Digestion, health and nutrition: Dr. Anil Minocha, a gastroenterologist and nutritionist

Watermelon, natural aphrodisiac sex stimulant

Guys love watermelon, atleast that's the trend in recent days. The same men who hated produce now filling their plates. Wonder why?

Quoting scientists from Texas, there has been a surge in media reports that watermelon may have effects similar to Viagra. If true, this would give us a natural aphrodisiac, cheap and without prescription.

How can watermelon help enhance the men's lives? Turns out, it has high concentrations of citrulline, which is then converted to arginine in the body, Arginine leads to higher levels of nitric oxide which is a vasodilator improving the blood supply to tissues.

However, the reports that watermelon is similar to Viagra may be grossly exaggerated. Watermelon ingesstion does improve blood supply everywhere in the body, however without focussing on "where it is needed". As such, you would need to eat lots of watermelon to match the effects of Viagra. Before you try that, don't forget the potential diuretic effects of watermelon!

Right diet for child's sex: son or daughter?

Boy? Girl? Would-be mother’s diet, i.e. preconception diet, can help make the choice. This comes from a study titled, You are what your mother ate”, published in the journal Proc Biol Sci in 2008. If son is the choice, the woman before pregnancy should be pigging out!

There is paucity of information about natural and/or environmental factors affecting mechanisms of sex allocation in human evolutionary process. The investigators studied 740 women. The women with the highest energy intake preconception were likely to have sons. While food intake during pregnancy had no impact, women with the top third intake food intake had sons 56% of the times, whereas only 45% from the group from the lower third of energy intake had sons.

Interestingly, women eating cereal everyday prior to conceiving had almost 90% chance of having a son as compared to those eating just one bowl or less of cereal per week. Women having sons ate about 300 more calories than the ones who had girls. Potassium rich diet is also likely to lead to a male child.

Is it because boys tend to be bigger and larger energy investment tilts balance?

Are these results plausible? While more data is needed to confirm these findings, these results are consistent with laboratory data related to fertilitization and survival of male embryos.

“Our results support hypotheses predicting investment in costly male offspring when resources are plentiful”, wrote the authors. These results also have implications for artificial gender selection in fertility clinics.

Do you think diet can or does affect ultimate sex of the would-be baby? Do you know of someone who goes by this theory and practice it? Please share your story.

Placebo pain relievers and price

Placebo pain relief, really?

Yes, placebos work for pain, so say Dr. Weber et al. in JAMA…the more the price, the better the placebos work. After all you get what you pay for.

Some doctors probably do use placebos knowingly or unknowingly for chronic painful conditions that they can’t find effective treatments? These may include irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, interstitial cystitis etc.

The question arises, should the doctors use placebos knowingly? If yes, the more expensive ones?

And where do you draw the line? Should the doctor be allowed to have a shop displaying remedies in his clinic?

Please share your thoughts.

Sex addiction on internet treated by naltrexone

Internet sex addiction is fast becoming one of the newer compulsive behaviors with immense health as well as psychosocial implications. Although triggers and manifestations be variable and unique for different individuals, the final neurochemical pathways are probably similar. Hence, one successful treatment modality against one is likely to be successful against other. One such option is naltrexone is an opiate blocker and is currently approved for alcoholism.

Drs. Bostwick and Bucci from the Mayo Clinic (Mayo Clinic Proc Feb 2008) report naltrexone based successful treatment of compulsive internet use for sexual gratifications, both self and virtual as well as spontaneous off-line sexual encounters with others he had met online.

The patient is a 24 year old male who presented complaining of “sexual addiction” that was affecting his job as well as his marital life. He attributed  this habit to his discovery of grandfather’s pornographic material as a child. Prior to online sexual fantasies and encounters, he used to indulge in phone sex on 900-lines. At the same time he felt guilty about his addition since he is a devout Christian.

He had tried multiple treatment modalities including antidepressants, psychotherapy, sexual addicts anonymous, pastoral counseling without any benefit.

He was then started on naltrexone resulting in sustained success at avoiding compulsive internet use. The discontinuation of naltrexone resulted in relapse of internet sexual habit which again resolved on restarting naltrexone.

Do you know of anyone around you who has had addiction problems, especially internet addiction and even more specifically internet based sex addiction. I am interested in knowing how the readers feel about internet based sex adiction in general, its impact on life and this report specifically.

Resolve to be healthy

The winds of public debate seem to be blowing towards a discussion about health care for everyone in the country.

Plans being currently discussed range from national health insurance to tax credits, and of course the hybrid plans involving both extremes. It is remarkable that all of the plans primarily involve paying at the back end for many of the chronic preventable diseases.

None of the currently discussed plans offer a comprehensive disease prevention strategy that would attack the roots of many of our sicknesses like heart disease, stroke and cancer. The disease prevention strategy would of course require tough decisions at all levels.

Tough options might include eliminating subsidies and perhaps even taxing unhealthy products that breed chronic illnesses and lifestyles. Use this money to build gyms and walking trails all over to the country and make them accessible to the population free of cost. At the same time, invest more money on safe bicycle trails in towns and cities including connecting suburbia to downtowns. This would be not only be a healthy and cost-effective strategy but would also curb pollution and our addiction to oil.

Use economic principles to force changes in eating habits. One strategy might be to impose extra-tax on “All you can eat” meals and establishments. At the same time, why not offer tax credit for establishments which offer only set number of calories per meal as a platter.

