Health advice from Dr. Oz

The flu
Is there going to be another H1N1 flu pandemic this year? If somebody didn’t get vaccinated should they?
If you’ve already been vaccinated for H1N1 this year, don’t worry about it, you’re done. And if you got sick, don’t worry about it, you’re done. H1N1 is a very promiscuous virus with a little bit of avian, swine and human, which means it can survive in all these species. That raises concerns about its ability to mutate. If you did not get vaccinated, swine flu will eventually get you. That stated, it’s a pretty safe virus.

Is it that big of a deal if you get H1N1?
You’ll be really sick for a couple days, but you’re almost always going to survive and contracting it will help defend you against future viruses like it. It may not be fun, but you almost want to get these viruses when they come around. Then your body can build immunity.

How can we make sure our bodies are ready to fight the flu?
Make sure your vitamin D levels are adequate, you get enough sleep, eat lots of brightly coloured foods that are full of antioxidants. Remember, oxidation weakens you – it’s like civil war – and if you’re already fighting against yourself, when an attack comes from somewhere else, you’re less able to defend yourself.

Hair loss
Women seem to be catching up to men in the balding department. How can we avoid losing our hair?

Balding is different for men than it is for women. Women shampoo their hair too much. Go ahead and rinse it every day, but unless you’re working under a car, you don’t have to shampoo every day. Three times a week is plenty. You can condition hair daily, but when you shampoo, you remove some of those valuable oils at the scalp. You have to be very careful when hair is wet. Wet hair’s a moist, cashmere sweater. You don’t want to pull at it, tug at it or over-dry it. You also want to ensure that you’re giving your hair the nutrients it needs. The classic mistake most people make is not eating enough Omega 3s.

Does flax work too?
Flax is valuable for different reasons. Flax is mostly ALA Omega 3s and fish oil contains DHA and EPA Omega 3s. They’re all Omega 3s, which is why they’re both valuable, walnuts also. Aim for unsaturated fats.

So we should eat lots of avocado?
Avocado is the best food for hair. It has B vitamins, which are all good for the hair. It also has copper; when women don’t have enough copper, their hair can grey.

Is there anything else? Does stress or lack of sleep make you lose your hair?
Stress can cause a very specific kind of hair loss where you lose it from one patch of your head. It’s reversible usually.

What about genetics?
Genetics is very important, but you can combat genetics with lecithin supplements.

Putting off pregnancy
Lots of women these days are delaying motherhood. How can we extend our fertile years?
The most important thing is to delay menopause. Most people think menopause starts with estrogen, but it actually starts another hormone: progesterone. Progesterone is like valium for the female brain. When you get pregnant, your progesterone levels go through the roof, which is why you’re able to tolerate an invasion of your body for that time period. When you start to see a reduction in progesterone levels, women become very antsy. Insults that used to be better tolerated are more of an issue. Women become much more irritable five years before they begin menopause.

But can we actually alter our biological clock?
It’s very difficult to change your menopause timeline. There’s a strong genetic element there, so you should find out from your mother when she experienced it to get a better sense of when you might. What you can do is make sure you don’t do anyting to speed up menopause. Obesity, for example, can speed up menopause because the fat becomes hormonally alive.

What does that mean?
The fat cells begin to make hormones. Those hormones destabilize, and make estrogen. Remember, normal menstruation is a balance between progesterone and estrogen, so if you’re making estrogen because you’re overweight, and you’re dropping progesterone because you’re getting closer to menopause, you’re no longer going to have regular periods. Without regular periods, it’s more difficult to have a baby. You want to keep the balance between estrogen and progesterone.

How do you know if it’s off balance?
You’ll start to get irregular periods and be more irritable.

So if your periods are still regular at 43...
But you’re getting really mad about things that didn’t used to bother you, you should be concerned your progesterone levels are dropping.

What impact do exercise and a healthy diet have?
They absolutely help. Without any question they help because they prevent one of the leading factors of infertility: obesity.

The fat myth
Obesity is the root of so many health issues. Why are we losing the battle against it?
Two words. Simple carbohydrates. Simple carbohydrates are addictive, fat is not. Simple carbohydrates are like crack cocaine for the brain. They stimulate your brain’s addictive centres so you actually crave more of it. That’s why when you sit down to have a soft drink at a meal, not only do you get the 160 extra calories from the drink, but you’ll also eat extra calories that you wouldn’t have normally eaten.

