine hooking up your sun-weathered, fissured garden hose to a fire hydrant and watering your delicate flowers! Your damaged arteries carry precious cargo (oxygen and nutrients) to the entire body, most importantly, the brain, heart and kidneys (your flowers). Constantly running highly pressurized blood through them causes injury to your tender organs. High blood pressure causes severe damage leading to STROKE, HEART ATTACKS and KIDNEY FAILURE. Disabling diseases that lead to dialysis, heart failure and paralysis.
HOW: Do you know if you are a TARGET?
First time BP reading should be done in both arms, with arms bare, at heart level, with the appropriate cuff size. Always sit and rest for 5 minutes before taking your BP. 
Pre-hypertension: 120 to 139 / 80-89
Hypertension: >140/ 90
*For those aged ≥ 60 years of age unless diabetic or kidney disease: >150/90
Listen up! The risk of cardiovascular events increases 2.5 fold in women and 1.6 fold in men with pre-hypertension, so start early with prevention.
 
WHO: Watch Out For These Intruders!
1. Processed Food
Inevitably, every patient will say the same thing, “Doc, I don’t add salt to anything”. But alas, they fail to see that salt has already been added to everything for us. If it is processed, packaged, ready-to-eat or restaurant food then it is bad for blood pressure.
Ready for a quiz?
 Q1. Which one of these has the most sodium?
A. Totinos Pepperoni Party Pizza Frozen
B. 1 cup of boneless, extra lean ham
C. Two Ball Park Hot dogs
Q2. Do you read nutrition labels?
A. Yes, I line up all my food so I can see the labels
B. No, labels what labels?
(Answers: *ham 1684mg, pizza 1380mg,  hotdogs 1100mg. Your daily allowance is 2000mg/day.
 
 If it has a nutrition label, it is processed. Log your daily intake of food in an app or website like My Fitness Pal to keep track of sodium and make changes to real whole food.)
2. Stress, Sleep & Sitting 
Genes can load the gun, BUT lifestyle fires the bullets!
Stress, smoking, excessive alcohol, obesity, poor sleep and a sedentary lifestyle leads to a quick path to stroke and heart disease. Take the first step to identify your reasons for change and set a course to make it happen.
 
WHAT: What are your weapons to STOP your assailant?

1. Nutrition   

Follow a DASH diet (Diet Against Systolic Hypertension) with whole food and 8-10 vegetables & fruit.  Fresh is best, frozen is okay, but avoid canned food. Researchers found that the DASH diet was associated with a drop in Systolic blood pressure (SBP) by an average of 6-11 mmHg and DBP by 3-6 mmHg. And a DASH-like diet significantly protects against cardiovascular diseases (20%), coronary heart disease (21%), heart failure (29%) and stroke (19%).
2. Add Foods and Micronutrients
A) Potassium & Magnesium rich foods– sweet potatoes, oranges, milk, beans, spinach, bananas, tomatoes, nuts, seeds, green leafy vegetables and whole grains.
B) Calcium & Vit D3 rich foods-vegetables, fortified dairy products, fortified non-dairy products, and fish.
A) Teas such as parsley, hibiscus, dandelion
B) Foods such as beet root and garlic
C) Supplements such as grape seed extract, CoQ10
 
3. Lifestyle Changes
 Find time in the day to do deep breath work, or listen to music. Get at least 30 minutes of continuous aerobic exercise on all or most days of the week. Try out meditation, yoga, Tai Chi or Qi Gong to help reduce stress and increase exercise. Quit SMOKING! If you struggle with weight loss and daytime fatigue, maybe get a sleep study to rule out sleep apnea. Walking is free. Do squats in your kitchen, in front of your TV, dance in your living room. Make it fun, do it for yourself and find reasons why your health matters.
4. Prescription Medications
Seek the care of a board certified healthcare provider to partner with you. Medications can be an adjunct to a healthy lifestyle, not a substitution. Often, patients will feel that being on medications is like having a safety net and so they continue eating poorly, not exercising or managing their stress. Medications rig the system to lower the pressure, but bad habits are still causing inflammation leading to organ disease, accelerated aging, starving your cells of important nutrients. Medical treatment for high blood pressure MUST be paired with weight loss, good nutrition, exercise, stress reduction and elimination of tobacco and heavy alcohol products. 
There are no victims, only volunteers. You chose your diet and lifestyle, it didn’t choose you. I know, staying the same is easy. Change is hard. Change happens when staying the same causes more fear than the process of change. To climb any mountain, it is important to take the first step.  How are you going to start your journey to good health?

profile pic

The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine.
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

The Three Sisters: Ovaries, Thyroid, and Adrenals

three sisters (2)

On her annual visit, I chatted with a lady in her 50’s about concerns that many women have in their own lives. Over the last year, she has had more fatigue, weight gain, and trouble sleeping. She finds herself more irritable and quick to react. Her periods ended two years ago and she was happy when the night sweats and hot flashes subsided. Her desire for intimacy has steadily declined over some time.

