Category Archives: Public Health Risks

Go Beyond Knowing Obesity Is Bad (Part 2)

By Hui Xie-Zukauskas

Warn-Danger Fats_FitWtCare & CPDWhat comes to your mind when you hear “Belly fat”?

Call it “Belly fat” as you like, but what I’m specifically talking about is visceral fat, the fat stored deeply inside your abdominal cavity and around your organs – unlike subcutaneous fat (under your skin) that’s visible and pinchable. (Image Credit: FitWeightCare)

Fat on Visceral Organs (i.e. intra-abdominal fat)

Everybody likely has visceral fat whether knowing it or not. but how much is too much?

Although visceral fat can only be measured by CT and MRI now, if you or your loved ones have an overhanging belly and large waist, that’s a warning sign of dangerous fat inside. That said, it doesn’t exclude relatively lean (with normal waistline) folks.

So, how dangerous is visceral fat exactly?

Visceral fat has deleterious effects on a variety of your organs and their functions. Clearly, it is attributed to increased inflammation by provoking inflammatory pathways and releasing pro-inflammatory chemicals. Also, extra visceral fat is strongly linked to insulin resistance and metabolic diseases, and to an elevated risk of death, even for people who have a normal body mass index (BMI).

Carrying around excess visceral fat increases a risk for a long list of chronic conditions or diseases including, but not limited to –

  • Coronary artery disease, heart attack, stroke
  • Cancer
  • High blood pressure, high blood cholesterol, and high blood glucose
  • Obesity – making it hard to lose weight
  • Type 2 diabetes – due to insulin resistance
  • Dementia
  • Depression and mood problems
  • Sleep disorders (e.g. sleep apnea)
  • Endocrinal, sexual dysfunction
  • Arthritis

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Here, I want to lay emphasize on cancer, as cancer’s impact on public health is increasingly prevalent. Excess visceral fat is a risk factor for several cancers of the gastrointestinal system, particularly esophageal, stomach, small intestine, colorectal, pancreatic, liver and gallbladder cancers. This is because overloaded adiposity is associated with fat tissue-derived inflammation, alterations in insulin signaling and sexual hormones’ pathways, then turning normal cells into cancerous ones. Moreover, visceral obesity is greatly associated with breast cancer.

Fat’s Influence on Other Vital Organs (e.g. brain)

Just because visceral fat is wrapped around abdominal organs such as the pancreas, liver and kidneys, it doesn’t mean that its damaging effects are local. For instance, liver fat may have a direct association with brain aging or shrinking. What’s more, greater visceral fat is correlated with a smaller total brain volume, which has been linked to neurodegenerative processes, and used as one of predictors for dementia.   

Excessive visceral fat results from a combination of hormonal, dietary, lifestyle (i.e. sedentary), and genetic factors. Now you can see how any big belly and large waistline are unhealthy.

Obesity and Aging   

As we get older, we store more visceral fat, because changes in body composition occur and co-morbidities accumulate. However, hopefully by now, you’ve come to the realization – simply accepting a growing midsection as an unavoidable product of aging may ignore or tone down your health risks.

On issues of aging and obesity, it’s inevitable not to touch on the gut microbiome, the microbial communities inhabiting the human body and containing a diverse array of microbes (in trillions).

The gut microbiota has emerged as a crucial regulator between how our food interacts with our body. They modulate how we balance levels of blood sugar and how we store fat, as well as how we respond to hormones. They play a key role in obesity.

As we age, altered gut microbiota in their composition and metabolites (called Dysbiosis) occurs. Science reveals that our gut microbiota undergoes the most prominent changes during infancy and old age, and profoundly, our immune health is also in its weakest and most unstable state during these two critical stages of life, indicating that the gut microbiota and immune function develop hand-in-hand with age.

Sure enough, with aging, levels of inflammatory mediators in the blood rise, and hence age-associated inflammation becomes a strong risk factor for morbidity and mortality in elders. It turns out that the gut microbiota may act as invisible yet important players in chronic inflammation.

