“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
email: livehealthy-livewell@cox.net
Past issues of “Health News” are available at http://livehealthy-livewell.blogspot.com/. It includes a search engine; just enter a key word to find past articles. LK
COFFEE DRINKING AND DIABETES – coffee drinkers are at lower risk for diabetes according to a review of 18 studies involving more than 450,000 people reported in the Archives of Internal Medicine. People who drink three to four cups of coffee a day were found to have a 25 percent lower risk of type 2 diabetes, compared to those who drink less (or no) coffee – and more consumption lead to a lower risk of the disease. Because decaffeinated coffee also reduced the risk, much of the benefit is likely due to other compounds in coffee besides caffeine. Tea was associated with reduced risk, also. University of California Berkeley Wellness Letter 3/10.
TURNING BACK TIME - a year after kicking the habit, smokers' arteries showed signs of reversing a problem that can set the stage for heart disease, according to a study of 1,500 smokers. The improvement came even though smokers gained an average of nine pounds after they quit. Their levels of good cholesterol (HDL) improved, also. The new research shows these people gain a health benefit even though they pick up pounds that hopefully can be shed once they have gotten used to not smoking, say the study published in the Journal of the American College of Cardiology. USA Today 3/17/10.
MORE THAN A “PET” – for a nutty, nutritious boost, add chia seeds to cereal, oatmeal, yogurt, or baked goods. These small gray seeds from Mexico are one of the best sources of alpha linolenic acid – a healthy omega-3 fat. A one-ounce serving (about three tablespoons) also provides lots of fiber (11 grams), along with some protein, calcium, iron, zinc, and other minerals. By forming a gelatinous mass when digested or mixed with a liquid beforehand, chia seeds may slow the absorption of sugar, help eliminate cholesterol from the body, and make you feel full – similar to soluble fiber supplements such as psyllium. Chia seeds are sold at health-food stores and on the internet. University of Berkeley Wellness Letter 3/10.
HOW A BODY-FAT SCALE WORKS – when you step on the scale’s electrodes, a 500 microampere current goes up the leg. Human skin can sense currents only stronger than 1 milliamp, which is twice as powerful as the scale’s charge.
As the current moves throughout the lower body, it encounters resistance in tissue. Water is a much better conductor of electricity than fat, so muscle, which is about 73 percent water, provides easier passage of the current.
The scale detects the total time it takes for the current to complete its path. The faster it travels, the more muscle and less fat you have. With this data, it computes the body-fat percentage. If you have a body-fat scale, it would be a good idea to compare the readings from the scale to body-fat measurements from more accurate means like body-calipers or water-displacement measurement methods. Men’s Health 6/07.
OVERRATED FOODS:
Granola – in the 1960’s, granola was a mixture of whole oats, nuts, sunflower seeds, raisins, oil and honey. Today, most marketed granola contains table sugar and corn syrup. Commercial granolas are usually high in calories coming in at over 200 calories from a serving that is a mere half cup with many popular ones packing in over 500 calories per serving.
If you enjoy granola, try mixing it with your favorite whole grain flakes, puffs, or squares which may be less calorie-dense. Be sure to read the nutritional label to see what ingredients you are actually consuming.
Smoothies – smoothies can be a healthy meal alternative if made with low-fat or non-fat yogurt, milk and fresh or frozen fruit.
Commercial smoothies may be loaded with added sugar and much heavier in calories than the homemade versions. Some commercial smoothie chains sell smoothies that contain from 600 to as much as 1,100 calories.
Vegetable Juice – V8 claims that it contains “2 Full Servings of Vegetables.” Yet V8 is mostly reconstituted tomato juice. According to the nutritional label, the next most abundant non-tomato vegetable juice is carrot, then celery, beets, parsley, lettuce, watercress, and spinach. One cup of carrot juice contains 900 percent of a day’s vitamin A; one cup of V8 contains 40 percent of the vitamin.
Regular V8 contains 600 milligrams of sodium in every 11 ½ ounce can; the Low Sodium V8 has 200 mgs.
