Semaglutide vs Tirzepatide for Weight Loss

For those looking to shed excess pounds, new medications semaglutide and tirzepatide are generating buzz. As a doctor, patients often ask me to explain the difference between these two injections for weight management.

Both semaglutide (brand names Ozempic, Wegovy) and tirzepatide (Mounjaro) are glucagon-like peptide-1 (GLP-1) receptor agonists that work by mimicking a hormone to reduce appetite, however tirzepatide uniquely also activates the glucose-dependent insulinotropic polypeptide (GIP) receptor unlike semaglutide which only activates the GLP-1 receptor.

Tirzepatide is the newcomer, approved by the FDA in 2022 as a treatment for type 2 diabetes. It’s also under investigation for obesity. Semaglutide has been around longer, with FDA obesity approval in 2021.

In clinical trials, tirzepatide led to greater weight loss compared to semaglutide – up to 25% total body weight loss versus 15%. It may also have additional blood sugar lowering effects.

However, semaglutide has a more established safety profile given its availability for several years. The most common side effects are gastrointestinal like nausea, vomiting, and diarrhea. Tirzepatide’s long-term effects require further study.

Overall, those seeking weight loss have a new and seemingly more potent option in tirzepatide. But semaglutide remains the first-in-class GLP-1 drug with proven results. As always, work closely with your doctor to determine if these medications fit into your health and wellness goals. The right choice depends on your medical history, budget, and more.

Eliminate Common Sleep Saboteurs

Getting a full night of quality sleep is essential for maintaining good health. However, many everyday habits can disrupt our sleep without us realizing it. As a doctor, I often counsel patients on sleep hygiene and recommend eliminating common sleep “saboteurs” from their evening routines. 

One of the most common sleep disruptors is caffeine. While coffee can perk you up in the morning, drinking it too late in the day can impair sleep. Caffeine is metabolized slowly and has a half-life of up to 5 hours. This means consuming coffee, tea, soda and even chocolate several hours before bed can overstimulate the nervous system and keep you awake. I advise stopping caffeine intake past 2 pm to allow adequate metabolism before bedtime.

Alcohol is another sleep saboteur. While some think alcohol helps induce sleep, it actually leads to frequent awakenings and disrupted sleep cycles later in the night as the body metabolizes it. Alcohol suppresses REM and deep sleep stages important for restorative rest. Limit intake to 1 drink, at least 3 hours before bedtime. Bigger or closer to bedtime has a greater impairing effect.

Eating too much close to bed can also disrupt sleep. A full stomach triggers digestive processes that interfere with sleep. Finish meals 2-3 hours before bedtime and avoid greasy, spicy or sugary foods that can cause discomfort or heartburn which disturbs sleep. Melatonin-disrupting light from TVs, phones and tablets is another issue. Avoid screen time for 1-2 hours before bed, and use blue light filters on devices in the evening.

Establishing a consistent, relaxing pre-bed routine is key to a good night’s rest. Unwind with a book, light stretches or meditation instead of high-intensity exercise. Get into bed at the same time each night to regulate your circadian clock. Ensure your sleep environment is cool, dark and comfortable. Following healthy sleep hygiene helps optimize the hours you spend in bed. Avoid sleep-disrupting habits that work against your body’s natural sleep mechanisms.

With simple lifestyle tweaks, you can prevent sabotage and get consistent, restorative sleep.

Getting the Inside Scoop on Mammograms

Getting the Inside Scoop on Mammograms

Friends, let’s have an open discussion about mammograms. This breast cancer screening procedure has saved countless lives, but it often gets a bad rap for being painful and inconvenient.

But there are some fascinating facts about mammography that make it worth your time. As a physician, I want to let you in on a few insider secrets to help you feel empowered about your next appointment.

Myth Buster: The Compression Only Lasts Seconds

That tight squeezing sensation doesn’t last nearly as long as you think! The compression only happens for a few seconds while the x-ray images are taken. Just a momentary uncomfortable feeling that gives your doctor a clearer view of your breast tissue.

Low-Dose Radiation Keeps You Safe

Rest assured, mammograms utilize low-dose radiation to minimize risks. The benefits of screening greatly outweigh the tiny amount of radiation. Just some peace of mind next time you’re in the scanning booth.

Dense Breast Tissue? Ask About 3D Mammography

If you have dense breasts, those flat 2D images don’t always tell the whole story. Opt for 3D tomosynthesis to get a layered view that could improve cancer detection. Chat with your doctor to see if this upgraded scan is right for you.

While mammograms require a little discomfort, I hope these insights provide some reassurance. Stay informed and proactive about your breast health!

Getting Your Zzz’s: The Best Magnesium for Sleep

As a primary care physician, I often have patients coming in with poor sleep quality asking what natural methods can help them get deeper, more restful sleep. One supplement I frequently recommend is magnesium. The right type and dose of magnesium can work wonders for improving sleep.  Magnesium is a cofactor for over 300 biochemical reactions in the body, including ones that regulate neurotransmitters and nerve signaling involved in sleep. It also binds to and activates NMDA receptors in the brain which help control nerve excitability that can interfere with sleep.

Absorbing the Best Form for Sleep Success

Some forms of magnesium are better absorbed than others. Magnesium glycinate, for example, consists of magnesium chemically bonded to glycine, an inhibitory neurotransmitter. This allows it to readily cross the blood-brain barrier and decrease neuronal firing, promoting a calming effect ideal for quality sleep. The dose is generally 200-500mg elemental magnesium taken about 30 minutes before bedtime.

