Sunday, March 13, 2011

Beat High Blood Pressure!

By Joy Bauer, M.S., R.D., C.D.N.
Mar 09, 2011
Along with exercising and losing weight, revamping your diet can help you get your blood pressure under control.  To lower your numbers, you’ll want to give these food groups a starring role in your meals and snacks:  
  • Vegetables, Fruits, and Legumes—A high intake of plant foods is definitively linked to lower incidence of high blood pressure.  Produce contributes fiber, potassium, and magnesium, three nutrients that have been associated with lower blood pressure. 
  • Whole Grains—A 2009 study showed that men with the highest intake of whole grains had about a 20% lower risk of developing high blood pressure compared to men with the lowest intake of whole grains.  Similar results have been found in women. 
  • Low-Fat Dairy—A diet that includes 2 to 3 daily servings of low-fat dairy products, such as milk, yogurt, and cheese, has been shown to aid in blood pressure control.  Researchers aren’t yet sure what ingredients in dairy foods are responsible for the benefit—it may be the calcium or vitamin D, the milk proteins, or some combination of these ingredients. 
  • Lean Proteins—For overall heart health, choose proteins that are low in saturated fat, such as fish and shellfish, skinless poultry, lean meat, and egg whites.  In addition, go out of your way to add more vegetarian proteins—including beans, lentils, and soy foods like tofu and edamame—to your meals.  Some research shows that plant proteins are more beneficial for lowering blood pressure than animal proteins. 
  • Healthy Fats—Substituting some of the carbohydrate—particularly refined carbs like white bread, white pasta, and sweets—in the diet for heart-healthy fats has been shown to reduce blood pressure.  The best sources of quality fats are nuts, seeds, avocado, fatty fish (like salmon and sardines), and olive and canola oil. 
And of course, you’ll need to carefully control your sodium intake. Major health organizations now advise keeping sodium levels below 1500 milligrams per day. I admit, this is not an easy task; following a low-salt diet will definitely require some careful planning and creativity in the kitchen. The majority of packaged foods are high in sodium, so you’ll need to carefully read labels before choosing products. Your best bet is to make whole foods—like vegetables, fruits, whole grains, low-fat dairy, lean meats, and healthy fats (without any added salt)—the core of your diet. 
To get you started, here’s a sample menu illustrating how to incorporate foods from these categories into an A+ day of eating!
Breakfast: Bowl of oatmeal made with skim milk and topped with fruit (berries or chopped apples)
Oatmeal is a whole grain, and, unlike many cereals (which contain added salt), a serving of plain oats from the canister has virtually 0 milligrams sodium.  A diet rich in low-fat dairy products like skim milk has been shown to aid in blood pressure control.
Lunch: Sliced grilled chicken sandwich on whole wheat bread with lettuce, tomato, onion, and a thin spread of mustard or reduced-fat mayo.  Pair with a generous helping of baby carrots, sliced bell pepper sticks, or other veggies.
Deli meats can have up to half your day’s sodium allotment in just one serving, so making your sandwich with plain grilled chicken breast (slice it up yourself) is a smart way to slash sodium at lunchtime.
  • Handful of unsalted nuts or sunflower seeds. Nuts and seeds are a rich source of heart-healthy fats as well as magnesium.
  • 6-ounce container of nonfat yogurt. Yogurt is rich in calcium, vitamin D, and potassium.
Dinner: Broiled/steamed/grilled salmon fillet seasoned with lemon and any herbs and seasonings (skip the salt).  Serve with sautéed greens (spinach, kale, Swiss chard, etc.) dressed with lemon or balsamic vinegar and half a baked white or sweet potato. For dessert, savor an ounce of 70% dark chocolate (flavonoids in chocolate have been shown to reduce blood pressure), or enjoy a cup of potassium-rich cantaloupe chunks.
For more information on healthy living, visit and follow Joy onFacebook and twitter.



Acne is a skin condition that causes whiteheads, blackheads, and inflamed red lesions (papules, pustules, and cysts) to form. These growths are commonly called pimples or "zits."

