*Think about hormone replacement therapy.

We already know that estrogen plus progesterone can help reduce colon cancer and osteoporosis, however this combo can also increase blood clots, stroke, heart attacks and breast cancer. Now studies have been done in postmenopausal women to assess the effect of estrogen and progesterone upon mental status. Unfortunately women in the hormone replacement group developed twice the incidence of dementia. The effect was small but significant. In other words, an additional 23 cases of dementia occurred per 10,000 women per year. Also combination hormone replacement increased the rate of urinary incontinence. It is important to emphasize two points: All of these women were in their sixties. This data may not apply to women around menopause in their forties or fifties. In fact, hormone replacement therapy may help women around menopause to decrease hot flashes, sweats and mood swings. Finally the above data only applies to combined hormone replacement therapy (estrogen and progesterone). Estrogen alone may prove to be beneficial but we do not have the data yet. Estrogen alone is given to patients who don’t have a uterus since this hormone can cause uterine cancer without the use of progesterone.

*What’s a better diet; Low fat or low carbohydrate.

The debate rages onwards. Is a low carb diet the best way to lose weight? Finally we are starting to get some data. A six month study was performed in obese subjects. Half received a low carb diet and the other half received a low fat diet. In the diabetic patients the low carb diet was victorious in lowering fasting sugar better than the low fat diet. Also triglycerides or fats fell further in the low carb group than the low fat group. In another 12 month study, both groups were compared again. In the first 6 months the low carb group lost significantly more weight but at 12 months both groups had regained weight and the difference in weight lost between the two groups was about the same. Both of these studies were small trials and 40 % dropped out.. This wouldn’t be unusual in the real world either. Finally, we have no data on the health benefits of either diet in these studies. Dean Ornish has shown that a low fat diet combined with smoking cessation and stress reduction can reverse blockages in the heart vessels. This trial was performed in only 48 patients. Low carb diets may help people lose weight but are there any health benefits? We just don’t know. My feeling is the best diet of all time is the Mediterranean diet. Diets rich in fruit, vegetables, grains, fish, olive oil and a little wine probably reduce heart attacks and cancer and help you lose weight. Combine this diet with exercise and you have a plan!

The “Back to Sleep Campaign” for infants works!

Sudden infant death syndrome (SIDS) has been reduced tremendously by having babies sleep on their backs. Researchers were concerned however, that such a position would result in aspiration of saliva into the lungs (aspiration pneumonia) and excessive heartburn. In a trial of over 3000 babies, results show that the above side effects did not occur with greater frequency in any position. In other words, fever spitting up, vomiting and hospitalizations did not increase when the babies were put to sleep on their backs. In fact, fewer episodes of fever, stuffy nose, trouble sleeping and ear infections occurred in the supine position(on the back). My advice remains “Back to the Future.”

Underage drinking is not the adult thing to do.

We know that alcohol leads to big trouble in our society. It is the number one cause of traffic accidents and it leads to countless medical problems including bleeding from the stomach, dementia, anemia, pancreatitis, seizures and many other conditions. Even when drivers on boats don’t drink, the drunken passengers can easily fall overboard and die. This phenomena is well documented. Alcohol also causes extreme psychological stress to innocent family members. If a driver who is legally drunk gets in an accident, irreparable harm may be caused to the user of alcohol and the all the innocent people involved in the motor vehicle accident. The psychologic trauma may affect generations of people. If you are underage and drink, then the incidence of substance abuse, employment problems, smoking and criminal behavior increases significantly. 7th graders were followed for over 10 years and drinking during adolescence was associated with the above problems. Don’t keep quiet on the alcohol issue. Talk to your children and email them with the negative message about alcohol. That message will have tremendous leverage upon our society.

Cigarette smoke not only gets in your eyes but your teeth too.

The most common chronic disease among children is tooth decay. This problem has decreased over the last 50 years due to brushing and fluoride in our water supply. Nevertheless, the problem is still quite common and not decreasing in the impoverished. Dental caries or cavities are caused by a bacteria called strep mutans. This bacteria ferments carbohydrates which produces lactic acid. Ths acid erodes the protective covering of the tooth and decay ensues. Now, according to the Journal of the American Medical Association, passive smoke increases the probability that a child will acquire tooth decay. We already know that passive smoke inhalation by children can cause ear infections, so this may not be much of a surprise. The nicotine present in smoke may increase the growth of the cavity causing bacteria found in the mouth. Reduction of passive smoke exposure to children may effectively reduce dental caries.

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