Soda, Donuts, Meat May Increase Colon Cancer

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Yes, Soda, Donuts, Meat May Increase Colon Cancer according two large studies.


Just last week our family lost a relative to cancer of the colon at 53 years of age. She never had any major illnesses till she complained nausea and vomiting after eating and feeling bloated. After seeing a physician she diagnosed to have stage 4 colon cancer after undergoing a CAT scan of her abdomen.

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a Stages of Colon Cancer

The colon or the large intestine is the part the stores waste products of digestion before evacuation and were water is absorbed from food. A recent two major studies have shown that drinking sugar loaded drinks, eating white bread and red meat may increase the risk of developing colon cancer.


These food are known to increase inflammation in your body and increases the chance of developing colon cancer. These foods irritate the lining of the colon and tend to stay longer in the colon (more constipating) because they are low on  fiber.


Dr. Edward Giovannuci, researcher and professor of nutrition and epidemiology at Harvard T.H. Chan School of Public Health in Boston, said “Basically what makes a healthy diet overall promotes a cancer-free colon.”


For years there been a known association of diet and colon cancer.  In an old study it showed that Japanese immigrants to the in this US compared with those who live in Japan had a significant higher incidence of colon and rectal cancer, and those Japanese that were born and raise in the US had 40-50% higher colon cancer. They noted that in Japan their diet consisted more of  rice, fish and vegetables and when they migrated to the US they adopted to the American with more red meat, high sugar and white bread.


According to Giovannucci and fellow researchers the inflammatory effects of certain foods people eat is one way that colon cancer risk is increased.


More and more research have shown that the chronic inflammatory effects of certain foods promotes or causes many disease processes in the body. It is not just cancer even heart disease, strokes, arthritis, immune disease and many other maybe the result of the negative effects of food causing chronic inflammation.


Studies were done on data gathered on 121,000 individuals in two studies – the Health Professionals Follow-up Studies and the Nurses’ Health studies. In both groups subjects were followed-up for a quarter century to track things that may influence their health.


The participants were made to fill out a food questionnaires every four years. This helped the researchers determine the dietary inflammation score on each individual.


During the course of the study 2,699 of the group develop colorectal cancer. The researchers compared the foods these subjects ate to those who did not develop that cancer. I showed that those who ate the most inflammatory foods  were 30% more likely to develop colon cancer and 70% more to develop rectal cancer.


According to Giovannucci, “processed meat (sausages, salami), red meat, refine floor (white flour) and sugary drinks were linked most to cancer related inflammation.” On the other hand he noted, “green leafy vegetables, dark yellow vegetables, whole grains and fruit juices reduced inflammation.”


Inflammation seems to be the new buzzword medicine. Dr. Brent Bauer, editorial Board member of Mayo Clinic Health Letter, says inflammatory foods play a role in many chronic diseases such cardiovascular disease, autoimmune diseases like rheumatoid arthritis, asthma, inflammatory bowel disease ulcerative colitis and Crohn’s disease. The possible connection of gum disease with cardiovascular disease, clogged arteries, stroke and bacterial endocarditis.


I recall one of my son-in-law requested a friend to drive him and his family to the airport, on the way back the friend decided to fill his car with gas. She pulled in to the gas station filled up the tank. She was barely able to get home because the car slowed down lucky for her it finally stop when she got home. When my son-in-law came back he had the car towed to the mechanic who discovered that instead of gasoline, diesel was in the tank. It cost him about $900 to fix the damage. It would have been cheaper to ride a taxi.


What does all mean to us? Obviously wrongful eating habits don’t have an immediate impact like putting diesel in gasoline engine but as one gets older many of the diseases resulting from it may cause disability and even early death. Remember that colon and rectal cancer are slow-growing and could be cured in it early stages so in yearly check up with your physician discuss it with your provider and also make some changes now.


The suggested healthy foods based on the Mediterranean diet:

  • Eating generous amounts of fresh fruits and vegetables
  • Consuming healthy fats, such as olive oil and canola oil
  • Eating small portions of nuts
  • Consuming very little or no red meat


In general adopt a plant-based diet and avoiding manufactured foods with all the preservatives, sugar, salt and other chemicals which is not healthy for you. Remember your body is more valuable and more complex than your car, feed it with premium food for optimal function so as you get old like some of us, you won’t have to be pre-occupied dealing and talking about aches and pains and other health problems. Bon appetite.


Laurence T. Gayao, MD

Total Fitness Medicine, Founder

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Who are Psychopaths

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Lately you may have heard more frequently mentioned in the media the word psychopath. I just did, listening to Human Kind, National Public Radio this morning while driving to work.  When we hear about psychopaths what comes to mind are characters in movie Texas Chain Saw Massacre and lately the just released movie Revenge in Kind, that portrays some kind of a crazed killer. In real life most psychopaths are not murderers. So who are pyschopaths?

