Should we throw away our medicines after the ‘Best Before’ or Expiry date?

The prostate is a small, walnut-sized, shaped organ below the bladder and in front of the rectum. The main functions are to create fluids for semen and force semen through the urethra during ejaculation. It is usual for the prostate to get larger as one age.  Because of the location just below the bladder and in front of the rectum, also wrapping around the upper part of the urethra, the tube that carries urine from the bladder out of the body, it means abnormal prostate conditions can affect urination and sexual function. The prostate is prone to three main conditions, which are Prostatitis, an infection or inflammation of the prostate gland; Benign prostatic hyperplasia (BPH), an aging-related enlargement of the prostate gland; Prostate cancer, the growth of cancerous cells inside the prostate, which may break out of the gland and affect other parts of the body.

Prostatitis

This is the inflammation (swelling) of the prostate gland, and common causes include infection (usually bacteria), injury, or an immune system disorder. The symptoms may include the inability to urinate, Painful or difficult urination, and painful ejaculation, accompanied by fever, Blood in the urine (hematuria), and Severe discomfort or pain in the pelvic area or genitals.

The Risk factors for prostatitis include:

Previous prostatitis, Infection of the urinary or reproductive system, HIV infection or AIDS, Use of a tube inserted into the urethra to drain the bladder (urinary catheter), and Diagnostic sampling of prostate tissue (biopsy).

Laboratory tests for Prostatitis include Urinalysis, urine microscopy/culture/sensitivity, HIV, measurement of Prostatic specific antigen levels in the blood, Scan, etc.

Benign prostatic hyperplasia (BPH)

The prostate will almost certainly get larger increasing age. A small amount of prostate enlargement is present in many men over age 40 years of age.  More than 90% of men over age 80 have the condition. It’s not clear why it happens, but it may be linked to the decline in the male sex hormone testosterone with aging. This enlargement is a condition called benign prostatic hyperplasia (BPH).  The key word is benign.  BPH has nothing to do with cancer and doesn’t increase the risk of prostate cancer. It can make urination and ejaculation difficult because as the prostate grows, it presses on the urethra. That interferes with the flow of urine and the release of ejaculate during orgasm. In less than half of all men with BPH, symptoms may include dribbling at the end of urinating, Inability to urinate (urinary retention), Incomplete emptying of the bladder, Incontinence, needing to urinate two or more times per night, Pain with urination or bloody urine (these may indicate infection). Slowed or delayed the start of the urinary stream, straining to urinate, Strong and sudden urge to urinate, and Weak urine stream.

The Link between BPH and Sexual Problems

Scientists aren’t sure why, but they agree that the worse the BPH symptoms are, the more likely an individual is to have sexual issues such as reduced sex drive, trouble keeping an erection, and less sexual satisfaction. It may have something to do with genetics or age. It’s also possible that the sleeplessness or anxiety that can come from an enlarged prostate makes sexual problems worse.

Laboratory Test for BPH.

A digital rectal exam is usually done to feel the prostate gland. Urine flow rate is monitored, Urinalysis to check for blood or infection, Urine culture to check for infection, Prostate-specific antigen (PSA) blood test to screen for prostate cancer, Cystoscopy, Blood urea nitrogen (BUN) and creatinine tests to check for reduced kidney function.

Risk Factors for BPH include;

• Age – symptoms start manifesting by age 50 to 60 in 60% of men.
• Unhealthy diet- daily consumption of a diet high in red or processed meat, saturated fats, and dairy products can increase your risk for prostate problems. Sodium (salt), Alcoholic and caffeinated beverages like coffee, tea, and soda can also increase your risk due to being diuretics that increase urine production.
• Type 2 diabetes, poorly managed Hypertension, and other heart diseases, Smoking, obesity, and a Sedentary lifestyle are common risk factors.
• Prostatitis
• Family history/genetics
• Frequent Urinary Tract infection (UTI)

Prostate Cancer

Cancer is a disease in which abnormal cells divide uncontrollably and destroy body tissue, in the case of prostate, abnormal prostate cells continue to grow until it has destroyed normal body tissues around and beyond the prostate.  Prostate cancer usually develops slowly, so there may be no signs for many years. Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis (urethra). When this happens, one may notice things like increased need to pee, straining while peeing, a feeling that the bladder has not fully emptied. Causes of prostate cancer are largely unknown. However, certain things can increase the risk of developing the condition.

Risk factors for Prostate cancer include;

• Age: The chances of developing prostate cancer increase as one gets older. Most cases develop in men aged 50 or older. Prostate cancer risk begins to rise sharply after age 55 years and peaks at age 70–74, after which it starts to decline. For reasons not yet understood, prostate cancer is more common in black men and less common in Asian men.
• Men whose fathers or brothers were affected by prostate cancer are at slightly increased risk themselves.
•  Other risk factors include Obesity, Smoking (increases steroid hormone production such as DHT, and estrogen), High levels of pesticides, excessive consumption of dairy products (milk, yogurt, cheese, lactose-free milk, and fortified soy milk and yogurt), excessive red meat consumption, Saturated fat, and Sedentary lifestyle.

