Category: Health

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Health

Lack of sleep could be killing you…

Lack of sleep is holding us back and shortening our lives! Sleep is a biological necessity – experts say we need 7 to 9 hours a night to maintain our health, feel good and perform our best. Although some of us have trouble getting enough sleep, many choose to stay awake longer, trying to fit in more activities – and accomplish more – each day. But this may not be a good decision…

Studies suggest that those who sleep less than 6 hours a night run a risk of 13% greater chance of dying. Decreased productivity is estimated to cost the economy $411 billion in US, $50 billion in UK and $21.4 billion in Canada. And researchers say the number of people who don’t get enough sleep is rising.

Lack of sleep doesn’t only leave you feeling more tired and less energetic. Memories are processed and stored while we sleep. We need enough time in the deeper stages of sleep to process the day’s events in order to remember them long-term.

So, cutting sleep short to create more waking hours with the goal of achieving more can backfire, reducing achievement both at school and work. As Arianna Huffington, co-creator of Huffington Post says, you need to “sleep your way to the top!” (see link to her TED talk below). Of course, she’s talking about getting enough sleep so you can achieve more at work. She came to this realization when she injured herself, hitting her head on her desk when she passed out from lack of sleep.

The other way to make more time in your day, of course, is to look at your daily activities and decide what’s most important to you. Evening TV? Facebook articles? Emails? Or that project you’ve been wanting to finish? Simplify your life (and email!), and limit time wasting activities to create more free hours to accomplish your passions instead of cutting short your refreshing, health-protecting sleep.

And if you can’t sleep but want to? Here’s a blog I wrote about what you can try for insomnia: Can’t Sleep?

But, if hormone related symptoms are keeping you awake at night, my new book Can I Speak to the Hormone Lady? Managing Menopause and Hormone Imbalances has information you can use. It’s available here.

References:

TED Talk: How to Succeed? Get More Sleep – Arianna Huffington

National Institutes of Health: A prospective study in sleep duration

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Health

Finding Wellness

What does Wellness mean to you? The World Health Organization defines it as: “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” It involves consciously making improvements to lifestyle, outlook, environment, belief systems and values to achieve your full potential and to help those around you do the same at home, in the workplace and in the community.

However, if you search the internet, you will find two types of “wellness” advice:

  • Information on wellness (sometimes referred to as lower case “wellness”) …solid advice on ways to promote health and prevent illness, backed by scientific evidence. It includes good nutrition, exercise, sleep, stress reduction and more, and essentially means the opposite of illness.

  • Promotional material on Wellness Products (Wellness with a capital “W”) …products often making pseudo-scientific health claims with sketchy proof and often marketed with a high price tag! The Wellness business is a billion-dollar industry…

How can you tell the difference when you’re reading a web page? I use two simple ways:

1. Who posted the information?

Is the web page associated with a large health organization, government or university? The goal of these organizations is generally to share information and promote public health. They have no financial incentive to hide negative information or exaggerate the positive effects of a wellness strategy.

Does the author have any credentials or experience as a health professional? While credentials are not entirely necessary (a good writer will get all the facts and present them in an unbiased way), it means they will likely have better background knowledge.

Where did the information originate? Look for references. Is it backed by scientific studies? A well referenced web page will have links to background studies that support what they are saying. Studies usually have a little summary at the beginning, called an “abstract” that is a brief description of the study. I also look at where it was published – many large medical organizations publish journals with information for their members that usually well researched.

2. Who paid for it?

The second thing I look for on a web page is, who paid to publicize the information, and whose advertising is displayed with the article. I learned a good lesson over 20 years ago when the internet was just starting up. The doctors next door asked if I could supply them with information about the herbal medicine, St. John’s Wort. I quickly found what looked like a perfect article on the internet. My pharmacy student, who was more tech-savvy than me, didn’t say a word…she just scrolled down and pointed to the advertisement for St. John’s Wort. An “aha” moment for me!

With a more critical look, I noticed the site described the herb as “safer than aspirin” and, while many would interpret this as saying it is very safe, as a pharmacist I know that aspirin can cause internal bleeding in some people. The site wasn’t being open and honest in an effort to increase sales, and chances were good they were hiding other important, but negative, information. I subscribed to an independent herbal website after that so I could easily access unbiased information about natural medicines.