At one time or another we have to deal with people have no trouble causing hurt to others. They may be trolls in social media who don’t care wither they cause grief on others or a boss at work at work who tries to demean those around him, and don’t to care for rules in order to get ahead. This article is to give light that there are people that are wired abnormally, so we could understand them and don’t lose sleep or waste emotional resources being hurt by them and try to avoid them because of their shenanigans. We learn to empathize with their problems and learn to deal with them.

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1 out of 100 is a psychopath

The fact is, many psycopaths blend in with the crowd appear like rest of us. They are usually not these wild eyed crazy individuals ready to kill at the drop of the hat. Findings in research suggests there is about 1 percent of the population that meets the characteristics of psychopathy. That could be your neighbor, you co-worker, friend or social media contact. The percentage is even higher among leaders, doctors, lawyers, politicians, executives, the number goes as high 2 to 4 times the general population.


Fortunately psychopathy has been has been studied by psychologists for years and have come up with cluster of traits the that would help us spot them to avoid being their victims. Knowing to identify them helps us in how to deal with them and understand why they think that way.


Psychologist have tend to agree the psychopaths exhibits three clusters of personality characteristics they refer to as the Dark Triad. These are Machiavellianism, lack of conscience or empathy and narcissism.


  1. Machiavellianism

Machiavellianism in psychology refers to “a personality trait which sees a person so focused on their own interests they will manipulate, deceive, and exploit others to achieve their goals.” The ends justifies the means, the priority is winning, money and power. They would disregard moral and social rules to achieve their goals. They would cheat, step on others, destroy relationship or manipulate them to get what they want without much guilt. They could be successful leaders by being able to reach their expected goals no matter what the cost may be. These group of people are master manipulators using flattery, deception, bullying and inducing guilt trips to coerce people to do what they want.


They could be very charming and appear interested in your welfare or empathetic to your problem to be able to influence you to do their bidding. They could even use sex as tool of influence individuals. In other words these people have no guilt using whatever means to accomplish their goals. Dictators like Hitler, Stalin, not to mention some of our politician and  others were and are masters of deception and manipulation of people.


  1. Lack of Conscience and Empathy

Conscience is defined as “an inner feeling or voice viewed as acting as a guide to the rightness or wrongness of one’s behavior.” It is that feeling or voice that gives us a moral compass. Among psychopaths this is either absent or very weak. In fact they if you don’t have it you are psychopath if you have a little of it you are sociopath. This results in them having no feeling of empathy, sympathy, pity, guilt, shame or remorse.


Often times people cross us and we feel like punching them in the nose or even killing them, but we never actually do it because there is that feeling or voice inside us that tells us it is not right to do so. The in general psychopaths however don’t have that thing to stop them, if want to do it they’ll do it without regard to the consequences.


These group of people we often refer to as short-tempered, easily agitated, prone to violence or aggression, impulsive and have many casual sex partners. The sex  partners are  just meant for self-satisfaction, with no thought of any long-term commitment, after they gotten what they want it’s over. They act on the impulse of the moment, with no self-control.


  1. Narcissism

The term narcissism originated from Greek mythology, where the young Narcissus fell in love with his own image reflected in a pool of water. Psychologist uses narcissism to call personality type of someone with extreme selfishness, with a grandiose view of one’s own talents and a craving for admiration.


These are very self-centered people, with an inflated sense of their own importance and worth. They are vain and see themselves as perfect and thinks others are dumb to assure themselves as being superior.


They are sensitive to insults and love to complimented and be placed on a pedestal. They lavishly praise those who speak well of them. When insulted they are quick to anger and retribution. To get along with them, don’t threaten their self-esteem. To them there is no such thing as constructive criticisms one coming from them. They often seek position of authority so they could control others and have the last say, and be able to mete out consequences should one cross their path. They never blames themselves for what goes wrong, it’s always the others fault, be it the opponents, subordinates or co-workers. Some else is to be at fault but him.



Another aspect research have revealed about many psychopaths is about their dysfunctional upbringing. Studies by Aina Gullhaugen and her team from the Norwegian University of Science and Technology on psychopaths in Norway she said, ”More than half of the psychopaths I have studied reported that they had been exposed to a parenting style that could be placed on either extreme of scales of physical abuse. Either they lived in a situation where no one cared, where the child is subjected to total control and must be submissive, or the child has been subjected to a neglectful parenting style.” Understanding these issues help reduce the stigmatization of the problem and provides a starting point for treatment.

Is someone in your life a psychopath? Chances are if you have, they would not admit having it even after reading this blog because they’ll accuse you of the one having the problem. I hope that by understanding this psychological disorder would have us better identify and understand people with this problem and avoid being their victims and learn to live with them by knowing how to best handle and relate to them.


Laurence T. Gayao, MD


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Research Suggests Diabetes Could be Classified Five Separate Disease Groups

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Research Suggests Diabetes Could be Classified Five Separate Disease Groups

Laurence T. Gayao MD

Uncontrolled blood sugar levels or diabetes affects about one in nine in the US population- they are labeled either type I or type 2 diabetics. Of those who have diabetes about 23% of them don’t know they have it. Over third of the US population are pre-diabetics.

