Q&A: Weight Loss; Cranberry Supplements; Radiation
Q. A friend thinks focusing on diet is enough to lose weight, but I say you need to combine diet and exercise—which of us is right?
A. Portion-control can help you lose weight by reducing your calorie intake, and exercise does so by helping you burn off calories. But both approaches are effective when used separately—you don’t necessarily need to combine them. However, you might see swifter results if you do, and combining them also may help you maintain a healthy weight ongoing.
I recommend replacing unrefined grains (such as white pasta and rice, and baked goods made from white flour) with whole-wheat bread and pasta, and brown rice. These unrefined grains are low in calories, and fiber-rich—and because fiber takes longer to digest you feel fuller for longer after eating it, and may be less likely to go for high-calorie snacks between meals. Also increase your consumption of fruits and vegetables. Boosting your protein intake can help too—it’s difficult to digest, so the body exerts more energy metabolizing it. In fact, one of the best ways to start the day in fat-burning mode is to include protein as part of your breakfast.
As far as exercise goes, aim to build up to (and preferably exceed) the target 150 minutes per week of moderate-intensity aerobic activity recommended by the Centers for Disease Control and Prevention (CDC). Also engage in strength training on two or more days per week. For more on the Federal exercise guidelines for seniors, visit the CDC website (www.cdc.gov). If you have any health issues, check with your doctor whether it’s safe for you to exercise—and if you’ve been sedentary up to now, start slow and gradually increase the amount and intensity of your physical activity.
Rosanne M. Leipzig, MD, PhD
Geriatric Medicine
Q. Is it true that cranberry supplements can help prevent urinary tract infections?
A. There is evidence that cranberry juice may help to prevent urinary tract infections (UTIs)—but that said, the juice is so tart as to be unpalatable for many, and this means that most commonly available versions are diluted with other juices. Cranberry supplements may be an effective alternative—one 2014 study found that older adults at high risk for UTIs (for example, those with diabetes or a history of UTIs) had 25 percent fewer UTIs over one year while taking a cranberry supplement.
Cranberry supplements may interact with some medications, including warfarin (Coumadin®), so if you decide to give the supplements a try, and you take other drugs, let your doctor or pharmacist know. The supplement used in the 2014 study included cranberry skin, seeds, pulp, juice and fiber, so look for an option that contains whole cranberries.
Patricia Bloom, MD
Geriatric Medicine
Q. My husband is scheduled to have a cardiac imaging test, and my sister mentioned that the radiation could harm his health. Should we be worried, given he is a cancer survivor?
A. Some commonly used conventional and nuclear radiography tests deliver a dose of radiation equivalent to 750 or more chest X-rays per procedure. There is evidence that this level of radiation exposure may slightly raise the risk for cancer years later, particularly in people who have undergone numerous other tests that use radiation. With this in mind, cardiologists have been urged to reduce patient exposure to heart imaging tests (research suggests that 30 to 50 percent of the tests may be partially or totally inappropriate).
If your husband has been advised by his doctor to have the test, I suggest that he asks if it would be appropriate for him to have a different test that does not use radiation, or if the test can be performed in a way that minimizes his exposure to radiation. If he has scheduled the test himself after responding to an advertisement for heart testing, I strongly recommend that he discuss the test with his doctor prior to having it.
Bruce Darrow, MD, PhD
Cardiology
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