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Dr Ross Walker
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Is your appendix your friend or foe?

Friday, May 24, 2019

When I started medical school, I was taught that the appendix was a useless little organ hanging off the start of the large intestine. Because of the sophistication of the modern world, the usefulness of the appendix had evolved out of existence. The theory at the time was that particulate matter from food or purely an infection blocked the appendix, causing appendicitis with a myriad of complications, including peritonitis and, rarely, death.

At one stage, it was a rule that you could not travel to the Antarctic unless you had your appendix removed.

Over the past decade, there has been emerging evidence that the appendix may well be a very important component of the immune system. Firstly, it appears that the appendix acts as a reservoir for beneficial gut bacteria. There is a much higher concentration of immune tissue in and around the appendix and the theory is that it is a safe house for beneficial bacteria to recolonise the bowel after a severe infection. For example, a common cause of childhood deaths in developing countries is infectious diarrhoea and thus the appendix could contribute healthy bacteria back into the bowel after a bout of this potentially lethal condition.

An even more surprising function of the appendix brings up the very topical concept of the Brain-Gut interaction. A study recently presented at the Digestive Disease week in San Diego, California looked at the link between having the appendix removed and Parkinson’s disease in 62 million people living in the US. Interestingly, having your appendix removed increases your risk for Parkinson’s disease three times. There is a particular protein known as alpha-synuclein which forms toxic clumps in the brain of people with Parkinson’s disease known as Lewy bodies. Interestingly this same protein is also found in the gastrointestinal tract of patients with Parkinson’s disease. The hypothesis is that the appendix through some immune function maintains lower levels of this protein and thus less Parkinson’s disease.

Finally, an interesting study from Sweden published a few years ago looked at the link between appendicectomy, tonsillectomy and risk for heart attack. This study reviewed the health history of every Swedish resident born between 1955 to 1970 with an average follow-up of just under 24 years. If your tonsils and appendix were removed before age 20, this increased the risk for a heart attack by 33% with appendicectomy and 44% with a tonsillectomy. The explanation is rather clear in that both organs are felt to play an important role in the immune system. Removing these organs changes the inflammatory response and it is possible that both the tonsils and the appendix play a role in a more appropriate inflammatory response and thus less vascular disease.

Thus, if your child develops either tonsillitis or appendicitis and the doctors involved in their care take a more conservative approach rather than rushing into surgery, they are probably doing your child a great favour in protecting them from future significant illnesses.

On Wednesday 29 May, Dr Ross Walker will be giving a talk on ‘The 5 keys to Ultimate Health’ at Sydney’s City Tattersalls Club to raise money for The Gut Foundation. Click here to buy tickets.

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Colorectal cancer - a genuine breakthrough

Thursday, May 09, 2019

The best treatment of any modern disease is no doubt, prevention. This is why I am a very strong supporter of the National Bowel Cancer screening program, not to mention the fact that I believe all adults over 50 should have at least one colonoscopy in their life.

For someone like myself, having watched my beautiful father die at age 73 from colorectal cancer, I recently had my fourth colonoscopy & am delighted to say I remain polyp free. As you can see, this topic is very personal for me.

If these screening programs were followed, we would see a marked reduction in bowel cancer death. It Is estimated that one in 13 people by age 85 will be diagnosed with colorectal cancer. It remains the third most common cancer diagnosis after breast and prostate cancer. Melanoma comes in at number four, with lung cancer at number five. Interestingly, lung cancer remains the commonest cause of cancer death as it is not as responsive to treatment as the other cancers on this list.

It is my opinion that vaccination was the most important health innovation of the last century. It is a pity that there are still some ill-informed people remaining, despite overwhelming scientific evidence, against vaccination.

Now it appears that in the not-too-distant future, we may have a safe and effective vaccine against colorectal cancer. This new study published in the Journal, Immunotherapy of Cancer was a small pilot study to establish the safety of the colorectal cancer vaccine. This vaccine has already been proven to be safe and effective in laboratory animals.

In this particular study, 10 individuals with either stage 1 or stage 2 colorectal cancer (earlier stages, better prognosis) were given the vaccine and then their blood was examined at 30 days, 90 days and then 180 days.

