Addicted to Anti-Anxiety or “Nerve” Pills — Benzodiazepine use disorder and what to do about it

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Image by Pete Linforth from Pixabay

Many people, especially women, develop feelings of anxiety and worry. Some call it “bad nerves.” This predisposition to feeling anxious can cause problems with everyday living, coping, and sleeping. I have assessed and interviewed many older people with a range of problems with anxiety. Feeling anxious is a completely normal reaction to stress or a situation where you may feel fearful. However, being in a continuous state of feeling afraid can cause problems both mentally and physically. Some say they feel like they are “trembling inside.”

Anti-anxiety medications (also known as “nerve pills”) are used by many people. These pills come from the family of “benzodiazepines.” Some of the commonly prescribed anxiolytics in Canada or the United States include (but not limited to):

  • Clonazepam (Rivotril)
  • Alprazolam (Xanax)
  • Lorazepam (Ativan)
  • Diazepam (Valium)

A commonly prescribed non-benzodiazepine that acts like one is Zopiclone (eszopiclone in the USA). It is commonly used as a “sleeping pill.”

Generally, benzodiazepines end in “pam” or “lam.” Use of these medications can initially improve symptoms by offering a sedating effect, however, they can also be addictive. Side effects of these drugs include increasing the risk of cognitive impairment, confusion, delirium, falls, fractures, drowsiness, and motor vehical accidents. They are not recommended for use by older adults. In fact, older people are recommended to gradually reduce their dosage (a slow and steady decrease is recommended over a sudden discontinuance due to withdrawal symptoms). Always talk to a doctor about any changes to your medication. As the dose is gradually reduced and preferably stopped, it is important to identify and optimize alternatives to managing any underlying issues. These alternatives are preferably not other medicines.

Sometimes these medications are used on an “as needed” basis. For example, if you are afraid of flying, and you need to go on an airplane, you can take one of these medications (prescribed by your doctor) to use in specific situations. Or, if you have claustrophobia and you need to go for a scan such as an MRI, taking this medication may make it more bearable.

I have also seen where these medications are prescribed for help with sleep. People who have an anxiety disorder may be prescribed this classification of medications to see if it helps reduce anxiety or panic attacks. In older people, antidepressants are the preferred class of medications to help with anxiety.

Some other key tips to remember:

  • Avoid taking benzodiazepines with opioids or alcohol.
  • These medications are more often prescribed to women (Almost 1 in 5 Canadian women report to have used in the past year).
  • Almost 1 in 10 Canadians in Quebec have been reported to have an addiction to benzodiazepines.
  • If a benzodiazepine addiction is present, consider there may also be other substance use disorders or behaviours present (e.g, alcohol, opioids, marijuana, gambling).
  • If you are older, it’s best not to start taking benzodiazepines.
  • If the addiction is getting worse, an admission to a treatment facility may be necessary.

If you are finding yourself feeling “addicted” or “dependent” on these medications (or other substances or behaviours), you are “craving” these drugs, or you are needing to increase your dosage, you may want to see your doctor to discuss alternatives. Reducing the risk of harm is key.

For more details, The Canadian Coalition for Seniors Mental Health has published the Canadian Guidelines on Benzodiazepine Receptor Agonist Use Disorder Among Older Adults (2019) and is found online: https://ccsmh.ca/wp-content/uploads/2019/11/Benzodiazepine_Receptor_Agonist_Use_Disorder_ENG.pdf

Angela G. Gentile, MSW, RSW

Cannabis and the Third Age: How Can Older Adults Benefit From This Plant?

Image from Pixabay

Image from Pixabay

This guest post is written by Bojana Petkovich. 

Cannabis (also known as marijuana) has suffered a fair share of stigma throughout the history of humankind. Even though plenty of its medicinal benefits have been known and tested for a long time, most of the world’s countries still keep cannabis illegal. Fortunately, Canada is not one of them any longer.

The Silent Generation and Baby Boomers clearly remember cannabis as illicit and all the stigma that went with it. One would think this mindset is perhaps the most difficult to change when it comes to fully embracing cannabis products, but this couldn’t be further from the truth. 

