Four ways to lower your cholesterol without medication

You’ve just been told your cholesterol levels are too high. This can be overwhelming and maybe a little scary. But the good news is that if caught early, you can reduce your cholesterol levels naturally and avoid medication.

High blood cholesterol is a major risk factor for heart disease and stroke. So, it’s important to understand what it is and how you can control it.

“High cholesterol levels occur when your low-density lipoprotein (LDL), or ‘bad’ cholesterol, is high, and your high-density lipoprotein (HDL), or ‘good’ cholesterol, is low,” says Layla Al-Rehany, a clinical dietician at The Scarborough Hospital. “Healthy lifestyle and nutrition are crucial to help managing cholesterol levels.”

Here are four healthy lifestyle and nutrition strategies to reduce your cholesterol levels:

Lose weight – being overweight can result in higher LDL and lower HDL. You can improve your cholesterol levels and lower your risk of heart disease by losing about five to 10 per cent of your body weight. So, if you weigh 150 lbs, you would have to lose 7.5 to 15 lbs to reduce your risk.

Increase physical activity – to stay healthy, everyone should exercise about 30 minutes a day five times a week. This can help lower LDL and raise HDL. If you’re not currently active, try starting with a low impact activity such as brisk walking, swimming or a leisurely bike ride.

Change your diet – select foods that are lower in saturated fats, trans fat and cholesterol. Make sure to include lots of fruits, vegetables, whole grains and lean sources of protein in your diet which are good sources of fibre and unsaturated fats. Here are some healthy food options:

• Oatmeal, oat bran and high-fibre foods such as kidney beans, apples, pears, barley and prunes contain soluble fibre which reduces your LDL.
• Fish and omega-3 fatty acids can reduce blood pressure and lower your risk of developing blood clots. Try to eat two servings per week of baked or grilled fatty fish such as salmon or mackerel. You can also take a fish oil supplement.
• Skinless lean cuts of meat and poultry.
• Skim or 1 per cent milk, yogurt with 1 per cent milk fat or less, cheese with 15 -20 per cent milk fat or less.
• Unsaturated oils such as canola, olive, peanut, safflower, soybean, sunflower or corn – about two tablespoons each day. Use them in marinades, stir fry and salad dressings. When it comes to oils, do not choose “light” versions as they are just more processed and you will get less benefit.
• Non-hydrogenated soft margarine made from unsaturated oils.
• Walnuts, almonds, hazelnuts, peanuts, pecans, some pine nuts and pistachio nuts can help reduce cholesterol. But they are high in calories, so stick to about a handful per day, and avoid nuts covered in salt or sugar.

Stop smoking – smoking lowers your HDL and raises your LDL. You can reverse these effects if you stop smoking today.

With some hard work and dedication, you can implement all of these strategies into your lifestyle and see significant changes in your blood cholesterol levels.

When does a diet become an Eating Disorder?

Many of us have experimented with crash diets, trendy exercise routines, calorie counting and a love-hate relationship with the bathroom scale because we may be dissatisfied with our bodies. But when does common concern become an obsession, and ultimately lead to an eating disorder? 

“An eating disorder begins to develop when an individual demonstrates goal-directed behaviour to lose weight, even when they are already clinically underweight,” says Joanna Blanchard, Mental Health Therapist at The Scarborough Hospital. “Pressure can come from media images that have likely been manipulated, and individuals aim for the physically impossible.”

However, many people are exposed to the same media, but do not develop an eating disorder. While societal and familial pressures or existing mental health issues such as depression can play a role in developing this mental illness, the direct cause remains unknown.

Some signs that an individual may be struggling with an eating disorder include:
• Restricted calorie intake
• Excessive exercise
• Excessive use of laxatives and/or diuretics
• Rapid weight loss

Often considered a ‘women’s disease,’ research shows that over the past few years, eating disorders such as Anorexia Nervosa and Bulimia Nervosa are affecting an increasing number of men.

“Traditionally men aspired for a muscular figure, but the modern male model is slim, which can put pressure on men to lose weight,” says Stephanie Luke, Child and Youth Worker at TSH.

