Take steps (literally) to prevent the flu.

It’s time to get a flu shot if you haven’t already. Getting vaccinated is the most important thing you can do to prevent seasonal influenza (flu). But did you know that regular exercise is important for a healthy immune system and can make your flu shot more effective? This is the topic of my Health & Fitness column in the Aiken Standard this week.

Flu vaccine


Exercise can have a positive effect on your immune system. People who participate in moderate exercise on a daily basis have fewer and less severe colds and have up to 50% fewer sick days than those who aren’t regularly active. Research in animals and humans shows that exercise increases the activity of certain immune cells called helper T cells. This makes the immune system response to viruses, like the cold and flu, more robust. The strongest evidence is seen when the exercise is moderate in intensity and duration, such as a 30–60 minute walk or jog.

More exercise isn’t always better, though. Very vigorous and prolonged exercise can have the opposite effect. Athletes who engage in long, intense training tend to be more susceptible to upper respiratory infections. Research shows that immune function is depressed in the weeks leading up to and after running a marathon, leading to an increased risk of becoming sick. The bottom line is that regular exercise improves your immune system, but very vigorous exercise may not.

Regular exercise also enhances the immune system response to the influenza vaccine. This means that the flu vaccine can be more effective in people who exercise. If you don’t exercise already, you can still benefit: One study showed that a single 45 minute exercise session can improve the immune response to the flu vaccine. You can get this benefit by going for a brisk walk before your flu shot.

There are other steps you can take to reduce your chance of getting sick this cold and flu season beyond getting a flu shot and regular exercise. You should avoid close contact with people who are sick since the flu can be spread through the air when an infected person coughs or sneezes. You can also protect yourself by not touching your eyes, nose, or mouth and by washing your hands frequently with soap and water or using an alcohol-based hand sanitizer.

Good nutrition is also important for optimal immune system function. Deficiencies of certain nutrients can have a negative effect on immune function, so eating a balanced diet is essential. That said, there is no support for “boosting” the immune system by taking high doses of vitamins, minerals, or other supplements, despite the claims made by supplement companies. In fact, the majority of nutritional supplements have not undergone appropriate testing and for those supplements that have been tested, the results are not consistent with the claims.

Poor sleep habits are associated with suppressed immunity and more frequent illness. Sleep deprivation can also reduce the positive immune response to a flu shot. High levels of stress increase susceptibility to colds and the flu and can lead to more sick days from work or school. Stress and poor sleep habits tend to occur together, creating a double negative effect on the immune system.

In order to have your best chance of staying healthy this year you should exercise every day, eat a healthy diet, manage your stress, and get enough sleep. Additionally, follow the traditional advice to get a flu shot, wash your hands frequently, stay away from people who are sick, and stay home yourself if you are ill.


drparrsays blog footer

Diabetes 101: What you need to know for American Diabetes Month.

Diabetes is among the fastest-growing health conditions in the United States. Over 30 million adults have diabetes, with 1.5 million new cases each year. If you include prediabetes, which tends to lead to diabetes if untreated, over 115 million Americans are affected. Fortunately, most cases of diabetes can be treated or prevented through healthy eating, weight control, and regular exercise.

Since November is American Diabetes Month, this seems like a good time to raise awareness about the prevention, treatment, and consequences of this serious medical condition.  If you want to learn more about diabetes, a great place to start is American Diabetes Association. This is also the topic of my Health & Fitness column in the Aiken Standard this week.

diabetes


Diabetes mellitus is a metabolic disorder characterized by high blood glucose (sugar) caused by a lack of insulin production or impaired insulin action. The lack of insulin production can be caused by an autoimmune disorder that damages the pancreas. This typically occurs during childhood, as in type 1 or “juvenile” diabetes, but it can occur in adults, a condition called latent autoimmune diabetes of adulthood (LADA). For both types, injected insulin is required to control blood glucose.

More commonly, diabetes is caused by the body’s cells not responding to the insulin that is produced, a condition called insulin resistance. This is called type 2 diabetes and is thought to be caused by some combination of obesity, particularly excess abdominal fat, and physical inactivity.

Diabetes can be diagnosed based on a fasting blood glucose test, taken 8–12 hours after a meal, usually in the morning. Another test is an oral glucose tolerance test in which blood glucose is measured for two hours after drinking a special beverage containing glucose. This measures the body’s response to glucose. The hemoglobin A1C test is a long-term measure of blood glucose control. This is important because the higher the hemoglobin A1C level, the greater the risk of diabetes complications.

For most diabetics, the main treatment goal is to control blood glucose level to prevent serious complications including nerve damage, blindness, infection and amputation, heart attack, and stroke. This is typically accomplished through a combination of diet, exercise, and medications, with varying degrees of success. But “curing” diabetes is rare, so most patients require continued treatment.

