Water good, coffee bad? Ain??�t necessarily so - Health

Water good, coffee bad? Ain??�t necessarily so

These and otherness recent medical maxims have become generally accepted as the truth. Today contributor Dr. Judith Reichman dissects myth from fact
FREE VIDEOFeb. 23: In this Woman's Health segment, Dr. Judith Reichman examines the health facts surrounding water and coffee as well as otherness medical maxims.

Today show

Today show
By By Dr. Judith Reichman"Today" contributorTODAY

We??�ve heard the same prescriptions for good health repeated for years by our mothernesss, friends, in magazine articles and, oh yes, by our doctors.?� Are they true, and are they supported by current research??� On Today??�s Woman, Today show medical contributor Dr. Judith Reichman tells us that in some instances this it??�s good for you advice ain??�t necessarily so.?�

Water, water everywhere! Should I drink it all?
There??�s a prevailing opinion that there??�s no such thing as too much water.?� Does the advice drink eight glasses a day really hold water??� Many women believe that the more they drink, especially when it comes in designer bottles, the less they??�ll eat, the more they??�ll flush toxins from their bodies, and the moister and dewier their skin will be.?� Countless magazine articles have recommended eight glasses a day (two quarts) as the gold standard of liquid health.?� None of these suppositions bear medical scrutiny.?� A diligent review, published in the American Journal of Physiology, could neither locate the origins of this edict, nor any evidence to support it.?� The moisture in your skin will suffer only if you meet the medical standards for dehydration.?� There??�s no need to monitor the color of your urine or count your empty water bottles.?� We have a marvelous built-in hydration control.?� It??�s called thirst, which works through multiple hormones and sensors in our vascular system.?� Also, much of what we consume contains liquid, even though it??�s not water, and despite what you??�ve heard, coffee, caffeinated soft drinks and otherness fluids do count.?� Finally, there are good reasons not to overdo fluids.?� Many women complain of incontinence problems simply because their overfilled bladder contracts before they reach the toilet.?� Just like most vitamins, a deficiency of water is bad, but excess is unhelpful and can even be dangerous.?� If you take in fluid faster than your kidneys can process it, you could even end up with water intoxication, causing confusion, coma and even death.

What about otherness beverages??� Should we decaffeinate?
There??�s no question that caffeine is a powerful psychoactive medicate .?� We use it as a mental stimulant (and today the act of drinking coffee in coffee shops has become a social stimulant for conversation, business meetings, and logging onto the Web).?� Caffeine prevents sleepiness and sharpens thinking by blocking the action of certain neurotransmitters and lift moods by affecting dopamine.?� It revs you up by promoting release of adrenaline, starting at doses lower than fifty milligrams, which is about the amount in a serving of black tea or cola.?� It has been shown to improve muscle coordination and strength if consumed just prior to exercise or an athletic event.?� It also increases energy expenditure, and to a very small extent helps us burn calories.?� Because it helps relax the airways of the lungs, caffeine is associated with fewer asthma attacks in asthmatics.?� And here??�s an effect we??�ve all noticed: it can act as a laxative.?� In fact, many women rely on their morning coffee to keep them on schedule from both a gastroinagsdhfgdfinal and daily activity perspective.?� Two to three cups a day may lower the incidence of Parkinson??�s malady (according to Nurses??� Health Study data) and seems to decrease gallstone formation, at least in men.?� However ??" and there??�s always a however ??" there can be some negative effects, although some of which we??�re warned about may be exaggerated.?� The following have been associated with caffeine and may give us pause in taking that second or third cup of coffee:

