Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
More on dieting, blood pressure and exercise. I mentioned
some of the particular problems in Israel: we eat a lot of
salads and vegetables which is a good thing; but we eat alot
of hydrogenated fats which is a bad thing. While in the USA
low fat is a selling point, this hasn't hit Israel as
strongly yet and won't likely until there is more consumer
pressure. Consider writing to Osem and other Israeli
companies.
In chutz la'aretz there is often a paucity of fresh
fruit in the winter and that which they do have is grown to
look well after traveling long distances even if it is
lacking in flavor. These countries are often more oriented
towards grain cereals which have their own problems.
In truth though, dieting results are dismal. People lack self
control. They "punish" food for tempting them by eating it.
They treat every day as a special day to "celebrate" by
eating sweets. They persist in traits learned as youngsters
such as making Mummy happy by finishing all that is on the
plate even if they are full.
If you are disciplined you will succeed, but most people are
not. I must say that new surgical techniques such as gastric
rings are quite impressive and they work to a degree. They
can be life-saving and I would consider them if you have
failed at dieting.
Drugs for dieting appear now and then. Many have been removed
from the market due to danger. Others work simply by
diuresis, that is by increasing elimination of water which in
truth doesn't lead to any permanent weight loss.
Vigorous exercise can help, but again you need self
discipline. I come from an exercise background so for me it
is easy. Remember, even using the steps instead of the
elevator is worthwhile. Losing weight can cure diabetes (type
II) and high blood pressure.
High blood pressure is usually without symptoms and can be
dangerous. It is a risk for heart attack and stroke. Don't
drive yourself crazy by having a machine in the house and
checking your pressure often; rather go to the doctor twice a
year. Medications here do help, and their effect on saving
lives has been documented.
There are different recommendations as to what medications
work depending on age, gender, and race. As of today, we
still target blood pressures to be lower than 140/90,
although the elderly often need higher blood pressure.
Drug treatment with high cholesterol is the most beneficial.
The statins lower risks of heart disease, Alzheimer's,
diabetes, stroke. They have few side effects.
For those naturalists among us, niacin does work. It is less
effective and causes flushing and bloating.
In all the above, remember that a program needs to be
tailored to your needs, lifestyle and personality. The key is
not to ignore these.
Assume that you are "pleasantly plump" or that your blood
pressure is up only because of the pressures of life. Work on
it, starting today. Write me in care of the Yated.
A message from Glaxo, sponsor of this column. It is
chicken pox season and Valtrex can make this disease easier
on parents and children. This potent anti-virus also works
for cold sores and can save the life of an infant with
suspected herpes infection. The days of nothing working in
viral infections are long over.
