Posts by Daniel Pendick
If you’re a man, you’ve undoubtedly heard that lack of energy or sex drive, trouble concentrating, or feeling down or not quite yourself could be related to low testosterone, or “low T” — and that a little testosterone replacement could have you back on your game. But testosterone replacement is tricky business, and its safety and effectiveness remain controversial. Further, there can be many other causes for the symptoms of “low T.” A thorough evaluation to determine whether low testosterone is really the problem, along with a careful weighing of the potential risks and benefits of testosterone replacement, are essential before considering this drug.
Cardiac arrest is the ultimate 911 emergency. The heart stops sending blood to the body. Death occurs in minutes — unless a bystander takes matters into his or her hands and starts cardiopulmonary resuscitation (CPR). This keeps blood circulating until trained and better-equipped first responders arrive on the scene to jump-start the heart back into a normal rhythm. Two new studies in JAMA provide compelling proof that efforts to train people to do life-saving CPR pay off. Many organizations sponsor CPR and AED training programs. Two notable ones are the American Heart Association and the American Red Cross. Many local departments of public health also provide CPR training, including “friends and family” classes for people close to someone at risk of cardiac arrest. The investment of time and effort to learn CPR is small. The potential payoff — saving a life — is huge.
Protein is essential to good health. The very origin of the word — from the Greek protos, meaning “first” — reflects protein’s top-shelf status in human nutrition. You need it to put meat on your bones and to make hair, blood, connective tissue, antibodies, enzymes, and more. It’s common for athletes and bodybuilders to wolf down extra protein to bulk up. But the message the rest of us often get is that we’re eating too much protein. The conclusion from a “Protein Summit” held in Washington, D.C., is that Americans may eat too little protein, not too much. The potential benefits of higher protein intake include preserving muscle strength despite aging and maintaining a lean, fat-burning physique. Based on the totality of the research presented at the summit, getting 15% to 25% of total daily calories from protein is a good target, although it could be above or below this range depending on your age, sex, and activity level. Healthful sources of protein — like fish, poultry, nuts, beans, and whole grains — are best when adding protein to the diet.
Each year, several million people with neck or back pain get injections of anti-inflammatory steroid medications. When they work (they don’t always), such injections can bring profound relief. But injecting these medications into the spine can cause partial or total paralysis, brain damage, stroke, and even death. Case reports beginning in 2002 highlighted serious problems linked to spinal steroid injections. In 2014, the FDA started requiring a warning on the labels of injectable steroids. A Viewpoint article in this week’s Journal of the American Medical Association spotlights new safety recommendations to help prevent these rare but real problems. The new recommendations are part of the FDA’s Safe Use Initiative.
This week’s inaugural April Fool’s Day edition of JAMA Internal Medicine carried a report entitled “Association Between Apple Consumption and Physician Visits: Appealing the Conventional Wisdom That an Apple a Day Keeps the Doctor Away.” Based on actual national nutrition data collected from nearly 8,400 men and women it concludes, “Evidence does not support that an apple a day keeps the doctor away; however, the small fraction of US adults who eat an apple a day do appear to use fewer prescription medications.” Apples may have failed this critical scientific test, but they are still an excellent choice as a snack, pick-me-up, or dessert.
Nuts have been gaining traction as an all-natural health food. Tree nuts like almonds, pecans, and walnuts are especially prized for their rich cargo of vitamins, minerals, and mono- and polyunsaturated fats. The downside is that tree nuts tend to be pricey. But a study published online this week in JAMA Internal Medicine puts the humble peanut squarely in the same nutritional league as its upscale cousins. This work makes the health benefits of nuts more accessible to lower-income shoppers. An international team of researchers found that in more than 200,000 people from Savannah to Shanghai, those who regularly ate peanuts and other nuts were substantially less likely to have died of any cause — particularly heart disease — over the study period than those who rarely ate nuts. A key take-home message from this study is that eating peanuts appears to be just as potent for preventing heart disease as eating other nuts.
Nearly 2 billion people around the world are anemic, meaning they don’t get enough iron to produce the red blood cells and oxygen-carrying hemoglobin needed to nourish their myriad cells. In developed nations like the United States, though, iron-poor blood is uncommon. The body stores most of its iron in hemoglobin inside red blood cells and in ferritin, a protein that latches onto iron and sequesters it in the liver, spleen, and bone marrow. Most Americans get all the iron they need from food. The body absorbs iron from meat more easily than it absorbs it from plants. Getting enough vitamin C helps the body absorb iron from food. Because the body does not excrete iron rapidly, it can build up over time and possibly cause problems. That’s why it’s a good idea to ask your doctor if you need to take an iron supplement.
Opioid painkillers like hydrocodone and oxycodone offer blessed relief from pain. But the body gets used to them, requiring ever-higher doses. They are also addictive, cause side effects, and can kill. A report in the New England Journal of Medicine says prescription painkiller abuse accounts for about 17,000 deaths a year. Doctors are learning to say no to opioids, but have limited scientific guidance on when and how to best use them for chronic pain. Ideally, these drugs should prescribed for the shortest time possible and, if pain persists, a transition made to a non-addictive form of pain control. This may be other medications or specialized counseling from a pain specialist that might include complementary and alternative treatments, like acupuncture and meditation.
Smartphones and tablets combine an extraordinary amount of portable computing power with connectivity to the world via cell phone signal and WiFi. Many health entrepreneurs are trying to harness that power to help people to get healthier. But do they work? A study published this week in the Annals of Internal Medicine on one popular weight-loss app finds that the answer is “not so much.” University of California, Los Angeles researchers tested one free app called MyFitnessPal. Overweight women who used it lost about five pounds over six months—but so did women who didn’t use the app. In spite of the app’s poor showing in the UCLA trial, MyFitnessPal and other health apps can be useful tools for people who want to manage their weight and lifestyle. But it takes two things from the user—motivation to make a change and using the app enough to produce the desired effect.
More and more experts now recommend that people with high blood pressure regularly check their blood pressure at home. Doing this gives people an idea where their blood pressure stands in between office visits, and can motivate them to care more about their health. It also helps doctors make quick medication adjustments to keep blood pressure in the healthy zone. But according to a new study, up to 15% of home blood pressure monitors as accurate as they should be. Readings can be off by as much as 20 points. If you check your blood pressure at home, bring your monitor and cuff to your doctor’s office and compare the reading you get with the doctor’s known, accurate instrument.