The blood tests showed clear evidence of activation of Killer T cells ,which are the immune cells that are activated against cancers and a number of other conditions, such as viral diseases. Interestingly, there were no serious side-effects from the vaccine. The vaccine works against a specific molecule known as GUCY2C. This molecule is present on the surface of tumours but not on healthy cells. The vaccine combines this specific molecule with another substance that augmented the reaction against these cancer cells. Thus, the Killer T cells reaction against colorectal cells is augmented.

There is strong evidence that this vaccine may also work against other gastrointestinal cancers such as gastric, oesophageal and pancreatic cancer. Combined, all these gastrointestinal cancers account for 20% of all cancer related deaths.

Over the past decade, there has been a welcome explosion of a variety of new, more targeted treatments towards many different forms of cancer. Some advanced cancers that were universally lethal are now being managed, and in many cases cured. This new vaccine is yet another example of the vital importance of sophisticated, high-level medical research, which has changed the outlook of what was once a death sentence for many people.

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Will stem cell therapy eradicate knee replacements?

Thursday, May 02, 2019

Stem cell therapy has long been hoped to end the reign of total knee replacement as the mainstay of therapy for severe osteoarthritis of the knee. Having personally had two separate treatments with stem cells derived from my own abdominal fat, on my dodgy right knee, the first 10 years ago making me worse and the second more recent attempt giving only minimal benefits, I found the entire exercise rather disappointing, not to mention, quite expensive.

But recent work published in the journal, Stem Cells Translational Medicine, from the University Health Network in Toronto used a different form of stem cells. These stem cells are derived from the person’s own bone marrow, thus requiring the rather uncomfortable bone marrow aspiration to harvest these particular cells, known as mesenchymal stem cells. This small study of only 12 people with moderately severe knee osteoarthritis used one of three different doses of mesenchymal stem cells. The levels of inflammatory biomarkers, the rate of cartilage breakdown, general review of the knee with an MRI scan, along with questionnaires to determine the level of pain, impairment and mobility were all measured over a 12-month period.

During this time, there was a significant reduction in pain and self-reported improvements in quality-of-life. It is no surprise that the best results occurred in the patients given the highest doses of their own stem cells. There was significant reduction in the inflammatory markers but interestingly no cartilage regrowth. This suggests that it’s much more likely that the improvements come from the anti-inflammatory chemicals liberated by these mesenchymal stem cells, rather than any magical regrowth in cartilage. This raises the question as to the long-term viability. It’s all well and good to have a significant improvement over 12 months but at present these therapies are rather expensive, costing up to $10,000 per treatment with no guarantee of success.

There have been a handful of studies to date showing promise from this technique but again in all studies there has been no dramatic regrowth in cartilage. I must assume that it was the pure anti-inflammatory benefits of the stem cells that has given the benefits. Having had recurrent injections of Synvisc with weak benefits, a few bouts of PRP (your own platelets taken from your blood stream, spun down & injected into the knee), again with weak to reasonable benefits, there is still no doubt that as we approach 2020, the definitive therapy for knee osteoarthritis, especially for people over the age of 65, is a knee replacement.

Knee replacements are successful in 90% of cases but if you are in the 10% where they don’t work or complications arise, a reduction in your quality of life is a strong possibility in a minority of cases.

Regardless, knee osteoarthritis is a common cause of chronic pain. This has a profound and negative effect on the quality of life and whatever works for you should be pursued.

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Does stress cause heart disease?

Thursday, April 18, 2019

For many years there has been conjecture in the medical profession around the place of stress and its relation to a number of diseases. There are still some members of the medical profession who believe that stress has no place in the precipitations or causation of cancer, whereas most people in cardiology do believe there is a clear & robust relationship.

A number of years ago, the Interheart study suggested that 20% of heart disease was directly related to some form of stress. Professor Geoffrey Toffler from Royal North Shore Hospital in Sydney has performed elegant work demonstrating that within two hours of becoming acutely angry or anxious there is an eight times increased risk for a heart attack.

There is now the relatively common and well-recognised Takutsubo’s cardiomyopathy, which is the development of acute heart failure whilst under stress, felt to be due to adrenaline induced constriction of the arteries in the heart.

