John Cannaday, M.D., a staff radiologist at Cooper Clinic discusses two studies reported in the December issue of the Archives of Internal Medicine, calling on physicians to limit CT Scans due to the risks associated with radiation exposure. The study headline read "Commonly performed CT scans are exposing patients to far more radiation than previously thought and in doses that could cause tens of thousands of cancers a year." In the two studies, the authors call on physicians to limit radiation exposure to patients.

Dr. Cannaday reports that CT scans are used regularly at Cooper Clinic as a tool in evaluating cardiovascular health, and diagnosing coronary artery disease and blockage. The technology over the past decade has dramatically improved - through CT scans it's possible to take a noninvasive three dimensional tour of the torso.

In the first study, a team (lead by Dr. Rebecca Smith-Bindman) at the University of California, San Francisco, collected data from 1,119 patients who received 11 types of CT scans in four area hospitals. The level of radiation exposure in the CT scans varied widely within and across the hospitals, with an average variation that was 13-fold. For example, the dose of radiation for a multiphase abdomen-pelvis CT scan ranged from 6 to 90 millisieverts, with an average dose of 31 millisieverts.

In the second study, Amy Berrington de Gonzalez and her team (from the National Cancer Institute's Division of Cancer Epidemiology and Genetics) estimated that 29,000 future cancers could be related to scans performed in 2007, and that these cases could result in about 14,500 deaths.

From a consumer standpoint, the more exposure we have to radiation, the higher the potential risk of cancer.  Dr. Cannaday says that we are not able to free ourselves from radiation, the average background radiation is 3 millisieverts. Scan ranges less than 100 millisieverts are considered low exposures.  The team at the Cooper Clinic have aggressively trained to run these tests with the lowest possible exposure possible.

The average exposure for a multiple slice of the heart to look for calcium scoring is approximately .9 millisieverts, so less than 1 millisievert. For the coronary CT antiogram which is a more extensive test, Cooper Clinic routinely performs this test with a millisieverts score of 2 or less. The test is more involved when looking at coronary bypass patients, and Cooper Clinic performs this test for 2.5 millisieverts or less.

Dr. Cannaday believes patients should talk with their physician about the radiation exposure of any test, and to ascertain if there are alternative ways to get the results without non-ionizing radiation, for example through MRI or ultra sound. Any exam in the imaging department needs to be tailored to the question being asked, and minimizing radiation exposure should be a consideration.

Patients need to keep in mind that scans are a tremendous tool in diagnosing cardiovascular, abdominal, chest and head diseases. While we need to be aware of radiation exposure, Dr. Cannaday hopes that studies like these don’t scare people away from having tests they may genuinely need for managing their overall health.

Reference
Studies Quantify Cancer Risks From CT Scans

Jill Turner is VP of Operations for Cooper Concepts, the company that markets Cooper Complete nutritional supplements, and oversees the Cooper Wellness Program, where individuals come to live at Cooper  for a week at a time to focus on living a healthy life. Jill regularly contributes information to the Cooper blog. Email jsturner@cooperwellness.com or call 972-560-3262 with your questions and comments.

Jennifer Engels, M.D. is a diagnostic radiologist at Cooper Clinic. Dr. Engels discusses new recommendations regarding mammograms from the U.S. Preventive Services Task Force.

On November 17, 2009, the U.S. Preventive Services Task Force issued new recommendations on screening mammography released in the Annals of Preventive Medicine.  

The task force recommends that women who are considered “low risk for breast cancer” should start screening mammograms at age 50 instead of age 40, and they should be performed every other year instead of annually. The report further recommends that women 75 years of age and older should no longer be screened.

Cooper Clinic recommends that all patients consider the risk of a potentially "false positive" mammogram in order to find an early, curable breast cancer. At Cooper Clinic, any additional mammographic views and/or breast ultrasound are performed on the same day as a screening mammogram. Patients leave Cooper Clinic that day with results from their exams without the anxiety of having to wait for the results to come through the mail.

Dr. Engels urges women continue to get their annual mammograms starting at age 40, as 23 percent of breast cancers are diagnosed in women under the age of 50. If the women are high risk, they may also want to talk to their physician about adding breast MRI.

