SmokersFitness.com

An essential health resource for current and former smokers

SmokersFitness.com - An essential health resource for current and former smokers

Category Archives: General Health

Hookah Research Results

The vast amount of research on smoking has been done on the harms of cigarettes, presumably because they’re the most common form of tobacco use and probably the most harmful. Recently, hookahs have become more popular, especially amongst college age people. In addition, in the Middle East and other parts of the world, hookahs are very popular. Some people are under the impression that hookahs are a safe alternative to cigarettes. They believe that the water filters out a lot of the harmful chemicals in hookahs and that whatever the water doesn’t get, the charcoal will get rid of.

Blue glass hookah

Unfortunately, there aren’t too many studies done on the health effects of hookahs. Although it’s generally agreed that the volume of smoke per hookah session is quite high (in fact, one 40 minute session can result in inhaling as much smoke as dozens upon dozens of cigarettes), the fact that the tobacco is not heated to as high of a temperature as in a cigarette may result in a lower amount of exposure to toxic compounds.

A recent study in Cancer Epidemiology, Biomarkers & Prevention compared the amount of nicotine and various carcinogens inhaled via hookah versus cigarettes, and found that while those who used hookahs had significantly less exposure to nicotine and certain carcinogens, levels of carbon monoxide and carcinogens such as benzene were higher. Benzene exposure for example is linked to the development of leukemia.

The study didn’t measure hard outcomes (i.e. it didn’t compare rates of cancer, heart disease, etc. between hookah users to those that smoke cigarettes). In fact, there aren’t any good, long-term head to head studies addressing this.

A 2010 review from the International Journal of Epidemiology did show that hookah smokers had more than double the risk of developing lung cancer, respiratory infections, and low birth weight babies, and 3 to 5 times the risk of having periodontal disease compared with nonsmokers. Of note, risks of throat and bladder cancers were not higher (which is the case in cigarette users).

The bottom line is that at this time, it’s unclear if hookah smoking is any better than smoking cigarettes. And even if it is, it certainly isn’t a safe habit, exposing the body to many harmful substances and increasing the risk of developing lung cancer and other diseases.

So if you do currently smoke a hookah as a safe alternative to cigarettes, quit, and take up a healthier habit (join a gym, play sports, take up gardening etc.)

- Tamir

(Image credit: Psych Central)

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Preventing worse menopausal symptoms

Many women going through menopause experience a variety of unpleasant symptoms; among the most bothersome are hot flashes and night sweats. With the exception of estrogen replacement therapy, which can unfortunately increase the risk of developing blood clots and breast cancer, there aren’t very effective treatments (yes, there are various medications and herbs that are used, but practically speaking, for many patients, these don’t produce satisfactory results).

Recent research conducted by the University of Queensland School of Population Health shows that there are many modifiable risk factors that can contribute to worsening hot flashes and nights sweats. The study team sampled 10,000 women, and found that those who smoked, gained weight, were diabetic, and drank too much alcohol had significantly worse symptoms.

Menopause symptoms

So if you’re currently going through menopause or are going to be there soon, this may be yet another good reason to quit smoking, lose some weight if you’re overweight, and cut down on the alcohol if you’re over doing it in that department.

- Tamir

(Image credit: 34-menopause-symptoms.com)

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Killer commutes

Unfortunately, many of us face very long commutes to work. If you’ve been stuck in traffic, stressed out about being late, grabbed a fast food meal because “who has time to make dinner after a long work day and an even longer commute,” lit up another cigarette which would hopefully help you cope (somewhat), you’ve had the realization that long commutes are probably unhealthy.

Road rage during a long commute

Researcher Erika Sandow from Sweden recently presented results of a study she did looking at health records of over 50,000 people and comparing the health of those with long versus short commutes. Those who commuted more than 30 miles a day were more likely to die younger, have heart disease, obesity, and stress. Women seemed to have it worse than men. In addition, earlier work from Professor Sandow found that those with long commutes also faced much high divorce rates.

