All posts by CoreMedical

Arthritis – Do Certain Foods Ease Joint Pain?

Arthritis – Do Certain Foods Ease Joint Pain?

One of the most common questions people with any form of arthritis have is, “What can I eat to help my joints?”

The answer, fortunately, is that many foods can help. Following a diet low in processed foods and saturated fat and rich in fruits, vegetables, fish, nuts and beans is great for your body. If this advice looks  familiar, it’s because these are the principles of the so-called Mediterranean diet, which is frequently touted for its anti-aging, disease-fighting powers.

There’s good science behind the hype. Studies confirm eating these foods lowers blood pressure and protects against chronic conditions ranging from cancer to stroke. It helps arthritis by curbing inflammation – which benefits your joints as well as your heart. Another bonus: Eating more healthy, whole foods commonly found in  Mediterranean cuisine – and fewer packaged foods – can also lead to weight loss, which makes a huge difference in managing joint pain.

Whether you call it a Mediterranean diet, an anti-inflammatory diet or simply an arthritis diet, here’s a look at the key foods – and a breakdown of why they’re so good for joint health.

Fish

How much: Health authorities like the American Heart Association and the Academy of Nutrition and Dietetics recommend three to four ounces of fish, twice a week. Arthritis experts claim more is better.

Why: Some types of fish are good sources of inflammation-fighting omega-3 fatty acids. A study of 727 postmenopausal women, published in the Journal of Nutrition, found those who had the highest consumption of omega-3s had lower levels of two inflammatory proteins: C-reactive protein (CRP) and interleukin-6.

More recently, researchers have shown that taking fish oil supplements helps reduce joint swelling and pain, duration of morning stiffness and disease activity among people who have rheumatoid arthritis .

Best sources: Salmon, tuna, sardines, herring, anchovies, scallops and other cold-water fish. Hate fish? Take a supplement. Studies show that taking 600 to 1,000 mg of fish oil daily eases joint stiffness, tenderness, pain and swelling.

Nuts & Seeds

How much: Eat 1.5 ounces of nuts daily (one ounce is about one handful).

Why: “Multiple studies confirm the role of nuts in an anti-inflammatory diet,” A study published in The American Journal of Clinical Nutrition found that over a 15-year period, men and women who consumed the most nuts had a 51 percent lower risk of dying from an inflammatory disease (like RA) compared with those who ate the fewest nuts. Another study, published in the journal Circulation, found that subjects with lower levels of vitamin B6 – found in most nuts – had higher levels of CRP and oxidative damage.

More good news: Nuts are jam-packed with inflammation-fighting monounsaturated fat.

Best sources: Walnuts, pine nuts, pistachios and almonds. In towns along the Mediterranean, you’ll see these nuts mixed into everything from salads and pilafs to main dishes and desserts.

Fruits & Veggies

How much: Aim for nine or more servings daily.

Why: Fruits and vegetables are loaded with antioxidants. These potent chemicals act as the body’s natural defense system, helping to neutralize unstable molecules called free radicals that can damage cells.

Olive Oil

How much: Two to three tablespoons daily

Why: Olive oil is made up largely of healthful, monounsaturated fat. It’s anti-inflammatory, heart-healthy and it’s tasty, too. But having the right type of fat isn’t the oil’s only value. In fact, experts claim at least half of its health benefits come from the olives, not the oil.

Ever notice a scratchy sensation in the back of your throat after dipping your bread in olive oil? That’s the phenolic compound, oleocanthal, one of the most concentrated anti-inflammatory compounds in olive oil.This compound inhibits activity of COX enzymes, with a pharmacological action similar to ibuprofen. Inhibiting these enzymes dampens the body’s inflammatory processes and reduces pain sensitivity. So it’s no wonder this oil has been linked with a reduced risk of a variety of chronic diseases.

Best sources: Extra virgin olive oil. It goes through less refining and processing, so it retains more nutrients than standard varieties.