The health problems resulting from diabetes are not immediate and changes could occur over time and often times it is only diagnosed because of the resulting complications. We of course know that diabetes increases the risk of heart attack, stroke, kidney failure and limb amputation.

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Insulin dependent diabetic
Today we classify diabetes as type I and type II.

Type I diabetes: This is an immune disease were the antibodies attach the cells (beta cells in pancreas) that produce the bodies insulin, so there is not enough insulin to control the sugar levels.

Type II diabetes: This largely disease that is largely a result of a poor life style where there is a buildup of disproportionately larger amount of body fat that affect the way insulin works, called insulin resistance.


Five Clusters of Diabetes
A study however published in The Lancet Diabetes and Endocrinology of a study done by Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine in Finland on 14,775 patients showed the diabetic could be separated in five clusters.
  • Cluster 1– those who have severe autoimmune diabetes. These are the same as the type I diabetics who when they were young and healthy had their beta cells attacked by their own wayward antibodies thus unable to produce insulin.
  • Cluster 2 – Were severely insulin deficient similar to those in cluster 1 but it was not their immune system that was at fault or causing the problem.
  • Cluster 3 – These were generally overweight and had severe insulin-resistance. They were making adequate insulin but no longer responding to it.
  • Cluster 4 – Mild diabetes seen in very overweight people but they metabolically closer to normal than cluster 3.
  • Cluster 5 – Mild age related-diabetes, develop symptoms when they are much older than other groups and have a milder in form.


With New Classification More Precision in Treatment

Classifying them into these clusters would give physicians for more precision in tailoring their treatment approach. “The five clusters found had different characteristics, with different complications, and called for different treatment needs,” according to the researchers. For example the cluster 2 patients have a higher risk of blindness and cluster 3 patients had higher risk of kidney failure.

According to Dr. Victoria Salem a clinical scientist and consultant at the Imperial College of London the use of type I and type II diabetes classification is not terribly an accurate system. Using the five clusters of the to classify diabetes is the future on how we think of the disease. Don’t be surprise if changes in the treatment of diabetes may not change  until more studies are done to develop better therapeutic protocols based on the 5 cluster classification.



For details on the research study click: Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables, The Lancet Diabetes and Endocrinology


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Fat Not a Dirty Word

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Fat has a important body function.

Laurence T. Gayao, MD

Yes, fat not a dirty word at all, however now a days the word fat has a rather a negative connotation. That was not so during my younger years growing up in the Philippines, being fat then had a more positive flare to it. It meant you were healthy, that you were financial well of to afford all that good food and you did not have to do all that hard physical labor.

During that time you would hear often people say to each other, “You’re looking good, getting fat, life must great!” and that would be taken as a compliment. Now a days it would not be cool to tell to someone he or she is fat unless want to be get slapped in the face. Don’t we often at times say the phrase with disgust, “Ugh, I am so fat.” These days being fat often implies some sort of a stigma, of one who lacks self-control, has lack of knowledge or a slob.


Obesity On the Rise World Wide

I am sure you have heard reports in the media that researchers have found that over the past 33 years, worldwide overweight and obesity rates among adults have increased by 27.5%, while such rates among children and adolescents have increased by 47.1%. We know that with obesity increase there has been also a proportional increase in:

  • Coronary heart disease
  • Type 2 diabetes
  • High blood pressure
  • Strokes
  • certain types of cancers


Fat in the Body- Not a Dirty Word

First of all let me emphasize,  fat is essential for good body function, in fact is a body organ. Now, let us talk about fat. You may be surprised to know that there are two distinct groups of fat tissues: White and brown fat tissues. Both of these groups of tissues are important for good body function. They secrete important hormones and substances that affect our immune system function store and burn energy. Depending on the amount of white fat tissue one has would affect ones health in a positive or negative way.


White Fat

 White fat tissue also known a white adipose tissue (WAT) is the principal energy storage for humans. Whatever extra calories you take is stored in these tissues and when the energy needs could not be provided for by the body the store calories are mobilize. This was important for our ancestors who had to survive in feast or famine conditions. During times when food was abundant they gained weight and when food was lean they used the stored calories to insure their survival.

WAT is found under the skin and around internal organs. Too much of this tissue would result in hormonal imbalance, affect the immune system causing inflammatory changes, insulin resistance causing type 2 diabetes, coronary heart disease, strokes, certain types of cancers. Over weight also is a strain to weight bearing joints causing arthritis.

Your waist circumference is a good measure the amount of WAT one has but this has may vary with sex and ethnicity.  A healthy body fat percentage for females 15-30% of body weight and for males 15-25%.