So I would like to share our discussion as there may be other women who are also looking for answers to these symptoms.

Let’s start with a story about our Three Sisters : Ovaries, Thyroid and Adrenals.

Sister #1: The Ovary. She is passionate and unpredictable in her 40’s and 50’s. She is beautiful, free of her reproductive ties, and is looking forward to this new phase of her life.  So what is the secret to experience the best of life?

  1. Exercise (weight lifting and cardiovascular) can help restore bones and muscles, while releasing natural endorphins to counter the mood effects of menopause. Exercise can reduce the body fat % and  decrease estrogens made in fat (estrones) which are linked to developing breast, colon and endometrial cancer. Exercise increases adinopectin and decreases leptin resistance, hormones that can help with weight loss.  Make it fun by mixing it up with aerobic, weights, stretching, balance for minimum of 150 minutes a week.
  2. Diet rich in fruits and vegetables, including natural phyto-estrogens like yams, flax seed and fermented organic soy can help one through hot flashes and night sweats. Some studies show Asian women who eat a more plant-based, high fiber, low animal fat diet fare better than American women who may consume less fiber, more dairy and animal fats. Chinese and Japanese women, who traditionally consume a fermented organic soy-rich diet (miso, tempeh, natto), have a lower risk of breast cancer, heart disease, and experience less vasomotor symptoms than American women. Adopt a plant-based diet and cut out sugar, refined flour, pesticides, preservatives, high salt foods. Eliminate animal products as much as possible to help optimize your health. Always asking the question, “Does this food serve me?”.
  3. Proper sleep habits can also add another layer of health optimization. Studies show that poor sleep can decrease growth hormone levels which is a fat-burning hormone and increase cortisol that can lead to weight gain. Poor sleep leads to fatigue, irritability, difficulty with focus and memory, so make it a priority to work on your sleep!
  4. Mind-body exercises like yoga and meditation can calm the stress centers minimizing the agitation and reactivity. Simple breath work can down regulate the fight or flight triggers that create anxiety, stress and depression.

Sister #2: The Thyroid. She is the sensitive sister. When excited, she is full of energy, vibrant and a go-getter. In times of stress, she slows down, stays quiet, sluggish and is easily affected by chemicals, pesticides, radiation, mental stress and environmental triggers. She can be the cause of weight gain, fatigue, depressed mood, hair loss, constipation and sleep disturbances. So, since she is sensitive in her 50’s, let’s see how she can be optimized.

  1. Avoid Endocrine Disruptors  (reduce chemicals that mess with our hormones)
    1. Parabens in cosmetic and personal hygiene products – check out skindeep.org!
    2. Perchlorate competes with iodine found in drinking water, produce and milk.
    3. BPA and Phalates in plastic products
    4. Dioxins in animal products, (meat, dairy, fish)
    5. Pesticides and herbicides like Atrazine and organophosphates
    6. Heavy metals like lead, mercury and arsenic
    7. Perfluorochemicals in non-stick pans, water resistant furniture and clothing
    8. Glycol Esters in paints, cleaning supplies and Flame Retardants in furniture
  2. Answers to Food choices
    1. Non-fermented Soy products may interfere with thyroid medications
    2. Cruciferous vegetables like broccoli and kale would need to be consumed in very large amounts to interfere with your thyroid. These affects are reduced by cooking them and I still recommend them as their health benefits far outweigh risks.
    3. Minimize gluten, processed, and fatty foods
    4. Alcohol, caffeine and sugars
  3. Stimulate an under active Thyroid
    1. Yoga poses like ‘Shoulder Stand’ increase blood flow to the thyroid

Sister #3: The Adrenals. She is the easily-triggered sister. Always ready to fight or flight. At the first sign of confrontation, fear or worry, she gears up and releases hormones that drive up adrenaline and puts her on defense. She can be on edge, exhausted, stressed and agitated at times. She is an over-achiever and works hard during times of stress, sometimes to a point of exhaustion. So how do we reduce her stress and keep her calm?

  1. Breathwork- my favorite exercise is 4-7-8. Breath in for a count of 4, hold your breath for a count of 7 and then exhale through your mouth for a count of 8. Another easy way to breath is to imagine smelling roses through your nose and blowing out candles through your mouth. Connecting to your breath reduces vagal tone, shutting down the fight or flight reaction. Free tool and use anytime!
  2. Meditation- a few minutes of quiet reflection and spending time on our inner work can make us resilient to stress. Just like you wouldn’t wait to fall into a pool before you learn to swim, you don’t want to force meditation when you are in the throws of a stressful time. Take 5-10 minutes each morning or evening to quietly meditate. There are several free apps that can guide you through it. (Insight timer, Calm, Headspace, Take a Break).
  3. Moving Meditation like Yoga and Tai Chi- for those who cannot sit still, moving meditation like yoga, tai chi, dance, body tapping, toe tapping can help expend that nervous energy and calm the mind and body. Join a class or download a video to get started today.
  4. Guided Imagery- Kaiser Permanente has a free website called Health Journeys that provides free guided imagery tracks to help with visual relaxation. People who are very artistic and imaginative enjoy this type of guidance.
  5. Spirituality & Gratitude- spirituality is believing in something bigger than ourselves and living in gratitude. It dissipates anger, resentment and pain. Spending time in nature, pet therapy, music, art, dance or any activity that serves a positive purpose has healing powers.

