Music lowers blood pressure
Listening to adagio by Mozart has been shown to lower blood pressure, while listening to the rock song “Bicycle Race” by Queen was shown to raise blood pressure. Italian researcher Dr Giuseppe Crippa had patients check a baseline blood pressure then simply sit in the reception area of a doctor’s office for eight minutes without music, or listening to classical or rock music, then rechecked their blood pressure. The classical music group dropped their blood pressure about 8 points (mm Hg) while the rock music group had a 4 point increase.
Being a musician and audiophile, of all types of music, I hate to disparage good ole’ rock’n roll! I think this study highlights music in the context of surroundings. It can be a powerful relaxer that lowers sympathetic nerve output and thus lowers blood pressure. During times of chaos or complexity, such as driving or sitting in a public waiting room, perhaps mellow instrumental music is a good idea?
Coffee lowers risk of stroke
A recent meta-analysis examined coffee consumption and the risk of stroke. The researchers presented their findings at the annual meeting of the European Society for Hypertension in which pooled data from multiple studies done all the way back to 1966 divided coffee drinkers into three groups including low (1 to 3 cups/day), moderate (3 to 6 cups/day) and high (> 6 cups/day) coffee drinkers. They found a 13% general decline in the risk of stroke in the low and moderate coffee drinkers. The high intake group had a non-significant lowering of stroke risk.
Coffee lowers risk of stroke and dementia and improves learning. But it can cause upset stomach and contribute to ulcers or trigger heart arrhytmias, so there are some risks. My biggest concern is patients who depend on coffee to keep themselves going in the face of fatigue that may be caused by poor sleep, poor diet, or hormone deficiencies such as low thyroid or cortisol.
This study was not that strong from a statistical standpoint and did not take into account that coffee drinkers may have other health habits that lower their risk of stroke. But… at least it is fair to say coffee does not increase risk of stroke and we doctors can relax a bit in considering coffee unhealthy.
Energy drinks increase blood pressure
A similar study examining the effects of energy drinks on the heart were also presented at the meeting of the European Society of Hypertension. Lead researcher, Dr Magdalena Szotowska, reported their study showed that energy drinks can increase blood pressure and cause tachycardia and arrhythmias in healthy volunteers and she believes that sales of these products should be regulated. She commented that doctors "should advise people with hypertension, heart problems, and diabetes not to drink these."
Energy drinks contain about 360mg of caffeine, about twice that of a typical cup of coffee. Coffee has about 150mg of caffeine per cup and teas are generally in the 50mg per cup range. It may be the added ingredients including sugars, taurine and inositol are causing some problems in combination with caffeine.
Habitual “chain-drinkers” of energy drinks are especially at risk with other studies showing high rates of emotional instability and “road-rage” as a result. My advice is to skip them entirely, just as I would sodas, and go for plain green tea or coffee if you need a little boost. Again, modesty is key.
Cheese for high blood pressure
Leave it to the Italians to report that some types of cheese will help lower blood pressure. The specific type of cheese from Northern Italy, called Grana Padano, has a grainy texture and was created nearly 1000 years ago by monks who used the cheese as a way to preserve excess milk.
Researchers found that daily consumption of 30 grams of this particular cheese lowered blood pressure about 7-8 points (mmHg). This is consistent with my experience using “modified whey peptides” derived from milk, in supplement form as a treatment for high blood pressure. The tripeptides found in the cheese are known to affect blood pressure in the same manner as the prescription drug class called “ACE inhibitors” such as lisinopril.
I would not recommend eating more of just any cheese to help blood pressure. The cheese in this study has very low sodium content. There are other Alpine cheeses and yogurts that also have high concentrations of the tripeptides as well as healthy omega-3 oils. Realistically, I don’t think most of us will have easy access to these European cheeses so consider trying the whey peptides in supplement form.
Weight loss lowers blood pressure
A study presented this week at the American Society of Hypertension 2012 Scientific Sessions has shown that using the drug combination of phentermine and topiramate helped patients lose weight. As many as 75% of patients in the drug group lost 5% of their body weight and 50% lost 10% of their body weight. For those who are overweight losing just 5-10% of body weight can result in about a 5 point (mmHg) lowering of systolic blood pressure.
With an epidemic of overweight Americans I think this study simply points out that weight loss is arguably one of the most important areas that physicians can help patients, in so many ways. I’m not particularly advocating the use of the mentioned drugs but the point is the same – we need to do whatever is necessary to help patients with weight loss. Certainly diet and exercise are paramount, followed by not smoking, getting good sleep and managing stress. Many supplements are proven to help weight loss. And finally prescription drugs do indeed have a role for many patients.
