Posts Tagged ‘Annual physical exam’

Myth or Fact? Balancing Acidic and Alkaline Foods for Your Stomach

The idea that we need to balance our inner pH with a special diet is a trendy one, but is there any evidence behind it?

The pH level (the balance of acid and alkaline) in your body is important, and can affect multiple body functions, but balancing pH is more complicated than simply changing your diet. It is true that a majority of the average American’s diet is loaded with acidic foods, but food isn’t the only factor that affects your inner pH.

“It is an interesting concept [balancing pH by adjusting the amount of acidic food you eat], but there is little basis or medically proven benefit of doing so,” says Cooper Clinic Director of Gastroenterology Abram Eisenstein, MD.

The human body is very sensitive to changes in pH and balance between acid and alkaline materials in our blood is very important part of our blood, but the body was developed with a number of mechanisms to guard against over acidity or over alkalinity in the blood. “Without these fundamental and life-protecting mechanisms, you can become very ill with chronic acidosis, but in the big scheme of things, what you put in your mouth has very little to do with the acid/alkaline balance in your body,” explains Dr. Eisenstein.

Serious diseases, such as uncontrolled diabetes and chronic kidney disease can have a far greater effect on your body’s pH levels than the food you eat. “While the recommendations that you can control pH by balancing acidic and alkaline foods in your diet come from well-meaning people, this idea is misguided,” says Dr. Eisenstein. “One of the beauties of our bodies is that our pH is regulated minute-by-minute. There is no long term effect on your blood from eating acidic foods.”

As far as the store bought urine tests claiming to check for a pH imbalance, Dr. Eisenstein doesn’t recommend giving them much thought either. “Measuring pH in the urine is not the way to find out if your pH is balanced or not because your kidneys are designed to balance the pH,” he says. “If you have too much acid in your blood, you’ll put out acid urine, if you have too much alkaline in your blood, you’ll put out alkaline urine.”

The bottom line: acidosis and alkalosis are serious medical problems, but unless you have other signs of serious poor health, worrying about your inner pH levels is unnecessary.

If you are concerned about your pH balance, schedule an appointment with your physician for an examination. If it is deemed necessary, your physician will order a blood pH test, which is the only correct way to check for a pH imbalance.

For more Prevention Plus articles, click here.

The Utility of General Health Checks in Adults Takes a Beating

November 27, 2012 Leave a comment

By Nina Radford, MD, Director of Clinic Research at Cooper Clinic

In a Cochrane systematic review and meta-analysis of 14 trials (involving 182,880 participants) recently published in the British Medical Journal, the authors from the Nordic Cochrane Center conclude that general health checks, defined as “a contact between a person and a health care professional to identify signs, symptoms or risk factors for disease that were previously unrecognized,” do not improve the health of patients. Specifically, the authors report that health checks do not reduce cardiovascular deaths or cancer deaths (in an analysis of data from 8 of the 14 trials).

So based on this review, does this mean you ought to cancel your upcoming doctor’s appointment for your annual examination and wait until you detect a problem with your health to make an appointment with your doctor? Absolutely not. 

If you take a careful look at the framework from which these authors made their conclusions as well as the studies included in their review, I think you will agree.

The authors set the stage for this review by challenging the notion that early detection of disease in a general health check leads to improved patient outcomes or reduction of disease or death. In their words, “Theoretically, there are many possible benefits of general health checks, through apparently intuitive mechanisms.” In other words, we think there are benefits of general health checks because that makes sense to us (so called intuition) but there is no rigorously proven scientific evidence. Furthermore, they go on to say that the detection of risk factors such as hypertension of hypercholesterolemia “may” lead to reductions in morbidity and mortality through preventive treatment.

You may be thinking that this is a crazy statement because we know that treating hypertension and hyperlipidemia in a primary prevention does reduce heart attacks and death from cardiovascular disease. Well, we know this is true if you are enrolled in a clinical trial, but do we know it is true if your hypertension or high cholesterol is detected by your primary care provider? Technically, we do not have clinical trials data to prove this, but why should we? The whole point of clinical trials is to prove that therapies are effective so they can be brought into clinical practice.

Let’s take a look at the eight studies included in the analysis of the impact of health checks on cardiovascular mortality and cancer death. Here are some features of these trials as a group:

  1. Seven of the eight trials were started between 1963 and 1971; one started in 1989. Many therapies that we know save lives were not available at the time of these trials. For example, the first statin was released for marketing 1987.
  2. Only three of the eight trials offered lifestyle interventions. Without effective drug therapies, education about healthy lifestyles is critical.
  3. The number of health checks ranged from just one (in three trials) to three. We know it is hard to change a health behavior in just one visit.
  4. The average follow up ranged from four to 22 years.

To give you a feel for what these studies were like, let me describe one. The authors included data from one study performed in Stockholm of 3,064 men and women ages 18 to 65 who underwent one health check in 1969 compared to 29,122 men and women who did not undergo a health check in 1969 and then ascertained the death status on all participants 22 years later.

Frankly, I am not surprised to find that people who had one health check in 1969 did not have a reduced risk of dying from heart disease or cancer more than two decades later compared to people who did not have one health check because there are so many potential confounders concerning how all those people lived (who smoked, who didn’t, etc.) and were treated (who had a regular doctor, who took medications) during the intervening 22 years. But I certainly do not see this as an indictment of routine health checks in 2012.

The authors of this study conclude that “our results do not support the use of general health checks aimed at a general adult population…” which is the tag line I am sure you will see on the 5:00 news.

However, the authors go on to say that physicians should not stop “clinically motivated testing and preventive activities” and that their results “do not imply that all individual components of health check are ineffective.…”

So, keep that doctor’s appointment, take your medications, watch what you eat and get some exercise. You’ll be glad you did.

Dr. Nina Radford is Director of Clinical Research and a cardiologist at Cooper Clinic. She received a Bachelor of Arts from Cornell University and a Medical Degree from Mount Sinai School of Medicine. She completed her internal medicine internship, residency and a clinical and research fellowship in cardiology at The University of Texas Southwestern Medical School Affiliated Hospitals. Dr. Radford also completed a fellowship at the American Heart Association Bugher Foundation Centers for Molecular Biology in the Cardiovascular System. She is certified in internal medicine with a subspecialty certification in cardiovascular disease by the American Board of Internal Medicine. She also is certified by the American Society of Hypertension and the Board of Nuclear Cardiology and is a Testamur of the National Board of Echocardiography. She serves on the Board of Directors of the Discovery Foundation and The Cooper Institute.

Should You Get a Physical Exam?

Dr. Kettles with a patient during a comprehensive physical exam.

You may have seen the recent New York Times article titled “Let’s (Not) Get Physicals“. The article discusses some of the advantages, but mostly focuses on the disadvantages to an annual physical,  including a list of possibly unnecessary procedures such as prostate specific antigen blood tests, pap smears and routine EKG’s.

As one of the eight healthy steps to Get Cooperized!, we recommend a regular, comprehensive physical exam. While it might not be appropriate for a 25-year-old, healthy, asymptomatic person to receive an annual physical, as we age (40’s, 50’s and on) it’s very important to have a regular, comprehensive exam. How do you know if you need an annual physical? Take into account your age, blood pressure, fitness levels and more.

Todd Whitthorne, President and CEO of Cooper Concepts, Inc. and Michele Kettles, MD, MSPH, COO and Preventive Medicine Physician at Cooper Clinic discuss the article and their recommendations in a podcast.

Click here to listen.