Thursday, August 30, 2012

Taking a Knife to your Baby's Penis

Reports like this reinforce my belief that many ancient traditional or religious practices are science-based and good for your health.  Here are some benefits of male circumcision:
- Reduced transmission of some sexually transmitted infections, including HIV
- Reduced transmission of HPV viruses that cause cervical cancer in women
- Prevention of urinary tract infections
- Prevention of penile cancer
None of these known benefits applies to the misnamed female "circumcision", which does not involve removal of foreskin, but resection of the clitoris entirely...but that's a whole different post...
Peace & health,
Dr. Safiyya

Evidence Favors Male Circumcision, But Parents Still Must Choose, Says AAP

Study: Increase in Neonatal Circumcisions Could Save Billions

By Matt Brown

Posted: 8/28/2012, 12:25 p.m. -- According to the American Academy of Pediatrics (AAP), the latest evidence shows (4-page PDF; About PDFs) the benefits of newborn male circumcision outweigh the risks.
Doctor circumcising newborn
The AAP, in an updated policy statement published Aug. 27 in Pediatrics, said that a multidisciplinary panel evaluated the evidence and determined that circumcision's benefits -- prevention of urinary tract infections, penile cancer and transmission of some sexually transmitted infections, including HIV -- justify access to the procedure (i.e., health insurance coverage) for families who choose it.

Previously, the AAP did not recommend for or against the procedure, citing insufficient evidence to make a determination in its earlier policy, which was published in 1999 and reaffirmed in 2005.

According to Susan Blank, M.D., chair of the AAP's statement and technical report task force, recent scientific research shows clearer health benefits to the procedure than had been demonstrated previously, but the choice still rests with parents.

"Ultimately, this is a decision that parents will have to make," Blank said in an AAP press release. "Parents are entitled to medically accurate and nonbiased information about circumcision, and they should weigh this medical information in the context of their own religious, ethical and cultural beliefs."

The AAFP Commission on Health of the Public and Science's Subcommittee on Clinical Practice Guidelines will review the update, as well as the accompanying technical report, in the coming months. Family physician Lesley Atwood, M.D., served as the AAFP's liaison to the AAP task force.

The Academy's position paper on neonatal circumcision, which was updated in 2007, does not recommend for or against the procedure and states that although the literature available at the time was "conflicting or inconclusive," the decision whether or not to circumcise generally comes down to nonmedical preferences. Therefore, physicians should discuss the potential harms and benefits of newborn male circumcision with all parents or legal guardians considering the procedure.

The AAP's shift in position may strengthen circumcision proponents' call to reverse the steadily declining rates of infant male circumcision in the United States. An Aug. 20 report in the Archives of Pediatrics & Adolescent Medicine indicates that circumcision rates have declined from 79 percent to 55 percent in the past two decades -- a drop that has coincided with reduced insurance coverage for the procedure.

Eighteen states currently do not provide Medicaid coverage for infant circumcision, and private third-party payers also are decreasing coverage, the study notes.

According to a release that accompanied the study, if this trend continues and rates decline to European levels, net present value of additional health care expenditures in the United States would exceed $4.4 billion in the next 10 annual birth cohorts.

The study, which indicates that the added expenses stem from higher rates of sexually transmitted infections and related cancers among uncircumcised men and their female partners, estimates that the current decline already has cost the United States more than $2 billion.

"Our economic evidence is backing up what our medical evidence has already shown to be perfectly clear," said Aaron Tobian, M.D., Ph.D., senior study investigator and health epidemiologist and pathologist at the Johns Hopkins University School of Medicine in Baltimore. "There are health benefits to infant male circumcision in guarding against illness and disease, and declining male circumcision rates come at a severe price, not just in human suffering, but in billions of health care dollars as well."

