What you need to know about the new COVID-19 pill
In “Alice in Wonderland,” when Alice comes across a cake marked “Eat Me,” she does, thinking it may help her negotiate the challenge she is facing. Instead, it makes her grow to such an enormous size that she can’t get out of the room she’s in.
New medicines can sometimes have equally bewildering effects. Take ritonavir-nirmatrelvir (Paxlovid), the new anti-viral pill for treating COVID-19.
The medication got emergency approval this past December for treatment of mild to moderate COVID-19 in patients at high risk of severe illness. In the trial, unvaccinated participants who hadn’t been previously infected with COVID-19 and came down with it saw an 88 percent reduction in their risk of hospitalization or death if they took the new med.
Sounds incredible. However, as cardiologist Dr. Anthony Pearson pointed out in a MedPage Today article, Paxlovid comes with serious warnings about a slew of drug interactions. Anyone taking medications for high blood pressure, coronary artery disease, atrial fibrillation (Afib) or elevated cholesterol (that’s millions of folks) may need to stop or modify their cardiac medications and monitor their blood pressure and heart rates closely while taking Paxlovid. The potential risks are serious.
If this describes you, print out the Food and Drug Administration Fact Sheet for Healthcare Providers: Emergency Use Authorization for Paxlovid (type that into Google search) and talk with your doctor about whether or how you might take Paxlovid if you get COVID-19. (Also get the vaccine/booster, if you haven’t!) You want to be prepared to make the right decision quickly if it becomes necessary.
New insights into improving quality of life with Parkinson’s
Michael J. Fox was diagnosed with Parkinson’s Disease 31 years ago. While it’s a progressive neurodegenerative condition, those who get it before age 50 — around 10 percent to 20 percent of cases — can, like Fox, live with it for decades. Even people diagnosed around age 60 can live for 10 to 20 more years. But the quality of those decades can vary widely, as two studies show.
A study in Neurology looked at the effect — over a five-year period — of four hours a week of moderate to vigorous exercise on the balance and walking ability of newly diagnosed patients. Turns out it slowed decline of motor skills related to posture and gait. The researchers also observed that folks who maintained a steady level of work-related activity stayed cognitively sharper than those who didn’t.
Another study in Neurology looked at the impact of dietary flavonoids on the lifespan of folks with PD. Getting more than three servings weekly of foods loaded with flavan-3-ols and anthocyanins was most beneficial, improving survival rates by 66 percent to 69 percent during the study period. Flavan-3-ols are in apples, hops, tea, beer, wine and black tea, and anthocyanins are in blackcurrants, blackberries and blueberries, eggplant skin, red cabbage, cranberries and cherries.
So, if you have PD, it’s time to eat (berries and apples), drink (black tea) and be active. For recipes, see my “What to Eat When Cookbook,” and for exercises, check out www.apdaparkinson.org. Search for “What types of exercises are best for people with Parkinson’s disease.”
You can gain more control over gestational diabetes
Around 3,750,000 births happen in the U.S. annually, and 375,000 babies are born preterm. That’s one of the consequences of gestational diabetes, which affects between 2 percent to 10 percent of all pregnancies. Premature birth is especially likely if you’re diagnosed with GD before week 24. Then you are 10 times more likely to deliver early than if GD develops later in your pregnancy.
Gestational diabetes’ other health risks to you and your fetus include preeclampsia in Mom (high blood pressure during pregnancy along with damage to organ systems) and C-section. For the fetus, being overweight at delivery can result in a difficult birth and even fetal death. After a birth with gestational diabetes, Mom is at increased risk for developing Type 2 diabetes, cardiovascular and chronic kidney disease, and cancer. And the child is at risk for obesity, insulin resistance and neurocognitive development problems.
That’s why research, published in Clinical Nutrition, is such good news. It shows that counting carbs and following a DASH (Dietary Approaches to Stop Hypertension) eating plan may lower insulin resistance and insulin and glucose levels while pregnant. The carbs you eat should be complex and fiber-rich (eliminate the whites — bread, grains and potatoes, including fries). And, according to another study published in Nutrients, you should limit carbohydrates to 35 percent to 45 percent of your total calories, with a minimum of 175 grams of quality carbs a day (about 700 calories) consumed in three small meals and two to four snacks. To get started, check out health.clevelandclinic.org; search for “DASH diet.”
Folks with Type 2 diabetes aren’t taking heart health to heart
After he was diagnosed with Type 2 diabetes in 2013, Tom Hanks, now 62, admitted: “I was a total idiot. I thought I could avoid it by removing the buns from my cheeseburgers.” But he learned his lesson and changed his ways: “Yep, I have #2 diabetes,” he tweeted. “Type 2, I can manage with good habits. I shall!”
For some reason, that determination to reclaim good health after a Type 2 diabetes diagnosis seems to elude most people. According to a new scientific statement published in Circulation, cardiovascular disease is the leading cause of death and disability among people with Type 2 diabetes, yet only 20 percent of people with the condition follow heart-protective practices.
Smoking, high blood pressure, elevated glucose, high LDL cholesterol and overweight/obesity are major factors that make heart disease such a huge problem for people with diabetes.
The expert panel says addressing those modifiable conditions can effectively slash CVD risks. Plus, they stress that newer Type 2 diabetes medications, such as GLP-1 receptor agonists, reduce the risk of heart disease, stroke, heart failure and kidney disease by stimulating release of insulin or decreasing insulin resistance. Also new and highly effective: SGLT-2 inhibitors. They reduce the risks of CVD and chronic kidney disease by spurring kidneys to dispose of excess glucose through the urine.
Your smart move: Work with your diabetes doctor to establish a lifestyle modification plan and ask about the new meds that are available. With these tools at your disposal, you can dramatically reduce your risk for CVD.
Nightly drinking ruins your sleep
Jay-Z’s champagne is called Armand de Brignac; Mary J. Blige’s brand is Sun Goddess Wines; and famed director of “Apocalypse Now,” Francis Ford Coppola, has a line called Sofia, named after his daughter.
Now, it’s not the end of the world if you imbibe these celebrity sips, but evidence shows that drinking nightly is seriously risky business. It appears that drinking within four hours of bedtime can interfere with quality sleep. That’s because it shortens periods of REM (rapid eye movement) and makes you wake up more often during the night as blood sugar fluctuates and other biochemical changes happen in your brain and body.
You need multiple episodes of REM nightly so your brain can consolidate memories and processes emotions. Insufficient REM also makes you experience pain more acutely and may block growth of new, healthy cells and tissue in your body.
For optimal sleep — and to eliminate both short- and long-term health risks associated with alcohol consumption — some researchers recommend drinking only once a week and limiting intake to one glass of wine for women and two for men. Having more, they say, would be a mistake.
Instead, to feel relaxed at bedtime, opt for daily exercise, don’t eat within three hours of bedtime and make sure your room is digital-free, dark, cool and quiet.
Talking about mistakes: Apologies to the late, great Bill Withers, who wrote and first sang “Ain’t No Sunshine When You’re Gone,” not Stevie Wonder (that came later), as was stated in a column recently.
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. To live your healthiest, tune into “The Dr. Oz Show” or visit www.sharecare.com.