Alternative Names

Acne vulgaris; Cystic acne; Pimples; Zits

Causes, incidence, and risk factors

Acne occurs when tiny holes on the surface of the skin, called pores, become clogged. Each pore is an opening to a canal called a follicle, which contains a hair and an oil gland. Normally, the oil glands help keep the skin lubricated and help remove old skin cells. When glands produce too much oil, the pores can become blocked, accumulating dirt, debris, and bacteria. The blockage is called a plug or comedone.
The top of the plug may be white (whitehead) or dark (blackhead). If it ruptures, the material inside, including oil and bacteria, can spread to the surrounding area and cause an inflammatory reaction. If the inflammation is deep in your skin, the pimples may enlarge to form firm, painful cysts.
Acne commonly appears on the face and shoulders, but may also occur on the trunk, arms, legs, and buttocks.
Acne is most common in teenagers, but it can happen at any age, even as an infant. Three out of four teenagers have acne to some extent, probably caused by hormonal changes that stimulate oil production. However, people in their 30s and 40s may also have acne.
Acne tends to run in families and can be triggered by:
  • Hormonal changes related to menstrual periods, pregnancy, birth control pills, or stress
  • Greasy or oily cosmetic and hair products
  • Certain drugs (such as steroids, testosterone, estrogen, and phenytoin)
  • High levels of humidity and sweating
Despite the popular belief that chocolate, nuts, and other foods cause acne, research does not confirm this idea.


  • Blackheads
  • Crusting of skin eruptions
  • Cysts
  • Pustules
  • Redness around the skin eruptions
  • Scarring of the skin
  • Whiteheads

Signs and tests

Your doctor can diagnose acne based on the appearance of the skin. Testing is usually not required.


Take the following self-care steps to lessen the effects of acne:
  • Clean your skin gently with a mild, non-drying soap (such as Dove, Neutrogena, or Basics). Remove all dirt or make-up. Wash once or twice a day, including after exercising. However, avoid excessive or repeated skin washing.
  • Shampoo your hair daily, especially if it's oily. Comb or pull your hair back to keep the hair out of your face. Avoid tight headbands.
  • Try not to squeeze, scratch, pick, or rub the pimples. Although it might be tempting to do this, it can lead to skin infections and scarring.
  • Avoid touching your face with your hands or fingers.
  • Avoid greasy cosmetics or creams. Look for water-based or "non-comedogenic" formulas. Take make-up off at night. Non-comedogenic products have been tested and proven not to clog pores and cause acne.
If these steps do not clear up the blemishes to an acceptable level, try over-the-counter acne medications. These products are applied directly to the skin. They may contain benzoyl peroxide, sulfur, resorcinol, or salicylic acid. They work by killing bacteria, drying up the oil, and causing the top layer of your skin to peel. They may cause redness or peeling of the skin.
If pimples are still a problem, a dermatologist can prescribe stronger medications and discuss other options with you.
Prescription medicines include:
  • Oral antibiotics (taken by mouth) such as minocycline, doxycycline,tetracycline, erythromycin, and amoxicillin
  • Topical antibiotics (applied to the skin) such as clindamycin, erythromycinm or dapsone
  • Retinoic acid cream or gel (Retin-A) and isotretinoin pills (Accutane) -- pregnant women and sexually active adolescent females should NOT take Accutane, as it causes severe birth defects. Women taking Accutane must use two forms of birth control before starting the drug and enroll in the iPledge program.
  • Prescription formulas of benzoyl peroxide, sulfur, resorcinol, salicylic acid
  • A pill called spironolactone may help women with hormonally controlled acne.
  • A laser procedure called photodynamic therapy may also be helpful.
Birth control pills can sometimes help clear up acne. (In some cases, though, they may make it worse.)
Your doctor may also suggest chemical skin peeling, removal of scars by dermabrasion, or removal, drainage, or injection of cysts.
A small amount of sun exposure may improve acne. However, excessive exposure to sunlight or ultraviolet rays is not recommended because it increases the risk of skin cancer.

Expectations (prognosis)

Acne usually subsides after adolescence, but may last into middle age. The condition generally responds well to treatment after 6 - 8 weeks, but may flare up from time to time. Scarring may occur if severe acne is not treated. Some people, especially teenagers, can become significantly depressed if acne is not treated.


