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A lecture on LIFE & how you should live it.

As broadcasted in the media, Randy Pausch, a professor at Carnegie Mellon University has passed away from pancreatic cancer. Like many others, I was moved by his lecture which can be seen on here. His memory will live on as he has shown us how to LIVE. If you haven't seen this, it's an important reminder of how one should live there lives.

Yours in health,
Dr. Ian Koo, ND

Naturopathic Essentials Health Centre
"The care you want, the health you need."

Are the medications you are on increasing your risk for sunburn?

Here are some known culprits in creating sun sensitivity:

  • Antibiotics - (Tetracyclines - many teenagers are on this for acne, Quinolones and Sulfa Drugs - often used for bladder infections)
  • Diuretics - like the blood pressure medication, hydrochlorothyazide
  • Glyburide, a medicine for diabetes
  • Amiodarone, for treating heart conditions
  • Skin care products like alpha hydroxy acid, and retin-A. Also, people with eczema who use Pimecrolimus (aka Elidel) also have an increased risk.
  • Some NSAID pain killers like Advil, Aleve, Motrin, and ibuprofen, and the prescription drug Celebrex.

Whether or not you use these products, it's important that you are protecting yourself from excessive sun exposure.

Do your best to avoid getting burned:
  • Be sure to use sunscreen - and lots of it - with a minimun SPF 15. UV rays pass through water so it's necessary to apply the sunscreen even when you're swimming, and then again afterward. Apply liberally - a thin layer will not provide the protection you need.
  • Cover up - even though it's hot, covering up is a great way to shield yourself on sunny days. Hats, long sleeves, umbrellas and sunglasses all provide protective layers. In Asia and even in parts of Toronto, you'll find many oriental people using umbrellas. I don't know what fashionistas haveto say about this, but I guess it's effective.
  • Avoid peak hours outdoors - between 10am and 3pm the sun is at its strongest. Try to avoid direct exposure during those times. Save your gardening for the early morning or evening!
  • Please limit your use of tanning booths. You are unnecessarily damaging your skin.
If, despite your best efforts, you still get burned, try some of these methods for relief:
  • Cool baths, or cool compresses on the burned areas
  • Use a soothing lotion that contains aloe. Or if you have an aloe plant, break off a piece and rub the "juice" that comes out on your burnt skin. This is even more effective than lotions that "contain aloe."
  • NSAIDs like Advil, which decrease pain and inflammation can be used to relieve the pain of sunburns - just don't go back out in the sun as they increase your skin's sensitivity to the sun.
  • Of course, there are more natural methods of fending off and dealing with sunburns. Many studies have been done on lycopene (a flavonoid/antioxidant) that's found abundantly in cooked tomatoes and watermelon. Researchers have found in trials that those participants who ingested a diet high in lycopene had less sun damage than the control group who did not eat lycopene. My guess is that outcome would probably extend to a number of other antioxidants. And remember, the best way to increase your body's antioxidant load is through a diet high in fruits and veggies. Smoothies and juices are good too! And if your diet is lacking, then maybe I would consider some supplements tailored to your specific concerns.
Yours in Health,
Dr. Ian Koo ND

"The care you want, the health you need."

Global warming & Kidney Stones....What's the link?

Here's a side effect of global warming that few have heard before. In the latest edition of the scientific journal Proceedings of the National Academy of Science, researchers postulate that the incidence of kidney stones could increase by 30% in some regions of the United States by 2050. The southeastern region of the United States is currently termed the "kidney stone belt" for the higher incidence of kidney stones in the general population. The reason being that warmer weather and dehydration are risk factors for developing kidney stones - thought to be the closest experience to childbirth than a man can go through, although some women who have gone through both situations claim that passing kidney stones is more painful. It's hard to say because women tend to forget or minimize the pain of childbirth after the fact. It's nature's way of helping the human race to keep procreating!

Global warming is expected to increase temperatures in the north, leading to more cases of dehydration and decreased urine output. Middle aged men are more at risk for developing kidney stones than women and the statistics show that about 1 in 10 Canadians will develop kidney stones in their lifetime.