Thursday, August 16, 2012

Controlling your Genetic Destiny

Unlocking the Potential of your DNA

  A few months ago I read an interesting article in the publication my med school alma mater sends outlining important advances in the field of epigenetics.  Most of us have heard about the Human Genome Project and perhaps understand the basic idea of how DNA works.  You know that DNA makes us who we are.  But have you ever wondered how all the cells in your body carry the same DNA as the first, but vary widely depending on location and function?  For instance, the cells in your stomach are pumping out acid strong enough to eat through nails, yet the cells in your eyeball have enough intelligence not to do that.  How is it that when a liver cell divides and makes a copy of your entire genome, it remembers that it is still a liver, not a lung?  Well the science that explains these observations is called epigenetics, literally “above the genes”.
This is the science of turning genes on and off on your DNA.  A good analogy I've read is that DNA is what is written in ink, your epigenome is what is written in pencil.  It determines the appearance, fate and function of the various cells, and ultimately the organism as a whole.  The bad news and the good news about this epigenome is that it is very responsive to the conditions in and around your body. 
It has been determined that the environmental conditions that one is subjected to are just as important, if not more important, than what is coded on the DNA itself.  Thus identical twins, literally clones of one another, can be so different in terms of the way that their genes are actually working, that one dies young of cancer, while the other enjoys a long, healthy life.  The difference between the two being factors such as diet, drug and toxin exposure, smoking, stress, physical activity, and any number of other human experiences.  Even more fascinating, these experiences and their effect on how the DNA is expressed can be passed on from one generation to the next. 
Furthermore, experiments have shown that you can reverse a harmful pattern of DNA expression in an animal’s offspring, by changing something as simple as the foods being consumed.  Check out this video from Nova describing how this was done with mice being fed methyl rich foods (Hint: navy beans, milk, & whole wheat bread are packed with methyl rich nutrients...)

There was even an article in Time magazine in January 2010 describing an observational study in Sweden, where it was found that boys who experienced just one abundant harvest and enjoyed just one gluttonous winter, produced sons and grandsons whose lives were curtailed.  When they controlled for certain socioeconomic factors, they found that this difference in lifespan was a whopping 32 years!  Similar lifespan reductions were observed in females.  As a physician who is all too aware of the overwhelmingly unhealthy diet of the men, women and children in our communities, this literally brought tears to my eyes.  If a single winter of a child overeating sentenced their grandchildren to an early death, where does that leave us? 
On the bright side, it has been shown that mental function in animals can be improved from one generation to the next with exposure to memory problems, toys, exercise, & extra attention.  So learn, live, love, laugh...and move!

Who knitted our DNA?

As I've spent the past month fasting for Ramadan, I have reflected on the
possibility that all of the prayers, fasting, restriction and other ways of devotion shared by many faiths around the world are a divine way of guiding us towards a heavenly state of body and mind while we live.  After all, if we were made in the image and likeness of God, maybe we share some of His DNA.  Following the commandments of the Creator might be doing something to our DNA that makes us more like Him.

I've never smoked, but I'm sure there were many things I could have done better...
 Perhaps that's a leap, but I believe there are reasons behind many religious practices that are based in science and lead to the spiritual outcome many of us are seeking.  In any case, it's good to know we can control our genetic destiny to a degree.  It's hard to avoid every environmental insult, but knowing the choices we make have a lasting effect has left me more motivated to acquire & maintain healthier habits.  I only wish I'd known this before I had my children.  I might have been even more careful about the epigenes I was passing down!

Peace & health,

Dr. Safiyya

Thursday, July 12, 2012

Superwoman Syndrome- Ebony Magazine feature

SUPERWOMAN SYNDROME:Are Black Women Killing Themselves to be Strong?

Shahida Muhammad explores how Black women's need to keep it all together can tear them apart
Are Black Women Killing Themselves to be Strong?

I am thrilled to have been featured as a commenting medical expert in this excellent new article featured in Ebony . The author discusses a cultural phenomenon among many women: Superwoman Syndrome.  Despite my own advice, I admittedly have not yet mastered the balancing act of wearing many different hats, but only after putting on my own oxygen mask first.

