Glucosamine and Chondroitin: Real or Placebo Effect?

I keep hearing this same information over and over again from reliable sources, I guess it is time to stop spending money on this product.

 (Berkeley Wellness)

Millions of Americans take glucosamine, often with chondroitin sulfate, for the aches and pains of osteoarthritis. Over the years, research has yielded inconsistent findings, but more recent studies have made things clearer.

Glucosamine and chondroitin sulfate are produced in the human body and are involved in the production and maintenance of the cartilage that cushions joints. The supplement glucosamine is manufactured from shellfish; chondroitin, usually from cow bone. It’s claimed that they cure or alleviate arthritis pain, help build cartilage and cushion the joints, and prevent deterioration of cartilage.

What the studies show: In 2006 the government-sponsored Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) reported that neither glucosamine hydrochloride nor chondroitin sulfate, alone or together, reduced pain and other symptoms significantly better than a placebo. (The prescription pain reliever Celebrex, also tested, fared only slightly better.)

But what about the main claim made for these supplements—that they slow or prevent the deterioration of joint-cushioning cartilage that is the hallmark of arthritis? In 2008 results of the second part of the study answered this question. The first GAIT study lasted six months and included 1,600 people with osteoarthritis of the knee, the joint that’s most likely to cause pain and loss of mobility. In the follow-up study, 357 of these subjects continued treatment (glucosamine, chondroitin, both supplements together, Celebrex, or placebo) for an additional 18 months and then had X-ray exams to measure cartilage loss. The exams found insignificant differences in cartilage loss between the groups. Interestingly, glucosamine and chondroitin did worse when taken together than alone, but nothing worked much better than the placebo.





Also in 2008, a Dutch study of 222 people with arthritis of the hip found that another form of glucosamine (sulfate) did not reduce pain or stiffness better than a placebo, and X-rays revealed no differences.

More discouraging news about glucosamine came in July from a well-designed study from Norway. It included people with low back pain and arthritis of the lower spine, half of whom took glucosamine sulfate (1,500 milligrams a day), the other half a placebo. After six months, both groups reported similar levels of disability, pain, and overall quality of life. That is, glucosamine worked no better than a placebo.

Bottom line

Americans spend billions of dollars every year on unproven arthritis remedies including glucosamine. There is no cure, but everything (including a placebo) seems to work at least for some people for a while. The placebo in the GAIT study helped relieve symptoms in a whopping 60% of subjects, about the same as the supplements. Pain relievers help many arthritis sufferers but don’t affect the underlying loss of cartilage. Discuss the options with your doctor. We suggest you forget about glucosamine and chondroitin—unless you are willing to pay $20 or more a month for what is probably a placebo effect. If you already take these supplements and think they help, continue with them, but consider stopping for a while to see if there’s a difference.

Osteoporosis

(Dr. Weil) What is osteoporosis?
Osteoporosis refers to a loss of bone mass causing the bones to become porous and fragile. Our skeletal frames are constantly being remodeled, with bone tissue being broken down and rebuilt on a regular basis. Bone density (the degree of mineralization of the bone matrix) usually increases until about the age of 30, but after that, trouble can begin. Osteoporosis sets in when more bone is lost than can be rebuilt. Eventually, bones become brittle and easily fractured. There are actually two different types of bone - both of which lose bone mass later in life, but at different times.

1. Trabecular bone refers to the inner portion of bone that contains calcium in lattice crystal-like structures. The years that comprise childhood through young adulthood are critical for depositing calcium in trabecular bone, which then provides a reserve of this mineral in later life. Trabecular bone is sensitive to several hormones, including estrogen, which control the amount of calcium deposited and withdrawn. The calcium in trabecular bone is used by the body when blood calcium levels are low. After age 30, a gradual loss in trabecular bone begins to occur.
2. Cortical bone is the dense layer that forms the outer shell of bone. While both types of bone are crucial to bone strength and both contain calcium, cortical bone does not give up its reserves as readily as trabecular bone, and does not begin to decline in mass until after about age 40.

What are the causes of osteoporosis?

