The “Sitting” Disease

Read in 4 minutes

Do you suffer from the sitting disease? Several scientific studies in recent years have found that prolonged sitting is more harmful for your health than even smoking! Here is what i found out :

  • Sitting continuously for several hours a day puts you at a higher risk for heart disease, high blood pressure , diabetes and weight gain.
  • Extra physical activity does not reduce the effects of prolonged sitting!This means that even if you have exercised for 30-60 minutes in the morning & then spend several hours at work sitting continuously,you are still at a high risk for disease!!All that morning exercise did not count!This was shocking information to me when i read it in Tom Rath’s great book “Eat,Move,Sleep”(I highly recommend that book).
  • A study in monozygotic twins of 32-36 years of age found that the more active twin had better blood sugar control & more brain volume than his less active brother. As we always say, your genes do not decide your destiny!
  • A study from Australia showed that among overweight/obese people ,interrupting sitting time with short bouts of light or moderate intensity walking can reduce after-meal blood sugar & insulin levels.
  • Continuous sitting is related to more coronary artery calcium, which is a marker for heart disease later in life.
  • Too much sitting reduces your bone mineral density makes them  more prone to fractures.

Is it continuous sitting or is it a lack of activity that is more important ?

It is both. This means that in addition to regular exercise you need to ensure that you interrupt your sitting time with movement for even as little as 2-7 minutes! This is absolutely do-able!

WHAT CAN YOU DO ABOUT IT:

Set reminders to get up. I have my laptop announcing the time every hour which is my cue to get up. You can get completely engrossed in your work and lose track of time!

Get up to drink water:Do not keep drinking water on your work table. This will make sure you walk to the water cooler! However, if you are someone for whom drinking enough water doesn’t come easily,please do keep a bottle on your table to remind you!

Use an active desk: A treadmill desk or an adjustable standing desk, which is better? Using active desks versus sitting desks have shown definite benefits in improving health,but studies have shown a clear benefit of a treadmill desk over a standing desk for reducing waist size, reducing blood sugar levels & improving heart rate.However, a treadmill desk certainly costs more and occupies more space in comparison to a standing desk.

My temporary low-cost solution: While i wait to get my treadmill desk, here is what i have done. I got a small wooden table to keep my laptop on. I place this on top of my regular table. Initially I tried one of those laptop stands that are meant for use on beds, but i found them too unstable.

Sit on an exercise/ stability ball. Instead of sitting on a chair you can try sitting on an exercise ball while you are at your table.

Set up walking meetings: Instead of having a meeting sitting at your office,go for a walk outdoors. Yes, i know you can’t take written notes while walking but use a voice recorder!

Do share your ideas on what you do to avoid the “sitting” disease on my FaceBook page https://www.facebook.com/drsdkar

Disclaimer:As always, this blogpost is not medical advice but for information only.

Resources:

beware-chair (1)

TED Video.

This is for some of you who would like to explore the subject in (nerdy) detail.

I have learnt a lot from Peter Janiszewski, PhD, and Travis Saunders, PhD, CEP ‘s blog on PLOS.

http://www.medscape.com/viewarticle/842077

http://www.sciencedaily.com/releases/2015/03/150305205959.htm

http://www.ncbi.nlm.nih.gov/pubmed/25003773

http://care.diabetesjournals.org/content/35/5/976

http://care.diabetesjournals.org/content/35/5/976

[BETTER] BRAIN

Read in 9 minutes

Many of you religiously go for an annual health check up . How much has that helped you? Probably not much! You have been told that your blood sugar is a “little on the higher side”, but you are not a diabetic yet & your cholesterol is high. So you leave your doctor’s clinic with a prescription for a cholesterol lowering medicine & the advise that next year if your blood sugar is in the “diabetes range” you will get the treatment for it. You may have even been told that you should exercise (How much? How often? Don’t know!!) & reduce stress and ( heaven forbid!), a low fat diet!!! There is no discussion about the amount of carbohydrates you eat or what type of fat is bad for you. Your level of inflammation (HsCRP) or homocysteine  levels were not even tested (Hint: Because they are not included in the “cost effective” plan you went for!) And the brain certainly did not come up in the discussion!I wish I could tell you to go through a questionnaire & find out how well your brain works. There is a place for questionnaires, but as a Functional Medicine practitioner I am looking for very early changes. According toDr.Eric Braverman of PATH Medical Centre, we lose 10 milliseconds of brain processing speed every decade! Such subtle changes cannot be detected through questionnaires! However, if you are concerned about dementia or know someone with the disease AND you would like to know how to reduce your own risk for it,then please read on.

