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Protect Yourself: How to Increase your HDL Cholesterol

High-density lipoprotein (HDL) is often referred to as the “good” cholesterol.

Having high HDL levels helps transport cholesterol from your arteries to your liver, where it can be used or excreted. In addition increased levels of HDL have both and antioxidant and anti-inflammatory benefit.

When it comes to cholesterol, it’s mostly about the numbers. While genetics definitely play a role, there are several other factors that affect HDL levels

The combination of low LDL “bad” cholesterol and trying to increase HDL “good” cholesterol is associated with lower risk of cardiovascular disease

Here are five healthy ways to raise your “good” HDL cholesterol.

1. Eat olive oil

   

   • Extra virgin olive oil may be more healthful than processed olive oils.
   • Olive oil is one of the healthiest fats around.
   • Research has shown that one of olive oil’s heart-healthy effects is an increase in HDL cholesterol. This effect is thought to be caused by antioxidants it contains called polyphenols

   Singh Snapshot: Extra virgin olive oil with a high polyphenol content has been shown to increase HDL levels in healthy people, the elderly and individuals with high cholesterol.

2. Exercise regularly

   

   • Being physically active is important for heart health.
   • Studies have shown that many different types of exercise are effective at raising HDL cholesterol, including strength training, high-intensity exercise and aerobic exercise
   • However, the biggest increases in HDL are typically seen with high-intensity exercise.

   Singh Snapshot: Exercising several times per week can help raise HDL cholesterol and enhance its anti-inflammatory and antioxidant effects. High-intensity forms of exercise may be especially effective.

3. Stub out smoking

   

   • Quitting smoking can reduce the risk of heart disease and lung cancer.
   • Smoking increases the risk of many health problems, including heart disease and 
   • One of its negative effects is a suppression of HDL cholesterol.
   • Studies have found that nicotine replacement therapy can lead to higher HDL cholesterol and HDL function improved, resulting in less inflammation and other beneficial effects on heart health

   Singh Snapshot: Quitting smoking can increase HDL levels, improve HDL function and help protect heart health.

4. Lose weight

   

   • When overweight and obese people lose weight, their HDL cholesterol levels usually increase.
   • What’s more, this benefit seems to occur whether weight loss is achieved by calorie counting, carb restriction, intermittent fasting, weight loss surgery or a combination of diet and exercise
   • The researchers found that losing at least 6.6 lbs (3 kg) led to an increase in HDL cholesterol of 4 mg/dl, on average

   Singh Snapshot: Several methods of weight loss have been shown to increase HDL cholesterol levels in people who are overweight or obese. The key to achieving and maintaining healthy HDL cholesterol levels is choosing the type of diet that makes it easiest for you to lose weight and keep it off.

5. Fish: Oily is Better

   

   • The omega-3 fats in fatty fish provide major benefits to heart health, including a reduction in inflammation and better functioning of the cells that line your arteries
   • There’s research showing that eating fatty fish or taking fish oil may also help raise low levels of HDL cholesterol.

   In addition to herring, other types of fatty fish that may help raise HDL cholesterol include salmon, sardines, mackerel and anchovies.

   Singh Snapshot: Eating fatty fish several times per week may help increase HDL cholesterol levels and provide other benefits to heart health. Fatty fish that may help raise HDL cholesterol:

   • Salmon
   • Sardines
   • Mackerel
   • Anchovies
   • Herring
   • Tuna

   Bottom Line

   Although your HDL cholesterol levels are partly determined by your genetics, there are many things you can do to naturally increase your own levels.

The Power of the Avocado

Did you know that avocados are actually a fruit…not a vegetable. They may in fact be the most powerful fruit out there.

Avocados are really fattening, but in a very good way.

• They have more fat than any other fruit, but don’t let that deter you from eating them!
• Avocados are full of incredibly healthy mono-unsaturated fat.
• It’s the most amazing kind of fat because it is good for your heart.
• Yes, you read that right. It’s full of a fat that makes your body healthy.

