November 2011 Magazine

People First

Helping People Live Better Lives

Winter Supplements Dr. Hister On

Type 1 Diabetes How To Manage Your Stress Company’s Coming Recipe

Vol. 11 No. 12

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People15 First

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Dr. Hister looks at Type 1 diabetes, an auto-immune disorder that accounts for 10% of people with diabetes.

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Vitamins & Supplements Great selection of quality health and wellness products from Peoples Pharmacy.

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Cold and flu season is here, give your immune system a hand in fighting the establishment and spread of infections.

Winter Supplements Peoples Pharmacist Ian Lloyd on supplements that will help create a healthy winter.

599999 Boost Your Immunity

Diabetes Management Products to help manage and take control of diabetes.

Diabetes Help Check out nutritional supplements that can help manage the symptoms of Diabetes.

Type 1 Diabetes

9

Pharmacist Recommended What you need to know about age-related macular degeneration. Health news on the benefits of folic acid.

14

Stressed Out Darlene Booth provides helpful advice on de-stressing and making the most of life.

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Apple Pecan Crisp Brand new feature recipe From Company’s Coming 30-Minute Diabetic Cooking.

Helping People Live Better Lives

Dr. Hister

Managing Type 1 Diabetes Menopause If there was ever a list put together about medical conditions that are most easily, as the young say, “dissed”, meaning that those conditions don’t get nearly the respect they deserve from the public compared to other health problems, I think a very strong case could be made for Type 1 diabetes to be top of that list.

I say that because I am continually forcefully reminded of how little people seem to know about Type 1 diabetes every time I discuss diabetes on one of my segments on radio or TV, which is very often, of course, because I focus mainly on how lifestyle adjustments can improve your life, and happily, Type 2 diabetes is the poster boy for conditions that can be significantly improved – nearly eliminated, in fact through healthier living, and don’t worry, I won’t lecture you again here but yes, it’s the same-old, same-old of losing weight and doing more exercise.

Anyway, the point is that every time I mention that there’s a strong connection between our lifestyle choices and our risk of developing diabetes, I get a few plaintive (and often angry) emails from parents of children who have Type 1 diabetes and who tell me that their kids have occasionally been the subjects of inappropriate comments – or even worse – from poorly informed adults who’ve apparently told the kids that they never would have developed diabetes if only they’d taken better care of themselves.

Which is complete nonsense of course and very hurtful too, I imagine, because unlike its sister, Type 2 diabetes, from what we currently know (and yes,

like all medical beliefs, this one may also change one day, maybe even tomorrow) Type 1 diabetes is not amenable to lifestyle intervention.

So let me repeat this for anyone who doesn’t know much about diabetes yet still feels that they know enough to tell someone else what to do with their lives: Type 1 diabetes cannot be prevented by keeping your weight down and doing more exercise.

In fact, we still have no clue about how to prevent Type 1 diabetes which accounts for roughly 10 % of all diabetes cases, and which used to be called juvenile onset diabetes because it generally shows up early in life, although the good news, I suppose, is that we are learning more and more about this increasingly common problem all the time, and one of the most interesting facts about Type 1 diabetes that we know now is that it’s what’s called an autoimmune disorder (other examples: rheumatoid arthritis , lupus, psoriasis, celiac disease - which is often called an “allergy” to gluten but which is really an auto-immune response set off by gluten MS, and a host of others), that is, a condition in which a person’s immune system attacks a part of thatperson’s own body, and destroys those cells.

In Type 1 diabetes, the auto-immune reaction kills the insulin-producing cells (beta cells) in the pancreas, thus destroying that person’s ability to produce insulin.

Why would the body be so stupid as to kill its own tissues?

Well, clearly, no one really knows why any autoContinued On Page 11

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Helpful Products And Advice For Diabetes

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Ian Lloyd

Pharmacist, Peoples Pharmacy

Winter Supplements Every year history repeats itself; winter returns and we panic. We check to ensure that our snow shovel will handle this year's dump of the white stuff, or at least ensure we have enough small bills to pay the neighbour's kid for its removal. The check list continues: rock salt, gloves and boots, bring in garden hose, snow tires, and so on. What about protecting your most important possession, your health. You can round out your list by stocking up on echinacea, kleenex, skin moistuizer, and zinc lozenges for your health.