The strategy would not be successful without active participation by the business community. Healthy workers lead to increased productivity. Large businesses with connected buildings should post “mile-posts” to encourage walking. Malls should create green and covered extended walkways between parking areas and buildings so able-bodied people can easily walk extra from their cars. Every building elevator should have a sign encouraging able-bodied individuals to walk if going up only for one or two floors.

Living a long healthy life is a privilege. Let us not take it for granted. We should elect leaders who believe in the concept, “prevention is better than cure”. At the same time, we must get down from our “spoilt high horse” and take personal responsibility-eat healthy (and less in most cases) and exercise our way out of the health care crisis.

Smoking is bad for arthritis too!

Evidence keeps piling up that smoking is bad not just for your breathing, lungs and heart, but also for your joints.

Dr. Amin and colleagues from the Mayo Clinic examined the relationship between smoking and osteoarthritis, a degenerative form of arthritis.

They studied 159 males with osteoarthritis of the knee. The study was conducted prospectively over a 30-month period. MRI scans were done at baseline and then at 15 months and then at end of the study. Pain scores were also measured.

After adjusting for the age and body weight, these investigators found that current smokers suffered a greater loss of cartilage. In addition, current smokers also greater pain, both at baseline as well as upon follow-up.

Above study highlights the deleterious effects of smoking.

Do you or someone you know smokes tobacco? Remember, it is never too late to quit smoking. Talk to your health professional.

Exercise makes radiation therapy easier

Radiation therapy is frequently undertaken as part of treatment of breast cancer. However, these beneficial effects come with a price. Sometimes the side effects can make the therapy intolerable and reuire additional medications to combat the unwanted adverse effects.

A recent study by Dr. Drouin and colleagues published in the journal Cancer (November 2006) suggests that aerobic exercise during therapy would help make this otherwise toxic treatment more tolerable.

They conducted a randomized controlled trial to study the impact of aerobic exercise twenty sedentary females with breast carcinoma during radiation therapy.

These investigators found that moderate intensity aerobic exercise maintains red blood cell counts and hemoglobin levels better during radiation treatment of breast cancer compared with the declines observed in patients who were not doing moderate level of exercise.

They concluded that exercise is a safe and cost-effective method to improve fitness and maintain hemoglobin levels in women during radiation treatment of breast cancer.

Do you exercise regularly? Do you do it with a trainer, in a group or by yourself?

Can exercise prevent colds?

The answer is an unequivocal yes, at least among older women according to a recently published study.

Dr. Chubak and colleagues from the Fred Hutchinson Cancer Research Center in Seattle, Washington studied the impact of a regular, moderate intensity exercise program on prevention of colds and upper respiratory infections. They published their findings in the American Journal of Medicine (November 2006).

These investigators studied 115 overweight and obese, sedentary, postmenopausal women. The subjects were divided into the moderate-intensity exercise group or the control group. The exercise program consisted on 45 minutes of moderate-intensity exercise 5 days per week for one year. Control subjects attended weekly stretching sessions.

During the study period, the risk of colds was significantly lower in the exercise group. The cumulative effect of exercise appeared to be greatest towards the end of the study when the risk of colds in the last 3 months was 3 times less in the exercise group.

These results add to the growing body of evidence that exercise may improve the immunity to ward of infections like colds. While the study was conducted only in older women, it is likely that the beneficial effects would apply to men also and probably at all ages.

Do you do regular exercise? Is your exercise program focussed on strength or endurance? What other benefits do you think you could be getting from your exercise program?

Uncontrolled diabetes, less brain

Diabetes tends to cause problems throughout body and glucose is a fuel for the brain. Question arises if too much blood glucose is bad for the brain function?

Dr. Yaffee and colleagues from the University of California in San Francisco wished to examine the impact of poorly controlled diabetes on the mental function especially in older persons and the potential for developing dementia.

These authors studied 1983 women including 53 diabetics. In this cohort, they examined relationship between the control of blood glucose (HbA1C level) and the risk for developing dementia.

They found that in women with HbA1C level of 7% or greater, the risk for developing mild cognitive impairment (MCI) was increased nearly 4-fold. Overall, the risk for developing MCI or dementia was enhanced almost three-fold.

Take home message: We should consider HbA1C monitoring in elderly patients at risk for mild cognitive impairment or dementia.

Do you or someone close to you has diabetes mellitus? Do you try to control the blood glucose compulsively? Are you convinced of the significance of the good blood glucose control?

Second opinion in medicine

The issue of second opinions in health profession frequently sparks a debate. The thoughts are diverse depending upon if you are a patient, versus his/her physician versus health policy maker.

Dr. Scott Haig at the Columbia University College of Physicians and Surgeons issues a strong indictment of medical profession by arguing that large number of physicians are quick to refer patients to another doctor rather than managing the situation themselves. This, according to him, is not only inefficient medicine but bad medicine.

Dr. Haig may be on to something that is not frequently verbalized by many of us. We all see such occurrences not too infrequently where the health care provider has made his/her money doing the easy part including the expensive procedures and then sends over the patient to someone else for second opinion to deal with issues that actually required some thinking.

On the other hand, what is the patient to do, especially when faced with a life-threatening diagnosis like cancer and/or complicated set of options?

Like it or not, second opinion with all its disadvantages is a fact of life and we should all be thankful that we have that option.

What do you think? Did you think it was a good exercise or do you feel you had to do out of frustration with your health care provider. Have you had occasions where you considered a second opinion? Did you think it was worth the cost and effort?