Don’t Let Laxatives Keep You Running to the Bathroom!

Magnesium citrate is another form that can help with sleep, but it tends to act as an osmotic laxative. So I recommend taking it 2-3 hours before bed and avoiding it close to sleep time. The citrate component combats acidosis which can disrupt sleep. The dose is 150-300mg elemental magnesium.

Magnesium Threonate – The Superior Sleep Supplement

Of all the forms, magnesium threonate may be most effective since it easily crosses into the central nervous system. At doses of 150-200mg before bedtime, it binds to NMDA receptors, blocking excitatory neurotransmission. Patients report improved sleep quality without morning grogginess.

Calm Your Mind with Magnesium and Taurine

Finally, magnesium taurate combines magnesium with taurine, an inhibitory neurotransmitter. Taken at 400-600mg about 30-60 minutes pre-bedtime, this calms the nervous system and brain to transition you into deep, uninterrupted sleep all night long.

The type, timing, and dosage of magnesium supplements can be tailored to each your needs and preferences.

ADHD Mythbusting – Debunk common myths and misconceptions about ADHD

ADHD Mythbusting

Attention-deficit/hyperactivity disorder (ADHD) is a commonly misunderstood condition. Let’s explore some frequent myths and misconceptions about ADHD:

Myth: ADHD isn’t real, it’s just an excuse for misbehavior.

Fact: ADHD is a legitimate neurological disorder involving impaired executive functioning. Brain imaging shows key differences in ADHD brains. While symptoms can include hyperactivity and impulsivity, ADHD is much more than just bad behavior.

Myth: You outgrow ADHD in adulthood.

Fact: While some ADHD symptoms may improve with age, over 50% of children with ADHD will continue experiencing symptoms as adults. Adult ADHD comes with its own challenges like disorganization, forgetfulness and difficulty focusing.

Myth: ADHD is the result of bad parenting.

Fact: While parenting strategies can help manage ADHD, the disorder stems from biological factors including genetics, brain structure and chemistry. Bad parenting does not cause ADHD.

Myth: ADHD is overdiagnosed.

Fact: The CDC estimates about 5% of U.S. children have ADHD, which is lower than some estimates from the late 1990s. Diagnostic criteria are strict and ADHD can only be confirmed through psychological testing.

Myth: ADHD can be cured with proper diet.

Fact: While nutrition may play a small role, there is no diet that effectively cures ADHD. Lifestyle strategies like a healthful diet, exercise, sleep and mindfulness support, but do not cure the disorder.

Understanding the facts about ADHD is key to properly managing this condition. Spread awareness and share this mythbusting information with others!

Book your ADHD evaluation today at One Oak Medical, offering both virtual and in office consultation.  You can also give us a call at 571-751-7100.

Sleep Success: How to Hack Your Way to Better Sleep

Get Your Best Sleep Ever with This Ideal Bedtime Routine

After a long day, there’s nothing better than crawling into bed for a restful night of sleep. But did you know you can optimize your sleep and set yourself up for success by following an intentional pre-bed routine? As a doctor, I often prescribe evidenced based “sleep hygiene” to my patients who are having trouble sleeping. This includes recommendations like:

Create the Right Environment

First, set the stage by adjusting the temperature. Ideal is around 65°F. Cooler air helps activate the body’s natural sleepiness cues. Warm baths 1-2 hours before bed also cue the circadian rhythm that nighttime is approaching. Dim the lights and eliminate blue light from phones/TVs. Consider blackout curtains to block excess light and sound. The brain needs dark and quiet to release melatonin and transition into deeper NREM sleep stages.

Do some Light Yoga

A few restorative yoga poses can relax the body and calm the mind. Child’s pose, legs up the wall, and gentle twists activate the parasympathetic nervous system to relieve stress.   Yoga Nidra is a game changer as it takes this further with guided meditation that brings the body into a deeply relaxed state between waking and sleeping. As little as 10 minutes can induce the relaxation response.

Supplement with Magnesium

This key mineral plays a biochemical role in regulating sleep. It binds to GABA receptors in the brain which promotes calmness and tempers anxiety. It also helps muscles fully relax which prevents tossing and turning. Take 200-400 mg of magnesium glycinate or citrate form about an hour before bed. But check with your doctor first if combining with other medications.

By intentionally structuring your evening with sleep-enhancing rituals, you can program your body to easily transition into a state of rest.

The result is falling asleep faster, staying asleep, and waking up refreshed.

Sleep tight!

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Do You Need More Calcium?

It’s drilled into us from an early age: Calcium is good for our bones.

Yet according to the National Institutes of Health, many Americans don’t get enough calcium from food and supplements, putting them at risk for bone fractures and other health problems.

Knowing the foods that contain calcium and how to safely take supplements can be beneficial to getting the calcium you need.

Why is calcium important?

Calcium has well-earned its reputation for helping in the development and maintenance of strong bones and healthy teeth. Calcium also helps ensure the proper function of muscles, nerves and enzymes. And calcium plays a vital role in heart function and blood clotting.

Calcium is mostly stored in the bones, so if your body doesn’t get enough calcium, you can develop bone problems, such as osteopenia and osteoporosis.

Osteopenia means your bone density is below normal, but not yet in the range of osteoporosis. Having osteoporosis means your bones and thin and brittle, with lots of holes inside of them, making them easy to break.

