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Supplements for Your Heart Peoples Pharmacist Ian Lloyd gives supplement advice that you can take to heart.
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Pharmacist Recommended Health news on keeping your brain active to help prevent Alzheimer’s. Beneficial vitamin D, are you getting enough?
B vitamins are essential for maintaining healthy nerves, and easing stress and anxiety.
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Curb the Salt Darlene Booth provides the health benefits of cutting back on sodium.
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Managing Menopause Menopause So what can an average guy like me safely say about menopause (my assignment for this month) without sounding like a total idiot (“not that that would be anything really new for you,” my wife commented when I put this issue to her; she was kidding, I think), because quite simply, although lots of male “experts” seem to be ever-willing to comment regularly in the media about any issues – even menopause - concerning women (and curiously, despite the many changes in medicine over the last few decades, the majority of “menopause” experts – at least in the media - still seem to be men), any man with even two working brain cells has to reluctantly acknowledge that menopause is a biological event that no man can ever really “understand” because guys experience nothing even remotely similar. “But, hey, Art, isn’t there a male menopause, too?” some of you will no doubt ask at this juncture, because you’ve been convinced by some much-hyped media focus that men also go through a “male menopause,” something that’s commonly referred to these days as “andropause.” In a word, no. First, I don’t believe that andropause is a real condition because to me the symptoms attributed to andropause are just a collection of some of the symptoms that nearly every aging individual, male or female, experiences as the years roll along (I’ll spare you a list of them, but if you think of a “vague” symptom – fatigue, mood changes, sleep changes chances are it’s on that list as being caused by andropause).
And besides, even the most fervent andropause proponents must admit at least two major differences when comparing menopause to andropause. First, while menopause clearly means the cessation of every woman’s ability to reproduce (without artificial assistance, of course), if called upon (although very happily for society, very few guys beyond middle age are ever called upon for this duty), most men continue to produce enough sperm to at least attempt to procreate well into their senior years, although as all those TV ads clearly point out, many guys also clearly need medical assistance with the mechanical aspects of procreation. The reasons, however, for that steep fall-off in many men’s ability to do what they were so able to do as younger bucks has way more to do, I think, with an unhealthy lifestyle than it has to do with biology; in fact, studies clearly show that the most important risk factors for erectile dysfunction, what used to be known as “impotence,” are unhealthy lifestyle practices, not aging or a drop in hormone levels. Second, at menopause, women’s hormone levels drop dramatically to very low levels over a period of a few years at most, while for most men, testosterone levels drop slowly but steadily (on average, at roughly 1 % a year) from early adulthood on but in most guys, testosterone levels are still present at pretty decent levels into their senior years. (Here’s an interesting aside: believe it or not, testosterone levels are still not easily determined in many, probably most, men because many seemingly unrelated but nonetheless vital factors can affect a man’s Continued On Page 11
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Ian Lloyd
Pharmacist, Peoples Pharmacy
Supplements For Your Heart Heart disease is on everyone's mind. As it should be; heart disease and stroke are the second and third leading causes of death in Canada. That means 29% of all deaths in Canada can be attributed to cardiovascular disease. In case you were wondering, cancer is at the top of the list at 30% of all deaths in Canada. Someone has a heart attack every seven minutes in Canada. There is good news though: rates of heart attack and stroke have been declining. The rates have dropped 25% over the last 10 years. The reasons for this are unclear, but I'm not fussy why. Any reason for a decline in heart disease is a good reason. Vitamin and botanical supplementation can play a role in the prevention of heart disease. This month I shall discuss the most popular supplements for heart disease and new research on the subject. Perhaps the best, and infrequently mentioned, supplement to prevent heart disease is regular exercise. The Canadian Physical Activity Guidelines recommend that you get at least 150 minutes of moderate to vigorous exercise per week. Preferably in bouts of 10 minutes or more. I like the idea of micro exercising. It can be hard to find time to dedicate a half to one hour of exercising three times a week. Why not do it in smaller pieces? Certainly anyone can be creative and find a few spare minutes to do this. If you drive to work, park your car at a location that is a 10 minute walk away (weather permitting). Take the stairs and not the elevator. Try and find time for a 10 minute walk twice a day: it is only 10 minutes Every morning I spend 10-15 6 People First peoplesdrugmart.com