Why Are Seniors So Attracted to CBD-Based Products?

The answer is rather simple: older age comes at a price — your body is not the same as it used to be when you were younger, and cannabis helps a lot. Your skeletal, nervous, and muscular systems have aged, and there are several age-related diseases seniors are prone to. 

Some of these diseases can, however, be mitigated and battled using cannabis and its major constituents, cannabinoids (CBD). Such substances are diverse, and thus can help with plenty of symptoms and negative side effects.

The main reason a lot of older people lean toward cannabis and its products is that it is not like other heavy prescription drugs. It has hardly any worrying negative effects on your body, and it can benefit you greatly. These products do not harm your gastrointestinal tract and your nervous system, as opposed to prescription drugs for various pains, inflammations, and diseases.

Still, cannabis is also offered as a prescription drug and should be treated as such; this means that its abuse can result in cannabis use disorder that leads to severe side effects.

The National Cannabis Survey conducted by the government of Canada revealed that there has been a rise in cannabis use in seniors. Statistically, just over 40,000 people aged 65 and older used cannabis in 2012. As of 2019, the number rose to more than 400,000 people from this age group who consumed cannabis.

Age-Related Diseases and Cannabis

Diseases such as arthritis, glaucoma, dementia, osteoporosis, and adult-onset diabetes are some of the most common ones that come with old age. Cannabis is, however, known to help with all of them and many others.

Osteoporosis and bone-weakening diseases are some of the most common ones for older adults. They cause severe pain, limited activity and mobility, and overall weakness of your bones. Cannabis use is especially helpful when it comes to such diseases, as it speeds up the healing process of your skeletal system through osteoblast stimulation. These cells act as rebuilders and repairers of your bones, making them up to 50% stronger once the CBD treatment is finished.

Dementia is difficult to deal with, both for the one suffering from it and the person’s loved ones. Other than forgetting crucial things about your life, such as close family members and places, many people with dementia experience severe agitation, aggression, depression, and similar. The neuron cells saturated by excessive amounts of amyloid protein get inflamed, causing this vile disease. Luckily, tetrahydrocannabinol (THC) is there to reduce the amount of this protein, while inducing calmness. 

Diabetes is a problem for a growing percentage of the world’s population, especially in adults and the elderly. Diabetes statistics show people who use cannabis have around 16% lower fasting levels of insulin compared to those who do not use it, and type two diabetes is rather uncommon in cannabis consumers.

Pain is linked to many diseases and is the most common symptom. Cannabis is known for its ability to reduce different types of pain. Factually, 62.2% of cannabis users choose this plant and products based on it so they can relieve chronic pain.

Arthritis, a disease that attacks joints, tends to trouble 1in 2 older people. The feeling of stiffness and pain, followed by fatigue and swelling are some of the most noticeable symptoms. A 2018 study from the International Journal of Geriatric Psychiatry reports a strong bond between arthritis and depression, and seniors have been using cannabis to fight this disease. Not only that, but in 2018 they were up to 20 times more likely to admit they used marijuana in comparison to statistics from 1984. 

Bottom Line

As we enter an era where many symptoms, illnesses, and diseases are becoming a part of a blurry past due to technological advancement, older people can finally start experiencing a painless and easy day-to-day life. Cannabis is already making a massive change, as people opt for CBD-based products more and more every year, and we cannot wait to see this plant’s full spectrum of benefits in the future.

 

About the author: Bojana Petkovich is always on the lookout for new adventures and creative drives. Bojana is currently mesmerized by the fast-paced cannabis industry and providing the internet community with valuable information via LoudCloudHealth. The information on LoudCloudHealth is backed up by scientific studies. The articles on diseases and conditions treated by cannabis or CBD have sources to scientific research in their links. The statistics pages have their sources listed at the end of each article.

Low-Risk Alcohol Usage Guidelines for Older Adults – Know your limits

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Photo by bruce mars on Pexels.com

Most adults enjoy drinking alcohol on occasion. Sometimes, though, this occasional drink turns into a daily habit. One drink turns into two or more. If a person is not mindful, this habit could turn into an addiction. Addiction is also known as dependency or substance use disorder.