So, whether your reason for looking for wellness information or alternative medicines is wanting to stay healthy and active as you age, or to address a need that is unmet by the medical system, don’t be taken in by marketing strategies for Wellness products. Know that a vitamin is a vitamin – they are all the same chemical structure – so there is no reason to pay $90 for a month’s supply when you can always buy good quality vitamins from a reputable manufacturer at your local pharmacy. When looking for health information on the internet, choose an academic or health-center site rather than one sponsored by a product manufacturer. Know when you’re being marketed to and be a savvy shopper.

But also make sure any alternative treatment is an addition to good medical care and not a replacement for it. Consider natural treatments as complementary to your medical treatment rather than a true “alternative”. Nothing can replace good medical care.

So, talk to your doctor about any non-prescription medications you are taking, even if they are being recommended by another health professional. While they may not have learned about it in medical school, they can help you evaluate the information you are reading and ensure there is no interference with any health condition you may have. Your pharmacist may be your most accessible health professional and they can help ensure you avoid conflicts with medications you are already taking. They also have access to scientific references on alternative and complementary products. Ask if they can find some solid information to share with you.

Talking with your doctor and pharmacist about non-prescription choices is a great way to start a conversation around your health goals and how best to achieve them. The internet can be a wonderful source of information but it’s best when used in consultation with your doctors, pharmacists, and other health professionals.

References:

The Self-Care Paradox

Definitions of Wellness

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Health

Autoimmune disease – more common now than cancer and heart disease

Autoimmune diseases occur when the body’s immune system attacks its own cells and tissues. This class of diseases includes many familiar ones like multiple sclerosis (MS), inflammatory bowel disease, Lupus, rheumatoid arthritis, Hashimoto’s thyroiditis, and over 100 more. It’s become the most common type of disease, more common than heart disease and cancer, and rates are increasing each year.

And because autoimmune disease takes time to show up and often has diverse symptoms, it can be difficult to diagnose. Patients with vague complaints are sometimes told they are depressed or just imagining their symptoms when their doctor cannot identify an obvious cause. It takes a person an average of 5 years and 5 doctors before an autoimmune disease is finally identified, according to the American Autoimmune Related Diseases Association (AARDA).

This happened to my mom when she was admitted to hospital last year because of shortness of breath and low blood oxygen. She was diagnosed first with heart failure, then pneumonia but the treatments for these conditions didn’t help. When they finally diagnosed that the rheumatoid arthritis she’d had for 2 years had attacked her lungs, too much damage had occurred, and she died in hospital. Apparently, the lungs are the most common non-joint area affected by rheumatoid arthritis, so one might think it could have been detected earlier – before her lungs became irreversibly damaged. But this is the nature of autoimmune disease: it often mimics other more common illnesses and is missed.

Autoimmune disease occurrence sharply increased in the 1980’s and 90’s. An Israeli study that looked at 30 studies from the last 30 years found the following yearly global increases in autoimmune diseases:

Rheumatic (arthritis-related) disease – 7.1%

Endocrinological (hormone-related) disease – 6.3%

Gastrointestinal (digestive system) disease – 6.2%

Neurological (nervous system) disease – 3.7%

And that’s been average increases yearly, worldwide, for the past 30 years.

But what has caused these dramatic increases in autoimmune diseases? Researchers don’t know for sure, but there are several theories.

Environment

Our environment has changed drastically over the past 100 years. And, although we have better medicine, cleaner water and plenty of food, these may have some connection with the onset of autoimmunity.

For example, the overuse of antibiotics has changed the make up of the normal bacteria that live in our digestive systems. Scientists are now realizing that some of these bacteria control our immune system activity.

Advanced farming practices have meant that our food is raised differently. As one researcher put it: not only are we what we eat, we are what our food eats! Different food for animals and plants means different nutrients (and perhaps missing nutrients) in our food. As well, processing food changes what it contains. Even the simple process of creating white flour removes many nutrients from the food that is made with it. And chemicals, not normally found in food, have been added for various reasons including increasing shelf life. Some speculate that some of these changes may be involved in the onset of autoimmunity, interfering with our systems’ ability to distinguish self from non-self. We need more study particularly to determine what effects commercially used chemicals may be having on autoimmunity.