Eating avocados can regulate your blood pressure.

• Avocados are full of magnesium and potassium, two nutrients known to help reduce blood pressure.
• The avocado provides more magnesium than twenty other fruits, including the banana, kiwi and strawberry.

Guacamole is the healthiest and best dip ever.

• Here’s a tip: Contrary to popular belief, adding the avocado’s pit to a bowl of guacamole is not what keeps your dip fresh and green days after making it.
• The real trick is adding plenty of lime and lemon juice.
• It’s the exposure to oxygen that turns your guac brown — lime and lemon juice’s acidity slows down the oxidation process.

There is such thing as avocado oil, and it’s said to do wonders for your body.

• Avocado oil, or fat pressed from the fruit, is similar in form to olive oil.
• However, when you cook with avocado oil, you could be fighting heart disease, cancer and signs of aging.
• These types of molecules are known to destroy cell membranes, proteins and DNA. Avocado oil to the rescue!

Avocados are a much cheaper version of Botox.

• That’s right, avocados are not only for eating.
• An avocado can serve as a wonderful moisturizer, treat sunburns by preventing chafing, and it even help reduce wrinkles.

Avocados are a great source of fiber.

• If you’re tired of eating beans to get your fiber fix, start eating some avocados.
• There are 10 grams of fiber in a medium-sized avocado, with 75 percent of that fiber being insoluble (the one that speeds up the digesting process), and the other 25 percent being soluble (responsible for making you feel “full”)

Avocados help your body absorb the nutrients from other foods.

• One study showed that when avocado is added to salad, the absorption of beta-carotene from carrots increased 13.6 times, and the absorption of alpha-carotene from lettuce increased 4.3 times compared to the same salad eaten without avocado.
• The reason is because the mono-saturated fat in an avocado helps the body absorb fat-soluble carotenoid phynutrients better.

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Dr. Ethan Rand’s

Avocado Summer Smoothie Recipe

Ingredients:

1/2 – Hass avocado

16 oz. – Vanilla yogurt

1 cup – Milk (can use any type, including almond or soy) – can adjust amount to desired thickness

1-2 tbs – Honey – add to desired level of sweetness

Add ingredients to blender and enjoy!

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We <3 avocados and they <3 us back...

Intermittent fasting

Intermittent fasting is a currently popular diet trend that does not restrict what or how much you eat, but rather when you eat. There are several versions of intermittent fasting:

1. Eat-Stop-Eat
   • Alternate day fasting: no eating for 24 hours for anywhere from 1 to 4 non-consecutive days per week, most commonly 1-2 days of fasting per week, while eating normally on the other days.
2. 5:2 diet
   • Eating 500-600 calories per day on 2 non-consecutive days per week while eating normally on the other days.
3. 16/8 Method
   • Time restricted eating: limiting the window of eating from 4-10 hours per day and fasting the other 14-20 hours.

The most commonly used pattern is an 8-hour eating window with 16 hours of fasting.

Does it work?

Intermittent fasting has been shown to be about equally effective in weight loss when compared to a generally restrictive diet in the few studies that have been done.

Besides weight-loss, intermittent fasting has been shown to:

• Improve insulin sensitivity
• Improve glucose levels and/or insulin levels
• Improve blood pressure
• Improve lipid profile
• Reduce inflammatory markers and oxidative stress

But, are the cardiovascular and metabolic benefits just from losing weight?

One small study of 8 prediabetic men looked at intermittent fasting using a 6-hour window vs eating during a 12-hour window daily while keeping the calorie count high enough to maintain weight. Intermittent fasting was shown to improve insulin levels, insulin sensitivity, blood pressure, and reduce oxidative stress despite maintaining weight.

Does it matter when I eat if doing the time restricted eating method?

