Another Risk For The Obese!

Obese people are more likely to develop heart disease, stroke, high blood pressure, high cholesterol and even certain kinds of cancer. A recent study reported on January 21, 2013 in ‘Emergency Medicine Journal’ that they are also facing a much higher risk, up to 80 percent, of dying in a car collision compared with people of normal weigh.

Using the United States databank on road accidents, the Fatality Analysis Reporting System (FARS), researchers from the University of California at Berkeley and the University of West Virginia dug out data from 1996 to 2008, covering more than 57,000 collisions that involved 2 cars.

They only looked at cases in which both parties involved in the collision had been driving vehicles of similar size and types. The final dataset used covered 3,403 pairs of drivers. Almost half of these drivers were of normal weight, 1 in 3 was overweight, and almost 1 in 5 (18 percent) was obese.

The risk of fatality against victim’s estimated body mass index (BMI) were compared. BMI is used to assess whether a person is fat and is calculated by dividing one's weight in kilograms by the square of one's height in meters. An adult is said to be of normal weight if his or her BMI is between 18.5 and 24.9. Below this range, this person is considered underweight; between 25 and 29.9 is considered overweight, and 30 and above is obese.

After taking into account of factors like age and alcohol use, the researchers found that underweight drivers had higher risk of 19 percent compared to those of normal weight. The increased risk was 21, 51 and 80 percent respectively for those of BMI between 30 and 34.9, between 35 and 39.9, and those who were extremely obese with BMI of 40 and above. Obese women were at even higher risk. Among those of BMI between 35 and 39.9, the risk of death was double compared with people of normal weight.

According to the data from hospitals’ intensive-care units, obese victims in the car accidents tended to have more chest injuries and fewer head injuries, were likelier to have more complications, required longer hospital stays, and were likelier to die of their injuries. The obese drivers were more likely to leave the seatbelt unbuckled or partially fastened because it is uncomfortable. Another reason could be the passenger vehicles are well designed to protect normal-weight vehicle occupants but not for overweight or obese patients.

Taking into account of the fact that more than 33 percent of adult men and 35 percent of adult women are obese, the ability of passenger vehicles to protect overweight or obese occupants may have increasing important public health occupations.

Are People Still Consuming Too Much Salt?

Being one of the oldest food seasonings, salt has 2 major components: sodium and chloride ions. Salt is needed by human body to perform a variety of essential functions. Besides helping maintain fluid in the body cells and transmitting information in the nerves and muscles, salt can also be used in the uptake of certain nutrients form the small intestines.

While human require only a small quantity of salt each day, the salt consumption has increased to a level that is harmful to the body. Statistics showed that most Americans eat more than twice the recommended daily allowance of sodium.

Excess intake of sodium can lead to hypertension (high blood pressure), which in turn is a major risk factor for stroke and heart disease. About 80 percent of the sodium consumed by Americans is from restaurants and food manufacturers.

Despite the urge by health experts to cut salt intake for better health, the amount of salt found in processed or fast food is still high, according to a study that was published online on May 13, 2013 in the ‘Journal Of The American Medical Association’.

The findings showed that there was little change in terms of sodium content in sample of 480 processed and restaurant food from 2005 to 2011. The sample is only a small percentage of the thousands of foods in restaurants and grocery stores.

Though some products like sliced cheddar cheese and canned tomato soup did show decreases, others showed increases. Restaurant French fries, cheese pizza, whole-wheat bread, Caesar dressing, and barbecue sauce were found to have higher sodium in 2011 than 2005. A decrease of at least 30 percent was found in some of the products studied, but an increase of at least 30 percent was found in a greater number of products.

As suggested by some research, lowering salt intake could save up to 150,000 lives a year in the United States. There are, however, different views on whether consumers should cut sodium or whether the food industry should face tighter regulations.

Judge by what the new study has revealed, it seems that voluntary approach has failed. The food industry has not been making much changes. Hence, the researchers urge government to step in to protect the public by imposing regulations on the food industry. Otherwise, it is estimated that at least one million deaths and $100 billion in health-care costs will be incurred in the coming decade.

Can Tomato Cut Stroke Risk?

Intake of fruits and vegetables and levels of serum carotenoids have been tied to lower risk of stroke but the so far the findings have been inconsistent.

To examine if serum concentrations of major carotenoids (alpha-tocopherol and retinol) were related to any stroke risk in men, researchers from various institutions in Finland looked at 1,031 Finnish men when they were first enrolled in the study in the early 1990s.

These men, aged between 46 and 65 years old, were part of a larger study examining at risk factors for the development of cardiovascular disease (heart disease and stroke). The findings were published in the October 9, 2012’s issue of the medical journal ‘Neurology’.

When the study began, blood levels of lycopene, alpha- and beta-carotene, and Vitamins E and A of these participants were measured. 7 years later, same measurements were done for most men. The men were followed an average of 12 years.

During the follow-up period, there were 11 strokes among the one-quarter of men with the highest lycopene levels, compared to 25 among the one-quarter with the lowest levels. Even after taking into accounts of some major factors that affect stroke risk, like smoking, high blood pressure and diabetes, the high-lycopene group still had a 55 percent lower risk of suffering a stroke.

The study had some limitations, though. For instance, it lacked information on the men's overall diet habits that might explain why lycopene was linked to lower risk. The findings did, however, support the current advice to get plenty of fruits and vegetables, and reinforced the prevailing recommendations for people to get a well-balanced diet, with fruits and vegetables.

