Long-term survival after heart attack

W. Gifford -Jones M.D. and Diana Gifford-Jones

Common Sense Health

Diana Gifford-Jones: You were 74 when a coronary attack nearly killed you. A short time later you had a coronary bypass. Readers often ask what you have done to prevent another coronary for so long?

W. Gifford-Jones, MD: I have no single answer. I’m convinced it’s been a combination of factors.

Diana: What’s your personal routine for heart health?

G-J: I was lucky to interview Dr. Linus Pauling years ago. He believed that heart disease is partially due to a deficiency of vitamin C. This causes microscopic cracks in the inner lining of arteries. A blood clot results with possibility of death. I didn’t want to pop handfuls of vitamin C tablets, so I formulated Medi-C Plus, a powder form of C in combination with lysine, and I’ve been taking 10,000 milligrams (mg) for 24 years without using cholesterol lowering drugs. Many doctors disagree with my approach.  But even if doctors insist on CLDs, adding vitamin C in combination with lysine is a good idea. Since vitamin C is water soluble and therefore lost in urination, it should ideally be taken three times a day.

Diana: Should everyone be taking such a high dose?

G-J: Only those who have suffered heart attack or are at high risk. For others, 2,000 mg twice a day is a good prevention strategy. Why? Because long-term high doses of C keep the inner lining of arteries “rubbery” and help prevent the build up of blockages.  If high doses of C result in diarrhea, cut back on the dosage, as bowel tolerance varies from person to person. Be patient to find the right balance. Remember, it’s better to sit on the toilet than to lie under a tombstone.

Diana: Dr. Sydney Bush, a U.K. ophthalmologist, showed that over many years of use, high doses of vitamin C reversed hardening of arteries. Sample retinal images of his patients are posted on our website.  What else do you take to protect your health?

G-J: I take 500 mg daily of magnesium – nature’s natural vasodilator that helps to expand arteries. Narrowed arteries cause a lack of oxygenated blood to various organs creating a pile of trouble such as Type 2 diabetes, all its complications, and eventually coronary attack.

Diana: You’ve also been taking one tablet of NEO40 daily for years. Why?

G-J: Nitric oxide is produced by the inner lining of arteries, but production gradually decreases with age. I take NEO40 to keep arteries healthy and decrease my risk of another coronary attack.

Diana: Any others?

G-J: Actually, several more. I take natural vitamin E. I recall a 70-year-old patient who stopped playing tennis due to leg pain from poor circulation. After supplementing with 1,200 mg a day he was back playing tennis in two months. Vitamin E increases the oxygenation of blood cells.

Diana: You and I recently took an Omega 3 blood test revealing ratios of good and bad fatty acids in the body.

G-J: Omega 3 EPA and DHA fight inflammation while omega 6 fatty acids cause inflammation linked to heart attack. Studies show 97 percent of Canadians have poor ratios. A U.S study showed similar results. Researchers also found a stunning 90 percent of those taking fish oil supplements did not score well as they are hard to absorb. But Canadian researchers have developed a fish oil called MaxSimil contained in Certified Naturals Clinical Omega3X. It’s three times more soluble than standard fish oil supplements, and that’s why I’ve recommended it and take it myself.

Diana: You are in your 98th year, and it’s been 24 years since your coronary attack. Some luck, yes.  But you couldn’t have done it without a healthy heart. Keep on ticking!

Read more in No Nonsense Health – Naturally! available at  www.docgiff.com. For products, visit a natural health food store. For comments, contact-us@docgiff.com. Follow us on Instagram @docgiff and @diana_gifford_jones

Symptoms of Magnesium Deficiency

Common Sense Health – W. Gifford-Jones, MD and Diana Gifford-Jones

Magnesium is involved in roughly 80 percent of metabolic functions in the body. It is critical in delivering energy to cells and for the production of glutathione, an important antioxidant inside cells. Today, due to depletion of magnesium in the soil and modern food processing, about 60 percent of North Americans are deficient in this vital mineral. This hidden depletion could be causing diverse symptoms.

Suffering Migraine Attacks?