There is limited evidence, but some studies have suggested that an earlier fasting window is works better than a late fasting window. The thought is that the earlier window works better with our natural circadian rhythm.

So, can I just eat whatever I want during the non-fasting periods?

Technically, yes. However, for best results it is recommended to not stray too far outside of typical calorie recommendations which range from 1500-2500 calories per day depending on current weight, activity level, and weight loss goals. Also, it is always recommended to try to eat a well-balanced diet rich in whole, plant-based foods.

Can anyone try intermittent fasting?

If you are:

• Pregnant
• Breast feeding
• Diabetic
• Have any major medical conditions requiring medications

Please consult your doctor prior to starting any type of intermittent fasting diet.

Acknowledgement
Dr. Christine Townsend
Resident Physician
Physical Medicine and Rehabilitation

Standing desks: Are they worth the hype?

A major problem for office workers (and even physicians), is that they sit down for most of the day working at a computer. People who sit a lot every day have an increased risk of diabetes, heart disease and early death. Sitting burns fewer calories and research has shown a link to weight gain and obesity.

So in a nutshell…Sitting too much is Bad for your Health!

Standing desks: What’s the rationale?

There has been incredible hype behind standing desks for years.

Proponents argue that sitting should be avoided, even at work, and that standing desks can improve cardiovascular health. However, improvement in cardiovascular health has not been proven in scientific studies. Standing desks are not a substitute for exercise. So, while your neck and back may feel better, and a standing desk may improve your ergonomics at work, it does not replace your home exercise program. You should still take walking breaks at work, regardless of if you are using a sitting or standing desk.

Benefits of a Standing Desk

1. Standing Lowers Your Risk of Weight Gain and Obesity
   • While exercise is the most effective way to burn calories quickly, simply choosing to stand instead of sitting can also be beneficial.
   • In fact, when compared to an afternoon of sedentary work, an equal amount of time spent standing has been shown to burn over 170 additional calories.
   • That’s almost 1000 extra calories burned each week from simply standing at our desk each afternoon.
2. Using a Standing Desk May Lower Blood Sugar Levels
   • Generally speaking, the more your blood sugar levels increase after meals, the worse it is for your health.
   • This is especially true for those with insulin resistance or type 2 diabetes.
   • In a small study of 10 office workers, standing for 180 minutes after lunch reduced the blood sugar spike by 43% compared to sitting for the same amount of time.
3. Standing Desks Appear to Reduce Back Pain
   • Back pain is one of the most common complaints of office workers who sit all day.
   • To determine if standing desks could improve this, several studies have been done on employees with long-term back pain.
   • Participants have reported up to a 32% improvement in lower back pain after several weeks of using standing desks.
4. Standing Desks Help Improve Mood and Energy Levels
   • Standing desks appear to have a positive influence on overall well-being.
   • In one 7-week study, participants using standing desks reported less stress and fatigue than those who remained seated the entire work day.
5. Standing More May Help You Live Longer
   • Studies have found a strong link between increased sitting time and early death.
   • This is not surprising given the strong association between sedentary time, type 2 diabetes and heart disease.
   • In fact, a review of 18 studies found those who sit the most are at a 49% greater risk of dying early than those who sit the least.

Take-aways:

• Standing desks are not a substitute for exercise. You should still take walking breaks at work and maintain your home exercise program.
• If your desk is too high, a keyboard tray with a negative slope improves your ergonomics by orienting your wrists in neutral.

It’s Time to Take a Stand

• Reducing sedentary time can improve physical, metabolic and even mental health. This is why sitting less and standing more is such an important lifestyle change.
• If you want to try this out, then most places who sell office furniture also offer sit-stand desks.
• If you plan to start using a standing desk, it’s recommended you split your time 50-50 between standing and sitting.

Acknowledgement
Dr. Jenny Yuan
Physical Medicine and Rehabilitation Resident
New York Presbyterian Hospital

Let’s walk 10,000 steps a day

You’ve probably heard that you should walk 10,000 steps per day for fitness and weight loss.