Aging-associated dysbiosis can promote intestinal barrier’s broken-down, systemic inflammation and immune dysfunction, which all contribute to the pathogenesis and progression of various diseases commonly seen in old people such as obesity-related disorders, liver diseases, cardiovascular diseases and cancer. Age-related changes in the gut microbiota have also been associated with various neurological and neurodegenerative disorders due to disturbed gut-brain communication.

Clearly, the gut microbiota can have a potent impact on human health and diseases.  But to date, there is no knowledge on “Which” gut microbe is doing “What”, “Why” and “How”. Without doubt, we can anticipate to learn more soon as a remarkable pace of scientific research is going on.

The Key Point Is –

If fats deposit where they should not be or more than they should be, then that will change a physiological condition to a pathological one through the effects of inflammatory chemicals. Excess body fat is like an inflammation-pumping machine.

For this reason, any extra fat – from both body and diet – any big belly or larger waistline poses a hidden risk. With obesity, people carry not only fat or weight but pain and health consequences.

Obesity is serious, regardless of the debate whether obesity is a disease or a condition. Obesity is just as significant as high blood pressure and high cholesterol – while none of them are actual diseases (but symptoms), all need to be medically treated lest they lead to termed “diseases”.

Indeed, causes of obesity are multifactorial and complex. However, for some, obesity is caused by genetic factor(s) and could be a life-long condition, which needs to be medically treated and individually managed. 

Doses of Wisdom for Prevention

Obesity, in most cases, is a modifiable and preventable. Lifestyle, diet and physical activity are key factors to prevent, ease or slow down obesity even with aging.

So, please don’t see obesity as a death sentence, because it’s not.

Nutritional and physical approaches, that are within your control, can prevent dangerous fat buildup, and thus lower a risk for obesity as well as chronic diseases such as heart disease, diabetes and cancer.

Furthermore, getting a good night sleep and reducing stress are also beneficial for a healthy weight, because the stress cortisol can increase the amount of visceral fat your body stores.

Ultimately, consider to recruit your hidden microbial players, keeping them in harmony and happy, which could help your weight control. 

Bonus: Valuable Principle on Diet

An optimal diet to manage obesity should be individual-focused and ensure a long-term maintenance of weight loss, along with the diet that’s safe, efficient, nutritionally adequate, culturally acceptable and economically affordable.

Critically important and specifically effective are diet plans including low-fat, low-carbohydrate, low-calorie but high-protein, high-fiber diet, and Mediterranean diet. Without fail, go for fiber-rich foods (e.g. fruits, vegetables and whole grains), because they are essential to boost growth and activity of beneficial gut microbiota.

Remember low-sugar diet too, as research findings indicate that a high-sugar diet increases visceral fat in humans and animals.

References (including Pt. 1 & Pt. 2) Click here

Image Credit: by FitWeightCare, CPD

 

Floodwater May Be Muddy but Health Threats Are Clear

By Hui Xie-Zukauskas

Flood danger_chbdc.govt.nz w-CPDFirst of all, our hearts go out to the victims and people suffering from Hurricane Harvey.

What can we learn from this catastrophic storm – especially for residents living in flood-prone areas?

I address this question, because the danger of flooding is not just drowning. Health hazards under seemingly calm floodwater cannot be taken lightly, and they will persist, in some cases, for a long time.

Therefore, I’m going to highlight what health hazards come with flooding and how your preparedness can help avoid them.

Let’s start with – Types of Health Hazards and Risks

  1. Bacteria and infections: Bacteria can cause infectious diseases. Exposure to contaminated water (e.g. from pathogens, chemicals or wastes) can result in infection and put a risk for other health problems.
  2. Injury: Cuts and harm result from invisible sharp glass or metal fragments.
  3. Stress: Tension is overwhelming, from devastated loss, upset, anxiety, exhaustion and sleep deprivation, etc. Stress may progress to mental health problems such as post-traumatic stress disorder and depression. Inevitably, the emergency responders experience stress as well.
  4. Mosquitoes: Warm, stagnant water is their breeding bed, which increase the prevalence of mosquito-borne diseases such as Zika, West Nile and dengue.
  5. Mold: Mold from water-soaked homes/walls can be harmful because it not only causes allergic reactions but also may worsen other existing health problems.

Next, Strategies and Actions You Can Take (in acronym P.I.C.)