Stephanie adds that athletes, who gain a competitive edge from weight control, are a high risk group. For example, wrestlers are seven to 10 times more likely to develop an eating disorder from a constant pressure to maintain a specific weight range.

Despite the goal, an eating disorder is the most lethal mental health disorder. It damages normal body functions, which can lead to several physical conditions including malnutrition, dehydration, esophageal damage and heart failure.

To learn more about eating disorders and other health and nutrition topics, please join us for the It’s Time to Talk Speakers’ Series, “Food for Thought: You Are What You Eat,” on March 1. Click here for more details.

The importance of prevention and screening for cervical cancer

Worldwide, cervical cancer is the second most common type of gynaecological cancer. In North America, it is the eighth most common cancer. The incidence of cervical cancer has decreased in the developed world because of regular Pap screening. Pap tests detect abnormal cells before they become cancer and further treatments can prevent them from ever becoming cancer. 

“Sadly, not all women go for regular testing and so we continue to see this lethal disease,” said Dr. Georgina Wilcock, an Obstetrician/Gynecologist at The Scarborough Hospital. “Each year in Canada, it’s estimated there are 1,300 new cases of cervical cancer diagnosed and 390 women will die of the disease. “

For these reasons, Dr. Wilcock reminds women about the importance of regular Pap test screening, which has been shown to decrease the incidence of cervical cancer by 50 per cent.

The Pap test is a quick, simple and usually painless procedure where a doctor scrapes and removes cells from the surface of the cervix with a small brush or spatula.  The cells are then examined in a laboratory. In the event that a Pap test shows  changes or abnormalities in the cervical cells, follow-up tests or procedures may be done.

Currently in Canada, it is recommended that women between the ages of 18 and 69 (or women under 18 who are sexually active) undergo cervical screening.

“Although the cause of cancer in general remains somewhat of a mystery, the cause of cervical cancer is not. The culprit is almost always the human papilloma virus (HPV) infection, one of the most common sexually transmitted infections (STIs),” points out Dr. Wilcock.

While some types of HPV cause genital warts, other strains of the virus can infect the cervix and then cause abnormal changes within the cells that may slowly progress to cancer.

There are several other important steps women can take to minimize their risk of developing cervical cancer:

• Get the HPV vaccine – The world’s first vaccination against HPV was approved in Canada and the U.S. in 2006. The vaccination provides protection from four different types of HPV – two of which cause 70 per cent of cervical cancer. In Ontario, this vaccine is given free to girls in grade eight. It is given at this young age because it has been shown that this is the best age for young women to develop a strong immunity to the virus.
• Practice safe sex – The HPV virus is most commonly transmitted via sexual contact and intercourse. Refraining from genital contact with an infected person or using a condom will reduce the risk of HPV infection.  However, condoms are not 100 per cent effective as they only protect the covered area.
• Stop smoking – Both tobacco smoking and exposure to second hand smoke have been associated with the development of cervical cancer. Quitting smoking can reduce the chance of developing the disease.

And, of course, ensure that you are receiving regular Pap testing.

Should you vaccinate your baby?

Most new or soon-to-be parents have struggled, or are struggling with a common question. Are vaccinations safe for my baby? The answer is yes.

“There is a lot of misinformation floating around out there about the safety of vaccinations,” says Dr. Peter Azzopardi, Chief of Paediatric Medicine at TSH. “Vaccines have been said to cause a number of health problems including autism and sudden infant death syndrome (SIDS). The reality is, these claims are just not true.”

Expert groups in Canada, and around the world, have researched and investigated these claims and have found no evidence of a link between vaccines and any of these health concerns.

“Vaccines are safe,” says Dr. Azzopardi. “Although some children may experience mild reactions from vaccinations, such as a sore arm or mild fever, the benefits of having your child vaccinated far outweigh the risks that come with the diseases the vaccinations prevent.”

In Ontario, when you vaccinate your child you protect them against a number of life-threatening diseases including:

• Whooping cough
• Polio
• Meningitis
• Measles
• Mumps
• German measles (rubella)
• Hepatitis
• Chickenpox
• Influenza

Many of these diseases are rare in Canada, and that’s because of our good vaccination rates. But they quickly reappear in Canadian populations who choose not to vaccinate – for example the measles outbreak in Quebec last year. As well, there is a risk if you travel to countries where the diseases are still common.