How did they come up with this amount?

Is this a fitness myth or is there any research that shows that it works?

In 1965, Japanese company Yamasa Toki introduced their new step-counter, which they called Manpo-Kei. This translated into “10,000 steps meter” and they marketed their device with the slogan, “Let’s walk 10,000 steps a day.”

Research studies show that 10,000 steps per day isn’t a magic number, but it is a good indicator of how much activity a person is achieving in a day. Walking more steps per day is also associated with being thinner.

Research from JAMA-Internal Medicine

A study was designed which included 17,000….That’s right seventeen thousand older women. Their average age was 72 and all women agreed to clip on wearable devices to track their steps as they went about their day-to-day activities.

It turns out that women who took about 4,000 steps per day got a boost in longevity, compared with women who took fewer steps. In fact, women who took 4,400 steps per day, on average, were about 40 percent less likely to die during the follow-up period of about four years compared with women who took 2,700 steps.

Another surprise: The benefits of walking maxed out at about 7,500 steps. In other words, women who walked more than 7,500 steps per day saw no additional boost in longevity.

Burning Enough Calories for Weight Loss With 10,000 Steps

The number of calories you burn by walking depends primarily on how much you weigh and secondarily on your speed of motion. Each 2,000 to 2,500 steps is about a mile. Walking a mile burns about 80 calories for a 150-pound person. Depending on your weight, walking 10,000 steps burns between 250 and 600 calories. You can use the pedometer steps to calories converter chart to estimate this for yourself. You will need to know your approximate steps per mile.

Still Gaining Weight? Add More Steps

If you are already logging 10,000 steps a day and not losing weight or maintaining your weight, then the key is to add another 2,000 more steps per day while eating the same amount or less. You can use many tips to find ways to add more activity throughout your day and to set aside time for dedicated moderate to vigorous intensity exercise.

You should also work on eliminating empty calories and getting good nutrition from everything you eat. A food and exercise diary can help you spot where to make improvements.

One study found that postal workers who walk 15,000 steps per day and spend little time sitting were more likely to be thinner and have fewer cardiometabolic risk factors.

Start Counting Your Steps Today

A step count goal can motivate you to increase your activity and exercise. Today, you don’t even need a separate pedometer, as your mobile phone tracks your steps taken while you carry it.

So, if 10,000 steps has been feeling out of reach to you, it may be time reset those factory settings on your fitness tracker. Instead, try to hit at least 4,400 a day, along with daily activities that you enjoy. And stick to it.

Guidelines

To achieve health benefits, adults aged 18-64 years should accumulate at least 150 minutes of moderate to vigorous aerobic physical activity per week, in bouts of 10 minutes or more.

The Importance of Getting our ZZZZZs

For those of us who suffer from a poor night’s sleep, we all know that feeling cranky and irritable the next morning is to be expected. But did you know that chronic sleep deprivation can have much more serious and surprising consequences than just impairing our memory and affecting our mood?

Ongoing lack of sleep may put us at increased risk for health problems such as weight gain, anxiety/depression, heart disease, diabetes, stroke and dementia.

Now a recent study shows that even the perception of pain may be heightened for those struggling to get a good night’s rest. Sleep deprivation can lower our threshold to pain and may amplify our reaction to pain by enhancing pain responsivity within the primary sensing region of the brain called the somatosensory cortex.

Simply put:
Sleep could serve as a novel therapeutic target for pain management!

Active Sleep:

Besides getting enough sleep – an ideal range somewhere between 7 and 9 hours a night for adults – the quality of our sleep is just as important. Sleeping is an active process that follows a pattern and alternates between REM (rapid eye movement) and NREM (non-rapid eye movement) sleep throughout a typical night.

