Category Archives: heart attacks

I Shouda Ran

I just came across some great news for joggers.  Researchers have found that strenuous exercise like jogging does NOT boost the risk of arthritis in one’s knees.  A recent study enlisted nearly 1,200 middle-aged and older people at high risk for knee arthritis.  Result?  After 10 years, those who did strenuous activities like jogging and cycling were no more likely to be diagnosed with arthritis than those who did none. (See the July/August 2020 issue of Nutrition Action, noting a study reported in the New England Journal of Medicine.)

And according to a writer in The Washington Post, most data show that running actually helps keep knee joints lubricated.  (See the report by John Briley on August 6, 2020.)

Hmmm…

So…maybe I shoulda ran?

What?

I’ll explain.

When my daughters were small, my husband and I often relied on PBS kids’ programming to keep us from going bananas whenever we were home with them for more than a few hours.

I’m still indebted to “Sesame Street” and “Mr. Rogers’ Neighborhood” for offering wonderfully positive content that expanded our daughters’ minds.

I can still remember many of Fred Rogers’s episodes and his delightful music.  The recent films (e.g., “A Beautiful Day in the Neighborhood”) that highlight his music and the many layers of his unfailing kindness are moving tributes to everything he did.  (I obliquely noted Rogers’s important role in our family when I briefly mentioned him in my 2011 novel, Jealous Mistress.)

Similarly, I can’t forget countless “Sesame Street” sketches and songs we watched over and over again. In addition to stalwarts like Kermit the Frog and Big Bird, I loved less-prominent Muppet characters like Don Music, who’d take out his creative frustrations by crashing his head on his piano keyboard.

One “Sesame Street” sketch I vividly recall focused on words than rhymed with “an.”

The setting is a rundown alley in a big city.  Tall buildings loom in the distance.  As the sketch begins, two Muppets garbed as gangsters breathlessly arrive at this spot.  The savvier gangster tells his partner Lefty that “We got the ‘Golden AN’.”

The word “AN” is clearly written in bold upper-case letters on a metal object he’s holding.  Explaining their “plan,” he points to a “tan van” and says, “This is the plan. You see that van? You take the Golden An to the tan van.  You give it to Dan, who will give it to Fran.”  He adds:  “Everything I’m telling you about the plan rhymes with AN.”  He takes off, leaving Lefty alone.

Lefty, who’s pretty much of a dolt, repeats the plan out loud a couple of times while a Muppet cop is watching and listening.  The cop approaches, identifies himself as “Stan…the man,” and tells Lefty he’s going to get “10 days in the can for stealing the Golden An.”

Lefty then chides himself:  “I shoulda ran.”

This carefully crafted sketch was clearly intended to teach little kids about words that rhyme with “an,” although much of it seemed aimed at parents and other adults watching along with the kids.  How many little ones knew the meaning of “the can”?  The bad grammar in the sketch (“I shoulda ran”) was forgivable because kids watching “Sesame Street” didn’t really notice it, and the whole thing was so darned funny.

But what has stayed with me over the decades is the final line:  I shoulda ran.

When I was growing up, I always liked running fast, and I rode my fat-tire Schwinn bike all over my neighborhood.  So I wasn’t indolent.  But as I grew older and entered public high school in Chicago, I encountered the blatantly sexist approach to sports.  Aside from synchronized swimming, my school offered no team sports for girls.  So although I would have loved to be on a track team, that simply wasn’t possible.  Girls couldn’t participate in gymnastics, track, basketball, baseball, tennis, or any of the other teams open to boys our age.

We were also actively discouraged from undertaking any sort of strenuous physical activity.  It was somewhat ironic that I applied to be, and became, the sports editor of my high school yearbook because I was completely shut out of the team sports that I covered in that yearbook .  And I foolishly gave up my coveted spot in the drama group to do it—what a mistake!

I had a somewhat different experience during my single semester in school in Los Angeles, where I spent the first half of 8th grade.  Although sexism was equally pervasive there, girls at least had a greater opportunity to benefit from physical activity.  Because of the beautiful weather, we played volleyball outdoors every day, and I actually learned not to be afraid of the ball!  I was prepared, when we returned to Chicago (reluctantly on my part), to enjoy a similar level of activity during my four years of high school.  But that would not happen.   The girls’ P.E. classes were a joke, a pathetic attempt at encouraging us to move our bodies.  And things didn’t begin to change until 1972, when Title IX was enacted into law.

Over the years, I continued to ride a bike wherever I lived and whenever weather permitted. I took up brisk walking and yoga as well.  And I sometimes thought about running.

Jogging– less intensive running–took off in the late 1970s and early 1980s.  Why didn’t I begin to jog?

