February is recognized as American Heart Month, a time to raise public awareness of heart disease, or cardiovascular disease.  According to the American Heart Association, heart disease is a significant health challenge.  It accounts for one-third of deaths in the U.S.  Many of these deaths are the result of heart attacks, stroke, or coronary artery disease.  The CDC cites heart disease as the leading cause of death for people of most racial and ethnic groups in the U.S.

There are three key risk factors for heart disease:  high blood pressure, high cholesterol, and smoking.  Other conditions that contribute to the risk for developing heart disease include diabetes, obesity, a sedentary lifestyle, and heavy alcohol use.  Let’s examine how these factors increase our risk.

High blood pressure (hypertension)

Blood pressure is determined by the amount of blood the heart pumps and the amount of resistance to blood flow in the arteries.  When the arteries become narrow due to plaque buildup, blood pressure goes up.  The heart has to work harder than it should.  Uncontrolled high blood pressure causes serious heart complications including heart attack, stroke, aneurysm, and heart failure.  Some effective ways to reduce blood pressure to more normal levels include getting more exercise, losing weight, eating less sodium (salt) in your diet, quitting smoking, reducing stress, and taking medication.

High cholesterol

LDL is the bad kind of cholesterol that is the main source of plaque.  When plaque builds up along the walls of the arteries, it causes them to narrow.  If blood supply to a portion of the heart is completely blocked, the result can be a heart attack.  Cholesterol levels can be controlled through diet and medication.

Smoking

Smokers are more likely than non-smokers to suffer heart attacks.  The nicotine in tobacco increases blood pressure, causes more blood clots, and results in less oxygen reaching the heart.

Diabetes

High blood glucose levels can be damaging to the blood vessels.  Diabetics are more prone to have other coronary risk factors such as high blood pressure and high cholesterol.

Obesity

Being overweight is linked to high blood pressure, high cholesterol and triglycerides, and impaired glucose tolerance.  All these factors contribute to heart disease.

Sedentary lifestyle

Physical inactivity puts people at greater risk for heart disease.  Adults should get at least thirty minutes of moderate daily exercise.  This can include various activities including walking, swimming, biking, gardening, stair climbing, and dancing.  Exercise also helps maintain a healthy weight and lowers blood pressure.

Alcohol use

Heavy alcohol use and binge drinking can lead to cardiomyopathy, a type of heart failure.  Alcohol is high in sugar content, so heavy drinking can contribute to obesity and raise blood pressure.  Alcohol can also affect the way some medications work.

Lower your risk factors

Many lifestyle changes can lower the risk of developing heart disease.  If you are overweight, establish healthy eating habits and get more exercise.  A Medical weight loss plan through a physician can help people be more successful in dropping excess pounds.  Stop smoking.  Within a year of quitting, the risk of heart attack drops significantly.  Get enough sleep to help relieve stress.  Avoid excessive alcohol use.

The physicians at RMD Primary Care can answer your questions about heart disease and medical weight loss.  Contact us today for an appointment.

Having a sensitivity to dairy products is fairly common in the U.S.  It can occur in childhood but often becomes more noticeable as people age.  Two common conditions are lactose intolerance and dairy allergy.  What is the difference, and how can these problems be managed?

Lactose Intolerance

People whose bodies do not produce enough of the digestive enzyme lactase will be lactose intolerant.  This means they cannot break down the sugar, or lactose, found in dairy products.  The condition becomes more noticeable as people age, because some people produce less of the enzyme lactase as they get older.  According to the National Institutes of Health, more than one third of American adults are lactose intolerant.  This may prevent them from getting enough calcium and vitamin D in their diet.  Lactose intolerance can be annoying and uncomfortable, but it is not dangerous.

When the body can’t break down lactose, people usually begin experiencing symptoms within 15-30 minutes after eating dairy.  Typical symptoms are bloating, gas, abdominal pain, cramping, and diarrhea.  Some people may be able to eat small amounts of dairy without having problems.  However, when they eat greater amounts, the symptoms get worse.  Lactose intolerance does not involve the immune system.  No antibodies are produced, and there is no inflammatory response.  The symptoms are generally limited to the GI tract.

Lactose intolerance can be treated several ways.  One way is to avoid dairy products altogether.  Another option is to buy dairy products, such as milk and ice cream, that are “lactose-free”.  Dairy free products are also widely available in grocery stores.  In addition, there are special digestive enzymes, like Lactaid, that can be taken with meals containing dairy.  This allows those with lactose intolerance to eat dairy foods with little or no discomfort.