• Genetics. Women are more at risk, but anyone of thin build and of Northern European or Asian descent is at higher risk. Studies of mothers and daughters have shown that heredity plays a role in bone density. Bone loss is more gradual in men, but once they reach age 70 their risk for osteoporosis increases significantly. Men in this age group are at increased risk for fractures, particularly if they are sedentary and have a diet low in calcium.
• Menopause. Particularly in those not taking hormone replacement therapy. estrogen plays an important role in maintaining bone mass. Once women reach menopause and estrogen levels decline, bone loss escalates. Rapid bone loss continues for about five years during and after menopause, and can deplete three to four percent of total bone mass. This surge of bone loss eventually tapers off after a few years, and soon equals the amount of bone loss in men of the same age. But the loss of bone minerals continues throughout the rest of a person's life. About one out of every three postmenopausal women has osteoporosis to some degree, even mild osteoporosis leads to an increased risk of fractures, particularly of the hip, vertebrae and wrists. Fractures can have serious consequences as well. About 20 percent of elderly women who undergo hip replacement surgery due to a hip fracture die within one year. And half of those who survive will require full-time nursing care.
• Poor intake of calcium. Calcium intake in the diet plays a vital role in bone mineralization during the growth years and is essential to depositing an abundant supply of calcium into the bones. Even after maximum bone mass has been achieved, calcium intake continues to be important to help slow down bone loss later in life. Dairy products are one of the best sources of calcium, but many people choose not to eat them or can't tolerate them because of lactose intolerance or allergy. Other food sources of calcium are canned sardines, dark green vegetables like broccoli, collard greens and bok choy, as well as tofu and calcium-fortified juices and soy milk. However, a supplement is recommended to ensure you are getting enough.
• Lack of vitamin D. Vitamin D plays a pivotal role in allowing the body to absorb calcium. Vitamin D is synthesized naturally in the skin when it is exposed to sunlight. It is also available in fortified milk and cereals. However, many people do not produce enough vitamin D or get enough from food. Vitamin D deficiency can be a problem for older people and those who are homebound or bed-ridden.
• Inactivity. Weight-bearing activities such as walking, jogging and weight training help to maintain bone density. A sedentary lifestyle promotes bone loss as well as muscle loss. Conversely, muscle use promotes the building of bone. Regular physical activity strengthens both muscles and bones, slows down bone loss and decreases the risk of injury from falls.
• Smoking. The relationship between bone loss and smoking has been confirmed by numerous studies. However, once you quit smoking, even later in life, the bone loss influenced by this habit can be minimized.
• Excessive alcohol intake. People who drink alcohol to excess are more prone to fractures. This may be partially due to the diuretic effect of alcohol, which induces calcium losses through the urine. Alcohol can also decrease the absorption of calcium from the intestines and cause deficiencies in vitamin D and magnesium - both of which are important to bone health.
• High sodium intake. Several studies have demonstrated the harmful effects of high dietary sodium on bone integrity. Reducing sodium intake can reduce bone loss considerably.
• Coffee. Coffee consumption of more than two cups a day may contribute to accelerated bone loss.
• High consumption of animal protein. Some studies have shown that a diet high in animal protein actually promotes bone loss by leaching calcium from the bones, although the verdict is still out on this issue.
• A high acid-ash diet. Recent research has suggested that eating an acid-ash producing diet (high in animal protein and grains, low in vegetables and fruit) causes an increase in urinary excretion of calcium, leading to bone loss.
• Medications. Certain medications, such as steroids and anticonvulsants, may contribute to bone demineralization.

How is osteoporosis diagnosed?
The most accurate testing method to measure bone density and diagnose osteoporosis is the DEXA (Dual Energy X-ray Absorptiometry), which uses a computer to scan an image of the hip and spine. Less accurate screening methods are now available in pharmacies and at health fairs. X-rays, which were used in the past, are not sensitive. At least 25 percent of bone loss has to occur before osteoporosis can be diagnosed from a routine X-ray.

What is the conventional treatment of osteoporosis?
I have recommended the conventional prescription drugs Actonel, Fosomax and Evista for osteoporosis treatment. They have different benefits and risks, however. Evista (raloxifene) might be suitable for some women while Actonel (risedronate sodium) or Fosamax (alendronate sodium) would be better for others. The choice has to be made on the basis of a woman's individual health profile and in consultation with her physician. Both Actonel and Fosamax seem to do a pretty good job of slowing menopausal bone loss. Fosamax's effects can be seen as soon as three months after treatment begins and continue as long as you are on the drug. Unfortunately, this drug can cause severe digestive reactions including irritation, inflammation, and ulceration of the esophagus, all of which may cause chest pain, heartburn or pain with swallowing.
Actonel is newer than Fosamax and works in much the same way. Research shows that it reduces the risk of new vertebral fractures by 65 percent within one year of treatment. I have tended to recommend it over Fosamax because patients tell me that the side effects are milder. The most common include stomach upset, diarrhea, headache and joint pain that may disappear as the body adjusts to the medication.
Evista (raloxifene) is an entirely different type of drug, a selective estrogen receptor modifier (SERM). These agents seem to provide the benefits of estrogen replacement without increasing breast cancer risk. In fact, Evista appears to reduce breast cancer risk as well as protect against osteoporosis. Side effects include hot flashes and vaginal discharge, dryness, or itching. We will know more about the benefits and risks of Evista when the National Cancer Institute completes a five year study comparing it to Tamoxifen, a drug used to treat breast cancer patients and recently shown to reduce the incidence of breast cancer among high risk women. Tamoxifen also protects against osteoporosis.
Fortunately, if you develop side effects to one of the available drugs, you can switch to another. Another drug receiving attention is strontium ranelate, a combination of the mineral strontium with ranelic acid. It has been licensed for sale in the UK and elsewhere in Europe for treatment of osteoporosis in postmenopausal women. A number of studies have shown that it can strengthen bone and reduce the risk of fractures, even among women 74 years of age or older when risks are highest. Strontium ranelate is not yet approved by the FDA for treatment or prevention of osteoporosis in the United States. It remains under study.
A final concern is that many women can't tolerate the side effects of the popular drugs Fosamax, Actonel and Boniva, which are all varieties of bisphosphonates. Irritation of the stomach and esophagus is the most common reported problem, but some oral surgeons and dentists have begun to report a more serious concern in a sub-group of their patients: jaw necrosis, the death of the jawbone. This warrants further study.
What therapies does Dr. Weil recommend for osteoporosis treatment or osteoporosis prevention?