Cooper Wellness Program with Peg Williams (Podcast)

Peg Williams, a two-time participant with Cooper Wellness Program, is interviewed by Todd Whitthorne. The Cooper Wellness Program is medically-supervised, in-residence lifestyle modification program. Since attending the program in June, 2008, Peg has lost 120 pounds.

Flying around the country for her job, Peg says she regularly saw the ad for the Cooper Wellness Program in the American Airlines in-flight magazine. While at a conference in 2008, Peg realized she was wearing her largest clothes, and they were tight! At that point, Peg made the decision to come to Cooper for help.

Peg says when she had a Cooper Clinic physical and spent a week in the Cooper Wellness Program, she knew she was overweight and that her clothes were tight, but at the time she didn’t think she felt bad. After getting a download of data during her Cooper Clinic physical and then during the Wellness Program, Peg realized she had been headed in the wrong direction. Luckily for her, all of her potential health issues were fixable with weight loss.

With weight loss as the goal, Peg focused on getting healthier. She says the key to her success has been to learn how to eat right, to make healthier choices, and to get moving. Peg learned during her week at Cooper that good food doesn’t have to taste bad. Departing a few pounds lighter after her week at Cooper, Peg started built on that success. She started watching her calories, and she started exercising.

In an exercise session at Cooper Fitness Center, a trainer told Peg she needed to get 200 minutes of aerobic exercise weekly. Peg says this number was about twice what she had hoped, but that little by little she slowly started upping her exercise time.

Between healthier eating habits, and increased activity at the gym, Peg was losing 2- to 3 pounds per week, and then it was just a matter of staying focused for the long run.

Peg travels most of the time on business, and is on a plane or in a hotel almost every week. She says the Wellness Program taught her that “this is only hard if you make it hard.” She found a couple of time things she can do all the time, and arms herself against excuses. For example, every hotel has a fitness center – it might not be pretty, but it’s there, so there’s just no excuse not to utilize them. And, when it comes to food, there are tons of choices, and restaurants are accommodating if asked. Peg says she has a list of go-to meals she utilizes when on the road.

Peg’s advice to those wanting to be healthier is to just get started. Do something and build on that. Get a little bit of exercise. And, at each meal, make one smarter choice. For example, for breakfast choose oatmeal instead of a donut. And, when ordering lunch, instead of ham and swiss with mayonnaise, order turkey on whole wheat. These are examples of small changes that add up. Success will follow!

Peg says her family, friends and colleagues all say she looks so much younger. And she truly feels great!

You can read about Peg’s weight loss in the Southern Living magazine blog http://livehealthy.southernliving.com/2009/07/lost-one-tiny-celebrity-or-the-equivalent-thereof.html

For information on scheduling a 4 or 6-day visit (and bring a friend!) with the Cooper Wellness Program, contact Cindy Bostick at 800-444-5192 or clbostick@cooperwellnessprogram.com.

Jill Turner is VP of Operations for Cooper Concepts, the company that markets Cooper Complete nutritional supplements. Jill regularly contributes information to the Cooper blog. Email jsturner@cooperwellness.com or call 972-560-3262 with your questions and comments.

Reference Information

Cooper Wellness Program information

http://www.cooperaerobics.com/For-Individuals/Wellness-Program/Program-Information.aspx

Benefits of exercise differ by sex and race (Podcast)

Dr. Tedd Mitchell, Cooper Clinic president and CEO is interviewed by Todd Whitthorne, and talks about how the benefits of exercise differ by sex and race.

The study, reported in the Journal of Lipid Research (August 2009 issue), began in the late 1980s, and used data from more than 15,000 middle-aged African American and Caucasian men and women (already participating in the Atherosclerosis Risk in Communities Study). Researchers wanted to evaluate the benefits of one hour of “mild” or 30 minutes of “moderate” exercise on HDL, the healthy cholesterol.