Dairy Allergy

A dairy allergy, or sensitivity, is an immune response to one of the proteins found in cow’s milk, typically whey or casein.  It usually results in histamines being released, which generates an inflammatory response in the body.  This can produce a range of symptoms including GI issues, skin rashes, eczema, hives, congestion, joint pain, headaches, wheezing, and a tightness in the throat.  Dairy allergies are more commonly diagnosed in children.  Those with a dairy allergy should avoid all foods containing dairy.  This includes reading food labels to determine if milk or any milk proteins are contained in the product.

Next steps

If you suspect you may have lactose intolerance or an allergy to dairy, talk to your healthcare provider.  There are medical tests that can be done to determine the cause of your problem.  The physicians at RMD Primary Care are experienced in diagnosing lactose intolerance and allergies.  Contact us today to schedule an appointment.    

Getting enough exercise during the holidays can be hard.  We are all so busy with shopping, cooking, social events, entertaining, and holiday travel.  With so many things to accomplish and extra demands on our time, it’s tempting to skip the exercise routine and focus on other things.  The colder temperatures and shorter daylight hours provide us with excuses not to get outdoors.  In spite of these challenges, we know that there are many health benefits to getting regular exercise.  For a lot of us, the holiday season is a time when we actually need it the most.

Benefits of regular exercise

Here are some benefits of continuing your regular exercise routine during the holidays:

• Prevents weight gain – Exercise burns calories and helps us maintain a healthy weight.  People tend to consume more calorie-rich foods during this time of year.  We attend parties, entertain friends and family, drink more alcohol, and buy extra treats.  This translates into added pounds unless we do something physical to burn off the calories.  In addition to preventing weight gain, exercise helps us maintain muscle mass and sustain metabolic rate.
• Alleviates stress – Exercise provides stress relief and reduces anxiety.  Physical activity can improve mood by stimulating the body’s production of endorphins, hormones that help us cope with stress and pain.  These “feel good” chemicals increase feelings of well-being and improve self-esteem.  They help us feel more relaxed and may provide better quality sleep.  Moderate exercise three times per week can raise endorphin levels.
• Counters depression – Some people are affected by seasonal depression during the late fall and winter.  Fewer hours of daylight and lack of sunshine can bring on the “winter blues”.  Exercising outdoors for thirty minutes a day, three days a week during daylight hours can improve symptoms.

How to fit in a workout

• Allow time in your schedule.  It can be a challenge to find time to exercise during the holidays, so be purposeful about it.  Remind yourself that you’ll feel better and have more energy if you try to stick to your exercise routine.
• Be creative with your workout.  If you don’t have time to go to the gym, find other ways to get exercise.  Take a walk around the neighborhood or enjoy a bike ride.  Park farther away at the mall so you’ll get more steps.  If you can’t make your aerobics class, turn on some music and do a short workout at home.  Even a few minutes of exercise can keep you motivated.
• Track your activity.  Use an activity tracker, fitness watch, or the health app on your cell phone to track daily progress.  This helps you be more conscious of your activity level.

Continuing a regular exercise routine during the holidays helps keep us on track.  It provides stability, helps us maintain sleep schedules, and helps compensate for the extra calories we consume.  It improves our mood and reduces stress in this hectic time of year.  Abandoning our workouts now makes it that much harder to refocus in January.

The physicians at RMD Primary Care can answer your questions about the health benefits of a regular exercise routine.  Contact us today for an appointment.

Insulin resistance is often an unseen change in the body.  Many people don’t realize they have it, and there is not a specific test to diagnose it.  Your doctor may look at several other blood tests to determine whether you may be at risk.  High blood sugar levels, high LDL cholesterol, low HDL cholesterol, and high triglycerides are warning signs.  No one knows exactly why some people will develop insulin resistance, but having a family history of type 2 diabetes seems to increase the risk.

What is insulin resistance?

Glucose is the main type of sugar in our blood.  The pancreas produces insulin, a hormone that helps the body absorb and process glucose.  Insulin resistance occurs when there is too much glucose in the blood, preventing the body from using insulin effectively.  People with insulin resistance are at risk for developing prediabetes or type 2 diabetes.

Risk factors

Risk factors for insulin resistance are the same as those for prediabetes and diabetes.  A major factor includes being overweight or obesity.  Excess abdominal fat makes the body less sensitive to insulin.  A sedentary lifestyle, smoking, and not getting enough sleep also contribute to insulin resistance.  Additionally, there is a study associating high blood pressure and insulin resistance.

Addressing insulin resistance

The following are some lifestyle changes that can help reverse insulin resistance.