#1 Prepare and Plan prior to flood

The key to effective preparedness is to plan ahead, protect assets, and get everything ready. Never wait till the last minute then act. Here are things you can do:

For care of vulnerable populations

  • Make sure to take care of necessities for babies and pregnant women.
  • Have enough back-up medications for folks with chronic diseases or health problems, and ensure the medications kept in a safe, water- and heat-proof place (e.g. cooler). Likewise, watch over personal medical device safety.
  • Make sure elderly, fragile folks stay in a dependable home/facility. 

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For general population

  • Keep a prevention-mindset. Your health is your most valuable asset, as you cannot expect to take all your possessions with you.
  • Have your family’s emergency package/kit ready-to-go.
  • While securing some belongings is essential, it’s important to guard some critical documents such as insurance, health and immunization records.
  • If possible, consider getting the vaccine for TDAP – tetanus, diphtheria and pertussis in case of unforeseen injury.

#2 Implement during and post flood

  • Execute your plan, and ensure vital items at hand when evacuation.
  • Turn off power to avoid any incident from getting electrocuted.
  • Take good care of open wounds to prevent infection, esp. avoid direct contact in water.
  • Pay attention to folks in poor health, because they are at a great risk of heat-related death due to power outage and resultant lack of air conditioning.
  • Always make sure that your drinking water is safe.
  • Maintain hygiene and food safety. Discard any moldy, rotten or illness-risky foods.
  • When cleaning up floodwater, avoid injury. And clean everything in direct contact with water.
  • Clean mold thoroughly, but take caution to the cleaning chemicals because of their potential harm to your body. If necessary, ask for professional help.

#3 Communicate for management and support

Be informed. Follow the instructions or updates on mass flooding from federal or state government and communities. Keep your families and friends posted about your well-being. Support each other in every way possible. 

Final point:

To my knowledge, there is no direct evidence whether Hurricane Harvey is caused by climate change. However, as we all understand, global warming can add to warmer or hotter air, build up more humidity and more moisture, which will increase the intensity of hurricane and consequential damage. Hence, climate change does play a role in deadly storms or weather-related natural disasters.

So, let’s face the reality, take responsible actions to protect the earth and future generations.

 

Image credit: Chbdc.govt.nz and CPD

Lifestyle Interventions in the Midst of Three Health Crises

By Hui Xie-Zukauskas Healthy Lifestyle in Right direction_CPD-Clipart combo

As a nation, we are facing three health crises: (1) Chronic diseases, (2) Obesity, and (3) Opioid epidemic.

The facts and figures below tell a sad story.

Impact of three health crises in the U.S. (estimated in 2016)

 

 

Morbidity

 

Mortality

% of All Death
Chronic diseases 25% of adults had two/more chronic health conditions. 595,690 deaths (cancer);  610,000~ deaths (heart disease) 48%
Obesity epidemic 36.5% of adults were obese; 35.6%, overweight. 300,000+ deaths (obesity attributable) 18%
Opioid overdose   59,000 – 60,000 deaths  

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Chronic diseases not only affect health and quality of life, they also add economical and social burdens. Specifically, about 86 percent of all health care spending goes towards treating individuals with one or more chronic conditions.

On the bright side, just eliminating three risk factors – poor diet, inactivity, and smoking – would prevent: 80% of heart disease and stroke, 80% of type 2 diabetes, and 40% of cancer, according to the Centers for Disease Control and Prevention (CDC).

It’s clear that poor lifestyle choices are key contributors in developing preventable chronic diseases such as cardiovascular disease, hypertension, diabetes, several types of cancer, and obesity. Lifestyle modification or intervention is not something new. However, it’s quite challenging to achieve and sustain success. So, here I will emphasize some key strategies and points you can use to fight these health crises personally.  

1. Keep a healthy diet. Intake a diet rich in vegetables, fruits, fish, beans, whole grains, nuts and other nutrients.

-          Reduce fats, sugar and salt in your diet, which may be packed as hidden ingredients in processed foods.

-          Reduce red meat, animal meats consumption too.

2. Participate in physical activity. Aim for a minimum of 150 minute exercise each week.

A combination of diet and exercise is effective in maintaining healthy weight. Take advantage of summer outdoor activities (e.g. swimming, walking, or playing at beach).