minutes doing pushups and sit ups. Try your best, the health rewards can be great. It is thought that if you are inactive and become physically active, you can reduce your heart attack risk by 35% to 55%. The next concern about heart disease involves intake of dietary fat. What kind should we eat and what should we avoid? I'm not a nutritionist 2look towards the end of this magazine to find one3. Generally, I say fats from land animals are bad and fats from plants and fish are good. This is oversimplified, but still good advice. There are some essential fats that we need to stay healthly; essential meaning that our body cannot produce them, so we must obtain them from our diet. The essential fatty acids (EFA) are called omega 3 and 6 and are thought to be helpful in protecting you from heart disease, arthritis and lupus. The omega-3 fatty acids include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Omega-6 fatty acids include linoleic acid (LA) and gamma-linolenic acid (GLA). Don’t worry about trying to remember their long names; just their initials are sufficient. A new found benefit of taking extra EFA is protection from ventricular arrhythmias and fatal heart attacks. In a large study, researchers found that people with diabetes, who had a heart attack, benefited by taking extra omega 3 EFA. Taking 2.4grams of a blend of ALA, DHA, EPA (OMG that's a lot of letters) reduced the risk of ventricular arrhythmia (VA) by 84% and combined arrhythmia and fatal Continued On Page
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Ian Lloyd...Continued From Page 6
heart attack by 72%. VA occurs when the large chamber of the heart does not beat properly. This is very, very bad. Taking extra EFA can also help to lower cholesterol, right? Wrong, this supplement has not consistently been shown to lower cholesterol. It is true that omega-3 EFA can lower triglycerides. It is also true that an increased intake of omega-3 EFAs has been associated with lower risks of cardiovascular disease. Customers have told me that their cholesterol has gone down after taking supplements high in DHA and EPA, but there are few studies that show this. There have been studies which show that omega-3 oils can lower triglycerides by 20%. Is there anything vitamin D cannot do? There is now thought that vitamin D deficiency can be a risk factor for heart disease. One study found your risk of cardiovascular disease can be between 53% to 80% higher if you have lower amounts of vitamin D in your body. There are a few reasons for this. Vitamin D can help lower blood pressure by posi-
tively regulating the renin-angiotensin-aldosterone system (RAAS). While this RAAS stuff might not sound familiar it will of interest to your Peoples Pharmacist. Taking increased amounts of this important vitamin can also reduce your chances of developing type 2 diabetes – another risk factor for heart disease. In one small study, taking 1000IU of vitamin D was enough to reduce insulin resistance and improve insulin sensitivity in some patients. I take 4000IU of this vitamin everyday. Another supplement that can be helpful for your heart is called Coenzyme Q10. It is also known as ubiquinone , the name comes from the word ubiquitous, which means “found everywhere.” Your body makes its own supply of CoQ10 and is found in every cell of your body. It plays a vital role in producing the energy which your cells need to function. It has been shown to be effective in treating congestive heart failure, HIV/AIDS, and migraines. CoQ10 is able to lower cholesterol, but its affects are not very significant. It can lower total cholesContinued On Page 10
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Vitamin D
Did you know that only 33% of Canadians had vitamin D levels desirable for overall health and disease prevention? Vitamin D is well known for its role in building strong bones and teeth but new research, showing additional health benefits, has led the Canadian Cancer Society and the Canadian Dermatology Association to increase their recommendations for Canadian adults, under the age of 50, from 200 IU of Vitamin D to 1000 IU daily. Sun exposure on bare skin is the major source of vitamin D, but length of seasons, geographic latitude, cloud cover, smog, and sunscreens can reduce UV ray exposure and vitamin D synthesis.