Causes of Kidney Stones:
  1. Calcium stones - Approximately 4 out of 5 cases of kidney stones are made of calcium and oxalate (found in fruits & veggies). However please don't decrease your intake of fruits & vegetables. Speak to a qualified health care practitioner if you are at risk of developing kidney stones and they should be able to put you on a diet low in oxalic acid. Other risk factors include excess calcium and vitamin D, certain drugs or hormones like diuretics and thyroid hormones, some kidney conditions and certain cancers.
  2. Struvite stones - Found more in women because of chronic urinary tract infections. Certain bacterial infections increase the pH of the urine making it alkaline because they increase the production of ammonia in the urine.
  3. Uric acid stones - Uric acid is most commonly associated with Gout, a condition whereby a person eats too much animal protein. Uric acid is a byproduct of protein metabolism. Other risk factors include people who have undergone chemotherapy and those with a genetic predisposition.
  4. Cystine stones - Least frequently seen as they form from individuals with a heriditary disorder that causes them to excrete large amounts of cystine (an amino acid) in the urine.

What you can do:
  • Drink plenty of fluids. The more urine you excrete, the less likely you are to make kidney stones.
  • Decrease your intake of meat proteins. Western cultures tend to eat more meat than is necessary. Remember my rule of thumb: half your plate should be veggies, a quarter grains and the remaining quarter meat. That translates to at most a 3 ounce steak. We don't need as much protein as we are lead to believe. That goes for most gym rats as well.
  • Get moving! Believe it or not, too much bed rest or living a sedentary lifestyle can increase your risk. As your activity level decreases, your bones begin to shrink as they are not put through the rigours of a hard workout or an active lifestyle. Shrinking bones leads to a release of calcium and other minerals that make up the bone.
  • If you're prone to uric acid stones or gout, cherry juice can help.
  • Of course, do your part for the environment and we will all benefit!
Yours in Health,
Dr. Ian Koo ND

"The care you want, the health you need."

What we know about the cervical cancer vaccine (Gardasil) - 2 years later

The US Centers for Disease Control & the CBC have new updates about the controversial cervical cancer vaccine Gardasil. At the time of widespread implementation by public health authorities, many health care practitioners voiced concerns about the rush to vaccinate young girls as they felt that there was too little data to warrant such a move. Two years worth of data have now been collected and the data looks promising. Of course, we'll know more when even longer time horizons are gathered and analyzed. In science and medicine, I've found that a clear picture for adverse effects and safety develops when you look at long term data. Also, the public should know that adverse reporting of vaccines & drugs is done on a voluntary basis. There is no system in place to actually follow-up with patients after they have received a vaccine or started on a new drug regiment. It is usually at the discretion of a health care practitioner to report to the ministry of health any side effects which they may have spotted. Therefore, as a caveat, such data does not give us a complete picture.

Nonetheless, I would say from a public health perspective that the number of adverse reactions reported is minimal, unless of course you're one of those people who incurred a severe reaction from this vaccine.

In the US, 2.2 million doses of Gardasil was distributed in 2006 and 11.3 million in 2007. In all, 7802 adverse events were reported between June 2006 and April 2008. Seven percent of those who reported adverse events had serious side effects - the worse being 31 reported cases of Guillain Barre Syndrome, a condition that usually results in temporary paralysis and is often triggered by a vaccine injection. Fifteen deaths were reported to the FDA, and ten were confirmed. However, the CDC says none of the ten were linked to the vaccine. The seven percent of serious side effects is apparently half the average of what is normally seen with vaccines. Of course, over the long term, these statistics can change, but the results are promising thus far.

Gardasil was designed to protect women from four strains of Human Papillomavirus - types 6, 11, 16 & 18 - which are responsible for 70% of cervical cancer cases. HPV is transmitted through sexual contact and is reported to infect up to half of all sexually active women between 18 and 22. Cervical cancer is the second most common type of cancer for young women.

Mosquito Season: Tips & Repellants. What works, what doesn't?

It's that time of year now where health officials will be warning communities about the West Nile Virus. I remember writing a paper for my epidemiology class about West Nile when everyone in the media was talking about this new disease that had reached Canada.

Many years later, we are now seeing a more virulent strain of the virus migrating up north from the US. The warmer weather - due to global warming - has led the mosquitoes further north and scientists have discovered that warmer temperatures also causes the virus to replicate faster in mosquitoes, thus increasing the risks of transmission. In general, the virus usually peaks in the late summer months.

Symptoms of West Nile

In general, the young, elderly and immuno-compromised are at an increased risk of complications from this virus. Most people (~80%) won't get sick with West Nile even if bitten by a West Nile carrying mosquito. Those that do, most will experience milder symptoms such as a fever, ache or a bad headache - reminiscent of flu symptoms. A small percentage might experience neurological symptoms and should seek medical attention.

