New Studies on Preventing Alzheimer’s

The Alzheimer’s Association estimates that one in eight people over age sixty-five has this disease and that the number will triple by 2050 to 16 million people. This would take a huge toll on our health care system, as well as on each family that would be burdened financially and emotionally dealing with their loved one. All of us, especially those approaching their “golden years,” want to do everything possible to avoid this fate.

Two new studies offer simple ways to prevent or treat what is called cognitive impairment, mild to moderate memory problems that can be early signs of dementia. The first study assigned participants with early memory impairment to either listen to music or to meditate for 12 minutes each day for three months. At the end of that time, both groups showed significant improvements in tests measuring memory and thinking ability. These gains were maintained or improved after another three months. Easy to do, cost-effective, and without side effects, these are activities that most of us can do on our own. (Journal of Alzheimer’s Disease, January 18, 2017)

You probably know that keeping active mentally is one way to prevent dementia. A recently-published study followed elderly people (ages 74-82) for four years to see how various activities affected their memory and thinking ability. Out of the 1929 people who were mentally normal at the beginning of the study, 456 developed cognitive impairment. Those who reported playing games, doing crafts, using a computer, or participating in social activities 1-2 times a week had a significantly lower risk of developing this problem than those who did them only 2-3 times a month. My bridge partner will be happy to hear this. (JAMA Neurology, January 30, 2017)

Finally, a provocative new study suggests that those people who develop high blood pressure late in life—age 80 or beyond—have a significantly lower risk of dementia. This is compatible with several other studies that found more cognitive impairment in seniors with a systolic blood pressure (the top number) below 130 and better mental functioning in those with values above 160. The authors of the new study theorize that higher blood pressure is needed in the elderly to force adequate blood flow to the brain due to age-associated hardening of the arteries. (Alzheimers Dement, January 17, 2017) On the other hand, high blood pressure earlier in life is thought to contribute to dementia, due to damage of the arteries leading to the brain.

There is also research linking many common drugs—statins, acid-reflux drugs, anti-histamines, tranquilizers, anti-depressants—with mental impairment and dementia. More about that in my book, coming June, 2018.

Disturbing News about Acid Reflux Drugs

A new study, reported at the November 2016 meeting of the American Heart Association, revealed a 20% increased risk of stroke in people taking proton-pump inhibitors (PPIs). This is on top of another study which found twice the risk of death from heart disease in people taking them. This is disturbing news, since experts estimate that seven out of ten people taking PPIs do not need them.

Proton-pump inhibitors are prescribed for acid reflux, also called GERD, and include Prilosec, Prevacid, and Nexium. They are blockbuster drugs, earning $13 billion each year in the US alone. While the approval of PPIs by the FDA was based on people taking them for only two weeks, many take them for years. Other dangerous side effects of PPIs include:

  • Vitamin D deficiency
  • Diarrhea infections
  • Pneumonia
  • Bone Fractures
  • Dementia
  • Kidney disease

Most of these side effects are because PPIs suppress the production of stomach acid, which you need to absorb important vitamins and minerals, such as calcium. PPIs also can destroy friendly bacteria in your stomach, paving the way for infections. The irony is that the vast majority of cases of acid reflux are not because of excess stomach acid. It is caused by weakness of a muscle that lets acid back up into the esophagus from the stomach.

There are several simple things that you can do to reduce acid reflux:

  • Lose five to ten pounds
  • Avoid tight clothing around the waist
  • Avoid certain foods—garlic, onion, tomato sauce, fatty and fried foods, caffeine
  • Eat several small meals throughout the day and wait 2-3 hours after dinner before going to bed
  • Elevate the head of your bed to help gravity keep food in your stomach

Unfortunately, if you are taking a PPI, it is very difficult to stop. This is because of a phenomenon known as rebound hyperacidity, whereby stomach acid actually increases after stopping a PPI. Tapering off these medications gradually and taking a simple antacid, such as Tums, Maalox, or Di-Gel, will help you to manage symptoms until your stomach acid returns to normal. Also, there are natural alternatives for acid reflux that you can use:

  • High-fiber foods, digestive enzymes, and probiotics
  • Aloe vera juice, licorice, apple cider vinegar, and slippery elm
  • Acupuncture and Chinese herbs
  • Stress reduction tapes, meditation, exercise

If your doctor has prescribed a PPI, talk to her about stopping it. The risk of serious side effects greatly outweighs its usefulness.

The study on PPIs and stroke can be found at: http://circ.ahajournals.org/content/134/Suppl_1/A18462. References for other studies on PPIs can be found in my book to be published in April.

Is Exercise Better Than Statins?

If you are one of the 36 million Americans taking a statin drug, or if you have been advised to take one, you should know about a new study that compares statins to exercise. Statins (Lipitor, Zocor, Crestor) are the most widely used drugs in the world, with $29 billion in sales in 2013. They are prescribed to lower cholesterol, which most doctors think contributes to heart disease.