Obviously, in this economy, we often are simply lucky to be holding a job. So I’m not suggesting simply quitting your job even if you do face a long commute. However, if you have the option of switching to a job closer to home, even if the pay is a little less, then it may be something to consider. In addition, if you’re currently stuck with a job that has a long commute, then be mindful of your health habits:

  • If you’re stressed out, then work on relaxation techniques such as deep breathing.
  • Don’t light up cigarette after cigarette in the car out of frustration – pick up some chewing gum or ask your doctor for some nicotine replacement products if you need them.
  • Make sure to squeeze in a little exercise every day, even if you do come home late; doing 15-20 minutes is better than nothing, especially when most of the rest of your day consists of sitting.
  • Pack healthy snacks and meals for the road if you come home too late or leave the house too early to sit down for a proper meal. Don’t snack on chips, candies, and fast food in the car. You can cook 1-2 times a week in larger volumes, and then pack individual meals to have ready.
  • Put on some music you enjoy and that soothes you in the car, or purchase audiobooks to listen to, to keep you engaged and to keep your mind off the endless road ahead.

- Tamir

(Image credit: Yaffe Real Estate.)

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Do What You Like

Many times when I bring up the topic of a regular exercise routine with patients who don’t currently exercise (or haven’t done so in a long time), they’ll ask me, “What type of exercise should I do?” Similarly, when discussing adopting a healthier diet, a patient will often ask me, “What diet should I follow?”

As we discuss in our book, there isn’t one golden approach to a healthy lifestyle. Although there are numerous health gurus out there who push their own brand of health and exclude all others (and often their way is full of “must have” nutritional supplements and videos that can cost an arm and a leg), the reality is that by following general health principles, you can improve your own health a tremendous amount, all the while doing it in a way that’s palatable to you.

Delicious fruits

There are numerous diet and exercise programs out there: Low carb, low fat, vegetarianism, paleo diets, no sugar, no white flour, gluten free, various gimmick diets centered around shakes and supplements, etc. etc. Similarly for exercise, there’s running, weight lifting, calisthenics, sports, swimming, biking, yoga, tai chi, other forms of martial arts, dance, etc. etc.

Most programs out there have something beneficial to offer. However, as human beings, we’re all unique individuals who have our likes and dislikes. For example, broccoli is a healthy vegetable. But if I told every person out there that they must include broccoli as part of a healthy diet, I would have many people who simply couldn’t follow such a diet due to their dislike of broccoli. However, if I advised people to simply include more vegetables in their diet, I would likely have more success given the fact that most people probably enjoy, or at least tolerate, some types of vegetables.

Similarly, if I told everyone that they must go on a brisk walk for 30 minutes on most days of the week (a healthy habit indeed), I will likely have several people who eagerly comply (especially if they live in a scenic area with a temperate climate). However, there are many people out there who for various reasons (they live in a bad neighborhood where it’s unsafe to walk, it’s too cold, too rainy, or too hot to walk, they dislike walking, they have chronic foot pain), won’t walk. So when people ask me what type of exercise they should take up, I simply tell them to start doing anything that they enjoy that will make them “huff and puff” a little (I do want to briefly mention that before embarking on an exercise program more intense than light walking, people at risk for heart attacks, strokes, joint pain, etc. should be cleared by their physician).

Even in the realm of smoking cessation, there are different approaches. Forcing everyone to chew nicotine gum or to wear a patch is just not realistic.

The bottom line is to make meaningful changes that you can stick to long term. I can tell you that if you don’t enjoy something, then it probably won’t last.

I know that some of you might be thinking that you enjoy smoking, don’t enjoy any fruits or vegetables, and think that the most physical kind of activity that you’ll tolerate is flipping channels on the TV or walking to the fridge. Hey, it’s a free country, and at the end of the day you can choose to treat your body the way you want. However, what I’m suggesting is finding a happy medium in which you at least adopt some healthy lifestyle measures without spending the balance of your life waking up at 4 am for a 10 mile run followed by hours of push-ups and feasting on nothing more than alfalfa sprouts, steamed asparagus and boiled chicken (unless of course, that’s what you enjoy).

- Tamir

(Image links back to source: NBC News)

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Heart-healthy habits can also decrease the risk of cancer

The American Heart Association came out with a list of 7 recommendations (named Life’s Simple 7) to attempt to increase heart health in the United States. These recommendations (in no particular order) are:

1. Being physically active
2. Maintaining a healthy weight
3. Eating a healthy diet
4. Maintaining healthy cholesterol levels
5. Keeping blood pressure down
6. Regulating blood sugar levels
7. Not smoking

In a study published in the March 18th edition of the American Heart Association journal, the authors found that adhering to the above guidelines significantly reduced the risk of developing cancer as well. Specifically, of the 13,000 or so people who were followed for 17-19 years, those that adapted 6-7 of the guidelines had a 51% reduced risk of developing cancer, those that followed 4 had a 33% lower risk, those that followed 3 had a roughly 25% risk, and even those who followed a couple of the recommendations had a 21% reduced risk.

