Be Well _ October 2011 Issue

Feature: Guess the Top Health Concerns for Men & Women

Guess the Top Health Concerns for Men & Women

We think we’re invulnerable when we’re young, but when we reach our late 30s, health concerns start cropping up. Major health concerns vary by age, notes Cleveland Clinic internist Raul Seballos, MD, Vice Chair of Preventive Medicine.

“Men in their 60s worry more about prostate cancer, while men in their 50s are more concerned about heart disease or ED (erectile dysfunction),” he says. “Women in their 50s are more concerned about menopause, while osteoporosis becomes a concern for women in their 60s.”

See if you've got a handle on the top health concerns for men and women. Some are unique to men, some are unique to women, and some are shared.

Here they are, in order:

Top health concerns for men
  1. Prostate cancer
  2. Heart disease risks, including high blood pressure and high cholesterol
  3. Erectile dysfunction
  4. Weight management with age
  5. Diabetes
  6. Stroke
Top health concerns for women
  1. Breast cancer
  2. Heart disease risks, including high blood pressure and high cholesterol
  3. Osteoporosis
  4. Menopause treatment options
  5. Weight management with age
  6. Diabetes
  7. Stroke

For health issues affecting both men and women, Dr. Seballos offers these tips:

Heart disease/high blood pressure/high cholesterol

If heart disease runs in your family or if your blood pressure or cholesterol levels are high, ask your doctor about taking medications to lower your blood pressure and cholesterol levels, and whether a daily aspirin might help. Your doctor will keep tabs on your cholesterol levels and blood pressure, and can order cardiac stress tests if any concerns about heart disease arise.

Weight management with age

As we age and our metabolisms slow down, it’s smarter than ever to right-size our meals by eating smaller portions of healthier food. Exercise also becomes increasingly important, to maintain flexibility and mobility. Both of these measures will help to prevent type 2 diabetes, arthritis and other weight-related problems.


Nearly 79 million Americans have prediabetes (elevated blood sugar), the precursor to type 2 diabetes. Type 2 diabetes can lead to heart disease, stroke, kidney failure, blindness and loss of limb. If you have prediabetes, studies show that a healthier diet and increased activity can restore your blood sugar to normal and prevent diabetes. Controlling your weight, cholesterol and blood pressure are critical, and if you smoke, it’s more important than ever to quit.


Become familiar with warning strokes or transient ischemic attacks (TIAs). If you or someone you know develops weakness or numbness of the face, arm or leg(s), confusion, speech or comprehension problems, vision loss, dizziness, or difficulty with walking, balance or coordination, call 9-1-1. Immediate treatment in the emergency department with clot-busting medication can be lifesaving.

For men with the following health concerns, Dr. Seballos has this advice:

Prostate cancer

Schedule a prostate screening, including a simple blood test of PSA levels, every year starting at age 50. If your father or brothers developed prostate cancer early or if you are African-American, start screening at age 40 or 45. Fortunately, prostate cancer is highly curable when caught early. Today, not every man with a high PSA level has to have surgery or radiation therapy. Depending upon age and risk factors, surveillance, or “watchful waiting,” may be recommended.

Erectile dysfunction

ED is very common, especially if you have developed diabetes or have had your prostate removed. In addition, men with ED are 1.6 times more likely to suffer a heart attack or stroke. That’s why it’s important to discuss your cardiovascular risk factors with your physician before asking for one of the ED medications.

For women with the following health concerns, Dr. Seballos has these pointers:

Breast cancer

In your 20s and 30s, get a clinical breast exam by a health professional at least every three years; after age 40, get an exam every year. Breast self-exam (BSE) is an option in your 20s and beyond, but know its benefits and limitations, and report any breast changes to a health professional right away. At age 40, start yearly screening mammograms, and continue them for as long as you’re in good health. Have any abnormality on a breast exam or mammogram checked out right away; if an abnormality is found, you may need more frequent mammograms. If there is breast cancer in the family, you may need BRCA gene testing. Women with the BRCA 1 or BRCA2 gene mutation are at very high risk of breast cancer.


Exercise is your friend when it comes to bone health. Being physically active, and getting adequate calcium and vitamin D in your diet or through supplements are some of the steps you can take to prevent bone fragility and fractures. It’s also important to avoid smoking, which weakens your bones.

Menopause and its treatments

Menopause does bring “change,” but talk to your doctor if symptoms arising from changing female hormone levels become troublesome. Hormone replacement therapy (HRT) can help some women manage hot flashes and night sweats, mood swings and other problems. A risk profile will determine whether or not HRT is right for you.

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Tip: Expand Your Whole-Grain Horizons

Tip: Expand Your Whole-Grain Horizons

Leave foods made with white flour in the dust. Besides whole-wheat flour, crackers, bread and pasta, try gluten-free brown rice products (add ground flax or chia to boost fiber content). Experiment with quinoa, a nutty-flavored whole grain and complete protein. Snack on popcorn, another whole grain, but keep it healthy by dusting with cinnamon, Italian herbs or chili powder instead of salt – and skip the butter.

Be Well – October 2011 Issue

Feature: Atrial Fibrillation – Dispelling 6 Myths

Feature: Atrial Fibrillation – Dispelling 6 Myths

Butterflies in the stomach can signal excitement or nervousness. But fluttering in the chest can signal a short circuit in the heart’s natural electrical wiring, or arrhythmia.

Atrial fibrillation (A-fib), the most common arrhythmia in the United States, is an off-speed rhythm in the heart’s upper chambers.