People can become addicted to not only alcohol but drugs, including prescription drugs (such as benzodiazepines and opiates). For example, nicotine, the drug found in cigarettes, is very addictive. Addictive behaviour can also be problematic, as in gambling, sex, or online gaming.

Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequences. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems. Yet a number of effective treatments are available and people can recover from addiction and lead normal, productive lives. – American Psychiatric Association, retrieved 03 Dec 2019.

For a number of reasons, it is essential to keep in mind that as we age, it is recommended we reduce our consumption of alcohol. For adults aged 65 and older, it is important to be aware of the low-risk guidelines.

Canada’s Low-Risk Guidelines (DrinkSense for Seniors) which is provided by the “Canadian Centre on Substance Use and Addiction”, states that limits for adults (not older adults) who drink alcohol should be 10 drinks a week for women with no more than two per day, and 15 drinks a week for men with no more than three drinks a day on most days. There is no specific limit for older adults, but one of their “Safer Drinking Tips” includes the advice of “Always consider your age, body weight, and health problems that might suggest lower limits.”

 

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Standard Drink Portions:

      • Beer – 341 ml (12 oz.) of 5% alcohol content
      • Wine – 142 ml (5 oz.) of 12% alcohol content
      • Cider/Cooler – 341 m. (12 oz.) 5% alcohol content
      • Distilled alcohol/80 proof liquor (rye, gin, rum, vodka, etc.) – 43 ml (1.5 oz.) 40% alcohol content

 

I attended an “Aging and Addictions” course in November 2019 which was held by the Addictions Foundation of Manitoba, and they supported the drafted recommendations entitled “Prevention: Low-Risk Drinking Guidelines” for those 65 and older (noted below).

 

Low-Risk Drinking Limits (65+)

    • Women: No more than 1 standard drink per day, with no more than 5 drinks in total per week.
    • Men: No more than 1-2 standard drinks per day, with no more than 7 per week in total.
    • Non-drinking days are recommended every week.

Source: Canadian Coalition for Seniors’ Health. Canadian Guidelines for Older Adults. Prevention, Assessment, and Treatment of Alcohol Use Disorder, 2019.

 

These drafted guidelines are more in line with what I would recommend. I have seen what alcohol dependence can do to people and it is heartbreaking. And as noted in a previous post here on my website, to help preserve cognitive health, experts recommend no more than 2-4 drinks per week (see my Memory Rescue book review.)

For those who have a drinking problem, there is often stigma and shame attached. Many people can’t abstain or reduce their drinking behaviour on their own (harm reduction) and need help. If you or someone you know has a drinking problem, addiction or dependence, please contact the Addictions Helpline in your area.

> Addictions Helpline Canada 

> Addictions Helpline USA

AA 12-Step (https://www.aa.org/) or Smart Recovery (https://www.smartrecovery.org/) are peer support options to consider as well.

If you are considering getting on top of your drinking problem and need someone to talk to, please contact me and I can assist you in finding the help you need.

Angela G. Gentile, MSW, RSW

 

References:

https://www.psychiatry.org/patients-families/addiction/what-is-addiction

https://amho.ca/wp-content/uploads/Mon-300pm-IP1-3a-Older-Adults-with-Alcohol-Related-Problems-Best-Practice-Guidelines.pdf

https://www.canada.ca/en/health-canada/services/substance-use/get-help/get-help-problematic-substance-use.html

https://www.samhsa.gov/find-help/national-helpline

https://www.aa.org/

https://www.smartrecovery.org/

https://www.drinksenseab.ca/drinksense-tips/seniors/

https://ccsmh.ca/alcohol-guidelines/

“A Standard Drink” image source: https://studentaffairs.lehigh.edu/content/what-standard-drink

 

 

 

 

One Day Without Caffeine – Here’s what I learned

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Photo by fotografierende on Pexels.com

I have been doing a lot of reading up on and learning about substance use problems and addictions and I quickly realized that I was using caffeine on a daily and habitual basis. I wondered if I was “addicted” to caffeine. Addiction in the sense that there is a compulsive need for and use of a habit-forming substance. Addictions always have negative consequences (think of those who are addicted to meth or alcohol). I have been having trouble sleeping at night so I wondered if caffeine was the culprit.