Through life’s journey, let us learn from the women ahead of us and guide the ones behind us, so we all may benefit from the knowledge we have gathered along the way.  The road to a happy and healthy journey is found through nutrition, exercise, sleep, and spirituality. Every phase of life as a woman should be celebrated as it opens doors to a better self.

References: www.mayoclinic.org, www.ewg.org, http://www.drweil.com, http://www.healthjourneys.com, The Role of Soy Foods in the Treatment of Menopausal Symptoms J Nutr. 2010 Dec; 140(12): 2318S–2321S

profile pic

The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine.
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

Alzheimer Disease: An Novel Approach

Brain AgingIn clinic, I visited with a lovely lady with Alzheimer Disease. She was accompanied by her husband who has been a loving and supportive companion. He mentioned that she gets more agitated when reminded of things and often forgets conversations. She is also increasingly sensitive to criticism or perceived confrontation. Her daily function of self-care and short term memory continue to decline. A slow progression of mood and personality changes, difficulty with finding words, confusion on familiar tasks and disorientation of time, person and location. With a sad expression, he mentions her care has become progressively challenging.

Memory loss can be like trees in the fall, the inevitable fading of memories, difficulty in processing and unable to care for oneself. Alzheimer Disease has become the number one worry of baby boomers, surpassing cancer and heart disease. Here are natural remedies for slowing the progression.

1. Chronic stress causes elevated cortisol levels which causes brain death in memory and language centers of the brain (the hippocampus) and shortened telomeres leading to accelerated Alzheimer disease and aging. 

Meditation can cultivate brain healing for patients and their caregivers. Compassion can reduce stress, fear and anxiety that is caused by this condition.

Love & Kindness Meditation: Close your eyes, start with sending love to yourself. Put your hands on your heart and repeat 3 times wishing yourself to be happy and well. Then, think of your loved one and send all your love and warm wishes to them:

May you live with ease, may you be happy, may you be free from pain. 
May you live with ease, may you be happy, may you be free from pain.
May you live with ease, may you be happy, may you be free from pain.

3. Aerobic exercise increases blood flow to the brain and increases the production of nerve growth factors. Multiple studies show exercise lowers the risk of cognitive decline. Not only physical activities, cognitive stimulation is also beneficial. So crossword puzzles, music or art and mental training allows couples to spend quality time together and is better than computerized cognitive training.

 

A specific brain exercise called Kirtan Kriya has been clinically shown through PET and SPECT brain scans to increase global brain energy, cerebral flow, oxygen delivery and glucose use. Studies out of Harvard University show increased activity in the memory and language centers of the brain with meditation based on kriyas.

Repeat the following words, sitting with eyes closed, focusing between the brows:

Saa : touch your index fingers to thumbs

Taa: Touch your middle fingers to thumbs

Naa: Touch your ring fingers to thumbs

Maa: Touch little fingers to thumbs

2 minutes in a normal voice, 2 minutes in a whisper, 2 minutes in your mind. Then reverse with 2 minutes in your mind, 2 minutes in a whisper and 2 minutes in a normal voice. Total 12 minutes. Inhale deeply, stretch your hands above your head and bring them down in a sweeping motion as you exhale.

3. Nutrition plays a key role in Alzheimer disease.

A high sugar diet increases risk for Alzheimer disease. A study published in the New England Journal of Medicine in August 2013 demonstrates that even mild elevation of blood sugar — a level of around 105 or 110 — is associated with an elevated risk for dementia.

Eat real food, organically grown. Pesticides on crops have been highly linked to Alzheimer disease. JAMA Neurology published a study that found that patients diagnosed with Alzheimer’s had four times higher levels of the DDT metabolite DDE in their blood compared to people of similar age who do not have the disease. DDT has been replaced by glyphosate which has similar effects on the body.

Increase brain specific nutrients such has B vitamins (folate and niacin), Vitamin E, phosphatidylserine, Coenzyme Q10, ginkgo and omega 3 fatty acids.

An Integrative approach with medications, nutrition, exercise, stress reduction can help slow down the progression of memory loss improving the quality of life for the both the patient and his/her caregiver. Whole medicine models that incorporate meditation, stress reduction, spirituality and social connections are the way of the future, share this article with someone you love.

