Cartoons for the holidays--II

Cartoons for the holidays--I

The post-diet age

Dieting is out. It is now considered tacky and anti-feminist. It’s been replaced with “body acceptance,” “fitness,” “mindful eating,” “wellness,” “intuitive eating,” and so forth. Because of diet fatigue, Weight Watchers watched its membership decline. In January 2015 the company’s chief executive noted that, “We’re having one of the worst Januaries that anyone could have imagined.”  What to do? Call Oprah! Ask her to be their spokesperson!

She had turned them down  in the past, but they caught her at a good time. She had just gained 17 pounds. So she said yes and bought a 10 percent stake in the company for $43 million, after which the stock shot up. Her investment is now worth $110 million. At the same time, people were disappointed that Oprah was on another diet.  As Taffy Brodesser-Akner, the author of the article from which I got this information, commented, “It was hard not to suspect that she was trapped, like so many of us are, in a culture that says one thing about fatness and means something very different.”

 Apparently, Oprah doesn’t care if she’s ever skinny again. But she said yes to Weight Watchers because “It’s a mechanism to keep myself on track that brings a level of consciousness and awareness to my eating. It actually is, for me, mindful eating….” In particular, she worries about her cardiovascular health and the fact that diabetes runs in her family.

Weight Watchers is designed to be successful only if you can stay on it forever, which, apparently Oprah is willing to do. Sounds like dieting to me.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Opioid alternatives--maybe for me

According to a randomized study, reported in the Journal of the American Medical Association, a combination of Tylenol and Advil worked just as well as opioids for pain relief in the emergency room. I’m sure such studies are looking for alternatives to opioids as a way to combat the epidemic of opioid addiction. But what about me?

Before reading about this, I never considered taking Tylenol plus Advil for my joint and muscle pain. I take two Advil fairly often, usually before golf or Jazzercise. But I’m going to give the combination a try. It makes sense, as the two drugs work in different ways. Advil (ibuprofen) is a nonsteroidal anti-inflammatory drug (NSAID). It works by inhibiting the synthesis of a group of compounds called prostaglandins that cause inflammation. (Aspirin and Aleve work in a similar way). Experts aren’t sure exactly how Tylenol (aceaminohen) relieves pain. It doesn’t suppress inflammation, but blocks pain in the brain.

As to dosage, Consumer Reports says to take the combination only occasionally and to stick to one pill of each per day: 325 mg of Tylenol and 200 mg of Advil. (The FDA set the maximum 24-hour dose of acetaminophen at 3,000 mg; the maximum dose for Advil is 1200 mg.) From what I understand, higher doses can give you more pain relief, but side effects of overdosing can be dangerous. Tylenol can be toxic to the liver, especially if you drink heavily. In fact, acetaminophen is the most common cause of acute liver failure in the United States. One-fifth of all patients who need a liver transplant sustained their injury using Tylenol. Advil is hard on your stomach and intestines. Plus, I’ve learned from experience, heavy doses suppress your immune system.

OK. I gave the combination of Advil plus Tylenol a try, one time before golf and another time before house cleaning followed by yoga. Meh. I think for me two Advils work better.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

New blood pressure guidelines: I'm ignoring them

The American Heart Association and American College of Cardiology are now recommending new blood pressure guidelines for anyone who has at least a 10 percent risk of a heart attack or stroke in the next decade. (Apparently simply being 65 or older puts you in that category.) Now high blood pressure is defined as 130/80, down from 140/90. This new level means that nearly half of all American adults and nearly 80 percent of those 65 and older will be considered to have high blood pressure, and, presumably, to need medication for it.

Dr. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, is my go-to guy for sensible advice. While he acknowledges that very high blood pressure is dangerous and should be treated, he questions the new guidelines—not only the numbers also the study that produced the guidelines.

For one thing, he notes that blood pressure is an “exceptionally volatile biologic variable,” meaning that it varies depending on what you’re doing, your stress level, and your surroundings. My blood pressure is always high in a doctor’s office—a common phenomenon called the “white coat syndrome.” I’ve tested my blood pressure at home and have also noticed that it varies from time to time. I just sit there testing until it reaches a level I like.

Welch says that “a national goal of 130 as measured in actual practice may lead many to be over-medicated—making their blood pressure too low. More medications and lower blood pressures are not always better for everyone.”  For one thing, he thinks that lowering blood pressure by too much makes people lightheaded and leads to falls and fractures. Moreover, intensive drug treatment in so many more patients may increase the rates of kidney disease. (In the trial, incidence of acute kidney injury was twice as high in the group receiving drugs to reduce their blood pressure to 120).

I may be sorry, but I’m just ignoring the whole business and still not taking blood pressure meds, even though I have a ten percent chance of having a heart attack or stroke—probably higher at age 81.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.