Category: Health

Can 20 minutes of exercise a day really make a difference in my health?

Globe reader Ron Renaud in Vancouver B.C. asks, “Can 20 minutes exercise a day really make a difference?” Globe Health fitness expert Kathleen Trotter has strong feelings on the matter: “Daily movement is imperative! Don’t let yourself off of the exercise hook by doubting how much of a long term difference it will make.” Trotter elaborates:

Any amount of movement – whether it lasts for 20 minutes or two – will positively affect your health.

The first reason: When you’re up and exercising – even just for 20 minutes, those are minutes not spent sitting. Prolonged sitting negatively affects the cardiovascular, lymphatic and digestive system, not to mention one’s metabolism. Sitting is associated with increased risk of cardiovascular disease, stroke and diabetes, and affects how our bodies metabolize glucose.

Secondly, once you get into the habit of being more active you can tweak your routine to ensure that you get your desired results – those that could “make a difference,”  as you say. Whether you want to lose weight, gain weight, or improve cardio endurance – I don’t know.  I can tell you that 20 minutes of training a day is a great start – and then you can tweak your routine from there.

Don’t get me wrong: walking for 20 minutes every day will not be enough to run a marathon. If you never start training, you will have no routine to tweak.

Even when you’re seriously training, you don’t need to spend hours at the gym to get results. Mini workouts can offer maximum benefits. I think Tabata intervals are going to be your friend: read about them here.

So many fun interval workouts are available, that don’t take hours every day. When I run, I love alternating 15 seconds of intense work with 45 seconds of moderate work for 20 minutes. For more of my favourite interval and mini workouts, read this and this.

For an efficient arm workout in just six minutes, watch this:

Want a great legs workout and short on time? No problem:

 Follow Kathleen Trotter on Twitter, and watch more of her Fitness Basics videos here.

I’ve read rice contains arsenic. Should I limit how much I eat?

Reader Carol G. asks: “I read that rice products have low levels of arsenic.  I am gluten-free for health reasons, so I consume rice regularly.  Is there a maximum quantity that I should consume to limit my exposure to arsenic? Or am I concerned unnecessarily?”

Globe Life contributor Kat Sieniuc investigated:

The short answer is: yes, there are low levels of arsenic in most of the rice we eat. Not surprising to chemists and food safety experts, trace amounts of arsenic actually is present in many foods, and rice is especially prone to accumulating it. For consumers, this may come as a shock.

Arsenic is a naturally occurring element present in rock, soil, water and air that was once used in pesticides and, until 2009, by poultry farmers in medication targeting parasites in their birds. Today, arsenic shows up as largely a byproduct of heavy metal industry.

It exists in two chemical forms: a less toxic organic form that we can ingest with virtually no risk and a slightly more toxic inorganic form that reacts in our bodies and can do damage.

In 2012, Consumer Reports conducted a study that found measurable levels of arsenic in almost all of the 60 rice variables and rice products they tested. Further study showed that the inorganic arsenic levels found in rice varied across geographic locations and types of rice.

The breakdown:

  • White basmati rice from California, India, and Pakistan, and sushi rice from the U.S. had half of the inorganic-arsenic amount of most other types of rice.
  • Rice from Arkansas, Louisiana, or Texas had the highest levels of inorganic arsenic.
  • White rice from California had 38 per cent less inorganic arsenic than white rice from other parts of the country.
  • Brown rice had 80 per cent more inorganic arsenic on average than white rice of the same type (this is because it accumulates in the grain’s outer layers, which are removed to make white rice).
  • And rice that’s grown organically took up arsenic the same way as conventional rice.

But how dangerous is arsenic – and should we be limiting the amount of rice we eat?

“Essentially… you would need to eat 3 kg of rice a day to get noticeable toxic effects,” says Keith Warriner, a professor of food science at the University of Guelph.  He says an international group of food safety experts called Codex has recommended a maximum level for arsenic in rice of .02 mg per kg – which means most of us don’t come close to eating toxic levels.

While Codex recommends adults limit their rice servings to four per week, and zero for children under five,  Health Canada and the Canadian Food Inspection Agency say the trace amounts of arsenic found in food are not considered a safety concern for Canadians.

Warriner says that while the risk of arsenic exposure from eating rice is minimal, there are precautions you can take if you are really concerned:

  • Eat white rice,  which has a lower arsenic level than brown
  • Soak rice overnight prior to cooking – this eliminates inorganic arsenic by 30 to 60 per cent
  • Choose rice sourced from geographic regions known to have lower levels of arsenic in its soil like India, Pakistan or California

Follow Kat Sieniuc on Twitter, and read our Globe Health coverage here

Are there any cosmetics in Canadian drug stores that have been proven safe?