Genetics

If one family member is diagnosed with an autoimmune disease, others in the family are at higher risk of developing that disease or another related one. Since these diseases can tend to run in families, it is suspected that there may be genes that can be inherited, making a person more susceptible.

Also 75% of autoimmune diseases occur in women. Some researchers have suggested that a tiny part of the X chromosome, called microRNA, is involved in immune system function. Since women have two X chromosomes, while men have one X and one Y chromosome, this might explain why women live longer but have a greater chance of immune dysfunction.

However, autoimmune diseases are increasing much faster than genes can pass them on. Scientists feel that it must be a combination of genetics plus exposure to something in the environment that could cause such dramatic increases in these diseases.

Hygiene hypothesis

Because the occurrence of infectious diseases was decreasing at the same time as autoimmune disease has been increasing, researchers theorize that the absence of infection is affecting our immune systems. Scientists are saying that our systems need regular and early exposure to common harmless bacteria to learn how to react to threats.

We are exposed to bacteria first during natural birth and breastfeeding, but also by spending time outdoors in green spaces, and eating a varied diet (especially fermented foods). We even seem to pick up good bacteria from those we are close to. The greater the diversity of organisms in our digestive system, the healthier we tend to be.

Stress

A 2018 study published in the Journal of the American Medical Society found that people with diagnosed stress-related conditions were significantly more likely to develop an autoimmune disease than those without. People with PTSD (post-traumatic stress disorder) who received treatment had lower chances of developing an autoimmune disease.

The idea of grouping these autoimmune diseases together, as they do with cancers, is relatively new. They’ve been thought of and researched as independent illnesses. However, they may have common factors and similar processes triggering the immune system to malfunction in different ways, attacking different parts of the body, and creating a different disease. Researchers are asking for a central database where occurrences of autoimmune diseases would be reported, so they can gain a better understanding of how many are affected, where cases are occurring and how quickly diseases are increasing. More information can lead to better understanding and research on this poorly recognized and understood group of diseases.

So, if you have vague symptoms and you are sure something is wrong with your health, persevere… try the treatments your doctor is recommending but, if they don’t help, keep asking. It might just be that 5th doctor who figures it out!

References:

Why Are Autoimmune Diseases on the Rise?

The World Incidence and Prevalence of Autoimmune Diseases is Increasing (International Journal of Celiac Disease)

Association of Stress-Related Disorders With Subsequent Autoimmune Disease

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Health

Needles are good for you…

Knitting needles, that is…

It’s been a busy week: a long haul back from Spain, dealing with lost and damaged luggage, unpacking, laundry… and jet-lag, of course.

But when I saw this article, I wanted to share it with you. You may know that I am an avid knitter – my grandmother taught me when I was 6 and I took it up in earnest at age 8 or 9 when I received a “how to” book on knitting. I’ve been knitting ever since! But did you know that knitting is good for your mental and physical health?

Research shows that knitting can reduce depression and anxiety, lower blood pressure, distract from chronic pain, decrease loneliness and isolation, and just generally make you feel good!

I’ve always found knitting to be soothing and relaxing – sort of a form of meditation. It’s something about the repetitious movements of forming the stitches, I think. And, if you choose a more complex pattern, you need to block out other thoughts and focus on the pattern or you may find yourself unravelling some of your work! It’s really a form of meditation at the same time as you are creating something…

Studies say that knitting can actually induce the “relaxation response” — I wrote about this back relaxation technique back in March of 2017. Click here to see it. So, from this point of view, it compares with other relaxing activities like meditation and yoga… except you are creating something beautiful and useful at the same time. And, if you give the item away, you add in some of that great feeling you get by helping others.

I guess this may be why, as researchers have discovered recently, knitting can help reduce anxiety, depression, chronic pain and more. And in addition, when you’re done, you have the reward of a useful knitted item like a hat, scarf, mittens, socks or sweater! What could be better than a relaxing activity that provides a sense of accomplishment?

So, ff you’ve never knitted, give it a try. Pick up an inexpensive ball or two of colourful yarn and a pair of knitting needles (the label on the ball will tell you what size to buy!) and Google “how to knit”. Or just ask a friend who know how. I’m sure they’d be excited to help you learn!