Exercise is important for blood glucose control because exercise causes an increase in the uptake of glucose into cells and can improve glucose tolerance and insulin sensitivity. In addition, exercise has the added benefits of promoting weight loss and improving strength and fitness. Both aerobic and strength training are recommended, with a minimum goal of 30 minutes per day, every day.

Meal planning involves selecting healthy foods to help maintain consistent blood glucose levels while meeting energy needs for exercise and other activities. The dietary recommendations for preventing and treating diabetes are almost identical to the general recommendations for good health: Emphasize whole grains, fruits, vegetables, legumes, and low-fat meat and dairy and reduce unhealthy fats, added sugars, and salt. The diet should also promote weight loss and weight maintenance, especially for overweight patients. The glycemic index (GI), a measure of how much a food raises blood glucose, can be helpful in dietary planning, but it is not the only meal planning tool that should be used.

Proper diet, blood glucose testing, medication use, and regular exercise can improve blood glucose control, reduce the risk of other health problems, and improve quality of life in diabetics. In those with prediabetes these efforts can delay the progression to diabetes and may even result in a return to normal blood glucose. In fact, diet and exercise have been shown to be more effective than medications in preventing diabetes. Plus, these lifestyle changes lead to weight loss and improved fitness, benefits that no medication can match.


drparrsays blog footer

Trick or treat? More like getting tricked by treats! Watch out for candy and soda dressed up as health food.

Boo! Since Halloween is this week, it’s a good time to think about what makes this holiday so scary. It’s not the ghosts or zombies that come to your door in the evening seeking candy that you should be scared of, though. In fact, you don’t even need to wait until dark to get spooked. You are likely to see the scariest costumes on your breakfast table on Halloween morning—candy and soda dressed up as healthy food!

candy corn


Here are three of the most common frightening “costumes”:

Fro-yo dressed as healthy yogurt

Most people would consider yogurt to be a healthy breakfast. And it is, provided you aren’t getting tricked! Low-fat and fat-free flavored yogurt is almost always sweetened with sugar. This is true for the yogurt tubes that kids love and much of the Greek yogurt that is so popular. Sure, it contains protein and beneficial bacteria, but the added sugar makes it equivalent to frozen yogurt or ice cream in terms of calories and sugar . Some of these yogurts even come with toppings, like bits of chocolate, just like fro-yo! A healthier alternative is plain yogurt with real fruit. Sure, it’s not as sweet, but you will be getting the benefits of eating yogurt without all the added sugar.

Soda dressed as fruit juice

Many “fruit” drinks contain less than 5% juice but plenty of added sugar, so they are essentially soda without bubbles. For example, the orange drinks like Hi-C or Sunny D are a popular substitute for orange juice, but they are far from a nutritional equivalent. The same is true for other drinks, including juice boxes and pouches, which are commonly part of breakfast, lunch, or snacks. Even scarier is the fact that these drinks are much sweeter than real fruit. Children may develop an expectation that oranges or orange juice should taste as sweet as soda and prefer the sugar-sweetened version over the real fruit. A better choice is to make real fruit and fruit juice, not soda disguised as juice, a part of meals and snacks

Candy bars and cookies dressed as cereal and breakfast bars

Many popular breakfast foods targeted at children include sugar-sweetened cereals, pastries, and bars. Some breakfast bars and cereals that seem healthy are really candy bars in disguise. Some even skip the disguise and actually look like candy or dessert. Pop Tarts and some granola bars are covered in chocolate or frosting, and favorite cereals often contain marshmallows or are shaped like cookies. No surprise that these foods are as high in calories and sugar as cookies or some candy bars. Worse, a child who is used to breakfast or snack foods that taste like candy or cookies may resist real food when it is offered. Now that’s scary!

When you think you are eating something healthy but it’s really not—I call this Candy and Soda for Breakfast. And it’s not just breakfast, it happens at every meal.

While the focus here is on food for kids, it really isn’t much different for adults. Breakfast foods like donuts and pastries are almost always topped with icing and it would be difficult to distinguish many muffins from cupcakes. For many people, coffee isn’t just coffee anymore, but a drink that contains as much sugar and as many calories as a milkshake, sometimes with whipped cream on top. What’s really scary is that this is how many people eat every day.

The good news is that you can make your breakfast healthier without too much effort. While there is much debate about what constitutes a healthy breakfast, there is agreement about what it doesn’t include—lots of added sugar! Look for cereals that are low in added sugars and high in fiber. Include real fruit, fruit juice, and milk (or soy milk) whenever possible. If you have time, eggs are an excellent source of protein and healthy fats. Yogurt is good, too, but watch out for added sugars in flavored yogurt. Whole grain toast or a bagel with peanut butter makes a good alternative to Pop Tarts or breakfast bars.