• Weight loss – Make healthy food choices and monitor portion control.  Eat a balanced diet to keep blood sugar levels in check.  Choose more fruits and vegetables, whole grains, and lean proteins.  Eliminate processed sugars, carbohydrates, and saturated fats.  Avoid skipping meals as this leads to unhealthy swings in insulin and blood sugar levels.  These dietary changes can aid in weight loss.
• Physical activity – A daily routine of physical activity can help with weight loss.  Exercise helps muscles use blood sugar for energy.  The body is more sensitive to insulin when we are more active, and our muscles are able to use glucose more effectively. 
• Lower blood sugar levels – Manage your carbohydrate intake to lower blood sugar.  A low carb diet prevents blood sugar spikes.  Increase fiber intake, as fiber slows carbohydrate digestion and sugar absorption.  Stay hydrated so the kidneys can flush out excess sugar through the urine.
• Reduce stress – According to the National Institutes of Health, studies show that chronic stress plays a role in insulin resistance.  Stress can affect blood sugar levels.  Getting enough sleep and making time in your schedule for relaxation can help reduce stress.
• Get enough sleep – Lack of sleep is associated with weight gain, and excess weight disrupts the function of insulin responsive cells.

The physicians at RMD Primary Care can answer your questions about insulin resistance and medical weight loss.  Contact us today for an appointment.

Obesity is on the rise in the U.S.  Research shows that one in three people in this country is obese.  It has even become a problem in children and adolescents aged 2-19 years.  Obesity has been linked to a number of different health issues of serious concern.  Many people have found that obesity has impacted their quality of life.

Obesity is determined by calculating a person’s Body Mass Index (BMI).  There are formulas available to calculate BMI based on height and weight.  A BMI of 30.0 and above is considered obese.

The following list contains serious health risks that are linked to obesity.

Heart disease and stroke

Obesity can cause a lowering of good cholesterol, an increase in bad cholesterol levels, and an increase in triglycerides.  Obesity is a major risk factor in coronary artery disease, which is a buildup of cholesterol plaque in the arteries of the heart.  Obesity puts individuals at risk for atrial fibrillation, an abnormal heart rhythm, and increases their risk for heart failure.  Even moderate weight loss can reduce the risks in these areas.

Diabetes

Obesity is the leading risk factor for type 2 diabetes.  Diabetes increases the risk for heart disease.  Excess abdominal fat can make the body less sensitive to insulin by disrupting the function of insulin responsive cells.  This is known as insulin resistance.  Weight loss is an important goal in treating type 2 diabetes and may reduce the need for medication.

High blood pressure

Obesity is linked to high blood pressure (hypertension).  Obese people need more blood to supply oxygen and nutrients to their bodies.  The heart has to work harder to accommodate the need.  High blood pressure is a common cause of heart attacks.

Sleep apnea

Sleep apnea is a sleep disorder in which breathing repeatedly stops and starts.  According to the Sleep Foundation, excess weight creates fat deposits in the neck that can block the upper airway during sleep.  Excess fat in the abdomen compresses the chest wall, reducing lung capacity.  Lack of sleep is associated with weight gain, making it a vicious cycle.

Osteoarthritis

Osteoarthritis is a chronic, progressive joint disorder that is strongly associated with obesity.  Being overweight puts extra pressure on joints like the knees and hips.  This speeds destruction of the cartilage.  Fat cells also release proteins that cause inflammation.  This increases the risk of developing osteoarthritis in non-load bearing joints such as the fingers and hands.

Some cancers

Many people do not realize that some cancers have been linked to obesity.  These include colon cancer, esophageal cancer, stomach cancer, liver cancer, kidney cancer, and pancreatic cancer.  Obese people often have chronic low-level inflammation, which is a risk factor for certain types of cancer.

RMD Primary Care offers medical weight loss services.  If you are looking for a healthy approach to weight loss, contact us today for an appointment.

B vitamins are vital in maintaining good health.  They help promote a healthy metabolism, play a significant role in nerve function, help in the formation of red blood cells, and are linked to a reduced risk of stroke.  Certain B vitamins are essential for normal brain development and for ensuring the immune system functions properly.  Eight B vitamins make up the B Complex.  All of them work together and are necessary for our well-being.

Importance for pregnant women

Vitamin B9 is essential during early pregnancy to prevent birth defects of the brain and spine.  Doctors often prescribe a prenatal vitamin supplement to ensure women are getting enough.  B vitamins can also help reduce PMS symptoms, reduce anxiety, improve mood, and improve memory.

B vitamins are water soluble, meaning they are not absorbed and stored in fat cells in the body.  Excess amounts are eliminated in the urine.  Many women don’t get enough B vitamins in their diet, although most are readily available in common foods.