Some studies have shown a correlation between adequate calcium intake and a reduced risk of colon cancer and rectal cancer. More research is needed to better determine the link.

How much calcium do I need?

In general, people ages 19-50 need about 1,000 mg of calcium daily.

Males ages 51-70 should aim for 1,000 mg daily.

Females ages 51-70 should aim for 1,200 mg daily.

In general, everyone ages 71 and older should get 1,200 mg daily.

Who needs more calcium?

Anyone who is not getting enough calcium in their diet should try to up their intake of this important mineral. People who may be at high risk of not getting enough calcium include:

  • Postmenopausal women and women who go through menopause before age 45. As women go through menopause, the amount of estrogen in their body declines. Estrogen plays an important role in regulating and absorbing calcium, so as the estrogen levels decrease during menopause, women become at higher risk of developing osteoporosis.
  • Men and women ages 65 and older. Osteoporosis risk increases with age, so it’s particularly important for people ages 65 and older to get enough calcium.
  • Anyone with a body mass index (BMI) less than 18.5.
  • Patients with malabsorption conditions that affect their ability to absorb nutrients from food, such as those with inflammatory bowel disease or celiac disease.
  • Smokers.
  • Anyone with a family history of osteoporosis.
  • Those who drink an excessive amount of alcohol.
  • Those who live a sedentary lifestyle.

People who have a low intake of calcium in their diet, such as vegans and people who are lactose intolerant or are allergic to milk, should talk to their physicians about ways to increase their calcium levels.

Being on certain medications can affect people’s absorption of calcium. Prednisone and some seizure medications, for example, decrease the absorption of calcium in the gut so when someone who is on these drugs eats something with calcium, the calcium won’t be adequately absorbed by the body. Proton pump inhibitors reduce the amount of acid in the stomach; acid is needed to help the body absorb calcium.

How to increase calcium safely

Check with your physician before increasing your calcium intake because too much calcium can interfere with certain medications. Also, people with certain medical conditions, such as kidney problems or hypercalcemia, should avoid too much calcium.

Those who are trying to increase their calcium levels must do so safely to avoid complications. Increasing calcium intake too quickly and consuming too much calcium overall can lead to constipation and kidney stones. Having too much calcium also can lead to poor absorption of other minerals, such as iron and zinc.

The best way to increase calcium intake safely is through food rather than supplements. Good food sources of calcium include dairy products, such as milk, cheese and yogurt. Leafy green vegetables, such as broccoli, kale and spinach, also are good sources of calcium. Other suggestions include salmon, tofu, peas, almonds, sesame seeds and fortified plant-based milk alternatives.

Calcium supplements

Calcium supplements are a convenient and easy way to increase calcium levels, but excessive intake can lead to constipation and kidney stones. Start slowly, with 500 mg, and gradually increase to the recommended levels under the guidance of your doctor. We usually advise not taking all of your calcium at once but instead spreading it out over the day to aid in the absorption of the mineral and to decrease the risk of constipation. For example, if you take two 500 mg calcium tablets a day, you may want to take one with breakfast and one with dinner.

There are different types of calcium supplements, such as calcium carbonate and calcium citrate. Both are helpful. Calcium carbonate should be taken with food whereas calcium citrate need not be.

We usually recommend taking calcium with vitamin D, which helps the body absorb calcium. The recommended dietary allowance of vitamin D is 600 international units (IU) for everyone ages 1-70, and 800 international units for adults older than 70. You likely will see mcg (micrograms) listed on food labels: 1 mcg equals 40 IU of vitamin D. Good food sources of vitamin D include cheese, eggs, beef liver and fatty fish. Many foods are fortified with vitamin D, such as orange juice, milk and many breakfast cereals.

Anyone at risk for osteoporosis should talk to doctor about supplements and how to best make dietary changes to increase calcium levels. Some patients may qualify for a DEXA scan, a test that screens for osteoporosis and evaluates risk for bone fractures.

Calcium alone is not enough to maintain strong bones. Vitamin D, regular physical activity and weight-bearing exercises also are important. I suggest eating a healthy, balanced diet with plenty of fruits and vegetables and minimizing sugar and processed foods.

Is Chocolate Healthy?

Chocolate is one of my favorite treats. I keep a bag of dark chocolate squares in my office at all times. As a doctor, I try to eat a healthy diet. Is my indulgence in chocolate part of healthy eating?

There have been many published studies on the health benefits and drawbacks of eating chocolate. My conclusion after reading the studies: A small amount of dark chocolate can be part of a healthy diet – a diet that is focused on fruits, vegetables, whole grains and lean proteins. Here are five things to know about chocolate and your health:

1. Dark chocolate is considered healthier than white chocolate or milk chocolate. Dark chocolate has less added sugar and lower amounts of saturated fats compared with other types of chocolate. Dark chocolate, which has very little if any milk, contains about 50 percent to 90 percent cocoa solids. As the percentage of cocoa solids increases, so, too, does the amount of flavonoids. Flavonoids are an antioxidant – antioxidants are nutrients that help minimize free-radical damage in the body. (Free radicals may play a role in many health conditions, including cancer and heart problems.)

2. The antioxidants in dark chocolate can improve your immune system and help prevent against viral and bacterial infections. Antioxidants also protect the body from inflammation.