Mental Health America article:

http://www.mentalhealthamerica.net/blog/mental-health-benefits-knitting

Inspiring anecdote from writer Chloe Grundmeier:

https://dailyevergreen.com/52666/life/try-knitting-for-your-mental-health/?fbclid=IwAR2vqUm6HA20x2wXtp-UDiBnzhZZyZLQHN_ABsqvGh–paXQk5z2o7L-N0Y

Here’s the science:

https://www.medicalbag.com/home/lifestyle/knit-one-purl-one-the-health-benefits-of-knitting/

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Health

Vitamin K2 – the Link Between Heart Disease and Osteoporosis

A hen and her chicks in the garden at our apartment building in Spain

Well, some of our family have gone home to Canada, and I’m finding a bit more time to read these days. I’m into a book about the tie between heart disease and osteoporosis. Who would have thought there is a connection? I certainly didn’t. But the book’s explanation of why we are seeing too much of these chronic diseases makes sense…

The connection is calcium – too little of it leads to thinning of bones and risk of osteoporosis – and too much can result in calcification (or “hardening”) of the arteries and blockages that can cause heart disease when they occur in arteries that supply the heart muscle. While this seems to present a paradox… too much calcium in one case and too little in the other… the link is a nutrient that controls where calcium goes in the body.

That nutrient is vitamin K2, a vitamin that was not widely studied until the last 20 years. It’s sister vitamin, K1, was researched more thoroughly as it was thought to be the only active form of vitamin K in the body. K1 is needed for blood clotting and is the vitamin whose action is blocked by the blood thinner, warfarin.

Vitamin K2, on the other hand, controls where calcium goes once it’s absorbed from the digestive system. It does this by activating two substances: osteocalcin and matrix gla protein (MGP). Once activated by vitamin K2, osteocalcin attracts calcium to bones and teeth making them stronger. Activated MGP, on the other hand, sweeps excess calcium away from soft tissues, including arteries and veins, preventing and removing dangerous plaque from inside arteries. A lack of vitamin K2 means that osteocalcin and MGP cannot be activated and therefore cannot perform these important functions.

Vitamin D is important too. You likely already know that this vitamin is needed to absorb calcium from your digestive system. This makes it an important factor in preventing osteoporosis. You may have taken calcium supplements with vitamin D added right into the tablet and probably have learned that it’s called the “sunshine vitamin” because we make it when the sun shines on our skin.

But vitamin D is also needed to make the MGP protein that removes calcium from soft tissues, preventing and reversing hardening of the arteries. So, vitamins D and K2 work together to prevent both osteoporosis and heart disease – vitamin D helps to get calcium into your system, and both vitamins K and D are needed to make sure the calcium goes to the right place.

Recommendations for calcium and vitamin D supplements have recently changed. Although recommended for many years for prevention and treatment of bone loss, recent studies suggest there may be more harm than benefit, especially in healthy adults and that there’s more to having healthy bones than just swallowing lots of calcium.

This information about vitamin K addresses several “paradoxes” in our explanation of causes of heart disease: Why do 50% of people who have a heart attack have normal cholesterol? Why do the French, with their rich, fatty diet, have less heart disease than us in North America? This is often called the “French Paradox”, and could be explained by different farming practices. How could there be so much osteoporosis (a disease of too little calcium) and heart disease (a disease of too much calcium) in a single population eating a similar diet?

Both heart disease and osteoporosis increased when farming practices changed in North America. Grass contains the precursor to vitamin K2 that animals convert for us. When animal feed was changed to grains to simplify production, the animals no longer ate chlorophyll, the green substance in plants with the pre-ingredient needed to produce K2. Without realizing the difference, we dramatically changed the content of our diet. Not only are you what you eat, you are what your food eats!

Vitamin K1 is found in green leafy vegetables, the broccoli/cauliflower family of vegetables, and small amounts in meat, fish and eggs. Animals and some bacteria can convert K1 into K2 but humans cannot. We need to consume it regularly in our diet as we don’t store this nutrient.