Everyday I encounter women whose health has declined as a result of self-neglect.  On a purely logistical level, it can be difficult to make healthy lifestyle choices on stolen moments of time and a shoestring budget.  Many women work outside of the home, often without a mate.  This is one reason for the proliferation of unhealthy "convenience foods" that provide a time savings at a low price point (though I'm convinced they are NOT cheaper overall).  Then there are the technological advances that reduce how much physical exertion one has to do to get through the day.  That creates yet another thing for superwoman to squeeze in- time to exercise.

After a long day at the office, some working women with families stand on either side of a judgmental fence.  On one side, those whose cultural norm has them rushing home to make dinner from scratch.  On the other, those who were molded to believe they're too smart for such a menial task.  She may fear being ridiculed for "slaving in the kitchen" to prepare a good meal for her family. Both the stressed-out chef and the takeout junkie might be at increased risk of heart disease, the #1 killer of women. 
"...I was going through some personal challenges. I showed up to work one day and a colleague said "Shabazz! What happened to your face?!" I'd developed a pretty bad case of acne almost overnight."
We all have crunch situations from time to time. But when our bodies are operating in a chronically stressed state, there can be dire health consequences. Not surprisingly, an unhealthy lifestyle can lead to weight challenges and the associated health conditions of hypertension, diabetes, joint pains, or depression.    Stress can also increase the risk of premature birth and other pregnancy complications.  Chronic stress reduces your cognitive (thinking) ability. It results in digestive illnesses like irritable bowel syndrome, exacerbates respiratory illnesses like asthma and allergies, and can cause skin conditions like chronic hives and acne.  During my residency training, I was going through some personal challenges. I showed up to work one day and a colleague said "Shabazz! What happened to your face?!" I'd developed a pretty bad case of acne almost overnight.

When I have a patient who has listed a number of seemingly unrelated or unexplained physical symptoms, I always consider the possibility that stress is at the root of those symptoms.  Unfortunately, so many women have been too busy to even do basic health maintenance or surveillance, so there are many times when a serious illness has gone undetected.  

What's a Girl to Do?
- Look at your own heart and take a few notes. While the heart beats non stop and keeps the rest of the body alive, the very first blood vessel is the coronary artery.  If the heart doesn't get taken care of first, the rest of your body won't survive.
- Become more organized with your time and space.  Learn to manage your finances. Much of our daily drama could be avoided or reduced with proper planning.

- To help relieve stress, find a healthy activity that is also a stress reliever.  Exercise can be as effective as medication for treating depression and relieving stress.  It is the only way to build new brain cells.  Find ways to do your everyday tasks in a way that requires more movement.  Stop asking your children to pass you this and that.  Get up and do it yourself just for the opportunity to move.

- Try gardening. When I'm tinkering around in my garden, I can literally feel any tension releasing from my chest.  It's also a great way to get yourself and your family more inspired to eat healthy, fresh food.  An herb garden is super easy to start and can add pizazz to your home-cooked meals.

- Pray. Call on the healing power and guidance of the Creator.  I believe we have all been given the ability to use our minds to solve problems...without doing anything illegal or immoral.

Peace & health,

Dr. Safiyya

Sunday, June 17, 2012

Father's Day- How's the Health of the Men in Your Life?

Happy Father's Day!

As I wake to what looks like another beautiful day on tap, I look forward to helping my husband feel a little more special today, but can't help wishing someone else was here to celebrate.  His name is Jeremiah (aka Jamal Shaheid Muslim) Shabazz.  That's my Daddy.  Unfortunately, we no longer celebrate Father's Day together.  My son & daughter (who looks just like him) never gave him a big squeeze around the neck, never had him pinch their noses.  He never puffed out his cheek with air and make a loud toot as they kissed it, or shared with them one of his amazing stories.  Nope, they missed all of that because his health failed him before they were even born.

My daughter & My Daddy

Now, my dad was kind of old when I was born.  Even some of my earliest memories involve him asking how old you have to be to get a senior citizen's discount.  My sister would often be close to fighting people who told her her granddad was waiting for her after school :) But still, as I have learned more and more about health and life, I have decided 70 is way too young to die.  In fact, when reviewing people's family history if they tell me a parent died of "natural causes", I always press for more info.  There is nothing natural about dying before the age of 100 (at least).  People die of some type of accident or injury, or they died of an illness.