Beans

How much: About one cup, twice a week (or more)

Why: Beans are loaded with fiber, a nutrient that helps lower CRP, an indicator of inflammation found in the blood. At high levels, CRP could indicate anything from an infection to RA. But fiber isn’t the only reason beans help fight inflammation. In a study recently published in the Journal of Food Composition and Analysis, scientists analyzed the nutrient content of 10 common bean varieties in southern Italy and identified a host of antioxidant and anti-inflammatory compounds, including quercetin, genistein, soysapogenin and oleanolic acid.

Another reason beans are an essential part of an arthritis-friendly diet: They are a great (and inexpensive) source of protein, with about 15 grams per cup, and protein is important for overall health, especially for muscle health. Protein helps prevent muscle shrinkage due to age or inactivity, and stronger muscles make it easier to keep joints moving.

This vegetarian source of protein fills you up, meaning less post-meal snacking – and potentially less weight on your joints. Beans also digest very slowly, providing sustained energy and preventing the blood-sugar roller coaster commonly associated with high-carb and/or processed foods. Many bean varieties also boast folic acid, which benefits the heart, as well as immune-boosting minerals like magnesium, iron, zinc and potassium.

Best Sources: Red beans, small red kidney beans and pinto beans rank among the U.S. Department of Agriculture’s top four antioxidant-containing foods. Other beans you may want to add to your rotation: black beans, garbanzo beans and black-eyed peas.

Should You Avoid Nightshades?

Nightshade vegetables, including eggplant, tomatoes, red bell peppers and potatoes, are hallmarks of Mediterranean cuisine. Each of these disease-fighting powerhouses boasts maximum nutrition for minimal calories. They also contain solanine, a chemical that has been branded the culprit in arthritis pain.

According to Tanya Edwards, MD, medical director of the Center for Integrative Medicine and Wellness Institute at the Cleveland Clinic, there’s no scientific evidence to suggest that nightshades trigger arthritis flares. In fact, some experts believe these vegetables contain a potent nutrient mix that helps inhibit arthritis pain.

Eggplant, for example, boasts anti-inflammatory anthocyanins, plus a hefty dose of fiber – all for only 35 calories per cup. Tomatoes are a rich source of the antioxidant lycopene, which has been shown to help neutralize free radicals. Red peppers are loaded with immune-boosting vitamin C (which also helps your body absorb iron). And potatoes are packed with potassium, which can help keep blood pressure in check, among other health benefits.

However, many people do report significant symptom relief when they avoid nightshade vegetables. If you notice that your arthritis pain flares after eating them, Dr. Edwards suggests you do a test: “Eliminate all nightshade vegetables from your diet for a few weeks. If you notice less pain, perhaps you should avoid these powerful foods.”

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Anxiety Disorders & Phobias… The Scoop

Anxiety Disorders & Phobias… The Scoop

Most people feel anxious from time to time. However, anxiety can become abnormal if it interferes with your day-to-day activities. Anxiety is a symptom of various anxiety disorders which are discussed below. They can often be treated. Treatments include various talking treatments, and medication.

What is anxiety?

When you are anxious you feel fearful and tense. In addition,you may also have one or more unpleasant physical symptoms. For example, you might have a fast heart rate, a thumping heart (palpitations), feeling sick, shaking (tremor), sweating, dry mouth, chest pain, headaches, fast breathing.

The physical symptoms are partly caused by the brain which sends lots of messages down nerves to various parts of the body when you are anxious. The nerve messages tend to make the heart, lungs, and other parts of the body work faster. In addition, you release stress hormones (such as adrenaline) into the bloodstream when you are anxious. These can also act on the heart, muscles and other parts of the body to cause symptoms.

Anxiety is normal in stressful situations, and can even be helpful. For example, most people will be anxious when threatened by an aggressive person, or before an important race. The burst of adrenaline and nerve impulses which we have in response to stressful situations can encourage a ‘fight or flight’ response.

Anxiety is abnormal if it:

  • Is out of proportion to the stressful situation; or
  • Persists when a stressful situation has gone, or the stress is minor; or
  • Appears for no apparent reason when there is no stressful situation.