(My posts are somewhat nerdy & I don’t apologise for that! If you are interested in exploring scientific studies,the references are at the bottom of the post. This is my first blog post so please bear with me!)

WHAT IS GOOD FOR YOUR HEART IS GOOD FOR YOUR BRAIN!

 Dementia is a group of brain diseases that affect how you think and remember. The onset is often gradual and worsens over time, ultimately affecting your day to day functioning. Emotional symptoms, decreased motivation & language difficulties may also be associated with dementia. Though the word dementia & Alzheimer’s Disease are used interchangeably,they are not the same.Alzheimer’s Disease is the most common type of dementia. Some of the other dementias include

  • Vascular Dementia
  • Lewy-Body Dementia
  • Fronto-temporal  Dementia
  • Parkinson’s Disease

A Few Facts About Alzheimer’s Disease:

  • There is no known cure for Alzheimer’s Disease yet.Therefore addressing several risk factors is a [BETTER] way to reduce your risk for the disease.
  • Though it commonly occurs in the older age group, Alzheimer’s Disease has been known to occur in people in their 40s and 50s.
  • Early onset disease is sometimes associated with genetic mutations.
  • The exact cause of Alzheimer’s Disease is not known. However experts agree that it occurs as a result of interaction between many factors like age, genetics, lifestyle and coexisting medical conditions like diabetes & heart disease.
  • According to the Alzheimer’s Association, anyone with a brain is at risk for Alzheimer’s Disease!

At [BETTER] Medical Centre  how do we look at your risk for Alzheimer’s Disease?

Our initial patient intake involves an extensive history taking & several laboratory tests.  In our speciality of Functional & Metabolic Medicine we take  a “bird’s-eye view” of the whole person, rather than looking at any one system alone. We know that our systems are interrelated & no organ works in isolation.

What You May Not Know About Alzheimer’s Disease Risk:

Neuroinflammation:

Alzheimer’s Disease (AD) has been known as a neurodegenerative disease of the elderly. However,of late neuroinflammation (inflammation of nerve tissue) has emerged as an important component of AD.A recent article in the journal Aging ,by Dr. Dale Bredesen,  a UCLA professor of Neurology, says there may be 3 different types of AD (Alzheimer’s Disease):

Inflammatory, in which C-Reactive Protein and serum albumin-globulin ratios are increased, Non-inflammatory, in which these markers may not change but other metabolic abnormalities are present and Cortical,which affects relatively younger people.In the same article Dr.Bredesen also mentions that the measuring fasting Insulin & Zinc levels are very important in the workup of someone with brain dysfunction.

High Homocysteine:

Homocysteine is an amino acid in the blood.High levels of homocysteine have been associated with increased risk of heart disease, stroke, vascular clotting & dementia. Deficiency of B vitamins (Folate,B6,B12) is associated with high homocysteine levels. Some people may have high homocysteine because of genetic variation in a gene called MTHFR.

A study from Oxford University,UK looking at the effect of supplementation with B vitamins on homocysteine & rate of brain atrophy in people with mild cognitive impairment found that the rate of brain atrophy was less in those taking B vitamins.

Medications :

An article in the journal JAMA Internal Medicine in March 2015 says that the use of anticholinergic medications increases the risk ofdementia.Some of the drugs showing adverse effects are benzodiazepines, diphenhydramine (Benadryl),tricyclic antidepressants like doxepin (Sinequan),  antihistamines like chlorpheniramine (Chlor-Trimeton), and antimuscarinics for bladder control like oxybutynin (Ditropan).It is very important that you do not stop these medicines without the advise of your doctor.

Anaemia:

Low levels of red blood cells may increase the risk of dementia.This was reported in an article in Neurology, the journal of the American Academy of Neurology, in July 2013. Anaemia is not difficult to correct!

Higher Fasting Blood Sugar:

We know that people who have diabetes are more prone to dementia. However even high plasma glucose levels within the normal range (<6.1 mmol/L/109.8 ng/dl) were shown to adversely affect brain structures involved in memory.This is one of  the reasons why we address suboptimal blood sugar levels, even when you are not labelled a diabetic.