Possible complications include:
  • Changes in skin color
  • Cysts
  • Damage to self-esteem, confidence, personality, and social life
  • Permanent facial scars
  • Side effects of Accutane (including very dry skin and mucus membranes, high triglyceride levels, liver damage, and birth defects in an unborn baby; call your doctor right away if you become pregnant while taking this drug)
  • Side effects of other medications

Calling your health care provider

Call your doctor or a dermatologist if:
  • Self-care measures and over-the-counter medicine have not helped after several months
  • Your acne is severe (for example, you have lots of redness around the pimples or you have cysts) or getting worse
  • You develop scars as your acne clears up
Call your pediatrician if your baby has acne that does not clear up on its own within 3 months.


Acne, rosacea, and related disorders. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 7.

Tuesday, March 8, 2011

These tests can save your life

Getty Images
The key health screenings you need to stay in top shape throughout the years.
By Aviva Patz

You’re busy. So busy that you might not even make it to the doctor when you’re sick, let alone for routine physicals, right? Well, here’s the good news: While you do need some basic checkups, they’re fewer in number than you might think—just a few per decade. "With these screenings, you’ll catch things early, before you have symptoms and when they’re most easily treated," says Christine Laine, MD, editor of Annals of Internal Medicine. Beyond an annual gynecological exam (a must for every woman), these are the bare minimum—but most critical—checks you’ll need for the next, oh, 10 to 50 years!

Your 20s
Complete physical
Go in for your first at age 21, then every five years until age 40, when you should start getting one annually, according to Marianne J. Legato, MD, professor of clinical medicine at Columbia University College of Physicians and Surgeons. Dr. Legato recommends getting checks of your blood sugar, cholesterol, thyroid function, liver and kidney function, and vitamin B12 and vitamin D levels. That’s because many serious health threats, such as high cholesterol, are silent killers with few to no symptoms to sound a warning. "I don’t know how many times I’ve seen a trace of protein in the urine of a 25-year-old, which could mean loss of kidney function later," Dr. Legato says.

Pap test
The Pap can spot the earliest signs of cervical cancer, when the chance of curing this disease is very high. It’s especially vital to be tested when you’re in your 20s because you’re more likely to have multiple sex partners and be exposed to the human papillomavirus (HPV), which can trigger dangerous cell changes. Get it at your yearly gyno exam, starting at age 21 (if you haven’t been tested before then). At age 30, if you’ve had three consecutive normal results, you may only need a Pap every three years until age 65.

Tests for sexually transmitted diseases (STDs)
There are some 19 million new STD infections each year, almost half of them among 15- to 24-year-olds. "Often there are no symptoms," says Beth Jordan, MD, medical director of the Association of Reproductive Health Professionals. "If left untreated, some infections can lead to infertility and other complications." Get tested annually for HIV, chlamydia, and gonorrhea when you become sexually active (and when you’re starting a new relationship) until age 24, or until you’re no longer "high risk" (meaning you have multiple sexual partners ora partner who has multiple partners, or you have unprotected sex). Ask your doctor whether you should be tested for the herpes simplex virus.

Skin check
Melanoma, the deadliest form of skin cancer, is the leading cause of cancer death for women ages 25 to 29. What’s more, incidence among young women has risen by 50% over the last three decades, largely due to the use of tanning beds. See a dermatologist annually if you have a family history of skin cancer or semiannually if you have actually had the disease. The rest of us can do a yearly self-check.

Go the extra mile:
Get your blood pressure checked every two years. Some young adults do develop high blood pressure, which can up your risk for heart disease—the leading cause of death for American women.

Have your cholesterol tested
 every five years starting at age 20 if you smoke, are obese, have diabetes or high blood pressure, or have a history of heart disease or a family history of heart attack.

Go for an eye exam
 every 5 to 10 years beginning at age 20, especially if you already wear glasses or contacts. An eye exam can also flag other diseases like diabetes.

Get to know your breasts
 and all their natural lumps and bumps so you’ll be better able to tell if something feels suspicious later on.

