Last Resort: Oral Contraceptives as Emergency Contraception

OCP 2Dear Dr. Mo: What if I needed an emergency contraception and didn’t have it (couldn’t get it) – would a regular pill do the trick?

Dear reader: Even though I don’t recommend this as a contraceptive practice of choice, the answer is Yes.

Any Oral Contraceptive Pill can, in principle, be used as an Emergency Postcoital Contraception (EPC) as long as it contains a certain amount of estrogen hormone; the required amount is 200 μg of ethinyl estradiol (usually 20 – 35 μg of ethinyl estradiol per tablet but it may vary – read the composition label) – take the number of tablets to amount to 200 μg, then repeat in 12 hours. Continue reading

Stroke – The Brain Under Attack – know when to act and do it fast

Early symptoms can be elusive and missed

Early symptoms can be elusive and missed

Dear readers: Some time ago, father of a friend of mine had suffered a stroke – he’s still alive and on his way to recovery mostly because of the prompt and immediate reaction of the people who were there when it happened.
Those first few hours following a stroke are what decide between living or dying, between serious and irreversible brain damage and a minor, repairable one.

Identifying and treating a stroke as quickly as possible can and does save brain cells, brain function, and ultimately, lives. With this in mind, all of us need to know the warning signs of a stroke and when to get help as fast as possible.

So, what signs to look for to suspect a stroke?

I like The U.S. National Stroke Association’s mnemonic FAST as it both conveys the urgency of the situation and it helps us memorize the most important clues. Remember it as Act FAST!

Here’s what it stands for: Continue reading

What is Glycemic Index and how to use it to eat healthy?

Dear Dr. Mo: I am trying to lose some weight and improve my diet. Is there a way to shop around for good foods that will load me with less sugar and help me eat healthier?

Foods with high GI will shoot your sugar through the roof

Foods with high GI will shoot your sugar through the roof

Dear reader: The total amount of carbohydrates we consume (with a meal or with a snack) mostly determines what happens to our blood sugar levels right after we eat. But, it’s not just the absolute amount of carbs that’s important – the food itself also plays a big part. So, for example, a serving of white bread or white rice has almost the same effect as eating pure table sugar— it produces a quick, high spike in blood sugar. On the other hand though, a serving of something like zucchini, beans or squash has a slower, smaller effect.

Strategically picking good sources of carbs can help us control our blood sugar and in most cases, our weight although I don’t want this to sound too simple. The levels of our activity, age, sex, overall health and metabolism and genetics are all important parts of the equation.

Okay so let me give you one good way we can choose our foods: we can use the glycemic index (GI) to know how much any given food boosts blood sugar.

The glycemic index gives us the effect a certain amount of specific food would have on blood sugar as compared with the same amount of pure glucose. This means that a food with a glycemic index of say 20 boosts blood sugar only 20% as much as pure glucose would. One with a GI of over 90 acts almost like pure glucose.

Glycemic index is easy to use, just choose foods with a low(er) index rather than higher whenever you can. Here’s the breakdown: Continue reading

5 health benefits of Onions – poor breath great health

Dear Dr. Mo: What about onions and health – I avoid them because they give me bad breath but I actually love onions. Should I eat them anyways?

Great combination

Great combination

Dear reader: With their unique combination of flavonoids and sulfur-containing nutrients, the allium vegetables—such as onions—belong in a healthy diet on a regular basis.

The total polyphenol content (polyphenol Quercetin) of onion is higher than its fellow allium vegetables, garlic and leeks and other polyphenol rich plants like tomatoes, carrots, and red bell pepper. Polyphenols are natural antioxidants linked to prevention of cardiovascular diseases (by primarily helping us regulate the cholesterol levels and reducing oxidative stresses).

When onions are simmered in a soup, their Quercetin is not destroyed. It simply leaks out into the water. By simmering at low-heat, you can preserve the health benefits of onion that are associated with Quercetin.