About 15 percent of the population experience one or more migraine attacks due to constricted blood vessels. Studies show that blood levels of magnesium in migraine patients are low compared to healthy patients. But they are even lower during a migraine attack. An intravenous injection of magnesium relaxes constricted vessels and relieves migraine pain.

Feeling Tired, Weak, Can’t Sleep, or Suffer Chronic Widespread Pain?

Dr. Marita Schauch, a nutrition expert says, “Magnesium can be helpful in treating fibromyalgia. Magnesium is required for the production of adenosine triphosphate (ATP) which is the major form of energy in the body. ATP has been found to be decreased at sites of pain in those suffering from fibromyalgia.”

Is Depression and Anxiety a Problem?

A study of 800 people over 65 years of age revealed that those with the lowest level of magnesium were 22 percent more likely to develop depression. In another study, researchers discovered that 450 milligrams of magnesium improved mood and was just as effective as antidepressant drugs.

Does Walking Faster Cause Chest Pain?

Magnesium is nature’s natural antispasmodic. In 1979, Dr. J.R. Chipperfield reported in the British journal, Lancet, that patients who suffer from angina often have low blood magnesium and that this mineral can ease spasm and pain. Magnesium also adds oil to the circulation, preventing platelets, small particles in the blood, from clotting and causing sudden death.

Wonder About an Irregular Heartbeat?

Auricular fibrillation referred to as “AFib” is diagnosed more often as people age. Each beat of the heart depends on an electrical system that must be in sync for a regular heart rate. Low blood magnesium tosses a monkey wrench into the process triggering this problem. Supplementing with oral magnesium can often restore normal rhythm.

28 Million North Americans Are Short of Breath

Dr. Carolyn Dean, a well-known guru of magnesium, says research shows that patients with asthma and other bronchial diseases have low magnesium. Moreover, many of the drugs that treat asthma cause a loss of magnesium, making asthma worse. Patients treated with magnesium report improvement in this disease. Dean adds that magnesium is a bronchodilator and an antihistamine, naturally reducing histamine levels which have a calming effect on the muscles of the bronchial tubes.

Maintaining a Normal Blood Sugar Level is Critical for Diabetes Patients

If magnesium levels are low, less glucose is unable to enter cell membranes and blood sugar increases. And since no one enjoys needle injections of insulin, if patients put off injections, this can also adversely affect blood sugar. Later this year a Canadian company may announce production of an insulin mouth rinse which should be a great asset to help maintain blood sugar levels.

What About Bone Health?

The National Institute of Health states that magnesium is critical in the maintenance and repair of compact bone.

Not All Magnesium Products Are the Same

We recommend Certified Naturals Marine-Source Magnesium based on research showing improved bioavailability of magnesium extracted from seawater and its content of 71 other important minerals that work synergistically with magnesium.

A reminder! Always consult your doctor or naturopath before starting new medications or supplements. For instance, you should not take magnesium if you have kidney disease.

Visit www.docgiff.com for past articles. For comments, contact-us@docgiff.com. Follow us on Instagram @docgiff and @diana_gifford_jones

How Accurate Is Your Blood Pressure Reading?

W. Gifford-Jones, MD and Diana Gifford-Jones
Common Sense Health

Having your blood pressure taken during an annual checkup is always part of the routine. In fact, compared to CT scans and MRI procedures used to detect complex problems, most people don’t give blood pressure readings much thought. As long as the doctor reports normal readings, there’s no reason for concern. But have you ever wondered if your blood pressure reading is accurate?

Multiple studies have shown that 15 to 30 percent of those who have elevated blood pressure in a doctor’s office or other health care setting have normal blood pressure when checked at home. It is not shocking news. You must be a pretty cool patient not to be somewhat uptight in medical offices. There is always the concern the doctor will have bad news.

What may be a surprise is that there are 19 requirements to obtain a true blood pressure reading! How many of these measures are followed in a busy doctor’s office?

For instance, patients are required to sit for five minutes before a blood pressure reading is taken with back supported and feet flat on the ground. This means that perching on an examining table with feet dangling is a no, no. So is crossing your legs. Never place the cuff over clothing. And at least two measurements should be taken during the visit, with the average being recorded.

Patients should also relax and breath normally. Smoking before the test, consuming caffeine, or exercising all forbidden before a blood pressure reading. And it you are on hypertensive medication, don’t take it just before the visit to the doctor’s office.

