Osteoporosis – weight, calcium and more

Osteoporosis affects at least 2 million Canadians and is often considered a women’s condition, but one-third of all cases are in men.

And, men suffer a higher mortality rate after a hip fracture than women: 37% die within 12 months versus 20% of women! Medical authorities believe men ignore their risk for osteoporosis and delay seeking medical intervention until the condition is well-advanced. The fact is, 1 in 5 men over 50 years of age will have a fracture due to osteoporosis in their lifetime.

Happiness & bone density!

More research is looking at ͞happiness͟ as a risk factor for health – or, more accurately, lack of happiness! Now, positive assessments of well-being have been associated with stronger bones. An analysis of more than 2000 women over 10 years found that those who rated life as satisfying on a 4-point scale had more bone density, both at baseline and the end of the study. They also had less morbidity and used less medications than the dissatisfied group!

Weight – find the balance

Both weight loss AND weight gain have been associated with osteoporosis in post-menopausal women. In a review of over 120,000 post-menopausal women, weight changes of more than 5% were considered. Unintentional weight loss increased the risk of hip and spine fractures, while intentional weight loss seemed to decrease hip fractures but increase lower limb fracture. Weight gain was associated with an increased risk of upper and lower limb fractures. Interesting!

More on calcium use

Recent evidence has suggested a need to be more cautious in calcium supplementation due to possible kidney stones or cardiac issues, but now a systematic review is questioning calcium guidelines – both from supplements and dietary sources. The findings suggest that the current recommendation of 1200mg/day does not have any effect on bone density or fracture risk. No one is suggesting changes just yet, though, as the results were not universal. Stay tuned!

November is Osteoporosis Awareness Month. Osteoporosis is the loss of bone density that increases the risk of debilitating bone fractures. Talk to your pharmacist about what you can do to improve your bone health.

Diabetes – risks and new treatments

More than 9 million Canadians have diabetes

It impacts everyone directly or indirectly. The prevalence of diabetes makes it the subject of much study – the search is constant for better ways to prevent and treat it. One significant risk of some diabetes therapies is hypoglycemia, a dangerously low level of blood glucose. Researchers have found that a drug used to treat asthma, formoterol, can reduce hypoglycemia and they theorize it may have a role to play in diabetes management. Watch for more info to come!

Drug combo may halt Type 1 diabetes

While Type 2 diabetes (T2D) gets plenty of attention due to its prevalence, Type 1 diabetes (T1D) affects more than 300,000 Canadians. It is thought to be an auto-immune condition where the cells producing insulin are destroyed. A study is underway to examine a combination of two drugs, cyclosporine and omeprazole, in the hopes that they may work together to halt the immune system attack and regenerate the necessary beta cells. Fingers crossed!

Bionic pancreas – not fiction

Several clinical trials are underway to test the effectiveness of a so-called “bionic” pancreas. The pancreas is the organ that functions to secrete insulin in response to blood glucose levels. The device is capable of measuring blood glucose and delivering insulin and glucagon in response to the levels it reads. So far, the device is performing very well in ͞real world͟ situations and, while not a cure, could be a safer treatment. It may hit the market as early as 2018.

Insulin pumped!

Modifications to current insulin pump delivery systems are being tested for value. The changes made to current insulin pumps involve ͞closing the loop͟ between blood glucose levels and insulin delivered. Carbohydrate-counting and bolus doses are still required, but the device has performed well for as long as three months and it’s expected that it could come to the market soon since it is based on existing technology.

Diabetes needs to be taken seriously as the consequences and complications are serious. Lifestyle plays a huge role in its development and management. Are you at risk? See www.take2minutes.ca and find out, or talk with your pharmacist.

Diabetes and sugar – the realities!

Most people are aware that there’s a relationship between sugar and diabetes

– that diabetics need to limit their caloric intake for better management. However, a comprehensive review has specifically singled-out sugar (especially fructose) added to foods (think: processed foods) as the culprit. Limit sugar to only 5-10% of your caloric intake to reduce diabetes risk as well as the associated morbidities such as kidney failure, blindness and painful neuropathy.

Watch out for added sugar in drinks

Soda pops and juices (usually with added sugars) are commonly known to be high sources of sugary calories. Some people think they are making a better choice with flavoured milk, milkshakes or smoothies. Wrong! The truth is, in spite of some potential nutritional value, the sugars in these drinks still contribute to diabetes. Rule of thumb: try not to drink your calories. Look to water or unsweetened tea or coffee instead.

A tax to promote health?

Due to the mounting evidence that sugar-sweetened beverages are contributing substantially to the diabetes epidemic, the Canadian Diabetes Association is calling for a special tax on these items and wants the funds raised to be used to promote the health of Canadians. Currently, more than one in four Canadians has diabetes or prediabetes – and that number is expected to grow to one in three by the year 2020.