Methods to measure body fat:
  1. Skin Calipers to measure the fat thickness.
  2. Bioelectrical Impedance. …
  3. Hydrostatic Weighing. …
  4. DEXA (Dual-Energy X-Ray Absorptiometry) …
  5. Air-Displacement Plethysmography. …
  6. 3D Body Scan.


Brown Fat

Brown fat or brown adipose tissue (BAT) is derived from muscles. These tissues are made up of cells which are the power house for energy in the body, where calories are burned. They are full of mitochondria that were the energy were the food is processed to produced and giving it the brown color. This fat cells help you maintain a healthy weight and also keeps you warm.


At birth we have a higher number BAT but this declines with age which explains why as one gets older it is harder to maintain one’s weight and why some individuals manage to maintain a healthy weight in their life time. Some of us may be lucky because of our genetics we have an abundance of BAT.


How Activate Brown Cells
  1. Cold temperatures activate brown fat

“In one study, Swedish researchers scanned five subjects after they’d spent two hours at temperatures ranging from 63°F to 66°F, it boosted their brown-fat activity 15-fold. Cold temperatures send a signal to your brain, which then acts to stimulate brown fat activity in two ways: by acting on your vascular system directly to increase blood flow to your brown fat stores and by sending nerve impulses to brown fat cells that stimulate am additional boost in cellular activity.


  1. Eat more apples—with the peel on

Ursolic acid—a substance that occurs in high concentrations in apple peels—increases brown fat and muscle mass, while at the same time reducing obesity and improving glucose tolerance. Other foods that contain ursolic acid include cranberries, blueberries, plums, and prunes, as well as the herbs oregano, thyme, lavender, holy basil, bilberry, devil’s claw, peppermint leaves, periwinkle, and hawthorn. Animal studies have also found that the herb bitter melon appears to increase brown fact activity.”

  1. Regular Exercise

 The same Swedish research team also feed a group of mice that resulted in making them overweight and having high blood sugar. They then injected these rats a daily dose of kynurenic  acid to break down kynurenine and they continued to be feed a high fat diet. Exercise result in muscle producing and enzyme the converts Kynurenene to kynurenic acid.

Despite of no change in their diet this group of mice lost weight and their glucose (sugar) tolerance improved. They think it is possible that kynurenic acid activate brown fat to boost metabolism and lower blood sugar levels.

How to Maintain a Healthy Weight

We are all different from each other as to the best way to maintain a healthy weight but in general follow these simple rules:

  • Regular and adequate sleep
  • Avoid stress or learning to deal with stress
  • Exercise regularly
  • Avoid sedentary activity
  • Avoid under and over eating
  • Maintain a healthy plant base diet
  • Taking the right amount of calories
  • Avoid manufactured food

It is important to set goals and to have a buddy or a group to help and motivate you to attain your goals if you have experience difficulty in doing it alone.

My Personal Program

Personally, I had to change my eating habits from when I was working regularly in hospitals. There was almost no limit to free food for physicians working in the emergency department and they were not the healthy kind. Now, I usually take a vegetable fruit shake in morning and afternoon and a regular noon meal. Doing this has cut down on time for food preparation and cleaning up the mess in the kitchen so my wife and I have more free time for other things. We noticed too that this has resulted in better sleep and more time and energy to exercise.

How do I stay motivated? In spite of all my health set-backs in the past, the simple answer is: I love and enjoy life and I would like to do all I can to stay healthy, happy and share what knowledge I gained to feel the same way. Remember, the grave is not our goal, keeping in shape is.







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How Exercise Eases Depression

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Exercise in the comfort of your home while watching TV

Laurence T. Gayao MD

For a long time people have observed that regular exercise helps them feel good and helped burn fat even before scientific studies were done that showed how exercise eases depression. We know that depression is a mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life and in extreme cases leads to drug abuse, alcoholism and  suicide.

I am sure you may have heard it said that depression is caused by a chemical imbalance in the brain. Lately several studies have shown that regular exercise helps individuals with depression and anxiety. The researchers from Karolinska Institutet in Sweden went on further and did a study in 2014 that found the molecular explanation to how exercise helps in depression and fat burning.


Chemical Changes Resulting from Exercise Eases Depression

The Swedish research team showed that when muscles works during exercise they produce an enzyme that breaks down the substance kynurenine. The substance Kynurenine is present in high levels in the blood of people with anxiety, depression and other mental disorders.

This enzyme acts on kynurenine to convert it to kynurenic acid, a substance that does not cross the blood brain barrier, so it is not able to enter the brain. This in turn protects the brain from the stress-induce changes that occurs in depression due high levels of kynurenine.


Exercise Effects on Obesity

The the same Swedish research team also feed a group of mice high fat diet that resulted in making them overweight and develop high blood sugar. They then injected these mice a daily dose of kynurenic  acid while they still continued to feed them a high fat diet.

Despite of no change in their diet this group of mice lost weight and their glucose (sugar) tolerance improved. They think it is possible that kynurenic acid helps converts white fat to brown fat which can boost metabolism and lower blood sugar levels.