Post-traumatic stress disorder is felt to be a chronic syndrome that follows on from acute stress. The symptoms of post-traumatic stress disorder include excessive reactions to loud noises, flashbacks to the stressful event, nightmares, feelings of detachment, anger, varying degrees of depression and irritability. The acute stress disorder occurs within 3-30 days of the event and is estimated that around 20% of motor-vehicle victims, 50% of rape, assault or survivors of mass shootings will develop an acute stress disorder. Of these, 50% will go on to experience post-traumatic stress disorder. It is estimated that just under 4% of adults living in the modern world are suffering some form of post-traumatic stress disorder.

This new study from the Swedish National Patient Register examined 136,637 patients with acute stress disorder and subsequent post-traumatic stress disorder, diagnosed between 1987-2013. They compared these people with around 1.5 million people without either of these disorders.

It appears that a stress-related illness increased the risk for cardiovascular disease by 64% within 12 months of exposure to the stress especially in people under the age of 50. Although this does not prove that stress causes cardiovascular disease, it still suggests that people who are predisposed to this disorder should try the best to minimise stress. Unfortunately, the underlying precipitant of acute stress disorder and post-traumatic stress disorder is typically a circumstance beyond the control of the sufferer, so the best approach here is for the health professionals involved in the care of such people should be considering cardiovascular risk factors and bring in appropriate measures to minimise any extra harm in this situation.

I say to all my patients that what puts the muck in the walls of your arteries in the first place is totally different to what actually makes the establish fatty plaques rupture to cause a heart attack or stroke. Whether stress is a factor in the generation of atherosclerosis (i.e. the major predisposing factor to acute vascular events such as heart attack or stroke) or whether it is purely a precipitant has not been clearly established. Regardless, it is vitally important to recognise that people who are under significant stress are much more vulnerable and the other health consequences of these variety of stresses needs to be recognised and managed.

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Nutrition: how much is enough?

Friday, April 12, 2019

I was recently sent the below question from a man in Western Australia.

“Can you provide some information on human mineral requirements (both major and trace) as affected by age, gender and physical activities. By world standards, Australian soils are generally regarded as relatively poor (proportion of clay, loam and sand) also affected by rainfall and potential for leaching. There is also an interaction with plant and animal uptake and storage.”

Typically, when most people talk of nutrition, the focus is on macronutrients: fat, carbohydrates and protein. The fat and carbohydrates are our major energy sources, whereas the proteins are the building blocks for our cellular structure and metabolism.

But, micronutrients are also vital as cofactors for all the metabolic reactions in our body. We, therefore, need a minimum daily intake of vitamins, minerals and trace metals that are present in varying amounts in our food. Typically, the richest source of these three micronutrient groups are plant-based foods i.e. fruit and vegetables. The suggested minimum daily intake of fruit and vegetables is two to three pieces of fruit per day and three to five servings of vegetables per day (one serving of vegetables, as an example, is half a carrot). It is a concerning fact that less than 10% of the population of Australia would consume this minimum recommended amount of fruit and vegetables on a daily basis.

I have included a table from Harvard University suggesting the recommended daily intake of vitamins, minerals and the common trace elements. There are, no doubt, variables relating to age, sex and physical activity but for the majority of adults, these differences are small. Thus, the recommended daily intake for adults is sufficient.

There is no doubt that there is a strong variability in the quality of soil around the world. For example, in rural China there are soil deficiencies in selenium & iodine, two common minerals. There is significant conjecture in the medical field as to the significance of selenium deficiency but there is a strong relationship between this deficiency and cardiomyopathy seen in cows. There is also no doubt that iodine deficiency has led to cretinism and other significant thyroid disorders in parts of the Chinese population.

Although Australian soil is not as deficient as the soil in other parts of the world, there is still concern that the quality of our fruit and vegetables has deteriorated over the past 50 years for a variety of reasons, some of which have been mentioned by the author of the question above.

The interesting question here is whether taking vitamin supplements adds any benefit to health? Most doctors will tell you that all vitamin supplements do is give you expensive urine. But, if you take a more global view of the wider medical literature, in many instances, supplements also give you expensive blood, which is exactly what you want.

