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A recent study involving 3654 people followed for eleven years sheds startling new light on the quotation "But if thine eye be evil, thy whole body shall be full of darkness". Researchers found that the presence of mild macular degeneration before age 75 increased the risk of dying during the 11 year period by 50%. If one had advanced macular degeneration the risk of an early death was increased by a shocking 250%. Yes, in this study, advanced macular degeneration increased the likelihood of dying during the study by 2.5 times. The association in persons younger than 75 years remained similar after further adjustment for triglyceride level, fibrinogen level, educational level, and walking disability.
In my opinion, evidence is mounting that chronic inflammation as evidenced by subtle changes in ones eyes are a marker of systemic wide dysfunction that leads to heart disease and other problems which result in illness, premature disability and death. So much attention is being given to the latest high tech advance to treat late stage macular degeneration when our emphasis must be redirected to preventing these problems starting from childhood. Diet, exercise, maintaining proper lean body mass, and appropriate dietary supplements are my recommendation for ocular health and general wellbeing. Truly, the eye is a window to the inner workings of the body and beyond-"if thine eye be evil, thy whole body shall be full of darkness", as confirmed by this recent report Visual Impairment, Age-Related Macular Degeneration, Cataract, and Long-term Mortality Arch Ophthalmol. 2007;125:917-924.
I recommend looking over the many posts on this site over the last year or so to find additional useful information to educate and encourage you in your efforts to maintain and optimize your health and wellbeing.
Michael A. Mong, M.D.
Ophthalmologist
Eye Physician and Surgeon
Grapevine, Texas
Dr. Richard K. Bernstein, the author of Diabetes Solution, weighed in on the new drug Symlin or Amylin. In his words this might be a "Wonder Drug" for the diabetic. Learn what he has to say:
It appears that higher blood levels of Vitamin D can lessen the risk of early forms of macular degeneration. The findings were reported in the May 2007 issue of the Archives of Ophthalmology. This is a very important study and adds to the large body of research that points to the fact that Vitamin D is an essential compound, and low Vitamin D is related to many diseases. Of note, even modest increases in Vitamin D levels showed a protective affect, lowering the risk of macular degeneration by 36%. Most labs list the lower limits of normal for Vitamin D to be between 20 to 25 ng/mL. In this study patients in the lowest level of Vitamin D of less than 16.8 ng/mL had a relative risk of 1.0. Levels between 16.8-21.6 ng/mL had a risk of 0.97, not much difference. At levels of 21.6-27.24 the relative risk was 0.75 or a 25% decrease. From 27.24-33.65 the risk was 0.70, and greater than 35 the relative risk was 0.64 or a 36% decrease.
Now here is what I think is exciting and most significant. Many experts, such as those at the Vitamin D Council are suggesting that all of us should have our Vitamin D levels checked and maintain levels of at least 35 ng/ml and up to 50-80 ng/ml. These levels can not generally be obtained with diet alone and one usually needs supplementation to maintain these levels throughout the year. I would strongly recommend that anyone with macular degeneration have their Vitamin D level checked and work with their doctor to bring their level into the upper end of the normal range. I might also suggest that one might want to read a bit more about Vitamin D at the Weston A price Founation.
And now Vitamin D and Macular Degeneration
Michael A. Mong, M.D.
Ophthalmologist
Grapevine Texas
I will be hosting another in a series of teleseminars with Dr. Richard K. Bernstein, M.D., a leading expert in the field of diabetes controll and prevention. Please join us on Tuesday evening at 7:00 PM Central for an information packed hour. Sign up to receive information via e-mail on how to join the call at http://www.askdrbernstein.com.
Michael Mong, M.D.
Ophthalmologist
Grapevine, Texas
Dr. Richard K. Bernstein has just released his updated classic Diabetes Solution. Listen below to what Dr. Bernstein has to say in his new book about inhaled insulin. Learn what Dr. Bernstein sees as the potential drawbacks, complications, side effects, and possible best uses for the inhaled insulin Exubera. Dr. Bernstein reads from his new book on the topic. Hope you enjoy his insights as much as I have.
Michael A. Mong, M.D.
Ophthalmologist
Grapevine, Texas
Run time 4:30 minutes
I am happy to announce that we will be having our 4th in a series of teleseminar with Dr. Bernstein on Tuesday February 27th at 7:00 PM Central time. Dr. Bernstein has completed the latest revision of his best seller, Diabetes Solution, which will be out soon. Look for more details about the call as they become available. In the mean time. Check out our Apil 2006 call at http://askdrbernstein.com/resources.html
Below are minimum recommendations for exercise in anyone without significant cardiac or orthopedic conditions. Of course check with your doctor first.
Michael Mong, M.D.