3. Studies have shown a correlation between eating flavonoids and lower blood pressure and improved blood circulation to the heart. Good blood flow to the heart reduces the risk of stroke and heart disease. But don’t overdo it: Dark chocolate does contain saturated fat, which can contribute to heart problems.

4. Studies also have shown a correlation between eating dark chocolate and increased insulin sensitivity. Insulin sensitivity helps people prevent and control diabetes. Diabetes is connected with a host of health problems, including chronic kidney disease, nerve damage and eye problems.

5. Eating dark chocolatemay improve mood. In one study, those who consumed dark chocolate with 85 percent cocoa had a better mood than those who ate chocolate with a lower cocoa content. The study authors wrote: “These results suggest that intake of dark chocolate with a higher cocoa content has a positive influence on negative emotional states.” Many people feel a connection between eating chocolate and a feeling of euphoria.

6. Eating dark chocolate may help your brain. One study, for example, showed a link between eating dark chocolate and improved cognitive processing, learning, memory and recall.

But before you go ahead and eat a whole dark chocolate candy bar in one sitting, keep in mind that dark chocolate contains a lot of saturated fat and calories. Though the sugar content may be lower than other types of chocolate, dark chocolate still has a lot of added sugars.

Also of note: Consumer Reports recently tested the amount of heavy metals in 28 dark chocolate bars and detected cadmium and lead in all of them. These metals can be especially dangerous to children and pregnant women.

Dark chocolate does contain small amounts of calcium, potassium, iron and other minerals, but don’t look to chocolate as a substitute for getting these vitamins and minerals from other sources, such as fruits, vegetables and lean proteins.

The bottom line? Eating approximately 30 grams of dark chocolate a day may have some health benefits when part of an overall healthy diet. So eating the whole candy bar may not be a healthy choice, but having a square of dark chocolate after a healthy meal can satisfy your sweet tooth, boost your mood and perhaps contribute to a healthier heart, brain and immune system.

Enjoy!

Ease into Dry January with Tips from an Expert

For many people, reducing alcohol intake is at the top of the list of goals for the new year. But “Dry January,” or abstaining from alcohol for an entire month, can be challenging. Northern Virginia adult and family medicine physician Jason Singh, MD, spoke with WJLA offering tips for people looking to cut back on drinking in January.

Dr. Singh noted that alcohol can have negative impacts on the body including heart, liver and pancreas issues; weakened immune system and even depression and anxiety. But even small reductions in alcohol can have a positive impact on the body, he explained.

“Some folks may have a hard time with Dry January. I have patients that are having a hard time cold turkey-ing it. So, we have something called ‘Damp January’ which is a modified version where you set your own rules, your own boundaries and find a good middle ground,” Dr. Singh said.

Dr. Singh suggested that Dry January can involve the entire family, not just those who are over 21 years old.

“A good strategy is to come up with a family fitness program. That’s what a lot of folks tend to lean towards. But also coming up with alternatives to alcohol: juices, teas, coffees, smoothies,” Dr. Singh said. “I love smoothies, my family loves making smoothies. My kids that are 10, 7 and 5 love making smoothies with me.”

Expert Advice: How to Combat Pandemic Sleep Loss

According to a recent study from the American Academy of Sleep, about 44 percent of Americans are losing sleep over the COVID-19 pandemic. Northern Virginia adult and family medicine physician Jason Singh, MD, spoke with WTOP about how to combat pandemic-related sleep loss.

“Sleep is your brain’s way of preparing you for the next day by creating new pathways to help you learn and remember things. It also enhances your focus, your creativity and decision-making abilities,” Dr. Singh said. “When we’re lacking sleep, we tend to be more irritable, more forgetful and fatigued. And this can strain your relationships and job performance.”

To counter the effects of sleep deprivation, Dr. Singh recommended patients practice good sleep hygiene, eat a balanced diet, limit alcohol and caffeine intake and reduce screen time before bed. He also said over-the-counter products like melatonin can help people who are struggling with sleep.

“Melatonin is incredibly helpful in situations like this, where we want to help encourage sleep and calibrate to a proper sleep cycle,” Dr. Singh said.

Dr. Singh noted that sleep problems can also be a symptom of an underlying health problem.

“Sleep disturbance can also be a symptom of mental health issues. If you’re having anxiety or depression, it’s really important to seek help and come talk to your doctor as well,” Dr. Singh said.

A Doctor’s Advice: Get Your Flu Shot Before Holidays

Many people are beginning their holiday preparations. Northern Virginia adult and family medicine physician Jason Singh, MD, said people should add one more thing to their list of preparations: a flu shot. He spoke with WJLA about why it’s important to get a flu shot before the holidays.

“What I tell my patients is in the last two years we’ve seen like an incredible decrease in common circulating viruses, mainly due to restriction protocols for masking and social distancing,” Dr. Singh said. “Because of that, overall immunity has been low for just not being exposed to the traditional pathogens in the environment. And so now, it may be back in full force during fall and winter.”

Dr. Singh said he has been seeing an uptick in viral illnesses since October. He said it is important to get vaccinated now in order to stay protected when interacting with people during the holidays.

“Generally, two weeks after you’ve gotten over the flu infection or COVID infection you can get the vaccine because the antibodies for the vaccine may still be different from the antibodies that you develop naturally from the infection,” Dr. Singh explained. “It takes about two weeks for [people] to develop antibodies to the vaccine.”