Choosing grass-fed meat and pastured eggs (from hens that feed in a pasture) can correct a vitamin K deficiency. Since betacarotene (a yellow nutrient) and chlorophyll (the green stuff in plants that animals make into vitamin K2) usually occur together, butter and egg yolks that contain vitamin K tend to be darker yellow. I’ve noticed that egg yolks here in Spain are a deep golden colour, so I suspect that hens here must be allowed to feed in pastures. Perhaps that’s one reason that the Spanish are one of the healthiest populations with a longer life span than us in North America!

Cheese is produced by bacterial action on milk, and some of these bacteria produce vitamin K2 at the same time. So some cheeses also contain vitamin K2. Some of us also have bacteria in our digestive systems that can convert small amounts of K1 to K2, but these bacteria can’t produce enough K2 to satisfy our needs.

If you can’t find grass-fed food or fermented products with the vitamin, you can take a vitamin K2 supplement. But supplements may not all be created equal. K2 is also called menaquinone or MK and, just to make it complicated, there are several different types of MK, depending on whether they are produced by animals or bacteria. MK-4 comes from animal sources. It works well but is cleared from the blood stream very quickly, so could require dosing several times a day to maintain activity. Menaquinone-7 (MK-7) comes from plant sources, and some feel it’s a better choice as it stays in the blood stream with once a day dosing. Of course, nutrients can continue to have their health effects after leaving the blood and moving into the tissues, so there are two schools of thought on which is better. The bottom line is that any vitamin K2 supplement is likely better than having none at all but, as always, it’s best to get your nutrients from food if possible.

So, I plan to buy my eggs from local farmers whenever I can in the future and will be asking whether they let them out of the coup once in a while. And I’ll be looking for an MK supplement for the days when I don’t have nice yellow-yolked eggs or grass-fed meat! What about you?

If you want to know more, here are some of the references I used:

Vitamin K2 and the Calcium Paradox by Kate Rheaume-Bleue, BSc, ND

Vitamin K2 – A little known nutrient can make a big difference in heart and bone health

Globe and Mail: Are Calcium Supplements Helping or Harming Your Health

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Health

Trouble sleeping?

It’s been a month since I arrived in Costa del Sol, Spain, and I’m still amazed by this beautiful place! And watching the snowy weather reports from back home in Canada, I realize we chose a good winter to travel here.

This week, I have another great article for you… This is the best collection of information I’ve ever found about insomnia, all in one place. It discusses the different types of sleeping problems, common causes, and what you can do to get back to a good night’s sleep.

In fact, I think it’s worth reading even if you don’t have problems sleeping – you may find things you can do (or avoid!) that can improve your sleep further or avoid problems developing in the future.

Here’s the link: https://betterhumans.coach.me/how-to-recognize-and-cure-any-insomnia-symptom-661ebfd119f9 Happy reading!

PS… The photo above is Benalmadena Pueblo, a beautiful village halfway up the mountains, near where we are staying. Note the quiet street and great blackout shutters on the windows… I’m sure they get a good night’s sleep there!

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Health

Going Off Antidepressants

Benalmadena Beach

I’ve had a busy week here in Spain, so not much time to research and write a blog Well, really I’ve been visiting outdoor markets, watching Flaminco dancing, and exploring nearby villages of Mijas and Arroyo de la Miel… busy having fun!

But I did spend one morning reading, and came across an excellent article about antidepressants from Harvard Medical School that I’d like to share. It discusses how the medications work, how long they should be taken, why they can cause withdrawal symptoms, and what to do when you decide (in discussion with your doctor) that it’s time to stop taking them.

Doctors will sometimes recommend continuing antidepressants for years to prevent depression in those who have had multiple severe bouts. But 6 months of treatment is often considered long enough for a first episode. Side effects, like drowsiness, insomnia, headache or sexual dysfunction, that are tolerable when seeking relief from depression may become bothersome and unacceptable once a person is feeling better.

Withdrawal effects that are known to sometimes develop when discontinuing antidepressant medications — called “antidepressant discontinuation syndrome” — can easily be confused with a return of depression itself. Working closely with a doctor while gradually decreasing the dose of the antidepressant is important. A doctor will monitor to ensure any new symptoms are caused by withdrawal and not a return of depression. A gradual taper of the medication will often be prescribed to help to minimize any withdrawal effects. Occasionally a return to a previous, slightly higher dose will be used to ease symptoms before gradually decreasing again.