• Eat plenty of vegetables and fruit. Potassium, magnesium, vitamin C and beta carotene (found in fruits and vegetables) have been associated with higher total bone mass. A diet rich in vegetables and fruit and moderate in animal protein and grains may minimize the acid-ash residue of the diet.
• Get enough calcium. This mineral is one of the primary constituents of bone, and adequate intakes are necessary for lifelong bone health. Choose non-fat dairy products such as yogurt and non-fat milk. Eat more sardines (with bones), dark green vegetables like collard greens, bok choy and broccoli, whole soy based products like tofu, and calcium-fortified soy milk and orange juice. Consider taking a calcium supplement if you are not eating at least three servings of dairy per day and/or calcium-fortified foods, if you are postmenopausal or if you have a family history of osteoporosis.
• Eat magnesium-rich foods every day, including spinach, tofu, almonds, broccoli and lentils. Pumpkin seeds and sunflower seeds are also good sources of magnesium.
• Eat vitamin K-rich foods every day. The best sources are green leafy vegetables (see the calcium-rich greens listed above), but most vegetables are good sources. Talk with your doctor about the effects of vitamin K if you are taking a blood-thinning medication.
• Make sure you get enough vitamin D. I recommend supplementing with 2,000 IU daily for adults.
• Decrease your sodium intake. Avoid salty processed foods and fast food. Don't salt your food before tasting it.
• Limit caffeine intake.
• Avoid alcohol or drink only in moderation.
• Increase weight-bearing activities, such as walking, weight training and calisthenics. Try to do at least 30 minutes of exercise most days of the week.

Expiration Dates

(Berkeley Wellness)

Our toothpaste just “expired.” What do you do—resuscitate it or toss it? Many products carry expiration dates, but it’s hard to know what they mean.

Expiration dates are not an exact science. They are not uniformly regulated—and not all states even require them. How long a product remains good also depends on how it’s been stored and handled. Still, it’s a good idea to select products with the latest dates.

Food: In general, buy foods before their “sell-by” dates, and observe “use-by” dates. Foods past their dates are often still safe, however, if they’ve been stored and handled properly (refrigerate perishables at 40° F or below). Milk can stay fresh up to a week after its sell-by date; eggs can last three to five weeks. Of course, if a food looks or smells bad, throw it out, no matter what the date.

Drugs: Expiration dates guarantee that drugs are potent and safe. They do not mean that they are not effective or safe afterward, though. In many cases, medications are stable far past their expiration dates. Drugs do begin to break down after you open the bottle and if they are exposed to heat, humidity, light, and temperature fluctuations—so store them in a cool, dry, dark place. If in doubt, consult a pharmacist.

Sunscreens: Most sunscreens have a three- to five-year shelf-life from time of manufacture and carry either an expiration date or a coded manufacture date that is harder to decipher. Heat and humidity can reduce the potency of sunscreens, so you should store them in a cool, dry place. If used properly—you need to apply a lot, frequently—you’re unlikely to have any left over, so expiration dates would not be a concern.

Toothpaste: Toothpaste is generally good for 12 to 18 months past its expiration date (which is two years after manufacture). Beyond that, there may be some loss in fluoride stability, ingredients may separate out or crystallize, and flavors may diminish. Toothpaste past its expiration date will not harm you.

What not to use past the expiration date

Certain drugs: Insulin, nitroglycerin, EpiPens (for severe allergic reactions), and liquid antibiotics degrade relatively quickly. There’s no good evidence these drugs become harmful after their expiration dates, but you need to be able to count on getting their full potency. Toss any other expired drugs that are essential for your health, and any that are discolored, develop a strong smell, or have turned powdery. In general, liquid medications and those that require refrigeration are less stable.

Condoms: Condoms have either an expiration date, after which they should not be used, or a manufacture date, after which they are good for up to five years. Outdated condoms are more likely to break. Store condoms in a cool, dry place. Do not use them if they are sticky or dry or if the wrapper is damaged.