Nighttime Heartburn If you suffer from heartburn or acid refux when you go to sleep, there are two changes you can make to help your symptoms. Avoid late meals. Give your stomach time to properly digest your meal before heading to bed. At least 2-3 hours before bedtime. Elevate the head of your bed by 6-8 inches. With the head higher than the stomach, gravity helps reduce this pressure, and keeps stomach contents where they belong--in the stomach. Talk to your Peoples Pharmacist about other tips and over the counter medications that can help you manage heartburn and acid reflux.
health news Challenging Brain May Ward Off Alzheimer's Protein People who challenge their brains throughout their lifetimes -- through playing games, reading, and writing--are less likely to develop protein deposits in the brain linked with Alzheimer's, reports a recent study. Prior studies have suggested that people who stay mentally active and well educated, build up brain reserves that allow them to stay sharp even if deposits of the destructive protein called beta amyloid form in the brain. But the latest study, based on brain-imaging research, suggests that people who stay mentally engaged beginning in childhood, and remain so throughout their lives, actually develop fewer amyloid plaques. The small study showed that starting brain-stimulating activities early enough might offer a way to prevent Alzheimer'srelated plaques from building up in the brain. The researchers studied 65 healthy, cognitively normal people aged 60 and older. They underwent extensive testing
to assess their memory and thinking skills, and their brains were scanned using a new tracer to look for amyloid deposits in the brain. The team compared the brain scans with those of 10 Alzheimer's patients and 11 healthy people in their 20s. They found that people who had been the most mentally active had lower levels of beta amyloid than others who had been less mentally active. People in the study who had recently taken up crosswords and other mental exercises did not appear to see much benefit. Amyloid may start accumulating many years before symptoms appear, so by the time memory problems start, there is little that can be done, the time for intervention should be before accumulation starts. Reading and playing challenging games is fun, keep your brain active and benefit from the long term effects.
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Ian Lloyd...Continued From Page
terol and LDL (bad) cholesterol. It has been shown to raise HDL (good) by 0.14 mmol/L, but how it does this is not clear. An HDL cholesterol level of less than 0.9 mmol/L means you're at higher risk for heart disease . This supplement can help to improve quality of life for patients with congestive heart failure. Co Q10 can help lower blood pressure. One analysis of information about CoQ10 and blood pressure found positive results. It found that taking 100120mg of this supplement daily could lower systolic blood pressure by 11 mmHg and diastolic blood pressure by 7 mmHg. I think another interesting fact about CoQ10 is the number of prescription medications that reduce its quantity in the body. The most notable class of drugs is the 4statins,’ which are used to lower cholesterol. Another class of medications, called betablockers, can lower CoQ10 levels also. If you wish to confirm this, ask your Peoples Pharmacist to show you his CPS (big blue book) and focus on the side effects for any 4statin.’ Many other medications can lower the amount of CoQ10 in the body, this is
called drug-induced nutrient depletion (one of my specialties). There have been no known side effects seen with CoQ10 use. However, this supplement can lower blood glucose levels, so people with diabetes should use this supplement with caution. CoQ10 can also interact with warfarin, a prescription blood-thinner. If you have any questions about CoQ10 ask your Peoples Pharmacist, they may be able to help. Love your heart – you only have one. Treat it right and the two of you will have many good years together. Some of the best things for your heart are not found in bottles. Watch what you eat, get plenty of exercise, lots of rest and check your blood pressure occasionally. Elevated blood pressure is the greatest risk factor for cardiovascular disease and the easiest to detect. High blood pressure might not be a sign of doom and gloom in the future, but it can be a wake-up call to focus on improving your health. Written By Ian Lloyd, Pharmacist & Chartered Herbalist, Peoples Pharmacy
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Dr. Hister...Continued From Page 4