References: Integrative Medicine by David Rakel, Alzheimer’s Association, National Institute of Aging.

profile pic

The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine.
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

 

 

Train Like a Jedi to stop Stress Eating

yodaThe

Stress can have a powerful effect on our programmed brains, and negative emotions drives our minds to comfort food and sugar.  
So, you get an email from a demanding boss or a phone call from a needy family member or an argument with a spouse. You find yourself raiding the pantry or finishing off a quart of ice cream. Only later to feel guilty and self- loathing for once again finding yourself victim to stress eating. So your doctors, personal trainer and online health guru says eat less, exercise more, like you didn’t know that already?
Early brain programming triggers you to seek food to feed an emotion. How do you unlearn what you have learned?
Rewire Your Brain: My advice to my patients, practice Mindfulness to re-program your brain. In the past, we were told our brains were rigid or static. ‘You are what you are based on genes or childhood experiences. You can’t change your behavior or thoughts’. Current evidence shows that the brain is constantly changing with our new experiences, emotions and environment. There is a growing acceptance of neuroplasticity of the brain which means you can rewire your thoughts and there is hope to develop your Jedi skills!
‘These are the steps you are looking for’:
  1. Recognize- recognize the stress that is triggering you. Slow Down. Move in slow-motion. Pay attention. Identify the trigger, person, event, emotion that has just occurred. Are you angry, sad, hurt, thirsty, bored, anxious, guilty, sad, depressed? Write the event and the emotion it evoked.
  2. Remind- remind yourself of your goals and reason why you need to change. Ask yourself, ‘ Does this food serve my purpose?”.  Remind yourself of a health scare, a cancer diagnosis, heart condition, recent death of a relative. Change is difficult. Staying the same is easy and comfortable. Remind yourself what motivates you to change.
  3. Redirect- remove yourself from the situation or location. Change rooms, leave the home, find another activity to redirect your mind into a positive, uplifting activity. Replace the tempting food with a healthy alternative. Know the difference between false hunger and true hunger. In true hunger, even water tastes sweet. If you pass over the cucumbers for cookies it is false hunger. Take a 15 minute pause, set the microwave timer, paint your nails, take a shower. Give yourself time to let false hunger pass. Cortisol (caused elevated by stress) and Insulin (caused elevated by blood sugar) are both hunger-causing and fat-storing hormones. Remind and redirect.
  4. Repeat- ‘Rome wasn’t built in a day’. For continued success, it is important to repeat this process daily. Repeating the same behavior will create new neural networks in the brain and form a new path, reprogramming the previously learned behavior. These new behaviors will forge a stronger path becoming roadways, then highways and then superhighways in the brain fostering healthy coping skills.
Food is an integral part of our culture, family, and psyche. Embrace your relationship with food, love yourself with all your gifts and imperfections. Forgive yourself for any set-backs. We are all dynamic, individual beings reshaped daily by our experiences and emotions. Hopefully, reading this blog will re-shape your thinking in a positive way!
Join us for our weekly group visits for healthy eating and weight loss. Share this with someone you know or love who may benefit from this information.
The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine.
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

A Prisoner of Parkinson

Handcuffed hands of a prisoner behind the bars of a prison with orange clothes - Crispy desaturated dramatic filtered look

As a child of the 80’s and 90’s, I spent most of my evenings watching sitcoms like Family Ties, entertained by a lovable, charismatic actor – Michael J. Fox. Of course who can forget him in Back to the Future, Teen Wolf, Spin City and more, right?
Now imagine being imprisoned in your body, trapped by a movement disorder, your muscles contract uncontrollably. The contraction causes your body to twist involuntarily, resulting in repetitive movements or abnormal postures.
Forced into movements that imitates an uncoordinated dance. Shackled to a body that causes excessive sweating, tremor and spontaneous drop in blood pressure. Slowly losing your ability to walk, balance and perform simple daily tasks.
This week, I treated a vibrant, kind, intelligent man who developed Parkinson Disease in his 50’s. His spirit and sense of humor still shine bright. He is a prisoner of Parkinson Disease and every day he looks for ways to free himself from his chains. He asked me questions of Why, Who, Where, How and What can he do?
Why:
Havoc is caused by a dangerous prison gang- The Lewy Bodies.
The theory is a bad gang calling themselves Lewy bodies made up of clumped proteins, alpha-synuclein, invade and kill nerves in the brain slowly spreading disease as the disease advances.This abnormal protein has been found in the gut and in the brain of Parkinson patients.
Who:
Criminal Chemicals….  Farmers are at increased risk for Parkinson Disease. If you live in rural areas, frequency increases with exposure to pesticides, heavy metals, and drinking well water. Why? Parkinson’s is linked to Rotenone, a pesticide used in farming and a herbicide, Paraquat. Other chemicals such as Trichloroethylene, found in dry cleaning solvents, cleaning agents and metal factories have been linked to five-fold increase risk in Parkinson Disease.  (Neurology February 4, 2014 vol. 82 no. 5 419-426. )
Where:
Go to the GUT….  A recent study showed links between certain mixes of gut bacteria and a greater likelihood of developing Parkinson’s. (Cell Volume 167, Issue 6, p1469-1480.e12, 1 December 2016). Injecting gut bacteria from Parkinson’s patients into germ-free mice caused the mice to go from showing hardly any symptoms to deteriorating rapidly.
How:
Highway that is the Vagus Nerve….. The Super Highway that possibly leads these abnormal proteins from the gut to the brain is the Vagus Nerve. A nerve that carries messages back and forth, now implicated in playing a role in the development of Parkinsons. Recent study in Neurology showed severing this super highway (Vagotomy) led to a 40% protective effect in developing Parkinson disease.  (Neurology  April 26, 2017)
 