What is ideal blood pressure?
Finally, leading experts in cardiology declared, “we just don’t know” at the annual meeting of the European Society of Hypertension. Despite decades of research there are still many unanswered questions as to the ideal blood pressure. Certainly a few readings in the doctor’s office are known to be notoriously incorrect. Monitoring blood pressure over 24 hours in the home setting is more accurate. Different age groups, diseases, and gender may all play more of a role than we realize. For now, 140/90 is the point we feel treatment is necessary. Most studies point to 120/70 as the ideal range – but again, watch for new recommendations in the coming years.
INSET
FREE SEMINAR
Low Thyroid: Misunderstood, Misdiagnosed, Missed!
Monday, June 4th at 6pm, at the IMC.
Seating is limited so RSVP at 245-6911 or online at rsvp@imcwc.com.
Bio
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com). Call (970) 245-6911 for an appointment or more information.
Exercise, Hunger and Weight Loss
If we exercise more then metabolism increases and we eat more. If we exercise less then metabolism decreases and we eat less. Sometimes the increased food intake caused by more exercise will sabotage weight loss efforts by offsetting the calories burned with more exercise. By understanding a few key hunger hormones we can tailor our exercise to minimize the hunger response.
The Hunger Hormones
Leptin and ghrelin are the main players in appetite. Leptin is made by fat cells and manages hunger on a day-to-day basis by telling our brain we are satiated or full and speeding up our metabolism. Ghrelin is made by an empty stomach, sends the message that we are hungry, and slows down the metabolism.
Exercise will affect both leptin and ghrelin, but different exercise has different effects. Moderate intensity prolonged exercise will increase the appetite while higher intensity shorter duration exercises have an appetite suppressing effect. It seems that low intensity activities such as casual walking has a neutral effect.
The longer duration moderate exercises such as swimming or running increases ghrelin and suppresses leptin. The short duration intense exercise such as sprinting or interval training will suppress both leptin and ghrelin.
Some studies show that doubling the exercise time will not result in twice the weight loss. It appears that the shorter duration intense exercise or the longer duration low intensity exercise will result in the least amount of hunger caused by the exercise itself.
Home programs such as P90X and Insanity are examples of more short duration high intensity programs. The interval training methods with peak intensity are also shown to promote the fat-burning-muscle-building hormone called growth hormone. (see my past columns on “high-intensity interval training” and “steps to super wellness”)
The increased appetite associated with exercise gives cause to consider just what food is consumed after exercise. This is especially true with high intensity exercises and strength training. This is the time to consider “recovery drinks”.
During and for a few hours immediately after exercise the body is primed to absorb nutrients, break down fat and rebuild muscle. What we feed the body has a huge impact on this process. A nutritious recovery drink can really improve the body’s response to your exercise efforts. (see my past columns on “sports nutrition”)
The Role of Insulin and Glucagon
Insulin is another key player in hunger. It is similar to leptin in that high levels of insulin will tell our brain we are full. Insulin is a “storage” hormone produced by the pancreas in response to a meal. It responds to high blood sugar levels by opening up muscle and liver cells so that glucose may leave the bloodstream and encourages excess glucose to be stored as energy that can be burned later. During and immediately after exercise insulin helps turn on protein building in muscle. During rest insulin encourages fat storage.
Glucagon is another hormone from the pancreas and is considered as the opposite of insulin. It responds to low blood sugar or a high protein meal by stimulating the release of stored glucose from the liver.
When all goes well our hunger hormones are an elegant system of appetite and metabolism control. During times of feast leptin signals the brain we are full and turns up metabolism while insulin stores the excess calories. During famine, ghrelin alerts our brain to get moving and find something to eat, while glucagon breaks down stored glucose to provide fuel for the energy to hunt down that next meal.
So where do things go awry? Starting with high calorie nutrient poor foods, coupled with lack of exercise and topped off with an aging metabolism, we tend to store calories and weight goes up. Once the extra weight builds up insulin and leptin both become less effective. We keep making more and more but our helpful hunger hormones just quit working as our body becomes more resistant to their effects.