Over the past 30 years, Harvard University has been performing the Male Physicians trial and the Nurses Health study. They have examined the health behaviour and parameters of 180,000 people over this time. To take the example of multivitamins, up to 10 years in the male doctors, there was no benefit from taking a daily multivitamin. But, when the 10-year data was analysed, there was an 8% reduction in common cancers and cataracts in those doctors randomised to a daily multivitamin. When the 15-year data was analysed in the Nurses Health study, there was a 75% reduction in bowel cancer, a 25% reduction in breast cancer and a 23% reduction in cardiovascular disease, just by taking a multivitamin on a daily basis. When the 20-year data was analysed in the males, there was a 44% reduction in cardiovascular disease in those doctors who persisted in taking a multivitamin daily over this period.

Thus, the vital importance of having a significant dose of vitamins, minerals and trace metals on a regular basis. In my view, fruit and vegetables are still the best source of these vital nutrients but you do gain added benefit from the daily ingestion of high-quality supplements.

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Is there a link between smoking & dementia?

Thursday, April 04, 2019

Although I would like to blame smoking for all the world’s medical ills, there are some conditions where there’s no particular link. But, come the revolution, and I’m running the show, cigarette smoking would be wiped off the face of the earth. 

There is no doubt that cigarette smoking and obesity are the two major preventable causes of many common illnesses. There is a direct link between cigarette smoking and the following illnesses

1.  Cardiovascular disease: 60% of smokers will develop some form of cardiovascular disease e.g. heart attack, stroke or peripheral vascular disease (arterial blockages in the legs).

2.  Chronic airways disease: 60% of smokers will develop either emphysema or chronic bronchitis as a consequence of long-term smoking. It is a sad fact that close to 100% of asthmatics who smoke will develop severe chronic lung disease.

3.  Lung cancer: 20% of smokers will develop lung cancer. Interestingly, it is also a little-known fact that 20% of lung cancer has nothing to do with smoking.

4.  Bladder cancer: there is a strong link between smoking and this relatively common form of cancer.

5.  Upper airway and upper gastrointestinal cancers such as throat and oesophageal cancers are also linked to cigarette smoking.

But, a recent study from the Journal of Alzheimer’s Disease studied the link between cigarette smoking and dementia. It has been estimated that 50 million people worldwide suffer some form of dementia, of which 60-70% is the common form, Alzheimer’s disease. The Alzheimer’s Disease Centre in Kentucky followed 531 older people for on average 11 ½ years who had no evidence of cognitive impairment (i.e. early Alzheimer’s) at the start of the study. 49 were current smokers and 231 were former smokers. Of the 531 people in the study, 111 were diagnosed with dementia whilst 242 died without dementia.

Cigarette smoking was associated with early death but not with dementia. I believe there is a clear explanation for this. When you smoke one cigarette, you are taking 48 well-documented poisons into your body. The least poisonous of these 48 chemicals is the highly addictive nicotine, which is what hooks you into smoking in the first place. But, it appears that it is the other 47 poisons that create the myriad of diseases I have listed above.

One in five people carry the receptors in their brain for nicotine addiction and this is why 50 years ago half the population smoked but when they found out about the dangers of cigarettes, many people quit but there was still that ingrained 20% of people who continued smoking. Fortunately, in Australia this is now down to around 13% of the adult population. Of course, I would prefer this to be zero.

But, it does appear that stimulating the nicotine receptors in the brain has some degree of protection against Alzheimer’s disease and Parkinson’s disease. This, of course, does not justify anyone smoking but certainly opens the possibility for using specific nicotine related therapy or a less addictive similar chemical as a potential therapy for these conditions, once it has been established that this is the case.

Regardless, if you’re a smoker, you should never see any justification for your habit. Every time you puff on one of those disgusting white sticks you are running the risk of all manner of lethal diseases and certainly giving yourself a chance of not making it to the age where you may have a weak protection against Alzheimer’s disease.

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What came first, the cholesterol or the egg?

Thursday, March 21, 2019

Just when you thought it was safe to tuck into your favourite dish of bacon and eggs on the weekend, new research was released this week, published in the highly acclaimed Journal of the American Association of Medicine, suggesting we should rethink this position.

This extensive study pooled data from six US cohorts totalling 29,615 people of whom 45% were males and 31% African Americans. The average age of the people in the study was 52 followed up to 31 years but on average 17 years. Thus, it was a very large study with a very long follow-up looking at the American population. 