NREM (75% of night)

N1 (formerly “Stage1”)

• Transition between wakefulness and sleep

N2 (formerly “Stage 2”)

• Onset of sleep
• Breathing and heart rate are regular
• Body temperature drops (therefore sleeping in a cool room is helpful)

N3 (formerly “Stage 3 and 4”)

• Deepest and most restorative sleep
• Blood pressure drops
• Breathing slows down
• Muscles are relaxed with an increased blood supply to muscles
• Tissue growth and repair occurs
• Hormones vital to growth and development are released

REM (25% of night)

• Dreams typically occur
• Onset about 90 minutes after falling asleep and recurs about every 90 minutes
• Provides energy to brain and body
• Supports daytime performance
• Eyes dart back and forth
• Body becomes immobile

Even though we acknowledge the vital role that sleep plays in our overall health and well-being, actually being able to sleep well – falling asleep and staying asleep throughout the night – remains elusive for millions of Americans.

Here are some tips on how to practice good sleep hygiene:

1. Stick to a set schedule: Try and go to bed and wake up at the same time, even on the weekends.
2. Exercise daily: Sweating it out during the day will help you fall asleep at night. Timing these workouts to maximize sleep potential – whether in the AM or PM – will vary.
3. Create your sleep oasis: Your bedroom should be cool, between 60 and 67 degrees. Try and eliminate light and noise by using blackout curtains, eye shades, ear plugs, “white noise” machines.
4. Sleep on a comfortable mattress: If you’ve been sleeping on the same mattress for over 10 years, you may want to consider buying a new one. As for the firmness of the mattress, there’s no right answer. However, there is general consensus among experts that a more firm mattress is better for back pain, while softer mattresses are advisable for tender points.
5. Get off the grid: The short-wavelength blue light emitted from electronic devices such as smartphones, laptops and tablets before bed delays your body’s internal clock by suppressing the release of sleep-inducing hormone melatonin. A smarter alternative: try reading a printed book under lamplight to help you unwind.
6. Keep it light: Avoid alcohol, caffeine, cigarettes in the evening. If possible, try not to eat heavy meals 2 to 3 hours before bedtime.
7. Seek professional help: If you’re still having trouble sleeping, consider speaking with your doctor who may want to evaluate you for other conditions underlying your inability to sleep.

Something To Sleep On

• Sleep deprivation negatively impacts how we look, feel, perform and interact with the world around us.
• Getting a sufficient amount of quality sleep is just as important as eating right and exercising
• While we spend 1/3 of our lives sleeping, optimizing those hours will keep us healthier, happier and more productive the other 2/3 of the time.

Acknowledgement:
Dr. Rosa Cho- Weill Cornell Medicine, Department of Rehabilitation Medicine

The Healing Properties of Medical Cannabis Oil?

Background: What is CBD?

• Cannabidiol (CBD) is a chemical occurring naturally in the cannabis plant.
• Cannabis contains many different chemicals, including tetrahydrocannabinol (THC), which has psychoactive, intoxicating properties.
• CBD does not have intoxicating properties.

What is CBD used for?

• CBD oil (oil containing CBD extracts) is marketed and sold for use treating a variety of health and medical ailments, including chronic pain, arthritis, anxiety, insomnia, smoking cessation.
• CBD is not approved by the FDA for any of these uses.
• The FDA recently approved a commercially produced CBD oil (Epidiolex) for use in treating seizures in children with two rare and severe forms of epilepsy.

How is it used?

• CBD is available as an oil or powder. Oil can be mixed with foods or beverages. For example, many coffee shops now offer CBD-infused coffee drinks. Other products include CBD-infused alcoholic spirits, lotions, bath bombs, candies, and dog biscuits.
• CBD may also be taken in capsule form or as an oral spray.
• CBD powder can be used to make creams or gels for use directly on the skin, such as for arthritis pain.

What do we know about CBD for pain?