Which supplements should you think about purchasing in the winter? Naturally your mind wanders to options for cold and flus. While this is a good idea, it is not where we will begin. I shall start with the most unlikely idea for winterization: skin cream. Our skin has a tendency to get dry in the winter months. There are a few reasons for this. First, heating the house usually makes the air drier. We also tend to take warmer showers and baths to ward off the winter chill. These, and other factors, can make one's skin dry. If your skin does become dry in the winter, remember to apply moisturizer after you shower or bathe. This will help to keep the moisture in your skin. When choosing a skin cream, pick one that hasĂ&#x; the fewest number of ingredients and does not contain added perfumes. If your skin gets excessively dry, ask you Peoples Drug Mart Pharmacist to help you choose a cream with extra moisturizers. Another good tip is to lower the water temperature in the shower or bath. You might also want to consider taking an omega-3 fatty acid supplement. Some people find that taking extra fish or flax seed oils can help relieve their dry skin.

Speaking of dry body parts, what about your eyes?

It is common to experience dry eyes in the winter time.

6 People First peoplesdrugmart.com

Perhaps the reasons for developing dry eyes are warmer houses, dry and cold winds and moving between cold and warm places. When choosing an eye drop look for one that is not medicated. Ask your Peoples Drug Mart Pharmacist to help you find the right, non-medicated eye drop. Whichever eye drop you choose, remember to discard it 6-8 weeks after opening. After this time, the risk of bacterial contamination is greater and could lead to eye infections. If eye dryness at night is an issue, you might consider using an eye gel or ointment. These thicker preparations offer longer relief of symptoms, but can make your vision a bit blurry. At night this shouldn't be an issue because you will be asleep. Persistent, or painfully, dry eyes should be brought to the attention of your eye doctor.

I hadn't forgot about the curse of winter: colds and flus. Elderberry juice is an often overlooked supplement to help treat colds and flus. There is early evidence to suggest that elderberry juice can help reduce the duration of flu symptoms. In one small study, subjects who took 15ml of elderberry extract (Sambucol), four times a day for five days, experienced a reduction in the duration of symptoms by about 56%. Their symptoms were relieved four days earlier compared to those who received placebo. While the evidence is small, elderberry is relatively inexpensive and safe.

Zinc is an essential mineral with numerous functions within the body: proper functioning of the immune system, growth, blood clotting, thyroid function, and normal taste perception. Zinc lozenges are also a popular treatment for colds and flus. When taken every two hours, they can reduce the severity and duration of cold symptoms. In another study, patients took one zinc lozenge every two hours for as long as they had Continued On Page 8

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peoplesdrugmart.com People First 7

Ian Lloyd...Continued From Page 6

cold symptoms. Each lozenge contained 13.3mg zinc (as zinc gluconate). The zinc group experienced significantly fewer days of coughing, headache, nasal congestion and sore throat. Another study used unflavoured 23mg zinc (gluconate) tablets dissolved under the tongue every two hours. This study also included children under the age of 11. After seven days of treatment, 90% of zinc patient and 49% of placebo patient reported no cold symptoms. Be warned that these lozenges might not taste very good. It is hard to mask the taste of zinc.

There is also evidence that shows the zinc can help prevent colds and flus. In another study involving 50 people, people took 45mg of zinc (gluconate) or a placebo for 1 year. Only 7 people in the zinc group while 35 people in the placebo group experienced an infection that year. Furthermore, people who took zinc had only one infection per year; whereas the people who received placebo had multiple infections over the year. Also only 8 people who took zinc compared to 48 people who took the placebo received antibiotics that year. Another interesting finding was that approxi-

mately 35% of the elderly subjects were considered to be zinc-deficient.

Yes, Yes, Yes, I know you have heard it all before; you need to take your vitamin D in the winter time. There is less sunshine, we spend more time indoors, blah, blah, blah.. But this time I have something new: vitamin D can help your immune system. Recently, Danish researchers determined exactly how vitamin D helps the immune system work. A specialized white blood cell, called a T cell, floats around in your blood looking for foreign invaders. If they come into contact with a possible disease causing pathogen, these T cells signal the body to activate them. What activates them is vitamin D. Once activated by vitamin D, these T cells begin the process of ridding the body of these infectious agents. However, if there is not enough vitamin D, these cells will not be able to begin this important immune system response.

