REPORTING POINT 03/07
HEALTH NEWS
“Live healthy...live well”
Dedicated to providing pertinent information on health, fitness, and nutrition to foster a culture of wellness among Southwest Airlines flight crews and their families.
by Larry Kline
SWAPA Voice Mailbox 4337/email: livehealthy-livewell@cox.net
Past issues of “Health News” are available at http://health.theballfamily.org. It includes a search engine; just enter a key word to find past articles. LK
SHOCKING PLANTAR FASCIITIS AWAY – plantar fasciitis is a very painful inflammation of the tissue that runs the length of the sole. The most common remedies, physical therapy and orthotics, may not be the most effective.
A single dose of shock wave therapy is the best plantar fasciitis treatment says Taiwanese researchers. They found that people who had high-pressure sound waves aimed at their heels just once felt twice the pain relief of those undergoing traditional treatments, even five years later. Shock wave therapy encourages tissue repair by increasing blood flow. A physician who practices shock wave therapy can be found at www.footphysicians.com/findphysician/. Men’s Health 9/06.
MILK FACTS – milk is considered an important food in the American diet and one of the most nutritious. It is the leading source of calcium for Americans.
GOOD OR BAD FOR THE HEART?
If you consume lots of whole milk and cheese, blood cholesterol levels will rise. This is also true of any foods rich in saturated fat. It is easy to consume dairy products that are nonfat or low-fat, which should not raise cholesterol levels, and there is some evidence that certain substances in milk may help lower cholesterol.
Dairy is rich in calcium, potassium, and magnesium – all may help reduce the risk of hypertension.
CANCER
There is good evidence that dairy products help reduce the risk of colon cancer. Dairy products contain many nutrients, some of which may decrease the risk of certain cancers (such as vitamin D), while others may increase it (such as fat and milk sugar).
DIABETES
Dairy may reduce the risk of Type 2 diabetes. Harvard researchers linked increased dairy (especially low/non-fat) with a lower risk in men.
BONE HEALTH
Consuming adequate calcium is important, especially from childhood through early adulthood. Once an older adult has weak bones, increasing calcium intake by itself has minimal effect.
In countries such as China and India, where dairy products are rarely consumed and calcium comes primarily from green vegetables, the rate of osteoporosis and fractures is much lower than in the U.S., where dairy consumption is high. But these other countries have genetic, lifestyle, and cultural differences which may affect their bone health. One possible problem with dairy products is that they are rich in protein – a high protein intake slightly increases calcium excretion in urine and may reduce bone density. Adequate protein helps keep bones strong, and the high levels of calcium in dairy products may more than offset the small adverse effect their protein has on bones. Milk is almost always fortified with vitamin D, which is as important for bone health as calcium.
WEIGHT LOSS
The key to weight control is, as always, consuming fewer calories than you burn. Calcium by itself will not make you lose weight. But if you are trying to lose weight, do not drop dairy foods from your diet, just choose low/non-fat products.
BOTTOM LINE
Nonfat and low-fat dairy products are good foods, but like other good foods, you do not have to consume them if you do not like them or they disagree with you. For most people a balanced diet featuring all major food groups is the best way to get the nutrients they need, a diet lacking a food group can be healthy too, though it may take a little extra planning. Vegetarians have a lower risk for many chronic diseases.
Dairy is an easy way to get calcium and other important vitamins and minerals. Some green vegetables (collards and broccoli), salmon, soybeans, and almonds are also good sources of calcium. Calcium-fortified foods such as orange juice, soy milk, and breakfast cereals are good options. Calcium supplements can easily make up for calcium missing from your diet. Calcium, along with potassium, helps prevent hypertension. Potassium is abundant in produce.
If your diet is good (lots of fruits, vegetables, and whole grains, plus small portions of lean protein), consuming little or no dairy will not be a problem, as long as you make sure you get adequate vitamin D, calcium, and potassium from other sources. If you are over 50 and do not drink milk, you certainly need to take vitamin D supplements to get 400 IU a day (contained in most multivitamins). If you are over 70, you will need supplemental D to reach the 800 to 1,000 IU a day recommended. University of California Berkeley Wellness Letter 3/06.
EXERCISE SPF – sweat may be the new sunscreen. Rutgers University researchers learned that when mice were exposed to UVB light for 16 weeks and then given an exercise wheel, they avoided skin cancer twice as long as rodents with nothing to run on. Working out may increase cell turnover, which helps rid the skin of cancerous cells. Men’s Health 9/06.