Here are 5 quick health benefits we derive from eating onions on regular basis:

1. Onions are high in vitamin C, dietary fiber, vitamin B6, folate and manganese;

2. They help relieve symptoms such as coughs, congestion, lung tightness in asthma and respiratory infections;

3. Sulfur-containing nutrients in onions have been linked to lowering blood pressure and cholesterol levels;

4. Onions contain natural anti-clotting agents with fibrinolytic activity and platelet-clumping suppression ability. The anti-clotting effect of onions closely correlates with their sulfur content and this property is again beneficial for preventing complications in cardiovascular diseases for example; Continue reading

The powerful vitamin A and what happens in vitamin deficiency

Dear Dr. Mo: You’ve mentioned that Squash is rich in vitamin A but cautioned not to take too much of it. How can vitamins hurt us? Specifically, why is vitamin A important and how can it be harmful? What’s happening in vitamins deficiency?

Squash and pumpkins are awesome sources of vitamin A

Squash and pumpkins are awesome sources of vitamin A

Dear reader: Vitamin A has many vital functions and people associate it with good vision and this is certainly true. This vitamin along with vitamins D,E and K is not water soluble, which means they are not easily removed from our body and can hang on for a long time in our fat tissue, being fat-soluble. That’s why too much of it will stick around and cause problems. Apart from good vision, here are a few other equally significant roles of vitamin A in normal, deficient and excess situation:

1. It is a cofactor for a hormone called PTH (Parathyroid hormone) and this means that without it the hormone cannot function properly. PTH is necessary for Calcium balance in our body – this means that PTH controls the levels of Calcium in our blood; it affects the strength and health of our bones, the absorption of Calcium from our gut etc. Except for bone health, Calcium is also very important in cellular functioning and without it (or with too much of it) many of our vital processes stop or become excessive (for example, muscle contractions including heart, secretion of hormones like for instance insulin etc..).
Contrary to deficiency, vitamin A excess will cause PTH to work too much and increase levels of Calcium at the expense of our bones; too much Calcium will cause problems with muscle contractions known as tetanic contractions, our heart will not beat properly, kidneys may develop stones, Calcium will leak out into urine and the entire system will be thrown off balance.

2. It’s necessary for production of the fluid that cushions and maintains our brain and spinal cord called Cerebro-Spinal Fluid (CSF) – in vitamin A deficiency the CSF production is low but the body doesn’t know it; on the flip side of it, if vitamin A is in excess, too much CSF will cause dangerous increase in pressure in the skull which manifests itself with strong headaches and optic nerve swelling and can lead if left untreated to blindness and/or even death via something called brain herniation.

3. It’s crucial in maturation of cells such as the ones in hair, skin and eyes or linings of our organs like the lungs or intestines. So if for example a child is recovering from Measles, a doctor may give some vitamin A to speed up the regeneration of the child’s worn away cells in the lungs. We also give vitamin A to transform one exceptionally lethal type of Leukemia called PML (Pro-Myeloblastic Leukemia) into one less lethal called AML to help patients live longer with the disease. Vitamin A is used in Dermatology to manage some diseases etc. Continue reading

Tired legs, fatigue and Low Energy State – what’s the connection?

Dear Dr. Mo: I feel tired and my legs feel tired and not just in the morning but sometimes during the day and in the evening. What could be causing me to feel low like that?

Dear reader: Feeling tired, sleepy and lacking energy is called fatigue and all these symptoms are our body’s response to something we call Low Energy State.

Legs can be just tired from too much use

Legs can be just tired from too much use

Weakness is usually one of the first symptoms of any medical condition (as 90% of them are tied to Low Energy State) and it should not be ignored. Together with shortness of breath these two are the most common first presentation of majority of illnesses.

If weakness/fatigue doesn’t go away after enough sleep, good nutrition and reduced stress a doctor should check it out.

Tiredness in legs can commonly be just a result of too much walking, standing or running but if it doesn’t go away or keeps coming back even without excessive physical exertion then you may be in a Low Energy State for some reason that you should discover and correct asap.

Now, a whole variety of reasons exist that result in Low Energy State, which then goes on to cause weakness, fatigue and more specifically, tired legs among other symptoms. These can include:

Lifestyle reasons – feelings of fatigue are most commonly caused by (before we jump to illnesses) sleep deprivation and other sleep disorders (like apnea), overwork (or working in shifts), sedentary behavior (lack of exercise) or unhealthy habits (like smoking, alcohol consumption, drug abuse, skipping meals and inappropriate dieting);

Medical reasons – unrelenting weakness may signal an underlying illness, such as a thyroid dysfunction (hypothyroidism), heart disease, diabetes, cancer, anemia, infection etc. All these deprive us of energy for cells’ functioning and cause exhaustion and fatigue; Continue reading

Health benefits of Melons

Dear Dr. Mo: I loved your posts on Squash and I have a question about Melons – I love Melons and I was wondering about possible health benefits I can incur from that fruit?

Refreshing and healthy!

Refreshing and healthy!

Dear reader: Melons are related to Squash and comparable to it in their health benefits. Let me list a few important ones:

Blood pressure control

Eating melons can help control blood pressure as they contain potassium and potassium lessens the effects sodium has in elevating blood pressure; cutting back on dietary salt is also important in maintaining a healthy blood pressure level.

Vitamins

Melon is a fine source of vitamin B6 which helps maintain our body’s metabolism and some recent data shows that this vitamin reduces inflammation, oxidative stress and helps regulate metabolic disturbances including obesity and diabetes.

Just like carrots for example, melons too owe their bright colour to vitamin A — one cup has about 40 percent of our daily needs. Vitamin A is important for vision and bone growth.

Another vitamin found in plentiful supply in Melons is vitamin C and this one is crucial for collagen formation to maintain your cartilage, bones, gums, skin etc. Vitamin C won’t do us much good when we catch a cold, just so you know, that’s a (pharmaceutical) myth. Continue reading

Cortisol effect – why do we suddenly go ‘uu-uu-uum’?

Dear Dr. Mo: Sometimes, when a professor calls out my name to answer a question, I just block and can’t answer even though I know that I knew the answer just moments ago. Why is that?

Cortisol effect can blur your mind's eye

Cortisol effect can blur your mind’s eye

Dear reader: To block when you want to speak can happen when you are suddenly put on the spot and it’s called the Cortisol effect – there’s a hormone called Cortisol and it is associated with stress among other things. Whenever you get nervous, even the smallest, tiniest amount of Cortisol that comes out into your blood in that fraction of a second can block the long term memory. All of a sudden, you start to stutter, mind is blank and you can’t remember what you knew a second ago. Familiar?

This effect can be desensitised by repeated practice and the more you’re being called out the better you’ll be able to cope with it but for some, no amount of practice will ever entirely defeat the underlying physiology. People who are terrified of public speaking know this all too well.

Continue reading

Should you wash poultry and other meats before cooking?

Dear Dr. Mo: My question is simple and yet kind of age old – should I wash poultry (and other meats for that matter) before cooking? I’d traditionally say yes, but when I think of it, I’m not so sure.

No need to wash it but handle it with care

No need to wash it but handle it with care

Dear reader: Contrary to popular belief, my answer has to be NO – you should not wash or rinse any raw meat prior to cooking. This is not just a matter of preference – it is really ill-advised.

Let me quickly explain why:

Washing raw meat and rinsing its juices only splashes any existing bacteria on that piece of meat all over your kitchen sink, utensils and nearby surfaces – this is termed “cross-contamination” and does very little to protect your health – quite on the contrary, this cross-contamination can easily cause a foodborne illness.
In addition, there are some bacteria so tightly attached to the meat that you would not remove them no matter how long or vigorously you washed it.

So how to be safe then? Continue reading

Baby’s first breaths and what you didn’t know about her first cries

Dear Dr. Mo: I’ve read your post on C-section and I wanted to know more about what you’ve said were risks for ‘increased respiratory problems of the newborn’ with C-section delivery. Also, why do babies always cry when they’re born?

Oxygen isn't just explosive - it burns

Oxygen isn’t just explosive – it burns

Dear reader: Your questions about newborn’s breathing at the instant of birth and crying are important and could prompt a very technical answer, which I will try to avoid here.