No article about winter supplements is complete without mentioning ginseng. Perhaps the most popular supplement for preventing colds and flus is a special ginseng extract called Cold-Fx. There are a few good studies which have shown that Cold-Fx can reduce the Continued On Page 10

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pharmacist recommended Health & Wellness Information From Your Peoples Pharmacist

leading cause of Age-Related The blindness in adults Macular over 40 is the degenof the macula Degeneration eration of the eyes, called age-related macular degeneration or AMD. Those at the greatest risk of experiencing macular degeneration are smokers, Baby Boomers, women, and those with light-coloured irises (blue). The macula form the central area of the retina, the better known part of the eyes that receive focused images of light for pick-up and transmission to the brain by the optic nerve. Macular degeneration disables this retinal function, leaving only a margin of peripheral vision. Such blindness for all practical purposes ushers in a loss of independence, an end to normal or robust sighted living, and effectively prevents enjoyable reading or fine finger work.

A lifetime of exposure to solar light causes critical degeneration of the macula tissue, unless they are regularly supplied with the dietary pigment, lutein. The macula have been shown to concentrate dietary lutein, and convert some of it into zeaxanthin as another related protective pigment. They belong to the carotinoids, the pigment class to which well known beta-carotene belongs. These pigments are able to absorb harmful blue light,

modulating the exposure to solar damage. The evidence is clear that people who regularly consume green leafy vegetables as an important part of their weekly diet are at a significantly reduced risk for blindness due to the deterioration of the macula region of the retina.

Another debilitating eye problem is the formation of cataracts, caused by solar damage to the lens proteins. The lens is also able to accumulate lutein to prevent cataracts and it has been found that when there is a high level of lutein in the macula, there is also a reduced incidence of cataracts. A Harvard University study examined the prevalence of cataracts in 50,000 nurses who responded to a dietary inquiry. It found that women who consumed five servings per week of spinach had significantly lower risk for cataracts than women who consumed five servings per week of carrots, sweet potatoes, or winter squash. This study bears out the understanding that the green leafy vegetables are the best sources of lutein.

Lutein is an an excellent choice for those people who do not consistently consume green leafy vegetables and who may be at risk of macula or lens solar damage.

health news Folic acid during pregnancy linked to better toddler speech Women who took folic acid supplements in the first two months of pregnancy were less likely to have kids with severe language delays reported in a recent study.

Folic acid is already known to reduce the risk of certain types of birth defects, and both the U.S. and Canada fortify grain products with folic acid to make sure pregnant women get enough of it. But that's not the case in some other countries, including Norway. The researchers gave surveys to close to 40,000 Norwegian women a few months into their pregnancies. Those included questions on what supplements women were taking in the four weeks before they got pregnant through eight weeks after conception.

Then, when their kids were three years old, the study asked the same women about kids' language skills. Four out of 1,000 kids born to women who took folic acid alone or combined with other vitamins had severe language delays. That

compared to nine out of 1,000 kids whose moms didn't take folic acid before and early in pregnancy.

The pattern remained after the study team took into account other factors that were linked to both folic acid supplementation and language skills, such as a mom's weight and education, and whether or not she was married.

The study can't prove that folic acid, itself, prevents language delay, they wrote in the Journal of the American Medical Association. But, the vitamin is known to affect the growth of neurons and could influence how proteins are made from certain genes.

Folic Acid is an important supplement for women planning to become pregnant, as it helps prevent neural tube defects when taken prior to becoming pregnant and during early pregnancy.

peoplesdrugmart.com People First 9

Ian Lloyd...Continued From Page 8

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severity of cold and flu symptoms. In one study, people who took 400mg of Cold-Fx daily for 4 months had 25% fewer colds and flus. These same people also had over a 30% reduction in severity and length of their colds or flus. There have been few reported side effects with Cold-Fx use. In theory, ginseng products can interfere with prescription blood thinning medications (warfarin). Therefore,people who take warfarin should avoid using Cold-Fx. Garlic is not just for cooking with anymore, there is

Don’t Leave Home Without Our Help We can help you take the right precautions • Travellers Diarrhea • Hepatitis • Maleria • Cholera • Dengue Fever

Vaccination Services Certain Peoples Pharmacists can provide shots for the seasonal flu or for travel vaccinations. Talk to your Peoples Pharmacist and ask if they provide this health service.

10 People First peoplesdrugmart.com

some evidence that it can help reduce the amount of wintertime suffering. One small study, in England, found that patients who took a garlic supplement daily between November and February had fewer colds than patients taking a placebo. While this sounds promising, it is still a little early to recommend that everyone take extra garlic in the winter. The product used was a specialized and concentrated form of garlic. Taking more than culinary doses of garlic can have drug interactions and side effects. Too much garlic can interfere with prescription blood thinning medications (warfarin). This supplement can also give your skin that particular odour of garlic.