Kaiser Permanente members can get a flu shot or COVID-19 boosters at 34 of our medical centers. To make an appointment, complete an E-visit on the KP app or kp.org or call 1-800-777-7904.

Can I Get Monkeypox at the Gym? A Doctor Explains

As monkeypox continues to spread throughout the nation, people are wondering if they can contract the virus while working out at the gym. Permanente adult and family medicine physician Jason Singh, MD, spoke with WJLA about how monkeypox spreads and if it can live on gym equipment.

“At this point, it’s unclear how long monkeypox can live on surfaces. There doesn’t appear to be any specific timeframe, though in rare instances, it has been found to survive in unoccupied homes for up to two weeks,” Dr. Singh said.

According to the U.S. Centers for Disease Control and Prevention, monkeypox is spread through direct contact with monkeypox rash or touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.

“Now, what is reassuring is that the virus is an enveloped virus, meaning the virus is coated with a fatty membrane which is easily disrupted with household detergents and cleaners,” Dr. Singh said. “So, without the envelope on the virus, it is no longer infectious, which is why it’s so important to wipe down the gym equipment before and after use.”

How “Purple Produce” Can Help Lower Cholesterol

September is Cholesterol Education Month, a great time to check on your HDL (good cholesterol) and LDL (bad cholesterol) levels. Permanente adult and family physician Jason Singh, MD, spoke with WTOP about how to manage your cholesterol and the tips for eating more “purple produce.”

“[HDL]is a level that you want to keep above 40,” Dr. Singh said. “And your HDL is interesting, it acts like a scavenger in your bloodstream and just gobbles up all the bad cholesterol and takes it back to the liver to process it out of the body.”

Dr. Singh explained that high cholesterol increases the risk for heart disease and stroke, two leading causes of death in the United States.

“When you have excess cholesterol, this creates a buildup of fatty deposits called plaques. And that sticks to the walls of your arteries and impedes blood flow,” Dr. Singh explained.

For people looking to lower their cholesterol, Dr. Singh recommended adding more “purple produce” to their diet. His favorite choices are eggplants, red cabbage, blueberries and blackberries.

“The purple stuff is great for increasing your HDL and actually lowering your LDL and triglycerides and that lowers your overall risk for having any kind of atherosclerotic cardiovascular disease.”

Dr. Singh emphasized the importance of yearly checkups for overall health assessments and preventive screenings.

“It’s also important to go over with your physician what is a good diet and exercise habit,” he said.

How to Prepare for Flu Season: Advice from A Doctor

Flu season is just around the corner. According to Permanente adult and family medicine physician Jason Singh, MD, now is the time to prepare. He spoke with WJLA on the importance of flu shots this season.

“Optimal timing [to get a flu shot] is before influenza activity begins in the community, which varies but typically starts in October and peaks between December and February, although activity can be seen as late as May,” Dr. Singh said. “It takes about two weeks to rise and get vaccinated, so that’s why it’s important to get it done before the flu activity starts.”

There was a sharp drop in flu cases over the past two years, likely due to pandemic precautions like wearing masks, social distancing and increased hand washing. Now that most COVID-19 restrictions have been lifted, Dr. Singh said there may be an increase in flu cases.

“It might be back in full force now that kids are back in school and most COVID restrictions are lifted,” Dr. Singh said.

Dr. Singh said one of the best ways to protect yourself is to practice proper hand hygiene.

“I have three kids myself and they are all back to school. Most important thing is washing your hands as frequently as you can,” he said.

Study: Too Much Table Salt Can Lead to Premature Death

A new study from the European Heart Journal suggests increased salt intake can lower a person’s life expectancy. People who always add salt to their meals faced a 28% increased risk of dying prematurely compared with those who never or rarely add salt. In an interview with WTOP, Permanente adult and family medicine Jason Singh, MD, explained the results of the study and offered tips for eating healthy.

The study followed 501,379 participants for an average of nine years. Researchers found that compared to people who rarely added salt to foods, people who always added salt could lose two years off their life.

“The researchers also found that increasing the intake of fresh fruits and vegetables weakened the association between salt use at mealtimes and premature death,” Dr. Singh explained.

Dr. Singh, who did not participate in the research, explained that the risk of premature death was lower in those who ate more potassium-rich fruits and vegetables because potassium helps process sodium out of the body.

“For me, [the study] really just emphasized our recommendations to modify eating behaviors to improve health, especially toward cardiovascular disease,” Dr. Singh said.

Dr. Singh offered some quick tips for reducing sodium intake:

  • Start looking at food labels.
  • Avoid canned soups and processed foods, such as boxed rice mixes that have seasoning packets.
  • Compare the amount of sodium in different products.
  • Remember that low sodium food products contain less than 140 milligrams per serving.
  • Try to keep your total daily sodium to less than 2,300 milligrams.
  • Look for hidden sources of sodium such as ketchup, salad dressings and soy sauce.

A Doctor’s Advice for Dealing with Scorching Summer Heat

A record-breaking heat wave is sweeping the Mid-Atlantic, leaving many people susceptible to heat-related illnesses. According to the U.S. Centers for Disease Control and Prevention (CDC), heat-related deaths are one of the deadliest weather-related health outcomes in the United States. Permanente adult and family medicine physician Jason Singh, MD, spoke with WTOP on how to spot heat exhaustion and heat stroke.

Symptoms of heat exhaustion include muscle cramps, nausea, fatigue, headache and dizziness. If someone is experiencing these symptoms, Dr. Singh recommends moving them to a cooler location, removing excess clothing and drinking water.