What can be done to improve quality of life:

1.       Exercise daily- Tai chi and yoga can help maintain and improve balance

2.      Massage daily- reduces and relaxes muscle tension

3.      Alexander technique- focuses on muscle posture, balance how to move

4.      Meditation daily- reduces stress and pain, improves well-being

5.      Music, Art, Pets- all forms of spiritual activities can help relax and improve mood

6.      Diet high in anti-oxidants and omega-3 fatty acids

7.     Reduce exposure to pesticides, heavy metals, industrial solvents, dry cleaning

8.     Improve the gut microbiome- diversify your bacteria with fermented foods

9.      Supplements for neuroprotection: Co Q10, Creatine, NAC, bacopa, cowhage, gingko, turmeric (check with your doctor if appropriate for you)

10.  Fall precautions

11.   Consume green tea 3/day

12.  Consult a neurologist for prescription medications and/or surgery

13.  Consider early detection with SPECT DaTScan or functional brain MRI

Parkinson Disease is a complex condition with multifactorial agents playing a role. Genes, environment, diet, microbiome, pesticides, toxins, cleaning agents, head injuries, all have been implicated in the disease.
We are what we eat, breathe, drink and touch. It is my intention to share information so we may improve our collective health through the spread of knowledge and information. Share with someone you know!
The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine.
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

What Small Towns and Probiotics have in Common

probioticsSo ever wondered if the probiotic capsules you diligently ingest daily are fulfilling the promise of ever-lasting gut health? Interesting that you ask! Let talk bugs 🙂

I come from a small town in Southern Illinois, and some of you may relate to small town U.S.A. where you have a local grocery store, hardware store, a post office and everyone knows your name!

Think of the colon as your home town. Some bacteria (Lactobacillis, Bifidobacterium, Streptococcus, Saccharomyces) were born in the colon, initially colonized through breastfeeding, vaginal birth or your surrounding environment as a newborn. They are here to stay. They own homes, own businesses, raising their families and have settled in your colon.

Bacteria from fermented food are like immigrants, moving into your town and bringing up the economy, diversity and buying up residence in your colon too. These are from fermented foods like yogurt, sauerkraut, miso, kimchi, kambucha etc. These beneficial bacteria keep your gut a healthy place and fight off harmful invaders like yeast and bad bacteria. Regular intake of these live foods have positive effects on your overall health. Coincidentally, they feed on fiber that we cannot digest called pre-biotic foods found in garlic, onions, artichokes, asparagus, chicory, bananas, wheat, oats, soybeans, jicama, burdock, inulin . These foods provide nourishment for the beneficial bacteria and keeps them from eating your gut lining which can cause inflammation and leaky gut :). These gut bacteria communicate with each other and with our cells affecting our immune system, mood, energy, nutrition, digestion, heart health and much more. The gut bacteria can shape our physique, weight and metabolism by influencing gene expression.

Just like any small town, bad influences can destroy the community. Some common factors that can have a negative effect on them are poor eating habits, chronic physical and emotional stress, lack of exercise, insufficient rest, frequent exposure to antibiotics, antacids and pesticides/chemicals in our food. Proliferation of bad bacteria and yeast can take over the gut causing havoc and disease, inflammation and illness. Our only defense is a healthy lifestyle and trillions of good hard-working bacteria.

Now, the Probiotic pill industry is a billion dollar industry and not all supplements are viable or beneficial.  Think of these bacteria as transient tourists. They come, they eat, they help the town and then they leave. They have long 3 day journey through rough terrains, acid and enzymes and don’t always make it or do you any good! That is why these are dosed in billions 🙂 One study of 14 brands found 93% were labeled incorrectly, 36% did not list all the strains, and 60% had contaminants. Another study tested 58 products and 62% did not have the dose it was supposed to and 29% did not contain the strains stated on the label.

Also, not all bugs are programmed to do the same job. Your town needs plumbers, electricians, doctors and you wouldn’t expect them all to do the same job? For example, Lactobacillus rhamnosus GG is good for diarrhea from infection or antibiotics in kids, Bifidobacterium is good for IBS, Saccharomyces boulardii is good for Clostridium difficile infecton. They also all live in different parts of town, some live on the lining, some in the lumen and require different pH levels. Be careful of probiotic cocktails with multiple strains since there are few studies to verify efficacy.  Also, cautionary use in patients with severe pancreatitis, immuno-compromised people and those with port/central venous access catheters.

Check reputable sources like consumerlab.com to verify your probiotic brand’s claims. Read the label and look for the USP and GMP seals. Look to see if the company participates in probiotic research.

Advice from a small town doc, eat fermented foods and grow your own produce so you get good bugs who plan to stay and foster a healthy, prosperous mind, body and spirit!

The light in me, bows to the light in you~ Namaste

profile pic

Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine. 