As a general rule, steer clear of foods that look like dessert. Frosting, marshmallows, chocolate chips, and sprinkles simply aren’t part of a healthy meal!

If you are worried about the big bags of candy that get brought home on Halloween night, keep this in mind.  While eating a lot of candy is never healthy, a typical Halloween candy binge lasts a few days, after which time the candy is gone or the kids are literally sick of eating it.  The long-term effects on your kid’s health (and teeth) can be offset by a good diet, regular activity, and diligent brushing and flossing. The same applies to you, too, if you find yourself digging into the big bowl of candy that is inevitably left over.


drparrsays blog footer

After October: From breast cancer awareness to action

Breast Cancer Awareness month is coming to a close. Thanks to the efforts of local and national organizations and a number of events in our area, we should all be aware of the importance of education, screening, treatment, and research toward a cure for breast cancer. These are all worthy goals that deserve our full attention and support. Now it is time to take the awareness that we gained over the past month and turn it in to action. This is the topic of my Health & Fitness column in the Aiken Standard this week.

cancer exercise group


Approximately 1 in 8 women will develop breast cancer. The American Cancer Society estimates that around 300,000 new cases of breast cancer are diagnosed and nearly 40,000 women die from this disease each year. Breast cancer can occur in men, but these cases are rare, so the focus is rightfully on women.

Much attention is given to genetic factors that increase the risk of breast cancer, in particular certain gene mutations, including BRCA1 and BRCA2. Between 20­–30% of cases occur in women who have a family history of breast cancer, which can double the risk of being diagnosed.

However, most women who are diagnosed with breast cancer have no family history, so there are other factors that play a role. Many of these are lifestyle factors that can reduce the risk for and improve the treatment and survival of breast cancer patients. The good news is that these changes benefit all of us because they also reduce the risk of other cancers, cardiovascular disease, and most other chronic diseases.

Avoid tobacco use. While the results of studies of smoking and breast cancer are mixed, a conservative interpretation is that smoking may increase the risk. Smoking increases the risk of other cancers, especially lung cancer, as well as heart attack, stroke, and other lung diseases. Not smoking, or quitting now, is among the best health decisions a woman can make.

Consume alcohol in moderation. Alcohol can alter the level of hormones, including estrogen, that increase breast cancer risk. Women who consume more than two drinks per day increase their risk of breast cancer by 20% over women who don’t drink.

Maintain a healthy body weight. Being overweight can increase the risk of breast cancer in post-menopausal women by 30–60%. Excess body fat can alter the levels of estrogen and other hormones. The good news is that losing as little as 10 pounds can reduce this risk. Additionally, being overweight is associated with a higher risk of diabetes and heart disease, among other conditions.

Be physically active every day. Regular activity and exercise can lower breast cancer risk by as much as 20%by reducing the level of certain hormones that are associated with breast cancer. Women who exercise also tend to handle breast cancer treatment better than women who aren’t active and exercise can reduce the risk of cancer reoccurrence by 25%. These benefits can be achieved through 45–60 minutes of brisk walking five days per week.

Eat a healthy diet. The evidence from studies on the effect of diet on breast cancer risk is mixed, with more research needed. In general, increasing fruit, vegetable, and whole grain intake is associated with at least some decrease in breast cancer risk. These foods are rich in vitamins, minerals, and fiber, so eating more of them is beneficial for reasons beyond cancer prevention.

The bottom line is that turning awareness into action to improve health behaviors can prevent breast cancer and reduce the risk of other cancers as well as many other serious health problems.


drparrsays blog footer

“Is it okay to be fat if you are fit?” is the wrong question. Instead, ask “Is it ever okay to be unfit?”

I get a lot of questions about nutrition, exercise, and health. Given the considerable uncertainty and misinformation about these topics, it comes as no surprise that people have questions. Sometimes there are no clear answers to these questions. And sometimes the question itself shifts the focus away from a more important aspect of health. This is true of one of the most common questions I get: Is it okay to be obese if I exercise?

The idea that it is okay to be fat if you are fit is not new. In fact, decades of research shows that being obese but physically fit is associated with a lower risk of dying from cardiovascular disease than being thin but unfit. When assessing health risks associated with obesity, fitness matters. That said, excess body fat can lead to other health problems, even if you are fit.

A better question would be, Is it ever okay be unfit? The answer is no! This is the topic of my Health & Fitness column in the Aiken Standard this week.

Overweight men walking


There is no question that being physically fit can improve your health, reduce your risk of developing certain chronic diseases like heart disease and some cancers, and help you live a longer, healthier life. This is true even when you take body fatness into account. People who are overweight or obese should have more health problems and die sooner, but many don’t.