There was a bunch of reasons.  First, I was afraid of damaging my knees.  I’ve always loved aerobic dancing, the kind popularized by Jacki Sorensen.  I’d jump along with the music in my favorite Jacki tape, and I began to notice that jumping was possibly beginning to wear away the cartilage in my knee joints because occasional pain resulted. So I kept dancing, but I stopped jumping.  I figured that running would place even further stress on my knees.

And then there was Jim Fixx.

I didn’t know a lot about Jim Fixx.  He became a media celebrity when he published his best-selling book, The Complete Book of Running, in 1977, and his claims about the health benefits of jogging suddenly showed up on the news.  But in 1977, I had a brand-new baby and a toddler, along with a challenging part-time job, and I couldn’t focus on starting something new like jogging.  By the time I was getting ready to launch into it, I heard the news that Fixx had died of a heart attack while jogging.  He was 52.

Fixx’s death shook me up.  I didn’t know at the time that he may have had a genetic predisposition to heart trouble and he had lived a stressful and unhealthy life as an overweight heavy smoker before he began running at age 36.   All that I knew was that this exemplar of health through running had died, while jogging, at age 52.

Chicago weather also stood in my way.  Happily ensconced in an area that allowed our family to ride our bikes along Lake Michigan and quiet residential streets, and where I could take long and pleasant walks with my husband, I was reasonably active outdoors during the six months of the year when good weather prevailed.  But during the harsh winters, confined indoors, I had less success.  I played my Jacki tapes, I tried using a stationary bike (it never fit me comfortably), and I sampled a local gym.  But I didn’t pursue strenuous exercise.

Now, learning about the recent evidence I’ve noted–that, if I’d jogged, my knees might have been OK after all–I regret that choice.  My current climate allows me to be outside almost every day, and I take advantage of it by briskly walking about 30 minutes daily, much of it uphill.  So that’s my workout now, and it’s a pretty good one.

But I probably would have loved running all those years.

It’s a bit late to start now, but I can’t help thinking:  I shoulda ran.

A new book you may want to know about

There’s one thing we can all agree on:  Trying to stay healthy.

That’s why you may want to know about a new book, Killer diseases, modern-day epidemics:  Keys to stopping heart disease, diabetes, cancer, and obesity in their tracks, by Swarna Moldanado, PhD, MPH, and Alex Moldanado, MD.

In this extraordinary book, the authors have pulled together an invaluable compendium of both evidence and advice on how to stop the “killer diseases” they call “modern-day epidemics.”

First, using their accumulated wisdom and experience in public health, nursing science, and family medical practice, Swarna and Alex Moldanado offer the reader a wide array of scientific evidence.  Next, they present their well-thought-out conclusions on how this evidence supports their theories of how to combat the killer diseases that plague us today.

Their most compelling conclusion:  Lifestyle choices have an overwhelming impact on our health.  So although some individuals may suffer from diseases that are unavoidable, evidence points to the tremendous importance of lifestyle choices.

Specifically, the authors note that evidence “points to the fact that some of the most lethal cancers are attributable to lifestyle choices.”  Choosing to smoke tobacco or consume alcohol in excess are examples of the sort of risky lifestyle choices that can lead to this killer disease.

Similarly, cardiovascular diseases–diseases of the heart and blood vessels–share many common risk factors.  Clear evidence demonstrates that eating an unhealthy diet, a diet that includes too many saturated fats—fatty meats, baked goods, and certain dairy products—is a critical factor in the development of cardiovascular disease. The increasing size of food portions in our diet is another risk factor many people may not be aware of.

On the other hand, most of us are aware of the dangers of physical inactivity.  But knowledge of these dangers is not enough.  Many of us must change our lifestyle choices.  Those of us in sedentary careers, for example, must become much more physically active than our lifestyles lend themselves to.

Yes, the basics of this information appear frequently in the media.  But the Moldanados reveal a great deal of scientific evidence you might not know about.

Even more importantly, in Chapter 8, “Making and Keeping the Right Lifestyle Choices,” the authors step up to the plate in a big way.  Here they clearly and forcefully state their specific recommendations for succeeding in the fight against killer diseases.

Following these recommendations could lead all of us to a healthier and brighter outcome.

Kudos to the authors for collecting an enormous volume of evidence, clearly presenting it to us, and concluding with their invaluable recommendations.

No more excuses!  Let’s resolve to follow their advice and move in the right direction to help ensure our good health.

 

 

 

 

Of Mice and Chocolate (with apologies to John Steinbeck)

Have you ever struggled with your weight?  If you have, here’s another question:  How’s your sense of smell?

Get ready for some startling news.  A study by researchers at UC Berkeley recently found that one’s sense of smell can influence an important decision by the brain:  whether to burn fat or to store it.