She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

Natural Supplements- Am I flushing my money down the toilet?

vitamins

So, I walk into the exam room to see my sweet, 78 year old patient holding a shopping bag full of vitamins and supplements in her lap.  She laid them out on the counter, a collection of colorful bottles at least 10, promising good health and vitality.

So how many of you can relate to having a cabinet full of supplements at home? Ever wonder if they are any good?

The majority of adults in the United States take one or more dietary supplements either every day or occasionally.  It can be a wonderful thing to supplement one’s health but it can also be elusive in creating unrealistic expectations. The words, ‘natural’ and ‘holistic’ with a promise of health benefits can sell quickly to the eager consumer. But all that glitters is not gold.

Here is what you need to know before buying a supplement:

  1. Check the OTHER Ingredients! Look for fillers (magnesium stearate), binders (gluten), flow agents, coating and glazes, gelatin, carrageenan, artificial flavors and colors, sugar, high fructose corn syrup, sweeteners, preservatives (parabens, benzoates, sorbates, sulfites), titanium dioxide and more.
  2. Use Evidence-Based Resources for Dietary Supplements. How do you know your product is legit? ‘Buyer Beware” – there are a few checks and balances. Look for this seal: 
    Good manufacturing practices (GMPs) for dietary supplements established by the FDA help ensure the product’s identity, purity, strength, and composition. These GMPs are designed to prevent the inclusion of the wrong ingredient, the addition of too much or too little of an ingredient, the possibility of contamination, and the improper packaging and labeling of a product. Facilities that manufacture dietary supplements are periodically by the FDA.
  3. Look for the USP SEAL of APPROVAL from independent organizations that offer quality testing. These seals of approval provide assurance that the product was properly manufactured, contains the ingredients listed on the label, and does not contain harmful levels of contaminants. These seals of approval do not guarantee that a product is safe or effective. Organizations that offer this quality testing include:
    1. U.S. Pharmacopeia- http://www.usp.org/
    2. http://www.ConsumerLab.com
    3. NSF International- http://www.nsf.org
    4. http://www.Labdoor.com
  4. Always be alert to the possibility of unexpected side effects, especially when taking a new supplement. The POTENTIAL for interactions is huge. It can interact with your current medications, increase risk of bleeding or affect your response to anesthesia in surgery. Just as you would not start a new prescription without expert advice, do the same for any vitamin or supplement.
  5. You might be over-dosing on the same vitamins. It is possible to have too of a good thing. For example, you may be taking Vitamin D3 in your multi-vitamin, your calcium supplement and a separate Vit D3 tablet, all causing toxicity from a fat-soluble vitamin. Supplements often have combinations of vitamins listed, look for overlap of the same vitamins in all your bottles. It’s important not to exceed the RDA without checking with your healthcare provider.
  6. The term “natural” doesn’t always mean safe. A supplement’s safety depends on many things, such as its chemical makeup, how it works in the body, how it is prepared, and the dose used. Dietary supplements do not require pre-market review or approval by the FDA. Different brands may have a different concentration or constitution of the same supplement making the effects less predictable and may increase risk of drug interactions. When making health claims, supplements are required to have this : “This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.” Please ask your doctor if it’s is right for you.

Talk with Your Health Care Provider

I ask our patients to bring all their dietary supplements, teas, tinctures and medication bottles to their visit. Make this your practice going forward. Have an open conversation with your doctor and ask them to help you determine which supplements, if any, might be valuable for you.

Supplements can’t take the place of the variety of foods that are important to a healthy diet but the right ones can help augment your deficiencies and optimize your health. Consider a micro-nutrient test like Spectracell or Genova Labs to identify your nutritional deficiencies. A targeted laboratory approach may prevent unnecessary supplements and help your wallet and health in the end!

The light in me, bows to the light in you~ Namaste

profile pic

Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016 and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine. 

She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

How to Shop Healthy on a Tight Budget?

farmers market

In clinic, I was discussing with a young mother the struggles of affording healthy food. She had two little kids under the age of 5 and had a tight budget. She said that breakfast was typically a fruit-colored or sugary cereal bought in bulk, they made lots of pasta, sauce from jars, mac & cheese and frozen processed meats and pizzas. Often they made trips to a local fast food restaurant, usually more than once a week. She mentioned that snacks were typically packaged cookies and chips, usually brand names.

So, frequently patients will share the misconception that it is too expensive to eat healthy. Unfortunately, the price to pay will be later in healthcare bills and prescriptions. Stretching your dollars to feed a family can be difficult. Just a few savvy shopping tips may help your wallet and your health!