Energy Bars – many energy bars are mostly a mixture of fructose and glucose (like ordinary sugar and high-fructose corn syrup). Sugar is indeed an energy source, but it is devoid of other healthy and nutritional compounds like fiber, vitamins and minerals. If you are an athlete who engages in strenuous and prolonged bouts of exercise, an energy bar can help replenish your glucose and glycogen stores. But if you are not partaking in strenuous exercise, energy bars are loaded with empty calories. A healthy alternative would be a piece of fruit instead of a vitamin-fortified cookie or candy bar. Nutritional Action Healthletter 5/10.
BE INFORMED TO STAY SLIM – researchers from the University of Mississippi, found that test subjects who checked a restaurant’s nutritional guide (especially in fast-food restaurants) before ordering ate 69 percent less when they checked the calorie content of meal items being considered on the menu. Men’s Health 6/07.
DON’T TAKE A PAIN RELIEVER BEFORE EXERCISE – some athletes and exercisers take aspirin or other non-steroidal drugs before an event or workout in order to reduce inflammation and soreness and thus boost performance, according to a recent editorial in the British Journal of Sports Medicine. The publication warned that this misuse can inhibit the body’s ability to adapt to challenging workouts and interfere with healing, besides increasing the risk of stomach bleeding and possibly cardiovascular problems. If you feel pain when exercising, your body is telling you to stop for a reason and you do not want to ignore this warning sign.
It is fine to occasionally take pain relievers to treat soreness and other symptoms after exercising. University of California Berkeley Wellness Letter 3/10.
INTERVAL TRAINING TO LOSE WEIGHT – an Australian study showed people who exercised with 20 minutes of high-intensity interval training three days a week dropped 10 percent of their body fat, while those who exercised longer but at a lower intensity did not lose any.
The researchers believe that interval training increases the body’s levels of catecholamine, a chemical that triggers fat burn. Men’s Health 6/07.
SOY AND BREAST CANCER – if you have had breast cancer, soy foods may lower the risk of dying. According to a Chinese study that tracked patients over four years, women who consumed the most soy protein (at least 11 grams a day) had a 30 percent lower risk of dying of breast cancer than those who ate the least soy protein (5 grams a day or less). The results were the same for women with either estrogen-positive or estrogen-negative tumors and for those taking tamoxifen or not.
Women who consumed the most isoflavones (more than 60 milligrams a day) from foods had roughly a 25 percent lower risk of dying or having their cancer recur than those who ate the least isoflavones (20 mg a day or less). Isoflavones are estrogen-like substances in plants that sometimes boost – and sometimes counter – the effects of the estrogen that the body produces. Unprocessed soy foods are rich in isoflavones.
Food sources of soy include soy milk or whole soy foods like tofu, edamame, miso, and soybeans. Nutrition Action Healthletter 3/10.
EATING FOR YOUR BLOOD TYPE? – ignore claims about diets based on blood type, body type, or personality type. These diets have no scientific evidence to back them up. Like most diets, these may help you lose weight in the short term because they tell you to eliminate groups of foods from your diet and thus trick you into eating fewer calories for a while. There has been legitimate preliminary research into how genetic factors interact with diet in influencing the risk of disease, but so far this has not yielded any practical dietary advice. University of California Berkeley Wellness Letter 12/09.
HEALTHIER GRILLING – is it healthier to grill with propane or charcoal?
Studies show that charcoal-grilled meats contain more carcinogens called polycyclic aromatic hydrocarbons (PAHs) than meat heated with propane. When fat drips from meat, the fat burns and creates PAH-infused smoke, which coats what you are cooking. Charcoal flames are hotter, which chars meat and creates heterocyclic amines (HCAs), another carcinogen. Propane still produces some PAHs and HCAs, so take these steps with any grill:
TRIM FAT. Lean meats create less drippings and less smoke, which reduces PAHs.
MARINATE. Soaking meat or other grilling entrees in vinegar or lemon juice reduces HCAs by 90 percent. Any marinate greatly reduces the HCAs.
FLIP FREQUENTLY. Studies have shown that turning meat frequently results in fewer HCAs. Men’s Health 6/07.
FROM THE FLIGHT SURGEON
(The following is reprinted with the author’s permission-LK)
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| From Live Healthy. Live Well. |
Cancer and Airmen Medical Certification
David Bryman, D.O
Senior Aviation Medical Examiner
FAA, Transport Canada, JAA
I recently saw an airline captain in my office that had a diagnosis of prostate cancer. He was very distraught and told my medical assistant that he was sure his career was over.
