Tag Archives: heart disease

Marriage Tax Pay Off: Living a Longer Life

You’ve probably heard of the “marriage tax.” It amounts to something like $10,000 per year if filing jointly instead of individually. But what Uncle Sam “taketh away,” you perhaps make up thanks to a healthier lifestyle.

A significant reduction in “lifestyle disease” among married couples is no huge surprise. One just has to consider, perhaps wistfully, your single life for a few seconds to make this clear. Single people tend to live life at the extremes. There typically is more drinking, smoking, not sleeping or eating right, and in general fast-lane living among the unattached. We might want to blame this on youthful exuberance, but we also see this behavior rediscovered in divorced middle-aged people. Married folks tend to moderate each other’s behavior and consequently the lifestyle diseases such as hypertension, diabetes and heart disease are significantly reduced.

All manner of traumatic death is also dramatically reduced in the married population. With a little more sleep, and less alcohol, motor vehicle fatalities are much lower among married people.

I gave up skydiving once I got married, perhaps saving me a violent end. Other violent deaths like suicide are also much lower. Depression, perhaps not coincidentally, is lower in people with a soul mate.

If cancer is one of your big fears in life, marriage is one of your best defenses. The lifestyle cancers attributed to smoking and drinking are all understandably reduced, most notably lung cancer.

Interestingly enough, the cancers having no obvious connection to any specific human behavior are similarly reduced in the married population.

Lymphoma, leukemia and pancreatic cancer are examples. In fact, the fatality rate from virtually any cancer you can name is lower among the married.

Most startling to me during my medical education was the lower death rate in married people goes across the vast spectrum of human disease and frailty. Pick the wildest thing you can think of – death by shark attack, getting hit by lightening – and you are less likely to die of that while you are married.

So let Uncle Sam take his cut, the pay off is married people have a better chance of living a longer, healthier life.

Take care.

Dr B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

Image courtesy of David Castillo/ FreeDigitalPhotos.net

The Proper Care and Feeding of Your Heart

Why should you invest a few precious heartbeats in learning something about your ticker?

Because of atherosclerosis and heart attacks – and because heart disease is still the No. 1 cause of death in this country.

Heart anatomyphoto © 2009 K Sandberg | more info (via: Wylio)

Most of us think the heart is the most important organ in your body. While this might spark a heated philosophical debate, the heart has a certain anatomic primacy based on the simple fact you can’t live without it, even for a few minutes. And few things will ruin your day more.

Most of the important organs in your body are designed with a certain redundancy, like airplanes having two spark plugs per cylinder. You have two kidneys, but can get by on one. You can lose more than half of your liver, just as much of your intestines, blood or lungs, and live, although not with all of that occurring simultaneously. Running on 50 percent function of most organs will leave you alive to fight again.

Ah, but the heart – there can be only one.

Conceptually, the heart is simple enough. It’s a variable speed pump. The faster it beats, the faster the blood goes round and round. It is actually kind of a double pump – one side pumps blood to the lungs, the other to the body. You have to be impressed by the build quality. Most hearts are good for 70+ years and more than 50 million cycles. Very few other things in the world, either living or inanimate, last 50 million cycles.

The heart is a lot like other pumps you know. Pumps, in general, don’t run on what they pump. Think about it – the oil pump in your car uses electricity to pump oil, and a pool pump uses the same to pump water. Similarly, the heart is not nourished by the blood inside the pump; rather, it is powered by the blood in vessels on the outside, namely the coronary arteries.

Given the coronary arteries’ well known propensity to plug up, perhaps the heart might have been better designed to get its nourishment from the blood inside.

But there are sound mechanical reasons why this can’t be. The first involves the heart’s thick muscular walls. There is no way for oxygen to passively diffuse across dense heart muscles in enough concentration to keep the heart alive, let alone beating.

Then there is the problem inherent in that whole beating thing. Blood leaves the heart in an intermittent flow (squirt-stop-squirt-stop). Most tissues, including the heart, don’t tolerate this type of flow. They need continuous flow. Getting this flow smoothed out is the job of the major arteries. These arteries have muscular walls that act as shock absorbers. They expand to absorb a slug of blood and then steadily contract to keep it moving. This works much like a water reservoir supplying water continuously to a town, even though rain is episodic.

Ah, but a heart is so much more than simple plumbing.

A heart’s got rhythm. Heart cells are a type of muscle cell, and like muscles everywhere, they contract. A specialized group of heart cells is a built-in pacemaker. This supplies the tempo. Everybody has to contract at once to get anything done. When they don’t, the heart sort of quivers and stops pumping, and that’s bad.