There are two kinds of fat, white and brown fat. White fat stores extra calories we eat which causes us to gain weight, while the brown fat burns the calories we eat converting it to energy for the body to use. The brown fat is muscle fat, while white fat is the fat underneath our skin and internal organs.  Both of them are useful the only problem is if you have too much of the white fat it causes type 2 diabetes, heart disease, hypertension, strokes and certain types of cancer.

Obesity is progressively getting to be a greater problem worldwide resulting in the increase in type 2 diabetes, high blood pressure, strokes, heart problem. The findings in this research may provide better understanding of depression and obesity that are both helped by increasing the amount of exercise and this may lead to more effective treatment approaches.


Sound Mind, Sound Body

Jorge Ruas the lead Swedish researcher said, “ We’ve linked the two parts of the expression, ‘sound mind, sound body.’ Our research adds to the understanding of why exercise training benefits the body and, in the long run, can lead to the development of new treatment of obesity and diabetes.”

Currently treatment of both depression and type 2 diabetes are rather challenging, relies heavily on the use of pharmaceuticals which have a lot of side effects and not consistently effective. Proper exercise you have for free and with no side effects should be certainly be a welcome alternative or in addition to medications for these problems.


How To Exercise With Minimal Expense

Exercise need not be in a gym, it could be brisk walking outdoors or low impact aerobics activities at home on a regular basis. Two years ago I and my wife started working out in a gym but after a year of paying the monthly fees and having to drive to gym we decided to workout at home with a set of weights and staircase exercise machine. We do this at least five times a week.  It helps when you do it together because you are able periodically remind and motivate each other to stick to the program. We exercise in front of our television so the routine does not get boring and time flies faster.


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Alcohol Damages Stem Cells Causing Cancer

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Alcohol has been known to cause many health and society problems, but you seldom hear that alcohol damages stem cells causing cancer.

Ever since men started keeping records our ancestors have been known to have used alcohol. Researchers says that our human ancestors discovered it by ingesting rotting and fermented fruits that fell of the forest floor gave them  buzz effect of alcohol. As time went on they learned to ferment and refined alcohol as a beverage.

Everyone is aware of the addicting effects of alcohol and devastating effects of alcoholism. What is often overlooked is that alcohol is known to raise the risk of no fewer than seven types of cancer. These are mouth, upper throat (pharynx), voice box (laryngeal), esophageal, breast, liver, and bowel cancer.

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How alcohol causes cancers

How alcohol induces these cancers is not well understood. A new study looking at blood stem cells uncovered fresh details surrounding the mechanisms by which alcohol raises the risk of developing cancer. Animal studies done at MRC Laboratory of Molecular Biology in Cambridge, United Kingdom gave a clearer picture of the alcohol-cancer relationship.

Alcohol when ingested is converted into the chemical acetaldehyde by bacteria when it gets to the gut. Acetaldehyde is know in previous studies to cause cancer in animals. Following the analysis researchers found that acetaldehyde could, in fact, damage and break DNA within blood stem cells. Chromosomes became rearranged, and the DNA sequence is permanently changed in stem cells. As result of damage of these stem cell some of them develop into cancers cells.

Our bodies have a protective mechanism in the form of an enzyme aldehyde dehydrogenases (ALDHs) which breaks down some of the acetaldehyde to down to acetate which the body uses to produce energy and store as fat. Acetate is the same chemical found in vinegar. Alcoholics have been found to be more efficient in converting acetate to energy that makes them feel better after drinking alcohol.

Millions of people however have low levels ALDHs or have defective ALDHs so they are not able to breakdown acetaldehyde to the non-harmful form acetate. Many East Asians fall into this group. They usually get flushed cheeks and feel ill after ingesting alcohol. These group of people have even greater risk to develop cancer from alcohol ingestion.

No type of alcohol is better or worse than another, because it is the alcohol itself that leads to the damage, regardless of whether it is from wine, beer or spirits. The lesser you use alcohol the lesser you risk of developing cancer. Whether you are binge drinker or a regular drinker the risk is the same. If one smokes and drinks, there is a greater risk of mouth and throat cancers be cause alcohol as a solvent cause more to the carcinogens from tobacco to be absorbed.

Other than alcohol causing several types of cancers all of us are aware that chronic abuse results in many health issues, cost of missed work, cost of care from disability from accidents and premature death.

Laurence T. Gayao, MD, Total Fitness Medicine








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New Year’s Resolution – Get Enough Sleep

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New year’s resolution- Get enough sleep? Yes, getting the right amount of sleep is just as important as good healthy diet and a regular fitness routine for a healthy body. For a good number of years, I took getting adequate sleep for granted because of my job as an emergency room physician. My work would require me to switch for days to nights and vise-versa on an irregular pattern. Looking back, I would say my health problems are related to over forty years sleep deprivation. Honestly, during that period I did not know much about the importance of adequate sleep. Being young one feels invincible in fact I often hear fellow workers say with macho pride, “I get by with five hours of sleep.”