A-fib may be linked to high blood pressure (hypertension), coronary artery disease, heart valve disease, heart failure, chronic lung disease or a clot in the lung (pulmonary embolism). But in 10 percent of cases, A-fib is not associated with any other disease.

A-fib can cause the following symptoms:

  • Heart palpitations
  • Dizziness
  • Fatigue
  • Chest discomfort
  • Shortness of breath

However, up to 30 percent of A-fib episodes cause no symptoms at all.

Below, Walid Saliba, MD, Director of the Electrophysiology Lab and the Center for Atrial Fibrillation in Cleveland Clinic’s Heart & Vascular Institute, addresses some common myths about A-fib:

Myth: If you have just one or two episodes of atrial fibrillation, it probably won’t come back.

Fact: Atrial fibrillation is almost always a chronic disease, and lifelong treatment is needed to avoid stroke and heart failure. Early on, episodes of A-fib tend to be sporadic. This is called paroxysmal atrial fibrillation. Over time, episodes usually become more frequent and last longer. Up to 30 percent of A-fib episodes cause no symptoms at all, but treatment is still needed to prevent stroke.

Myth: Cardioversion can stop atrial fibrillation for good.

Fact: Electrical cardioversion can “shock” the heart back to normal rhythm, but does not guarantee that normal rhythm will be maintained. Medication will be needed to maintain normal heart rhythm and prevent stroke. “One to three types of medication are used in combination: those that control heart rate, such as beta blockers; anti-arrhythmic drugs to maintain normal rhythm; and anticoagulants to prevent blood clots,” says Dr. Saliba.

Myth: Your medicine isn’t working if you still get episodes of A-fib.

Fact: “Medication will not cure A-fib, but it will relieve symptoms by decreasing the frequency and duration of episodes,” says Dr. Saliba. Reducing a patient’s episodes from frequent to occasional is considered successful treatment — as long as the symptoms don’t trouble the patient. However, he notes that medications tend to become less effective over time and, when that happens, catheter ablation is more likely to help.

Myth: Catheter ablation won’t help you if it doesn’t ‘take’ the first time.

Fact: Sometimes more than one catheter ablation procedure— in which radiofrequency energy is used to interrupt faulty electrical pathways in the heart — is needed to get the best result. The cure rate of 70 to 80 percent after one catheter ablation goes up to 90 percent after a second or third one if there is no underlying heart disease. When A-fib is chronic or when there is underlying heart disease and the upper filling chambers of the heart are severely enlarged, maze surgery may be recommended.

Myth: If ablation works, you can stop taking Coumadin®.

Fact: “The decision to continue or stop Coumadin, an anticoagulant that requires frequent blood tests, depends upon the risk factors for stroke rather than on the success of the ablation,“ says Dr. Saliba. Doctors calculate stroke risk in patients with A-fib using a formula based on the following factors:

  • Congestive heart failure
  • Hypertension
  • Age over 75
  • Diabetes
  • A past stroke
Myth: If you take medication for A-fib and no longer have symptoms, you’re cured.

Fact: “A-fib cannot be cured, but ablation or surgery offers the closest possible symptom relief. There is no rush to undergo ablation if you are doing well on medication,” says Dr. Saliba. Ablation is safe even for patients in their 60s and 70s.

Episodes of A-fib can be triggered by stress, exercise, sleep apnea and hot flashes; talk to your cardiologist about any concerns. Meanwhile, to minimize symptoms of A-fib and to improve heart health, Dr. Saliba advises patients to:

  • Quit smoking
  • Drink in moderation
  • Ask about exercise guidelines
  • Limit caffeine use
  • Read labels on cough and cold medicines to avoid those containing stimulants
  • Seek treatment for sleep apnea
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Be Well – October 2011 Issue

Your Free Guide to Lung Cancer

Your Free Guide to Lung Cancer

Learn about lung cancer, mesothelioma and other chest tumors, and how they are diagnosed and treated. Discover how Cleveland Clinic patients benefit from coordinated care by specialists from many disciplines.

Recipe: Vegetable Cream Cheese Pinwheels

Recipe: Vegetable Cream Cheese Pinwheels

Make delicious pinwheels from whole wheat tortillas, light vegetable cream cheese and a healthy array of veggies.


2 8-ounce containers light vegetable cream cheese, softened
4 whole-wheat tortillas (12-inch size)
2 green onions, minced
½ cup red bell peppers, diced
½ cup celery, diced
¼ cup black olives, drained and diced
¼ cup carrots, shredded

  1. In mixing bowl, blend cream cheese and green onions.
  2. Spread cream cheese blend over each tortilla evenly. Sprinkle celery, red bell peppers, black olives and carrots on top of cream cheese spread.
  3. Roll up each tortilla tightly.
  4. Wrap tortillas in plastic wrap and chill for two hours.
  5. Just before serving, slice each tortilla roll into 1-inch pieces.

Makes 48 servings


Per serving:
48 calories
2 g fat
1 g saturated fat
2 g protein
5 g carbohydrates
5 mg cholesterol
89 mg sodium
25 mg potassium
0.6 g fiber

Recipe from our Children's Hospital Pediatric Nutrition Support Team

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Be Well – October 2011 Issue

Let's Move It! Free Mobile App

Let Cleveland Clinic and your mobile phone keep you motivated. More than just a pedometer, our free mobile app offers walking challenges, a calorie tracker and videos to encourage and inspire.