Sherry Lamb in Toronto asks: “Are there any widely-available cosmetics in big drug stores in Canada that have been proven non-carcinogenic?”  Globe Health reporter Carly Weeks says, “There is no end in sight to the debate over the potential toxicity of mascara, lipstick and other cosmetics. Mainly that’s because there are few clear answers about the long-term health effects of many of the ingredients used to make those products.”

But is there a way for concerned consumers to minimize their exposure to potentially harmful substances in moisturizers, nail polish, eyeliner and other products? Weeks explains:

Health Canada oversees cosmetics, and companies are required to let the department know what ingredients go into their products. Health Canada also maintains a “Hotlist” of substances that are prohibited from being added to cosmetic products. But there are still plenty of other ingredients that can be used to make the perfect pink shade of blush or the best wrinkle-reducing foundation. And many of those substances have never been subjected to rigorous scientific scrutiny. In other cases, some research shows that certain ingredients may disrupt hormones or be linked to an increased risk of cancer.

But, as the American Cancer Society notes, simply because an ingredient was flagged as potentially harmful in a study does not mean it causes cancer. For instance, scientists often use high concentrations of a substance to study its effects – concentrations that likely go well beyond what a consumer would be exposed to through normal use of a product. Still, for some consumers, that isn’t good enough.

It’s plausible that in the future, new research will show that low levels of exposure to a certain ingredient over the course of many years could be harmful. Or that an ingredient previously believed to be safe is, in fact, tied to long-term health effects. So what can they do to reduce their exposure to potentially harmful ingredients?

The market for safer, less toxic or all-natural cosmetic products has grown significantly in recent years.  (Read: Do you know how many toxic chemicals are in your shampoo, your lipstick, your toothpaste?)  Plenty of department and drug stores now carry products that claim to be natural and less toxic.

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I don’t know if I’ve been vaccinated for measles. Is there a way to tell?

“Need I worry about measles?” writes Gertrude de Souza in Quebec City. “I’m a senior and planning to travel to California soon. I don’t remember if I ever had it or had the vaccination.  Should I be vaccinated? Is there a way to tell if I am immune?” André Picard, The Globe’s public health reporter says, “If you are a senior, you almost certainly had measles when you were a child and don’t need to be vaccinated.” Picard elaborates:

With the outbreak of measles linked to Disneyland, and the recent cases in Canada (10 cases in Quebec, eight in Ontario and one in Manitoba), many people are wondering if they are immunized.

Dr. Caroline Quach-Thanh, an associate professor of paediatrics at McGill University and present-elect of the Association of Medical Microbioogy and Infectious Disease Canada, said that as a general rule physicians and the public should assume :

  • If you were born in Canada before 1970, you very likely had measles and are immune. (If you were born in the U.S., it’s 1957 and varies depending on when countries introduced measles vaccination for children.)
  • If you were born between 1970 and 1979 you likely received only one dose of measles vaccine, but likely have immunity because measles was still circulating widely;
  • If you were born after 1979, you likely received two doses of measles vaccine and have immunity.

If you’re not sure if you had the measles or if you were vaccinated, the easiest thing to do is get re-vaccinated.

Dr. Quach said the take-home message is simple: If in doubt, vaccinate.

You can have your level of immunity medically tested, but the test is usually only done for pregnant women and those with immune deficiencies, and others who cannot get the vaccine.

While the outbreak in California is getting a lot of attention, remember that there are a lot of countries where contracting measles is a risk.

Most measles cases imported to Canada are in travellers from the Phillipines, India and France. (While there are just over 100 measles cases linked to the Disneyland outbreak, there have been more than 22,000 cases in an on-going outbreak in France, where childhood vaccination rates are among the lowest in the world – just 67 per cent for measles.)

Follow Picard on Twitter and read his recent column:  Majority of Canadians appear to back mandatory childhood vaccination

Does heavy use of antibiotics in childhood cause problems later in life?

‘Are heavy use of antibiotics in childhood tied to problems later in life?” asks Greg Bradshaw, in Hampton Ont., who wrote of his experience – heavy antibiotics as a child and a teen, “followed by a lifetime of being allergic to the world and all the food in it.” Microbiologist and Globe Health advisor Jason Tetro, says “up until the latter part of the 1990s, antibiotics were thought to be beneficial to the body.”