“Mild” exercise activities included walking for pleasure, bowling, and weight lifting, while “moderate” exercise included playing basketball, hiking, and modern dance. Researchers found that either an hour of mild exercise or a half hour of moderate exercise each week increased the level of heart healthy HDL cholesterol. Regarding triglycerides and LDL (lousy) cholesterol, the impact exercise has is less clear. Researchers saw a reduction in triglycerides in Caucasians, but not in African Americans. And, researchers found that the LDL cholesterol level was reduced, but only in women.

Dr. Mitchell says the big takeaway from this study is that exercise is good, and for health benefits we don’t need that much, and that consistency with exercise, not intensity, is the key. One hour of mild exercise, or 30 minutes of moderate exercise positively impacted HDL cholesterol levels.

Jill Turner is VP of Operations for Cooper Concepts, the company that markets Cooper Complete nutritional supplements. Jill regularly contributes information to the Cooper blog. Email jsturner@cooperwellness.com or call 972-560-3262 with your questions and comments.

Reference Information

Atherosclerosis Risk in Communities Study

http://www.cscc.unc.edu/aric/

Atherosclerosis Risk in Communities Study: Community Surveillance and Cohort Morbidity/Mortality Follow-up

http://www.cscc.unc.edu/aric/visit/General_Description_and_Study_Management.5_1.pdf

Benefits of exercise differ by sex and race

http://www.reuters.com/article/healthNews/idUSTRE5862SY20090907

Dr. Tedd Mitchell, Cooper Clinic president and CEO is interviewed by Todd Whitthorne, and talks about how a recent study linking high blood pressure to memory loss in adults 45 years and older.

The study, reported in the Journal of Neurology (August 25, 2009 issue), looked at the link between high blood pressure and memory. People as young at 45 years of age with high blood pressure, are more likely to have memory issues, suggesting that aggressive early treatment of high blood pressure can have huge dividends. Dr. Mitchell says one of the things we have long associated with high blood pressure is small strokes, mini strokes (Transient Ischemic Attack), but it’s generally in the elderly. What this study suggests is that there may be an effect on cognitive function in people with high blood pressure, even if they don’t show evidence of any mini strokes (TIAs).

The study included almost 20,000 people, ages 45 and older, with no evidence of stroke or TIAs. More than 7 percent of the subjects had memory problems, and nearly half of the people were taking medication for high blood pressure. Researchers found that for every 10 point increase in the bottom blood pressure number, the systolic number, odds of having cognitive problems increased by 7 percent!

Our bodily systems are related, and what we do for our heart is good for our brain. Likewise, the health choices we make that aren’t good for our heart also have a potential negative impact on our brain. Dr. Mitchell reminds us that being treated for high blood pressure doesn’t necessarily mean that our blood pressure is controlled and monitoring is imperative – with a blood pressure cuff at home or by using the machines at the grocery or drug store. The detriments of high blood pressure impact us early and it’s just imperative that we keep our number down. When it comes to blood pressure, a general rule of thumb is that the lower the blood pressure the better. The lower we can drop our blood pressure, the lower our impact on the organs of the body.

When watching blood pressure, salt may be an issue. The elderly and African Americans tend to be more salt sensitive than others. For some, cutting sodium significantly reduces blood pressure, while for others it doesn’t make a significant difference.

High Blood Pressure Linked to Memory Loss in Those 45 and Older

http://www.bloomberg.com/apps/news?pid=20601087&sid=aGDh1hu6N3Xk

Association of higher diastolic blood pressure levels with cognitive impairment

http://intl.neurology.org/cgi/content/abstract/73/8/589

Dictionary.com defines Pilates as “a method of physical and mental exercise involving stretches and breathing that focus on strengthening the abdominal core.”  Jay Grimes, a leading authority and practitioner of Pilates was recently in town for a day of teaching. We caught up with Jay and talked with him about Pilates.

With more than 40 years of Pilates experience, Jay got his start in pilates by training with Joseph Pilates during the last few years of Joseph’s life, and then with Joseph’s wife Clara following Joseph’s death. A professional dancer for eighteen years, Jay attributes his injury free dancing career to pilates. Jay compares the idea of a well tuned body with a wonderfully maintained musical instrument – if an instrument is tuned and in good working order it can be used to play any type or style of music well. Our body is the same way, according to Jay – a well tuned body doesn’t care if it’s bowling or dancing ballet.

