MORE* Reasons to BIKE and WALK

I love it when new studies come out that reinforce what I already have been telling patients! Today, in the Archives of Internal Medicine, a study from the Harvard School of Public Health was published with the illustrious title: Bicycle riding, walking, and weight gain in premenopausal women. Basically, they found that YOUNG women-less than age 50, give or take- (yes, at 44, I still count as "young") who either walked briskly or bicycled had less weight gain than those who did not.

On the one hand, this seems like a no-brainer. Those who exercised more gained less weight. Where's the shock?
However, there is more to it, and I think this is is an interesting study. It derives from a large study (over 100,000 participants) of female nurses aged 25-42 in 1989, and follows them over 16 years. Sadly, despite their medical knowledge, they ALL gained weight in this timeframe, with an average gain of close to 20 pounds. Remember, that's barely over a pound per year, so it wasn't dramatic as it happened, but this is why we've got to look at the big picture!

The good news is that this study does document that small increases in activity- specifically adding even 5 minutes per day of bicycling (stationary or outdoor) or 30 minutes of brisk walking- will decrease weight gain. Obviously, if you are going for weight LOSS or weight maintenance, you've got to up the amount or intensity (and ultimately, calories OUT must be greater than calories IN.)

The best take home point of this study is that if you can make a lifestyle change such as BIKING TO WORK instead of driving (or biking with the kids to school instead of driving) then "bicycling could then be an unconscious form of exercise because the trip's destination, and not the exercise, could be the goal."

BOTTOM LINE: Find ways to get moving MORE in your daily life, and avoid that annual 1-2 pound weight gain!
(*See "MORE" strategies for weight loss in the January 2010 posts)

Mooove Cow's Milk Off the Menu!

Okay, pardon the pun, but today I'm talking about removing cow's milk from the diet of kids affected with chronic constipation. An interesting study was recently published that showed roughly 40% of kids (age range of 6 months to 14 years) in the study had resolution of their constipation by simply removing cow's milk from their diet.

Why did this happen? Researchers are really not sure, but believe it may be an allergic or otherwise immune-type response. This study was small- only 69 patients. However, the format of of the study is fairly convincing. They started with a baseline of one week, where they ran tests. Next, milk was removed and replaced with rice milk- and the researchers looked to see whether or not the constipation went away. This phase was followed with re-introducing the milk for three weeks, and then removing it for the final three weeks. Nearly 40% of the kids had normal bowel function in the two phases without milk, and returned to constipation in the weeks with milk.

What does this mean for your toddler or older child? Well, as long as you pay attention to calcium intake, it will do no harm to remove milk from your child's diet for a few weeks, and if that solves the constipation, terrific!
Will this work for adults? Hmm...maybe. Again, this is not a harmful fad diet, so why not give it a shot?

BOTTOM LINE: Consider a several week trial of removing milk from your child's diet if they suffer from chronic constipation.

Having "THE TALK" with your TEEN

Big thanks to Dr. Ira Breite on SiriusXM satellite radio, Sirius114/XM119, for having me as a guest on his show in NYC this Monday!
We spent some time chatting about how to have "the TALK" with your teen.Non-subscribers can sign up for a 30-day FREE online subscription at www.sirius.com/doctorradio, and catch the replay of our show throughout this week.
A few things to remember:
1. Of course this talk is awkward! You still don't want to think about your parents having sex, any more than your kid wants to realize that you and your spouse might be intimate. This topic will always be a bit embarrassing between generations, so accept that and move on!
2. KNOW THE FACTS YOURSELF before you initiate this talk.
3. Realize that if your teen asks you something you do not know, it's OKAY to tell them you aren't sure, but that you'll find out and let them know in a day or two. (NOTE: be sure to follow up on this, even if you used it as a stall tactic.)
4. Don't start interrogating them about their (or their friends') behavior! Your teen is already in a defensive mode, and this will shut down the lines of communication quickly.
5. Keep it short, pay attention, and...REPEAT. Take a minute or two each time you and your teen are together and the media hands you an opportunity to reinforce your message. Believe me, that will happen every time the tv is turned on!
Check out more hints on my primary website: JillGrimesMD.com

BOTTOM LINE: "THE TALK" is really an ongoing conversation with your teen, so make sure you're armed and ready with accurate knowledge and know you will NOT actually die of embarrassment!

Pull the Plug!