Prevention Tips

  • Avoid fragrances & smells like shampoos, perfumes, lotions.
  • The bigger you are, the more of a target you are - so cover up with long sleeves and pants. I know, very hard to do in the summer!
  • Bugs like dark solids compared to clothes with light colours, stripped or floral patterns.
  • The darker your hair, the more attractive you are to a mosquito, though I'm not suggesting you bleach your hair.
  • Heat & moisture (ie. sweat) attracts mosquitoes….so something like exercising outdoors makes you look tasty to a mosquito.
  • Going out after a meal also attracts mosquitoes because the digestion process increases heat in your body.
  • Avoid alcohol – when you sweat, it comes out of your pores & attracts the mosquitoes.
  • Mosquitoes are not the strongest flyers, so the breeze from an electric fan may also help prevent them from feasting on you & your guests.
  • There are more expensive mosquito zappers out on the market that emit a warm, moist carbon dioxide mist, which attracts mosquitoes. This mist mimics a human's breath.
  • Note: There are a number of bug zapping devices that claim to eradicate mosquitoes, but research has shown that mosquitoes make up a small percentage of the insects that are caught. As few as 3% of the insects caught are female mosquitoes - the ones that bite humans.

Repellants that work

  • DEET works best in all trials performed thus far. It lasts the longest compared to other products out on the market. A product with 20% DEET can ward off mosquitoes for almost four hours and a product with 6.65% DEET lasts for almost two hours.
  • When it comes to DEET, don't use a stronger product than you need. Don't apply it near your mouth, nose, eyes or on broken skin. And please wash the repellant off your skin once you come back indoors.

Natural Alternatives that also Work (but not as effectively as DEET)

  • Products with citronella will last upto 30 min. Depending on the product, it can offer protection for as little as 2 minutes. Health Canada recommends that you don't rub the stuff on your skin so spray on your clothing.
  • Products with 2% soybean oil will protect you for ~94 min
  • The Centre for Disease Control (CDC) states that the oil of lemon of eucalyptus (its chemical name is PMD, for para-menthane-3,8-diol) is quite effective, but it is not recommended for children under 3 years old. It may provide protection for up to 2 hrs.

Interesting Fact

Mid-cycle is a bad time of the month for women as you are tastier to the mosquitoes because of a surge in your hormones.

Are nuts good for you? Which kinds?

The Best Nuts

Walnuts and Almonds both have good fats in the form of omega 3 fatty acids. These fats are the ones found in fish and can decrease inflammation, while improving cardiovascular health. Studies have shown that both walnuts & almonds can increase levels of good cholesterol (HDL) while lowering bad cholesterol (LDL).
(One ounce of Walnuts = 14 halves 185 calories, 4 g protein, 19 g fat)
(One ounce of Almonds = 23 nuts 163 calories, 6 g protein, 14 g fat)

Pistachios are high in lutein, an antioxidant that's been shown to protect our eyes from macular degeneration. These little green nuts have also demonstrated the ability to drop total cholesterol levels.
(One ounce = 49 pistachios 158 calories, 6 g protein, 13 g fat)

Pecan have antioxidants that have been shown to prevent LDL from building up in the arteries and have lowered total cholesterol levels. Compared with other nuts, pecans have one of the highest levels of phytosterols, a group of plant chemicals that may help protect against cardiovascular disease.
(One ounce = 19 halves 196 calories, 3 g protein, 20 g fat)

Hazelnuts have a good amount of folate, a B-Vitamin that can lower the risk of heart disease, cancer, and depression. Folate is especially important for women who are planning on getting pregnant as it is needed to prevent birth defects.
(One ounce = 21 nuts 178 calories, 4 g protein, 17 g fat)

Information you should know

Stay away from pre-packaged nut mixes. They are usually coated in salt & oil. Ideally, you would buy raw nuts and toast them in the oven or on the stove top to bring out their flavor.

Brazil nuts, macadamias, and cashews have relatively high levels of saturated fats, which over time can clog arteries and lead to heart disease. Having said that, they too are tasty and have benefits as well. Brazil nuts contain the highest amount of selenium of any foods. This mineral is an important antioxidant that helps to eliminate free radicals. Macadamias are high in thiamine - another important B-Vitamin. Cashews are rich in the following minerals: copper, magnesium & zinc, which are all important for the body and the immune system.

My advice: Eat nuts with saturated fat sparingly, especially if you have high cholesterol or have a family history of it.

Interesting Facts

Did you know that peanuts are technically not nuts. They are considered legumes and belong to the same family as beans and peas.