  1. Farmer’s Markets! Weekend trips to a farmers market can yield the freshest, locally grown, in season produce that is dirt cheap. (I personally love Singh Farms in my area). Organic produce that is locally grown is not only amazingly healthy but also inexpensive compared to supermarkets. Remember, you are paying less for a fruit or vegetable that hasn’t traveled half way around the world. To find a farmer’s market closest to you visit  the USDA site.  https://www.ams.usda.gov/local-food-directories/farmersmarkets
  2. Cook in Bulk! Plan your meals in advance. A meal can stretch to two or three meals when you make large stews, soups, lasagna, chili, casseroles, stir-fry, burritos or salads. Rather than buying pre-cut veggies, buy in bulk and cut them up yourself- much cheaper! Better yet, make it a family activity and divide up the prep work. Families that cook together, eat together 🙂
  3. Buy Less Processed Junk Foods!  Despite this big misconception, boxes of processed cereal, cookies, chips, fruit snacks, shredded cheese, frozen waffles, soda and juice will rack up quickly at the register.  Not only do these foods have no nutritional value,  they add chemicals and sugar to your body and they kill your budget. A more frugal option is to buy in whole oats, millet, barley, lentils, nuts, brown rice, frozen fruit and vegetables, canned beans and whole grain flour. You can buy them in larger quantities, they keep for long time and they are a much cheaper option.
  4. Replace your Meat! The biggest ticket items are usually meat, dairy and grains. Try protein alternatives once or twice a week. Add in canned fish, eggs, beans, legumes and whole organic tofu to your dishes.
  5. Don’t Buy Brand & Get Coupons! Marketing ads has programmed us for brand recognition. We seek the familiar brands and pay the extra price. Read labels, compare, download coupons and become a savvy shopper. Buy things in season and look for sales. Buy your favorite items in bulk when they are on sale and freeze them.
  6. Frozen is Good! Vegetables and fruit in the freezer section maintain their nutrient value so if you can’t buy fresh, buy frozen. It’s great for cooking, smoothies, topping on your oatmeal or yogurt. And you can buy them in bulk!
  7. Pack Your Lunch! Lead by example! Encourage your co-workers to bring sack lunches. Cook at home too, skip the trips through the drive-through and eating out. Eating out is very expensive. If you cook in bulk, left overs are a great way to save money and stay healthy and make great lunches. Set an example for your kids and pack your lunch starting today.
  8. Grow your Own Food! Okay, so you knew I would recommend you grow your own food 🙂 Home grown food tastes so much better and seeds are cheap. A great activity with your kids and teaching them where food comes from and building good habits. Small indoor pots are affordable and rewarding if you lack outdoor space!
  9. Make a List! Impulsive buys can add up quickly. Plan your meals and stick to your list. Stay on the perimeter of the store, buy whole and fresh. Stay away from the middle aisles which will tempt you to buy processed, pre-packaged expensive items.

Often I hear the same excuses, “the kids won’t eat it”, “my husband needs his treats”, “it’s easier to eat out”. If saving money is a priority in your household and improving the health of your loved ones, convince your family to try the above recommendations. Bad food leads to bad health, foul mood, weight gain, low energy and bigger medical bills. Your health is worth investing in!

The light in me, bows to the light in you~ Namaste

profile pic

Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016 and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine. 

She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

stop-bullying-4

 

Last week in clinic, a young patient explained how they were being bullied in school playground by other kids who would harass, point and laugh. It broke my heart to hear this story and others who are silently suffering from these despicable acts.

Bullying is not just for playgrounds anymore, social media has become an active, virtual playground for children to vent their frustrations and project their anger onto others. Though, Cyberbullying may seem harmless and can be a form of entertainment, it can create lasting harm in the person it is inflicted upon.  Ongoing cyberbullying is a threat to both victims and bullies in creating greater risk for anxiety, depression, and other stress-related disorders.

“Cyberbullying” is when a child, preteen or teen is tormented, threatened, harassed, humiliated, embarrassed or otherwise targeted by another child, preteen or teen using the Internet, interactive and digital technologies or mobile phones.

A recent published study, showed that children who were exposed to the most persistent bullying were associated with 2 to 3 fold increase in risk for suicidal behaviors. Associations of childhood bullying victimization with lifetime suicidal behaviors among new U.S. Army soldiers. – Depress Anxiety. 2017 Apr 3. doi: 10.1002/da.22621.)

As parents, what can you do?

  1. Watch for signs to see if your child is being bullied:
  • being emotionally upset during or after using the Internet or the phone
  • being very secretive or protective of one’s digital life
  • withdrawal from family members, friends, and activities
  • avoiding school or group gatherings
  • slipping grades and “acting out” in anger at home
  • changes in mood, behavior, sleep, or appetite
  • wanting to stop using the computer or cellphone
  • being nervous or jumpy when getting an instant message, text, or email
  • avoiding discussions about computer or cellphone activities

2.  Show compassion and listen to your child. Share stories about your childhood experiences. Tell them you are proud of them for coming forward and that it is not their fault and they are not alone. Encourage them not to engage with the bully but keep a record of all online activities for future evidence. Let your child know that you plan to bring it up to the school i.e head of school, teachers, counselor.

3. Set Limits. You can set online parameters to block the bully, limit tech time for your child and know your child’s online world by ‘friending them’ or following them on social sites. Set them up with counseling so they can receive help for the stress they have encountered.