The flu vaccine is important for every member of the family. Many people don’t realize the flu can be much more debilitating than the common cold and has the potential for severe illness and even death. The flu shot will protect you. You may also choose to use the new nasal spray that’s available this year and is covered by most drug plans.

Talk to your doctor about when your child should be vaccinated.

Visit the Ontario Ministry of Health website to view a vaccination schedule and get more information about vaccinating your child.

Caring for someone with Alzheimer’s Disease

Your loved one has been diagnosed with Alzheimer’s Disease. You decide to be the primary caregiver so they can remain at home and benefit from a familiar environment and continued independence. As the disease progresses, you may be faced with more challenges which take a significant toll on your physical and mental well-being.

Caregiver stress is serious, and if ignored can lead to illness and, in some cases, hospitalization.

“The most important thing a caregiver can do is take care of him or herself,” says Dr. Tanya Pinto, Geriatric Psychiatrist with the GAIN Clinic at The Scarborough Hospital. “This means identifying supports and asking for help, taking personal time and managing their own health.”

The Geriatric Assessment and Intervention Network (GAIN) Clinic at TSH provides a holistic approach to care, including comprehensive assessments,providing education for caregivers and connecting them with appropriate community resources.

“Information is power,” says Debbie Driver, Nurse Practitioner with the GAIN Clinic at TSH. “Knowing what resources are available within your community and understanding the disease can reduce the stress in caring for your loved one.”

Debbie adds that several agencies will provide services such as home assessments to identify safety modifications, bathing and grooming care and education and resources to help a caregiver understand the disease and prepare for the future.

Dr. Pinto and Debbie also identify some strategies to help caregivers remain at an optimal level of well-being.

Learn about Alzheimer’s Disease. A person with Alzheimer’s Disease can present challenging behaviour as they experience memory loss. The behaviours can be frustrating, but understanding them will enable you to better cope with the situation. Speak to staff at the GAIN Clinic, consult your family doctor, read books and online information, and contact specialized agencies such as your local Alzheimer Society chapter.

Take a break. Sometimes a short walk around the block is enough to help you maintain your mental and physical health. If you need a longer break, such as a vacation, consider respite care. Ontarians who receive CCAC service are eligible for up to 90 days respite care annually. This could also serve as an initial introduction to a long-term care facility.

Ensure you get enough sleep. People with Alzheimer’s Disease often wake during the night, and their activity can disrupt your sleep. Ensure you both practice good sleep hygiene such as limiting daytime naps, joining a day program, and engaging in quiet activities before bedtime. Continued restlessness throughout the night, could indicate a physical issue such as sleep apnea, restless leg syndrome or a bladder infection. Visit your family doctor to rule out or address any physical conditions.

Have the challenging conversations early on. Once you have received the diagnosis, think about and discuss future plans before the disease progresses. For example, would your loved one want CPR or a feeding tube if needed? How do they feel about a long-term care facility? What does quality of life mean to them? These conversations are difficult, but discussing wishes ahead of time will reduce future stress.

Don’t take things personally. Emotional outbursts may arise from time to time, which may be directed at you since you are a familiar person. These outbursts are the result of frustration, and are not necessarily meant to hurt you. As difficult as it may be, try to remain objective during these outbursts.

Don’t be afraid to ask for help. You are not alone. Identify your support system, and don’t be afraid to ask for help. Family, friends, neighbours, a support group and healthcare professionals are available to help you through this difficult time and ensure you maintain your physical and mental health.

Remember that Alzheimer’s Disease is an evolving process, and every situation is unique. As a caregiver, you will be faced with constant change, so try your best to remain flexible. Experiment with different strategies and techniques to determine what works within your lifestyle.

Six strategies to help you quit smoking

From sanitizing wipes to seatbelts to life jackets, Canadians take numerous precautions to ensure we keep ourselves and each other healthy and safe. Yet, so many Canadians continue to smoke when research shows that smoking remains the number one cause of preventable death in Canada.