Tetro says that these drugs fought and helped to prevent infections, particularly in children. “Then microbiologists began to see the importance of the trillions of microbes in and on the body.” Doctors then realized, Tetro writes, that there may be a problem based on the diversity of the gut microbiota:

Researchers eventually learned people with a more diverse population of microbes were healthier. Further study showed chronic diseases such as inflammatory bowel disease, obesity and diabetes were due in part to poor diversity in the gastrointestinal tract, known as dysbiosis. A change from diversity to dysbiosis could thus mean a higher risk for a chronic ailment.

We know antibiotics kill bacteria but they do not kill all types. When inside the gut, only a fraction of the bacteria are removed. This alters the diversity and leads to dysbiosis. The change can last for up to two years after only one seven-day prescription. If antibiotics are used more heavily, longterm effects can be seen well into the teen years and adulthood.

With this in mind, analyses of antibiotics in children have revealed associations between antibiotic use in childhood and chronic diseases later in life. These include asthma, Crohn’s Disease, irritable bowel syndrome, weight gain and obesity. Other possible problems being explored include eczema and possibly psychological afflictions.

Thankfully, there may be a solution. Researchers are now exploring how to restore diversity through the use of probiotics. Trials have been ongoing for years and continue today. Already significant benefits have been seen with the addition of probiotics to antibiotic therapy. The reduction of dysbiosis has led some doctors to co-prescribe the two. The benefit is so great some want to see probiotics covered by health insurance so everyone can take them.

As for those already suffering from dysbiosis, the hope is that data and research will soon help. Although no definitive conclusions can be made at this time, the trends from clinical trials suggest probiotics and other similar interventions, such as fecal transplantation, may be the way forward. In essence, by restoring diversity, one might be able to restore good health and a better quality of life.

For more, read Tetro’s column: Do you know what antibiotics you’re eating? and Globe Health columnist André  Picard’s piece: We will pay for antibiotic abuse

Three-year-old twins need a living liver donor. How can adults be tested as a match?

Reader Leah Potter asks on Twitter: “There are three-year-old twins in Ontario who need a living liver donor.  How can adults be tested as a match?”  Globe Health columnist André Picard  answers:

The three-year-old twin girls, Binh and Phuoc Wagner of Kingston, Ont., suffer from Alagille syndrome, a genetic condition that can result in malformed bile ducts, which carry bile from the liver to the gallbladder. As a result, both need a liver transplant. (Read their full story here)

In Ontario, the organ donation program is administered by Trillium Gift of Life Network.  Live organ transplants are overseen by transplant programs in individual hospitals – in this case, Toronto General Hospital.

Normally, organs for transplant come from deceased donors, but the wait can be long and deadly. But three organs can come from live donors:  kidneys and lungs (because there are two) and liver (because it can regenerate itself). It is also possible to donate eye tissue, a procedure called conjunctival limbal transplant.

Michael Wagner, the girls’ father, is going to donate part of his liver, but he can only donate to one daughter.  So the family has made a public plea for an altruistic donor. A potential live liver donor must, from the outset, have the following characteristics:

1) be aged 18-60;

2) be in good overall health – physical and mental;

3) have a compatible blood type with the recipient: in this case A or O;

4) have a BMI of less than 35 during testing and no greater than 32 at the time of surgery.

Extensive testing for compatibility is done – such as blood tests, liver function testing, a CAT scan and interviews with a psychiatrist – which takes 3-4 days in Toronto. If the donor is accepted, surgery normally takes place within two weeks. Donors should not smoke or drink alcohol.

The surgery itself takes about six hours. Surgeons remove one lobe of the liver’s two lobes – 30-60 per cent, depending on the size of the recipient. If the transplant is for an adult, the gallbladder is also removed.

After surgery, a donor can expect to be in hospital for 5-10 days, and full recovery takes 6-12 weeks. Like any major surgery, there is a risk of complications, including wound infections, pneumonia, blood clots, bleeding and mental stress. The donor’s liver will regenerate and regrow to its original size within 6-8 weeks.

Because of the chronic shortage of donor organs, live donation is becoming more common, but living liver donation by strangers is rare. In 2012, the most recent year for which detailed data are available, there were 359 liver transplants performed in Canada, including 66 live donations from family members, and 12 from unrelated donors.

In Canada, donors cannot be paid for transplant organs. However, they can apply for financial assistance to compensate for time off work.