Everything in pilates is based on everyday movement, and fine tuning the body so that every move made is a constructive exercise – even simple things like getting in and out of the car, or walking across the kitchen. The benefits of pilates are numerous and include:

• Supports an overall good and healthy body
• You’ll look and feel good
• Offers stress relief
• Promotes better posture
• Improves sleep
• Aids digestion

An initial pilates session or two often seems deceptively simple, as the journey to pilates mastery is incredibly long. To “get pilates into the body” Jay believes a master might only need three- to five years, while the average person might need somewhere between eight- and ten years. In Jay’s opinion, there are benefits to be gained in the journey.

Despite the difficulty of the discipline, there’s very little oversight in the business, and teaches have as little as a few months of experience up to several decades of learning.  Donna Fisher, the head pilates instructor at Cooper Fitness Center, has been practicing and teaching for 18 years, and says she was humbled to learn under Jay for a day. And Jay, after 45 years of experience, says there’s always room for improvement and he still considers himself a student. When looking for an instructor, it’s important to do our homework and ask lots of questions. Jay suggests we start with:

• What kind of training does the teacher have?
• How long have they been training?
• Are they still doing continuing education?

For the pilates aficionado, Jay’s believes three weekly sessions of 30 minutes are enough time for someone to maintain and keep their body in tune.

Jill Turner is VP of Operations for Cooper Concepts, the company that markets Cooper Complete nutritional supplements. Jill regularly contributes information to the Cooper blog. Email jsturner@cooperwellness.com or call 972-560-3262 with your questions and comments.

Reference Information
Jay Grimes - http://www.jaygrimes.com/

Weekly group mat Pilates classes are offered free to Cooper Fitness Center members - http://www.cooperaerobics.com/For-Individuals/PersonalFitness/Preston-Road-Dallas/Pilates.aspx

Donna Fisher, Cooper Fitness Center Pilates program director – 972-233-4832, ext 4423 - http://www.cooperaerobics.com/For-Individuals/PersonalFitness/Preston-Road-Dallas/Pilates.aspx

Todd Whitthorne interviews Colette Cole, a personal trainer at Cooper Fitness Center. Colette has a masters degree in exercise physiology, and co-authored Women’s Health and Fitness Guide with Michele Kettles, M.D., M.S.P.H., medical director of Cooper Clinic in Dallas.

Research shows lifestyle changes such as increasing physical activity and eating a healthy diet can reduce the risk for developing many chronic diseases, and can help manage existing health conditions.  With this in mind, Colette started Female Focus, a four- week lifestyle program specifically for women, concentrating on a range of health topics including fibromyalgia, osteoporosis and cancer. Each group of 8- to 10 women meets twice each week for a group exercise class which focuses on the individual needs of the participants. The class aims to teach both how- and why- each exercise is done, and also includes nutrition coaching from a registered dietitian.

Although the health benefits of exercise are known, when we need to exercise often the first thing we don’t want to do is exercise. The class is designed to help women work through barriers to exercise. Colette says the small group dynamic is fantastic. Exercising with a group is motivating and Female Focus offers the benefits of group motivation in small enough classes where participants are ensured personalized attention. Research supports that if we exercise with a “buddy” we’re more likely to stick with it.  Colette has noticed that often after a class has ended, the women will continue their friendships and get together to attend a yoga or pilates class, or to walk on the track.

Statistics show one in two women will get osteoporosis, a largely preventable disease, and 30 to 40 percent of the women enrolled in the class are there to prevent osteoporosis. Exercise can improve osteopenia, especially in the trunk. Increasing strength helps prevent falls and improve balance.

Many women lack the knowledge or may be intimidated by strength training and mistakenly participate in cardio training only. Colette believes this is a mistake. It’s a misconception that weight training builds “bulk” in women – in fact it’s the opposite. Strength training helps slim, tone, curve and shape the female figure.  Female Focus classes concentrate on increasing trunk strength and balance to prevent falls as well as incorporating exercise into everyday activities outside of class. 