Heat stroke is the more extreme condition. A person suffering from heat stroke often has a fever greater than 103° F. According to the CDC, very high body temperatures can damage the brain or other vital organs. In severe cases, the problem can lead to multiple organ system failure and death.

“You start to have red-hot skin with no sweat, a rapid, strong pulse or you feel dizzy and confused. [Heat stroke] is a medical emergency, so seek attention right away,” Dr. Singh explained.

Dr. Singh said heat-related illnesses are usually preventable.

“Wear a wide-brimmed hat, and shades, and put on sunscreen of SPF 30 or higher,” he said.

How to Take Stock of Your Health During Men’s Health Month

According to the U.S. Centers for Disease Control and Prevention, heart disease and cancer are the top two leading causes of death in men. More than 40% of men aged 20 and older are obese, and nearly 52% have hypertension. This Men’s Health Month, Permanente adult and family medicine physician Jason Singh, MD, has a message for men: “It’s not unmanly” to seek preventive care. He spoke with WJLA and offered practical tips for men of all ages looking to get a better handle on their physical and mental well-being.

“When you stratify the top ten leading causes of death by gender, men lead in almost every one of those categories,” Dr. Singh said. “By and large, most of those conditions are manageable and preventable.”

Dr. Singh said men of all ages should make preventive care appointments with their primary care physicians. Routine exams and lab work can often catch health problems in early stages. He said the earlier issues are caught, the better the outcome.

“Only 40% of men go to the doctor when they fear they have a serious medical condition,” Dr. Singh said.

He said there are things men can do at home to improve their health. Eating well and exercising can improve sleep and help reduce stress and anxiety. Dr. Singh explained that primary care doctors can connect patients to mental health resources like therapists and psychiatrists, as well as explain mindfulness exercises. Calm is a mental health app designed to help lower stress, reduce anxiety, and more. Kaiser Permanente patients can access all the great features of the Calm app at no additional cost.

“We really ought to encourage that seeking help for mental health is a sign of strength and that ought to be highly encouraged. It’s not unmanly to talk about mental health,” he said.

For more information about men’s health and cancer prevention, watch a Facebook Live event with Permanente physicians on June 22.

Know the Signs of a Heat-Related Illness

Memorial Day marks the unofficial start of summer, and people will be outside enjoying the warm weather. Permanente adult and family medicine physician Jason Singh, MD, spoke with WTOP and offered summer safety tips and explained the signs of heat-related illnesses.

“There’s heat cramps, which presents as muscle pains or spasms in the stomach, arms or legs,” Dr. Singh said. “Then there’s heat exhaustion, which presents as heavy sweating, muscle cramps, fatigue, dizziness and nausea.”

Dr. Singh said anyone experiencing heat cramps or heat exhaustion should get to a cooler location, remove excess layers of clothing and hydrate. If not, they may develop heat stroke, a serious medical emergency.

“This is an oral temperature of greater than 103 and you have red, hot, dry skin with no sweat and a rapid strong pulse and feel dizzy or confusion. This is an emergency so it’s important to get to the closest emergency room or dial 911,” Dr. Singh said.

According to the U.S. Centers for Disease Control and Prevention, if someone is experiencing a heat stroke, they should be moved to a cooler location and given a cool cloth. The CDC advises not to give the person anything to drink, as fluids may enter the lungs through the trachea or airway.

Dr. Singh also noted the importance of sunscreen and taking breaks from the sun.

“Sunburn affects our body’s ability to cool down and can also make you dehydrated,” he said.

A Good Night’s Sleep Could Help Prevent Obesity: A Physician Explains

We know sleep plays an integral role in our overall physical and mental health. But did you know sleep can help you lose weight? Permanente adult and family medicine physician Jason Singh, MD, spoke with WTOP about a new study showing sleep can help people lose weight and prevent obesity.

“There’s actually a lot of health benefits just from getting adequate sleep at night,’ Dr. Singh said. “More recently, the Journal of the American Medical Association pointed out from a randomized clinical trial that improving and maintaining adequate sleep could reduce weight and actually suggested it to be a viable intervention for obesity prevention and weight loss programs.”

He explained that when a person is well rested, their appetite decreases. Neurohormones that stimulate appetite are suppressed when someone’s well rested, so they’re less likely to indulge in food.

Dr. Singh said daylight saving time could impact people’s sleep schedules.

“When you’re exposed to more light in the evening, your body will not prepare you as well for sleep, and without proper sleep, our body goes into a heightened state of stress,” Dr. Singh said. “And that starts to affect our blood pressure, our heart rate, breathing, focus, judgment—and that’s where you start to develop health problems.”

  • He offered these tips to maintain good sleep hygiene during the time change.
  • Stick to a regular sleep schedule.
  • Get enough natural light, especially earlier in the day.
  • Be active but try not to exercise within a few hours of bedtime.
  • Avoid caffeine within six hours of bedtime.
  • Avoid alcohol and foods high in fat or sugar before bedtime.
  • Avoid artificial light and turn off screens such as TVs or smartphones 30 to 60 minutes before bedtime.
  • Use a blue light filter on your computer or smartphone throughout the day.
  • Keep the bedroom dark and quiet.
  • Keep the room temperature somewhere between 60 to 67 degrees.