testosterone levels, such as, for example, this vital matter of life-and-death for many guys: whether or not their home team won or lost the night before they got get tested (and who says guys are not complicated beings, eh?) So acknowledging up front that I happily bow to any woman in her knowledge about what menopause feels like, I would still like to offer a word or two of potentially useful information about that passage. Most important of course, is to stress, that despite all the emphasis the last couple of decades on treating it, menopause is a normal event that all women go through if they live long enough, although, menopausal symptoms vary tremendously from woman to woman, and that’s where so much controversy still exists, namely about which symptoms to treat, if any, and what to treat those symptoms with. Now, most of you will no doubt recall that a decade ago, a huge American study - the Women’s Health Initiative (WHI) - concluded that using hormones for menopause raises the risks of many dire health problems including breast cancer, strokes, heart attacks, and blood clots, although in this study, menopause “hormone replacement” (which is a terrible term, I think) also lowered the risks of colon cancer and osteoporosis. As a result of that study, however, use of hormones to “treat” menopause plummeted in North America (as did – in studies originating from the US - the rate of breast cancer, interestingly). However, more recently, many experts have again begun to promote at least some use of hormones for many menopausal women arguing that 1) hormones remain the best option to treat severe menopausal symptoms, and 2) since the women enrolled in the WHI were much older on average than women who usually use hormones for menopausal symptoms, the negative results in the WHI should not worry most younger women who will end up using hormones only on a limited basis (there is no universal agreement on what “limited” means, of course, but generally, it’s taken to mean anywhere from 2 to 5 years, which is a huge gap, of course). Further, some experts even argue that limited use of hormones in younger women can lead to eventual huge potential benefits, such as a lower risk of heart
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Dr. Hister...Continued on Page 13
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Dr. Hister...Continued From Page 11
disease in the senior years, for example. In addition, spurred on by such notable medical mavens as Suzanne Somers, some people are now strongly promoting the use of “bioidentical” hormones instead of the old standard estrogen/progesterone combinations. Bioidentical hormones are hormone-like compounds found naturally in plants (wild yams or soy), which are then specially “produced” for each individual by a pharmacist, and because “bioidentical hormones” come from natural sources”, these folks argue that bioidentical hormones allow women to get all the advantages of hormones with none of the same risks that estrogen/progesterone combinations lead to. But I’m not at all sold on either of those trends. First, for me, “bioidentical” hormones have simply not been studied enough to definitively say how safe they might be over the longer term. Second, although some form of hormone “therapy” does indeed remain the best choice for severe menopausal symptoms (sadly, despite many attempts to find other treatments, especially “natural” ones such as “black cohosh,” studies have failed to yield anything that’s really significantly more effective than a placebo), the plain truth is that we still have absolutely no idea if even a few months’ use of hormones is enough – in some women, at least - to raise the risk of some of those severe negative consequences, most notably, breast cancer. The bottom line here is simple: no one really knows enough to say with any certainty what any individual woman should do when that time of life arrives, so as always, you are your own best doctor. Educate yourself as best you can, and then decide – in conjunction with your doctor - what makes the most sense for you. Now, that that’s done, I sincerely hope that the topic my editor picks for next month is something a man like me feels more comfortable discussing, the benefits of alcohol, for example, or even better, whether the Canucks need more “toughness” (they don’t), although I’d happily write an instant 15000 word opinion piece on those issues, as would nearly every guy in BC, I think. Dr. Art Hister can be heard on CKNW and other Corus Radio Network stations on House Calls on Saturdays at 10 AM, as well as seen on Global TV news on Saturday mornings at 9:20.
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B
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Curb the Salt February is not just the month where cupid plays on our heartstrings; it is also National Heart Month in Canada. Every red heart we see this month symbolizes romantic love while a concurrent campaign aims to bring education and awareness around keeping our own hearts beating healthy and strong. Despite this growing public awareness, heart disease still remains to be a leading cause of death and disability all over our country. Often, we take this precious organ for granted until something goes wrong but you don’t have to wait for a wake up call. Prevention is the best strategy against heart disease and a great place to begin is by becoming aware of your sodium or salt intake. Sodium is an essential nutrient needed in small amounts by our muscles and nervous system; it also helps to regulate the fluid balance in our bodies. We simply cannot live without salt and must get it from the food we eat. Deficiency of this electrolyte can be severe and life threatening and may be brought about by excessive fluid loss such as sweating, vomiting or diarrhea; it can result from an underlying medical condition that affects the organs involved in water and sodium regulation or from