I also wondered if cutting out caffeine would cause me any withdrawal symptoms and if I was physically or psychologically dependent on it. I am not a heavy caffeine user. I have two, maybe three cups of orange pekoe tea (i.e. Red Rose) a day. Sometimes I have a special green tea drink. I rarely drink cola anymore. The chocolate I eat is also something I feel I am dependent on but that’s for another day!

I woke up as usual, around 7:00 am and boiled my hot water for tea. This time I put orange pekoe decaf tea in the cup (i.e. Typhoo). I added some milk and I realized in my mind, I was preparing for withdrawal such as headaches and fatigue. Most people are afraid of getting a headache as a caffeine-withdrawal symptom. I made sure I had my ginger tablets with me just in case. I enjoyed my cup of tea and tried to trick my brain that it had caffeine. Just to see if that helped.

By 9:30 am, while at work, I was noticing a “foggy and fuzzy” feeling on my face.

I imagined if I had had some caffeine at this point, perhaps the foggy feeling would go away. I had a glass of water to help with any dehydration/thirst symptoms.

At noon I had my lunch. I enjoyed another decaf tea with milk. I was feeling a little fuzzy in the face still. Kind of like what I feel like when I first wake up in the morning.

At 1:00 pm I was feeling some heat in my cheeks. A tired feeling was coming over me. I needed to be alert for work. I noticed I was craving sugar and carbohydrates. It’s as if my brain was telling me what to have to help perk me up if I can’t have caffeine. The second best option was sugar and carbs. So I had a couple of little candies. It helped for a short time.

By 2:30 pm I was feeling tired and was craving potato chips. I knew a cup of tea would help curb my afternoon crash, but I wanted to see if I could work through it. I had a few chips. It helped.

The need for carbs continued. At 3:45 pm I had some Nutella on a rice cake. By now I am totally convinced my body is craving sugar and carbs for a little energy boost to help keep me awake.

I can see how easy it is – and perhaps a healthier choice – to grab a cup of tea (or coffee for coffee drinkers) when you need a little “pick-me-up.”

Going for a tea (or coffee) seems a lot healthier than eating candies and potato chips. I then started to think about those who smoke and want to quit smoking. I have often heard how people gain weight when they quit. I can now understand why that is.

By 5:15 pm I was snacking before dinner. I ate a small piece of leftover garlic toast. I also had another glass of water to help me push through until dinner time.

During dinner, I told my family that I had not had any caffeine today and that I felt like I never completely woke up. 

After dinner, I felt very sluggish and tired. I had less energy and felt like having a nap on the couch. I fought it though.

When bedtime came around, I was yawning, felt tired, but unfortunately had trouble falling asleep.  My theory of  “a caffeine-free day will help me sleep at night” was disproven. The other theory of getting a “caffeine-withdrawal headache” was also disproven.

So, I’ve decided that it’s okay for me to have my cup of tea, or two, or not. I can go without it if I need to. I don’t consider myself dependent or addicted to caffeine. I see it as a comfort and habit that helps curb my appetite. It also helps me “wake up.” I have also read there are health benefits of drinking tea (and coffee) in reasonable amounts. Especially green tea. I will continue to work on my insomnia issues.

Challenge yourself to a caffeine-free day and see what you learn about yourself and your relationship to caffeine.

Angela G. Gentile, MSW, RSW

 

Heavy, Painful, Achy Arms Can Signify a Heart Attack – Crystal’s Story

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Photo by Daria Shevtsova on Pexels.com

This is a guest post, written by Crystal Lindal (47), Ontario, Canada. I first saw her Facebook post on October 22, 2019, and she agreed to allow me to share her story. 

 

It’s been exactly one month today.

Not a lot of people know I had a heart attack on September 22, 2019, in the early morning. And I wasn’t going to say anything on Facebook, but … BUT … if it helps just one person, then I’m okay with posting this.

Women have different heart attacks than men! Most women experience symptoms, they pass after a bit, and they go on with their day. They think, “It’s probably just my stomach … my arthritis … I haven’t eaten much today … I’m just too busy” … you get the idea!