Ophthalmologist
Grapevine, Texas
If death was not bad enough, now blindness is a possible complication of obesity and it’s treatment. A series of patients have recently been identified who presented with Vitamin A deficiency from several months to 18 years after gastric bypass surgery. With the increasing frequency of the procedure, both patients and healthcare providers need to be aware of the potential for Vitamin A deficiency in patients who have had any number of surgeries for obesity as well as other surgeries such as liver transplants. I myself identified a young man with severe Vitamin A deficiency after a liver transplant. It would appear that the complaint of night blindness is the most common presentation as it was in this patient as well as the four patients recently reported by researchers from Texas.
So, another good reason to look carefully at one’s diet and lifestyle, avoid the Metabolic Syndrome X, gastric bypass surgery,and purpose to maintain an ideal body weight.
Michael Mong, M.D.
Grapevine, Texas
Yet another report that shows a 70% decrease in the progression of macular degeneration in patients who report even modest levels of routine exercise. Imagine that, the mere fact of regular exercise was shown to reduce the chance of serious vision loss in a group of several thousand patients. Exercise may help protect against age-related macular degeneration (AMD), according to the results of a large cohort study published online in the October 31 issue of the British Journal of Ophthalmology.
"These data show a protective effect of physical activity for incident exudative AMD, independent of body mass index and other confounders," the authors write. "These data suggest a possible modifiable behavior that might be protective against developing AMD."
Longer life, less diabetes, fewer Metabolic Syndrome X symptoms, and now less vision loss, are all associated with increased physical activity and increased muscle mass. Now, purpose to exercise 4 to 5 times a week regularly as your health allows. For those of you that are diabetics, I would strongly suggest checking out resources on this blog from Dr. Richard K. Bernstein. He has excellent materials you can view here. Listen to informative audio programs from him here.
Michael Mong, M.D.
Ophthalmologist
Grapevine, Texas
A recent research report from Finland highlights why I have started this Blog and why I am providing information about Metabolic Syndrome X, diabetes, obesity, and related issues that negatively impact ocular health and general well being. This study reported in a November 2006 issue of Lancet. 2006;368:1673-1679 confirms previous work that indicates that changing peoples lifestyle can reduce the risk of developing Type 2 diabetes by close to 60%. In the Finnish study, the effect of lifestyle interventions reduced the risk of becoming a diabetic by 38% and the effect lasted for a three year period. In a similar report found in the New England Journal of Medicine, February 2002 called the Diabetes Prevention Program Study, showed a reduction in type 2 diabetes by an impressive 58%. This was compared with a lesser reduction with a common medication called metformin. A third medication, Rezulin was also used in the study but had to be stopped due to liver damage in the study participants.
"From a public health point of view there is an important message: an intensive lifestyle intervention lasting for a limited time can yield long-term benefits in reducing the risk of type 2 diabetes in high-risk individuals," say Lindstrom and colleagues.
The studies show that helping patients address the fundamental issue (and I must say the principle issue) of diet and exercise is the most effective way to prevent type 2 diabetes. It is more effective than the search for the proverbial "silver bullet". If one’s diet and exercise routines are not what they need to be, medications merely offer a short term "fix" to make one’s lab work look better but lead to increases in weight, hypertension, fatigue, frustration, and a general decline in health. As an ophthalmologist, I also know that diabetes and other Metabolic Syndrome X symptoms such as hypertension and elevated cholesterol and triglycerides lead to destruction of the circulation in the eye and eventual retinopathy and thus damage to the eye.
It make sense doesn’t it. If the problem stems from inappropriate diet and insufficient exercise, the fix is a better diet and increased exercise. Medications at best are a bridge or crutch for most patients to get them started. If you break a leg, you need a cast and a set of crutches. The will heal if given half a chance, the cast comes off and you get rid of the crutches. What would happen to the leg if the cast and crutches are added and never removed? The answer is obvious, nothing good. Likewise, to rely on medications to make up for poor diet and exercise is a prescription for long term failure. Besides, working with patients to address these "lifestyle" issues work the best as these studies show.
I have had increasing success over the last several years at helping my patients loss weight, reduce their blood sugar and HgA1c levels, and even reduce or eliminate medication by taking a few extra minutes to address these key issues. Many patients, if given the right information, are very able and willing to make significant changes in their diets and exercise. It takes a bit more time, but it is the only long term solution for most patients who want to optimize their health and wellbeing.
So, the reason for the blog and effort is to educate interested individuals about the critical issues with respect to Metabolic Syndrome X, diabetes, and the eyes and attempt to effect longterm and lasting changes for the best. I sincerely hope many individual will find this effort of benefit.
Michael Mong, M.D.
Grapevine, Texas