As a compounding pharmacist, I have made capsules of strengths between those commercially available to allow a more gradual dose decrease in sensitive individuals. But often withdrawal can be managed by using tablets that can be cut, liquids that can be measured in small amounts, or by switching to longer acting medications that are cleared from the body more slowly.

If you, or someone you know, is considering stopping a long term antidepressant medication, I’d encourage you to read more about going off antidepressants here And be sure to work closely with your doctor and your pharmacist to ensure this change is accomplished safely and as comfortably as possible.

Reference:

Harvard Health Publishing

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Health

8 Tips for a Healthy Holiday

Merry Christmas to all my readers!

I thought I’d share a few tips for a healthy holiday with you for my Christmas blog…

  1. Keep moving

  2. Have a plan

    • As I always like to say, “everything in moderation”. So, enjoy the special holiday goodies, but make a plan to avoid excess. Your plan could be to take half a piece, or to sample only a certain number of treats to limit your intake. Try to stay aware of how much you’re having.

  3. Stay hydrated

    • Sometimes you’re thirsty, not actually hungry.

    • Alternating drinks with a glass of water helps to moderate alcohol intake too. It’s easiest if you fill your wine or drink glass with water so you won’t be tempted to refill your drink before you’ve finished your water break.

  4. Make lists

    • The holidays can be a hectic time. Making a “to do” list is a good way to reduce the stress of worrying that you’ll forget something important.

  5. Forget perfection

    • The holidays are a time for enjoying time with family and friends. When entertaining, plan to make it casual. Do a “pot luck”, ask for help when you need it, and make cooking and decorating a group activity.

  6. Exercise early in the day

    • I have a little routine I try to do each morning. Especially during the holidays, something to do can easily crop up later in the day, thwarting your plan to exercise.

  7. Plan outdoor activities

    • Even if you have a house full of guests, an after dinner walk or other outing gives everyone a change of scenery, fresh air and some exercise. And any elderly or unwell guests will have a peaceful break while the rest of you are out!

    • We always have a “beach walk” after Christmas dinner… and our doggie visitors love it too. (All 3 of my children have dogs… we had 5 dogs here one holiday!).

  8. Only indulge for the day

    • Splurging on one day will never make or break your fitness plan – as long as you keep it to a day or two and not a whole month of indulgence! Enjoy the holiday with all its special treats (in moderation) then get back to your healthy life plan!

This will be my last blog for 2018 and I plan to take a little break for a while. My book about balancing hormones is ready to self-publish and I have a big learning curve ahead of me (that I’ve been putting off for far too long). And my hubby and I are planning a trip to Spain for 3 months…

So, have a wonderful holiday season and all the best for 2019… and I’ll write from time to time when I find a topic that’s especially interesting!

Reference:

US News-Health

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Health

Exercise: An ideal "prescription" for chronic disease

“If it was a pill, exercise would be a trillion-dollar money-maker prescribed to everyone.” Dr. Scott Lear, heart disease prevention researcher at Simon Fraser University, British Columbia, Canada.

A prescription for exercise?

Exercise is so effective at preventing and treating some chronic diseases, doctors are being encouraged to write prescriptions for it… Exercise decreases the risk of many diseases, including heart disease, stroke, Type 2 diabetes, depression (as discussed in last week’s blog ), and many cancers. Here are a few statistics for lowering chronic disease risk, as quoted on the website, Moving Medicine (a beta site being developed to encourage doctors to “prescribe” exercise to their patients):

  • Type 2 diabetes -40%

  • Cardiovascular disease -35%

  • Falls -30%

  • Dementia -30%

  • Depression -30%

  • Joint and back pain -20%

Physical activity is as important for health as many medications, but without the side effects. Humans were made to move, and inactivity is believed to be as harmful to our health as cigarettes. But, the more affluent our society becomes, the less we tend to move.

Who needs this prescription?

A global study of activity found that, on average, more than one-quarter of adults worldwide are not getting enough physical activity. And high-income Western countries (like us in North America) have inactivity rates twice as high as those of poorer countries, over 50% in some areas.