Another important no-no which you may not have considered is that blood pressure must not be taken when you have a full bladder. So, have the courage to say, “Doctor, before you take my blood pressure, could you wait for a few minutes so I can use the bathroom?”

What about the blood pressure cuff? A cuff that is too small or large can cause an unreliable reading. So can a cuff that is too tight or not tight enough. Your arm should be resting on a table roughly the height of your heart while blood pressure is being taken. A series of readings over time are more accurate if taken at the same time of the day in a similar context.

Do you still have blind confidence in your blood pressure readings? If you have been prescribed blood pressure medication, do you need it? Or was the diagnosis the result of “white-coat hypertension”?

If these basic blood pressure requirements are not filled during a medical examination, patients left with a quandary. It requires a strong personality to say to the nurse or doctor, “I’m worried this may be not an accurate blood pressure reading because you failed to follow the standard procedures.” It’s not the best way to engender good relations between doctor and patient. So, what else can be done?

For anyone taking blood pressure drugs, it’s prudent to purchase an automatic digital blood pressure monitor. These are more accurate than the traditional manual devices used in offices that require a squeeze of the rubber bulb to inflate the cuff. All you have to do with a digital device is to wrap the cuff around the arm, push the button to inflate the cuff, and in a few moments, you have the result.

Now it’s easy to say, “Doctor my digital cuff says my blood pressure is consistently 130/80 when I am at home. Maybe I just have white coat hypertension.”

Visit www.docgiff.com for past articles. For comments, contact-us@docgiff.com. Follow us on Instagram @docgiff and @diana_gifford_jones

Is it good to have too much of a good thing?

W. Gifford-Jones, MD and Diana Gifford-Jones
Common Sense Health

Mae West, the American movie star who rarely lacked for lifestyle advice, once conceded, “When in doubt, take a bath.” She didn’t have a forest setting in mind. But did you know that forest bathing might be just as therapeutic as a soak in the suds?

Some people gravitate, even in unfavourable weather, to the outdoors. Others are most comfortable in front of the hearth. But a walk in the woods may be just the remedy you could use after months of confinement at home. A glimpse into the research surrounding this little-known “forest bathing” therapy offers insights on benefits including improved cardiovascular function, brain activity, immune systems, self-esteem, and reduced anxiety and depression.

According to Ann Martin, a certified Forest Therapy Guide with the Association of Nature and Forest Therapy, the practice of forest therapy originated in Japan, where it is called shinrin-yoku. The term was coined in 1982 by the Director of the Japanese forest agency as a way to link forest visits with health.

During the 1980s, as Japan industrialized becoming a technological society, chronic stress symptoms emerged in the population. Researchers documented the physiological effects of people taking walks in wooded areas. Martin says, “The forest therapy we know in North America is inspired by shinrin-yoku and also weaves together several other wellness practices.”

A forest therapy walk is a process of spending a couple of hours in the forest or out in nature and slowing down to focus on a connection with nature. “The idea is not only to experience the psychological benefits of being in the forest, but also to be open psychological effects as well – like improved mood and feelings of wellness,” Martin notes. “Sometimes we’re not even aware of the subtle changes that happen when we allow ourselves to really experience a connection with the natural world.”

When stressed, the human body produces adrenaline and cortisol, hormones linked to heart disease, metabolic diseases, dementia and depression. Evergreen trees emit piney-smelling volatile organic compounds, also known as phytoncides. These chemical compounds have properties that decrease the production of adrenaline and cortisol and result in benefits such as lower blood pressure.

One systematic review of the research on forest bathing involved more than 200 studies conducted over a five-year period. The research showed that “forest bathing activities might have the following merits: remarkably improving cardiovascular function, hemodynamic indexes, neuroendocrine indexes, metabolic indexes, immunity and inflammatory indexes, antioxidant indexes, and electrophysiological indexes; significantly enhancing people’s emotional state, attitude, and feelings towards things, physical and psychological recovery, and adaptive behaviors; and obvious alleviation of anxiety and depression.” That is quite a list. Take note, there were no negative side effects. (One would be well advised, however, to avoid walking in tick invested areas or sitting down on a bee’s nest!)

