Monday, January 30, 2012

HPV: Not Just for Genitals...

A recent study published in JAMA has created a buzz about the Human Papilloma Virus- HPV- again, but this time, the focus is on the mouth. Researches have noted that despite a significant decrease in smoking, head and neck cancer rates are not falling in proportion. It turns out that not only does HPV cause cancers in the genital area (cervical, penile, anal, etc.), but HPV also plays a significant role in causing head and neck cancers.

The study is titled "Prevalence of Oral HPV Infection in the United States, 2009-2010." Over 5000 people (ages 14-69) participated in the study, and it turns out that roughly 7% of them had HPV detected in their mouths. (They swished mouthwash in their mouths for 30 seconds, then this liquid was DNA analyzed for the the presence of different HPV strains.) Men had a higher rate- 10% in men vs. 3.6% in women, and infection was much less common in those people with no history of any type of sexual contact (less than 1% in "virgins" vs. 7.5% in others.) The good news is that the primary cancer causing strain- type 16- was only present at a 1% prevalence rate across the board. (Let's step aside and note here that with HPV, certain strains cause warts, and others cause cancers, so not all strains are equally medically dangerous.) How does the HPV even reach the mouth? Mostly through oral sex. Use barriers (condoms) for ALL sexual intimacy, please. 'Nuff said.

So, will the HPV vaccines (Gardasil and Cevarix) protect against head and neck cancers, too? We certainly hope so! As we get more "herd immunity" (which means more people are vaccinated than not, and so live disease is passed less and less) we hope to see not only a decrease in genital cancers, but hopefully a parallel decline in oral cancers, too.

BOTTOM LINE: HPV is COMMON, both "top" and "bottoms"...let's use our knowledge to prevent the cancers HPV can cause! For me, this is yet another good reason to immunize against HPV.

Thursday, January 19, 2012

It's NOT the Carrots!

I've been practicing medicine for nearly two decades now, and I find it fascinating to see some of the persistent myths in medicine- most of which pertain to food/calories/weight loss. I find that people get very caught up in looking at specifics, and miss the big picture entirely. The classic example of this is CARROTS.

Many of my diabetic patients tell me that they are careful to avoid CARROTS, because they have such a high glycemic index. The same is true for fruits ("don't worry, Dr. Grimes, I KNOW not to eat bananas or apples!") Seriously? I believe with all my heart that everyone SHOULD know deep down that carrots and fruits are HEALTHY choices. Diabetic or not, these foods should be part of your healthy diet. Okay, yes, if eaten alone, carrots can transiently raise your blood sugar, but if you have adult onset diabetes, it is WEIGHT LOSS that will ultimately improve your blood sugars. I have yet to meet a SINGLE person who is overweight from eating too many fruits and vegetables. It simply does not happen.

If you are overweight, please take an honest look at what you are eating. In fact, write it down- all of it- for a few days. Perhaps the daily Starbucks muffin & latte have a little something to do with your extra calories...And while lettuce, carrots, tomatoes and cucumbers are all healthy, low calorie choices, adding tons of croutons, sunflower seeds, cheese and a generous amount of ranch dressing take a healthy salad and push the calories too high to help with a weight loss plan.

Carrots are a wonderful source of nutrition. They are packed with provitamin A, vitamin E and vitamin K. Carrots satisfy the need to crunch and work beautifully to scoop up hummus as an afternoon snack.

BOTTOM LINE: Recognize that no one is UNHEALTHY from eating too many fruits and vegetables. Ramp up these foods, limit processed "junk", and talk to a registered dietitian if you want to get serious about improving your diet!

Tuesday, January 10, 2012

Just One Meal...

January is a great time to focus on your health, as we all feel that sense of renewal and a "clean slate" start-over. Rather than jumping into a strict diet that consists only of twigs & berries, why not start with JUST ONE MEAL? We eat (in theory) twenty one meals per week, right? (As an aside, if you are skipping breakfast, please start with adding IN that meal before anything else.)

I would like to suggest that you commit to having ONE vegetarian meal per week, and ONE meal that includes FISH as an entree. Vegetarian meals do not need to be bland, by the way. Picture a delicious taco salad, but with beans instead of beef or chicken. I often have the do-it-yourself version of this at home by making nachos loaded up with beans, onions, lettuce & tomatoes. Or you might try a colorful collection of veggies sautéed in olive oil and serve them over a bed of pasta or rice. I find that keeping bags of chopped onions, shredded carrots and bite-sized tomatoes minimizes my prep time and therefore makes it far more likely that I will include them in my lunch when I only have ten or fifteen minutes to prepare & eat it.