Your 30s
HPV test
HPV is the leading cause of cervical cancer, and most sexually active women get the infection at some point. While 90% of those infections clear up on their own, that’s less the case as we age. "Beginning around age 30, women become more prone to persistent infection because our immune systems are less robust," says Debbie Saslow, PhD, director of breast and gynecological cancers for the American Cancer Society. So get the HPV test at age 30 and then with your Pap every three years if results have been normal.

Blood sugar test
"Here, we’re actively looking for blood sugar that’s heading toward abnormal—anything above 90 milligrams per deciliter—so we can intervene before you develop full-blown diabetes," says Pamela W. Smith, MD, a specialist in metabolic medicine at the University of South Florida College of Medicine. Go in for the test at age 30, and then every three years until you turn 50, when you should start getting it annually (since the risk of diabetes increases significantly with age).

Don’t forget!
An annual gyno exam with breast and blood pressure check; a Pap test every 3 years after normal results; a physical every 5 years; an eye exam every 5 to 10 years; a skin self-check annually; a cholesterol check every 5 years if you’re high risk.

Your 40s
Cholesterol test
Head in for physicals annually (instead of every five years) and include this test, particularly if you smoke or have high blood pressure, diabetes, or a family history of heart disease. In this decade, plaque buildup on the walls of your arteries can begin to become especially problematic, Dr. Laine notes. What’s more, as your estrogen production winds down in your late 40s, you start losing the beneficial effects that estrogen has on blood lipids (fats).

Don’t forget!
An annual gyno exam with breast and blood pressure check; a Pap test every 3 years after normal results; an eye exam every 5 to 10 years; a skin self-check annually; a blood sugar test every 3 years.

Go the extra mile
Consider a mammogram. The National Cancer Institute (NCI) recommends getting screened for breast cancer at least every two years beginning at age 40, but because there’s a higher rate of false positives at this age, many experts (including those on a recent federal panel) suggest waiting until 50 if you’re not high risk.

All premenopausal women
Rethink your birth control
If you keep forgetting to take your Pill, or you’re sick of buying condoms after years of marriage, go ahead and complain to your doc. There are lots of new options she can recommend that might suit you better—some with perks like clearer skin and milder PMS. "I always ask my patients two questions: ‘How important is it to not get pregnant?’ and ‘Which method is the best match for your life right now?’" says Beth Jordan, MD, medical director of the Association of Reproductive Health Professionals. Reassess your birth control when your relationship changes (you go from dating to committed or vice versa), before and after childbirth, and anytime you’re not sticking to—or are unhappy with—your current method.

Your 50s+

"At 50, the benefits of getting mammograms clearly outweigh any risks," Dr. Laine says. The NCI recommends getting mammograms every one to two years, but talk to your doctor about what’s right for you based on your personal risk factors. The overall risk of getting breast cancer increases with age: Between ages 50 and 59, 1 in 42 women are likely to develop it, according to the NCI. That number climbs to 1 in 29 for women ages 60 to 69. Early detection and treatment help prevent the spread of the disease and boost your odds of recovery.

Go in for the procedure at age 50, then every 10 years, to screen for colorectal cancer, the second leading killer in the United States among cancers affecting both men and women. Adults 50 and older are at the greatest risk of developing the disease—but studies show that people who get a colonoscopy every 10 years have better outcomes if they do develop cancer than those who don’t get the test. (If you have a parent or sibling who’s had colorectal cancer, get tested 10 years before the age your relative was diagnosed.)

Don’t forget!
An annual gyno exam with breast and blood pressure check; a Pap test every 3 years after normal results; an eye exam every 5 to 10 years; a skin self-check annually; a yearly physical with cholesterol and blood sugar testing.

Go the extra mile
Get a bone-density check in your 50s if you’re considering hormone replacement therapy or if you’re at high risk for osteoporosis (say, you smoke, are underweight or sedentary, or take steroids). Otherwise, routine screening begins at age 60.

Consider a hearing test. Age-related hearing loss begins to show up at about age 55 and affects some 1 in 10 Americans, according to the Healthy Aging Partnership.

Talk to your doctor about taking low-dose aspirin
 every day to lower your risk of heart attack, stroke, and even cancer: A new British study suggests that taking a daily aspirin may cut deaths from a range of cancers by 10 to 60%.