The conclusion of the study was each additional intake of dietary cholesterol of 300 mg per day equated to an increase in cardiovascular events of 17% and death from any cause of 18%. In real terms, for each 1,000 people studied, those who consumed two eggs per day compared with those who didn’t, but otherwise had a similar diet, there were 32 more cardiovascular events and 4 more deaths in the egg consumers. Eggs by themselves were not really the culprit but rather dietary cholesterol, which can come from any animal source.

So, is that the end of the story? Should we never look another egg in the face or tuck into the often consumed eggs and bacon or one of my favourites, Eggs Benedict?

The clear answer here it is to drill down on the research and find out exactly how the study was done. Once you have understood this, you’ll realise what little credence this information has for your eating habits. Basically, this entire information is based on one dietary questionnaire performed at the start of the study. This questionnaire asked the participants about the food they had consumed either in the previous month or 12 months based on the particular cohort investigated. Could you remember accurately what you consumed during these periods?

There were no further questionnaires administered and basically the health and disease events were followed for the next period up to 31 years but on average 17 years. Clearly, any intelligent human being would question the validity of such a study. Many people change their dietary and life habits over such a long period of time. Many people become ill and often radically change their diets as well.

Another recent study looked at young and ageing mice and compared their vascular health pre-and post antibiotics. They found that a course of antibiotics did nothing to the vascular health of the younger mice but profoundly improved the vascular health of the older mice. The hypothesis here is that as mice age, the gut bacteria changes to become more pathogenic. Young healthy people have young healthy gut bacteria. With years of exposure to western diets, which may or may not include eggs, our gut bacteria change from the young healthy pattern to older, more pathologic bacteria and liberate toxic chemicals into the bloodstream. There has been a significant amount of work around the chemical TMAO, which has been found to have a direct toxic effect on blood vessels, making them much stiffer and more prone to atherosclerosis, the basic underlying cause of heart disease. It appears that predisposed individuals who do have a diet high in animal products may liberate more TMAO into their bloodstreams from the interaction of these animal products and defective gut bacteria.

But, over the past two years, there have been two components of a trial known as the PURE study both of which have put this cholesterol and saturated fat argument to bed. The PURE study was conducted in 50 different countries, not just America, where we all know that dietary habits for many people living in America are very poor. It may be that it is not those couple of extra eggs per day consumed with a typically poor American diet that needs radical rethinking, but the overall diet itself.

The first component of the PURE study, released in 2017, looked at 135,000 people in 50 different countries followed for nine years and showed that those with the highest carbohydrate intake had a 28% increased death risk, where as those with the highest fat intake had a 23% reduction in death and those with the highest saturated fat intake i.e. animal products, had a 14% reduction in death.

The second component of the PURE study, released in 2018 followed 220,000 people in 50 different countries again for nine years and show that those people who had three servings of high-fat dairy and 100g of red meat on a daily basis had a 25% reduction in death and cardiovascular disease.

It is my opinion, from a more global analysis of the literature, that if you enjoy eggs on a regular basis but combine this with other healthy dietary patterns, clearly not the norm in America, that the evidence or harm is non-existent. We should be more focused on our overall lifestyle and dietary patterns and maintaining healthy gut bacteria through the consumption of at least 2 to 3 pieces of fruit per day and 3 to 5 servings of vegetables per day, rather than demonising one particular food i.e. eggs. The reality is that eggs contain high-quality protein, many essential vitamins & minerals, along with lutein, which is very good for the eyes; choline, which is essential for the memory and, of course, cholesterol, which is the basic, natural chemical essential for many normal and healthy compounds produced on a daily basis.

Medical science is essential to continue to improve the health of society but it doesn’t mean that the research is always correct and shouldn’t be questioned. I certainly question this study that makes rather emphatic conclusions based on one dietary questionnaire performed at the start of the study and not any further analysis of the person’s lifestyle for the next (at least) 17 years. You make up your own mind, but , for mine, I will continue to practice healthy lifestyle principles and enjoy eggs when I feel like eating them.

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Is there a link between some vaccinations and autism?

Thursday, March 14, 2019

For reasons only known to those bizarre human beings known as anti-vaxxers, there has been ongoing debate over the past few decades as to the benefits and potential detriments of vaccination. If you are an anti-vaxxer, please do not waste your time sending me hate mail, because I will delete it immediately. It is my opinion that vaccinations were the greatest advances in medicine of the last century, having abolished diseases such as smallpox and polio and markedly reduced the risk of serious, life-threatening complications of many other illnesses. There are not too many absolutes in medicine but this is certainly one of them.