On the tv set, mind you! A recent study from the Centers for Disease Control and Prevention (CDC) notes that despite the recommendations of the American Academy of Pediatrics to limit children's television viewing to one or two quality shows per day and to remove tv's from kid's bedrooms, almost one in five TODDLERS have tv's in their bedrooms! There is no question that the kids with tv's in their bedrooms watch more than two hours per day. Of course they do- it's available all the time!
We know that excessive television exposure is linked with impaired childhood development and childhood obesity. Parents complain that their kids need to be entertained. Well, if they grow up BEING constantly "entertained" by the moving screen, is this a surprise?

Parents, I promise you that if you remove the tv and leave books and A FEW non-electronic toys in your child's room (legos, dolls, blocks) - your child's imagination will be STIMULATED and they WILL be happy and play! TRY IT!

BOTTOM LINE: REMOVE the tv's from kid's rooms and let their imaginations EXERCISE!

New Weight Loss Drug in the New England Journal!

PLEASE do not ask me for this drug! I cringe every time that there is media attention to a new weight loss drug. This is not rocket science! If you read the study in the New England Journal of Medicine, ultimately this is what you will see:

1. All the participants received nutrition counseling and behavior modification in addition to the drug.
2. Yes, the folks on the test drug (Lorcaserin) lost more weight than placebo.
3. The people on the drug lost an average of roughly 12 pounds in ONE YEAR (note-one pound per month), and the placebo group lost an average of almost 5 pounds.
4. Everyone was relieved that there were no serious heart valve issues.
5. Side effects include: headache, dizziness and nausea.

Good weight loss from improving the quality of your diet (more fruits and veggies) and starting to exercise regularly is one half to one pound per week- so 2-4 pounds per month, or 50 pounds or more in a year. Side effects? Let's see- you feel better, have more energy, and bonus- don't mind looking in the mirror.

Please stop looking for a magic pill! All medications have side effects, and this new weight loss pill is no exception.
BOTTOM LINE: Old fashioned fruits, vegetables and exercise yield better weight loss with fewer side effects! Spend your money on MIchelle May, MD's book: Eat What You Love, Love What You Eat and break out of your "eat-repent-repeat" eating cycles!

More Drug Warnings- This Time, Rosiglitazone

We seem to be constantly bombarded with drug warnings these days. Today, an FDA panel is debating about a diabetes medication that has been on the market since 1991, rosiglitazone (Avandia). Studies have shown that patients taking this medication have a higher rate of "cardiovascular events", though it is not clear whether or not these events lead to a greater death rate.

Why is there any debate? Shouldn't we simply remove it from the market, since there are other diabetes drugs? Well, of course, it's not that simple. Diabetes itself causes an increased risk of cardiovascular events. There are many diabetics who have uncontrolled blood sugars despite being on several other medications. This class of drugs actually has produced significant lowering of high blood sugars for many patients. It's all a balance.

Ultimately, this puts me back on my soap box. Though I have a few (literally less than five) patients with adult-onset diabetes who eat perfectly (tons of fruits and veggies, high fiber, and few sweets), and have normal weight, yet still require medications to control their blood sugars (yes you, "FP"!), the VAST MAJORITY of my adult onset diabetic patients would have completely normal blood sugars if they ate well, exercised, and lost weight.

BOTTOM LINE: NO medication is without risk, so MAXIMIZE your health with proper diet and exercise and MINIMIZE the number of medications you need to take!

Leg Cramps Killing You?

Okay, on a more serious note today, there is a way leg cramps could kill you. Unfortunately, the prescription drug, quinine sulfate, that has been used off-label for decades as an effective cure for nighttime leg cramps is once again having continued reports of serious side effects- from bleeding to kidney damage to death.

If you are taking this medication and you notice bleeding gums, easy bruising,or blood in your urine- go immediately to your doctor and she will need to check your blood count, with special attention to your platelets (the team members that cause your blood to clot.)

So, what are you to do if you swear by this drug? First of all, please discuss it with your doctor. Make sure you have been recently checked for low iron stores (a ferritin level) to be sure that isn't the real cause of your leg pain. Your physician will examine you and possibly check a few blood tests.

If all is normal, here is one alternative medicine thing to try. Don't laugh (although I did chuckle when my dear patient first told me about this!). Try sleeping with a bar of soap. Yes. What brand? Whichever one you prefer. There are actually a few scientific studies that have shown promise with this, though I'll be the first to say I wont expect this to help everyone. On the plus side, though, there are no serious negative side effects from sleeping with a bar of soap under your pillow or covers!

BOTTOM LINE: If you take quinine for leg cramps, it's time for another discussion with your doctor!