As an example, Type 2 diabetics have insulin resistance. Once fat starts building up in muscle and liver tissue, insulin resistance sets in and we can’t handle the glucose in the bloodstream. This starts a vicious cycle since high blood sugar leads to high blood triglycerides, while high insulin levels encourage more fat storage. Even the first 10 pounds of extra weight will cause some degree of insulin resistance.
Leptin resistance also occurs with weight gain. Similar to insulin in the diabetic, we make more and more leptin as we gain weight, but it quits working to signal the brain that we are full, thus leading to a cycle of persistent hunger pains.
Keys to Weight Control
Work with the hunger hormones to keep appetite under control. Get the right kinds of exercise. Give the body the right types of recovery nutrients after a workout. Eating patterns in general can encourage the hunger hormones to work for you instead of against you.
Help insulin work by cutting out insulin spiking foods such as sugar and high-glycemic carbohydrates. Eat more complex carbohydrates including greens and other colored vegetables and fruits. Exercise increases insulin sensitivity so take a 15 minute walk after eating. Insulin is hard at work in muscle tissue so include a bit of resistance or strength training.
Include protein at every meal for good metabolism, to help stabilize insulin spikes, provide building blocks for muscle and to encourage glucagon release. This means lean meats and fish, eggs, milk, cheese, yogurt, and beans.
Don’t skip breakfast! If you don’t take in some calories first thing in the morning, as a “break from the overnight fast”, then your body will go into emergency mode, releasing the stress hormone cortisol and breaking down stored glucose for fuel. This causes a quick insulin spike and leads to irregular sugar / insulin balance throughout the day. Insulin spikes lead to insulin resistance whereas the smooth release of insulin from the intake of complex carbohydrates and protein is much more efficient.
Try a “wake-up” protein if you don’t get to breakfast right away. Whey protein isolate or concentrate in plain water, or mixed in a smoothie, is an excellent complete protein source. Studies show that eating breakfast and especially including protein at breakfast leads to less hunger and less weight gain.
Sleep is a very important suppressor of ghrelin, and poor sleep will increase ghrelin levels leading to increased appetite the next day. Interestingly, ghrelin helps us get into a good sleep cycle, so going to bed with a full stomach and low ghrelin can interfere with sleep. Don’t eat a big meal just before bedtime and be sure to get enough sleep.
We use a variety of targeted supplements that help insulin and leptin work better. Our staff exercise physiologist specializes in developing custom workouts and diet plans that can help your exercise efforts better target your friendly hunger hormones.
INSET
FREE SEMINAR
Low Thyroid: Misunderstood, Misdiagnosed, Missed!
Monday, June 4th at 6pm, at the IMC.
Seating is limited so RSVP at 245-6911 or online at rsvp@imcwc.com.
Bio
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com). Call (970) 245-6911 for an appointment or more information.
Sunscreen Tips for Youthful Skin
By Scott Rollins, MD and Erin Larson, CLS
The number one thing that ages skin is sunshine. Not just the sunburns, but the relentless day to day exposure to the sun causes the skin damage that leads to discolored spots, wrinkles and sagging skin. And don’t be fooled as most sunscreens do not protect from all the skin-damaging rays. If you want youthful skin then your number one skin care strategy is to avoid excessive sun and use a true sun protective sunscreen.
Sunlight Basics
Just below the spectrum of light that is visible to our eye lies the ultra-violet (UV) light spectrum. First is the longer wavelength UVA (315-400 nanometers), then intermediate UVB (280-315 nm), and last the shortest wavelength UVC (100-280nm). The shorter wavelengths are more irritating to the surface while the longer wavelengths penetrate the skin and cause deeper damage.
The visible light spectrum (400-780nm) gives us our rainbow of colors, starting with violet-indigo-blue-green-yellow-orange and finally red as the light wavelength increases on up into the “infra-red” spectrum (> 780nm). Infra-red rays radiate heat and give us warmth.
UVC is actually the most damaging of the UV rays, causing the skin to burn and promoting cancer changes. UVC will even kill germs and is known as “germicidal” rays. Fortunately most all UVC is blocked by the earth’s ozone layer.
UVB causes the familiar “sunburn” by damaging the skin’s outer layer, the epidermis, leading to dark spots, fine wrinkles, broken surface capillaries, and skin cancers that arise from the epidermis. Cumulative sun exposure causes the familiar basal and squamous cell skin cancers to erupt from the skin’s epidermal layer. These are typically gray in color, either smooth or scaly lesions, that show up on the face or arms where the skin has been most exposed.