Whether or not to take a statin is a dilemma for many, since official guidelines recommend them for virtually everyone over age 65. But as many as one in five people taking statins develop muscle aches and pains, which causes them to stop exercising. This is bad news, since exercise is important for preventing heart disease. So a group of researchers looked at ways that people taking statins could avoid muscle problems and continue to exercise.

Their surprising conclusion after analyzing dozens of studies? People are better off stopping their statins and exercising instead! The researchers reported that:

  • Exercise is equivalent to statins in preventing heart attacks and strokes, but it is better in reducing overall deaths.
  • Exercise can delay or prevent diabetes while statins increase the risk of diabetes.
  • Exercise is associated with decreased obesity while statins sometimes cause weight gain.
  • Exercise has been shown to increase quality of life, while statins have not.
  • Exercise benefits the elderly (over age 75) while statins have not been shown to do so.
  • There is more evidence of the benefits of exercise over the long-term (more than 10 years) than with statins

Not mentioned in the study were the many other side effects of statins, including memory loss and dementia, cataracts, liver and kidney damage, excessive fatigue, mood and sleep disorders, and sexual dysfunction. You can read more about these in my book.

How much exercise is enough? The authors were not specific, but a minimum of 30 minutes of moderate exercise (fast walking, biking, dancing, swimming, running) three times a week is the recommendation by many expert groups.

For those of you interested in more details about the study, it was published in the Journal of the American Board of Family Medicine in 2016, Volume 29, pages 727-740.

Great News About Heart Disease

My father died of a heart attack when I was only sixteen. He was 58 and it was the third one that he suffered, his first at age 44. So heart disease is a subject close to my heart, no pun intended. And as you probably know, heart disease tends to run in families.

That’s one reason I am excited to tell you the great news about a recent medical study. The authors reported that your chances of having heart disease can be cut in half by following only three of four positive lifestyle practices—not smoking, not being obese, exercising regularly, and eating a healthy diet. This was true even for people like me with a strong family history of heart disease.  And these lifestyle practices are easy enough for most of us to achieve. Specifically, they are:

  • Not currently smoking
  • Not being obese—this means a Body Mass Index less than 30. You can google BMI to get the formula for determining yours, based on your height and weight
  • Exercising regularly—this was defined in the study as physical activity once a week or more, less than I would expect
  • Healthy diet pattern—eating an increased amount of fruits, nuts, vegetables, whole grains, fish, and dairy products and a reduced amount of refined grains, processed meats, red meats, and sugar-sweetened beverages

The study found that those having three of the four lifestyle factors had half the risk of heart disease compared with those with one or no factors, even in people with a high genetic risk of heart disease. Having four of these factors should reduce your risk even more, although the authors did not report this in the study.

If you are already meeting these goals, Good on ya! as my friend from North Dakota says. If not, get busy making these positive lifestyle changes. Not only will you decrease your risk of heart disease, you will also feel better and improve your overall health.

The Top Five Drugs To Avoid

pharmacideWhile researching my book, Do You Really Need That Pill?, I came upon many drugs that can cause more harm than good. But there are five specific types that I think most people should avoid, due to their questionable effectiveness and potential side effects. Many of these are blockbusters heavily advertised by Big Pharma. Of course, there are people who actually need these drugs, but they are few and far between.

My book covers these drugs in much greater detail and I will focus on each one more specifically in a later post. But for now, here is the nitty gritty on the top five types of drugs to avoid, if you can:

  • Statins (Lipitor, Zocor, Crestor) are prescribed to lower cholesterol. Current guidelines advise that nearly everyone over age 65 take them but there is little evidence that they actually prevent heart disease in people without risk factors or a previous heart attack or stroke. One out of every five people taking them experiences muscle damage and they can double the risk of diabetes. Statins have also been associated with memory loss, dementia, and impaired liver function.
  • Acid Reflux Drugs (Nexium, Prilosec, Prevacid) were approved by the FDA to be taken for only 2 weeks, yet many people take them for months or even years. They suppress stomach acid, which prevents the body from absorbing essential nutrients such as calcium, iron, and Vitamin B12. This leads to such problems as anemia, depression, bone fractures, and dementia.
  • Osteoporosis drugs (Fosamax, Reclast) are unnecessary for the vast majority of women who take them. There is little evidence that they strengthen bones or prevent hip fractures and there are several dangerous side effects. Exercising, getting plenty of calcium and Vitamin D in your diet, and avoiding excess alcohol and caffeine are better ways to improve your bone health.
  • Anti-depressants (Prozac, Paxil, Zoloft, Effexor) are effective in as few as one out of seven people with mild to moderate depression. Side effects include sexual dysfunction, suicide, bleeding disorders, and diabetes. Psychotherapy, exercise, meditation, yoga, and alternative therapies such as acupuncture and homeopathy can alleviate depression.
  •  Opioid pain relievers (morphine, codeine, OxyContin, Vicodin, Percocet) caused more than 30,000 overdose deaths in 2017 despite research showing they are no more effective than over-the-counter pain pills like ibuprofen. Another nearly 30,000 deaths were attributed to synthetic opioids such as fentanyl. Because of their potential for addiction, the FDA now recommends that prescriptions for opioids be limited to seven days.