In 1998, a British researcher, Dr Andrew Wakefield published a paper suggesting there was a link between vaccination for measles, mumps and rubella and the development of autism. Despite the fact that this gentleman falsified his research, he has since been discredited and  stripped of academic credentials, there are a bunch of extremely gullible people around the world who still believe this nonsense.

Unfortunately, when a tragedy such as autism occurs, the parents want to blame something other than a combination of genetic and a variety of environmental factors. Because speech and behaviour really starts to manifest around the same time as the MMR vaccine is administered, then the vaccination was the obvious, but not the logical, target.

A recent study from Denmark published in the Annals of Internal Medicine, looked at the Danish population registry with access to data from all children in Denmark. This involved 657,461 children with a 10-year follow up period. During this period, 6,517 children were diagnosed with autism.

The results of this study were absolute, showing no relationship between the MMR vaccine and the risk for autism. It also showed that vaccination did not trigger autism in susceptible children and also showed that there was no clustering of autism cases in the period after vaccination. Interestingly, there were also no links between other vaccines and autism.

Hopefully, this extremely large study will put to bed any inferences that vaccinations are linked to autism. In the vast majority of cases, vaccination is perfectly safe and prevents children from having the complications of, at times, life-threatening illnesses. Unfortunately, the lunacy perpetrated by anti-vaxxers will continue, despite solid scientific evidence.

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Let’s sleep on it

Thursday, March 07, 2019

Over the past decade, there has been increasing emphasis on the place of good quality sleep as part of an excellent quality health regimen. Some studies have suggested that 7-8 hours of good quality sleep per night is as good for the body as not smoking. With the increasing stresses and pressures of the modern world, along with the ubiquitous presence of electronics, the quality and length of sleep is being constantly eroded.

On top of this is the very common diagnosis of sleep apnoea and some other less common but still very disturbing conditions of sleep that can markedly affect the quality and quantity of a good sleep habit.

Three recent studies on sleep have prompted me to revisit this issue. The first study published in Nature Genetics from Holland assessed the DNA and sleep characteristics in 1.3 million people who were part of the US based “23 and me” genetic screening program. It has been estimated that around 30% of the population suffer some degree of insomnia, where 1 in 10 people have chronic poor sleep and subsequent daytime consequences. It has been estimated that 770 million people worldwide suffer significant chronic insomnia.

Interestingly, this new study showed that there are just under 1,000 gene variants that contribute to insomnia and this appears unrelated to whether you’re a lark i.e. go to bed early, wake up early or a night owl i.e. go to bed late, wake up late; which appears to be genetically determined with a 70-30 ratio of larks to night owls. But there does appear to be a clear link between these abnormal gene variants and insomnia with depression and anxiety.

The second study published in Science Advances from the University of Rochester was performed on mice using a variety of anaesthetic regimens, one of which simulated the effects of deep non-REM sleep. This is the phase of sleep where we rejuvenate the body for the next day. Interestingly, it has been discovered that the brain has a glymphatic system. This is the part of the immune system that helps to clear waste and other toxic proteins from the brain. It appears that this system is most active during deep sleep. Thus, if we do not have good quality deep sleep, we are not clearing toxins from the brain and thus the link between poor quality sleep and the increasing risk for Alzheimer’s disease.

The final study, published in Current Biology from the University of Colorado, looked at 36 healthy volunteers aged 18-40 and monitored their food intake, exposure to light and sleep over nine nights. They split these people into three groups, with the first group sleeping nine hours each night for nine nights, the second only five hours per night for nine nights and the third, five hours per night for five days, with an unrestricted weekend and then two further days of five hours per night. The conclusion of this study was that trying to catch up for the lost sleep on weekends does not really benefit your metabolism, with anywhere between a 9-27% reduction in insulin sensitivity by this yo-yo effect on the circadian rhythm, the vital rhythm that maintains our wake-sleep cycle each day and allows the rhythmic release of a variety of body chemicals and hormones to maintain normal body balance.