• Most studies have been performed using mice or rats rather than humans.
• A large study (2012) published in the Journal of Experimental Medicine showed that CBD helped reduce inflammation and chronic pain in mice and rats.
• More recently (2017), another study found that CBD may be helpful in reducing joint pain in osteoarthritis.
• There is currently not enough research to conclusively determine whether CBD is an effective pain treatment in humans.

Is it safe?

• While we do not know yet whether CBD is an effective treatment for pain, studies have suggested that there is little risk of harm at doses recommended by most producers.
• There are many different commercial CBD oil products available, and the amount of CBD in them may vary by manufacturer and lot.
• Side effects of CBD can include: drowsiness, fatigue, irritability, and nausea.
• Clinical trials have not found any indication of physical dependence.
• CBD is legal in many US states, but not all of them. Before buying and using CBD products, know the laws in your local area.

Conclusions:

• CBD (cannabidiol) is a chemical compound found in the cannabis plant.
• CBD is produced and marketed for a variety of medical uses including chronic pain, anxiety, insomnia, and smoking cessation.
• Though there is hope that CBD may be effective for the treatment of chronic pain, there is not yet sufficient medical research to support its use for these medical problems.
• The FDA has approved a CBD product (Epidiolex) for use only in treatment of seizures in children with two rare and severe forms of epilepsy.
• The sale and use of CBD is legal in some, but not all, states.
• Common side effects of CBD are relatively mild when used at recommended doses and there appears to be little risk of physical dependence.
• More studies are needed to determine the effectiveness and safety of CBD for the treatment of chronic pain.

Acknowledgements:

Dr. Charles Scott – Physical Medicine and Rehabilitation Resident- New York Presbyterian Hospital

Don’t Skip the Gym: It Could Be as Bad as Smoking!!

How surprising is to hear that not exercising can be worse for your health than smoking?

According to a new study published at the Cleveland clinic this was in fact found to be true.

Background

• Current literature shows that the better your cardiorespiratory fitness (aka fitness level), the lower your risk of mortality.
• Exercise can potentially decrease your chances of developing high blood pressure, diabetes, stroke and cancer.

New Evidence

• The study looked at 122,007 patients who underwent exercise treadmill testing and found that patients participating in regular exercise had a decrease in all-cause mortality.
• High levels of aerobic fitness were correlated with the greatest survival.
• They also discovered a larger benefit to older patients and those with high blood pressure.
• Taking into account the mortality risk, they found that not exercising was comparable to and potentially even greater of a risk factor than smoking for mortality.
• Health care professionals should continue to encourage patients to participate in regular exercise.

Not Exercising = Smoking

Don’t Have Enough Time?

• You can engage is High Intensity Interval Training.
• Or try the 7 minute workout
• Even Supreme Court Justice, Ruth Bader Ginsburg has time to work out.

Centers for Disease Control and Prevention;

Physical activity guidelines

150 minutes of moderate activity weekly

OR

75 minutes of vigorous activity weekly

In Summary

• Regular aerobic exercise at any age can improve your mortality risk
• Poor exercise tolerance on treadmill or exercise stress testing was found to have a worse prognosis (regarding death) than other risk factors including high blood pressure, diabetes or being a current smoker.
• Make sure to discuss with your doctor if you are planning to starting a new exercise program

“…there is no limit to how much exercise is too much.”

The RBG Workout

How does Just Ruth Bader Ginsburg remain so active and fit even at the age of 85? The RBG Workout is an hour-long routine that Justice Ginsburg does twice a week with her personal trainer, Bryant Johnson.

Do you want to be as fit as the Notorious RBG (a.k.a Supreme Court Justice Ruth Bader Ginsburg)?

The exercises and illustrations below are from The RBG Workout.

Warm-up

1. Jog for five minutes on a treadmill
2. Light stretching of the neck, arms, legs, and back

Strength Exercises

The entire workout includes strengthening exercises targeting various parts of the body, and is too extensive to cover here. Here are five of the exercises used by Justice Ginsburg:

1. Front and Side Planks

Front planks: 2 sets for 30 seconds

With your elbows and forearms on the ground, and your elbows directly underneath your shoulders, maintain a straight line from your shoulders to the backs of your heels while engaging the core muscles.