Even when smoking was taken out of the equation (since smoking is one of the biggest contributors to many different cancers), people who adopted 5-6 of the recommendations had a 25% lower risk of developing cancer.

What is the take home message? Obviously, if you smoke, then quit. However, as you can see from the above study, adopting other healthy lifestyle choices such as eating a healthy diet, exercising, watching your weight, etc. can make a big impact, not just with respect to heart disease, but with cancer as well. So even if you cannot quit at present, or choose not to, then at least improve your health in other ways.

- Tamir

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Lessons from Harry Chapin

One of Harry Chapin’s most famous songs, 1974′s “Cat’s in the Cradle,” tells the story of a father who is always too busy to spend time with his son as he’s growing up. Towards the end of the song, the son, who is now all grown up, is too busy to spend any time with the now retired father.

Cat's in the Cradle by Harry Chapin

We often go through life too busy to stop and smell the roses. But time does fly, and those of us fortunate enough to reach a ripe old age are currently, or one day will be, in a situation where we look back at our lives. It would be unfortunate if that life consisted entirely of one long day at the office. I’m sure most of you don’t remember the typical day at work. However, you probably do recall, and cherish, quality time spent with family on a vacation, teaching your child how to ride a bike, volunteering at a soup kitchen on Thanksgiving, etc. When we take an account of our lives, most of us would like to believe that we lived it to our maximal potential.

I am not saying that work isn’t important. Many of us accomplish tremendous good and improve society as a whole through the work we do. However, there has to be a balance. Usually, when career makes up one’s entire life and being, other important aspects of life such as family, friends, and helping others are neglected, often to our long term detriment. After all, when all is said and done, and our time to leave this material existence arrives, does it really matter if we had $100,000 or $1,000,000 or $10,000,000 in the bank? Does it matter if we successfully sold 1,000 more units, or scored 20 more big accounts?

You may be thinking, “This is all very nice, but how does it tie in to smoking?” If you currently smoke, depending on how much you smoke, you probably waste hours and hours a week satisfying your cravings for cigarettes and increasing the chances that your life will be shorter and/or poorer in quality. Consider what you could be doing with that time instead.

- Tamir

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Are you getting enough sleep?

In today’s busy world, insufficient sleep is quite prevalent. Although many of us don’t think much of it, people who on a regular basis get too little sleep (less than 6 hours a night; 7-8 hours is ideal for most adults), are at a significantly higher risk of having many different disorders, both physical and mental.

Coffee is sometimes not enough

We all know that too little sleep will make us tired and perhaps more irritable. However, it is not well known that in addition, chronic sleep deprivation has been linked to obesity (through stimulation of the production of ghrelin, a substance in the body that causes hunger, and suppression of leptin, which causes feelings of satiety), diabetes, high blood pressure (possibly through the release of stress hormones), premature death, heart disease, increased susceptibility to catching colds and other infections (through suppressed immune function), stunted growth in children and adolescents, and even depression.

A recent study published in the prestigious Proceedings of the National Academy of Sciences sheds some additional light as to the mechanisms behind these adverse health outcomes. The study showed that in sleep-deprived volunteers, hundreds of genes regulating many processes in the body, including those involved in metabolism, inflammation, immune function, and stress response were negatively affected. Although the study was small and of short duration, and does not per se “prove” that lack of sleep harms the body, it offers corroborative evidence to a growing body of literature regarding chronic sleep deprivation and poor health.

So next time you want to stay up and watch the Late Late Late Night Show or some obscure 1980′s movie playing at 1 am, jump into bed instead – your body will thank you for it.

-Tamir

(The image links back to its source: Weight Matters.)

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Further evidence that it’s never too late to quit

In our book, A Smoker’s Guide to Health & Fitness, as well as in several of our blog posts, we emphasize over and over again how important it is to quit, no matter how long you have been smoking.

A recent study published in the European Journal of Epidemiology, which followed close to 9,000 people aged 50-74 for close to a decade, adds further evidence to the benefits of smoking cessation in even long-time smokers. As expected, compared to non-smokers, current smokers had an over twofold risk of suffering a heart attack or a stroke after adjustment for other risk factors such as presence of diabetes, high blood pressure, elevated cholesterol, alcohol use, etc.