There can be either blood flow problems, rhythm problems or both from similar things. Atherosclerosis, or plugged coronary arteries, starves the heart cells. Sometimes these cells curl up and die. Sometimes they go electrically haywire and a rhythm disturbance occurs.

So the most important care and feeding of your heart are keeping good freshly oxygenated blood flowing through your coronary arteries. You have been prewired for this to happen. All you have to do is not screw it up. To do this simply means don’t do the stuff that clogs arteries.

• Do control your blood pressure
• Do control you weight
• Do control your cholesterol
• Do control your sugar if you have diabetes
• Do control your stress
• Do not smoke
• Do laugh as often as possible; it helps immunize against stress
• Do drink some red wine – it’s good for your heart and might also help with stress
• Do get some exercise, and for heaven’s sake, don’t suffer for it. If you do, the stress might cancel the benefit of the exercise.

So while hearts may continue to be a mystery to young lovers, you now have the necessary information to understand what makes them tick.

Take care,

Dr. B

Obesity’s Burgeoning Burden on Employers

America is fat and getting fatter. It’s hard to be more than a block from a fast food franchise unless you’re deep sea diving or mountain climbing.

The subliminal message is: How bad can it be?

Any child can walk into a burger joint and purchase 1,200 calories of cooked animal fat for pocket change. The child doesn’t even need to show ID or a parental permission slip. As a society, we seem to be saying a big, sloppy, cholesterol-laden cheeseburger is much safer than cigarettes, driving, PG-13 movies or beer.

Is it really? And why should employers care? Because you have to spend a couple extra dollars on XXL uniforms?

Obesity in the workplace has a much more profound effect on the company than just a few extra dollars for uniform fabric.

Let’s make sure we’re all on the same page. We medical types use something called the Body Mass Index (BMI), which is a measurement of a person’s weight to height. The higher the BMI, the more overweight a person is. The standard definition of weight class is:

• BMI of 25 or less – normal weight
• BMI of 25 to 30 – overweight
• BMI over 30 – obese

Obesity is among the most common of medical conditions in the United States. Close to 75 percent of our population is overweight or obese. Unfortunately this high-risk condition of being overweight is rapidly becoming “normal” in this country.

Obesity, the more serious condition, occurs in more than 25 percent of the population. The care associated with obesity is thought to be more expensive than that caused from smoking cigarettes or alcoholism.

Employers get hit from several directions with the burden of obesity. In this country, the employer partly or mostly pays health insurance, and the costs associated with obesity make this an increasingly expensive proposition.

It’s well known being overweight or obese is associated with much higher risk of hypertension, heart disease, stroke and Type 2 diabetes. The added strain of carrying around this extra weight also takes its toll on the joints and spine. Chances of osteoarthritis of the knees, hips and back are greatly increased.

Add up all this extra disease and the total cost of obesity is well over $100 billion per year. And we wonder why our insurance premiums continue to go up.

If the direct medical costs of obesity don’t break an employer’s back, the injury rates among obese employees just might. Employees having a BMI over 40 file twice as many workers’ compensation claims and have 12 times more lost work days from these work injuries.

 Repetitive motion injuries such as carpel tunnel syndrome and tendonitis in various joints are also more common. Obesity is even a risk factor for workplace violence.

Treatment for obesity has historically been fraught with failure. The sheer caloric load stored in a significantly overweight person is impressive. A pound of fat holds about 9,000 calories, so a person who is 50 lbs. overweight has a reserve of almost 500,000 calories to burn.

Since it’s difficult to keep the body burning an extra 1,000 calories a day, it takes quite awhile to make a dent in the fat calories. This makes it imperative to concentrate on the effort of maintaining normal body weight. Like most problems in life, prevention is easier and less expensive than repair.

For those who are already obese, only a long-term strategy has much chance of success. The person has to stop adding weight and stop adding to the problem. This can be an effort in itself, but it’s a prerequisite for success.

Once weight gain is stopped, activity and intake can be calculated to make some progress on the fat storage issue. Real progress on this is something that is measured in months and years, not weeks.

On that note, maybe I’ll skip that cheeseburger and fries for lunch.

Take care,

Dr. B

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Salt, as with most good things… in Moderation

Now that we have all enjoyed a good barbecued meal for the 4th of July, lets discuss a few important points regarding that salt shaker.