Infant formulas and baby food: Buy and use before their “use-by” dates, after which nutrient levels and quality decline.

My motto is "when in doubt throw it out".

Bed Bugs

I know this not a pleasant subject, but I did not know much about bedbugs myself.

(Dr. Weil)
After more than 20 years of near extinction, bed bugs (Cimex lectularius) now seem to be everywhere in the U.S. The Environmental Protection Agency (EPA) now regards bed bugs as a "major problem." The reason for the big uptick seems to be increased international travel - these pests are hitching rides in our luggage. The good news is that bed bugs don't transmit disease - they're certainly unpleasant to have around, but they don't pose an immediate health risk.
You may have a bed bug infestation if:

• You see the bugs themselves - they are oval, flattened, brown, wingless insects that are about 1/4 inch long.
• When you get up in the morning you have red welts on your skin.
• You see blood and orangish-brown spots of bug feces on pillows and sheets.
• There is an unpleasant, pungent odor in or near the bed.

To prevent an infestation, try these measures:

• When traveling, check behind hotel bed frames and under mattress covers for orangish-brown fecal spots.
• When you get home, wash all your clothes in hot water and store suitcases in a plastic bag in a hot car trunk or attic.
• Use a mattress cover designed to suppress bed bugs.

Getting rid of bed bugs isn't easy, as they seem to be developing resistance to most natural pesticides.  If you have bed bugs, get professionals to handle the extermination, and ask them to first try pumping hot air into your bedroom - bed bugs can't survive extreme heat.

Southwestern Chicken Salad

Southwestern Grilled Chicken Salad with Tomato and Black Bean Salsa
by Susie Middleton
We really like this salad, the salmon was a great alternative to chicken and you could substitute other fish as well.

Serves four.
1 boneless skinless chicken breast half (6 to 7 oz.), trimmed ( I used Salmon)
1/2 Tbs. chili powder
1 tsp. light or dark brown sugar ( I added 1 tbsp)
1/2 tsp. ground coriander
1/2 tsp. ground cumin
Kosher salt

6 Tbs. extra-virgin olive oil; more for the grill 2 Tbs.
 2 tsp. fresh lime juice
1 Tbs. plus 2 tsp. chopped fresh cilantro, plus leaves for garnish
2 tsp. honey
Freshly ground black pepper
Green Tabasco (optional)
(I added 1 clove of garlic and 1 tsp of the spice mix)

1 cup canned black beans, rinsed and drained
4 oz. small cherry or grape tomatoes, quartered or halved (about 3/4 cup)
1 large scallion, thinly sliced
2 small heads Bibb lettuce, torn into bite-size pieces (about 9 cups)
1 medium firm-ripe avocado
1/4 cup toasted pine nuts or pepitas
( you could also add fresh corn or other vegetables)

Prepare a medium-high gas or charcoal grill fire.
Trim and then butterfly the chicken breast by slicing it horizontally almost but not entirely in half so you can open it like a book.
Combine the chili powder, brown sugar, coriander, cumin, and 3/4 tsp. salt in a small bowl. Rub some of the spice mix over both sides of the butterflied chicken breast (you won’t need it all) and let sit while the grill heats.
Clean and oil the grill grate. Grill the breast until the edges of the top side are white, about 3 minutes. Flip and cook until just done, 1 to 2 minutes more. Let the chicken rest for 5 to 10 minutes.
In a small bowl or a glass jar with a tight lid, combine the olive oil, lime juice, 1?Tbs. of the cilantro, the honey, 1/2 tsp. salt, a few grinds of pepper, and a few shakes of green Tabasco (if using). Whisk or shake well to combine.
Combine the black beans, tomatoes, scallion, the remaining 2 tsp. cilantro, and a pinch of salt in a small bowl. Add 2 Tbs. of the dressing and toss gently.
Put the lettuce in a bowl, season with a little salt, and toss with just enough of the dressing to lightly coat. (Reserve a little to drizzle on the chicken.) Arrange the lettuce on a platter or four dinner plates. Slice the chicken breast very thinly. Pit and slice the avocado. Arrange the chicken, avocado, and salsa on the lettuce. Drizzle a little of the remaining dressing over the chicken and avocado. Garnish with the pine nuts or pepitas and the cilantro leaves.
serving suggestions
Serve with sweet, toasty Grilled Corn on the Cob. (and maybe a corn muffin, I love corn muffins!)

nutrition information (per serving): Calories (kcal): 470; Fat (g): 33; Fat Calories (kcal): 290; Saturated Fat (g): 5; Protein (g): 18; Monounsaturated Fat (g): 21; Carbohydrates (g): 28; Polyunsaturated Fat (g): 5; Sodium (mg): 510; Cholesterol (mg): 25; Fiber (g): 9;
photo: Scott Phillips From Fine Cooking 106, pp. 58

Natural versus Artificial Trans Fats

 (Berkeley Wellness)
Bottom line is to stay away from all artificial products and stick to what Mother Nature gave us. Choose low fat and non fat foods and if you are craving something bad, just have a small portion once in a while.