3. Quit or avoid addictive behavior such as tobacco, alcohol and illicit drug use.

-          Tobacco smoking takes more than 480,000 lives each year.

-          Rather than seeking substances as a mean for momentary pleasure, living a healthy lifestyle is an excellent regimen for meeting one’s physical, emotional, and social needs.

4. Maintain healthy weight. Weight control is about energy balance, i.e. Energy In = Energy Out. When energy intake exceeds energy expenditure, weight gain occurs.

-          Do eat good breakfast, and consume enough fibers and proteins.

-          Avoid emotional eating.

-          Yes, it’s not easy to make a big change. One step at a time. Don’t go it alone, lock arms for support and motivation.

5. Manage stress. There are many techniques to relieve stress, but the best ones are enjoyable, self-help ways that work for you.

-          Importantly, keep counting your blessings, because gratitude is a secret to happiness.

6. Get a good night’s sleep. Many people overlook this issue.

-          Lack of sleep for a long time may increase your risk of obesity, diabetes, and cardiovascular disease.

-          Sleep hygiene is essential to getting sound sleep (see previous article)

All of above healthy habits will effectively reduce triglyceride levels, cut blood sugar levels, minimize waist circumference, and lower blood pressure. As a result, most chronic conditions and obesity are preventable, and some can even be reversed.

So, go for a healthy, vibrant lifestyle!

 

Image credits: https://openclipart.org/; CPD

5 Reasons for a Higher Awareness of Zika

By Hui Xie-Zukauskas

Zika_Pt.2_CPDZika virus continuously poses a public health threat in the U.S.. Since my last post “Zika Virus Infection and Cancer Care Indication”, as of August 24th, 29 people in Florida have been infected with Zika virus through local mosquito transmission, along with 2,487 travel-related cases across the country, according to the CDC.

This is a more alarming reality than that presented three months ago when all 544 Zika cases in the U.S. were travel-related. Regions along the Gulf Coast are at an elevated risk for Zika outbreak, especially Louisiana, because of recent devastating flooding.

Pregnant women are particularly vulnerable to the Zika crisis. Of importance is to avoid traveling to Zika outbreak areas and stay self-protected to prevent mosquito bites. I won’t get into details here because plenty of information or guidance is available elsewhere.

Based on some new research and clinical findings, I’d like to emphasize FIVE reasons why we need a higher alert and responsiveness to Zika infection. Here goes:

1.      There are various ways for Zika virus transmission.

A person who has acquired the Zika infection could pass virus along through mosquito bites, maternal-fetal and/or sexual transmission. Unmistakably, blood transfusion also becomes a major concern as Zika-positive blood donation is evident. That’s why the FDA recently recommended nationwide screening of blood donations for Zika virus. Thank about it – why is it necessary to run such a costly and time-consuming testing for a massive blood donation system? Remember that people infected with Zika virus could be symptomless.

2.      Zika virus can damage not only a baby’s brain but also an adult’s brain cells.

Painful scan images have shown that Zika infects a fetus, causes brain calcification, and destroys a baby’s brain. Severe brain damage may bring about long-term developmental problems or neurological complications affecting vision, movement and epilepsy. On the other hand, new research reveals that Zika virus impacts a different area of adult mice’s brain, such as a specific neural cell, and it could affect long-term memory in some adults.

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Infections by viruses can suppress the immune system. Moreover, a person’s inflammatory response to mosquito bites may augment the severity of arbovirus infection (e.g. Zika). Studies suggest that mosquito bites, especially in individuals hypersensitive to mosquito bites, may be linked to cancer development through activating cancer cellular pathways by mosquito-feeding, and/or through influencing human metabolic pathways leading to the initiation of cancer.

4.      It’s challenging to control mosquitoes.

Mosquito population is measured in the millions, and usually in the hundreds of millions. There is no way to distinguish Zika-infected mosquitoes from the rest uninfected. It’s virtually impossible to eradicate them all. But it doesn’t mean we should give up our effort.