“Cigarettes are designed to directly affect the brain,” says Dr. John Oyston, Anaesthesiologist at The Scarborough Hospital. “When the chemicals reach the brain, dopamine is released, which makes people feel happy and calm. Once you get used to that feeling, it’s very hard to give up.”

Dr. Oyston adds that cigarettes are more addictive than drugs such as cocaine and heroin, and the most effective way to avoid the addiction is to avoid smoking that first cigarette altogether.

As an anaesthesiologist, Dr. Oyston has a ringside seat to the harm smoking causes the body. After bearing witness to the damaging effects, he took action and launched the Quit Quarter Campaign, which encourages tobacco control and promotes smoking cessation by minting and distributing a coin stamped with a broken cigarette design.

For those who do smoke, but have decided to quit, Lori Irvine, Organization and Employee Development Coordinator at The Scarborough Hospital, provides some strategies to becoming smoke-free. 

1. Keep your mouth busy – chew gum or snack on healthy foods such as grapes, plain popcorn, or pistachios nuts.  This will keep both your hands and mouth busy for the duration of your craving, which will generally last about seven minutes.
2. Spend time in places where you can’t smoke – the good news is that most places are now smoke-free. Smokers generally have to go outdoors to smoke, so winter is a great time to try and quit because going outside is less tempting in cold winter weather.
3. Reward yourself – smoking is expensive. With the money you save from buying cigarettes, treat yourself to a small reward such as a new piece of clothing or save toward a larger reward such as a vacation.
4. Set a goal for your success – write down what you want to accomplish and share your goal with loved ones. Being accountable to yourself and others will help to sustain your success.
5. Follow up with your goal – Look back at the day or week and track when you were successful and when you smoked. Were there consistent times in your schedule when you smoked, such as during your break or after a meal? If the answer is yes, try to break those routines by replacing smoking with another activity like a short walk. Also being aware of your triggers can help you to overcome your craving.
6. Ask for support – ask a loved one or your family doctor for help, or call a smokers’ helpline for advice and support. There are many resources available to help you butt-out for good.

Quitting smoking is difficult, and often people try several times before they are successful.

“For some people it happens quickly and for others it can take some time,” says Lori. “Everyone is unique, so develop a plan that works within your lifestyle. If you can’t quit cold turkey then try cutting back at first. Don’t set yourself up for failure, and remember to give yourself the opportunity to be human.”

Keeping your New Year’s fitness goals

The New Year is an opportunity for fresh starts and setting new goals. Improving fitness levels continues to be one of the most popular resolutions, yet it’s also one of the most difficult for a majority of individuals to maintain.

“Research indicates that more than two-thirds of people who set fitness goals at the beginning of the year give up within two months,” says Lori Irvine, Organization and Employee Development Coordinator at The Scarborough Hospital. “However, by following some key steps, you can dramatically improve your odds of sticking to your goals.”

Lori offers the following tips when setting a New Year’s fitness plan:

• Set realistic fitness goals – Ensure you speak with your physician before beginning any fitness regimen and make an appointment with a personal trainer who can help you break your overall goals into smaller, reachable targets.
• Write down your fitness goals – Simply writing down your short-term and long-term goals and the steps involved in meeting them can increase your motivation and reduce the chance of giving up. 
• Tell your family and friends – Verbalizing your fitness plan and letting others know about it can help you feel more accountable to your goals.
• Prioritize and schedule regular exercise – You’ll be more likely to stick to your fitness routine if it’s scheduled into your calendar like any other commitment.
• Choose a gym or fitness routine that is close to your home or accessible during your commute to and from work – A convenient location means you’ll be less likely to skip your fitness routine due to factors such as bad weather, traffic, etc.
• Don’t try to be perfect! – Whether it’s missing a couple of workouts or giving in to a treat, don’t beat yourself up over the occasional slip.
• Reward yourself – Whenever you achieve or complete a part of your fitness plan, reward yourself! Buy something you’ve wanted for a while, go for a spa treatment, etc. Do whatever makes you feel good about all your hard work – you deserve it!

Feeling your best over the holidays

The holiday season is upon us, and that means lots of stress, socializing and late nights. It can be fun, but it’s hard on your overall well-being. That’s why is pays to take it easy, slow down and enjoy the festivities in moderation.