4. Keep evidence of cyberbullying. Record the dates, times, and descriptions of instances when cyberbullying has occurred. Save and print screenshots, emails, and text messages. Use this evidence to report cyberbullying to web and cell phone service providers. Report cyberbullying to the social media site so they can take action against users abusing the terms of service.

5. Report cyberbullying. When cyberbullying involves threats of violence, child pornography or sending sexually explicit messages or photos, taking a photo or video or someone in a place where he or she would expect privacy, stalking and hate crime it is considered a crime and should be reported to law enforcement.

6. Set a good example yourself.  Model good online habits to help your kids understand the benefits and the dangers of life in the digital world. Once adults become involved, it is considered cyber-harassment or cyberstalking, a crime that can have legal consequences and involve jail time.

7. Make sure your child is not a Bully. Bullying in any form is unacceptable.  Severe, long-term, or frequent cyberbullying can leave both victims and bullies at greater risk for anxiety, depression, and other stress-related disorders. Unfortunately, these kids are at a higher risk for suicidal thoughts, attempts, and completed suicides.

8. Get Help. If you know of anyone who is feeling hopeless or thinking of suicide, contact the National Suicide Prevention Lifeline online or at 1-800-273-TALK (8255). The toll-free call goes to the nearest crisis center in our national network. These centers provide 24-hour crisis counseling and mental health referrals.

The light in me, bows to the light in you~ Namaste

profile pic

Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016 and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine. 

She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

Increased Suicidal Risk Associated with Childhood Bullying

Can Food Be Medicine?

In clinic, I saw a young teenage girl suffering from chronic abdominal pain, bloating, gas and alternating explosive diarrhea, urgency and constipation. It had been going on for months. It was affecting her school work, energy levels, focus, and mood. Her check up and the blood tests were normal. Parents are told everything is normal?

Young woman in pain

I see this many times in the clinic. A young patient has gastrointestinal symptoms and the full medical work up does not reveal any pathologic findings. She gets labeled with IBS (irritable bowel syndrome). This leaves a frustrated and discouraged family to carry on their lives with no valuable treatment solutions. So why is food not considered medicine when we seek medical treatment? Why have we become so dependent on a pill, an antibiotic or a procedure as the only medical solution.  Food is Medicine. It’s time to change that mindset!

So my simple solutions:

  1. Find the ROOT CAUSE- sometimes it is as simple as being Sherlock Holmes. Elimination diets are great and cost nothing. Start a food log and eliminate one food at a time. Common triggers are gluten, dairy, sugar, processed foods, artificial sweeteners, fruit juices, dyes, preservatives, and prepackaged meals. If you can’t pronounce it or find it in your pantry, don’t eat it or drink it. Cleaning the gut can take months so be patient, one week isn’t enough to give up!
  2. Choose GUT FRIENDLY FOODS- high fiber foods, pre-biotics and probiotics when the bowel is acutely inflamed can be rough on the stomach and can make gas, bloating, cramping and diarrhea worse. Especially if there is inflammation, malabsorption and dysbiosis. Start with a gentle gut healing diet like a low FODMAP diet. (fructose (when in excess of glucose), fructans, galacto-oligosaccharides (GOS), lactose and polyols (eg. sorbitol and mannitol). It makes it easier for the bowels to heal without the additional stress.
  3. Avoid certain MEDICATIONS -common side effect of some medications can be abdominal pain, diarrhea or constipation (antibiotics, narcotics, antacids). Even natural supplements like Vitamin C, aloe and magnesium can cause diarrhea.
  4. Manage STRESS- the mind and body are connected as one. Every illness can be traced to an initial stress. As long as the mind is not at rest, the gut may not heal. Work towards breath work, meditation, guided imagery, exercise, connecting with friends and having fun.
  5. Work towards a HEALTHY DIET- once the gut has calmed down, adding in more fruits and vegetables, pre and probiotics via foods is a great idea. If symptoms reappear, then step back and reassess potential triggers. Eat natural, whole and organic when possible. Eat a more plant based diet. Red meat and processed meats like hot dogs, sausages and cold cuts have been classified by the World Health Organization as a Class 2 Carcinogen, same as cigarettes. So rethink your sandwich meats and school lunches!
  6. Additional WORKUPS that may help- allergy and food sensitivity/gluten testing, SIBO or small bowel overgrowth testing, Comprehensive Stool Analysis for malabsorption, dysbiosis or infection. Micronutrient testing for deficiencies like ZINC can be the cause. These can be outside of insurance coverage and expensive at times. So do 1-5 first!

The gut is a wonderful, tropical rainforest with lots of species of bacteria living in a nutrient rich environment sharing a symbiotic relationship with us. Just like the outside world, if we pollute the space they live in, poison the cells and food supply, these bacteria die and become sick which in turn makes us sick. Teach your kids to nourish their bodies with good, healthy, whole food so they can remain healthy inside and out. Food is Medicine!

The light in me, bows to the light in you~ Namaste

profile pic

Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016 and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine. 

She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

Find Jyotipatelmd on Facebook & Twitter & Instagram