The key message from all of the studies performed on sleep is that this is a vital part of your day and one that should be respected and not abused. We should be aiming for a regular, constant sleep habit that is maintained each day. With the increasing issues around all aspects of modern living, many people are cutting back on sleep or having disrupted sleep because of stress, electronics and many other factors. We hear so much about the importance of diet and exercise but it is my opinion that good quality sleep is another vital factor in the generation of good health. Sleep poorly at your peril.

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Should you be vaccinated against influenza?

Thursday, February 28, 2019

We are approaching that time of year when we need to start thinking about getting our flu vaccine. Although influenza in 2018 was nowhere near as vicious as the previous year, there is always the chance of serious complications and occasionally death.

It is my strong advice that anyone over the age of 50; anyone with a chronic illness; pregnant women and young children should all consider having an influenza vaccine. Those vaccinated are 70% less likely to see a general practitioner with a flulike infection and also 60% less likely to be hospitalised.

Vaccinations are never 100% effective and certainly not effective against all strains of influenza. The standard quadrivalent vaccine is directed against two strains of Influenza A and two strains of Influenza B. Hopefully, this will cover the predicted strains that will infect our community over the winter months.

There are certain myths around influenza vaccination that need to be stressed every year.

1.  Having a flu vaccination protects against all other colds and viruses

2.  You can actually get the flu from the flu vaccine

3.  Is important to take antibiotics with the onset of influenza

These three statements are certainly myths. You can still catch a cold despite having had the flu vaccine. The vaccine only protects against the strains in the vaccine to which you are exposed and even then, as stated above, is never 100% effective.

You may have a reaction to the flu vaccine where you experience mild flulike symptoms but you cannot contract influenza from the vaccine.

The reality is that antibiotics are useless in treating influenza. The only reason to see your doctor would be to have specific antivirals such as Tamiflu; to obtain a work certificate and also for the doctor to check for serious complications of influenza.

Some good news around influenza has come from Doherty institute in Melbourne published in the Journal “Nature Immunology”.

T cells are specific immune cells that fight viruses and tumours. Killer cells are types of T cells active in the immune response to influenza and protect against all types of influenza. Typically Influenza A causes the pandemics that spread through the community like wildfire whereas Influenza B is typically milder but in certain cases may be very severe, especially in young children. A peptide is a small part of a protein and the influenza virus has specific common peptides which activates Killer T cells which markedly reduces the effects of the flu virus and inflammation. The group from the Doherty Institute in Melbourne identified parts of the virus that are universal to all influenza viruses that specifically activate Killer T cells, giving us universal protection against influenza. This vaccine is now patented & will soon be trialled in humans.

I believe we are not far from the day when we will all have a universal flu vaccine possibly once every 10 years, rather similar to the vaccinations we had as children protecting us for many years against what were once lethal infections that used to kill young children. This is yet another example of the vital importance of scientific research and it is exciting to see this type of work occurring in Australia. There is no doubt with the funding received by Australian medical researchers, we are punching well above our weight in this category.

Postscript: As I am not a general practitioner, I checked with my colleagues in this area & my local pharmacy. As yet, they are not expecting the first batches of flu vaccine until sometime in March.

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Myth - An elevated PSA always means cancer

Choosing wisely

How long can we really live?

Low fat is dead

Sudden death - can it be prevented?

New study another nail in the coffin for E-cigarettes

Alcohol - is it all bad?

Breast cancer: What hurts and what helps

Overdiagnosis and overtreatment

Thinking - your brain needs it!

Can air pollution increase the risk of dementia?

Prevention is better than cure

Contraceptive Microchip

Weight loss - is it all about calories?

Is low dose alcohol safe?

Aspirin for all?

Can you die of a broken heart?

3 common myths about Fibromyalgia

Statin use in older people

Doctors warned about using the word pain

Euthanasia and compassionate medicine

Are hospitals always the safest place to be?

The death of general practice

Non-alcoholic fatty liver disease

Strokecheck: does it cause more harm than good?

4 good reasons to eat your fruit and veggies

Eating ourselves to death

How do you find Doctor Right?

Myth: BPA free is a safer alternative

Medical myth: Having a life purpose is a delusion

Is there any basis for Hanson's vaccination comments?

Myth: Contraception is only for women

Medicare: our God-given right?




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