To my Patients,
Here’s a smattering of the latest health news highlights…enjoy!
How many steps?
Traditionally, we’ve thought of 10,000 steps per day as the ideal for maintaining good health. For many, this may seem daunting. However, a new study of older women just published in JAMA International Medicine suggests that dramatically fewer steps per day can still significantly lower mortality. Investigators from Brigham and Women’s Hospital found that as few as 4,400 steps per day led to a 41% reduction in mortality. In this study, the health benefit seemed to level off at 7,500 steps per day. So let’s not allow perfection to be the enemy of good…get your steps in and call it a day!
Acid vs mortality
Over the years, there has been ongoing speculation as to whether or not long-term use of omeprazole (brand: Prilosec), pantoprazole (brand: Protonix), lansoprazole (brand: Prevacid) and esomeprazole (brand: Nexium) can be associated with increased mortality risk. Yet the pendulum seems to keep swinging on this evolving topic. A new study in the British Medical Journal now suggests that use of these medications is associated with increased risk for death from certain conditions, including cardiovascular disease, gastrointestinal cancer, and chronic kidney disease. Interestingly, the disease risk seems to be higher in those who do not necessarily need to be taking these medications for medical reasons. Additionally, an increased risk was associated with a longer duration of use.
The prevalence of use of these medications in our population is very high, and in many cases, they are overused. To me, this article suggests that these medications should only be used if medically indicated and for the minimum amount of time necessary. If you happen to be using one of these medications, I encourage you to speak with your doctor about whether or not it’s necessary to continue it for the long term.
A pair of studies recently published in the British Medical Journal suggests that high dietary intake of ultra-processed foods is associated with increased risk for cardiovascular disease and death. Ultra-processed foods, such as packaged baked goods, dehydrated soups, ice cream, sugary cereals, sugary beverages, and pre-prepared freezer items have long been suspected as being detrimental to our health, and these new studies serve to confirm this worrisome phenomenon.
In the first study, over 100,000 adults in France provided dietary records for over two years. After about five years, cardiovascular event rates were higher among people in the top quarter of ultra-processed food consumption compared with the lowest quarter. For each 10% increase in intake of ultra-processed foods, an 11-13% increased risk of heart attacks and strokes was noted.
In the second study, 20,000 Spanish adults were followed for 10 years. A 62% increase in mortality risk was found in those in the top quarter of ultra-processed food consumption (which equated to five servings of ultra-processed foods per day).
Not-so-healthy energy drinks
A small study published in the Journal the American Heart Association found that drinking just four servings of a typical commercial so-called “energy drink” can lead to an increase in blood pressure and can aggravate a potentially deadly heart rhythm abnormality called prolonged QT syndrome. Additionally, these products often contain artificial additives which serve no health purpose and may be harmful. Bottom line: stay away from highly-caffeinated and/or sweetened energy drinks, as their inherent risks outweigh any potential benefits. Stick with water-it’s what works best.
Not so fast!
Recent updates to medical guidelines have suggested that it may not necessary for most of us to endure an overnight fast in preparation for cholesterol blood tests. A new study just published in JAMA Internal Medicine provides us with further reassurance that, in most cases, fasting prior to routine cholesterol testing is generally unnecessary. One exception might be for patients with a strong family history of genetically-driven high cholesterol and/or premature heart disease. Additionally, the same recommendation does not necessarily apply if additional tests are being done, such as blood glucose in those who are prone to or suffer from conditions such as diabetes. And more specialized cholesterol panels exist that provide more accurate information when drawn in the fasting state (and I do often order these panels for my patients).
The dark side of some sunscreens
A review recently published in the Journal of the American Medical Association (JAMA) based on data from the US Food and Drug Administration (FDA) suggests that using maximal levels of commercially available sunscreens results in plasma concentrations of chemicals that exceed the FDA’s established safety thresholds. Evidence from prior studies suggests that some of the ingredients in these sunscreen products may increase the risk of health issues such as hormonal disruptions and some cancers.
The authors of this review make it clear that they are not recommending we stop using these products, as skin cancer prevention remains an important priority. That said, it would be reasonable to consider alternative means by which we can minimize our exposure to the sun’s UV rays, including seeking shade when possible, wearing UV protective clothing and using sunblocks that do not contain these potentially hazardous chemicals. And as I’ve discussed in a recent installment of this newsletter, moderate sun exposure can be beneficial to our health. For those who are not at high risk for skin cancer, 15 minutes of sun exposure with arms and legs uncovered, 3 to 5 days per week is sufficient for us to reap our sun’s health benefits.
That’s all for now…I hope you enjoy the sunny days ahead!
Larry Leibowitz, MD