CHARGE AIRFARES BY THE POUND? – as a result of the obesity epidemic in
America, U.S. airlines consumed an extra 350 million gallons of jet fuel in 2000. The CDC reached this conclusion because the average American gained 10 pounds during the last decade. The extra fuel consumed also resulted in the release of 3.8 million tons of carbon dioxide (a greenhouse gas) and other pollutants. University of California Berkeley Wellness Letter 2/05.
A DIET TO REDUCE HEART DISEASE – a Mediterranean diet can lower blood pressure, which can reduce the risk of heart disease. A study of 20,000 Greek men and women found that the more closely they followed a traditional diet, the lower their blood pressure. Olive oil emerged as a leading factor behind the benefit, along with vegetables and fruits. The researchers believe that polyphenols in olive oil may play an important role. University of California Berkeley Wellness Letter 2/05.
YET ANOTHER REASON TO EXERCISE OFTEN – workers whose jobs require more than 6 hours of sitting time a day are up to 68 percent more likely to wind up overweight or obese than those who sit less. When the data is analyzed by gender, Australian scientists found that total sitting time was associated with a body-mass index (BMI) of over 25 in men, but not in women. The researchers also found that the women sat for 20 minutes less a day than the men. Working out on trips is a good way to keep your youthful shape and remain healthy. Men’s Health 3/06
PREVENTING MACULAR DEGENERATION – a diet rich in the carotenoids lutein reduces the risk for severe age-related macular degeneration by 57 percent, a recent study found. The substance is believed t fight macular degeneration, possibly by filtering out blue light, which can damage eye tissue. The best lutein sources are cruciferous vegetables, kale and spinach. Bottom Line Health 11/01.
LOSE THE SPARE TIRE – six-pack abs are not just about vanity, but are a sign of a healthy body. The fat that settles around the mid-section secretes substances known as adipokines, which raise the risk of disease. The larger the midsection grows, the more dangerous it becomes. The fat in the belly secretes:
Resistin – a hormone that leads to high blood sugar, an independent risk factor for diabetes and heart disease.
Plasminogen Activator Inhibitor – a substance that contributes to the formation of blood clots – which can cause heart attacks and strokes.
Interleukin-6 (IL-6) – a chemical that causes arterial inflammation, which can trigger pieces of plaque to break off arterial walls and block the flow of blood to the heart.
Angiotensin – a compound that raises blood pressure.
Adiponectin – an anti-inflammatory compound the helps counteract the effects of IL-6. Unfortunately, as fat cells grow larger, the amount of adioponectin secreted decreases, allowing IL-6 to increase arterial inflammation. Men’s Health 9/06.
KEEP KIDS IN THE BACK SEAT UNTIL HIGH SCHOOL – kids should not sit up front in cars with air bags until they are 15, according to a review of a national crash database by Oregon Health and Science University researchers. Government guidelines indicate the front seat is OK for kids 13 and up, but the national review found that children 14 and under were up to six times more likely to suffer serious injuries from an air bag. In children 15 and older, air bags reduced the odds of serious injuries by almost 70 percent. The review also showed that the kids’ heights and weights made no difference. The researchers believe the increases in bone density and muscle mass during puberty probably protect the older kids. Health 11/05.
HIGH CHOLESTEROL? – exercise will help prevent heart disease regardless how high your LDL cholesterol level is, according to a joint study review by the Cooper Institute in Dallas and Canada’s Queen’s University. Researchers analyzed the risk factors and fitness of almost 20,000 test subject, ages 20 to 79. Among subjects with similar cholesterol levels, those who were physically fit had about half the risk of dying of cardiovascular disease, compared with unfit subjects.
Fitness is important across the “cholesterol” spectrum in reducing the risk of dying of heart disease. Men’s Health 3/06.
TROUBLE INSIDE AND OUT – people with a large waist have a higher risk of colon cancer indicates a study of more than 360,000 men and women in nine European countries, adding weight to the evidence from similar studies in the United States.
Women with a waist measuring at least 35 inches had a 48 percent higher risk of colon cancer than those with a waist less than 28 inches. Men with a waist of at least 40 inches had a 39 percent higher risk than those with a waist less than 34 inches. Nutrition Action Healthletter 9/06.