Dr. Susan Abookire, an assistant professor at Harvard Medical School, who is also a forest therapy guide, explains, “Even people confined to a hospital bed may benefit from viewing nature.” She references a study comparing gallbladder surgery patients recovering in a hospital room with a window to those with only a view of a brick wall. “People who could see nature recovered more quickly and needed less powerful pain medication than people who could not see nature.”

So the next time you feel the urge to take a bath, think about another famous Mae West quote, “Too much of a good thing can be wonderful,” and go have a bath in the forest.

The weekly column by W. Gifford-Jones, MD has been published without interruption for 45 years. The same no-nonsense tradition now continues in a father-daughter collaboration. Sign-up at www.docgiff.com to receive our weekly e-newsletter. For comments, contact-us@docgiff.com.

Finding truth in science is a moving target

W. Gifford-Jones, MD and Diana Gifford-Jones
Common Sense Health

Having a good debate about matters of your health is not a bad thing. As has been said, “It is better to debate a question without settling it than to settle a question without debating it.” But recently, having a difference of opinion has become too closely associated with the polarized politics that is endemic in many countries. People have lost their sensibilities amid noisy pundits arguing nonsense about facts and fake news.

So if you do not know who to turn to for the “truth”, you are not alone. And maybe you are chasing in the wrong direction.

In the old days, there were fewer authorities holding credible and accessible medical knowledge. Research was bound in books, and it was the “good doctor” who held a monopoly on the practice of medicine. Well trained, experienced and distinguished, it was customary that the doctor could explain disease symptoms and treatments with confidence, clarity, and compassion. Patients could trust the doctor for medical expertise and outstanding judgment in the face of difficult decisions.

Today, even the wisest polymaths on the planet cannot compete with the computing powers that effortlessly generate big data, crunch statistics, run algorithms, and deploy artificial intelligence that can predict problems before they occur. The volume of published research is growing exponentially. To boot, an upheaval in communications has multiplied the sources of good and bad information for patient and doctor alike.

Some old lessons stick. In 1902, Henri Poincare, the French mathematician published Science and Hypothesis in which he argued the absolute truth of science is non-existent. He wrote, “Experiment is the sole source of truth. It alone can teach us something new; it alone can give us certainty.” To appreciate his point, one needs to understand the purpose of research.

The Lancet, one of the world’s leading medical journals, stated nearly a decade ago, in a 2012 editorial on medical research, “Truth in its purest form is rarely apparent. Results are presented not as facts, but as probabilities and uncertainties. The job of medical researchers is to ensure that these probabilities and uncertainty margins are robust—a task that is contingent on the pursuit, not of truth, but of methodological rigour.”

Still, people want answers to their questions. But before jumping to conclusions based on the latest YouTube video or Facebook post, or even the statements of esteemed public health authorities, have a look at the objectives of the research they cite, the questions that have been posed, the quality of methodology, and the communication of findings.

Be cautious about interpreting findings from medical research as rigid facts. The perspective of a statistician will differ from an ethicist when looking at the same experiment. Ask the director of a clinical trials unit if the objective is finding truth. The response will be an emphatic no. Clinical trials are about evaluating an intervention to weigh effectiveness in a controlled experiment.

Reviewing the detailed parameters of research is not a practical pursuit for most. Selection and synthesis is the job of the journalist – and now the public too. People need to be far more discerning in their assessment of information. This means, don’t expect absolutely certainty in the answers to medical problems. Rather, accept that finding truth in science is a moving target. Bertrand Russell, a British Nobel laureate and a champion for freedom of opinion, wrote, “When a man tells you that he knows the exact truth about anything, you are safe in inferring that he is an inexact man.”

The weekly column by W. Gifford-Jones, MD has been published without interruption for 45 years. The same no-nonsense tradition now continues in a father-daughter collaboration. Sign-up at www.docgiff.com to receive our weekly e-newsletter. For comments, contact-us@docgiff.com.

Are you taking too much medication?

W. Gifford-Jones, MD and Diana Gifford-Jones
Common Sense Health

Many diseases can be effectively managed thanks to therapeutic treatments involving pharmaceutical drugs. But have we gone too far in popping pills for every ache?  Or even for serious health conditions, has your doctor put as much thought into how to get you off prescription medications as has gone into putting you on them?