Lycopene is a chemical that gives a reddish hue to foods like tomatoes, red peppers, watermelon and papaya. It is a potent antioxidant that helps protect body cells from damage that can ultimately lead to disease. Research also suggested that lycopene might help fight inflammation and blood clots better than other antioxidants.

But in cutting stroke, diet does play an important role. The so-called “DASH” diet, which has been shown to reduce blood pressure and cholesterol levels, suggests cutting salt and getting more fiber-rich grains, nuts and legumes, and a low-fat dairy, as well as 4 to 5 servings of fruits and vegetables a day.

In 2010, the United States updated its dietary guidelines, stating that Americans should raise their fruit and vegetable intake - at least 2 and half cups of fruits and vegetables per day can reduce risk of heart attack and stroke.

Can Smart Mobile Devices Help Lose Weight?

Being obese or overweight is no longer an individual issue. It has become a serious global health crisis. In the United States alone, it is estimated that nearly 68 percent of adults are either overweight or obese, and 5 to 10 percent of all healthcare costs in the United States are devoted to dealing with obesity related diseases, including diabetes, heart disease, high blood pressure and stroke.

Technology has been accused as a culprit among many other factors responsible for obesity epidemic. But recently, a group of researchers from various institutions including the Northwestern University Feinberg School of Medicine in Chicago found that mobile devices that enable people to track how much they eat and exercise might help them lose weight.

Their findings, which were published on January 28, 2013 in the ‘Archives of Internal Medicine’, reported that overweight and obese adults could lose an average of over 3.6 kilos more when they had personal digital assistants (PDAs) and occasional phone coaching to assist them, in addition to a group program.

69 overweight and obese people, who were in their late 50s and were referred to a Veterans Affairs clinic for weight-loss support, participated in the study.

Over a trial period of 6 months, the participants were enrolled in 12 group sessions that focused on nutrition, exercise and behavioral changes to promote weight loss. Half of the participants were given a PDA to record their food and activity throughout the day and there was a coach who was in contact with them by phone.

At the end of the trial period, those in the PDA group had lost an average of almost 10 pounds (4.5 kilos) and 41 percent of these participants had met the goal of losing at least 5 percent of their initial body weight. In comparison, those not in the PDA group had lost an average of 2 pounds (1 kilo) and only 11 percent of them had achieved the weight loss goal.

The most important thing about weight loss is self-monitoring - watch and keep a record of what is eaten. App (program) on a mobile device is cheaper and can easily be personalized. It can not only help people keep track of their eating habit but also help re-engage people who have trouble. Moreover, it can widely be available whenever people carry their mobile phones or PDAs.

While PDAs are mostly not in use nowadays, the emergence of smart phones such as iPhone, Android and Window phones can serve almost the same purpose. In the United States, smartphone usages continued to climb and more than 61 percent of mobile subscribers owned a smartphone.

Nevertheless, there is evidence that apps on mobile devices alone do not have much of an impact. Hence, experts believe that technology can only be used as an aid to help from a doctor or nutritionist.

How To Treat Atrial Fibrillation Induced Stroke?

Being an irregular heartbeat, atrial fibrillation (AF) is the commonest heart rhythm problems in cardiological clinical practice. People with AF will have abnormal beat of the upper chambers of the heart, causing stagnation of blood in the left upper chamber. Clots can then be formed and be carried in the bloodstream to the brain. The consequence is a large area of brain is damaged and permanent disability and even dead could be resulted. More importantly, an AF-induced stroke can be recurrent.

About 1 percent of the population has AF, which is the cause for 1 in 5 stroke cases. The chance for octogenarians to get an AF is 15 percent. Congestive heart failure, diabetes, high blood pressure, valve disease, coronary artery disease are some other conditions associated with AF.

While some people with AF can have symptoms such as heart palpitations, shortness of breath and tiredness, some might not feel anything at all. Taking appropriate anticoagulation drugs to prevent blood clots can actually reduce AF-induced stroke by 60 percent.

It is not recommended to prescribe anticoagulation drugs like Warfarin to patients who are not aware that they have AF, and do not have at least one of the risk factors like advanced age, hypertension, diabetes, prior history of stroke, and presence of heart failure. This is to avoid possible bleeding risk and side effects.

Fortunately, new drugs like Rivaroxaban (brand name Xarelto) have been proven to be easier to use and more effective than Warfarin. In fact, Rivaroxaban is a single fixed dosage that does not require monitoring.

In Germany, about 45 percent of the elderly with AF are not prescribed with blood thinners in fear of bleeding risk. But with Rivaroxaban, the risk of fatal bleeding is cut by 50 percent and the risk of intracranial bleeding is reduced by 35 percent. It is also 20 percent better than Warfarin in lowering stroke and systemic embolism.

But in reality, the biggest problem in preventing AF-related stroke is detecting AF itself. Many patients have no syndromes hence they do not even get diagnosed by ECG (electrocardiogram) that can detect AF for people having AF symptoms.

Meanwhile, there is a so-called temporary and transient AF, which can come and go, yet carry the same stroke risk. Unfortunately, doctors would only prescribe a blood thinner to patients who are confirmed by an ECG that they have an irregular heartbeat, and it is not a usual practice for patients to take ECGs on a regular basis just to detect AF.

AF is a tricky disease that carries a high stroke risk. But it is now possible, with the help of new drugs like Rivaroxaban that is effective and safe to take, to substantially reduce the stroke risks linked to AF.