In other words, just smelling food could cause you to gain weight.

But hold on.  The researchers didn’t study humans.  They studied mice.

The researchers, Andrew Dillin and Celine Riera, studied three groups of mice.  They categorized the mice as “normal” mice, “super-smellers,” and those without any sense of smell.  Dillin and Riera found a direct correlation between the ability to smell and how much weight the mice gained from a high-fat diet.

Each mouse ate the same amount of food, but the super-smellers gained the most weight.

The normal mice gained some weight, too.  But the mice who couldn’t smell anything gained very little.

The study, published in the journal Cell Metabolism in July 2017 was reported in the San Francisco Chronicle.  It concluded that outside influences, like smell, can affect the brain’s functions that relate to appetite and metabolism.

According to the researchers, extrapolating their results to humans is possible.  People who are obese could have their sense of smell wiped out or temporarily reduced to help them control cravings and burn calories and fat faster.  But Dillin and Riera warned about risks.

People who lose their sense of smell “can get depressed” because they lose the pleasure of eating, Riera said.  Even the mice who lost their sense of smell had a stress response that could lead to a heart attack.  So eliminating a human’s sense of smell would be a radical step, said Dillin.  But for those who are considering surgery to deal with obesity, it might be an option.

Here comes another mighty mouse study to save the day.  Maybe it offers an even better way to deal with being overweight.

This study, published in the journal Cell Reports in September 2017, also focused on creating more effective treatments for obesity and diabetes.  A team of researchers at the Washington University School of Medicine in St. Louis found a way to convert bad white fact into good brown fat—in mice.

Researcher Irfan J. Lodhi noted that by targeting a protein in white fat, we can convert bad fat into a type of fat (beige fat) that fights obesity.  Beige fat (yes, beige fat) was discovered in adult humans in 2015.  It functions more like brown fat, which burns calories, and can therefore protect against obesity.

When Lodhi’s team blocked a protein called PexRAP, the mice were able to convert white fat into beige fat.  If this protein could be blocked safely in white fat cells in humans, people might have an easier time losing weight.

Just when we learned about these new efforts to fight obesity, the high-fat world came out with some news of its own.  A Swiss chocolate manufacturer, Barry Callebaut, unveiled a new kind of chocolate it calls “ruby chocolate.”  The company said its new product offers “a totally new taste experience…a tension between berry-fruitiness and luscious smoothness.”

The “ruby bean,” grown in countries like Ecuador, Brazil, and Ivory Coast, apparently comes from the same species of cacao plant found in other chocolates.  But the Swiss company claims that ruby chocolate has a special mix of compounds that lend it a distinctive pink hue and fruity taste.

A company officer told The New York Times that “hedonistic indulgence” is a consumer need and that ruby chocolate addresses that need, more than any other kind of chocolate, because it’s so flavorful and exciting.

So let’s sum up:  Medical researchers are exploring whether the scent of chocolate or any other high-fat food might cause weight-gain (at least for those of us who are “super-smellers”), and whether high-fat food like chocolate could possibly lead to white fat cells “going beige.”

In light of these efforts by medical researchers, shouldn’t we ask ourselves this question:  Do we really need another kind of chocolate?

You wouldn’t like me when I’m angry

We see anger all around us. And it’s worse than ever. As The New York Times recently noted, rudeness and bad behavior “have grown over the last decades.” The Times focused on rudeness and incivility by “mean bosses” who cause stress in the workplace, but the phenomenon is widespread, appearing almost everywhere.

Along with mean bosses, we’ve all witnessed incidents of “road rage.” These sometimes lead to fatal results. I can understand road rage because I’m susceptible to it myself, but I strive to keep it under control. (I’m usually satisfied by hurling vicious insults at other drivers that they fortunately can’t hear.)

As a pedestrian, I’m often angered by rude and careless drivers who nearly mow me down as I walk through a crosswalk. Fortunately, my rage is usually tempered by my silent riposte, “I’m walkin’ here,” Ratso Rizzo’s enduring phrase.

Other common examples of anger include parents’ frustration with their children’s behavior. You’ve probably seen parents going so far as to hit their children in public, unable to restrain their anger even when others are watching.

Can we deal with anger by seeking revenge? That tactic, unwisely adopted by the two enraged drivers in the Argentinian film “Wild Tales,” may be tempting, but it’s clearly not the answer. Why? Because being angry simply isn’t good for your health.

Although anger can be useful—helping the body prepare to fight or flee from danger–strong anger releases hormones, adrenaline and cortisol, into the bloodstream. These can trigger an increase in heart rate and blood pressure and problems metabolizing sugar (leading to still other problems).