People who are interested can call the Living Donor Transplant Office at Toronto General Hospital for more information (416-340-4800, ext. 6581).

Follow André Picard on Twitter, and read more from Globe Health.

I’m allergic to sulphites in wine. Can you cook them out?

“I love wine but can’t drink it anymore,” writes Lois Vatcher, in Duncan B.C. “Does cooking with wine remove the sulphites?”  The Globe’s wine expert, Beppi Crosariol says yes – but cautions sulphites may not be your issue:

Sulphites break down when wine is cooked, especially in the presence of other ingredients, such as herbs, vegetables and stock. They also evaporate when the liquid is simmered in an uncovered pan and reduced to make a sauce, as in a stew or gravy.

Andrew Waterhouse, a professor of oenology and wine chemist at the University of California Davis, one of the world’s leading wine-research institutions, says “boiling the sauce in air will completely eliminate the sulphites.”

Sulphites (also spelled “sulfites”) – a hot topic among many wine consumers – are typically added in small quantities at the production and bottling stages to curb microbial growth and shield wine from the bruising effects of oxygen. They’re also a natural product of fermentation, which means that virtually all wines contain the compounds to some degree, even bottles that have been produced organically.

But you might want to make certain that sulphites are indeed at the source of your intolerance before you empty all that expensive cabernet into the stock pot. Health concerns surrounding sulphites are vastly overstated. Only about 1 per cent of the general population is sulphite-sensitive. This notably includes a small percentage of asthmatics, who can suffer severely because they lack a sufficient quantity of the enzyme that neutralizes the compounds . That latter group is a key reason several countries (including Canada, as of 2012) require wine labels to carry a “contains sulphites” warning.

Prof. Waterhouse stresses that sulphites are present not only in bottles of wine but also in our bodies. “We produce in our bodies between half a gram and a gram a day of sulphites” as a result of amino-acid metabolism, he says. That concentration is 50 to 100 times greater than you’ll find in a typical glass of wine, at 10 milligrams. All cells in the vast majority of people contain sulphite oxidase, which prevents chronic toxic sulphite overload.  You can visit his website,, for more information. (Click on the “What’s in wine” link.)

You may be surprised to learn that a wide range of other foods and beverages contain sulphites, some of which contain higher levels and yet are not required to carry warning stickers. One key example: light-coloured dried fruits sold in bulk, such as dried apricots and apples. Sulphites are added to those products to prevent browning.

It’s wise to check with your doctor, but if you want to test your sensitivity conclusively, ask yourself whether you have ever reacted to dried apricots, a two-ounce serving of which contains about 10 times the dose present in a typical glass of wine. Other foods that frequently contain sulphites include beer, baked goods such as pizza and pie crusts, frozen shrimp and frozen lobster (to prevent “black spot”), corn starch, shredded coconut, jams and jellies and canned seafood soups – and that’s a small fraction of the full list.

If your sensitivity to wine involves headaches (a common complaint), it’s far more likely that you’re reacting to the alcohol itself or even a group of compounds known as amines, which have nothing to do with sulphites.

“The medical literature has no reports on sulphites inducing headache,” Prof. Waterhouse says. “There’s nothing credible out there.”

Read more from Beppi Crosariol, and follow Globe Food & Wine on Twitter

I can’t think of putting my aging parents in a home. Where do I start for in-home options?

Bruno in Toronto writes, “My parents are aging and I can’t think of putting them in a home. In the unfortunate event that they fall ill or require care  as they get older, what options are available for care in their own home? How does someone begin to search for such options?” Globe Health reporter Kelly Grant has the answer:

“The answer to this question varies depending on where in Canada you live. But since you live in Ontario, let’s start there.

In Ontario, publicly funded home care is co-ordinated at the local level by organizations called Community Care Access Centres, or CCACs. There are 14 such organizations across the province. To figure out which CCAC is closest to you, visit this website , which has a handy map and a postal code search function to guide you to the right CCAC, or you can call a central number from anywhere in the province: 310-CCAC.

Once you connect with your local CCAC, the organization will assign your parents a care co-ordinator who will help you – and them – navigate the system. What happens next depends on your parents’ needs, according to Dipti Purbhoo, the senior director of client services at the Toronto Central CCAC.

If, for instance, your parents are still in good health but are having trouble cooking for themselves, the CCAC could provide a solution over the phone.

“That might be a simple, straightforward referral to their local Meals on Wheels provider,” Ms. Purbhoo said.