Perhaps the best advice to stay healthy in the winter months is to wash your hands. This is also good advice for any season. Try not to think of winter time as cold, being stuck indoors and having to shovel snow. Put a positive spin on it. More time to reflect, read a good book, spend time with loved ones (indoors) and you don't have to mow the lawn.

Written By Ian Lloyd, Pharmacist & Chartered Herbalist, Peoples Pharmacy

Don’t Play A Guessing Game With Your Daily Medications Peoples Drug Mart and Peoples Pharmacy offer a medication compliance program called “Med Manager.” The Med Manager is a medication compliance card that conveniently organizes your medications for a full week and helps you easily identify what medications are to be taken at what time of the day.

Talk to your Peoples Pharmacist about the convenient Med Manager program.

PEOPLES PHARMACISTS

Dr. Hister...Continued From Page 4

immune condition arises (I blame my own celiac disease, by the way, on my parents, although in fairness I have to say that my mom vigorously denies responsibility, usually with her typical dismissive, “Oh, just grow up, Arthur”).

But as always we have theories, and with Type 1 diabetes, the prevalent theory is that in a susceptible person (genetics plays a role in who gets this condition), exposure to some provocative factor early in life, perhaps even in prenatal life, sets off a destructive and progressive reaction in a person’s pancreas that eventually kills enough cells so that for the rest of his or her life, that person will require some method of replacing the insulin they can no longer produce. (A very hot area of research, by the way, is to find a drug that can stop that auto-immune reaction while there are still some working beta cells alive, although so far, there’s nothing exciting to report).

But what kind of culprit, you may wonder, could set off such a toxic reaction?

Currently lots of attention is being focussed on some type of infection, and to that end, many studies have indeed found higher rates of certain infections in Type 1 diabetics (although no one can yet say if the infection produced the diabetes, or if after getting diabetes, those people just became more susceptible to certain infections).

Recently, though, there’s been a growing interest in looking at the other side of that same coin, namely that perhaps some auto-immune conditions occur because today’s newborns and infants are brought up in too “clean” an environment, that is, in such pristine circumstances that they’re rarely exposed to infections and other toxins like mites and allergens, as opposed to people my age, of course, who as kids, used to regularly get thrown out of the house with instructions to “Go play in the dirt with all those other dirty kids, Arthur, and don’t come back till it’s dark.”

So, perhaps, this “cleanliness theory” proposes, in some of today’s kids, when later in childhood they start pre-school and for the first time encounter a bunch of other kids and finally meet up with some of those ubiquitous body invaders – infections,

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Dr. Hister...Continued on Page 13

peoplesdrugmart.com People First 11

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Dr. Hister...Continued From Page 11

cat dander, dust, etc. – their immune systems, which still have no idea that those “toxins” are actually common and not to be feared, go in to overdrive to protect those kids against those innocuous substances, and eventually that over-reaction may result in an allergy or an auto-immune reaction.

But before every mom of a 2-year-old reading this decides to instantly roll her kid in the nearest dirt pile, remember that this is a theory only and no one yet knows if it’s true, and even if it is true, what to do about it.

The standard therapy for Type 1 diabetes includes regular monitoring of glucose levels and regular injections of insulin, and that goes on of course 24/7, no matter what else a diabetic may be up to, so it’s really not hard to understand that it’s often very hard for a Type 1 diabetic to maintain the kind of constant blood sugar control doctors would like them to have, especially, of course, in the case of newly-diagnosed teenagers, who have enough trouble making sense of who they are and where they fit in without having this major burden – constant testing, constant treatment, constant visits to clinics - added to their lives.

That said, many studies have shown that the better control a Type 1 diabetic can manage over their glucose levels, the better they will do, both in the short- term with fewer insulin - or hypoglycemic – reactions as well as in the long-term through a much lower risk for some of the many potential and awful complications linked to diabetes – strokes, heart attacks, kidney damage, blindness, some cancers, amputations, Alzheimer’s disease, and others.

Bottom line: a frustrating condition that we can’t prevent, and one that we still know far too little about, but one that, thankfully, is also the source of much excellent research so that, one hopes, not too long from now, we’ll actually be able to tell someone what to do to prevent it.

Dr. Art Hister can be heard on CKNW and other Corus Radio Network stations on House Calls on Saturdays at 10 AM, as well as seen on Global TV news on Saturday mornings at 9:20.

PEOPLES PHARMACISTS Helping People Live Better Lives We Can Help With Medication Reviews.

