Immunizations aren't just for kids. In addition to your annual flu shot in early fall, you may need to update some other immunizations. 

SHINGLES:  Adults age 50 to 64 need a shingles vaccination. It is a 2-part vaccination. A second vaccination injection needs to be administered 2 months after the first one.  Heads-up: This vaccine can sometimes make people feel a little flu-ish for a day or two. This is because your immune system gets a little revved up by the immunization. 

TDAP (Tetanus, Diptheria, & Pertussis): This booster is needed every 10 years throughout life.  

MEASLES:  If you were immunized for measles within the years 1963 to 1967, it's possible that your measles immunity has decreased or was not developed. This is because two forms of the measles vaccination were used during that period, a "live" and a "killed" vaccine. Only the live version of the vaccine provide to be effective.  If you were immunized against measles in that period, it's a good idea to get your blood tested for measles antibodies.  Those born before 1958 were exposed to two major measles outbreaks are are assumed to be have developed immunity through exposure. 

Annual physical exams and screenings are an important part of wellness. 

The purposes of annual exams and screenings are to:

• Provide and discuss preventive care and wellness recommendations
• Detect disease that has no apparent symptoms (this is called secondary prevention)
• Evaluate efficacy and side effects of any prescription medications you are taking
• To update your clinical data, for tracking physical data trends, which point to medical health threats and progress
• Better understand your disease risks and prevention strategies.

In addition, annual physical exams are important to:

• Better personalize your medical care. Dr. Maybury will know you better and be able to interpret your medical and health data, symptoms, and signs in light of your whole context.  
• Better personalize your wellness goals and needs. When you are seen regularly, Dr. Maybury can better help you reach your health and wellness goals and track changes in your physical health. When you are better known by your physician, Dr. Maybury can help you understand how your life context is contributing to your wellness or disease risk, and how to address those issues. 

If you have not had your annual exam, please call us and schedule your appointment. 

Have you heard? Sitting is the new smoking. And it's generally true. We all sit most of the time. So we all think, It's fine! It's normal. It must be okay.  But in fact, sitting too long is bad for your health.  

American adults spend 11 to 12 hours a day sitting.  Sitting too much is not the same as getting too little exercise. Even if you get the recommended amount of exercise, prolonged sitting is still likely to be harmful. 

Research has connected prolonged sitting with the following negative health impacts, among others. 

• Increased risk of dementia -- risk increases with amount of sedentariness
• Metabolic syndrome
• ​Deep vein thrombosis
• It undoes the benefits of exercise
• Early death. There's even a name for it: Sedentary death syndrome.

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​Researchers and physicians are clear that any activity all is a great improvement over sitting, a study published in a top-rated journal found.  According to a scientist quoted in the above-linked article, "People who don't exercise can be healthier even if all they do is reduce the amount of time they sit," he said. "People who do exercise can be healthier by decreasing the time they spend sitting, too. What we are really talking about is a change in the fundamental way that we do things in society by reducing sedentary time. We've known an active lifestyle is better for a long time."

ACTIONS YOU CAN TAKE NOW: 
Research finds that really small reductions in sitting can greatly reduce the risk of disease linked to sitting.  Swapping out just 30 minutes of sitting for walking or doing light chores around the house can reduce risk of death by 17 percent. Swapping 30 minutes of sitting for more vigorous activity can reduce risk of death by any cause by 35 percent. 

• Try to balance out hours spent sitting with more active time. 
• Incorporate more vigorous physical activity (walking, biking, gardening, working out) throughout the week. The Mayo Clinic advises 60 to 76 minutes of moderately intense physical activity per day.
• Take a break from sitting every 30 minutes, for 3 or 4 minutes. Just change tasks. Please who sit for less than 30 minutes at a time have the lowest risk of early death.
• Build a new habit to integrate more activity - take the stairs instead of the elevator. Walk a few blocks before you catch Muni or BART or your Lyft.
• Switch work or coffee-shop meetings to a walk-and-talk meeting.
• Substitute activities for coffee, bar, or restaurant get-togethers with friends.
• Can you eliminate some meetings or seated entertainment time altogether? Switch from movie night to game night?​
• Stand up when you talk on the phone or watch TV.

Our first blog entry is about the negative health effects of too much sugar in the diet. This is intentional: Sugar intake is under our control, and excessive intake can cause significant health and medical problems. 

Excessive dietary sugar is a major contributor to weight gain, obesity, type 2 diabetes, and many other chronic health problems. Reducing your daily sugar intake and educating yourself about the deleterious effects of sugar on your body is one of the most important things you can do to improve your health.  

Sugar is truly addictive. Excessive consumption of sugar causes sugar cravings, which then prompt us to eat still more sugar. Consuming excessive sugar changes the hormones in our body that govern weight and liver function among other things. The fat sugar adds in our bodies leads to weight gain ,  These impacts can cause a cascade of bad health effects, including metabolic syndrome, type 2 diabetes, heart disease obesity, muscle loss, and even brain damage and reduced brain function. 

The American Heart Association (AHA) recommends a maximum of 6 teaspoons (25 grams) of added sugar a day for women and 9 teaspoons (38 grams) for men. The AHA recommends between 3 and 6 teaspoons (12-25 grams) per day for children (less for younger children).

As your doctor, I highly recommend that you reduce your sugar intake, whether you are overweight or not. Along with exercise, reducing sugar (and increasing whole foods) is one of the three most impactful moves you can make to improve your health and wellness.

​Take the 6 month challenge:  Limit your added sugar intake to 25 grams a day for 6 months. Come in and let's get your weight and vitals and a couple of labs; then come back in 6 months and find out how they have changed.  Here's some simple guidance for reducing sugar.  Ready to detox: Here's how. 

For those who want to really dig in to the latest research, I highly recommend the book, Sugar: The Bitter Truth. 

STEPS TO TAKE NOW: 

• Limit your daily sugar intake to 6 tsp or 25 grams of sugar a day.
• Eliminate sweetened beverages and juice from your diet, including sugary coffee drinks -- the ones with pumpkin or caramel in the name.
• Eliminate added sweeteners, like sugar, syrup, honey, coconut sugar.
• Read labels so you know how much added sugar you're consuming.
• Limit sugar to special treats. Do not eat pastry or donuts and other treats for breakfast or in between meals.

HELP:
Here's a guide to reducing sugar in your diet.  

More information:
UCSF has produced important research on the wide ranging negative effects of sugar in our diets. Check out these UCSF websites and other resources for important information that could literally add years to your life: