AskDrRachel.com

Link: http://www.aafp.org/online/en/home/publications/news/news-now/clinical-care-research/20090902gardasil-jama.html

After a summer of worries about the safety of the vaccine for cervical cancer, marketed under the trade name Gardasil, a new study was released in the August 19, 2009 edition of the Journal of the American Medical Association which demonstrates that the vaccine is safe and effective.   Side effects following more than 23 million doses of Gardasil are on par with side effects from other vaccines; however, lightheadedness and fainting (about 8 per 100,000 doses) and blood clots (0.2 per 100,000) were found to happen more often than with other vaccines.

I encourage all young women to discuss the Gardasil vaccine with their physicians to prevent the often serious complications of HPV infection.  More than 75% of sexually active young people are infected with HPV by the time they enter college.  HPV is responsible for more than 98% of all cases of cervical cancer, and the risk of cancer is greatly reduced by the vaccine.  

I have no financial relationship with the maker of the Gardasil vaccine (Merck) and have no conflicts of interest to disclose.

Five Wonder Foods

By Rachel Franklin, M.D., “Your Family Doc”

OU Physicians Family Medicine

I wanted to revisit the subject of using food as fuel for your body, as many of you work towards making healthy lifestyle choices your permanent goal.  For those of you whose confidence and skill are advancing as the year goes on, congratulations!  For those of you who’ve been tempted to give up in the face of challenges, go back to my earlier blogs for encouragement to renew your resolutions.  Above all, realize that it’s never too late to try again!

Evidence is mounting over the past few years that shows that all the supplements we take – for heart health, cancer prevention and longer lives – have little to no benefit, and some may be harmful.  Every study I’ve read lately says the same thing: you can only get the health benefit of antioxidants, vitamins, minerals and so on by EATING WHOLE FOODS.  Vitamin and other supplements were only ever intended to bridge gaps in our healthy diet, never to serve as substitutes for a healthy diet!

I wanted to use this time to introduce you to try a few whole-food powerhouses of health.  I challenge you to find ways to incorporate some or all of these foods in your diet for a healthier you! 

Healthy eating tip #1: Beware of overcooking your foods (except eggs, which must not be undercooked) – if the food has lost its flavor due to overcooking, it has probably also lost many of its vitamins.

Healthy eating tip #2:  Try to get the freshest produce you can find.  Studies of fruits and vegetables have shown that the nutrient value declines rapidly after harvest.  Spinach that is more than 1 week old may have little nutrient value left.  Don’t know when you’re going to eat those berries?  Frozen produce is almost as healthy as produce that’s just been picked!

Try these “Wonder Foods” today:

• Eggs.  Eggs are the only food source of every protein the human body needs for all of its functions.  One large egg has only 85 calories and contains heart-healthy fats.  Boil a dozen on Saturday and take them to the office with you for a quick and healthy snack!
• Tomatoes.  Tomatoes have a huge number of antioxidants, including lycopene, that have been shown to prevent heart disease, cancer, cataracts and many other diseases.  Opt for crushed tomatoes, lightly cooked with a small amount of olive oil to get the most benefit.  Enjoy bruschetta, salsa, pico de gallo or a cup of tomato soup.
• Broccoli.  Best when eaten raw or steamed, broccoli offers protection against stroke and many cancers, including bladder, prostate and colon cancer.  It is a better source of vitamin C than an orange and has more vitamin A than most other foods.  It helps your immune system stay healthy and can prevent macular degeneration.
• Spinach.  Popeye was right – but flavorless canned spinach isn’t the best for us (or the tastiest).  Again, best if eaten raw or lightly cooked, spinach is a powerhouse.  A great source of iron, potassium and fiber, spinach helps prevent heart disease.  Rich in chlorophyll and beta-carotene, it has been shown to help prevent cancers, cataracts and macular degeneration.  It keeps bones strong and helps lower blood pressure due to its high calcium content.  It has also been shown to help prevent memory loss.
• Blueberries.  These little gems are low-calorie, no-fat and pack more antioxidants per ounce than any other known food.  They can prevent cancer, memory loss and vision loss, have heart-protective benefits and have even been shown to contain a compound that can lower cholesterol.  Buy a container and freeze blueberries for up to a month – then serve a few on your cereal, desserts, yogurt, or eat them by the handful for a midday snack.

However, I can’t stress enough: produce is best when eaten as soon as possible after it’s been picked, since the first step in the dying process of a fruit or veggie is loss of vitamins.  Make this the year you visit your farmer’s market each Saturday.  You’ll support the local economy (instead of buying produce from another country through the grocery store), your food will be fresher and better for you, and it won’t cost any more money than going to the store.

Please remember to email april-sandefer@ouhsc.edu or contact OU Physicians at 405-271-5067 if you have ideas you’d like to read about in this column.  Here’s to your good health!

Dr. Franklin is a board certified family medicine specialist. Her areas of special interest include preventive health and wellness and women’s and children’s health. Her advice has been featured in outlets including The Learning Channel, Parents Magazine and FitPregnancy. For an appointment with Dr. Franklin or any of the OU Physicians Family Medicine physicians, call 405-271-4311

Does Alcohol Have Health Benefits?

By Rachel Franklin, M.D., “Your Family Doc”

OU Physicians Family Medicine

As we enter the holiday season, and mulled wine and cider enter some of our traditions, I wanted to take a moment and tell you the latest information about the risks and benefits of drinking alcohol.

One of the oldest running jokes on TV was about granny’s little brown jug, labeled triple-X, that she used for “medicinal” purposes.  Ever since humans learned that by fermenting their food they could make it last longer (think vinegar, sauerkraut, and other foods), they have used fermented drinks for pleasure, pain control and social gatherings.

In the past two decades, the medical community has discovered that granny might have been right after all.  Studies of people living in France and the Mediterranean have found that moderate consumption of alcohol – 2 or fewer drinks for men and 1 or less for women - reduced the risk for heart attack and stroke.  This data that was once limited to wine has expanded with further studies to the conclusion that alcohol from any source – beer, wine, and liquor – may have similar benefits.

But not so fast!  A recent study suggested that even moderate alcohol use by women may raise our risk of several types of cancer, including breast and esophageal cancer (cancer of the swallowing tube).  In addition, like all medications (even herbals and over-the-counter ones), alcohol use has risks.  So what should we do when considering its use?

Consider a few important items before you decide to say you’re using alcohol for health benefits:

• Alcohol affects your brain.  Alcohol is a drug as much as caffeine or nicotine.  It affects your judgment in the short-term and too much of it is harmful.  Never drive or perform possibly dangerous tasks after consuming alcohol.
• Alcohol has a dark side.  People at risk for addiction – especially those with a past personal or family history of alcoholism – should not try using alcohol for health benefits. 
• Alcohol is a “no-no” for some.  Compromising your personal ethical or religious views regarding alcohol is not worth any possible health benefits from its consumption.
• Women will have to prioritize.  Are you at higher risk for heart attack or cancer?  Drinking one or fewer servings of alcohol per day and less than 5 per week can help prevent heart attack, but may slightly increase your risk for cancer.  Could you be pregnant?  There is no amount of alcohol believed to be safe during pregnancy!
• Alcohol is not a heart “cure-all.”  Studies have also shown that eating a heart-healthy, portion controlled diet low in saturated fat and high in fruits and vegetables, when combined with exercise has more heart-attack reducing benefits than alcohol consumption.  Smoking cessation works better than alcohol.  Maintaining a healthy weight works better than alcohol.

Men, if you currently enjoy alcohol in moderation without trouble, I’d advise you to continue.  Women, if you are at greater risk for heart disease than cancer, you might consider it with caution.  Either way, remember that drinking alcohol is no replacement for an overall healthy lifestyle.

Please remember to email april-sandefer@ouhsc.edu or contact OU Physicians at 405-271-5067 if you have ideas you’d like to read about in this column.  Here’s to your good health!

Dr. Franklin is a board certified family medicine specialist. Her areas of special interest include preventive health and wellness and women’s and children’s health. Her advice has been featured in outlets including The Learning Channel, Parents Magazine and FitPregnancy. For an appointment with Dr. Franklin or any of the OU Physicians Family Medicine physicians, call 405-271-4311

Get Some Sleep!

By Rachel Franklin, M.D., “Your Family Doc”

OU Physicians Family Medicine

Many of us find ourselves burning the midnight oil to finish a project, get kids’ forgotten homework done or to wind down with a movie or TV show before going to bed.  Celebrities and business leaders in magazines brag about how little sleep they require and can make us feel inferior when we groggily read the interviews while getting ready the next morning.  Adults need at least 8-10 hours of sleep each night, and children need 10-12 hours.  The average adult gets only 6-7 hours – and boy, do we feel it!

There are many benefits to sleep.  It has been shown to improve our mental focus and memory, help children to focus in school and to grow taller and stronger, increase our tolerance for stress and reduce our risk of high blood pressure, heart attack and stroke.

If we don’t get enough, we are at risk for:

• Daytime sleepiness.  Those of us who drive while sleepy are proven to be as dangerous as those who drive while drunk.  We even instituted work hours restrictions for doctors in training (80 hours per week max) years ago after studies proved that poor medical decision making – and potentially dangerous patient care - was connected to sleep deprivation.
• Weakened immune system.  The immune system is one of many in the body that is repaired only during sleep.  Have you wondered why you’re always sick? 
• Obesity.  Losing sleep is stressful to the body, which responds by increasing stress hormones that increase our blood sugar, decrease our metabolism and make us crave fat and salt.  We also eat more and are less likely to exercise in response to fatigue.
• Heart attack/stroke.  In a normal sleep/wake cycle, special hormones put us to bed and wake us up on a natural schedule.  Forcing a body to wake up too early in that cycle (by going to bed too late) increases blood pressure and the risk for an early morning attack.
• Chronic fatigue/headaches/depression/fibromyalgia.  For all of the reasons discussed above, those of us who don’t get enough sleep are at much higher risk for these conditions.

While some of us suffer from sleep disorders, from insomnia to sleep apnea, that interfere with our sleep, most of us just suffer from poor habits.  Use the bedroom only for sleep or intimacy.  Go to bed when you’re tired.  Set a regular wake time – even on the weekends.  And try to get at least 8 hours of sleep every night.

Please remember to email april-sandefer@ouhsc.edu or contact OU Physicians at 405-271-5067 if you have ideas you’d like to read about in this column.  Here’s to your good health!

Dr. Franklin is a board certified family medicine specialist. Her areas of special interest include preventive health and wellness and women’s and children’s health. Her advice has been featured in outlets including The Learning Channel, Parents Magazine and FitPregnancy. For an appointment with Dr. Franklin or any of the OU Physicians Family Medicine physicians, call 405-271-4311

Going “Green” – Should You Become a Vegetarian?

By Rachel Franklin, M.D., “Your Family Doc”

OU Physicians Family Medicine

Meat and potatoes have long been the mainstay of an American diet, imported by the immigrant farmers who settled here years ago.  For many of us, it is still what “dinner” means.  The problem is that, in an ideal diet, meat is a once-daily condiment and potatoes do not refer to French fries.  We know that the best diet combines fats and proteins with much larger portions of vegetables and fruits than most of us are used to eating.  For more information, please refer to my previous blogs or to www.mypyramid.gov</span>. 

Whether for ethical/religious reasons or in the interest of becoming healthier, many people are turning to an ancient dietary practice, vegetarianism.  Ancient Greeks and Indians adopted vegetarianism as part of religious/philosophical practice.  To this day in many parts of the world, especially India, up to 40% of people eat no meat.  In America, around 3% of us are vegetarian or vegan.  Vegetarians may eat eggs, milk, cheeses, or fish, depending upon their personal ethics; vegans will eat nothing from an animal, including animal by-products such as gelatin.

But is it safe to NEVER eat meat?  The answer is yes, if a vegetarian plans his or her diet carefully.  In fact, some evidence suggests that properly-practicing vegetarians weigh less and are healthier than those of us who eat meat.  See below for the most common nutritional mistakes people can make when deciding to adopt this lifestyle:

• Vitamin deficiency.  Yes, really!  Vitamin B12 and calcium are mostly found in animal products.  Make sure to get a daily serving of dark greens or tofu to stay balanced.
• Protein deficiency.  If you can agree to eat eggs or dairy products, you should be okay.  If not, be sure to ingest foods from as large a variety of plant sources as possible and include legumes (beans and peas), quinoa and especially soy.
• Iron deficiency.  Especially in women of childbearing age, iron is essential for our blood system to recover from monthly cycles, and the iron in meat is more readily accepted by the body than that from plant sources.  Be sure to include tomatoes, oats, legumes, soy, and whole wheat to keep iron levels high enough.
• Fatty acids.  Omega 3 fatty acids reduce blood pressure, prevent heart disease and improve brain function.  While the largest source is deep water fish (tuna, salmon and mackerel), a vegan can also find it in purslane, pumpkin seeds, soy and walnuts.

No matter what manner of eating is most attractive to you, the most important thing is that you focus on creating for yourself a well-balanced diet.  Remember to eat the appropriate portions of proteins, fats and carbohydrates, and to work toward getting at least 9 servings of fruit and vegetables daily.  Exercise at least 30 minutes every day and don’t smoke.  You’ll be well on your way to a healthier life!

Please remember to email april-sandefer@ouhsc.edu or contact OU Physicians at 405-271-5067 if you have ideas you’d like to read about in this column.  Here’s to your good health!

Dr. Franklin is a board certified family medicine specialist. Her areas of special interest include preventive health and wellness and women’s and children’s health. Her advice has been featured in outlets including The Learning Channel, Parents Magazine and FitPregnancy. For an appointment with Dr. Franklin or any of the OU Physicians Family Medicine physicians, call 405-271-4311