I had slept over at my mom’s who lives next door. I woke up about 6:30 a.m., made coffee, and was sitting quietly on the computer – just scrolling Facebook and checking emails when the symptoms started at 7:15 a.m.

My heart attack symptoms:
> Both arms got extremely heavy and achy (the ache was very painful)
> Then I got nauseous
> Then my lower jaw hurt – felt like I had been sucker-punched!

I got up, walked around. I tried to shake my arms, thinking maybe I slept wrong or pinched my elbows somehow. I started pacing and went into the kitchen. While laying my arms and head across the kitchen island and concentrating on my breathing (because I thought it was some sort of anxiety attack) I looked over at the kitchen sink and there in all its glory was a bottle of low-dose Aspirin! I still have no idea what made me walk over and take one – but I’m pretty sure it saved my life!

My mom called the ambulance around 7:40 a.m. and it arrived shortly after. If she hadn’t done that, I most likely would have just got on with my day as I felt completely fine by then. I felt silly going to the hospital in an ambulance – I actually felt embarrassed!!

“Don’t doubt yourself! Don’t negate the signs and symptoms of a heart attack!”

Crystal Lindal, Heart Attack Survivor

I did get flown to Thunder Bay – and the doctor said I’m one of the lucky ones as my blockage is only at 50%. They only usually stent at 75%+ so no stent for me. But I now know I can do things in my life to reverse the blockage or at least stall it!

So, there ya go! My hope is that this may help someone out there to listen to their bodies. When something’s not right, it’s not right.

And I do suggest a bottle of low-dose Aspirin in every household!

– Crystal Lindal

 

For further information:

If you would like to reach Crystal, please use the Contact Form and your message will be forwarded to her.

Edited by Angela G. Gentile, MSW, RSW

Integrative Medicine – The “Best of Both Worlds”

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Integrative Medicine and Cancer

 

It’s been one year since the release of my latest book, “Cancer Up the Wazoo”  and to celebrate I am offering another chapter for free! Chapter 17 is about my beliefs and experiences with “integrative medicine.”

Check out the PDF “Integrative Medicine” on how complementary therapies combined with conventional treatment can help provide the best treatment for a diagnosis of cancer.

(The other chapter I offer for free is on Anal Cancer Basics.)

Cancer Up the Wazoo

If you would like to read the rest of the book, it is available on Amazon.

 

Angela G. Gentile, MSW, RSW

www.AngelaGGentile.com

My Low-FODMAP Elimination Diet Experience to Treat Irritable Bowel Syndrome

 

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Pasta with garlic bread. Off-limits for people with GOS sensitivity

Normally I don’t like to share my personal stuff here on the World Wide Web, however, once in a while I come across something that I think, if I share this with the world, maybe, just maybe, it will help someone else. In this article, I want to share with you my very personal (and embarrassing) experience with irritable bowel syndrome (IBS), and a way to help diagnose and manage further episodes of diarrhea and stomach upset.

My “tummy troubles” started when I was in my early 20’s. I was in university and I remember having cramps and diarrhea that would seem to come out of nowhere. Sometimes it was worse when I felt stressed, but it usually took me by surprise. I usually had little warning and a short amount of time before I needed to relieve myself. It was embarrassing, and I remember once when I was working with Home Care, I had to use a client’s bathroom. Another time, I had to cancel a support group I was running because I was suddenly taken over by vomiting and diarrhea.

The doctor I saw at the time recommended I have a colonoscopy to determine if there was anything going on such as colitis. The results came back as “minor irritable bowel syndrome.” I am not sure how that was determined, but for me, it was more than minor. I had also been tested for celiac disease (gluten allergy), and that test came back negative.

Fast forward to 30 years later, plus a bout of chemoradiation for anal cancer, I was really desperate to figure out how to control this irritable bowel. My sphincter muscles are no longer as strong or healthy as they used to be (imagine your bum being put into a microwave oven and fried!) so my IBS symptoms are much more concerning. The control I had before is now at half the strength it used to be (I’ve never lost control, thank God!).  I asked my doctor once again for a referral to a specialist, this time to a gastroenterologist (GE).