Gluten: 

In an interview titled “Dementia:Is Gluten the Culprit?” on Medscape Neurology with Dr.David Perlmutter, Neurologist & author of the book Grain Brain, talks about the possible relation of brain dysfunction with gluten.Do all of you need to be gluten-free? Maybe not! Do this test yourself:Stay off of gluten for 3 weeks ,re-introduce it & track yoursymptoms.You be the best judge. However, as Functional & Metabolic Medicine specialists,we recommend that anyone with an autoimmune disease remains gluten free.

Gut Health,Human Microbiome:

In the last few years there have been several scientific studies showing  a relationship of the microbes present in our intestine with health and disease.Evidence indicates a close relationship of the human microbiome through complex pathways connecting the gut, skin, liver & other organs to the central nervous system. This is why we talk about the gut-brain-immune connection. In fact your gut is considered to be your “second brain”.

Hormones:

Imbalance of hormones like estrogen , testosterone, progesterone , cortisol, pregnenolone, thyroid hormones, parathyroid hormones have been associated with cognitive decline. In fact recent studies have shown that many of these hormones act as neurosteroids,i.e. they have very important protective activity in the brain.

Heavy Metal Toxicities:

Toxicities from metals like Arsenic, Cadmium, Mercury, Aluminum and Lead have been found to be associated with impaired brain function.

Cigarette smoking is associated with higher Cadmium levels.People who eat a lot of fish and those that have old mercury fillings may have mercury toxicity. However many people without any risk are frequently been found to have significantly elevated levels of heavy metals.

Binge Drinking, Heavy Drinking :

Heavy drinking & binge drinking have been associated with an increased incidence of dementia.Alcohol is a poison for the brain.

The Substance Abuse and Mental Health Services Administration (SAMHSA), defines binge drinking as drinking 5 or more alcoholic drinks on the same occasion on at least 1 day in the past 30 days.

Head Trauma:

There is a strong link between serious head trauma and the risk of dementia. So continue using that helmet!

Dr.Daniel Amen who is known as America’s Brain Doctor ,talks about how a detailed brain function assessment along with a SPECT scan can help you to test brain function. Our clinics are affiliated with Dr.Daniel Amen’s clinic in USA.

Sleep:

Sleep is considered to be the “master reset button” of your body. If you have poor quality sleep or Obstructive Sleep Apnea , your brain function will be affected.

We are pleased to have Dr. Adam Moscovitch, Canada’s eminent Sleep Medicine Expert provide Sleep medicine at our facility in Calgary.

What Can You Do to Reduce Your Risk of Dementia?

It turns out that there is a lot that you can do to reduce your risk for dementia!

    • Get a Functional & Metabolic Medical assessment done.
    • Sleep
    • Stress Reduction
    • Maintain optimal blood sugar.
    • Eat a brain-healthy diet. A DASH diet or a Mediterranean diet has shown a lot of benefits.Eat plenty of fresh vegetables & moderate quantity of nuts and fruit.
    • Reduce alcohol consumption.
    • Learn something new. Mental stimulation prevents cognitive decline.
    • Maintain social contacts.
    • Exercise: This increases your levels of BDNF (Brain Derived Neurotrophic Factor).
    • Meditation. We always knew meditation was good for you , but science now has tools to demonstrate what a regular meditation practice can do to your brain. fMRI studies have shown that there was less atrophy of the hippocampus (a brain area associated with memory), in those practicing MBSR (Mindfulness Based Stress Reduction) than in those without.
    • Know the 10 early Signs of Dementia. A very valuable website

http://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp?type=alzFooter#signs

Please post your comments on FaceBook at https://www.facebook.com/drsdkar

References:

http://www.sciencedaily.com/releases/2015/09/150916165404.htm

http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/journal.pone.0012244&representation=PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358759/

http://www.sciencedaily.com/releases/2013/07/130731164713.htm

http://www.neurology.org/content/79/10/1019#

http://www.medscape.com/viewarticle/819232_1

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775450/

http://www.sciencedaily.com/releases/2013/11/131118141817.htm

http://www.nytimes.com/2015/01/09/opinion/skip-your-annual-physical.html?_r=0

Disclaimer:The contents of this blog are for information only. Please discuss with a knowledgable medical practitioner before implementing this information.