“Our daily routine is often challenged at this time of year, when there are so many demands on your time,” explains Dr. Farid Boutros, Endocrinologist with The Scarborough Hospital. “While it’s tempting to over-indulge in all the rich food, alcohol and parties, it can all be very taxing on the body.”

Dr. Boutros recommends these tips to feel your best throughout the holidays and after:

1. Steer clear of the buffet. Microbes love parties. Watch out for food that is meant to be hot or cold but has been sitting at room temperature for more than two hours.
2. Wash your hands. Frequent and thorough hand washing, or use of an alcohol-based hand sanitizer, prevents the spread of cold and flu viruses. It’s especially important during the holidays when you are around more people.
3. Keep fit. Exercise schedules often take a back seat to all the holiday festivities. Walk to some of your errands, work or social events, or go for a stroll in the evening.
4. Sleep. It’s tough to get the right amount of shut-eye when there is so much partying and socializing going on. But would you rather get enough sleep or risk staying in bed over the holidays because you’re sick?
5. Just say no. Choose your priorities and decline any social commitments that will put you over the top.
6. Adjust your expectations. Not everything has to be perfect for a pleasant holiday. Spending time with family and friends is, after all, the most important thing.
7. Keep your cool. Stuff happens. Relax, and have a good laugh. It really is the best medicine.
8. Stay on budget. Money matters are a big stress factor. Make a strict shopping list and stick to a budget.

Signs of an abusive relationship

Today is the National Day of Remembrance and Action on Violence Against Women in Canada. Today, we honour the 14 female engineering students whose lives were cut short at École Polytchnique de Montreal.  The tragic events of December 6, 1989 are a stark reminder that women are at risk of violence because they are women.

Violence against women continues to be a serious issue in Canada. Violence has a strong impact on the health status of female victims, and often, it’s difficult for women to even recognize they are in an abusive relationship.

“We are working with a number of agencies including the Toronto Police, Victim Services and shelters to promote the concept that as friends, families and neighbours, we all need to be involved in providing support and safety to women and children at risk of violence,” explains Shirley Broekstra, Manager, Sexual Assault/Domestic Violence Care Centre at The Scarborough Hospital.

Recognizing the signs of an abusive relationship can be as subtle as a partner keeping you from seeing friends or family, or as obvious as physical harm. Shirley adds that other signs that you might be in an abusive relationship can be determined if your partner:

• Has a bad and unpredictable temper.
• Hurts you or threatens to hurt or kill you.
• Threatens to take your children away or harm them.
• Threatens to commit suicide if you leave.
• Forces you to have sex.
• Destroys your belongings.
• Acts excessively jealous and possessive.
• Controls where you go and what you do.
• Limits your access to money, the phone or the car.
• Constantly checks up on you.

If you are in an abusive relationship or have been assaulted, contact the Sexual Assault and Domestic Violence Care Centre at The Scarborough Hospital at 416-495-2555 or http://www.sacc.to.

Protecting your skin from winter weather

Love it or hate it, there’s no denying the impact winter weather can have on our skin.

“Low temperatures, low humidity and strong, harsh winds can deplete skin of its natural lipid layer, which keeps it from drying out. Skin can also lose moisture from the dry air from furnaces and other heating sources,” said Dr. Sophie Hofstader, a dermatologist at The Scarborough Hospital.

Dr. Hofstader offers the following advice to avoid cracked, peeling skin and lips:

• Use lukewarm water for showering and washing your hands. Hot water can rob your skin of moisture.
• Ensure you moisturize your skin after showering or hand washing.
• Apply moisturizer before putting on gloves when you go outside in winter.
• Use lip balm regularly, as lips retain less moisture than other parts of the body and tend to dry out more quickly.
• Invest in a humidifier to keep the air moist in your home.
• Get enough omega-3 fatty acids by eating fish such as salmon, mackerel, cod, tuna, sardines and herring. The beneficial oils work at the cell level for skin.
• Be sure to wear a sunblock with an SPF of at least 30 if you’re going to be outside in the snow for more than 30 minutes, and re-apply it every two hours.

“As unusual as it may sound, the goal is not so much to add moisture to the skin, but to keep moisture in,” explains Dr. Hofstader.