I saw the GE in April 2019. He recommended I go on a low-FODMAP diet. He told me about a mobile app I could use on my phone. He then said he would schedule a flexible sigmoidoscopy and a biopsy for microscopic colitis. He also took a blood test to check for celiac disease.

When I went home, I looked up low FODMAP. I had heard of this before, but I was not totally sure what it was. I came across the Monash University in Australia and found out they have done a lot of work in the last 12 years on helping people manage their IBS. They had an app that cost around $10 CAD, and from the reviews I had read on it, it was something I felt I could really get some good use out of.  I purchased it and never regretted it. It is something I use regularly. I can look up things for my friends, too!

FODMAP (pronounced “fawd-map”) stands for a group of carbohydrates found in foods – Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols. Many people (about 10-15%) find these types of ingredients hard to digest, therefore, causing an abdominal upset. These symptoms include abdominal pain, bloating, gas, nausea, diarrhea, constipation, and could include a combination of any or all of these. For me, it can get so severe, that I also vomit. This may be too much information for some of you, but unfortunately at times, when I am having a bad “attack,” my body expels my stomach and bowel contents at the same time. I have it “coming out of both ends.” It is very quick and short-lived. I feel better soon after these attacks. So, I get it pretty bad sometimes.

The low-FODMAP process includes eliminating all foods that have the FODMAP irritants until all symptoms noted above are gone. The foods fall into different categories: Fructose, Lactose (many people are lactose intolerant), Mannitol, Sorbitol, GOS, and Fructan. This process can take two to six weeks. For me, it only took a couple of weeks. My family was very supportive and I avoided eating out. Once symptoms are under control, then you start reintroducing each of the foods to see if it triggers a response. There are “safe serving sizes” for each food that are very helpful.

For me, it turns out I am sensitive to GOS –- Galacto-oligosaccharides. These are found in foods such as nuts, beans, legumes, wheat, and grains. I found out quickly that I can only handle 8-10 pistachios or almonds at a time and I need to wait a few hours between having these foods again, in fear of “stacking” and causing an attack.

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All those years I thought I was eating healthy (12-grain bread, almonds, cashews, pistachios, legumes, etc.) turned out to be one of the worst things I could be doing for my body. Thirty years of suffering, not understanding why I was having so much trouble. One time I remember calling a restaurant to say I was sure I had food poisoning. Looking back now, it was probably just an IBS attack.

By June of 2019 (two months later) I was feeling I had a handle on my diet. I had also seen a dietician for nutrition counselling, and I had a Nutrigenomix DNA test to help me personalize my dietary approach. I had also started intermittent fasting and tried out the ketogenic diet for a bit.

Overall, the low FODMAP diet and Monash University FODMAP Diet app changed my life, for the better. Every once in a while I have an upset, and I go to the app or I find out what the ingredients were in a meal I ate. I am still learning as I go, and unfortunately, durum wheat semolina pasta with a side order of brioche garlic bread is the equivalence of dynamite for me. Enzyme therapy is another option that I could consider to help manage my GOS sensitivity. I am looking into this.

I am hopeful that research will continue and the lives of people with IBS with improve. Although it is not a cure-all, considering doing a low-FODMAP diet to help improve and manage your “tummy troubles” is highly recommended. Working with your healthcare professionals and specialists is also important.

Angela G. Gentile, MSW, RSW

Social Worker/Author

For more info: www.AngelaGGentile.com

How to Prevent Heart Disease — The Number One Cause of Death Worldwide

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Image by Bruno Glätsch from Pixabay

Heart disease is the number one killer, worldwide. Prevention is key. Although these ten points were written for healthcare professionals,  there are a few points that we can incorporate into our own lives. In the first point, we are to be encouraged to aim for a healthy lifestyle throughout life. It’s never too early or too late to start living a heart-healthy lifestyle.

It is also important to note points four and five — the heart-healthy diet and exercise recommendations. Making healthy choices 80% of the time is what we are aiming for. Knowledge is power.

 

Top 10 Take-Home Messages for the Primary Prevention of Cardiovascular Disease

American Heart Association, 2019

1.  The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life.

2.  A team-based care approach is an effective strategy for the prevention of cardiovascular disease. Clinicians should evaluate the social determinants of health that affect individuals to inform treatment decisions.

