Cartoon II for the holidays

"Don't bother."

Cartoon I for the holidays

"You should start taking probiotics now, before we discover that they don't make any difference."

Gaining weight in old age

Over the past five or so years, I’ve put on about ten pounds. I don’t mind so much. Like my mother-in-law used to say, “what’s so great going to happen to me if I get thin?” However, I do mind that the waistband of some of my pants has become too tight. Even so, I’m certainly not going to diet.

The latest research shows that people who restrict their eating are more likely to engage in stress eating. Moreover, unlike intuitive eaters, who eat when they’re hungry, dieters exert mental effort to control their intake. According to psychologists, this effort to restrain eating can increase negative emotions. Dieters—including people who simply watch what they eat—are more likely to suffer from depression, low self-esteem, disordered eating and overall psychological distress than intuitive eaters. In contrast, intuitive eaters have more positive moods, greater body appreciation, and overall life satisfaction. Food deprivation, they say, seems to play a role in creating the very mental conditions that lead people to want to self-soothe with food. 

Research has also shown that the notion of being “addicted” to sugar is bogus. Sugar addiction is the idea that sugar activates the reward centers of our brains, making it irresistible. In fact, it’s the dieters whose brains are significantly activated in response to sweet foods. The brains of intuitive eaters are unfazed by sugar.

I don’t know why I gained ten pounds. My diet and activity haven't changed over these past years. If anything, I eat less. I always thought that old people sort of waste away, getting thin and frail. I’ll just hang around and wait for that to happen. 

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

Heart attack triggers

Both my parents died of heart attacks; my father at age 79, my mother at 85. Both deaths were sudden. The other day, I came across an article in the Harvard Medical School newsletter about factors that trigger heart attacks. According to the newsletter, sudden stress is the primary culprit. Stress activates the sympathetic nervous system, which is responsible for the body’s fight-or-flight response. The sympathetic nervous system sends hormones into the bloodstream that can cause a sudden surge in blood pressure or make the heart beat faster and harder. The hormones may also cause the sudden formation of a blood clot, a tear in a blood vessel, or a wild heart rhythm.

According to research, the most important triggers include heavy physical exertion, severe weather, anger, natural disasters, war, sexual activity, air pollution, and infection. Some of these triggers are not surprising. As to disasters, researchers in New Jersey found a 49 percent increase in heart attacks within a 50-mile radius of the World Trade Center immediately after 9/11. But here’s a surprising trigger listed as the top one in the newsletter: waking from sleep. Before waking up your body prepares for a new day by trickling stress hormones into your bloodstream, making your small blood vessels constrict, your heart beat faster, and your blood pressure rise.

As it happens, my father died after getting up to go to the bathroom. My mother died after she finished giving a speech—a stressful activity, I presume.  I’m 83 as I write this. Like you, I’ve experienced plenty of these triggers, including shoveling snow, earthquakes, smog, and all the rest (although not anger so much). I can avoid most of these triggers, but I do plan to continue getting up in the morning. Living dangerously!

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

The latest on stents

Here’s the latest on stents (those little wire cages inserted into blocked coronary arteries): if you’re having a heart attack, a stent (or bypass surgery) can be lifesaving. Otherwise, they have not proven to prolong life or prevent heart attacks. That is, if you’ve had procedures in a non-emergency situation that show some blockage in your arteries and/or if you have angina (chest pain), inserting stents into those arteries is not more beneficial than drugs at keeping you from heart attacks or death. (Stents do help with chest pain, but about a third of patients with stents develop chest pain again within 30 days to six months of the stent insertion and end up receiving another stent.) The drugs include statins—of which I disapprove—aspirin, blood pressure meds, and, in some cases, meds that slow heart rate (beta blockers).

This is not the first time that studies have come up with this result, but the newest study was longer and more thorough, putting earlier skepticism to rest . It followed 5,179 participants for three and a half years. All patients had moderate to severe blockages and most had a history of chest pain. They were randomly assigned to get only the “medical therapy” (drugs mentioned above); or “intervention” (stents or bypass surgery). Of those thousands of people, 145 people who’d had the intervention died compared with 144 who’d had only the meds. The number who had suffered heart attacks were also about evenly divided between the two groups.

These results, as with the results of earlier studies, are consistent with the current understanding of heart disease, namely, that narrowed arteries can usually be found throughout the arterial system, and docs can’t predict where in this system a problem might occur. Researchers no longer believe that “clogged pipes” cause heart attacks. Rather, heart attacks occur when a trigger, such as anger or physical exertion, causes damaged arteries to release blood clots that block the flow of blood to the heart. So just calm down and take it easy.

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