What is the treatment for anxiety disorders and phobias?

The main aim of treatment is to help you to reduce symptoms so that anxiety no longer affects your day-to-day life.

The treatment options depend on what condition you have, and how severely you are affected. They may include one or more of the following:

NON-MEDICATION TREATMENTS

Understanding

Understanding the cause of symptoms, and talking things over with a friend, family member or health professional may help. In particular, some people worry that the physical symptoms of anxiety, such as a thumping heart (palpitations), are due to a physical illness. This can make anxiety worse. Understanding that you have an anxiety disorder is unlikely to cure it, but it often helps.

Counselling

This may help some people with certain conditions. For example, counselling which focuses on problem-solving skills may help if you have GAD (Generalised Anxiety Disorder).

Anxiety management courses

These may be an option for some conditions. The courses may include: learning how to relax, problem-solving skills, coping strategies, and group support.

Cognitive and behavioural therapy

These therapies can work well for persisting anxiety disorders and phobias.

MEDICATION

Antidepressant medicines

These are commonly used to treat depression, but also help to reduce the symptoms of anxiety even if you are not depressed. They work by interfering with brain chemicals (neurotransmitters) such as serotonin which may be involved in causing anxiety symptoms.

  • Antidepressants do not work straightaway. It takes 2-4 weeks before their effect builds up and the anxiety symptoms are helped. A common problem is that some people stop the medicine after a week or so, as they feel that it is doing no good. This is often too soon to know if the medication will work.
  • Antidepressants are not tranquillisers, and are not usually addictive.
  • There are several types of antidepressants, each with various pros and cons. They may differ in their possible side-effects. However, selective serotonin reuptake inhibitor (SSRI) antidepressants are the ones most commonly used for anxiety disorders. Two examples of SSRIs are escitalopram and sertraline.
  • Note: after first starting an antidepressant, in some people the anxiety symptoms become worse for a few days before they start to improve. Your doctor or practice nurse will want to keep a check on you in the first few weeks of treatment to see if you have any problems.

Benzodiazepines

Benzodiazepines such as diazepam used to be the most commonly prescribed medicines for anxiety. They were known as the minor tranquilisers, but they do have some serious known side-effects. They often work well to ease symptoms. The problem is they are addictive and can lose their effect if you take them for more than a few weeks. They may also make you drowsy. Now they are not used much for persistent anxiety conditions. A short course of up to two weeks may be an option for anxiety which is very severe and short-term, or now and then to help you over a bad spell if you have persistent anxiety symptoms.

Buspirone

Buspirone is sometimes prescribed to treat GAD. It is an anti-anxiety medicine, but different to the benzodiazepines and is not thought to be addictive. It is not clear how it works. It is thought to affect serotonin, a brain chemical which may be involved in causing anxiety symptoms.

Beta-blocker medicines

A beta-blocker, for example propranolol, can ease some of the physical symptoms such as trembling and a thumping heart (palpitations). They do not directly affect the mental symptoms such as worry. However, some people relax more easily if their physical symptoms are eased. These tend to work best in short-lived (acute) anxiety. For example, if you become more anxious before performing in a concert then a beta-blocker may help to ease ‘the shakes’.

In some cases a combination of treatments such as cognitive therapy and an antidepressant may work better than either treatment alone.

Alcohol and anxiety

Although alcohol may ease symptoms in the short term, don’t be fooled that drinking helps to cure anxiety. In the long run, it does not. Drinking alcohol to ‘calm nerves’ can lead to problem drinking and may make problems with anxiety and depression worse in the long term.

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Breast Cancer Awareness Month

Breast Cancer Awareness Month

October is an important month for raising awareness and support for breast cancer.  Breast cancer is the most common cancer in women. There is a one in eight risk of developing breast cancer for women in the UK, and I’m sure that we all have a colleague, friend or family member who has been affected by breast cancer at some point.