The 8 B vitamins

Here are the eight B vitamins, ways the body uses them, and how to incorporate them into our diets.

B1 – (thiamin)  Helps the body properly use carbohydrates.  Found in whole grain cereal, nuts, beans, and meat.

B2 – (riboflavin)  Necessary for normal cell growth and function; boosts the immune system.  Found in eggs, dairy products, meat, nuts, and green vegetables.

B3 – (niacin)  Improves cholesterol levels; boosts good HDL and lowers triglycerides.  Found in meat, poultry, fish, eggs, and greens.

B5 – (pantothenic acid)  Necessary for hormone production; helps the body properly use carbs, proteins, and lipids.  Found in organ meats, vegetables, cereal grains, eggs, dairy products, and legumes.

B6 – (pyridoxine)  Necessary for proper growth and development of the brain, nerves, and skin; helps the body use sugars, fats, and proteins.  Found in cereal grains, bananas, beans, spinach, lentils, eggs, and meat.

B7 – (biotin)  Helps break down fats and carbs.  Found in eggs, dairy products, and bananas.

B9 – (folate and folic acid)  Involved in the production of genetic material, DNA.  Found in leafy vegetables, okra, bananas, orange juice, and tomato juice.

B12 – (cyanocobalamin)  Helps maintain healthy metabolism, blood cells, and nerves.  Found in organ meats, beef, tuna, salmon, clams, sardines, and dairy products.

Vitamin B deficiency can result in symptoms that include anemia, fatigue, depression, eczema, hair loss, muscle cramps, and loss of appetite.  Talk to the health care providers at RMD Primary Care to learn more about B vitamins and women’s health.

Summer is the perfect season to relax and enjoy outdoor activities.  Backyard barbecues, pool parties, and picnics at the park are family favorites.  The following health and safety tips will help ensure everyone has a good time.

Avoid Sunburn

Protecting your skin from sun damage is a key factor in preventing skin cancer, the most common type of cancer in the U.S.  According to the Skin Cancer Foundation, 1 in 5 Americans will develop skin cancer by age 70.  A history of sunburns increases the risk for skin cancer.  To prevent sunburn, avoid sun exposure between the hours of 10am and 4pm when UVA and UVB rays are strongest.  Wear sunscreen with an SPF of 30 or higher.  Apply sunscreen 30 minutes before going outdoors so the skin has time to absorb it.  Reapply every two hours.  If swimming or sweating heavily, sunscreen may need to be applied more often.  Wear a hat to shade the face, scalp, and neck.  Wear sunglasses to protect the eyes from the sun.

Prevent Insect Bites

Insect bites can be more than just a summer annoyance.  Insects can carry disease.  Mosquitos can cause

illnesses such as West Nile Virus, encephalitis, and dengue fever.  Avoid outdoor activities during dawn and dusk, which are peak mosquito times.  Wear an insect repellent on exposed skin or wear clothing that covers arms and legs.  Eliminate areas of standing water in your yard to prevent mosquitos from breeding.

Prevent tick bites by staying out of wooded areas and high grass.  Keep to the middle of the trail when hiking.  Use an insect repellent that is effective against ticks.  Shower soon after coming indoors and check your body for ticks.  Serious diseases including Rocky Mountain Spotted Fever and Lyme Disease are transmitted to humans through tick bites.

Stay Hydrated

When outside in the heat, drink plenty of water to replace fluids that the body loses through sweating.  Carry a water bottle when working outside or exercising.  Avoid alcohol and caffeinated beverages as they are not effective in preventing dehydration.  Signs of dehydration include dry mouth, headache, dizziness, muscle cramps, and little to no urination.

Minimize Risks of Food Poisoning

Don’t allow a family picnic to become a source of food poisoning.  Uncooked meat and foods containing mayonnaise, eggs, and dairy can spoil within a couple of hours if not refrigerated or kept on ice in an insulated cooler.  Make sure meats are grilled to a proper temperature on the inside to avoid E. Coli infections.  Steaks should be cooked to an internal temperature of 145 degrees and ground meats should be cooked to 160 degrees.  Wash hands thoroughly after handling raw meat and thoroughly clean utensils and platters that have touched raw meats.

RMD Primary Care provides a number of General Practice and Family Medicine services for your family’s health.  Contact us today for an appointment.

According to the National Institutes of Health, sleep affects our mental and physical health.  When we try to fit so many things into our busy lives, we often sacrifice sleep.  The National Sleep Foundation recommends that adults get between seven and nine hours of sleep each night.  People who are well rested are more alert during the day, focus better, and have faster reflexes.  People who are tired are less productive, pay less attention to detail, feel higher levels of stress, tend to be moodier, and are more likely to be involved in driving accidents.  The body repairs and rejuvenates itself each night as we sleep.  However, sleep deprivation over time can have negative effects on our hormone levels, immune system, blood pressure, heart health, and mental health.