Fortunately, if you look at the most common causes of death, most, if not all are preventable.  According to the CDC, the leading causes of death in America are heart disease, cancer, lung disease and stroke.  The list is similar for ethnic group subsets.  The risk of all of those can be dramatically reduced by following a healthier lifestyle- one that results in a slim waistline, does not include cigarettes (which happens to give you a slightly fatter wallet), that is high in fresh fruits and veggies but low in fat, meat, and processed food.  For blacks and Latinos in particular, the statistics on other health indicators help you understand why we tend to die younger.  Here is just a snippet:

Black men who currently smoke: 24.4%
Black men who are obese: 38.1%
Black men with hypertension: 37.6%
U.S. adults with pre-diabetes: 35%
Latinos & Blacks with diagnosed diabetes: ~12%

My dad had many healthy habits.  He did not smoke, he jogged 5 miles nearly every day, and ate lots of home cooked meals including the vitamin & protein packed navy bean soup almost every day.  However, becoming relaxed with his 20 year pattern of eating one meal a day led to overindulgence that resulted in weight gain in his 40's.  He was diagnosed with diabetes by the time he was in his early 50's.  There are things I can look back on that I now know were clues that he did not have good control of his condition.  He urinated frequently, a tell-tale sign your sugar is too high.  He had a sweet tooth.  We all were under the false impression that his diabetes wasn't that serious because he didn't take insulin.  He didn't even own a glucose meter to monitor his sugar levels.  After jogging, much of the benefit of his vigorous exercise was undone with a fat & sugar packed meal soon after.  He ate beef and lamb more often than he should.

My Dad in his younger years, with Malcolm X & The Hon. Elijah Muhammad. An FBI report I have says he was a slender 5'10" and 160 pounds at the time.

My freshman year in college, he started having symptoms of congestive heart failure, a common complication of uncontrolled diabetes.  His heart was no longer strong enough for him to jog every day.  He was in and out of the hospital over the next 5 years.  Keeping close with the prognosis of CHF at the time, he passed away months after his 70th birthday.  I was, and still am, heartbroken.

There are a few lessons in all of this that I hope any reader can learn and some actions steps to consider.  For one, most of my patients are women.  I am not convinced that the men are only visiting male doctors, I think men are less likely to visit any doctor.  This is especially true in terms of getting preventive care.  Bleeding, swelling, or pain might send a macho man to the exam table, but without it, they might need a little nudge from someone else.  Most of the time, the women in their lives will have to take action, but there is so much power in brothers encouraging each other to get a check-up.

This week (maybe not today), pick up the phone.  Ask the men in your life if they have had a check up in the last year.  Offer to help them get an appointment set up.  Ask your dad if he would mind you coming along to one of his appointments so that you can get a sense of how he is handling any medical conditions and what you can do to help. Here are some tips on how to do this. I know it's hard, especially when we start worrying about our loved ones, but try not to brow beat him.  I can still hear my dad's voice in annoyance "I don't need you admonishing me!"  Let him know how much you love and care about him and that you want him to be present and healthy for every grandchild, graduation, wedding, etc to come.  This Father's Day, let the men in your life know you really care.  Redo your fridge & pantry to contain food choices that prolong life and encourage men to make their health a priority.

Peace & health,

Dr. Safiyya

Tuesday, June 5, 2012

'Itis & Other Mind Numbing Effects of Junk Food

A friend posted this clip of the Boondocks "The Itis" Episode on facebook.  I hope you are able to watch it in its entirety.  While there is some profanity, a number of issues are covered in the sketch which deserve serious consideration.  I imagine it was meant to be both informative and entertaining.