It’s interesting because we’ve been programmed to think eating fat is the problem...
But it’s not. A friend of mine calls it a big fat lie.

It is a big fat lie!
The real issue is too many simple carbs, too much sugar and the prevalence of processed food in our diets

Vitamin supplements
LJ: Do you take supplements?
DO: I do.
LJ: What do you take?
DO: I take vitamin A, B, C, D, E and a multivitamin. Then I take calcium magnesium and Omega 3. But you know what I’m most interested in? The way that vitamins exist in real food. The problem with taking pharmaceutical doses of vitamins is that the body’s not used to absorbing them in that way. Take vitamin A. When you give vitamin A to smokers, you don’t reduce their cancer rates, but if you give carrots to smokers, you do. Because carrots aren’t just vitamin A, there are dozens of different chemicals in them. There’s a sacredness to the whole food that I think ultimately is the biggest trigger for us.

Bad fat
You talk a lot about the dangers of belly fat. Is it really so bad for our health?
First off, let’s clarify what type of belly fat I’m talking about. Fat that’s beneath the skin isn’t the problem. The problem is belly fat that’s underneath the muscle. That fat has a special name: it’s called omentum and it’s designed to shoot nutrients and calories quickly to the liver. But it comes with a price because if you accumulate too much it will also supply the liver with inflammatory chemicals. That inflammation leads to a change in how your lipids are made. Cholesterol, for example, turns from the HDL healthy kind, to the lousy LDL variant. That’s issue number one. Number two, it physically puts pressure on the kidneys, so you develop high blood pressure. Why? Because the kidneys regulate your blood pressure and if they’re feeling squeezed, they can’t get blood so they actually have to elevate your blood pressure to get enough fluid to come to them. Number three, belly fat blocks insulin’s ability to work, which causes diabetes. Those three problems – high cholesterol, high blood sugar and high blood pressure – all contribute to our biggest health epidemics, including heart disease and cancer.

How can we reduce the bad belly fat?
Belly fat is reduced in two ways. First, you have to have muscle mass to burn calories. Walking and jogging, all of these are important foundation elements. Second, you have to shave off about 100 calories a day from what you eat for as long as you need until you lose the weight. That’s about one large apple.

Cancer
What about when it comes to eyeballing moles, freckles, that sort of thing, skin cancer?
We have a rule of thumb. It’s called ABCD. So A is asymmetry, is it perfectly round? If it is, it’s not a problem. B is border, is the border irregular? C is colour, multiple colours in the mole is bad. And D is maybe the most important, diameter, you want the mole to be less than 6 millimetres. So you know those little number 2 pencils we always wrote tests with in school? If you can cover the mole with an eraser head, I wouldn’t worry about it that much.

What about vitamin D? I’m hearing we should stop wearing sunscreen sometimes because we need to get some vitamin D from the sun.
Exactly. You’re not getting enough sun in the winter months and in the summer months, you put on sunblock. Ideally, everyone needs 10-15 minutes of direct sunlight a day, anywhere on the body will do, just not on your face. Put sun block on your face and the back of your hands because those are the two places you’ll care about 20 years from now.

What about breast cancer?
The way we’ll beat breast cancer is by using a martial arts approach. Instead of trying to whack it with surgery and knives, we have to figure out how our immune system can naturally beat these things. You can’t heal with steel when it comes to cancer, because remember, you and I both have toxins in our bodies now that can lead to cancer.

I know, I hate it.
But your immune system is awake enough to kill them. So how do we enhance the body’s natural desire to kill off a breast cancer or ovarian cancer or whatever? That’s part one. The other issue is earlier detection, which is not just about going and getting a mammogram, it’s about developing better tests.

I know several women who’ve gone for their regular mammogram every year, and then in their 50s all of a sudden they have advanced breast cancer because the mammogram didn’t pick it up.
Mammograms are the best tests we have, but we do need to develop better diagnostic tools.

Should they be asking for MRIs?
No. I think we need to get more serious about better testing for breast cancer. One idea that I’m very interested in is milking fluid from the nipples. Imagine if I could get the fluid out and look to see if there are cancer cells in the fluid?