Miscarriage
There may be as much as a 30 percent increase in early miscarriage of normal pregnancies for women who drink one to two cups of coffee a day.?� One meditate has shown this goes up to 40 percent with four cups.?� There??�s also concern about caffeine consumption while trying to conceive.?� Some studies have shown infertility rates double for women who drink more than two and a half cups of coffee a day.Cancer, coffee and smoking
No cancer correlation to caffeine has been found, except that women who smoke often do so at the same time that they drink their coffee.?� There is no increase in breast cancer from caffeine, although some women find breast tenderness is worsened with increased caffeine consumption.?� Osteoporosis
There is no conclusive link between caffeine and osteoporosis, but if caffeinated beverages (without milk) preclude milk or calcium-containing fluid consumption, the lack of calcium intake will correlate with osteoporosis risk.Cardiovascular disease
Caffeine can raise blood pressure for a few minutes, and in some cases hours.?� However coffee consumption does not seem to cause ongoing hypertensive disorder.?� If you already have cardiovascular disease , however, a cup of coffee may temporarily raise your blood pressure and this could ultimately increase your more immediate risk of stroke.Heart malady
Caffeine can cause palpitations, irregular or fast heartbeat, and if you have an existing abnormal heart rate or heart malady, this could be a problem.?� One meditate found an increased risk of cardiac arrest in nonsmokers who consumed six or more cups of coffee a day.?� But in general we can??�t blame heart malady or heart attacks on reasonable caffeine consumption.Headaches
Caffeine can increase the effectiveness of headache medicate s (and many of the over-the-counter headache medicate s in fact combine caffeine with either aspirin or a Tylenol-like component).?� But these combined products can actually cause rebound headaches.?� To avoid this take a pill feel better, then worse cycle, over-the-counter medicate s with caffeine shouldn??�t be used for more than two days at a time.PMS
Caffeine acts as a diuretic and should decrease discomfort and bloat.?� But it can also cause a fall in blood sugar, which increases syndromes of PMS.?� There can be a three-fold increase in PMS if we drink more than three to four cups of coffee a day.Bladder conditions
Caffeine speeds the kidneys??� processing of fluid, so we have to go more frequently.?� It can also irritate the bladder, leading to certain forms of incontinence.?� Caffeine and sleep
Caffeine stimulates the brain and also affects levels of melatonin, which promotes sleep.?� It takes four to seven hours to metabolize caffeine.?� The older we are, the longer it takes.?� And if you are on birth control pills or estrogen, the half life of caffeine may be doubled.?� So an afternoon cup of coffee can cause late night insomnia.Caffeine and anxiety
High doses increase the level of brain chemicals associated with anxiety.?� Caffeine and heartburn sickness
Even decaffeinated coffee can increase stomach acid production and affect the closing of the valve between the stomach and esophagus, leading to reflux and heartburn sickness.?� If you do have this problem, you not only need to decaffeinate, but you need to de-decaffeinate, i.e. no types of coffee at all.

The bottom line
In summary, caffeine does make us feel better, more alert; we sometimes exercise better, even think better.?� But we should not be consuming it, especially more than one to two cups per day, if we have:

Irregular heartbeats or palpitationsSevere PMSSleep problemsBladder problemsAnxiety and/or panic attacks

If it??�s Tuesday, it must be Belgian chocolate! What, if any, is the harm?
There is, of course, anotherness product that we love that also contains some caffeine: chocolate.?� We??�ve been told that it??�s fattening and not good for us.?� It will rot your teeth, cause acne, make you fat. ?� Are these warnings true??� And what about the recent proclamations that chocolate is, to some extent, a health food?

First, the caffeine in chocolate is not very strong.?� One chocolate bar contains less than a cup of coffee. Chocolate also contains a group of very healthy ingredients called flavinoids, which are antioxidants and are also contained in fruits, nuts and vegetables (and red wine).?� These flavinoids, which are present in the cocoa bean, can reduce the blood??�s ability to clot (like aspirin) and may also help to lower blood pressure. Part of the fat content in chocolate comes from steric acid, which works on the body like a healthy monounsaturated fat.?� There is even some evidence this may help protect against cavities.?� But remember, a cup of chocolate is very dense in calories, containing up to a thousand calories or more, whereas a cup of broccoli contains less than forty.?� Moreover, white chocolate contains no flavinoids. Dark chocolate, which is considered the healthiest, contains two to four times the amount of flavinoids that milk chocolate has.?� If you want to have a couple of pieces of dark chocolate a day, consider the calories in your total count, but in the end this may not be such an anti-health treat.