Side planks: 1 set/15-30 seconds on each side

Place your forearm on the ground with your elbow directly underneath your shoulder while lifting your other arm up in the air.

2. Wall Squat with Exercise Ball: 3 sets/10-12 reps

With an exercise ball placed between your back and the wall, and your feet shoulder-width apart, grab a dumbbell in each hand. Bend your knees to 90 degrees (B), then straighten your legs again (A).

3. Medicine Ball Push-Ups: 1 set/10-12 reps each hand

Get in a push-up position with your knees on the ground, one foot crossed behind the other, one hand on a medicine ball, and one hand on the ground (A). Lower your body downward until your chest is 6-8 inches from the ground (B), then push your body upward (A).

4. Knee Lifts: 1 set/10-12 reps each leg

Step onto a step or box with one foot. Push off the ground with the other foot and lift that knee up. Step backward onto the ground with both feet. Repeat with alternating feet.

4. Bench Sit and Stand with Medicine Ball: 3 sets/8-10 reps

Hold a medicine ball at chest level with your arms extended, and stand in front of a bench or chair with feet shoulder-width apart. Bend your knees and sit down, while bending the elbows to bring the ball to your chest. Return to standing position while extending the arms. If you are working out with a friend or workout partner, you can toss the ball to them as you stand up, and have them toss the ball back to you.

Cool Down

Repeat light stretching of the neck, arms, legs, and back

Bottom Line

• Justice Ginsburg is 85 years old — you are never too old to exercise
• The RBG Workout is a full-body workout which builds strength, balance, and flexibility
• The RBG Workout can be done at the gym or at home
• If you are very busy or are just beginning to exercise, you can start out with just a few of the exercises in the RBG Workout, or do a lower number of sets and reps

Acknowledgement Mimi Zheng, M.D.
Physical Medicine and Rehabilitation Resident
New York Presbyterian Hospital
The University Hospital of Columbia and Cornell

How much alcohol is good for you?

All the studies about alcohol can leave you a bit confused. But research suggests that you still need to keep moderation in mind when you raise a glass.

I have previously written about red wine in particular, and the suggestion that it can boost health, especially heart health, because of its antioxidant resveratrol.

Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. A new study, published in the Lancet, found that the risk of mortality, and of cancers specifically, rises with increasing levels of consumption. More importantly, the level of consumption that minimizes health loss is zero.

Impact on health

A recent study, funded by the Bill and Melinda Gates Foundation, found that:

• Alcohol is the 7th risk factor for death and disability in general, and 1st in the age group 15-49
• Risk of death rises with increasing consumption
• Alcohol contributes to 2% of female and 7% of male deaths worldwide
• The safest amount of drinking is no alcohol

Alcohol-related diseases

• Alcohol affects negatively multiple medical conditions
• Cancer is the leading cause of alcohol-related deaths for people older than 50
• Road injuries, violence, self-induced accidents, and tuberculosis for people between 15 and 49

But my cardiologist told me to drink 1-2 glasses of wine every night…

• Prior studies have shown that one drink a day for women and two for men may reduce the risk of heart disease and diabetes
• The current study:
  • Confirmed this trend, but
  • When all risks/diseases are included (e.g. accidents, canner, infection), alcohol is always associated with lower life expectancy

In summary

• Alcohol is one of the leading causes of death worldwide
• Its consumption is associated with multiple medical problems, including cancer, injuries, and infection
• The risks of drinking alcohol outweigh any benefits
• The only safe amount of alcohol is no alcohol at all

Acknowledgement
Tasos Gogakos
Weill Cornell/ Rockefeller/Sloan-Kettering
Tri-Institutional MD/PhD Program