The statistics are alarming.  A study of drug use among seniors in Canada in 2016 found that 2 out of 3 Canadians over the age of 65 were taking at least 5 different prescription medications and over a quarter took at least 10 different prescription medications!  In the U.S., a 2018 national survey found that 48.6% of the entire population used at least one prescription drug in the month prior to the survey.  Some of these statistics are certainly made up by people who are taking medications they no longer need.

Among adults aged 60–79, the most commonly used drug types in the United States were lipid-lowering drugs, antidiabetic agents, and beta blockers; in Canada, they were lipid-lowering drugs, analgesics, and proton pump inhibitors.

How should you proceed if you want to reduce the numbers of medications you take?  First, take all your medications to your doctor and have a discussion.  But don’t expect miraculous answers, as doctors are known for writing more, not fewer, prescriptions – and sometimes, for good reasons.

About 50% of those prescribed medications for chronic conditions stop taking them within the first year of starting therapy. This non-adherence can further deteriorate health. More hospitalizations result, costing an estimated $300 million in avoidable expenditures per year

About 1 in 5 individuals prescribed antidepressants who stop medication can suffer a host of problems, collectively called discontinuation syndrome. 

But there are many situations where less medication is not such tricky business.  Sleeping pills, for example, should only be for short-term use.  Allergy medication should only be used when allergens cause symptoms.

Stopping blood pressure medication needs your doctor’s endorsement.  But one way to manage hypertension and get blood pressure into the normal range is to lose extra weight.  Finding natural alternatives to strong, addictive painkillers is another smart move.

It’s also highly advisable to have a strategy for reducing cholesterol medicines, known as statins, which can have devastating side effects, including liver damage and memory problems. Has your doctor made you aware of all your choices? If you’ve read this column for years, you’ll know that high-dose vitamin C could be a life-saving option for reducing the rick of heart attack or stroke.

A special note about those who are very elderly or frail.  These individuals can be more susceptible to medications, particularly when considering the extent of inappropriate polypharmacy (i.e., too many drugs, unnecessary drugs, and/or doses that are too high) that they are often taking without adequate oversight.  If you are, or know someone, at risk, then be careful to ensure that the doctor has full information about all medications and that the patient understands benefits and harms of medication and gives consent.

Socioeconomic factors are also noteworthy. Seniors living in long-term care facilities, low-income neighbourhoods and rural/remote neighbourhoods used more drugs, with one study showing 21.4% of seniors living in the lowest-income neighbourhoods were prescribed 10 or more drug classes, compared with 14.3% of seniors living in the highest-income neighbourhoods.

Finally, if you have been able to make reductions, how should you dispose of all the unused or expired medications?  Most jurisdictions have drug take back sites.  The U.S. Food and Drug Administration has a “Flush List” of those medications that can be disposed of in the toilet.  Whatever your means of disposal, remember that drugs pose a huge hazard to unsuspecting children or pets.  Dispose of them safely.

The weekly column by W. Gifford-Jones, MD has been published without interruption for 45 years. The same no-nonsense tradition now continues in a father-daughter collaboration. Sign-up at www.docgiff.com to receive our weekly e-newsletter. For comments, contact-us@docgiff.com.

Go natural to debut your new hair colour

by W. Gifford-Jones and Diana Gifford-Jones
Common Sense Health

The American star of the silver screen, Jean Harlow, was known as the “Blonde Bombshell”. She once remarked, “If it wasn’t for my hair, Hollywood wouldn’t know me.” But did the blonde hair come at a huge price? Harlow was dead at the age of 26.

Do you make a habit of dying your hair? Now that lockdowns are easing and you cannot wait to get a haircut, you might want to think twice about permanent hair dye and chemical hair straighteners. Some recent studies have raised health concerns.

The practice of dying hair goes back to ancient Egypt, Greece, and Rome when terrible concoctions were used to alter hair colour, both for beauty and to show rank on the battlefield. In years past, animal studies questioned the safety of hair dyes. But research on humans produced inconsistent findings. More recently, studies are yielding findings that should be enough to make people pause.