Let’s just imagine a baby floating in water for 9 months – this is the baby’s natural environment in the womb. The baby doesn’t breathe the way she will breathe after birth and so the water fills up her lungs. The natural act of birth is so important because the birth canal through which the baby is traveling pushes on the baby and squeezes out that fluid (almost all of it) from the lungs and compresses the lungs so much that at the instant both of baby’s shoulders are delivered, the lungs automatically and involuntarily inflate taking that first and only passive breath the baby will ever take. Every following breath, for the rest of her life will be active breathing effort.

So you see, if this natural pathway of delivery is circumvented via C-section, the baby’s lungs don’t have the assistance to expel the fluid out and the newborn may have some problems with breathing in the first few hours – this manifests itself as a very rapid breathing called tachipnea and it’s in most cases transient. Sometimes though, more serious breathing problems can occur and if this rapid breathing does not go away within 4 hours, we always have to rule out sepsis as the most dangerous complication.

Now about that crying, there’s a myth here to debunk: Continue reading

How “whole” are whole grains and are they always healthy?

Dear readers: Whenever I spot a link between food industry professionals and scientists, I get a queazy feeling in my stomach as their intention is almost by definition driven by profits and never by our health and well being.

Look twice

Look twice

In the 1999’s definition of “whole grain” by the American Association of Cereal Chemists (AACC) International, which is exactly that ominous kind of mixture of food industry professionals and scientists, “whole grain” can be any mixture of components of an intact grain (the bran, endosperm and germ) but the grains are allowed to be (and usually are), processed so that the parts are separated and ground before being put into foods.

To clear things up a bit – the “whole grain” is an INTACT grain – a fiber-rich coating of bran surrounding a starchy endosperm and a reproductive kernel called the germ. The fiber content is what’s synonymous with good health, good digestion, lower cholesterol, heart health etc.

When you separate these components and process them, the contents of healthy fiber and nutrients drop significantly.

The U.S. Food and Drug Administration adopted (to no wonder) the AACC definition in 2006, allowing the food industry to push out their products marketed as “whole grain” that contain very little fiber and lots of sugar.

As reported by the Scientific American’s text Whole Grain Foods Not Always Healthful from July 2013:

“An individual would have to eat 10 bowls of Multi-grain Cheerios, 16 slices of whole-wheat bread, or nine cups of brown rice to get the fiber recommended for an American adult for one day. “There’s nothing wrong with eating brown rice, but you can’t expect health benefits if you’re going to be eating brown rice as your source of whole grains,” David Klurfeld the national program leader for human nutrition in the Agricultural Research Service at the U.S. Department of  Agriculture.”

When the whole grains are being processed (usually by grinding or flaking) to make them tastier and longer lasting, this also degrades their natural antioxidant content and markedly reduces the amount of fiber – remember, those are the two ingredients that make whole grains good for the heart and over-all health.

To make matters worse, the AACC International recently went on to propose a modification of its definition of “whole grain”, which is bad as it is, to allow for this nutrient loss during processing. Continue reading

Cesarean versus vaginal delivery – which to go for and why?

Dear Dr. Mo: I’m due soon and I’ve been considering to ask for a cesarean birth – what would you medically recommend a woman should go for, normal or cesarean?

No matter how you deliver, this is your future

No matter how you deliver, this is your future

Dear reader: What you are considering is what we term a Cesarean delivery (C-section) on maternal request, in which case you would undergo a planned C-section delivery before the natural onset of labor, without you or your baby really medically needing it and in such scenarios, I tend to advise against it.

But here’s the thing:

The reality is that there’s no good evidence to facilitate a textbook counselling in this case and most of the available data comparing the two delivery routes (planned C-section versus planned vaginal delivery or what you refer to as ‘normal’) is weak and ought to be interpreted cautiously.

Things to consider:

When you desire a cesarean delivery, your doctor should consider your specific (risk) factors, such as age, body mass index (i.e. if you’ve gained a lot of pregnancy weight, any surgery is more risky), accuracy of estimated gestational age (i.e. C-section on maternal request should not be performed before a gestational age of 39 weeks which is full term), reproductive plans for the future, personal values, and cultural context. I know that sometimes, some past experiences (e.g, violence, trauma, or poor obstetric outcomes) and anxiety about the whole birth process may be what’s prompting such requests and if any of these are what concerns you, bring it up with your doctor.