I am surprised by a study in the British  Journal of Cardiology that report that the average life span of emergency physicians is only 57.5 years that is about 14 years lower that the average lifespan of physicians in general which is 73 years.

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Emergency physicians average lifespan 57.5 years

According to the Center Disease Control and Prevention (CDC) about 35% of people are sleep deprived and they also report about the same amount people are obese. This connection may not be just coincidence. To stay healthy one has to eat less and move or exercise more. When one is sleep deprived one tends to eat more and exercise less. One may be accused of being lazy, having lack of will power or has just has a genetic trait causing their obesity, when the culprit all along is sleep deprivation.

Sleeping less than seven hours a night could negate the benefits of good diet and exercise according to a research published in the Annals of Internal Medicine and that insufficient sleep in it self may contribute to obesity. Many of us  believes that hunger is related to will power and learning to control the cravings of our stomachs, but that is not true. Two hormones control our appetites: leptin and ghrelin. The lesser leptin you produce the more hungry you get, on the other hand the more ghrelin you produce the more hungry you get. Sleep deprivation lowers your leptin level and increases your ghrelin level making it really hard to lose weight. A hormone called cortisol also increases your appetite; this too is increases with loss of sleep. If you’re sleep deprived even after a good meal you may still feel hungry.

Matthew Walker in his book “Why Sleep” says one really can’t get by with six to seven hours of sleep at night, we need an average of eight hours a night. Experts recommends going to sleep and waking up at the same time every night and avoiding TVs, computers or cell phones at least half an hour before bedtime. For more sleeping tips: click 10 tips

Health dangers of sleep deprivation:
  • Increase risk of developing type II diabetes
  • Cardiovascular disease and hypertension.
  • Diminished immune function
  • Mood disorder
  • Memory problems
  • Judgment and Safety

Type II Diabetes

Increase risk for type II diabetes is associated  obesity especially with  with people who slept 5 hours or less a night. This group was found to have insulin resistance; fortunately improved sleep positively influences blood sugar control.

Cardiovascular Disease and Hypertension

Studies showed that even moderately reduced sleep six-seven hours a night greatly increase the risk of coronary heart disease (calcium build up  in the arteries) which causes heart attack, hypertension, strokes and irregular heart beat. Studies also have shown that sleep deprivation due sleep apnea leads to the same problems. Dr. Amneet Sandhu reported his study in 2014 at the American College of Cardiology that the Monday after day light saving time there was a 25% increase in heart attacks compared to other Mondays of the year and a 21% drop on the Monday after the clock was put back to standard time.


Diminished Immune Function

Many studies have shown effects of sleep deprivation ability to fight infection. In a recent study showed that people who slept less than seven hours a night were three times more to get common cold symptoms when exposed to cold-causing rhinovirus in volunteers compare to those who slept 8 hours.

Mood Disorder

Everybody knows that poor and inadequate sleep causes irritability and stress. Chronic insomnia (lack of sleep) may cause psychological problems such as depression and anxiety. People who have depression and anxiety disorders have trouble sleeping as part of those disorders. Studies have shown that people who have insomnia had five times more problems with depression compared to those who did not have insomnia.

Memory Problems

Inadequate sleep appears to affect the brain’s ability to consolidate factual information and procedural memory. Studies have shown that only 11 percent of students sleep well, 40 percent feel well rested 2 nights a week. Memory consolidation occurs in sleep immediately following the lesson. Learning involves three processes: acquisition, consolidation and recall.

A recent study came out summer 2017 that showed in sleep deprived individuals had higher levels proteins associated with Alzheimer’s and dementia of the brain.

Judgment and Safety

Did you know that one sleepless night can impair your performance as much as blood alcohol level of 0.10 percent which is considered beyond the legal limit to drive. I still recall those times coming home from work from long night duties when I would transiently black out and be awaken hitting the curve or the gravel at the side of the road. I guess I must have been lucky or someone much has been watching over me, to not have had any serious or fatal car accidents. Institute of Medicine estimates that drowsy driving is responsible for 20 percent of vehicle crushes. That would mean 1 million crushes, 500,000 injuries and 8,000 deaths each year in the US. Thank God I am not part of that statistic.

Studies done on errors committed by medical intern physicians in the care of ICU patients, one-quarter of those errors were attributed to their  being sleep deprived due to extreme work schedule. Given that medical errors causes about 100,000 deaths a year in the US, sleep deprivation at work by nurses and doctors is considered major health issue. Staying awake for 17 to 24 hours and working or driving is like doing it under the influence of alcohol.

To add it all up, “Chronic lack of adequate sleep over time is with a shortened lifespan.”