And women tend to be less active than men – up to 20% less in some countries. A 2017 survey published in Health Reports found that only 2% of girls aged 12-17 met the Canadian Movement Guidelines that include adequate sleep and at least 60 minutes of moderate to vigorous activity. A Dalhousie University study noted that teenage girls are concerned about appearances when they exercise: they worry about being pretty but natural-looking, thin but not too skinny, fit but not too muscular. Their responses in the study suggest that outdoor activities can provide an important venue to feel comfortable, safe and confident doing physical activity, compared to a gym setting where, as self-conscious teenagers, they felt they needed to be more concerned about clothing and appearances.

How to get more people moving…

Community infrastructure can influence activity in the young and old. Open spaces, like parks and walking/biking paths, provide enjoyable and convenient opportunities for physical activity. A visible example is the throngs of people who use the skating oval added to the Commons in downtown Halifax. You can even borrow skates and helmets there for free!

High quality public transport and incentives to use it rather than motorized vehicles can result in an overall increased population activity being incorporated into daily routines for those who use the systems. I noticed a marked increase in my activity level when using public transit while travelling in Europe, just by walking to and from the nearest system access.

With statistical evidence that inactivity is worsening in too many areas year by year, and with a corresponding increase in chronic diseases like diabetes and heart disease, it is time to think seriously about ways to increase physical activity levels across populations.

So, if you want to reduce your chances of developing a chronic disease as you age, look for ways to incorporate more exercise into your day, and it doesn’t have to be a session at the gym. Remember that ten minutes of activity three times a day is considered equal to a single 30-minute session. Park farther away from the door when doing errands or take the stairs instead of the elevator – it all adds up. My husband and I enjoy a daily 25-minute walk to check our mailbox most days and climbing up and down the stairs in our 3-story house adds to the daily total.

How much should you exercise to benefit?

The World Health Organization guidelines for physical activity recommend a minimum of 150 minutes per week of moderate-intensity activity like brisk walking, biking or dancing… or 75 minutes a week of vigorous activity like jogging or playing an active sport. If you have a chronic disease, check with your doctor first, start slowly and increase activity gradually. You can expect a few sore muscles as you begin but stop exercising and contact your doctor right away if you experience any chest pain or other alarming symptoms. Any exercise that makes it difficult to speak is likely too intense and could be a risk to your immediate health. Specialized exercise programs are available in some areas to help those with chronic diseases, such as heart disease or back problems, to get started safely. The cardiac rehab program my husband took after his heart attack 14 years ago was a game-changer, and we’ve worked to keep up our activity level since then.

So, don’t be surprised if your doctor gives you an unusual prescription…

In addition to the Moving Medicine program in UK mentioned above, Canadian medical schools are also revising their curricula to teach future doctors about the benefits of exercise to prevent and treat chronic diseases. It’s better and less costly to prevent diseases than to treat them!

(Please note that underlined phrases above and in the references are links to the source of the information)

References:

Exercise is Medicine, and Doctors are Starting to Prescribe It, The Conversation

Prescribing Movement (UK website under development to encourage doctors to prescribe exercise)

Girls and Women Need More Time in Nature to be Healthy

Worldwide Trends in Physical Inactivity 2001-2016

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Health

Why Are Strokes Worse in Women?

Each year in Canada, about 32,000 men and 30,000 women have a stroke. But one-third more women die from stroke: 59% compared to 41% of men. Women’s disability from stroke is more severe too — almost twice as many end up in nursing homes, compared to men.

Why is this? Stroke treatment, awareness and research has increased over the past 20 years but fewer women are involved in the studies, so the reasons are not well understood. However some researchers have thoughts on what some of the reasons might be…

Risk factors for Stroke

First, researchers found that seventy percent of women don’t know any of the risk factors for stroke. They could be at increased risk but they don’t know it, and don’t do anything to prevent it. Time for more public education directed at women. So, read on, ladies (and gents too…)

Some risk factors can’t be controlled: increased age, family history, being of South Asian, African or Indigenous descent, or just being female! Other risk factors can be changed, like high blood pressure (an important one!), diabetes, unhealthy diet, physical inactivity, unhealthy weight, smoking, stress and excess alcohol.