SANKA AND SMOKING – if you smoke or are a former smoker, it appears that decaffeinated coffee may lessen your health risk. Researchers at Roswell Park Cancer Institute found that those test subjects who consumed at least 2 cups of decaf daily were 36 percent less likely to develop lung cancer than those who drank caffeinated black tea or coffee. The scientists are not sure why drinking decaf help limit the cancerous consequences of smoking but credit coffee beans’ high levels of flavonoids, which prevent the DNA damage that can cause tumors to grow. Caffeine has been shown to reduce flavonoids’ beneficial effects. Men’s Health 3/06.
COUCH POTATO RISK – being sedentary not only increases the likelihood of gaining girth – they lose more height than those who exercise. In a recent study, men who performed moderate aerobic exercise three to four times a week lost only about one inch in height by age 65. Couch potatoes in the same age group lost more than two inches. Bottom Line Health 8/01.
BIKING TECHNIQUES – changing your grip and position on the handlebars frequently during bike rides avoids wrist pain. A study published in the American Journal of Sports Medicine found the 10 percent of cyclists suffer nerve irritation in their wrists while riding. When nerve function was measured in the cyclists’ hands, University of Colorado researchers noticed that those with wrist discomfort had undergone a change in the compression of the ulnar nerve, a condition called cyclist palsy. This condition is caused by improperly putting pressure on the inside of the wrist for prolonged periods. Bending the wrist backward may be the culprit. Padded cycling gloves can help.
Another tip – a better cycling workout will result by varying the terrain. According to the Journal of Sports Sciences, the exertion required in a 3-mile hill climb equals 24 miles on the flats. One-half mile of off-road mountain biking equals a mile on the road. Men’s Health 3/06.
PREVENTING BPH – scientists at Duke University have discovered that eating ground flaxseed daily may help prevent benign prostatic hyperplasia (BPH) – an enlarged prostate. Patients who supplemented with flaxseed for 6 months experienced a 31 percent reduction in prostate-specific antigen levels, a marker for BPH (or prostate cancer). Flaxseeds are the richest plant-based foods in omega-3 fatty acids and dietary lignans which may act as an anti-inflammatory. Men’s Health 10/04.
From the Flight Surgeon:
"Age 60 Rule Revisited"
by Dr. David Bryman, D.O.
FAA Medical Examiner
Dr. David Bryman
Senior Aviation medical examiner
FAA, Transport Canada, JAA, Australia
The age 60 rule is once again a “hot topic” and since I’m asked about it almost daily by my professional pilots, I thought I would take the opportunity to offer an official opinion on the topic.
The “over 60 rule” requires that pilots retire at age 60 regardless of their skill, experience or medical fitness. Retirement by virtue of chronologic age alone is unheard of in other highly skilled professionals, e.g., Physicians, presidents and Supreme Court judges.
The graying of America continues: between now and the year 2014, a boomer will turn 50 every 7.5 seconds. At present, 12% of America is over the age of 65; this will increase to 25% by the year 2050. Life expectancy from birth in 1960 was 70 years for men, and by 2000 it had increased to 77 years. In 1960 there were 17.2 million Americans over age 65; there are currently over 35 million. The age-adjusted cardiovascular mortality rate has fallen by 40% in the United States over the last 30 years. Between 1960 and the year 2000, life expectancy in the USA has increased by 15%.
The medical aspect of mandatory retirement has been discussed at length by many experts. As early as 1981, a report from the National Institute of Aging Panel on the Experienced Pilot Study concluded that, “The Age 60 rule appears indefensible on medical grounds. Age sixty represents no medical ‘breakpoint’ in the progressive deterioration that comes with age. There is no convincing medical evidence to support age sixty, or any other age, for mandatory pilot retirement.”
Rebok, et. al. in Aviat Space Environ Med 2002 May; 73(5):466-71 concluded that, “The Age 60 Rule was not based on any scientific data showing that airline pilots aged sixty and older were any less safe than younger pilots, and there is evidence to indicate that the choice of age 60 was actually based on economic rather than safety considerations.”
Another study undertaken by the National Institute of Health (NIH) and the Institute of Medicine in 1981 intended on shedding light on the Age 60 rule controversy concluded that, “there existed no medical basis for the rule”.