For people who don’t have access to Cooper Fitness Center, Todd and Colette talk about how to find a good personal trainer. There are folks in many health clubs who became personal trainers after a 4- or 5 day class. Colette’s advice is to look for a Certified Personal Trainer who has a college degree in exercise physiology, kinesiology, or another related field of study. In addition, the trainer needs to be certified from a reputable organization such as the National Academy of Sports Medicine, Cooper Institute, National Strength and Conditioning Association or IDEA.  Continuing education is also key – there’s always new info coming out, so a good personal trainer will continue to engage in ongoing training. Finally, find someone with experience in the area for the need you have. Personal trainers tend to have specialties, so look for someone who has experience working with people who have similar issues.

To enroll in Female Focus, or for more information, contact Colette Cole at 972-233-4832.
 
Jill Turner is VP of Operations for Cooper Concepts, the company that markets Cooper Complete nutritional supplements. Jill regularly contributes information to the Cooper blog. Email jsturner@cooperwellness.com or call 972-560-3262 with your questions and comments.

Reference Information

Cooper Fitness Center Female Focus program information

Women’s Health and Fitness Guide book

IDEA Health & Fitness Association

National Strength and Conditioning Association (NSCA)

National Academy of Sports Medicine (NASM) 

The Cooper Institute

Dr. Radford reviews how changes in physical activity impact longevity
Dr. Nina Radford, Cooper Clinic director of cardiovascular medicine was interviewed by Todd Whitthorne, and gave her thoughts on the recent study published in the British Medical Journal looking at lifestyle changes in terms of physical activity for 50-year old men, in a 35-year follow-up.

Dr. Radford reports that patients often come into Cooper Clinic for the first time around age 50. The good news is, even if you start to adopt healthy lifestyles at age 50, you’ll see lots of benefits. The study supports Dr. Radford’s assertion that positive lifestyle changes positively impact overall health.

In the study reported in the British Medical Journal, 2,200 Swedish men were evaluated at age 50 (between 1970 and 1973), and then re-evaluated at ages 60, 70, 77, and 82 years. Researchers wanted to determine the impact of physical activity in inactive, moderately active and very active men, and see if increased physical activity resulted in improved health benefits.

Increased physical activity was determined by asking a couple of simple questions. Men who answered “Yes” to “Do you spend most of your time reading, watching TV, going to the movies, or engaging in mostly sedentary activities?” were labeled low-activity.

The men labeled “moderately active” answered “Yes” to the question “Do you often go walking or cycling for pleasure?”

Men who reported that they engage in any active recreational sport or heavy gardening at least 3 hours every week, or who stated they regularly engage in hard physical training or competitive sports were labeled high-activity.

Researchers followed these men over 35 years. In their conclusions, researchers stated “Increased physical activity in middle age is eventually followed by a reduction in mortality to the same level as seen among men with constantly high physical activity. This reduction is comparable with that associated with smoking cessation.”

Dr. Radford says it took about 10 years in the high-activity level for the previously low- or medium-active men to realize the increased health benefits of the men who had constantly high had physical activity. The benefits were significant though – researchers saw a reduction in cardiac risk for these guys – as much as the benefits seen when someone stops smoking.

Todd mentions that research shows over-and-over that 150 minutes of exercise per week seems to be the magic number we need to meet in order to get all the health benefits of exercise. Dr. Radford noted that the 3 hours (180 minutes) of exercise seen in the study was pretty minimal given the incredible health rewards.

Dr. Radford suggests that people following as few as 2 reality shows a week probably spend 5- to 6 hours in front of the TV for those programs. If time is tight, her recommendation is that spending time on the treadmill or exercise bike while watching a TV program is an easy way to “find” the time needed to exercise.

Jill Turner is VP of Operations for Cooper Concepts, the company that markets Cooper Complete nutritional supplements. Jill regularly contributes information to the Cooper blog. Email jsturner@cooperwellness.com or call 972-560-3262 with your questions and comments.

Reference Information
Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort
http://www.bmj.com/cgi/content/full/338/mar05_2/b688