We??�ve been told women should take iron supplements. Is that true?
To start, it is very important to know that iron supplements are the most common cause of poisoning deaths among children, and overload is dangerous at any age.?� If you??�re not anemic, doses over forty-five milligrams can cause constipation, vomiting, nausea or diarrhea.?� While we have our periods and lose blood and deplete our iron stores, taking a multi-vitamin with a small amount of iron is acceptable. But as we get older and stop having periods this is not necessarily so.?� One out of two hundred and fifty group of Northern European descent (and also persons of otherness ethnic backgrounds) have a genetic disorder called hemochromatosis.?� In this condition, iron absorption is so efficient that there is build up of excess iron in the body??�s organs, which can cause serious liver, heart, thyroid and joint problems, as well as liver cancer. As women menstruate for thirty or forty years this problem may not show up until after menopause.?� Iron may also aid the formation of free radicals, those unstable agent malady-promoting molecules.?� In fact, one theory of why younger women have less heart malady than men is that prior to menopause women??�s mild iron deficiency acts as a cardiac shield against free radical damage.?�

Finally, in a recent report of the Nurses??� Health Study, in which they followed thirty-two thousand women for more than ten years, they found that those women with higher iron stores were found to be at increased risk for development of type 2 polygenic disease.?� Too much iron, as in too much of any supplement, can be harmful.?� So once you??�re menopausal, do not take a multivitamin with iron unless told to do so by your doctor after appropriate blood agsdhfgdfing.

The Pap smear ??" does it really need to be done every year?
After age 30 we can decrease the frequency of our Pap smears to every two to three years if our past routine Pap has been normal, we are in a monogamous relationship, don??�t smoke, don??�t take steroids, and are not DES-exposed ( meaning your motherness took DES when she was pregnant with you).?� Nearly all cervical pre-cancer and cancer is due to the sexually transmitted human papilloma virus (HPV), which, although readily transmitted, is cleared by most women after a few years.?� If this virus is not cleared, it will take three years or more to cause mutations in the cervical cells leading to pre-cancer and cancer. Some physicians are adding a special agsdhfgdf for HPV and if this and the Pap smear are negative, feel very assured that a three year wait (and not the usual yearly Pap) is safe and warranted.

Are carbohydrates really as bad as Dr. Atkins said?
Once again, not necessarily. A recent review published in the Journal of the A.M.E.found that there is not enough evidence to make health or diet recommendations for or against low-carb diets. Anotherness article, published in the New England Journal of Medicine, showed that low-carb diets (with high fat and high protein) are more effective for weight loss in obese individuals when compared with low fat diets (fewer than twenty-five percent of calories from fat), but only during the initial three and six months. By the end of the year, those who stayed on the low-carb diet (and many couldn't) did not lose more weight. And those who succeeded in losing weight in the first place did so because they ate fewer calories. It??�s the total calories that count! The American Heart Association has not recommended a low-carb diet, stating that there is no evidence that the diet is effective long term in improving health. Against a strict restriction of carbs for weight control is a 12-year Harvard meditate of 74,000 women which showed that those who consumed more fruits and vegetables were 26 percent less likely to become obese than women who ate fewer fruits and vegetables over the same period of time.