Many breast cancers are discovered by you, women yourselves, and so it’s really important to be aware of the signs and symptoms and when to get advice.  The earlier a cancer is detected, the easier the treatment and the greater the chance of a cure.  For this reason, during October, we are trying to encourage you to be breast aware.  Hopefully, this means that should there ever be a change in your breasts, you will be able to notice this early on.

Breast cancer can present with symptoms of;

  • Breast lumps
  • Nipple changes
  • Nipple discharge
  • Skin changes
  • Breast pain

We are not saying that it is necessary to examine your breasts every day.  Instead we want you to understand what feels normal to you, and how your breasts change throughout your cycle. It is normal to have lumpier breasts around the time of a period, and if this is the same in both breasts, and resolves a few days after your period is over, there is nothing to be concerned about.  Examining yourself over a few cycles should help you get used to these normal hormonal changes so you can recognize when there is a new change for you which could potentially represent something abnormal.

It is easiest to check your breasts in the shower or bath and you are checking for changes in the size, shape or feel of your breast, swellings in the armpits and any changes to the skin of the breast and nipple.

Should anything unusual be discovered when you examine yourself, this does not usually mean cancer and there are a number of other benign or non-cancerous causes of breast lumps.  Often, these require no treatment and can be left alone, once we as doctors are happy that the lump is nothing worrying.

At Core Medical Group we understand the effect of breast cancer on a woman’s life.  We are strong supporters of the breast cancer campaign during October.  Should you want to have your breasts checked, or learn how to check your breast properly, we would be happy to see you in our clinic.  This month, to show our support of breast cancer awareness, we are offering a breast check at the clinic for the discounted rate of £70.

Call before the end of October to book in and take advantage of this discount.

If there is one main message to take away from reading this; if you do discuss a new lump or a change in your breasts, see a doctor straight away.

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Osteoporosis Awareness

Osteoporosis Awareness

World Osteoporosis Day is observed annually on 20 October, and launches a year-long campaign dedicated to raising global awareness of the prevention, diagnosis and treatment of osteoporosis and metabolic bone disease. Organized by the International Osteoporosis Foundation (IOF), World Osteoporosis Day involves campaigns by national osteoporosis patient societies from around the world with activities in over 90 countries.

What is osteoporosis?

Osteoporosis is a condition that affects bone strength (the word osteoporosis literally means “porous bones”). Bone is a living tissue and contains cells that make, mould and resorb (take back up) bone. Initially, as you grow, bone formation exceeds bone resorption. But, as you get older, this reverses and, after about the age of 45, you start to lose a certain amount of bone material. Your bones become less dense and less strong. The amount of bone loss can vary. If you have a lot of bone loss, then you have osteoporosis. If you have osteoporosis, your bones can break more easily than normal, especially if you have an injury such as a fall. If you have a milder degree of bone loss, this is known as osteopenia.

Measures to prevent osteoporosis: 

1) Exercise Regular weight-bearing exercise throughout life is best, but it is never too late to start. This means exercise where your feet and legs bear your body’s weight, such as brisk walking, aerobics, dancing, running, etc. For older people, a regular walk is a good start. However, the more vigorous the exercise, the better. For the most benefit, you should exercise regularly – aiming for at least 30 minutes of moderate exercise or physical activity at least five times per week. Excessive exercise such as marathon running may not be so good. (Note: because swimming is not weight-bearing exercise, this is not so helpful in preventing osteoporosis.)

Muscle strengthening exercises are also important. They help to give strength to the supporting muscles around bones. This helps to increase tone, improve balance, etc, which may help to prevent you from falling. Examples of muscle strengthening exercises include press-ups and weight lifting but you do not necessarily have to lift weights in a gym. There are some simple exercises that you can do at home.