Aerial spraying and backpack fogging carried out by the professionals can help reduce mosquito populations in epidemic areas. There are also effect measures that individual citizens can take right at home or the backyard with little or no cost. For instance, the best ways to control local mosquito population is to eliminate the places where mosquitoes breed, such as water-filled buckets, flowerpots, containers, puddles or pools of standing water outdoors.

Using pesticides to kill mosquitoes is delicate. Be cautious about unintended consequence, because pesticides often contain some toxic chemicals that can be harmful to human health if inhaled or ingested. 

5.      Finally, keep in mind those young women whose newborns suffering from microcephaly, neurological abnormalities and birth defects. What would their hardship be? – raising their ill babies, caring for the infants with various disabilities, and likely dealing with their own stress, anxiety, depression or quality of life.

 

Image credit: physio-pedia.com and CPD

Zika Virus Infection and Cancer Care Indication

By Hui Xie-Zukauskas

Zika in USA map_smAre you worried about Zika virus infection? Are you ready for Zika outbreak?

Consider again − after learning the public health threat highlighted here with eyes on the U.S. region.

Let’s start with a snapshot on the crucial timeline to see how Zika epidemic has been evolved after the 1st Zika case identified in Brazil in April 2015.

Snapshot on Timeline of Zika Outbreak

As you may know, Zika virus is transmitted to people primarily through the bite of an infected mosquito. Travel-associated cases imply individuals infected abroad and then returned to the country. No immediately mosquito-transmitted Zika infection has been reported in the 50 US states so far, but the CDC has alerted the epidemic is likely to change with mosquito season’s arrival.

How should you be concerned?

Birth defects (e.g. microcephaly, fetal malformations) have been linked to Zika virus. Thus, pregnant women are particularly vulnerable to this emerging infectious disease.

If you are a healthy adult, you’re still not Zika-proof. In most cases, Zika virus causes a brief, mild flu-like illness. As documented, adults have also suffered from severe neurological disorders such as meningitis, meningoencephalitis and Guillain-Barre syndrome. A rare complication may be internal bleeding, which caused the first US Zika-related death.

Here are a few key points:

  • There is no vaccine or effective treatment for this disease.
  • Zika-specific tests could be expensive and not readily available.
  • There is a lot of UNKNOWN, though more research is underway.

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How would you possibly be impacted?

With summer approaching, mosquitoes are coming. But don’t panic, not all mosquitoes spread this disease.

Two mosquito species may carry Zika virus: 1) Aedes aegypti; and 2) Aedes albopictus, the latter is also known as Asian Tiger mosquito. However, there is no way to tell if a mosquito is Zika-infected.

Next, where would Zika-carrier mosquitoes likely to be found?

Places like Florida, Texas and Louisiana are home of the Aedes aegypti mosquito, whereas the Midwest and much of the East Coast happen to be climate or environment for Aedes albopictus (Asian tiger) mosquito. So, a “New Bug” is expected to be around.

What can you do?

Current strategic measure is Self-Prevention and Self-Protection, as briefly summarized in the following areas:

Travel cautions: Pregnant women are advised against travel to the affected countries, and if a trip is required, test the positivity of Zika virus presence once returning.

Personal protection: Extra vigilance and care for pregnant women, wearing long-sleeved clothes, gearing up with mosquito repellent (EPA-certified), and remember – The mosquito-biting time could be daytime!

Note that other routes of Zika infection include sexual or maternal-fetal transmission or blood transfusion.

Environmental prevention: Eliminate potential mosquito’s egg-laying sites by emptying or drying water buckets, water storage units and other plant pots.

Medication alert: Although analgesics is a part of supportive management, avoid Aspirin and Non-steroidal anti-inflammatory drugs because of the risk for hemorrhage among patients with cancer or dengue or taking specific therapies at elevated danger of bleeding.

Last but not the least, because it’s unclear as how the course of Zika infection influences that of cancer, cancer patients should maintain close check-up or follow-up with your physicians and specialists, particularly for those with an immune-suppressed condition or with significant comorbidity.

Zika outbreak may come rapidly, so get prepared and get ready!

 

References: 1) Hepner and del Pilar Estevez Diz: Journal of Global Oncology. April 2016; and 2) Plourde and Bloch: EID journal. Vol.22, 2016

Image credit: physio-pedia.com and CPD