If your main worry is pain during delivery, then prenatal childbirth education, emotional support in labor (i.e. your partner or someone else close to you could attend), and anesthesia for childbirth (epidural) should be offered and could eliminate this issue entirely. Continue reading

If you don’t have your health, everything is ruined

Dear readers: In a recent interview for Esquire, titled “What I’ve Learned”, Woody Allen says an interesting and important thing he’d learned from his dad: “My dad didn’t even teach me how to shave — I learned that from a cabdriver. But the biggest lesson he imparted is that if you don’t have your health, you have nothing. No matter how great things are going for you, if you have a toothache, if you have a sore throat, if you’re nauseated, or, God forbid, you have some serious thing wrong with you — everything is ruined..

Image credit: www.kalisthenixfitnessblog.com

Image credit: www.kalisthenixfitnessblog.com

Inspired by Mr. Allen’s lesson from his father, and in relation to my recent post in which I wrote about some cool health benefits of Butternut Squash that even made it to the list of those healthful foods that can heal your tired legs, I’ve decided to share with you one simple recipe for a quick, healthy and easy way to make a very tasty Squash.

Here’s how to do it: Continue reading

Tired legs? Try these 5 dietary tweaks to help your tired legs

Legs could be windows into health - if they're tired, you need a recharge

Legs could be windows into health – if they’re tired, you need a recharge

Dear Dr. Mo: My legs feel tired relatively often and I’d like to know if there is something I can do about it? Should I be worried?

Dear reader: The feeling of tiredness in legs is a relatively common complaint and the reasons for this feeling could be different. If the feeling is more than just tiredness and it extends into pain and cramps, swelling, numbness and other more severe symptoms, you should see your doctor immediately as these could signal a more serious underlying condition.

That said, check out my earlier post on the Tired legs in the morning and the possible causes as well as several things you can do about it.

Use a healthy diet in your favour to get rid of tiredness in your legs and in some instances even pain (but like I said, for pain, always see your doctor first and discuss your options, including your diet).

Include foods that are rich in calcium, fiber, proteins and vitamin E in your diet as well as foods that will clean up your blood vessels  and regulate your blood pressure. These ingredients will maintain your health and specifically improve the strength and fitness of your legs.

What exactly do I mean? Here are 5 important points that you can use in your diet to improve the health of your legs and reduce the feeling of tiredness:

1. Try these 4 foods to keep you blood vessels clean from cholesterol plaques – healthy blood vessels also mean good blood supply to your legs, and well fed legs are fit and recover quickly from walking, running, jumping or just simply standing.

2. For blood pressure regulation try Beets, which can help to regulate mild hypertension (high normal and even stage 1)

3. Eat weekly some Butternut Squash and spinach for a healthy dose of fiber, vitamins A, E, C and B

And fiber is a necessity in any healthy diet, for good digestion and a healthy weight.  Continue reading

6 amazing health benefits of Butternut Squash

"The apple of Gods" according to American natives

“The apple of Gods” according to American natives

Dear readers: I’d like to share with you 6 amazing health benefits of Butternut Squash, my latest discovery on my quest for delicious healthy foods. It didn’t seem appealing or eye catching and I remember my grandpa used to dry it up to make a ladle out of it but I’ve never tried it until recently. So, here is my list:

Benefit 1 – Vitamin A and Beta carotene:

Squash is literally loaded with vitamin A – 1 cup of cooked squash has over 400% of the recommended daily allowance (RDA) – Vitamin A is important for our vision, bone health, cell function, reproduction and the immune system. ~One note here: Vitamin A is not water soluble, which means that its excess it is not easily removed from our body so do not overindulge in this treat – perhaps not more than once a week.

The squash’s orange color means it is high in beta carotene, an antioxidant relevant for vision health and possible reduction of breast cancer risk.

Benefit 2 – Fiber:

Squash is a very good source of fiber – one cup of cooked or baked squash has almost 7 g of fiber! Fiber is important for healthy digestion, cholesterol regulation and weight management.

Benefit 3 – Potassium:

It has more potassium than a banana with over 550 mg and potassium is important for the heart health and it participates in fluid and mineral regulation. Continue reading