Laurence T. Gayao MD, Total Fitness Medicine






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What are Your New Year Health and Fitness Goals

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Laurence T. Gayao MD

Happy New Years to the Total Fitness Medicine Facebook Group and my blog subscribers. I am sure you are enjoying the Holidays and hope you had good year and look forward in anticipation what the coming year brings to your life. What are Your New Year Health and Fitness Goals?


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Laurence T. Gayao MD working on this blog.

Thank you, for being part of this journey with me to help each other live healthy and happier lives. It’s hard to believe I have been blogging for the last 4 years sharing what I have learned to enhance our not only our health but also our lives as whole. It has been satisfying for me getting positive feedback from many of you. I was even surprised that some of medical colleagues are following my blog. I remember I was in job interview when the physician commended me for doing the blog. Although I finance from my own pocket the expense of website hosting and the plugins, I have been more than compensated from the many testimonials from many of you on how my blog have helped you and the knowledge you’ve gained.

With the advent of the internet there is no shortage of health and medical advice out there, and frequently I would run across people asking about the veracity of information they have read from some of them.  According to a study if you use google about only 43% of websites give accurate information. The most accurate websites are the government sponsored and has about 80% accuracy. The least accurate websites are blogs which sadly is only 40% reliable.

In regards to my blog my background being a physician has been a valuable asset and with some knowledge in statistical analysis, these has helped me in getting as accurate information as possible. I am also not sponsored by any organization promoting their products. After reading many research studies I found that many of them are sponsored by industries that benefit from results that were reported. There are obvious biases built into many of these studies.

If you are going to search for medical advice on Google, double-check the sources’ validity before acting on the advice. Websites ending in .gov or .org or .state are accurate and reputable sources. Websites of medical institutions like universities and large national medical organization like American Diabetic Association, American Heart Association, American Cancer Society to name a few are more reliable.

It rather is interesting that people will often set goals for themselves in the areas of Career money, weight, personal development, houses, cars and clothes. But people very seldom set goals for exactly how long they want to live and what standard of health they want to enjoy throughout their lives. They sort of take the whole issue of health and longevity for granted. The goal of the Total Fitness Medicine blog is bring to your attention that health and fitness is of paramount importance and if you don’t have these two the rest of the things you work for would be worth nothing. 

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A lot of TLC to have that many miles

The other day a friend posted the odometer reading of his Toyota Camry Car with 437,300 miles, the picture of the car’s body appeared to be still in good shape. He mentioned that he did his own maintenance on the car. To have a car last that long one has to really care for it well. It sad to say, most of us go through life taking our bodies for granted, which results in premature deterioration and demise. One would not place diesel in gasoline car or vise-versa but many of us don’t take in account what eat or drink. The body breaks down for luck of exercise or lack of sleep. It is time to set some short and long-term goals for your health and fitness this new year. Invest time, effort and get assistance from experts to achieve your goals. Approach it in a systematic fashion with specific benchmarks  and if you keep it up I am sure it will pay off big time in the long run in terms of health and well being.

Here are a few examples of goals you may adopt:

  • Losing Weight
  • Sticking to a Workout Regimen
  • Increasing Strength and Stamina
  • Increase Flexibility and balance
  • Sticking to Dietary Regimen
  • Improve Cardiovascular Health
  • Partner with a buddy to motivate each other or with a personal trainer

The knowledge I share with you readers are just like tools to help you develop a healthy lifestyle. Like other tools they do you no good unless you use them. If you have underlying health problems remember that the right food may be one of the best medicines for you especially supplemented a good physical exercise program (ask your doctor for advice).

As we usher the coming year let us step up a notch on our personal health fitness program and share with relatives and friends the knowledge you’ve learned and the benefits that you’ve gained.

What ever you health and fitness goals are for the New Year I would suggest the mantra: It does’t have to be perfect but is should be my best.

Total Fitness Medicine wishes you not only a Happy New Year but also healthier and fitter you.

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Leafy Vegetables Each Day May Keep Dementia At Bay

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Laurence T. Gayao, MD

Because of my work as a physician I interact with a lot of elderly folks and through years I have observed a great amount of variance in mental function with in this age group. I have seen patients in their fifties who have lost cognitive function and are fully dependent on nursing care on the other hand others in their nineties with full cognitive function and living independently. Well a study has shown that eating leafy vegetable each day may keep dementia at bay.

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Dementia: memory and cognitive dysfunction

Among the changes that occurs with aging, dementia (decline in memory and cognitive function) is the most feared. It does not matter how successful or how much money you have earned in life once you lose your mental function it is always a tragic situation.

So far there is no known cure or effective treatment for senile dementia once it has set in. The good news is there may be a way to keep it at bay. A study has showed that eating one or two servings of green leafy vegetables such as kale, lettuce or spinach slowed the cognitive decline. At the end of the studies those who eat that much and more vegetables showed their cognitive function was similar to those who were eleven years younger.

The study involved 960 individuals between the ages 55-99, average age 81 years. They where given questionnaires on how often they eat certain foods the over the period of 4.7 years.  The researchers estimated the nutrients each of them consumed based on their answers.