3.  Adults who are 40 to 75 years of age and are being evaluated for cardiovascular disease prevention should undergo 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation and have a clinician–patient risk discussion before starting on pharmacological therapy, such as antihypertensive therapy, a statin, or aspirin. In addition, assessing for other risk-enhancing factors can help guide decisions about preventive interventions in select individuals, as can coronary artery calcium scanning.

4.  All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, processed meats, refined carbohydrates, and sweetened beverages. For adults with overweight and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss.

5.  Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity.

6.  For adults with type 2 diabetes mellitus, lifestyle changes, such as improving dietary habits and achieving exercise recommendations, are crucial. If medication is indicated, metformin is first-line therapy, followed by consideration of a sodium-glucose cotransporter 2 inhibitor or a glucagon-like peptide-1 receptor agonist.

7.  All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit.

8.  Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit.

9.  Statin therapy is first-line treatment for primary prevention of ASCVD in patients with elevated low-density lipoprotein cholesterol levels (≥190 mg/dL), those with diabetes mellitus, who are 40 to 75 years of age, and those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion.

10.  Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be <130/80 mm Hg.

Arnett et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000678

Age well, my friend.

Angela G. Gentile, MSW, RSW

Eat According to Your Genes – Nutrigenomix. Part 1

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Nutrigenomix packaging

I have been learning a lot about nutrition and diets. After reading Gin Stephen’s book “Feast Without Fear,” I was curious to find out what kind of “personalized nutrition” options were available to me. I came across this company called Nutrigenomix (out of Toronto, Ontario, Canada) and talked to my doctor and dietician about it. It’s a genetic test for personalized nutrition worth $499.00 CAD, so I wanted to make sure it was worth it.  With a doctor’s referral, I could get 80% of the cost covered by Manitoba Blue Cross. My doctor agreed to give me a referral.

I found a dietician that was trained in doing this kind of testing (at the Wellness Institute in Winnipeg), and I booked an initial consultation with Laura. On the first visit, I had to read over and sign a consent form.

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Page 1 of Nutrigenomix consent form

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Page 2 of Nutrigenomix consent form

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Tube for Nutrigenomix saliva (DNA) sample

Laura then took a history, a brief assessment and told me a little about the DNA test. She was very interested in my intermittent fasting, so we talked a little bit about that. I also told her about the Low FODMAP Diet (for irritable bowel syndrome) and that I was learning I have an intolerance to certain foods like pistachios, almonds, and wheat flour.

She opened up the packaging and told me to get ready to provide a saliva sample for the DNA test. I had done a similar test for Ancestry DNA a few years back, so I knew it would take me a while to fill the tube up to the line (not including bubbles!). She said she would call when the results were in, which would take about three to four weeks.

Easy-peasy. Now the wait begins. Stay tuned. Watch for Part 2 when I receive the results!

 

Angela G. Gentile, MSW, RSW

 

 

The Benefits of Participating in a 24-Hour Online Group-Fast for Health and Wellness

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I have been using the “intermittent fasting” method for health and weight management for four months now. Intermittent fasting, or IF, includes a variety of approaches to patterned eating. My typical schedule evolved from fasting for 16 hours a day to 17 – 18 hours a day. Depending on my social and family life, sometimes I change my fasting time to include longer 24-hour fasts. I have also used fasting as a health tool to help boost my immunity. My longest fast to date was 60 hours.

Due to my interest and passion for helping and supporting others in their health and wellness goals, I created and now administer a Facebook group for women called “What IF.” We help and encourage each other on our IF methods and approaches. A few weeks back I shared a great article by Benjamin Hardy called “The Number One Secret to Superhuman Willpower,” and it was all about fasting. Hardy spoke mainly about the spiritual aspects of going for long periods of time without eating, and he made a point about “getting a group of people together to fast…leads to miracles and radical breakthroughs.” He goes on to say “fast in whatever group you want – so long as the purpose for the fast is relevant to each member of the group.”