Artificial trans fats—used in margarines, baked goods, and other processed foods—have known health risks. But what about the trans fats found naturally in small amounts in the fat of dairy and meat products? Are they a risk, too?

Trans fats are created by adding hydrogen molecules to unsaturated fats (vegetable oils) to make them more solid and stable, a process called partial hydrogenation. But some trans fats are also formed naturally by bacteria in the stomachs of cows, sheep, and other ruminant animals. About 20% of the trans fats we eat is natural. 

Preliminary research suggests that natural trans fats have different effects in the body than artificial ones. Artificial trans fats raise total and LDL (“bad”) cholesterol and lower HDL (“good”) cholesterol, thus increasing the risk of heart disease. In contrast, a few population studies suggest that natural trans fats, at normal dietary levels, have a neutral effect on heart health and may even be protective. Two short studies in the American Journal of Clinical Nutrition found that natural trans fats—even at levels higher than the average diet—did not adversely affect cholesterol. Both studies were funded by the dairy industry, which has a vested interest in showing that these fats are safe.

Take-home message: Avoid artificial trans fats in processed foods as much as possible. But don’t worry about natural trans fats. The amounts are so low that they don’t even show up on nutrition labels. Of more concern are the saturated fats that accompany them—a good reason to eat low-fat or nonfat dairy foods and lean meats.

Soymilk

 (Dr. Weil)

 Soymilk is made by soaking dried soy beans in water, then grinding, heating and pressing them. The fluid is then strained and packaged as "milk" Among its many benefits, soymilk:
Can substitute for cow's milk in many culinary applications, thus avoiding the butterfat, which is unhealthy

• Does not contain milk protein (casein), which can increase mucus production and irritate the immune system in some people
• Does not contain milk sugar (lactose), which can cause digestive distress in those that are lactose intolerant.
• Is a good source of protein - one cup contains four to 10 grams of soy protein.

When choosing soymilk, opt for a brand that is:

• Fortified with calcium - while soymilk is naturally a good source of calcium, it doesn't have as much as cow's milk
• Organic - many soy crops are heavily treated with pesticides
• Free of the thickening agent carrageenan, a seaweed derivative, which I believe may be harmful, especially to the intestinal tract
• A low-fat version, especially if you are watching your weight.

I recommend one to two one-cup servings daily.

Tips to Prevent Poison Oak or Ivy

(Dr. Weil)
These are some great tips, but also if it gets very bad see the doctor! They have stronger medicines that help.

If you enjoy camping out in the spring and summer, you should be aware of poison ivy.  Along with poison oak and sumac, this non-flowering plant can cause severe allergic reactions, resulting in an intensely itchy, red rash with bumps or blisters. Once you make contact with poison ivy, try the following to minimize symptoms:

1. Avoid touching other parts of your body. This is especially important immediately after exposure, since the irritating oils can be transferred to other areas.
2. Rinse affected areas with plenty of cold water immediately after exposure to flush out oils, or wash with rubbing alcohol.
3. Use an over-the-counter product known as Tecnu lotion, which works well to remove oils up to 24 hours after contact.
4. If the itching has begun to develop, run hot water - as hot as you can stand - on the affected areas. The itching will briefly become intense, but then will stop for several hours, as the nerves that convey the sensory information to the brain become overloaded and quit. Repeat the hot water treatment as necessary.
5. Relieve itching with calamine lotion and aloe vera gel.
6. Try witch hazel (Hamamelis virginiana) to treat poison ivy blisters. Available in liquid distillation, it can be found at any drug store and can be safely used by both adults and children.

Keep in mind that serious cases of poison ivy require medical supervision and prescription treatment - contact your physician if you run a fever of 101 degrees or higher, if blisters ooze pus, or if the rash is widespread or near sensitive areas such as eyes, mouth or genitals. For more information, visit the Condition Care Guide.

GRILLED SOY LEMON HALIBUT

 

This is one of my favorite marinades for fish, I found it in the Sunset Kitchen Cabinet cookbook which has a wonderful array of old tried and true recipes.

 

 GRILLED SOY-LEMON HALIBUT

---

□   3 tbsp. butter, melted, can add a bit of olive oil to the butter if desired
□   3 tbsp. soy sauce
□   2 tbsp. lemon juice
□   1 tbsp. sugar
□   1 tbsp. Worcestershire sauce
□   1/2 tsp. ginger or grate some fresh ginger
□   Shake of garlic powder or fresh garlic
□   1/8 tsp. pepper
□   2 lb. halibut (orange roughy works well, too)

 

 We marinate the fish for 1-2 hours in the refrigerator. Grill for 8-10 min.