Not all the info is on the label

Nutrition labels on foods are very helpful in assessing the nutritional quality of the food and in managing the intake of specific nutrients. However, current labels only provide information on total sugar content. Since added sugars are emerging as an especially important consideration in health (as opposed to naturally-occurring sugars), there is a call to start providing this information. A single 20-ounce soda contains 130% of the daily recommended intake! November is Diabetes Awareness Month and there is a lot you can do to reduce your risk of diabetes and better manage diabetes to prevent the gruesome consequences. Talk with your pharmacist or visit: www.diabetes.ca

Make Sure To Get Your Sleep

Many studies have pointed to the importance of sleep in a variety of health conditions.

There are several tips for getting optimal sleep:  maintain a regular sleep schedule, create an environment conducive to sleep, avoid stimulants (caffeine, nicotine) & sedatives (alcohol, sleeping pills), get regular exercise, and keep napping to a minimum.  There is evidence that “screen time” affects sleep patterns as well, so limit television and computer use an hour or two before bedtime.

Many people prefer to skip good “sleep hygiene” to manage insomnia and, instead, turn to drugs for “immediate” relief.

However, these medications don’t produce a good “restorative” sleep and come with their share of side effects, including dry mouth, blurred vision, constipation, and hang-over effects.  They also cause confusion and can increase the risk of falls – especially in the elderly.  At best, they are a band-aid and you’re best to address any underlying causes.

If you suffer from more than occasional insomnia, bypass medications and look to one of the following techniques to re-set your sleep cycle.

1) Sleep Restriction: do not allow yourself to nap to make up sleep shortfalls and, if awake in bed, get up and do something relaxing until the urge to sleep returns.  2) Reserve the bed only for sleep (and sex!) – no TV, paperwork, etc.  3) Learn relaxation techniques.  4) Look into CBT – cognitive behavioural therapy.

Jet lag can occur any time our travels take us more than a couple of time zones away – and seems to be particularly bad when travelling east.  There are steps you can take to minimize jet lag.  Gradually start moving bedtime and mealtimes towards those of your destination, starting about a week beforehand.  Once there, go directly to the new schedule (avoid naps and snacks) and get as much daytime sunlight exposure as you can, to reset your circadian rhythm.

Whether you’re considering a sleeping pill or something “natural,” such as melatonin, to help re-set your sleep cycle, our pharmacists can help steer you in the appropriate directions to improve the quality of your sleep.

Listen To Your Body

Pay attention to what your body is trying to tell you – especially when you’re pregnant.

For example, most headaches are simply due to tension or eye strain, but a headache that is atypical for you may be a sign of something more serious.  A severe headache (or any headache, if you don’t normally suffer from them) may be an early warning sign for pre-eclampsia – a dangerous condition.  Other warning signs:  increased blood pressure, fever & seizures.  Seek help!

Pregnancy often causes women to lose some bone density

Pregnancy often causes women to lose some bone density as the body sacrifices important minerals to meet the demands of the growing fetus, however levels to return to normal about a year after breastfeeding ends.  Studies looking at vitamin D supplements to mitigate this bone loss have conflicting results.  Bottom line:  high doses are not recommended.  Stick to the usual guidelines, 600 iu daily (from all sources), preferably from diet, not supplements.

Many misconceptions persist about alcohol consumption during pregnancy.

1 in 10 women continue to drink while pregnant and many others think it’s only an issue in the first trimester or that a little sip now-and-then won’t hurt.  The American Academy of Pediatrics has issued a report that NO level is safe at any time during pregnancy.  Alcohol in pregnancy can lead to birth defects as well as neurodevelopmental, intellectual and/or behavioural disabilities.

You not only need to monitor what you consume during pregnancy, but also when you’re trying to become pregnant!  NSAIDs are a group of drugs, including ibuprofen, ASA & naproxen, commonly used for pain relief and available without prescription.  They have been shown to block ovulation by preventing the follicle from rupturing to release the egg.  They also reduce progesterone levels, furthering decreasing ovulation and preventing implantation of a fertilized egg.

Pregnancy is a critical time for managing your health and weighing the pros & cons of the treatments you seek.  Many drugs that are generally considered safe may have a significant impact on a developing fetus.  Ask our pharmacist first!

Ranking Lifestyle Factors

What poses the greatest risk to health?

Australian researchers looked at various lifestyle factors to try to rank which ones, individually or in combination, posed the greater risks to health.  Not surprisingly, smoking was the highest hazard, with high alcohol consumption and physical inactivity close behind.  Interesting factors that had significant impact were prolonged sitting time, short sleep duration and long sleep duration!  Obviously, combining two or more of these lifestyle factors upped the risks.