UVA causes the darkening of skin known as “suntan” and was once thought to be harmless but is now known to be very damaging to the skin. By absorbing into the deeper dermal layers UVA causes the collagen that supports our skin to simply waste away leading to thinning and sagging of the skin. UVA is responsible for much of the premature aging of skin evidenced by inflammation and dryness, and eventually uneven pigmentation, fine wrinkles, and skin cancer.
UVB exposure occurs mainly in the summer months and is worse from 10am to 4pm. It does not penetrate glass and is basically filtered out during winter months. However, the UVA rays are present all year round, all day long, and go right through glass. Even while driving the UVA rays are streaming into the auto and soaking right into exposed skin.
High altitude allows much more of the UV rays to get through the atmosphere. This explains why the mountain states have a higher incidence of skin cancer! And more sun damaged, aging skin…
Sun Protection
The well-known sun-protection-factor or SPF is misleading, outdated, and frankly worthless when it comes to insuring your skin is protected. The SPF ratings only apply to UVB rays. Many products advertise “blocking both UVB and UVA” but in fact only a tiny percentage of the UVA spectrum is really blocked - just enough to allow the marketing but not even close to the complete blockage we really need.
There are about 15 FDA approved chemicals that will absorb UV rays and are used in various combinations as sunscreens. Some examples include Octyl Salicylate, the oldest in use, Padimate O which is the most common in the US, and Octyl Methoxycinnamate which is the most common world-wide. These sunscreens block a narrow range of UVB light in the 300-315nm range, leaving the UVA spectrum untouched. Thus, other chemical absorbers, such as Oxybenzone and Avobenzone, are mixed in to give a bit more protection up into the UVA range, but they are very limited in effectiveness.
Physical blockers, known as “metal oxides” are the most complete remedy for truly blocking the UVA and UVB rays. These natural occurring particles will physically block all UV rays, as well as protect from wind and block the heat from infra-red rays thus keeping the skin cooler. Titanium dioxide, used to lighten cosmetic products, blocks most of the UV spectrum but misses a bit of UVA. Zinc Oxide really blocks the UVA spectrum well and thus is commonly blended with titanium dioxide to add full UVA coverage.
No matter what sunscreen is used, the actual protection offered is directly related to their level of concentration, how long they remain stable when exposed to sun, the film thickness applied to the skin, as well as the careful, frequent total coverage of the exposed skin sites.
Skin Protection
As skin goes through repeated cycles of sun exposure, especially with sunburn and suntan, inflammation and skin darkening occurs, and over time the photo-aging and skin cancer. The UV rays cause damage to the skin that generates damaging “free radicals” that react with and oxidize any tissue in the area. The inflammation and oxidation leads to skin breakdown and DNA damage that promotes cancer. Even the defenses against infection are impaired as the UV rays suppress the skin’s immune system.
Supplemental nutrients can be added to sunscreens to provide direct and indirect protection to the skin. Antioxidants such as vitamins E, C and A, and selenium help “clean up” the free radicals generated by sun damage. Bioflavanoid antioxidants such as pycnogenol from pine-bark, and resveratrol from grapes, are also found in better products. Studies confirm the ability of these highly specialized antioxidant bioflavanoids to augment vitamin C, protect cells and collagen tissue, and also to strengthen blood vessels and capillaries.
With our laser skin care we can do amazing things to help restore healthy youthful skin and remove years of sun damage. However, it all starts with protecting what you’ve got so enjoy the great Colorado outdoors but be sun-smart and protect your precious skin. If you are making the effort to use sunscreen then be sure you are using the right stuff. We recommend and carry a professional line of sunscreens from Fallene Cosmeceuticals, called “Solar Protection Formula”.
Open House
Bellezza Laser Aesthetics
Register to WIN a free iPixel treatment worth $1500
Register to WIN a free vial of Juvederm cosmetic filler worth $500
Learn about the latest professional grade sunscreens and mineral make-up
Wednesday, May 16th, 6pm
RSVP at 254-1195
Bio
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in Bioidentical Hormone Replacement, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com). Call (970) 245-6911 for appointments or more information.
Erin Larson is a certified laser specialist, aesthetician, and co-owner of Bellezza Laser Aesthetics. She has worked with many different brands of laser equipment and is experienced with every aesthetic laser procedure as well as the Levulan procedure for precancerous lesions, microdermabrasion and numerous skin care product lines. Bellezza is located in the Integrative Medicine Center of Western Colorado (www.imcwc.com). Call 254-1195 for a complimentary consultation.