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peoplesdrugmart.com People First 13

Darlene Booth R.H.N

Stressed Out? Here we are in November and many of us are coming down the home stretch leading up to the most stressful time of year. Final exams, holiday plans, relationship dynamics, and financial worries all top the charts for this season’s major stressors. For the most part, a little stress now and then is not a bad thing and a natural by-product of daily living. In small doses, it can actually help us lead a more productive life by motivating us to do well on an exam or finish up a procrastination pile; it can save our life when we face a dangerous situation and it can keep us alert in situations where we need to be on our toes. Yes, the stress response is a most excellent thing when it comes to fight or flight, but too much stress over an extended period of time can lead to a depletion of essential nutrients and seriously affect our mental and physical health.

Man cannot thrive on potato chips and soda alone. During stressful times the body requires more of the foods that nourish and strengthen the adrenal glands and nervous system.

The problem here is that when things get tough it can totally alter our normal relationship with food; some people turn to the comfort of junk food while others totally turn away from food. The common thread here is that the actual nutrition we need to ride the stress wave is actually lacking. And if you are eating an inferior diet to begin with, your resilience to stress will be compromised from the start. By eating a nutritious and well balanced diet to begin with, you will be able to handle stressful situations with more ease.

If you are feeling like stress is nipping at your heels and trying to bring you down, try incorporating the following dietary strategies into your life to bolster your own natural reserves: 1. When we are stressed, this can cause serotonin levels to drop and this may have a negative impact on mood, sex drive, brain function and sleep patterns. Complex carbohydrates and foods that contain the amino acid, tryptophan, are the best ways to boost serotonin levels naturally. Incorporate more fish, turkey, whole grains, legumes, dried beans, nuts, seeds, sea vegetables and dairy foods into the daily menu. Simple sugars and stimulants like coffee can also give

14 People First peoplesdrugmart.com

you a temporary reprieve but they generally are followed by a down swing so minimize them or make sure you balance them out as part of a healthy meal.

2. Vitamin B Complex and Vitamin C are needed by the adrenal system and the nervous system in times of stress. These water-soluble vitamins are not stored in the body and need to be replenished on a daily basis. Eat more dairy foods, nutritional yeast, whole grains, green leafy vegetables, eggs, meat, poultry, nuts, fruit and green leafy vegetables to keep B vitamin reserves. Foods high in Vitamin C include; citrus fruits, dark green vegetables, strawberries, acerola cherries, rosehips, kiwi fruit, papaya and many other fruits and vegetables. During times of stress I highly recommend taking a daily supplement formulated for stress support.

3. Eat small nutritious meals regularly. Don’t let a blood sugar crash take you down the rabbit hole. Carry small snacks with you so you don’t wind up at the vending machine trying to choose between chocolate and chips. Keep a small stash of almonds, dried fruit, protein bars, trail mix or crackers and cheese handy for healthy options.

While we can’t always avoid stress we do have a choice on how we deal with it. Sometimes stress is like the frog in the hot water analogy; we tend to ignore and keep adapting to the little stresses that eventually add up to overwhelm us.

At this point we likely turn to one of many common unhealthy coping strategies including; self medication via food, drink or drugs, distraction, social withdrawal, procrastination and misdirected anger. If there are areas in your life that are causing concern, don’t try to suppress them and hope they will go away. Meditation, exercise, laughter, spending time with friends, a walk in the park and uplifting music are healthy ways to recharge spirit and soul.

And there are times when all the self-help and well-meaning friends in the world just aren’t enough. If stress is taking over your life and you can’t seem to find a way through it, talk with a trusted professional. Sometimes all it takes is a new perspective to bring that bounce back to your step.

Good Health to You!

Apple Pecan Crisp

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Recipes For Good Health

Apple Pecan Crisp 30-Minute Diabetic Cooking Cookbooks

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The articles published in People First are for the general information of the reader. While effort is made to reflect accepted medical practice and knowledge, articles should not be relied upon for the treatment or management of any specific medical concern or problem and People First accepts no liability for reliance on the articles. For proper diagnosis and medical care, you should always consult your family physician promptly. Opinions expressed in sponsored articles by, Dr. Art Hister, Ian Lloyd, and Darlene Booth are paid editorials and are not necessarily shared by Peoples Drug Mart stores or Peoples Drug Mart (B.C.) Ltd. Some advertised products are not available in all stores. We reserve the right to substitute products or limit quantities. Prices effective while quantities last.

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