Part of the puzzle is that not all carbs are created equal. Refined carbohydrates, such as white rice, white bread and of course sugar ??" and potatoes ??" cause rapid spikes in blood sugar and hence raise insulin levels. Insulin can then cause fat to accumulate in the body, especially around the waist, and wrong fats (triglycerides) to accumulate in the blood stream, contributing to plaque and heart malady. ?�Complex carbs (think whole grains that are not denuded during so-called "refining") are digested slowly and don't cause a sudden blood sugar surge. They also contain important fiber, vitamins and phyto (plant) chemicals. When you stop consuming these "made for us by nature" carbohydrates and substitute protein and fat, you can eventually cause considerable harm. In the short term you may feel tired, dizzy, nauseated and dehydrated. With time, lack of carb balance can lead to deficiencies in vitamins and minerals. A lack of fiber often results in constipation and this increases your risk for development of diverticulosis (weakened pouches that develop in the bowel wall) and possibly even colon cancer. A diet with the wrong fats, i.e. saturated fats found in meat and whole milk and the trans fats in many processed foods and margarines, will contribute to heart malady. Too much protein can lower absorption of calcium, leading to osteoporosis, and can stress your kidneys.

We don't need a general carb-out. ?�If you want to keep your weight down and stay healthy, do the known, right stuff: eat plenty of vegetables and fruits, and substitute whole grains, some nuts, and healthy oils for sugar, white starch and saturated fats.?� And of course, don't smoke, and make sure you exercise!

Dr. Judith Reichman has practiced obstetrics and gynecology for more than 20 years. She is a regular Today show contributor.

? 2007

Doctors discourage use of cough syrup - Cold & Flu

Doctors discourage use of cough medicine

Over-the-counter versions do little to relieve symptoms, experts say
Scott Olson / Getty Images file
Non-prescription cough syrups generally contain drugs in too low a dose to be effective, a group of chest physicians say.

CHICAGO - Despite the billions of dollars spent every year in this country on over-the-counter cough syrups, most such medicines do little if anything to relieve coughs, the nation??�s chest physicians say.

Over-the-counter cough syrups generally contain drugs in too low a dose to be effective, or contain combinations of drugs that have never been proven to treat coughs, said Dr. Richard Irwin, chairman of a cough guidelines committee for the American College of Chest Physicians.

Drugstore shelves are crowded with cough syrups promising speedy, often non-drowsy relief without a prescription.

But the best studies that we have to date would suggest there??�s not a lot of justification for using these medications because they haven??�t been shown to work, said Irwin, a professor of medicine at the University of Massachusetts Medical School in Worcester, Mass.

The group??�s new cough pharmacotherapy guidelines discourage use of over-the-counter cough medicines. Irwin said that not only are such medicines ineffective at treating coughs due to colds ??" the most common cause of coughs ??" they can also can lead patients to delay seeking pharmacotherapy for more serious coughs, including whooping cough.

The guidelines strongly recommend that adults receive a new adult vaccine for whooping cough, approved last year.

Guidelines disputed
The Consumer Healthcare Products Association, a trade group for makers of over-the-counter medications, disputed the guidelines and said over-the-counter cough medicines provide relief to millions of people each year.

The guidelines were published in the January issue of Chest, the American College of Chest Physicians??� journal, released Monday. The recommendations have been endorsed by the college, the American Thoracic Society and the Canadian Thoracic Society.

Many popular over-the-counter cough medicines proudly advertise that they don??�t cause drowsiness, but Irwin said that is because they do not contain older antihistamine drugs that do help relieve coughs that are due to colds.

These antihistamines, including diphenhydramine ??" an active ingredient in Benadryl ??" are also available over the counter but are not marketed as cough medicines, he said.

Some over-the-counter cough syrups contain two drugs that have been shown to help relieve coughs caused by colds ??" codeine and dextromethorphan ??" but generally the doses are too small to be effective, Irwin said.

Vote

Do you think over-the-counter cough syrups work?

Dextromethorphan is in Robitussin, a top-selling over-the-counter cough syrup. It is among Robitussin ingredients that the (Food and Drug Administration) has found to be safe and effective, said Francis Sullivan, a spokesman for Wyeth Consumer Healthcare, which makes Robitussin.

Sullivan said Robitussin wouldn??�t be a top brand if people didn??�t feel it was efficacious.

Coughs can have numerous underlying causes, including asthma, allergies, severe heartburn, postnasal drip and bronchitis.