I was inspired by Hardy’s idea of fasting in a group and wanted to see if there were people online that would be interested in doing a virtual 24-hour group fast. I set up an “Event” on my Author Angela G. Gentile Facebook page and shared the link in various other groups and on my personal Facebook page. It was advertised 11 days ahead of the event.

The plan was to fast from a Wednesday evening after our supper meal, until the same time (24-hours later) on a Thursday evening. The start and stop times were going to be staggered, and it could be personalized to suit a person’s lifestyle. I chose to fast from 6:50 pm until 6:50 pm the next day. I answered questions as they came up and encouraged people to let me know when they started and ended their fast. I also made a “24-Hour Fast” chat group on Messenger.

The response was more encouraging than I expected! I ended up with “25 Went and 45 Interested.” The event was a huge success, and I decided to do a short survey on “Survey Monkey” afterward to see if I should do this again, and how I could improve on it.

I received 21 survey responses – from 19 women and two men. The responses were helpful, insightful and encouraging. See the highlights below.

1. How did you first hear about the “24-Hour Group-Fast” event?
What IF Facebook group (8), Angela G. Gentile’s personal Facebook page (7), Author Angela G. Gentile’s business Facebook page (1), Other (6) included Keto groups on Facebook

2. How many hours did you successfully fast for this 24-hour event?
Surprisingly a few went way past the 24-hour mark. It seemed to trigger something in some people. The longest fast was recorded as 61 hours! The shortest was 22. There were a few who did over 40 hours. 17 of us did between the 23.5-36 hour mark!

3. How did you feel DURING the fast?
Most people reported feeling “Fine,” “Good,” “Great!”. One person said “Amazing!!!! A new level of happy and wellbeing.” Another response was “Focused!” One person said “I felt really great! I had forgotten how fasting makes your sides feel clean, as I hadn’t done it for so long!”
For those who felt hungry, they said “I felt OK as long as I kept busy” and “Fine in the AM. Hungry around 17-20, but less hungry the last 4 hours.” One person said they were “only hungry when I had to prepare food for my daughter.”
Not everyone had a great experience though. One person said “I felt bad at first. I am out of practice. But at 20 hours I felt great.” One had a “slight headache and felt tired late in the day”; another reported my “head ached and felt jittery at the end.” One felt a “little light-headed later in the afternoon but got home from work, relaxed and felt better.”

4. How did you feel AFTER the fast?
Most people had something very positive to say about how they felt after the fast. Typical responses were: “Good,” “Great!” “Really Good!” “Excellent,” “Empowered!” “Energized” and “Energetic.” One person said, “Energized, hopeful and happy.” One person felt “Detoxed,” and another said their “bowel seemed to work better.” Two said they could have gone longer.” One person said they felt “Tired.” Another reported, “I felt my good choice after fasting wasn’t great and I felt icky after eating.” One enthusiastically stated, “I slept better than I had in a very long time! I felt so refreshed!”

5. How often would you like to do a fast?
“Once a week” received the most responses (9). “Once a month” (6), and “Once every two weeks “ (4). One person said they were “going to try to fast from Sunday night until Tuesday afternoon each week for the month of May.” One would like to do this “3-4 times a week.”

The “general” responses included lots of “Thank yous” and other kind words of appreciation for organizing the event. I enjoyed hosting this group fast and I even personally benefitted from it! I flexed my fasting muscle and willpower, and I felt in control. I enjoyed the group aspect of it and learned from others in the Messenger group and on the Facebook discussions and comments.

These final comments stand out for me and verify that deciding to run this fasting event was an excellent idea! Thank you to all who participated and took the time to answer the survey.

“Thank you so much for this opportunity! I believe fasting is good for you and it’s a lot easier when you have people doing it with you and cheering you on!”

“It helped me stay motivated knowing others were doing it too.”

“It was nice to complete as a group.”

NOTE: If you would like to be notified of the next 24-hour group fast, or if you would like more information on intermittent fasting for health and weight management, please let me know.

Angela G. Gentile

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Angela G. Gentile  MSW, RSW is a clinical social worker and author. She lives in Winnipeg, Manitoba with her husband and has two adult children. For more information visit: www.AngelaGGentile.com.