Soymilk

(Dr. Weil)
I believe soymilk is a great alternative to milk, there is controversy regarding too much soy in your diet which I would suggest doing more research on. But my motto is 'everything in moderation'. There are other great alternatives to milk on the grocery shelves these days. I prefer the vanilla versions.

Soymilk is made by soaking dried soy beans in water, then grinding, heating and pressing them. The fluid is then strained and packaged as "milk" Among its many benefits, soymilk:
Can substitute for cow's milk in many culinary applications, thus avoiding the butterfat, which is unhealthy

• Does not contain milk protein (casein), which can increase mucus production and irritate the immune system in some people
• Does not contain milk sugar (lactose), which can cause digestive distress in those that are lactose intolerant.
• Is a good source of protein - one cup contains four to 10 grams of soy protein.

When choosing soymilk, opt for a brand that is:

• Fortified with calcium - while soymilk is naturally a good source of calcium, it doesn't have as much as cow's milk
• Organic - many soy crops are heavily treated with pesticides
• Free of the thickening agent carrageenan, a seaweed derivative, which I believe may be harmful, especially to the intestinal tract
• A low-fat version, especially if you are watching your weight.

I recommend one to two one-cup servings daily.

Is Fatter Better as You Age?

 (Dr. Weil)
The question was is fatter better as you age? Interesting thought...

You're no doubt referring to a widely publicized study from Australia, which found that being a bit overweight in your 70s is associated with a longer life expectancy than being either obese or of normal weight. Researchers at the Western Australia Center for Health and Aging reviewed data on more than 9,000 men and women between the ages of 70 and 75 and found that those whose body mass index (BMI) classified them as overweight were the least likely to die over their study's 10-year follow up. (BMI is a measure of body fat based on height and weight.

The Australian study showed that the study participants most likely to die during the 10 years were the obese and the underweight; those with a BMI in the "healthy" range had a slightly higher risk of dying during this time frame than the overweight. They also found that a sedentary lifestyle doubled the mortality risk for women, and increased men's mortality risk by 28 percent.

The researchers concluded that their findings lend credence to claims that BMI thresholds for the overweight and obese are "overly restrictive" for older people.

In my book Healthy Aging I took issue with the notion that simply being overweight¸ as indicated by tables of ideal heights and weights or BMI measurements, makes people unhealthy and less likely to age gracefully. I also noted that being too lean may compromise health and longevity.

In fact, several earlier studies have come to the same conclusion as the recent Australian one. The difference is that the Australian investigators analyzed common causes of death such as cardiovascular disease and cancer and found that here, too, participants with an "overweight" BMI had a 13 percent lower risk of death compared those who were of normal weight or were obese.

My view is that individuals who are somewhat overweight in middle age may enjoy a healthier and longer old age than those who are not. I believe that it is better to be fit and fat than lean and not fit.

I'm not suggesting that it's OK to resign yourself to being fat. Obesity is a known health risk. But if you are somewhat overweight and cannot maintain the ideal weight of actuarial tables, I think you should forget about the numbers and concentrate on maintaining optimum health by eating right and keeping physically active.

Andrew Weil, M.D.

Sunburn Help

(Prevention Magazine)

These are really good tips to remember especially when traveling to high altitudes and the tropical areas. The sun exposure and heat is much more intense.

 Use compresses

Following a burn, skin is inflamed. Cool it down with compresses dipped in any of the following substances.

• Cold water. Use either plain water from the faucet or add a few ice cubes, says Michael Schreiber, M.D. Dip a cloth into the liquid and lay it over the burn. Repeat every few minutes as the cloth warms. Apply several times a day for a total of 10 to 15 minutes each.
• Aluminum acetate. If itching is intense, says Thomas Gossel, Ph.D., R.Ph., try mixing Domeboro's powder packets (available in drugstores) with water. The aluminum acetate in the powder keeps skin from getting too dry or itchy. Follow package directions.
• Witch hazel. Moisten a cloth with witch hazel, says Fredric Haberman, M.D. This incredible astringent has been shown to have long-lasting anti-inflammatory relief. Apply often for temporary relief. For smaller areas, dip cotton balls into the liquid and gently wipe on. 

Common kitchen staples can be great sunburn soothers.