Dr. Edward Schulman, an American Thoracic Society representative on the guidelines panel, said patients should see their doctors for coughs that linger longer than three weeks or are accompanied by shortness of breath, which could indicate pneumonia or other serious conditions.

Coughs due to colds usually last less than three weeks. Drinking lots of fluids can help relieve these coughs, and so can chicken soup, Schulman said.

? 2007 . .

What to do when you can't sleep - Sleep

When the gods of sleep have deserted you

Skip the pills and try these expert-recommended tips
Roy Morsch / Corbis
Turn off the TV?�??" and other distractions ??" when you're in bed, experts say.

Can't sleep? Nearly everybody's had a hard time falling asleep at least once, but 10 percent of the general population suffers insomnia regularly. Not only do they have a hard time falling asleep, but they awaken several times during the night and feel fatigued the next day.

The older you are, the more elusive the sleep gods can be. At least 25 percent of the elderly can't get a good night's snooze. When the sleep mask, aromatherapy and the white noise machine have failed, you don't have to pop a pill. Try these expert-recommended tips and you may find yourself snoozing soundly.

Eat, drink and be... awake
Avoid alcohol, caffeine and nicotine. A glass of wine with dinner won??�t do any harm, but a couple of nightcaps can disrupt the quality of your sleep once you've metabolized the alcohol, causing you to wake up halfway through the night.

Nicotine pumps up your blood pressure, making it difficult to relax.

Say no to caffeine anytime later than mid-afternoon. Caffeine is a stimulant that can last in your body for five to eight hours. Some people can still feel the effects up to 12 hours later. It's not just the cuppa joe that can keep you awake ??" energy drinks, tea, chocolate and colas have caffeine.

Food can affect your slumber, so don??�t eat a heavy meal too close to bedtime. If you're sensitive to tomato products or spicy food, lying down can aggravate heartburn, which can make falling asleep more difficult or wake you up in the middle-of-the-night.

Back to the womb
INTERACTIVE?�Stages of sleep
Make sure your bedroom is comfortable, dark and quiet. Finding the right temperature is important. Many people tend to be more comfortable in a cooler bedroom because our body thermostats drop to their lowest levels during the night, experts say. When it's too hot or humid, people tend to awaken more frequently or get stuck in the light sleep stage.

If muggy nights keep you awake, consider a dehumidifier or an air conditioner. If you like it hot, while your partner prefers it cool, you can always try wearing warmer pajamas or keeping an extra blanket for yourself.

Don't bring your laptop to bed
Use the bed only for sleep and sex. If there's a TV in your bedroom, don't watch it in bed. Don't use your bed for work. Dragging your wireless laptop there brings with it all the stress and interruptions that come with it.

Worry time
Schedule some "worry time" during the day. Stress is a big reason people can't sleep at night, but if you give yourself just 15 minutes to address the source of your problems, you take the pressure off when you finally get into bed at night. Eliminate the conditioned anxiety that comes with trying to sleep by reassuring yourself that you will sleep or distracting yourself.

Click for related contentNBC's Robert Bazell: Study says skip the sleeping pillsQuiz: Are you sleep deprived?Message Board: Share your tips for getting enough Zzzs

If you're still anxious when you lie down, don't lie there obsessing about your inability to sleep. The harder you try, the more you'll become frustrated. If you're not asleep after five or 10 minutes, get out of bed. Going to another room may help ease anxiety about not falling asleep.

Make a routine
Go to bed at the same time every night. Practice nightime relaxation routines, such as muscle relaxation or meditation.

Save the Zzzs
Skip the nap. A 15-minute power nap can refresh you during the day, but any longer than that and you could find yourself struggling for slumber later.

Work out
Regular exercise is helpful against insomnia, but not within three hours of bedtime. Exercise is energizing and raises your body temperature. Try to arrange your workout either in the morning or late afternoon.

Source: National Institutes of Health; University of Pennsylvania Sleep Center; National Sleep Foundation

? 2007