Researchers for a study published in International Journal of Cancer analyzed data from the “Sister Study”. This ongoing study involves more than 50,000 women between the ages of 35 and 74, all having a sister with breast cancer. Having a sister with breast cancer placed them at higher risk for developing breast cancer themselves. But researchers used the cohort to study the cancer risk of hair dye. Although all participants share the same family history, only some of them used hair dye and straighteners, allowing for interesting comparisons.

What did epidemiologist Dr. Alexandra White find? She is an investigator with the National Institute of Environmental Health Sciences, studying risk factors for breast cancer.

She found that white women who frequently used permanent hair dyes had a 7% higher risk of breast cancer and black women a 45% higher risk. For women who frequently used chemical straighteners the risk was 30%, with no race difference.

What happened to Harlow? Apparently, Harlow insisted she was a natural blonde. But one Hollywood stylist, Alfred Pagano, knew otherwise. He reported that to make her platinum blonde, peroxide, ammonia, Clorox and Lux flakes were used. Whether his account is accurate, we will never know. But Clorox mixed with ammonia produces the noxious gas, hydrochloric acid, not a healthy mixture.

The hair treatments took a toll, and when Harlow’s hair began to fall out, she turned to a wig. In short order, she was dead of kidney failure.

Today, hair products are not all the same, and they can contain any of more than 5,000 chemicals, some of which are known to cause cancer in lab animals being fed large amount of these dyes over time. White notes that “For chemical hair straighteners, one of the big concerns is formaldehyde, which is a known carcinogen.” Products that do not overtly contain formaldehyde may yet release this hazardous substance when the product is heated.

The global market for hair dyes was US$29B in 2019 and is expected to grow to US$40B by 2025. White’s research will not slow this growth. Vanity too readily trumps prudence.

Should you be concerned? On current evidence, the risk is low compared to other known carcinogens such as tobacco and radiation. If you use hair dye, the risk is in all probability small. But remember, formaldehyde is used to embalm people for burial!
Natural, vegetable-based hair dyes are available. So instead of going for permanent colour, what’s wrong with taking a less drastic approach. Temporary and fading colours need not be a drawback. Set the tone with a positive attitude for going natural. And natural hair – meaning whatever Mother Nature gave you – is beautiful.

The weekly column by W. Gifford-Jones, MD has been published without interruption for 45 years. The same no-nonsense tradition now continues in a father-daughter collaboration. Sign-up at www.docgiff.com to receive our weekly e-newsletter. For comments, contact-us@docgiff.com.

How diet and inflammation affect colon cancer

by W. Gifford-Jones MD and Diana Gifford-Jones
Common Sense Health

It’s been said “We are what we eat,” or “garbage in garbage out.” Less catchy advice might be “Eat an anti-inflammatory diet, rather than a pro-inflammatory one.” It could make the difference in the likelihood of developing a malignancy of the large bowel. Not many people realize that if you take away skin cancers, colon cancer is the third most common malignancy in North America.

A study in the Journal of the American Medical Association, Oncology, points out a strong association between chronic inflammation and the risk of colon cancer.

Researchers at Harvard University discovered that people who had dietary patterns that triggered chronic inflammation were 32 percent more likely to develop colon cancer than those who followed a lowered inflammatory diet.

Dr. Joel Mason, Director of the Vitamins and Carcinogenesis Laboratory, Tufts University, says, “This study adds to previous evidence that inflammation is an important factor in colon cancer and that a diet with less potential to cause inflammation can decrease the risk.”

How did Harvard researchers determine what foods were associated with inflammation and what foods fought it?

They analyzed the health and nutrition habits of 120,000 people over a 26-year period. This involved 18 food groups and tracking how they affected inflammatory markers in the blood.

Diets with the lowest level of inflammatory potential were tea, coffee, dark yellow vegetables, dark and leafy greens. In contrast, diets with the highest level of inflammation included processed meat, red meat and sugar-sweetened carbonized beverages.

Overweight or obese males did not fare well. They were 48 percent more likely to develop cancer of the colon over the course of the study than those who consumed a low inflammatory diet. But even lean males were at higher risk, although not as much as the obese ones.