• Oatmeal. Wrap dry oatmeal in cheesecloth or gauze. Run cool water through it. Discard the oatmeal and soak compresses in the liquid. Apply every 2 to 4 hours.
• Fat-free milk. Mix 1 cup fat-free milk with 4 cups water, then add a few ice cubes. Apply compresses for 15 to 20 minutes; repeat every 2 to 4 hours.
• Cornstarch. Add enough water to cornstarch to make a paste. Apply directly to the sunburn.
• Lettuce. Boil lettuce leaves in water. Strain, then let the liquid cool several hours in the refrigerator. Dip cotton balls into the liquid and gently press or wipe onto irritated skin.
• Yogurt. Apply yogurt to all sunburned areas. Rinse off in a cool shower, then gently pat skin dry.
• Tea bags. If your eyelids are burned, apply tea bags soaked in cool water to decrease swelling and help relieve pain. Tea has tannic acid, which seems to ease sunburn pain.

 Don’t make it worse! Soap can dry and irritate burned skin.

Do not soak in soapy water. Likewise, stay away from bubble baths. If you must use soap, says Dr. Gossel, use only a mild brand and rinse it off very well.

What you can do is take a cool bath, as an alternative to compresses. Add more water as needed to keep the temperature cool. Afterward, gently pat your skin dry with a clean towel. Do not rub your skin, or you'll irritate it further.

You can also add one of the following to reduce pain, itching, and inflammation.

• Vinegar. Mix 1 cup of white or apple cider vinegar into a tub of cool water, says Carl Korn, M.D. A great astringent, it soothes sunburn pain.
• Aveeno powder. If the sunburn involves a large area, use the premeasured packets or add 1/2 cup of Aveeno Soothing Bath Treatment, made from oatmeal, to a tub of cool water, says Dr. Schreiber. Soak for 15 to 20 minutes. Aveeno is a well-known remedy for itching.
• Baking soda. Generously sprinkle baking soda into tepid bathwater, suggests Dr. Haberman. Instead of toweling off, let the solution dry on your skin. It is completely nontoxic, and it will soothe the pain. 

• Apply a sunscreen about 30 minutes before going out, even if it's overcast. (Harmful rays can penetrate cloud cover.) Don't forget to protect your lips, hands, ears, and the back of your neck. Reapply as necessary after swimming or perspiring heavily.
• Pick a sunscreen with a sun protection factor (SPF) between 15 and 30. Sunscreens with SPF 15 protect against 94 percent of the sun's harmful rays, and those with SPF 30 protect against 97 percent. Also look for the ingredients zinc oxide, titanium dioxide, or avobenzone in your sunscreen. These block both ultraviolet A and B rays.
• Take extra care between the hours of 10:00 a.m. and 3:00 p.m. (11:00 a.m. and 4:00 p.m., daylight saving time), when the sun is at its strongest.
• Wear protective clothing when not swimming. Hats, tightly woven fabrics, and long sleeves help keep the sun off your skin. 

Soaks and compresses feel good and give temporary relief, says Rodney Basler, M.D. But they can make your skin feel drier than before if you don't apply moisturizer immediately afterward. Pat yourself dry, then smooth on some bath oil.

Let it soak in for a minute, then apply a moisturizing cream or lotion, such as Eucerin. 

 

• Relieve with hydrocortisone: Soothe skin irritation and inflammation with a topical lotion, spray, or ointment containing 1 percent hydrocortisone, such as Cortaid or Cortizone-10, says Dr. Basler.
• Soothe with aloe: "We're starting to see evidence in medical literature that aloe vera may really help wound healing," says Dr. Basler. Simply break off a leaf and apply the juice. But test a small area first, he cautions, to make sure you're not allergic to aloe.
• Guard against infection: If you have an infection or are worried that one will develop, use an over-the-counter antibacterial ointment such as Polysporin or Neosporin, says Dr. Schreiber.
• Numb with an anesthetic: If your burn is mild, an over-the-counter anesthetic can relieve pain and itching, says Dr. Gossel. Look for brands that contain benzocaine, benzyl alcohol, lidocaine, or diphenhydramine hydrochloride. Aerosols are easier to apply than creams or ointments, but never spray them directly onto your face. Instead, put some on a piece of gauze or a cotton pad and pat it on your face to avoid contact with your eyes. 

An ice pack can also provide relief if the burn is mild. Wrap it in a damp cloth and hold it over the sunburn. Improvise, if necessary, says Dr. Haberman. "You could even take a bag of frozen peas, for instance, and use that. But make sure to wrap it first so that you're not placing the icy package directly against your skin." 

It's a good idea to drink lots of water to help counteract the drying effects of a sunburn, says Dr. Gossel.

The water in fruit counts, too. One large wedge of watermelon provides 9 ounces--more than 1 full cup--of water. (It's also an excellent source of cancer-fighting lycopene.) Other fruit standouts: 1 c diced honeydew (5.4 ounces of water); 1 c sliced beets (5.2 ounces of water); 1 c cubed cantaloupe (5.1 ounces of water).

Eat lightly but wisely, Dr. Gossel adds. A balanced diet helps provide the nutrients your skin needs to regenerate. 