At the start of the study participants were tested for memory and cognitive function. This was repeated annually for over 10 years.

There was a significant difference in participants who ate 1.3 servings of leafy vegetables compared to those who ate lesser. The researcher found that the memory and cognitive functions of those who ate that 1.3 servings and more vegetables was comparable to those 11 years younger.  This study was done at Rush University and Tuft University.

Dr. Martha Clare Morris, lead author of the study and author of the new book “Diet for the Mind,” said: “The findings suggest this benefit is likely from important nutrients found in these vegetables, such as folate, lutein and nitrate which were also associated with slower mental decline.” The association of greens was strongest with those rich in phylloquinone, lutein, a-tocopherol, nitrate and kaempferol.

Green leafy vegetables are rich in antioxidant nutrients that protect against inflammation and stress causing damage to the brain as been shown in previous studies.

Dr. James Pickett, head of research at Alzheimer’s Society, said: “It’s not secret that eating vegetables is good for your health. This study found that eating food rich in vitamin K – like spinach, kale, asparagus and everyone’s favorite, Brussel sprout – appears to slow cognitive decline as people age.”

The over all beneficial effects of a healthy diet are, it keeps the arteries clean, reduces the risk of type 2 diabetes, good for the heart and all these are good for the brain. Leafy greens not only rich in nutrients but are also low in fats, sugars, salts and have a high in fiber content.

Other things known to help maintain brain function are regular physical exercise, mentally stimulating activities, not smoking and avoidance of mind altering drugs such as alcohol, anticholinergics (like Benadryl), regular sleeping habits, keeping positive attitude and many others.

Until a treatment or a cure is found for senile dementia, our best bet is to prevent it or delay the process. Don’t wait till you have memory or cognitive problems to do something about it most specially if you have a family history of early dementia.

Remember to be in control of your life, especially during your retirement years and enjoy the fruits of your labor a healthy mind is of prime importance. It has been well said, “The mind is a terrible thing to waste.”


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Moderate Loss of Weight in Overweight and Obese Women Decreases Risk for Breast Cancer

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Laurence T. Gayao, MD

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Overweight women increased for breast cancer risk

Studies have consistently shown that women who are overweight compared to women who maintain a normal weight have higher risk of developing breast cancer. New studies however shows that moderate loss of weight in overweight and obese women  decreases risk for breast cancer.


Who are considered overweight or obese women?  

To find out click if one is overweight or obese we use the BMI (body mass index) to calculate and if it is over 25 one is considered overweight, if it is higher than 30 one is considered obese. The higher the BMI the greater the risk; a BMI of >35 had 52%, BMI of >40 had 86% increased risk of developing cancer compared to women with BMI of <25.


Overweight and Obesity Linked to Cancers

The higher risk breast cancer in over weight women has been partially blamed to increase amount of fat cells. These fat cells produce estrogen so the more fat cells one has the higher the amount of estrogen released to the body. This would stimulate the positive hormone breast cancer receptors in the breast to develop cancer. It has also been noted that fat cells produce inflammatory substances that cause chronic inflammation in the body which can increase the risk of breast cancer and other forms of cancers. In fact there are 12 other cancers that are noted increased with overweight and obesity and according to the Centers of Disease Control and Prevention (CDC). Studies also have shown that 40% of cancers are associated with obesity.

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13 Cancers are associated with overweight and obesity

The progressively increasing amount of obesity in recent years is an alarming trend around the world. Today 66% of women are considered obese, thus they are at an increased risk for breast and other cancers.


Studies on Weight Loss and Reduction of Breast Cancer Risk

The good news is a new study reports that even just a loss of 5% body weight or on the average 10 lbs. among those overweight and obese women significantly reduces the risk of developing breast cancer compared to women who did not loss weight.

This research called the Women’s Health Initiative Observational Study (WHI) involved 161,608 postmenopausal women ages 50-79. None of these women had breast cancer when they joined the group. The object of the study was to find links between health, diet, and lifestyle factors and health problems such as cancer. Rowan Chlebowski, MD, PhD lead researcher wanted to find out if losing weight resulted in decrease risk of developing breast cancer.

During the 11.4 years of study 3,061 women got newly diagnosed breast cancer. They found that those who lost 5% body weight or more were 12% less likely to get breast cancer. Women who lost 15% or more weight were 37% less likely to develop breast cancer.


Prevention Is Better Than Treatment

It could not be over emphasized that “An ounce of prevention is better that a pound of cure.” This true especially in you’re talking about cancer. So if find yourself obese or overweight do something about it.

I know as one gets older losing weight is a lot more difficult, but with the right diet and exercise program it could be done. Consult you doctor, health couch or a fitness trainer to create program tailored for you and to follow-up your progress.

For more information on breast cancer and diet to lose weight go to Breast Cancer Risk Factors: Being Overweight





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