According to the Times article, Robert M. Sapolsky, a Stanford professor and author of “Why Zebras Don’t Get Ulcers,” argues that when people experience even intermittent stressors like incivility for too long or too often, their immune systems pay the price. Major health problems, including cardiovascular disease, cancer, diabetes, and ulcers may result.

A host of medical researchers are not at all upset to tell you the results of their studies. “Anger is bad for just about everything we have going on physically,” according to Duke researcher Redford Williams, co-author of “Anger Kills: Seventeen Strategies for Controlling the Hostility That Can Harm Your Health.” Over time, he adds, chronic anger can cause long-term damage to the heart.

For example, new evidence suggests that people increase their risk for a heart attack more than eight times after an extremely angry episode. A study published in March 2015 revealed that patients who’d experienced intense anger had an 8.5 times greater risk of suffering a heart attack in the two hours after an outburst of intense anger than they would normally.

The study, published in the European Heart Journal: Acute Cardiovascular Care, focused on patients in a Sydney, Australia, hospital who’d been “very angry, body tense, maybe fists clenched, ready to burst,” or “enraged, out of control, throwing objects, hurting [themselves] or others.” Although those are instances of extreme anger, not a typical angry episode, the finding is useful nonetheless.

A review of nine other studies, including a combined 6,400 patients, found a higher rate of problems like strokes as well as heart attacks and irregular heartbeat.

According to a recent article in The Wall Street Journal, most doctors believe smoking and obesity pose greater heart risks than anger does. But someone with risk factors for heart trouble or a history of heart attack or stroke who is “frequently angry” has “a much higher absolute excess risk accumulated over time,” according to Elizabeth Mostofsky at Boston’s Beth Israel Deaconess Medical Center, who help lead the nine-study review.

As the Journal article noted, some older studies have suggested that anger may be linked to other unfavorable results: increased alcohol consumption, increased smoking, and greater caloric intake. One study also found that high levels of anger were associated with serious sleep disturbances.

How do we deal with all of this anger? Anger-management counselors like Joe Pereira, cited by the Journal, recommend ways to curb hostility. First, avoid assuming others are deliberately trying to harm or annoy you. Also learn to tolerate unfairness, and avoid having rigid rules about how others should behave. “The more rules we have, the more people are going to break them. And that makes us angry,” Pereira says.

Experts also advise taking a timeout when one is gripped by anger. Karina Davidson, director of the Center for Behavioral Cardiovascular Health at Columbia University Medical Center, advises those who are prone to shouting to tell others “I’m very [hotheaded and] say things that don’t help the situation. It would help me if I could have 10 minutes and then maybe we could work together to resolve the situation.”

Lawyers are people who deal with anger all the time. As long ago as ancient Rome, the poet Horace wrote that lawyers are “men who hire out their words and anger.” Today, lawyers not only confront angry clients but also have to manage anger stemming from their opponents and themselves.

An article in the June 2014 issue of California Lawyer noted that lawyers currently face “an epidemic of incivility contaminating…the profession.” The authors, Boston lawyer Russell E. Haddleton and Joseph A. Shrand , M.D. (author of “Outsmarting Anger”), noted that the California Supreme Court had just approved a revised oath of admission requiring that new lawyers commit to conducting themselves “at all times with dignity, courtesy, and integrity.”

Acknowledging that incivility will continue to crop up, the authors maintain that an angry lawyer is an ineffective advocate. They suggest a number of things lawyers can do to stay calm. Tips like these can help all of us.

Among their suggestions: Begin by recognizing the physical signs of anger, and think of ways to change the situation. Next, try to avoid being jealous of a talented adversary. Jealousy can cloud one’s vision and ignite anger. Finally, to defuse anger “in yourself, your opponent, the judge, jurors, or a witness,” they advise lawyers to aim for a calm demeanor that displays empathy, communicates clearly, and above all, shows respect for others.

“Respect” is the key watchword here. The authors argue that it gives lawyers an advantage by allowing them to use reason and common sense instead of rashly reacting to what goes on in a courtroom. Lawyers who reject angry responses and choose a respectful approach are better advocates. This approach can clearly help non-lawyers as well.

In the current Pixar film, “Inside Out,” an 11-year-old girl struggles with her emotions. The emotion of Anger (voiced by Lewis Black) sometimes tries to dominate, but the emotion of Joy (voiced by Amy Poehler) seeks to keep it under control, not letting it take over. This may be the answer for all of us. If we try to find the joy in our lives—the good things that make us happy–we can triumph over anger and all of the dangerous consequences that flow from it.

We don’t have to turn into a large green Hulk every time something angers us. Let’s try instead to emulate the non-angry side of the Hulk.

I plan to do just that. You’ll like me much better that way.