What about women? It’s strange that being overweight or obese did not increase or decrease the risk of colon malignancy in females. But in lean women who had the most pro-inflammatory diet, there was a 31 percent greater risk of colon cancer than those who consumed the least inflammatory diet. Researchers were not certain if these findings were related to hormonal changes in women.

So, what’s the message? It pays dividends to stay active and not gain weight. This is not the first time nutritionists have told us that leafy green vegetables are more conducive to a longer life and it’s prudent to decrease the amount of red meat consumed. Hopefully it will help make everyone realize that the use of sugar sweetened beverages is not a healthy habit.

An equally strong message remains that North Americans are needlessly dying from colon cancer due to a fear of having a colonoscopy performed.

We know that colon cancer begins in a polyp that remains localized, providing ample time for colonoscopy and removable of this lesion.

This procedure should be done regularly starting at 50 years of age or younger, and usually ending at 75 years. Discuss with your doctor whether this is the age for you to end colonoscopy.

If several colonoscopies have been done over the years without any polyps being detected, the decision is usually to stop. The reason being that it’s unlikely one will form after the age of 75 and if it does some other event will end life long before a slow growing polyp causes trouble.

The discomfort of colonoscopy is miniscule to the suffering of terminal colon cancer. For those dead set against the procedure, stool card tests done at home are an option. So, never, never, fall into the trap of skipping these life-saving tests.

The weekly column by W. Gifford-Jones, MD has been published without interruption for 45 years. The same no-nonsense tradition now continues in a father-daughter collaboration. Sign-up at www.docgiff.com to receive our weekly e-newsletter. For comments, contact-us@docgiff.com.

How to make takeout healthy

by W. Gifford-Jones M.D. and Diana Gifford-Jones
Common Sense Health

Eating takeout meals can be a way of life, often driven by the necessity for fast, convenient food. During the pandemic, enthusiasts for restaurant dining have created a surge in demand for takeout meals. Unfortunately, fast food outlets have never been beacons of nutritional value. But have times changed? With the plethora of new home meal delivery services and more conscious consumers, is it possible to eat healthy delivery or pickup meals?

Here are three tips.

First, watch out for sugar and salt. Today, most sodium consumed is from added salt during commercial food processing. Fast food outlets often use high levels of salt. Restaurants also tend to use excess salt. One study by Tufts University found that a single full-service meal contained more than twice the daily recommendation of 2,300 milligrams of sodium.

Sodium is found in soups, bread, processed meats, sauces and dressings. So, look carefully at the menu and enquire about low sodium options. Even if it is not offered on the menu, ask if you can swap French fries for a healthy fruit cup or cottage cheese.

Processed meat such as pepperoni, bacon, sausage, deli turkey and ham have been linked to cancer, heart disease, stroke, diabetes, and premature death. So, always think of moderation when choosing these foods.

Try to order seafood and poultry, looking for dishes that are baked, broiled, grilled, and steamed, rather than ones that are deep fried, breaded and served with butter and cream sauce.

Avoiding meat altogether is an option. Instead, select from minimally processed plant foods, such as fruits, vegetables, nuts, seeds, and whole grains. The potassium in these foods helps to counter the effect of excessive amounts of sodium in other foods.

Go for high fiber bread, crackers, cereals and snacks, as fibre in the diet lowers the risk of cardiovascular disease, cancer, Type 2 diabetes and even constipation.

Avoid sugary drinks and enormous desserts that contribute little good to your health.

The second tip is to limit portion sizes. Tufts researchers show how difficult it is to limit calories. One study showed that some restaurant meals (even without the drinks, appetizers, or dessert) contained more calories than recommended for an entire day for an average adult!

Studies also show that when people are presented with more food than they require, they will eat it. Many restaurants are overly generous with serving sizes. So order half sizes, split a meal with someone else, or choose appetizers instead of an entrée. When ordering delivered meals involving large quantities of food, set aside a portion for a subsequent meal.

The third tip is to be careful about falling victim to the convenience of take-out and delivery.

Instead of relying on services that bring food to you, make the effort to go to where healthier food options are available. For example, take the time to go for a walk to a take-out meal and get some much-needed outdoor refreshment. Have a picnic in a park.