BOTTOM LINE: Make permanent changes in your diet by starting with ONE MEAL per week...and then feel free to increase that frequency as you enjoy these healthy, delicious meals!

Friday, January 6, 2012

2012 Health Action Plan (aka. New Year's Resolutions)

Welcome to the first Friday in 2012! How are those New Year's Resolutions coming along? Already blown them? If so, no worries, because you are not alone. I'm hearing more people say they haven't even MADE their resolutions yet, so really, you could be ahead of the game if you even know WHAT you'd like to change. Though I am sitting here with my laptop in glow of our Christmas tree lights, many people have packed up their holiday decorations or plan to "clean up" this weekend. As we all make the mental shift from holiday time back to ordinary routines, I'd like to encourage you to make CONCRETE PLANS to improve your health- whether you call them New Year's resolutions or not. Here's a starter list:

1.If you have ANY health concerns that you have not fully addressed with your family doctor, call TODAY and schedule an appointment. And PLEASE let the office know what you are truly coming in for- even if you simply say "I have four or five separate minor concerns" if you don't want to list specifically what they are. If you are trying to squeeze in questions about your weight, insomnia, or indigestion during an office visit you've booked for your sore throat (or worse, during your spouse's or child's visit), you are obviously not going to get the full attention and evaluation those issues deserve. I find that patients don't want to "bother" their doctors with "minor stuff like that"- but we'd much rather you schedule a longer appointment to address multiple concerns than to either ignore them or to toss them in as a "by the way, while I'm here..."

2. Step on the scale. This advice is directed at the silent majority of Americans who fall into the "overweight" category, but don't realize it. If you are 100 or even 50 pounds overweight, I'm betting you are aware of it (and same goes for underweight.) However, I have found that many of us don't realize just how many pounds we have added over the last year...or two...or decade. If you fall into this category, please step on the scale, own the number, and move forward with an action plan to improve your health in 2012.

3. Clear out the candy! Cheerful red and green M&Ms, candy kisses, or candy canes decorate many offices and homes during December. Before you replace them with Valentines or Easter candies, consider setting out flowers, candles, or scent infusers instead. Or, simply give yourself permission to put the bowls away. Empty bowls will get filled up...and emptied again & again.

BOTTOM LINE: Make HEALTH a PRIORITY in 2012, and create specific, concrete action items on your health to-do list!

Sunday, January 1, 2012

New Year's Resolutions- a WEIGHTy Issue

Happy New Year! Welcome to 2012, the year that holds the potential to be your HEALTHIEST yet! Virtually every list of top 10 New Year's Resolutions leads off with the battle of the bulge- whether it is "lose weight", "get fit", "eat healthy", "join weight watchers", "join a gym" or some other variation. With the vast majority of Americans falling into the "OVERWEIGHT" or "OBESE" categories, these resolutions certainly make sense. Unfortunately, many of us fight the SAME 10, 20, or even 30-plus pounds over and over again. We get motivated, make healthy changes, lose weight...and then gain it back. Ugh. What might we do differently this year?
Here is some food for thought...

1. Figure out the WHY of your eating behaviors, and learn to eat MINDFULLY. Dr. Michelle May's book "Eat What You Love, Love What You Eat" is a FABULOUS start- buy it today. Her focus is how to break the "eat, repent, repeat cycle". AMEN.

2. Speaking of buying- let's put our money where our mouth is- literally! I have heard over and over again that it's too expensive to meet with a dietician, join a gym, or eat fresh fruits & vegetables, or take up a new sport, yet these same people are spending far more discretionary money on their daily Starbucks, hair highlights or a round of golf. Seriously, we need to prioritize our health and be willing to pay for it!

3. Commit to ONE small permanent change each month. Experts say it takes 21 days to cement a new habit, so why not make 2012 the year to develop 12 new healthy habits? Start with something simple, like making sure you eat breakfast every day OR (assuming this was not part of your routine already.) In this case, it can be a granola bar or a cup of yogurt. Remember to keep it simple. If you try to make a change from no breakfast to cooking a veggie omelette and drinking freshly squeezed grapefruit juice- well, I'm not optimistic it will stick!

Whatever you choose, find a way to make yourself accountable. Make a deal with a friend, tell your co-workers, announce it to your family (if you have teens, they will HAPPILY hold you accountable), or simply record it on your smart phone, computer or an old fashioned piece of paper.

BOTTOM LINE: Make 2012 the year you make your New Year's Resolutions last beyond Janaury, and choose GOOD HEALTH!