We at U.S. HealthWorks know that many meal options include foods ranked high in sodium, and as a culture, we tend to salt up without thinking about the consequences.  As we watch news reports on obesity, diabetes and hypertension, we forget how significantly many of our food choices impact our health.  Many of us are keenly aware and monitor the medications and supplements we consume, however forget the power behind the product we consume every day… food.

Photo credit: FDA

Sodium plays an important role in maintaining the body’s fluid balance, it is essential for muscles and nerves to function properly and it is a leading dietary factor in the aggravation of hypertension and its consequences.

The FDA guidelines call for less than 2,400 mg of sodium per day — about 1 teaspoon of table salt. Surprisingly, most of our salt intake doesn’t come from the salt shaker; it’s hidden in many of the foods we buy at the grocery store.


Frozen Dinners
The American quick meal!  Always easy and quick, but they are loaded with sodium, many over 800 mg of sodium.  A tiny 5 oz frozen turkey and gravy dinner packs a whopping 780 mg of sodium.

Tip:  Beware the “lighter” version may have less salt, but it’s no guarantee. Read the labels to be sure. Many times “Lighter” refers to fat only, and may be packed with salt and sugar to make the meal more tasty.

Packaged Deli Meats
One look at the sodium content in packaged meats should stop you in your tracks.  If you are already dealing with a diagnosis of hypertension it might literally stop you in your tracks! Beef or pork salami (2 slices) can pack 604 mg of sodium.

Tip: Be a label reader. There’s no way around it — different brands and different meats have differing amounts of sodium. And beware: a “healthier” packaged meat may actually have more sodium than its higher-fat counterpart. Some brands have meats with 50% less sodium.

Marinades and Flavorings
Notoriously high-sodium offenders include teriyaki sauce (1 tablespoon) which contains 690 mg of sodium, and soy sauce (1 tablespoon), which may contain up to 1,000 mg of sodium.

Tips: Even “lower-sodium” soy sauce packs a wallop, so use sparingly. Go for vinegar and lemon juice to enhance flavor — they naturally have less sodium. And try orange or pineapple juice as a base for meat marinades.

Spicing It Up
Adding spices to an entrée can be an easy way to forgo the salt shaker. Just make sure there’s no hidden sodium in your selection. For example, canned jalapeno peppers (1/4 cup, solids and liquids) contain about 434 mg of sodium.

Tip: Go for the pepper in its natural form to ditch the sodium used in processing. Or use herbs and sodium-free spices instead.

The Obvious Offenders
These snack-time favorites are always going to have a high salt content. Here’s how a 1 oz servings compare:
•    Potato chips = 149 mg
•    Cheese puffs = 258 mg
•    Pretzels = 385 mg

Tip: Even “baked” or fat-free snacks can pack the same amount of sodium or more, so read the label.  Again remember, low-fat often means high sodium and/or sugar.

Condiments Do Count
If you think those little extras you add to your food don’t count, think again.
•    Ketchup (1 tbsp) = 178 mg
•    Sweet relish (1 tbsp) = 121 mg
•    Capers (1 tbsp) = 255 mg

Tip: Go for low-sodium or sodium-free condiments. Or get creative with your substitutions: Try cranberry relish or apple butter for a naturally lower sodium choice.

Food Label Claims
Can’t keep up with the jargon? Here’s a cheat sheet:
•    Sodium-free: Less than 5 mg of sodium per serving
•    Very low-sodium: 35 mg or less per serving
•    Low-sodium: Less than 140 mg per serving
•    Reduced sodium: Sodium level reduced by 25%
•    Unsalted, no salt added, or without added salt: Made without the salt that’s normally used, but still contains the sodium that’s a natural part of the food itself.

‘Dos’ When Dining Out
•    Ask how food is prepared.
•    Choose a restaurant where food is made to order.
•    Ask that your meal be prepared without any forms of sodium, then add a dash of low-sodium seasoning you brought from home.
•    Request unsalted butter for your bread.

Who Should Go Low-Sodium?
Eating less sodium can help lower blood pressure in some individuals. It can help reduce the risk of heart disease, as well. For people with high blood pressure, eating high-sodium foods raises their risk of heart disease, stroke, and kidney damage.  Again, for most of us, it is about balance and moderation.

Track Your Sodium Intake
As with anything related to your health, ultimately it’s up to you to make wise and healthy decisions.  Wellness is more than an annual physical provided by your employer or insurance carrier; it is the state of balance we all should strive toward by educating ourselves, involving your physician as a resource and moving forward with decisions that improve your life.  We want you to be healthy and happy for a long time.

-Troy Manchester, M.D. Regional Medical Director, Northern California

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