Many of the foods that people have come to know as "soul food" are unhealthy for both body and mind.  It doesn't take a doctor to figure out that eating foods high in fat, salt, sugar, & preservatives can make you obese, but most people don't know about the effects of these foods on the function of the brain.  Food is used to enrich some while oppressing others.  By marketing poisonous, highly addictive foods to the masses without regard for public safety, the food giants deliberately prey on the unaware. Unfortunately, it tastes sooooo gooood, most people don't realized they are being treated inhumanely.
There is ample evidence supporting my strong belief that eating the wrong food causes cognitive impairment.  To avoid any misunderstanding, I will give you some other common terms for what I'm talking about. Mental retardation, intellectual disability, dementia, brain damage- you can choose the term you're most comfortable with. The fact is, the brain doesn't have anywhere else to live but in your body.  If you beat up your body with unhealthy food or an excess of any food, your brain will suffer the consequences.  The end result is a person with both a dulled level of intelligence and a low level of function in everyday life.  If you haven't come across anyone like this, you might want to evaluate your own health status. 

The brain is the master of thought and behavior.  Therefore, a poor state of your health will soon manifest itself in one's actions.  The Honorable Elijah Muhammad put this very simplistically in the timeless book How to Eat to Live
“…we prepare our own sick bed, hospital bills, and undertaker bills with what we eat and what we drink. And besides this comes a sick mind and after a sick mind comes death.”

Shortly after the movie Precious was released, a high school friend was writing about whether the image of swine sizzling in a frying pan had anything to do with the stomach-turning behavior in the movie.  Science would say it most certainly does.  Here are a few links with more information about how food effects your brain and behavior.  Yes, soda can make you violent, sugar can make you stupid, and sausage can give you Alzheimer's.  This is your brain on bacon.  Any questions?

Wednesday, May 30, 2012

Babies with Boobies? What's Next?


Are you sure which one your baby will need next?

Soy has become a pervasive food additive that is touted by the industry as a superfood. However, a number of studies have suggested harmful effects of soy on sexual development in children. One recent study in the journal, Paediatric & Perinatal Epidemiology found a 25% increased risk of early menarche (first menstrual period) in girls fed soy formula early in infancy.  In this study only 2% of the nearly 3000 girls studied had soy formula before age 4 months and the researchers were still able to pick up this difference.  In the US, 65% of babies have had formula by age 3 months and soy formulas currently make up 25% of the US formula market. Soy is praised for its estrogen stimulating effects in menopausal women, so just thinking rationally, it isn't hard to see that it would be harmful to give an estrogen stimulant to a small child for its total diet.

Less publicized studies found that soy formula in male infants may effect sexual development & preference during adolescence. Another associated soy intake with persistent sexual arousal syndrome.  Others suggest soy interferes with the absorption of calcium and other minerals needed for proper growth & development. This may be related to high levels of phytates, nutrient blocking chemicals found in soy, nuts and other beans.

The American Academy of Pediatrics advises against using soy formula unless a child truly has a medical reason why they cannot have cow's milk based formula (which is actually pretty unusual).  In fact more babies are allergic to soy than cow's milk. 

Please, please, please be more cautious about giving soy formula to infants (male & female).  Not everything marketed as food should be eaten. Everything free (ie WIC programs) still comes at a price. Eating properly is important for proper mental and physical functioning of children and adults. Breastfeeding is best.  If you must use formula, avoid using soy formulas unless absolutely necessary.  Please pass on this information to people you may know who are feeding or considering feeding their children soy formula.

Link to a summary of this article here: Early-life soy exposure and age at menarche

Peace & health,

Dr. Safiyya

Saturday, May 26, 2012

Food & Mood: Muslim Wellness & Recovery

The link below takes you to a powerpoint presentation I gave for the Muslim Wellness & Recovery Foundation's Workshop Series on May 12.

Food & Mood: Muslim Wellness & Recovery Foundation

In it, you can find information about how your dietary habits affect your mood, brain function, even addictions. Even though you don't have the narration to go along with the slides, you can get a good overview of the topic. I plan to post an update with a couple of video clips from the presentation, but have to overcome a few technical issues.

Be sure to like Muslim Wellness & Recovery Foundation on facebook and check in often for the latest updates.

Peace & health,

Dr. Safiyya