Current smoking advanced the chance of a heart attack by 19 years and that of a stroke by almost 10 years (i.e., a 60 year old smoker would have roughly the same risk of suffering a heart attack as a 79 year old non-smoker, and the same risk of having a stroke as a 70 year old non-smoker).

What was remarkable was that despite the fact that the smokers in this study had been smoking for many years (as mentioned above, the study included people from the ages of 50 to 74) those who quit during the study had a 40% less chance of having a heart attack or stroke, and roughly 5 years after quitting, most of the excess risk was mitigated.

So once again . . . quit – it’s never too late.

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Do penalties for smokers and obese people make sense?

A recent intriguing article from Mike Stobbe of the Associated Press brings to the forefront the ongoing debate regarding our individual choice or right to smoke, overeat, and/or not exercise. One one hand, this is for the most part a free country, and people do have a right to do as they please, as long as they’re not hurting anyone else – and this is exactly what the debate is about.

Free2BMe smoking and obesity cartoon

It’s well-known that smokers and obese people incur high health costs from the variety of illnesses associated with long-term smoking and obesity. In addition, smokers may expose others to second hand smoke which may harm their health. But even taking that out of the equation, many question whether it is fair for those who opt for a healthy lifestyle to shoulder the financial burden for those who choose an unhealthy path in life. With taxpayers footing much of the bill for healthcare in this country through government programs such as Medicare and Medicaid, it’s a real issue.

On the one hand, some people argue to let smokers and obese people do what they want, but to subsequently “let them die” (i.e. not pay for expensive, life-prolonging measures such as chemotherapy, bypass surgery for the heart, etc.) when they end up becoming sick from their unhealthy lifestyles. On the other hand, others advocate for increased taxes on cigarettes (and perhaps by extension other unhealthy products such as soda), and other regulatory measures (such as New York City’s ban on trans fats and large sodas) in order to “force/coerce” people into leading healthy lifestyles.

The realization of either of these two positions have profound, society-wide implications, both financial and with respect to one’s individual freedom to do as he or she pleases. In the meantime, since no one knows how things will ultimately play out, it’s probably safer to adopt a healthier lifestyle. This way, whatever happens, you decrease your chances of needing expensive medical interventions.

- Tamir

(Image links back to its source: stayhealthyy.com)

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The Harms of Calcium Supplements

Something we discuss in our book is how for most people, calcium supplements do not have any specific benefit, even with respect to prevention of osteoporosis (weak thin bones). Obtaining sufficient calcium from a healthy diet IS important for bone health and other processes in the body, but we mentioned how calcium supplements may in some cases increase the risk of kidney stones, and we discussed a few studies showing a mildly increased risk of heart attacks and strokes in middle-aged to older women who regularly consume calcium supplements.

A recent study published in JAMA Internal Medicine shows that this increased risk of heart disease seems to hold true in men as well. Men who took over 1000 mg daily of supplemental calcium (not an unusual dose in those who consume such supplements) had a roughly 20% increased risk of dying from heart disease.

What’s the difference between getting calcium from a supplement as opposed to one’s natural diet?

The authors speculate that the high levels of calcium that enter the bloodstream after consumption of calcium supplements may lead to calcification of blood vessels, including those that supply blood to the heart. Calcium deposits in those vessels are directly related to the risk of having significant heart disease. There may be other mechanisms at play as well. In contrast, when one consumes calcium rich foods, the calcium slowly enters the body as the food is digested, and doesn’t cause spikes in the blood levels of calcium.

The bottom line is to obtain your daily calcium needs through a healthy diet containing calcium rich foods (sardines, dairy, sesame seeds, leafy vegetables, almonds, beans). If your diet is absolutely atrocious (and you have no desire to improve it), or if your doctor advises you to take supplements because of certain medical problems, my advice is to avoid large amounts (eg 500 to 1000 mg) at one shot; instead, take lower doses (200 to 250 mg) several times a day.

Lastly, don’t forget that in order to strengthen one’s bones, in addition to calcium, it is also important to engage in regular weight-bearing exercise, consume sufficient amounts of vitamin D, magnesium, and potassium, avoid excessive salt, and, of course, quit smoking.

- Tamir

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