Young Adults are Getting the Flu: Here’s How to Reduce Your Risk

As college-aged kids return home from school for winter break, they may be bringing the flu home with them. The flu was nearly non-existent in 2020, but data shows the virus is back in a big way – and young adults are the ones getting sick. Permanente adult and family medicine physician Jason Singh, MD, spoke with WJLA about the best ways for people of all ages to lower their risk of getting the flu this season.

“Eighty percent of the cases are amongst young adults. So, 5-24 years of age and that’s absolutely it right there,” Dr. Singh said. “Going to college, work, getting together… that’s where the cases are really rising and those are the folks that are bringing it back home and putting our elderly patients or those with chronic conditions at risk.”

According to the U.S. Centers for Disease Control and Prevention, young adults consistently have the lowest flu vaccination rate in the United States. When you add that to the close quarters at college campuses, Dr. Singh said it is “a perfect storm for infections to increase and transmit.”

“What I usually tell my patients is, the vaccine minimizes complications from the flu. It doesn’t prevent you from having it. It’s kind of like wearing a seatbelt, right? You can still get into a car accident, but the seatbelt protects you from getting severe injury,” Dr. Singh said.

Dr. Singh said the best way to lower your risk of getting the flu is to get your flu shot, practice proper handwashing and take vitamins to fortify your immune system.

“Washing hands is incredibly important. Most of the germs are on your hands and the hands-to-nose sort of touch, so just washing your hands frequently and just making sure you are favoring a robust immune system,” Dr. Singh said. “What that means is taking your vitamin C, your Zinc, your echinacea and turmeric. These are all evidence-based and shown to build a better immune system and protect you from various infections like the flu.”

4 Tips to Keep Your Family Safe this Flu Season

Doctors are anticipating an increase in flu cases this year because more people are out and about. This is on top of rising COVID-19 cases due to the highly transmissible Delta variant. Permanente Medicine adult and family medicine physician Jason Singh, MD, spoke with NBC4 about how you can keep your family safe this flu season amid the COVID-19 pandemic.

“We are expecting cold and flu cases to increase this year,” Dr. Singh said. “Our immune systems aren’t as robust [as previous years] because of isolation.”

Dr. Singh offered four tips to keep people safe this flu season.

1) Get the flu shot and the COVID-19 vaccine. You can get both vaccines at the same time. Most pharmacies offer flu shots at this time. Anyone 12 and older can get the COVID-19 vaccine, and anyone 6 months and older can get the flu shot.

2) Get the flu shot before flu season. The flu usually is found in communities in October, then peaks in January.

3) You may experience mild side effects from the flu shot such as soreness at the injection site, headache, fever or muscle aches. These effects only last a few days, and pale in comparison to getting the flu.

4) You can still get sick with the flu if you got the flu shot, just as you can still get sick from COVID-19 if you have the vaccine. Both of the shots significantly reduce the risk of severe illness and death.

“The best way to keep yourself safe is to get the flu shot and get the COVID-19 vaccine if you haven’t already done so,” Dr. Singh said. “As always, practice good handwashing, masking and social distancing, too.”

“Remember the Three Bs”: Physician Shares Healthy Living Tips for Men

June is Men’s Health Month, and men are encouraged to step back and take stock of their health. When doctors stratify the top ten leading causes of death by sex, men lead in nine out of the ten categories. Board-certified family medicine physician Jason Singh, MD, told WTOP that preventative care is the key to men living longer, healthier lives.

“Just remember the three Bs,” Dr. Singh said. “Berries, beans and broccoli — because these foods are particularly rich in fiber and that promotes good gut health, which lowers the risk of colon cancer.”

Dr. Singh also explained that men can stay on top of their health with annual doctor visits and cancer screenings.

“I always tell the guys, ‘Listen, if there are three numbers you need to commit to memory, it’s your cholesterol, sugar and blood pressure’ — because these are risk factors to heart disease, which is the leading cause of death in men,” Dr. Singh said. “Then closely behind is cancer, and that’s why regular checkups are so important and to be aware of the screening timelines for colon cancer and prostate cancer, which affects one in six men.”

“It’s Not Unmanly”: Permanente Physician Encourages Men to Make Health a Priority

June is Men’s Health Month, and Permanente internal medicine physician Jason Singh, MD, wants all men to use this month as motivation to take better care of their health. In an interview with ABC7, he said men shouldn’t be afraid to talk to their doctor.

“When you stratify the top 10 leading causes of death by gender, men lead in nearly every one of those categories; nine out of ten,” Dr. Singh said. “A large part of that is guys are just reluctant to see us unless something is wrong. So, this is really something that we ought to borrow a page from the women’s playbook. It’s very important to come see your doctor.”

Dr. Singh offered tips for men looking to improve their overall health like taking the stairs instead of an elevator or scheduling time for deep breathing exercises throughout the day. When it comes to mental health, he stressed that men should be a good role model for younger generations and ask for help if they are struggling.

“I think this starts as early as our young adolescents. Guys just have to learn that it’s not unmanly to talk about their mental health,” he said.

How to Get Your Health Back on Track

During the COVID-19 pandemic, many people put off taking care of themselves. There are understandable reasons why, including being overwhelmed with work responsibilities, worrying about finances, juggling childcare and feeling afraid to seek non-emergency medical care during a pandemic.

As a result, screenings for several types of cancers dropped since the pandemic began in March 2020, according to the Epic Health Research Network. And a lot of people haven’t communicated with or seen their physician for care they need.