2) Diet Calcium and vitamin D are important for bone health. Your body needs adequate supplies of vitamin D in order to absorb (take up) the calcium that you eat or drink in your diet. The recommended daily intake for calcium in adults over the age of 50 is at least 1,000 mg per day. Everyone aged over 50 years should also aim for adequate amounts of vitamin D daily (800 IU). Protein is also important in your diet and one gram a day of protein per kilogram of your body weight is recommended. Briefly:

Calcium – you can get 1,000 mg of calcium most easily by:

  • drinking a pint of milk a day (this can include semi-skimmed or skimmed milk); plus
  • eating 50 g (2 oz) hard cheese such as Cheddar or Edam, or one pot of yoghurt (125 g), or 50 g of sardines.
  • Bread, calcium-fortified soya milk, some vegetables (curly kale, okra, spinach, and watercress) and some fruits (dried apricots, dried figs, and mixed peel) are also good sources of calcium. Butter, cream, and soft cheeses do not contain much calcium.

Vitamin D – there are only a few foods that are a good source of vitamin D. Approximately 115 g (4 oz) of cooked salmon or cooked mackerel provide 400 IU of vitamin D. The same amount of vitamin D can also be obtained from 170 g (6 oz) of tuna fish or 80 g (3 oz) of sardines (both canned in oil). Vitamin D is also made by your body after exposure to the sun. The ultraviolet rays in sunshine trigger your skin to make vitamin D.

Some people over the age of 50 may need to take supplements if they are unable to get adequate amounts of calcium or vitamin D from their diet or sunlight. In fact, for most people aged over 65, an adequate amount of vitamin D can only be achieved by taking vitamin D supplements. For this reason, a dietary supplement of vitamin D is commonly recommended for people over the age of 65 and for others who may lack vitamin D. For example, people who have a poor diet, or people whose exposure to sunlight is limited, such as those who are largely housebound or women whose whole body is always covered by clothing.

3) Smoking and drinking Chemicals from tobacco can get into your bloodstream and can affect your bones, making bone loss worse. If you smoke, you should try to make every effort to stop. Also, you should try to cut down on your alcohol intake if you drink more than three units of alcohol daily.

4) Hormone replacement therapy HRT contains oestrogen. A few years ago, HRT was widely used to prevent osteoporosis. However, the recent findings on the potential long-term health risks of HRT have meant that it is now not commonly used for this purpose (except in women who have had an early menopause). This is because of the small increased risk of breast cancer and cardiovascular disease (heart disease and stroke) if HRT is used in the long term.

 

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Stoptober – Quit Smoking This Month

Stoptober – Quit Smoking This Month

It’s hard to believe that today is the first day in October.  Summer has been and gone and soon we will be waking up in darkness and needing an extra layer of clothing.

From a health awareness perspective, October is a busy month.  We will be hearing lots about breast cancer and today marked the start of Stoptober.  For those wondering what Stoptober is all about, this is a time for the smokers amongst you and it represents a campaign to encourage stopping smoking.

Currently about twenty percent of the population in the UK are smokers.  I’m certain that everybody is aware that smoking has a huge negative impact on health, and smoking remains one of the leading causes of death and illness.  Around 90% of lung cancers are caused by smoking, and smoking also is the main contributing factor to long-term lung conditions including COPD, chronic bronchitis and emphysema.

I realise that if you have been smoking for a long time, stopping is no easy task.  It certainly needs a lot of will power and a lot of encouragement, so this a great time as there will undoubtedly be people around you who are trying to give up themselves and can empathise with you.  Last year Stoptober was a massive success and around 160,000 people stopped smoking for the month of October.  Research has shown that if you can manage to stop smoking for four weeks, then you are five times more likely to give up smoking completely.

So, join in, take advantage of the camaraderie amongst your fellow smokers and give your lungs a break.  Whatever age you are, and however long you have been smoking, stopping smoking now will invariably improve your health and your quality of life.

You don’t need to do it alone, and there are so many things available to help ease the cravings.  This includes nicotine replacement therapy that now comes in a number of forms (patches, gum, inhalators) and also medications, which specifically act to reduce the desire for a cigarette.

If you need some support during Stoptober, or want to talk through the options of what is available to help you, please book a consultation.  During the month of October, all smoking cessation appointments will be offered at a reduced rate of £70 to show our support for Stoptober.