So, what can we do to enjoy a better night’s sleep?  Here are three tips that may help.

Reduce caffeine intake

Caffeine may be robbing you of a good night’s sleep.  Caffeine is a chemical found in coffee, tea, chocolate, and some sodas.  It’s a stimulant that acts on the body’s central nervous system, increasing alertness and reducing fatigue.  Caffeine interferes with adenosine receptors in the brain.  Adenosine is what tells the brain that the body needs rest.  Caffeine can last as long as six hours in your system, so consuming caffeine late in the afternoon or in the evening can certainly affect a person’s ability to fall asleep at bedtime.  Eliminate caffeine intake late in the day, or switch to decaffeinated coffee or tea.

Limit use of electronics at bedtime 

Many people have become accustomed to using electronics right before bedtime.  This includes looking at laptops, tablets, cell phones, and TV in bed.  The blue light produced by these devices may make it more difficult to fall asleep.  Children and teens are especially sensitive to blue light.  It prevents the body from releasing melatonin, a sleep hormone, by tricking the brain into thinking it’s daytime.  Technology also stimulates the brain, making it harder to relax and fall asleep.  For better quality sleep, try eliminating electronics from the bedroom.

Establish a bedtime routine  

Establish a regular routine of going to bed at the same time each night and waking up at the same time each morning.  Irregular sleep habits can interfere with the body’s natural circadian rhythm.  Any activities before bedtime should be relaxing.  A warm bath may be helpful for some.  Avoid bright lighting in the bedroom.  This can also interfere with melatonin production.  Make the bedroom a quiet and relaxing place.  Try to minimize external light and noise.

Sleep plays a key role in health, so make a good night’s sleep a high priority.  If you’ve tried these tips and continue to have difficulty getting a good night’s sleep, talk to your healthcare provider.  Contact RMD Primary Care to schedule a visit with one of our doctors.   

Dietary fiber is defined as the plant components of our food that are not broken down by our digestive enzymes.  It is sometimes referred to as roughage.  Dietary fiber is essential for a healthy diet, and doctors often urge patients to eat more of it.  But many people don’t know whether they are getting enough fiber, or what foods will help boost their daily intake.

How does fiber work?

There are two components of dietary fiber – soluble and insoluble.  Both types are important for the body.  Soluble fiber dissolves in water.  It delays gastric emptying of the stomach, which means we feel full longer.  Soluble fiber may reduce cholesterol levels and help control blood sugar.  Insoluble fiber does not dissolve in water.  It promotes bowel health by attracting water to the stool, making bowel movements easier to pass.

Benefits of fiber

Our body benefits from fiber in many ways.  Fiber regulates bowel movements and prevents constipation.  It helps lower the risk of developing diverticulosis and colon cancer.  Fiber helps control body weight by lowering fat absorption.  This helps prevent obesity.  Fiber slows down the digestion rate of carbohydrates, regulating blood sugar levels.  This lowers the risk of developing type 2 diabetes.  Fiber helps regulate cholesterol levels by preventing some cholesterol from being digested.  This can reduce the risk of cardiovascular disease.

Fiber recommendations

Here are the USDA’s recommended amounts of daily fiber.

• Men age 50 and under – 38 grams per day
• Men over 50 – 30 grams per day
• Women age 50 and under – 25 grams per day
• Women over 50 – 21 grams per day

It is better to get dietary fiber from whole foods we eat rather than from supplements.  Whole foods provide vitamins, minerals, and other nutrients that supplements lack.

Foods high in fiber

Try to increase your fiber intake if your diet contains too many refined carbohydrates, sugar,  white bread, pasta, and processed foods.  Nutrition labels on packaged foods list the amount of dietary fiber in each serving.  Foods rich in fiber content include fresh vegetables, fruit, whole grains, and nuts.  Here are some examples of foods that may be included in a high fiber diet:  beans, peas, lentils, artichokes, broccoli, Brussels sprouts, kale, avocado, baked and sweet potatoes (with the peel), raspberries, bananas, oranges, apples and pears (with the skin), raw almonds and pistachios, oatmeal, whole grain bread, and whole grain pasta.  Raw fruits and vegetables are often higher in fiber that canned varieties.

Speak to your healthcare provider if you think you may need more fiber in your diet.  Contact RMD Primary Care to schedule a visit with our doctors. Our dedication lies with helping our patients live happier, healthier lives.