Sleeping on a sunburn can be challenging, but you need rest for your body to recover . Try sprinkling talcum powder on your sheets to minimize chafing and friction, says Dr. Haberman. A waterbed or air mattress might also help you sleep more easily. 

If blisters develop, you have a pretty bad burn. If they bother you and they cover only a small area, you may carefully drain them, says Dr. Basler. But do not peel the top skin off—you'll have less discomfort and danger of infection if air does not come in contact with sensitive nerve endings.

To drain the fluid, first sterilize a needle by holding it over a flame. Then puncture the edge of the blister and press gently on the top to let the fluid come out. Do this three times in the first 24 hours, says Dr. Basler. Then leave the blisters alone. 

The question is whether certain drugs increase your sensitivity to the sun and lead to a burnlike dermatitis.

Antibiotics, tranquilizers, and antifungal medications can cause reactions, says Dr. Basler. So can oral contraceptives, diuretics, drugs for diabetes, and even PABA-containing sunscreens. Always ask your doctor about potential side effects of any drugs you may be taking.

Even common foods can trigger a bad reaction. "Two young women I know tried to lighten their hair with lime juice," he says. "They didn't realize what a potent photosensitizer lime juice can be until they developed terrible dermatitis every place the juice had run down their faces and arms." 

After you've gotten burned, it takes 3 to 6 months for your skin to return to normal, says Dr. Schreiber. "When you get a sunburn and the top layer of skin peels off, the newly exposed skin is more sensitive than ever. That means you'll burn even faster than you did before if you're not careful."

Be sensitive about your sun exposure and protect yourself with sunscreen, hats, and clothing. 

A severe burn can take a lot out of you, says Dr. Basler. Consult a doctor if you experience nausea, chills, fever, faintness, extensive blistering, general weakness, patches of purple discoloration, or intense itching. Be aware that if the burn seems to be spreading, you could have an infection compounding the problem.

 

 

 

 

 

 

Six Layer Brownie Bars

1	box (1 lb 2.4 oz) Betty Crocker® Original Supreme Premium brownie mix
1/3	cup butter or margarine, melted
1	egg
2/3	cup coconut
2/3	cup toffee bits
2/3	cup semisweet chocolate chips
2/3	cup chopped pecans
3/4	cup plus 2 tablespoons sweetened condensed milk (not evaporated), from 14 oz can*

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	About Concordance™

1.	Heat oven to 350°F (325°F for dark or nonstick pan). Grease bottom only of 9-inch square pan with cooking spray or shortening. (For easier cutting, line pan with foil, then grease foil on bottom only of pan.)
2.	In large bowl, stir brownie mix, pouch of chocolate syrup, butter and egg until well blended. Press into pan. Bake 14 minutes (16 minutes for dark pan).
3.	Top with coconut, toffee bits, chocolate chips and pecans. Drizzle evenly with condensed milk to within 1/2 inch of sides. Bake 35 to 39 minutes longer or until center is set, (37 to 41 minutes for dark pan or until and center is light golden brown). Cool completely, about 2 hours. For bars, cut into 6 rows by 4 rows.   (These are very rich and very decadent)

Snoring

(Berkeley Wellness)
Snoring is usually a minor affair, except for those who have to listen to it. But heavy snoring can be a symptom of sleep apnea, thought to affect at least 10% of adults, mostly men.

Sleep apnea can keep you from getting a restful night’s sleep. What happens is that you stop breathing (for anywhere from 10 seconds to more than a minute), then emit a choking, explosive sound as you struggle to recover—a pattern that may be repeated hundreds of times a night. Besides causing fatigue, daytime drowsiness, and headaches, sleep apnea has been linked to heart attacks, strokes, hypertension, diabetes, and depression.

If you think you have sleep apnea, it makes sense to get help. Being overweight is not only a risk factor for sleep apnea, but also makes it more likely that you’ll develop medical problems as a result. Sleeping pills of all kinds may promote sleep apnea, too. Your doctor may refer you to an ear, nose, and throat specialist or to a sleep disorders center (see below), the most reliable place to have sleep apnea diagnosed.

Fortunately, there are effective treatments for sleep apnea, including practical steps like losing weight and limiting alcohol. Or you may be fitted for an air pump, called CPAP (continuous positive airway pressure), which is attached to a mask or nasal tube and can maintain a reliable flow of air while you sleep. Custom-made mouth devices that pull the tongue and jaw forward may also help.

Checking into a sleep center

Sleep disorders centers, usually attached to hospitals, can be found in most states. Physicians and technicians in these centers have the training and equipment to diagnose a wide range of sleep problems, including sleep apnea. You may be required to stay overnight so that your sleep patterns can be observed and recorded. Alternatively, you may be able to perform sleep apnea testing at home, after being evaluated by a doctor who is board-certified in sleep medicine. The American Academy of Sleep Medicine accredits centers; its website can help you locate the nearest accredited center.