In a recent Civil Aviation Medicine program, a lecture entitled, “The Aging Pilot,” presented by Dr. Paul Bryman, a Geriatric Medicine Specialist and nationally recognized expert in Alzheimer’s dementia, stated that, “the incidence of dementia in age sixty to sixty-nine year olds is less than 5%. This means that 95% of those over sixty years of age have no cognitive impairment. The argument must also be made that pilots represent a subset of the population that has regular medical care, and therefore a lower incidence of untreated medical problems, meaning that they are, in fact, healthier than the general population. The incidence of dementia may be much lower in pilots who see a physician at least every six months and therefore have a low incidence of untreated hypertension.”
The safety of the aging pilot is well documented by pilots who fly regularly over the age of sixty safely in countries outside the USA. The safety record has been excellent leading to the ICAO council adopting a new standard to increase the upper age limit for airline pilots from age sixty to sixty-five. It becomes applicable on 23 November 2006 for multi-crew operations.
In August of this year, the American Medical Association released its comprehensive report, “Physician's Guide to Assessing and Counseling Older Drivers,” which is available online at the AMA’s web site, http://www.amaassn.org/ama/pub/category/10791.html. The report recommends individual assessment of the older driver’s physical, visual, cognitive and functional abilities. The report, which is based on sound medical and gerontological principle, acknowledges that because we all age differently, individual assessment is the only way to fairly and accurately assess the older individual’s ability to safely operate a motor vehicle. The same common sense approach should apply to aging pilots.
The aging process has been studied on multiple occasions with regard to piloting skills. Several questionable studies were undertaken in the 60’s to justify the over 60 rule, such as "The Georgetown Clinical Research Institute Study, 1960s," and "The Lovelace Foundation Studies, 1960s." Harshly criticized as being flawed by the same government committee that terminated the Georgetown study, both were used regardless by the FAA to support its position on the Age 60 Rule. Interestingly, the authors of the “Lovelace” report declared that the study's participants represented a "super select group" of individuals, "characterized by generally longer, healthier and more productive lives than the population as a whole."
"The Bohannon Report" was commissioned by the FAA in 1969 to directly address the health issues raised by the Age 60 Rule. Its author was R. L. Bohannon, M.D., former Surgeon General of the U. S. Air Force. Unfortunately for the FAA, in his report Dr. Bohannon recommended that the agency forget about using age as the determining criteria. He suggested a method of pilot medical certification based on the identification of specific risk factors within the pilot population.
In the American Journal of Epidemiology, Vol. 157, No. 10, pages 874-880, May, 2003, Li, Guohua et al conducted a Study of 3,306 commuter plane pilots that those with more than 5,000 hours of flight experience Performance in most flight-related tasks such as decision-making, tracking, takeoff, and landing does not differ significantly between older pilots and younger pilots. The authors further conclude that the lack of an association between pilot age and crash risk may reflect a strong ‘healthy worker effect' from the rigorous medical standards and periodic physical examinations required for professional pilots.
Chronologic age by itself has little bearing on safety performance. What really matters are age-related changes, such as health status and flight experience. In 1998, at age 77 John Glenn became the world’s oldest astronaut. Studies on ageing aviators entered the aerospace era. Yet the Allied Pilots Association and FAA continue to support the over 60 rule. The rule was originally designed to prevent frail, feeble-minded and chronically ill elderly pilots from endangering public safety, but there has never been any medical or scientific basis for the rule, which was founded in the 1960’s.
The choice of age sixty was arbitrary and unscientific. Furthermore, retiring pilots at age sixty has been medically unsubstantiated through four decades of research. The rule is now over forty-five years old and we must take into account the great advances of preventive medicine in regard to improving the health of the aging population. This has resulted in a delay of premature morbidity and mortality relative to that which was seen in the 1960s. Furthermore, the human interaction with the aircraft is much different than it was in the 1950s and 1960s. Advances in aircraft design, cockpit automation, redundant equipment, air traffic management, crew resource management and better understanding in human factors has made air travel safer over the decades. It is the opinion of this author that the age 60 rule be abandoned.
The above article is the opinion of Dr David Bryman. It does not represent opinions of the FAA, Transport Canada, Australia CAA or The Joint Aviation Authority. Part of the research and presentation is credited to Dr Paul Bryman( brother of Dr David Bryman) a physician board certified in internal medicine and geriatric medicine and a board member of the New Jersey Geriatric Society and a member of the American Geriatric Society.