Nutrition labels on foods help us to make better choices for our health but, when dining out, we generally don’t know how good or bad the menu items really are.

Recently, the New York City Board of Health unanimously voted to have chain restaurants and some concessions post salt warnings on their menus.  Any item containing more than 2300mcg of salt is labelled with the image of a salt shaker on a black triangle.  This may be the start of a great trend!

In this era of more casual dressing, a study has found patients prefer their physicians to wear a white coat – at least if s/he is a dermatologist!

Apparently, professional attire – in particular, a white labcoat – forms part of the impression the physician makes on the patient; patients believe the physician to be more knowledgeable & skillful.  Such impressions have been shown to affect patient outcomes, not just in dermatology, but other medical specialties as well.

Statistics are showing that one of the most dangerous times for patients is the time period after discharge from hospital.  Often, this transition involves medication changes, diverse care providers, uncertainty about procedures, and delays in documentation for both patients and care providers – and sometimes combinations of these issues.  It behoves all involved – caregivers AND patients with their families – to be extra vigilant and ask questions during this risky time.

Our pharmacists want to ensure you, or your family members, understand your therapy.  Take the time to listen to the counseling and don’t be afraid to ask questions.  Isn’t your health worth the time investment?

Hot Drinks Can Give You Cancer??

Well, here’s a new one for you – drinking very hot drinks increases your risk of cancer; specifically, esophageal cancer!

The International Agency for Research on Cancer has determined that the temperature of your drinks is likely much more important than what you’re drinking.  “Very hot,” defined as 70o Celsius or 160o Fahrenheit, (temperatures commonly enjoyed in places like China, Turkey, Iran and South America) is now considered carcinogenic to humans.

The National Health Service (NHS) in the UK is bracing for a surge in cancer rates they believe will be fueled by an epidemic of obesity.

Going hand-in-hand with this will be increases in type 2 diabetes and coronary heart disease – all costing the system an additional £2.5 billion annually by the year 2035.  The NHS is recommending drastic changes to stem the problem, including marketing restrictions, a sugar tax, and steps to increase physical activity.

You may have already heard that marriage benefits your health, but a California study has quantified the benefit – at least in terms of cancer.

Married men enjoy a 29% lower risk of death from cancer than their unmarried counterparts and married women have a 17% lower risk.  However, they aren’t sure why; there are 2 schools of thought:  economic benefits of marriage or social benefits.  The same study found minimal economic impact, pointing to social advantages.

When it comes to cancer, many patients experience significant guilt – believing something in their lifestyle is responsible for their illness.  Researchers at the National Cancer Institute are trying to sort out how much cancer risk is attributable to environmental factors (i.e. lifestyle) or just “bad luck,” such as random gene mutations.  The bottom line is that both contribute to cancer risk, but environmental factors are probably responsible for up to 90% of cancers.

Knowing that YOU can influence your health and it isn’t all beyond your control is very empowering.  Our pharmacists are ready to help you make positive changes in your lifestyle – whether it’s smoking, sleep, diet or activity.

Keep An Eye On Non-Prescription Medications

Non-prescription medications are not necessarily as innocuous as many people think.

Newer antihistamines claim to be non-drowsy, however they would be better termed “reduced drowsiness!”  Children can have unpredictable reactions to drugs and these new antihistamines have been associated with effects such as behavioral changes, headache and skin eruptions in kids.  Convulsions have even occurred!  Always weigh the pros & cons in consultation with your pharmacist.

It’s important for both health care providers and patients to be vigilant for adverse effects with their medications to ensure problems are managed quickly.

An article in the Journal of the American Medical Association has pointed to a link between sildenafil (Viagra®), used for erectile dysfunction, and an increased risk of melanoma – a form of skin cancer.  The overall numbers were still low but suggest the need to investigate further.

With all the news about sun protection and skin cancer, it’s worth knowing that some sun exposure is actually good for your health!

A 20-year Swedish study of over 30,000 women found that sun avoidance led to a life expectancy equivalent to smokers – that is, getting NO sun is as bad for you as smoking!  While they didn’t identify an effective “dose” of sunshine, benefits increased with increased exposure – as did skin cancer, but also with a better prognosis.

Although some sun exposure can be considered healthy, too much can lead to uncomfortable burns, aging of the skin and increased risk of skin cancer.  Sunscreens help to offset these risks, but only if they are used properly.  Choose an SPF of 30-45 and make sure it is a broad spectrum product to block both UVB and UBA rays.  Apply liberally, about 1 oz (2 tablespoonsful) before going out and re-apply every 2 hours – more often with water exposure or perspiration.

There is a dizzying array of sunscreens on the market and some are better than others.  Also, one size does not fit all, so talk to our pharmacists about which product is the best one for your skin and activities.