High cholesterol is often included in risk factors for stroke: it’s accepted as being a risk factor for heart disease, and established heart disease puts you at higher risk of a stroke. But low cholesterol was identified as a risk factor for bleeding stroke in Japan decades ago, so there’s some controversy about this one. Read my earlier blog, The Cholesterol Controversy, for more information on that ongoing discussion.

Atrial fibrillation, an irregular beat in the upper part of the heart, is another important risk factor for stroke. In this condition, blood tends to pool in the upper chambers of the heart instead of being sent through to the lower chambers, promoting formation of blood clots that can later be sent to the brain, causing a stroke.

Women are also at increased risk of stroke during pregnancy (3 times increased risk), during the menopausal change and in their elderly years. So, although stroke is more common in older women, it can occur in adult women of all ages. Both birth control pills and hormone replacement therapy can increase risk of stroke, just as our own hormones do during pregnancy, by making blood clots form more easily. Blood clots are at the root of the majority of both strokes and heart attacks. Some people refer to a stroke as a “brain attack” because the process is often similar.

What exactly is a stroke?

There are two main types of stroke plus a few other less common types:

  1. Ischemic stroke, where a blood clot or other type of material blocks an artery in the brain. This accounts for 90% of strokes.

  2. Hemorrhagic (bleeding) stroke, where a blood vessel in the brain bursts, allowing blood to leak rather than travelling to supply an area of the brain.

  3. Transient Ischemic Attack (TIA), is caused by a small clot that temporarily blocks an artery in the brain, giving temporary symptoms. Sometimes it precedes a major stroke.

  4. A tumor, infection or brain swelling from an injury can also cause a stroke in rare occasions.

Signs that a stroke is happening

A Heart and Stroke Foundation survey found that only 60% of women knew exactly what a stroke is, and only 8% knew all 3 signs that a stroke was occurring. Use the acronym FAST to remember them:

  • Face – Is it drooping?

  • Arms – Can they raise both?

  • Speech – It is slurred or jumbled?

  • Time – Time to call 9-1-1 right away!

Act FAST because the quicker you act, the more of the person’s brain you save!

Poorer outcomes in women

The emergency treatment for a stroke is to unblock the artery (for a blood clot stroke) or to stop the bleeding (for a bleeding stroke). Because brain damage is caused by lack of blood to an area of the brain, the more quickly the artery is unblocked (or the bleeding is stopped), the less damage and disability that will occur.

But women’s stroke symptoms are not always as clear as those in men, so strokes are sometimes not identified as quickly. Cases diagnosed as a TIA (a temporary stroke) in some women have later been discovered to be a full stroke. Studies have found, on average, women receive treatment more slowly than men.

Researchers looked at the “door to needle” time – the amount of time from when women arrived at hospital until she received an injection of a clot-busting drug to open the blocked artery in an ischemic stroke. On average, this time was 12% longer in women. Women are also less likely to be sent for the specialized surgery to remove a blood clot. And more women live alone, so often no-one is there to help them call for emergency transport to hospital when a stroke occurs.

Recovery from stroke is possible

The good news is that the brain can continue to recover and improve for several years after a stroke, if you do have one. Rehab and physiotherapy services can help improve function and mobility greatly. And the harder you work, the better your results.

However, women have been found to be 2 to 3 times more likely to have a poor outcome from rehab after a stroke than men. Experts suspect that women may have more difficulty getting to therapy sessions, or return to family and work responsibilities before they are fully recovered, but we need more research to find out why women don’t recover as well as men. Then we can work to change these factors and help women to better stroke recovery.

Conclusion…

So, know your risk factors for stroke, and work to reduce your risk. Know the FAST warning signs for a stroke and act quickly to get treatment to reduce damage to the brain: call 9-1-1-! When the ambulance arrives, tell them you think you might be having a stroke, even if the signs are not completely clear. Symptoms are not always as clear in women as in men.

If you do have a stroke, know that rehab and physio exercises will help you improve, and you can keep improving for several years. But you have to do the work, take the time, and stay determined to heal and recover as much as possible. The brain can reorganize itself and make new connections, but you need to stay in training mode to make it happen!

Read the link below (“Lives Disrupted”, for stories of women of all ages who have recovered well from stroke and returned to normal life…

References/Resources:

Lives Disrupted: The Impact of Stroke on Women

FAST signs of stroke

Types of stroke