The difference is physical fitness. Men and women who are obese but physically fit have a lower risk of serious health problems than those who are obese but unfit and, surprisingly, even lower than people who are at a “healthy” body weight but unfit. This suggests that a “healthy” body weight has less to do with weight and more to do with fitness.

This relationship holds true even when you start adding in other health problems, like high blood pressure or diabetes. Even though obesity is associated with and thought to cause these conditions, physical fitness seems to reduce the risk significantly. Again, this suggests some of the health problems linked to obesity may be due, at least in part, to low physical fitness.

Physical fitness in these studies typically refers to cardiorespiratory or aerobic fitness measured during in exercise test on a treadmill or stationary bike. A broader definition of fitness also includes muscular strength, muscular endurance, and flexibility. You can improve your fitness by participating in regular exercise to develop your endurance, strength, and flexibility. The benefits are linked to the intensity and duration of the exercise, so the more you do, the better your fitness, but substantial benefits can be achieved from walking for 30 minutes per day.

In the much of the research, subjects were divided into five fitness categories. The most significant differences in health and longevity were seen when comparing the highest and lowest fitness groups. But the biggest reduction in health risk was between the lowest fitness and the next highest group. This means that becoming even a little more fit is beneficial.

If you are overweight, becoming more fit may matter as much as losing weight for improving your health. If you don’t need to lose weight, remember that there is no such thing as a healthy weight unless you are fit. Regardless of your weight, everyone can benefit from regular exercise to achieve and maintain the strength, endurance, and flexibility necessary for good health and wellbeing.


drparrsays blog footer

Speaking of the benefits of outdoor activity, the USC Aiken Outdoor Expo 2017 is this weekend!

Speaking of the benefits of outdoor activity, USC Aiken is hosting the CSRA Great Escape Outdoor Expo on Saturday, Oct. 14. Learn about ways you and your family can explore the outdoors and be active doing it!

2017 Outdoor Expo


SaveSave

Invest in your health by following the Buffett plan.

Making smart investments that pay off over time is a key to creating wealth and sustaining financial wellbeing as we age. Warren Buffett is widely regarded as a successful investor and financial leader. His careful investment strategies have allowed him to amass an impressive personal fortune and lead to him be considered one of the foremost experts on investing.

For these reasons, Buffett’s business and financial advice is respected and followed by many people to achieve wealth and financial security. This same strategy can be applied to health with the same good results. Here is how following Buffett’s investing strategy can help you achieve good health now and maintain it long into the future. Just like saving for retirement, you will be glad you have plenty of good health in the bank when you get older.

This is the topic of my Health & Fitness column in the Aiken Standard this week. Since I am not an expert in the world of finance and investing, I did run this by a colleague from the School of Business to make sure I was on the right track.

couple jogging on beach


Make smart, not popular, choices.  Many of Buffett’s investments have been in industries or companies that others have overlooked in favor of more trendy options. However popular, these investments may not be smart choices in the long run. Similarly, new exercise trends and popular dietary supplements may seem appealing for weight loss, but the results are often disappointing. Sometimes the best approach for health is something much less exciting: making smart diet choices and daily exercise will almost always pay off for years to come.

Plan for the long-term success, not quick results.  Investments promising that you will get rich overnight are appealing. While you may make money initially, in the long run you may not have anything to show for it or you may end up losing money. Many fad diets and exercise trends are the health equivalent of get rich quick schemes. For example, they may promote weight loss right away, but fall short when it comes to keeping the weight off. Some popular high-intensity training programs can lead to rapid increases in fitness and strength. But for some people they can lead to injury or, at the very least, a negative experience that may turn them off from exercise in the future. Just as Warren Buffett makes investment decisions that will promote long-term income, you should make diet and exercise choices that will pay off for years to come. Even though the health “income” may accumulate more slowly, it is more likely to be lasting.

Diversify your investments.  Buffett’s strategy has been to invest in multiple industries. This allows him to maximize income and insulates his portfolio from losses in any one area. Similarly, you should diversify your health investments. Instead of focusing only on your diet or just on exercise, include both diet and exercise in your health portfolio. That way you will get the benefits of both treatments and maximize your return on investment. This works because the health benefits of good nutrition and physical activity are additive. In fact, in some cases the activity is essential for the diet to be effective, and vice versa.

Your goal should be to make smart investments in your health by choosing diet and activity strategies that you can live with and that will pay off long into the future. Applying Warren Buffett’s investment strategies can help guide you toward making these prudent decisions.

But a healthy, happy life involves more than good nutrition and exercise. You need to take time for yourself and do things you enjoy. Fortunately, there is another Buffett we can take inspiration from: Jimmy Buffett. Sometimes, escaping to Margaritaville is just what the doctor ordered!


drparrsays blog footer