low dietary intake. These days however, unless an individual is consciously following a low sodium diet, it is unlikely that dietary deficiency will be a concern; it is more likely that most of us could benefit by reducing our intake. As with everything, balance is the key; too much sodium also poses a health caution. There is a link between excessive sodium intake and high blood pressure, which may increase risk of stroke, heart attack and heart disease. So here is yet another reason to stay away from the middle aisles in the grocery store. Salt is a prevalent ingredient in the food processing industry and used for preservation as well as taste enhancement. And don’t think that its use is limited to just the savoury items; sodium hides in our sweets as well. Sometimes it is as overt as dark chocolate with sea salt, but other times it is quiet and subtle unless you read the labels. Reading the labels is an essential habit for health conscious consumers. Shopping the perimeter of the store is also a good habit to get into; the perimeter is where you will
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find the more wholesome foods that are less processed. According to the Mayo Clinic, depending on individual needs and sensitivities, most adults should set sodium limits between 1,550 to 2,300 mg daily. Even if you hide the saltshaker and avoid the obvious pitfalls of soy sauce 21000 mg per tablespoon3 and salty snacks, your sodium count can still add up quickly. Considering that the sodium count of a cup of canned chicken noodle soup is around 800 mg., 400 mg. for popular spaghetti sauces and somewhere between 400 – 500 mg. hiding in a medium order of fast food french fries, you can see how easy it is to overindulge. In short the more processed food you eat, the more likely your sodium levels are high. It would be wrong to talk about sodium without mentioning potassium; sodium and potassium work together to maintain the body’s water balance. A potassium rich diet can help counterbalance the effect of sodium on our health. Potassium is found in fresh foods like fish, poultry, nuts seeds, beans, dairy and produce. Personally, I eat a wholesome diet but I do love salt. There came a point in my life where I recognized that my taste buds had become desensitized to the taste of it and I found myself adding more to get the same taste satisfaction. At this point I began to gradually wean off the addiction. Food without salt tasted bland so as I decreased my sodium dependency slowly while I increased the use of herbs, spices and salt free seasonings to keep my food interesting. I have found that a squirt of lemon juice can add some excitement to most dishes and I now opt for low sodium products when I can. As an added bonus, I have found my clothes fitting more comfortably; an excess of sodium also causes the body to retain more water. Curb the salt habit and celebrate your heart this month by exploring the real flavour of food underneath all the sodium. As an added bonus, you might even be able to get into your skinny jeans once again Good Health to You
Hearty Irish Soda Bread
r-for-you loaf full A rustic, golden, bette served up for ct of sweet raisins. Perfe rved with se or breakfast with jam, a bowl of soup. lunch to accompany Whole-wheat flour Dark raisins Wheat germ, toasted Brown sugar, packed Baking soda Caraway seed Salt 1% buttermilk (or soured milk) Low-fat plain yogurt Canola oil
11⁄2 cups 375 mL 1 125 mL ⁄2 cup 1 60 mL ⁄4 cup 2 tbsp. 30mL 11⁄2 tsp. 7 mL 5 mL 1 tsp. 3 ⁄4 tsp. 4 mL 11⁄2 cups 375 mL ⁄2 cup ⁄4 cup
1
1
125 mL 60 mL
well ts in large bowl. Make a Combine first 8 ingredien in centre. d redients in small bowl. Ad Combine remaining 3 ing in nly istened. Spread eve to well. Stir until just mo x 12.5 x 7.5 cm) loaf pan. (22 h greased 9 x 5 x 3 inc until en for about 50 minutes Bake in 350ºF (175ºC) ov Let . centre comes out clean wooden pick inserted in e tes before removing to wir stand in pan for 10 minu slices. rack to cool. Cuts into 16 Sat); lories; 7g Total Fat (4 g BEFORE: 1 slice: 160 Ca 331 mg Sodium no, ies; 4 g Total Fat (2 g Mo AFTER: 1 slice: 157 Calor hy rbo Ca g 25 ; Cholesterol 1 g Poly, 0 g Sat); 3 mg m diu So mg 5 tein; 25 drate; 2 g Fibre; 4 g Pro
Recipes For Good Health
Hearty Irish Soda Bread Healthy Recipe Makeovers Cookbooks are available at participating
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The articles published in People First are for the general information of the reader. While effort is made to reflect accepted medical practice and knowledge, articles should not be relied upon for the treatment or management of any specific medical concern or problem and People First accepts no liability for reliance on the articles. For proper diagnosis and medical care, you should always consult your family physician promptly. Opinions expressed in sponsored articles by, Dr. Art Hister, Ian Lloyd, and Darlene Booth are paid editorials and are not necessarily shared by Peoples Drug Mart stores or Peoples Drug Mart (B.C.) Ltd. Some advertised products are not available in all stores. We reserve the right to substitute products or limit quantities. Prices effective while quantities last. Sale in retail quantities only.
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