Fortunately, he was incorrect and medical certification was easy and quickly obtained.
The diagnosis of cancer is of concern to both the pilot and the FAA regarding medical certification. In this article, I will try and review some common malignancies and how they might be evaluated and processed by the AME. I will focus on the aeromedical aspect rather than on disease process and treatment. In other words if a pilot is diagnosed with cancer, how does he/she get back in the air?
Firstly, to understand the logic in special issuance (explained below) as it relates to malignancies (cancers), it is important to understand which cancers are at higher risk to metastasize. Metastasis is a term we use to describe a cancer that has spread to another organ such as the brain, liver or lymph nodes. Some cancers are very aggressive and tend to spread quickly, while others are slower growing and tend to remain confined for a longer period of time.
The reason that brain involvement is so important is that even a small amount of cancer in the brain can cause extreme neurological symptoms such as seizures( common for melanoma), numbness, weakness, headaches, visual changes, personality change, altered consciousness and of course pilot incapacitation.
Lung, breast, melanoma, renal (kidney), and colon cancers are the most common primary tumors to metastasize to the brain (in that order). Other cancers that can spread to the brain include testicular, head and neck tumors, esophageal and prostate (not a complete list). Of course there are tumors that may start in the brain as primary cancers.
Cancers in general are disqualifying under the “normal” process where an AME issues the medical certificate after an office visit. Most malignancies fall under the special issuance category at the FAA and are usually placed in the “AME assisted special issuance program”. This means that the AME must defer the airman’s medical form to the FAA for the initial certification. After that the AME and the pilot are sent a letter that outlines the procedure for future medicals that can be issued directly by the AME.
For example, if a pilot has a diagnosis of prostate cancer and was treated by surgery or radiation he would probably qualify to return to flight status. The pilot in this case being proactive should call his AME prior to the visit to find out what he needs to bring and arrive well prepared.
If he brings all required documentation, the process will be much easier. The required items in this case would include; a current status letter from the urologist documenting his treatment, diagnosis, prognosis, and follow up plan. He will also need to bring a copy of the hospital history and physical as well as the discharge summary and pathology reports, x-ray results, and recent lab work including a PSA. Usually, the treating physician has all the required information readily available in the patients chart.
The AME will then send his report to the FAA along with the information collected by the pilot. The FAA will review the information and issue a medical certificate directly from Oklahoma City. The certificate will almost always be time-limited for 1 year. There will be clear instructions to the pilot in a letter as to how subsequent certificates will be issued. The FAA will usually request a current status letter from the treating physician at yearly intervals documenting that there is no evidence of recurrence of the malignancy and that the pilot’s condition has remained stable. In the above example, it is likely that a statement will be required by the urologist that the pilot has remained cancer free, along with a copy of the most recent PSA.
Not all cancers require special issuance by the FAA. Many less aggressive malignancies can be issued by the AME at the time of visit. These are cancers that are less invasive or diagnosed very early. For example, basal cell carcinoma is a very common form of skin cancer related to sun exposure. It is not likely to spread and usually is treated with excision or freezing. Also, certification of a pilot with very early melanoma can sometimes be done at the visit with the AME. Again, being prepared is important, and the pathology report is absolutely necessary in this case for the AME to decide if deferral to the FAA is warranted.
In regards to malignancies that can metastasize to the brain such as those mentioned previously, the applicant may be required to prove that there has been no brain involvement. Often, a copy of an MRI report will suffice.
In my experience, the FAA has been very reasonable in regards to special issuance of a medical certificate when a pilot has been diagnosed with cancer. In fact it is rare that a case is not approved. After the special issuance is obtained, the AME can usually continue to issue the medical as long as the pilot obtains the necessary items outlined in their authorization letter. The FAA probably will follow the pilot under this program for 5 years. Of course this will vary based upon the aggressiveness of the malignancy.
Remember, when it comes to certification after a malignancy, work with an experienced AME and come to your office visit well prepared. In some instances a fax and a few phone calls from your AME to the FAA can lead to approval of your medical in a very short time. The most common cause of delayed certification is because the pilot did not supply the necessary information for the FAA to make a determination.
Disclaimer- My opinions regarding certification are based on my experience as an AME. The information presented is designed to be informative and educational and are not intended to represent opinions by the FAA.