If your parents’ needs are more complex, the CCAC will dispatch a care co-ordinator to their home to conduct a comprehensive assessment of their health.  They will find out answers to questions such as: Do they need limited nursing care? Physiotherapy? Help with medications? Help with bathing?

Working with you and your parents, the care co-ordinator will determine what kinds of services they need and how often they need them. The CCAC will then either deliver the care directly or enlist one of the agencies it has on contract, such as the Victorian Order of Nurses or ParaMed.

How much would all this cost you or your parents?  “If someone does qualify for publicly funded home care, it is fully funded by the government,” Ms. Purbhoo said. “Now that doesn’t mean people can’t privately purchase additional hours of support if that’s what they feel is important for them. We have families who choose to do that.”

Some people purchase extra private care because they want more help than what the CCAC has deemed necessary, which has been a source of complaint about some CCACs in Ontario, especially given how hard the provincial government is working to keep seniors out of more expensive hospital and nursing home beds. Home care is the one area of Ontario’s health-care budget that is going up significantly ever year, and that’s by design.

If your parents’ health deteriorates to the point where they can no longer stay at home, you can also ask the CCAC for help. The organization co-ordinates entries into the province’s nursing homes too.

For people living outside Ontario, the best place to start is your provincial’s government’s home or community care website:

British Columbia
Nova Scotia
New Brunswick
Prince Edward Island
Newfoundland and Labrador
Northwest Territories

Follow Kelly Grant on Twitter, and revisit our column: Home care is where the heart is

Why don’t Canadian death certificates show cause of death?

On Twitter, reader @TishHeaven asked: “Why doesn’t cause of death appear on Canadian death certificates?” She wanted to know as part of her quest to learn more about her family medical history. Globe reporter Josh O’Kane investigated, and found the answer is complex.  Death certificates in Canada are issued by the provinces and territories, so O’Kane reached out to all 13 of the agencies responsible for administering them. Here’s what he learned:

It comes down to privacy of personal information. You’re right –  a relative’s cause of death is important to learn more about your medical history. But because the cause of death is a component of a deceased person’s own medical history, it’s covered by the same kinds of privacy laws that exist to protect the medical records of the living.

I heard back from the governments of Yukon, British Columbia, Alberta, Manitoba, Ontario, Quebec and New Brunswick before this article’s publication. Confidentiality of medical records was the universal theme in restricting information about cause of death on publicly available death certificates.

“We operate within a number of different privacy regulations,” said Cynthia Vukets, a spokesperson for Ontario’s Ministry of Government and Consumer Services, in an interview. That ministry oversees Service Ontario – which in turn oversees the province’s administration of death certificates. “There’s a certain amount of personal information that is available to the public, and the rest is covered under privacy laws.”

But there is a lesser-known document, not available to the public, that a small group of people close to the deceased can request. Often called a “Medical Certificate of Death,” it’s usually filled out by a doctor and does include the cause of death. In most cases, next-of-kin family members can apply to their province’s Vital Statistics agency for a copy of this. It’s best to reach out to your province’s agency directly to see if you’re eligible as next of kin.

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What are the best exercises to strengthen the core and improve posture?   

Reader Ann Ranson asks: “What are the best exercises to strengthen the core and improve posture?” Kathleen Trotter, Globe Health‘s fitness expert, says it’s equally important to know which exercises are conducive to “anti-posture.”

The worst offender is any abdominal exercise where you curl your body forward – think crunches and bike kicks because these reinforce a hunched posture. I also consider them “anti-posture” because crunches primarily work the superficial rectus abdominals (a.k.a. “the six pack”), which means that they don’t train the entire core or help support the spine.

The other exercises that don’t promote good posture are chest exercises like the push-up and bench press. If your chest becomes stronger than your upper back your shoulders will be pulled forward into a rounded posture.

Don’t panic: I am not arguing that you should avoid working your chest or doing crunches. But I advise picking functional core exercises like planks and bird dogs over crunches, and prioritize strengthening your upper back over your chest. If you do an “anti posture” exercise, no problem – but make sure you also do a minimum of one, but ideally two, “pro posture” exercises.

My advice for a “pro posture” upper body routine:

1. Stretch out your chest – tight chest muscles will pull your shoulders forward. Try lying face up on a foam roller for two minutes after every chest workout, and ideally nightly before bed.

2. Strengthen your upper back muscles. A strong upper back will help you stand tall. Consider doing two upper back exercises for every one chest exercise. For example, if you do push-ups, do rows and reverse flys.

Here is my tutorial for one exercise that works both your legs and upper back:

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