You can tell from just the fluid?
Yes. Then, what you could do, instead of knocking the whole breast out, you could put a small, microscopic scope in and kill those cells instead of having to cut the breast out. So, you could be much more strategic in early detection and early treatment, which means it would be more like taking off a skin lesion than lopping off the breast.

How far away are we from that kind of treatment?
Over the next five years, I expect to see significant changes in how we treat breast cancer. In particular you probably know about something called ductal carcinoma in situ (DCIS) which accounts for something like 20 percent of breast cancer cases. It can be complicated because women can have cancer cells in several places, and it can be difficult to get it all. And we’re operating on those folks and I think that we can actually, very effectively, treat them microscopically.

Brain health
What about our brain? How much of cognitive decline is normal and how much can we prevent?
It’s about 50/50. Alzheimer’s is a big problem that has a strong genetic element but we know that in India, prevalence of Alzheimer’s is a lot lower than it is in North America, in part because they eat a lot of curry.

Is that the turmeric?
Exactly. Turmeric inhibits the deposition of beta amyloid, which is the goopy stuff that goes into the brains of Alzheimer’s patients. That’s number one, number two is Omega 3s.

You’re really big on those Omega 3s!
You can take any Omega 3. And now you can get smaller pills from algae sources that aren’t those big fish oil capsules. Some people don’t like those so they refuse to take them. I just wanted to point out that you have a smaller pill that’s cheap and sustainable for the environment. But it’s Omega 3s from the sea, because walnuts and flax seed, which I love also for different reasons, are not associated as much with cognitive issues.

Do you suggest anything else?
The best thing that you can do to prevent cognitive decline is physical activity. It’s very strongly correlated with healthy brain growth in children. A couple reasons, if you think crossword puzzles are good exercise, dancing is better. Think about it, not only are you remembering moves, but your body has to make those moves so your brain is using a lot more powerful tools to make things happen than with the crossword puzzle, which uses just one part of the brain.
Physical activity also revs the heart and the blood vessels going to the brain, which get calcified over time. Half of the dementia that we see is not Alzheimer’s, it’s infartia, small little brain attacks, so you want to prevent those as well. That’s why physical activity, we believe, is such an important long-term predictor of mental health.

Medical procedures
These days we’re all trying to be smart patients. What should we do when we get different advice from different types of health-care providers, your Chinese medicine practitioner says one thing, your family doctor says another, your osteopath might say something else?
I tell most people to start with the least invasive option. So I’d much rather strengthen my knees through physical therapy than take a supplement for my aching knees. I’d much rather do a head massage than take a pill for a headache.

How can we convince doctors to not put us on drugs right away?
I make a rule for my patients.

But you’re different.
Not for me, for my patients. You don’t have to be on more than six medications. If you’re on more than six medications, you have to ask your doctor what can you cut off. Invariably, after you’re on six, they’re putting you on other medications to treat the side effects of the prior ones. And the chances of a drug/drug interaction if you’re taking six pills is very high. So look what’s the least evil thing that’s wrong with you? Is it the cholesterol that’s just a little bit off? Maybe you can impact it without a pill.

Things like high cholesterol or blood pressure can be controlled with dietary modifications and exercise, right?
Usually. Ninety percent of the time you can impact that.

Some people think GPs just give you a prescription to get you out the door.
It’s a two way street, they think you want it. If you go in there and say listen I don’t want to be on another pill, tell me how can I deal with this. It’s different than saying I have a headache, what should I do? They think you want a pill for that.

So ask for something other than a fast fix.
Yes, or just say: I prefer to not have a prescription, what are my other options? You should also look around the office and see if the other patients look like you, because doctors will develop practice patterns. If you’re in there with a sports injury and everyone else is 94, you don’t fit perfectly. If everyone else is male, you’re female, that kind of stuff. See if the kind of people you’re seeing are the kind of people you are. And finally, see what kind of a hospital they have privileges at. I will put all of these under the rubic of seeing the right doctor.

Sex
Is there any women’s health issue that you think is really pressing, really important that we haven’t touched on today?
We didn’t talk about sex, but for a lot of women lack of satisfying sex is having a negative impact on their overall wellbeing. Everyone needs a healthy sex life. People are embarrassed to talk about it, and feel shy about it, but sex is one of those areas where you can reach that zen mode. Just like prayer and meditation, it offers lots of health benefits.