Delivery services are wonderful, but they reinforce a sedentary lifestyle. Even the time spent standing while cooking in the kitchen is easily lost when a delivered meal becomes the ideal companion to the couch and more screen time.

Give it a try. Find a neighbourhood restaurant having healthy choices. Build time into your day for a walk to pick-up food.

Take your own water bottle. Eat smaller portions while enjoying the scene in a nearby park. With the walk back home, you will feel satiated, refreshed, and healthier.

The weekly column by W. Gifford-Jones, MD has been published without interruption for 45 years. The same no-nonsense tradition now continues in a father-daughter collaboration. Sign-up at www.docgiff.com to receive our weekly e-newsletter. For comments, contact-us@docgiff.com.

COVID means double trouble and worse

by W. Gifford Jones, M.D. and Diana Gifford-Jones
Common sense health

If ever a time to act on your health, this is it. Study after study in leading medical journals reports compounding troubles from COVID-19. What was described as a lung disease early in the pandemic is now better recognized as an attack on health systems – your own body’s systems involving multiple organs as well as societal systems of disease surveillance and care delivery. Whether you have been infected or not, chances are high your health is becoming worse.

New research should raise alarm bells.

In the journal, Nature, Dr. Ziyad Al-Aly, chief of research at Veterans Affairs St. Louis Health Care System, reported on deteriorated health of COVID-19 survivors. To his amazement, the disease was not just deadlier for people with underlying conditions like diabetes. Data show that people are seemingly developing metabolic disease as a result of the infection.

How this happens is yet to be understood. Some scientists think SARS-CoV-2 not only damages the lungs, but other organs too. The pancreas which produces insulin needed to convert blood-sugar to energy might be affected by the infection. Another concern is the sedentary lifestyle brought on by the pandemic. Late or missed diagnoses of health issues among people skipping or unable to maintain medical appointments could be a factor.

Obesity and poor lifestyle issues are leading ever more children down the path to avoidable chronic disease. COVID is compounding problems for children who develop Type 2 diabetes. A study of such youth published in Diabetes Care showed a troubling and unexplained increase last year in diabetic ketoacidosis, a dangerous buildup of acid in the blood due to inadequate insulin supply.

Pregnancy is another area of concern. Research published in JAMA Pediatrics involving 18 countries found COVID-19 in pregnancy was associated with consistent and substantial increases in severe maternal morbidity and mortality and neonatal complications when pregnant women with and without COVID-19 diagnosis were compared. This underscores precautions to prevent COVID illness during pregnancy by following public health measures.

But how is COVID making you sick, even if you don’t catch the virus?

For one, the pandemic has caused a sharp decline in preventative care and screening, particularly for breast, colon, cervical and lung cancers.

One study in California, conducted by researchers at the Centers for Disease Control and Prevention, found that between March and June of 2020, the rate of cervical cancer screening among 1.5 million women decreased by roughly 80%, compared with the same period in 2019.

Another study at the University of Cincinnati Medical Centre found that in March 2020 alone, more than 800 appointments for lung cancer screening were postponed. Upon resumption of screenings two months later, the percentage of people tested who had lung nodules suspicious for cancer had increased from 8% before the pandemic to 29%.

In some health care systems, a rapid switch to at-home screening tests, such as the fecal immunochemical test (FIT) for colorectal cancer, has kept pace with pre-pandemic testing. But in most places, individuals need to take the initiative to request the test kits and get it done.

Delays in screening, especially among people at risk, can mean missing early diagnosis. Cancers may grow larger and more deadly before they are detected.

Delays in all kinds of surgeries are yet another concern.

Research has only begun to emerge regarding the tsunami of mental health problems that have crept or crashed into the lives of many. An echo pandemic of mental illness will almost certainly follow.

So do not wait for trouble. Prevention is key. Make lifestyle changes to improve your health. Get tested where advisable or do at-home screening. Read past articles at docgiff.com if you need reminders.

The weekly column by W. Gifford-Jones, MD has been published without interruption for 45 years. The same no-nonsense tradition now continues in a father-daughter collaboration. Sign-up at www.docgiff.com to receive our weekly e-newsletter. For comments, contact-us@docgiff.com.