Make a change!

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Booked it, packed it, got immunised…

Booked it, packed it, got immunised…

Whilst we all look forward to out summer holiday and spend lots of time planning exactly what clothes, shoes and accessories we want to take, we often forget to put the same amount of thought into our holiday health.

If you are travelling out of Europe, North America, Australia or New Zealand, then the likelihood is that you will need some vaccinations to keep yourself protected. Nobody wants to return home to the UK with an unwanted holiday souvenir…

Don’t think that you can put off your injections and leave them to the last minute. It takes time for the body to build up your immunity after an immunisation, and often more than one injection will be needed to give you an adequate level of protection. It is best to contact the clinic at least three months before you go away so we can help you to plan exactly what you need and how long before you travel you need to start your immunisation programme. Don’t be scared, it’s just a sharp scratch remember!

Travel advice is not just about immunisations. We also can advise you on medication to help prevent malaria when indicated and issue prescriptions to you.  We are happy to give general hints and tips on how to keep yourself safe and well.

Contact the clinic and make an appointment to see myself and or Laila. We will look forward to advising you and hearing all about your summer plans!

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Make Sure You Protect Yourself!

Make Sure You Protect Yourself!

Whilst we haven’t seen very much of the sun so far this year, summer is approaching and lots of us will soon be travelling to spend some time soaking up the sun as we relax on the beach. Whilst this does give us a boost of vitamin D, it also exposes us to the harmful effects of ultraviolet rays. We all like the healthy glow of a sun kissed tan, but are we putting ourselves at risk?

In the UK, the most common cancer is skin cancer. Thankfully the majority of these are the less worrying benign skin cancers, but we mustn’t forget the more concerning malignant melanoma. Whilst melanoma is the least common type of skin cancer it is by far the most serious as it can spread to other organs in the body.

Each year we are seeing up to 10,000 new cases in the UK, and the major risk factor is sun damage.

To try and prevent melanoma, we therefore must all take precautions and prevent excessive exposure to the sun. I’m sure everyone remembers the ‘Slip, Slop, Slap’ campaign, but to remind us some tips to help include;

  • Wearing sun cream with a high SPF – remember to reapply regularly.
  • Covering up when out in the sunshine.
  • Avoiding the sun between 11am and 3pm.

If you have a mole that you are concerned about, it is important to book an appointment and have it checked as soon as possible. The earlier sun damage is detected, the more successful treatment can be.

Worrying signs to look out for which could suggest melanoma include;

  • Irregular edge without symmetry
  • Irregular colour – A health mole is usually one shade
  • Increasing in size
  • Itching
  • Bleeding
  • Crusting

You may want to have your moles photographed so you can monitor change – we are happy to refer you for this.

Remember the tips above and enjoy the sunshine…safely!

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The Pollen Season is Here!

The Pollen Season is Here!

I’ve certainly noticed that I’ve started to get the usual symptoms of a runny nose and itchy eyes every time I leave the house. Does this mean that summer is finally around the corner?

The plants and trees around us are all prolifically producing pollens right now. Whilst this is great for the other plant and trees around them, it’s not so good for those of us who are allergic.

If you suffer from hay fever, this means that your immune system is fighting against the pollen. The immune response triggers inflammation in the nose, eyes and throat, resulting in the uncomfortable hay fever symptoms.

We are usually able to diagnose hay fever from the symptoms alone. Pollen allergy can also be confirmed by allergy testing.

Sadly as pollen is all around us, it’s not something that we can choose to ignore. We can try to stay indoors, keep our windows closed and avoid grassy areas, but I certainly don’t want to spend my summer months trapped inside!

Luckily there are a number of treatments that can be prescribed to help your symptoms. These include eye drops, nasal sprays and tablets. If your symptoms are particularly severe, Specialists can organise desensitization therapy.

If you have any questions or concerns about hay fever, and want help with your symptoms, book an appointment with Laila or myself and we’ll be happy to help.

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