Beyond delaying care, many people got out of their healthy routines during the pandemic. In some cases, people had difficulty finding time to exercise, or didn’t find a substitute for a closed gym. Some people, working from home, found themselves raiding the pantry or fridge, even if they weren’t hungry.

Now is the time to get your health back on track!

Whether that means taking 30 minutes to exercise, scheduling a mammogram or reaching out to your doctor about whether you should have a colorectal cancer screening test, take time to take care of your health. Delaying care can lead to serious health problems down the road; we know patients are more likely to fare better and survive many illnesses if they are caught early.

Schedule Your Screenings

  • Are you 45 or older? It may be time for colorectal cancer (cancer of the colon or rectum) screening. New guidelines recently lowered the recommended age to begin screening for colorectal cancer from age 50 to age 45. This applies to men and women. Many patients can be screened for colorectal cancer by using the fecal immunochemical test (FIT), which can be sent to Kaiser Permanente members in the mail. Patients can perform this test in the comfort and privacy of their home and simply drop the completed test in the mail. It’s a good option for patients at average risk of colorectal cancer. Since colorectal cancer is one of the leading causes of cancer-related deaths, keeping up with screening is important. Kaiser Permanente patients with colorectal cancer have lower mortality rates than the national benchmarks in large part because of our commitment to screening and early detection.
  • Do you have a history of smoking? Now may be the time for lung cancer screening. Lung cancer is the leading cause of cancer death in men and women in the United States. Guidelines recently changed: We are now screening members as young as age 50 who have a 20 pack-year history. (Pack years are calculated by multiplying the number of cigarette packs smoked per day by the number of years the person smoked, so if you smoked two packs a day for 30 years, you have a 60 pack-year history.) The lung cancer screening test is short, painless and uses low-dose radiation.
  • Are you a woman age 65 or older? It’s time for a bone density test. A baseline scan should be conducted at age 65, or earlier if you have additional risk factors such as tobacco use, early menopause or regular use of certain medications, such as glucocorticoids. A bone density test will enable your physician to assess the strength of your bones.

We encourage women to keep up to date on their breast cancer and cervical cancer screenings:

  • Are you a woman and over the age of 40? Talk with your physician about breast cancer screening. We offer mammograms for women at low risk of developing breast cancer starting at age 40, and then every 1-2 years thereafter. For women at high risk for breast cancer, we will start screening earlier. Women should talk to their physician about a schedule that makes the most sense for them based on their personal risk factors. Our patients have lower breast cancer mortality rates compared to national benchmarks; part of the reason our patients have better outcomes is because of our commitment to ensuring women get mammograms when appropriate.
  • Are you a woman 21 years old or older? Cervical cancer screenings (Pap smears) are recommended starting at age 21, and then every three to five years depending on age and prior Pap results.

Transgender men and gender expansive patients should talk to their physician to see if cervical cancer screening, breast cancer screening, or other cancer screening is appropriate.

Although the HPV vaccine has decreased the incidence of cervical cancer and pre-cancer, this screening test remains important. And if you’re wondering about the HPV vaccine, it is recommended for everyone age 9 through age 26, and, in some cases, for people up to age 45. People between ages 27-45 should discuss the vaccine with their physician to see if they would benefit from the vaccine. Those who are most likely to benefit are those who are not in monogamous (one sexual partner) relationships and those with recently diagnosed sexually transmitted infections.

Schedule Your Immunizations

Keeping up with all immunizations is an important way to protect against severe illness. Kaiser Permanente members can sign in on kp.org to see if they are due for any immunizations.

  • Check your medical record or check in with your doctor to find out whether now is the time for a tetanus, diphtheria and pertussis booster or an HPV immunization.
  • If you are 50 or older, you should get the shingles vaccine series. The vaccine against pneumonia is recommended for those ages 65 and older.
  • People under age 65 with conditions that weaken the immune system or with risk factors such as a history of smoking or asthma should talk to their physician about when to get vaccinated against pneumonia.

Though the 2020-21 flu season was extremely light with very few cases, we are hearing that the upcoming flu season may be intense. We urge everyone to get a flu shot when it is available, usually in September.

And of course, everyone ages 12 and older should be vaccinated against COVID-19! Please schedule today if you haven’t been vaccinated.

Take Stock of Your Mental Health

The pandemic has caused many people to have mental health challenges. If you are struggling, reach out for help immediately. Kaiser Permanente members can download the Calm and myStrength apps at no cost.

Eat Well

During the pandemic, many people gained weight. Now is the time to get back on track; being overweight can lead to a variety of health problems, including joint pain, heart disease, some cancers and Type 2 diabetes. Kaiser Permanente patients have access to health coaches and wellness classes to help.

Try for a diet high in fiber and complex carbohydrates and lower in fat and sugar. Focus on the Mediterranean diet, which emphasizes fruits, vegetables, lean chicken and fish, nuts, seeds, beans, legumes and olive oil.

If you found that your alcohol consumption has gone up during the pandemic, now is a good time to cut back. Reach out to your physician if you need help.

Exercise

Strive to get 150 minutes of moderate exercise each week. That means you should be able to say only a few words when working out before feeling short of breath. You don’t need to join a gym. Walking, jogging, swimming and home workout routines can help you stay fit.

Many medical conditions are preventable or manageable if caught early. Take the time to invest in your health so that you can get back to enjoying spending time with your friends and family and doing the things you love.