Beneficial Foods to Eat

A diet rich in fruits, vegetables, and healthy fats, such as the Mediterranean diet, may benefit health. Salmon, rich in healthy fats that contain omega-3 fatty acids, helps prevent and reduce inflammation within the body, and other cold-water fish, such as sardines and trout, are also rich in these fats.

Tomatoes: Tomatoes are packed with lycopene, an antioxidant that may benefit prostate gland cells. Cooking tomatoes, such as in tomato sauce or soup, helps to release the lycopene and make it more readily available to the body. Berries: Strawberries, blueberries, raspberries, and blackberries are excellent sources of antioxidants, which help to remove free radicals from the body. Free radicals are the byproducts of reactions that occur within the body and can cause damage and disease such as concern over time.

Broccoli: Broccoli and other cruciferous vegetables, including bok choy, cauliflower, Brussels sprouts, and cabbage, contain a chemical known as sulforaphane. This is thought to target cancer cells and promote a healthy prostate.

Nuts: Nuts are rich in zinc, a trace mineral. Zinc is found in high concentrations in the prostate and is thought to help balance testosterone and DHT. Besides nuts, shellfish and legumes are also high in zinc.

Citrus: Oranges, lemons, limes, and grapefruits are all high in vitamin C, which may help to protect the prostate gland.

All these are vital in addition to exercises to strengthen the pelvic floor muscles, such as brisk walking, Kegel exercise, and moderate strength training.

(Written by Ebenezer Dic-Ijiewere PhD.)

High cholesterol (hypercholesterolemia) refers to elevated levels of cholesterol in the blood, especially low-density lipoprotein cholesterol (LDL-C)—which is widely regarded as a key modifiable risk factor for atherosclerosis and cardiovascular disease (CVD). LDL-C can deposit in arterial walls, forming plaques that narrow arteries and increase the risk of heart attack and stroke. Meanwhile, high-density lipoprotein (HDL-C) is considered “good” cholesterol because it helps transport cholesterol away from the arteries to the liver for excretion. Several factors can increase the level of cholesterol in the blood, as indicated below

Factors That Contribute to Elevated Cholesterol

• Poor diet
• Lack of Physical Exercise
• Excess body weight
• Smoking increases cholesterol profile, and excessive alcohol increases triglycerides
• Genetic traits
• Chronic stress and poor sleep
• Diet low fiber

To decrease high cholesterol in the blood, it is important to make positive changes to health behaviors by following the strategies below:

Strategies to Decrease High Cholesterol Levels

• Reduce intake of saturated and trans fats, and substitute with MUFA and PUFA-rich foods such as fatty fish(Salmon and Mackerel), olive oil/canola oil, Avocado/nuts

A study by Okobi et al. (2023) found that an avocado-rich diet can lower total cholesterol (TC) and low-density lipoprotein (LDL) levels.

• Increase consumption of food high in soluble fiber, such as oats, fruits, apples, and legumes.
• Regular aerobic exercise for 150 minutes/week lowers LDL and triglycerides and improves HDL.
• Losing excessive weight will improve LDL profiles.
• Quitting smoking will improve cardiovascular health and HDL levels

With the government shutdown, many aspects of daily life have been severely impacted. The rate of food insecurity is increasing, and challenges related to housing, transportation, and other social determinants of health are becoming more pressing. SNAP benefits have been frozen, leaving many families struggling to put food on the table. As a result, more individuals and families are turning to food pantries and community resources for support.

At the same time, the cost of food and necessities continues to rise, deepening the struggles faced by countless households. These are difficult times, but I want to encourage everyone affected to stay strong, remain hopeful, and trust that better days are ahead.

Here are some practical ways to cope and survive during the rising costs and government shutdown:

• You must focus on needs such as housing, food, transportation, utilities, and medication.
• Decrease or pause non-essential spending, such as new purchases, entertainment, or dining out.

  Manage Your Money Wisely

• Avoid any unnecessary debt.
• Prioritize rent/mortgage and food.
• Discuss with your utility company, landlord, or bank to explore any available payment plans or deferments during the shutdown.

Explore any available community resources

• Assess community and faith-based resources (Local food banks, churches, non-profits) for support with food and bills.
• Check your city’s website to find out what supports are available to access.

   Protect Your Mental and Emotional Health during the difficult time

• Financial insecurity can be draining. Stay connected with family, friends, and coworkers for emotional support.
• Get good exercise, rest, and be consistent with your routines
• Have faith and be hopeful that the challenges are temporary and will surely pass
• Focus on what’s within your control.

Maintain Perspective

• Use this period to build your financial discipline and strength
• Celebrate each time you pay a bill and make meals; a win is worth celebrating
• Reflect on value by focusing on more relationships, essentials, and faith than on any material things

The rising cost of living has become a significant public health concern, particularly for low-income individuals who are struggling daily to survive. Addressing the social determinants of health among this population remains an urgent issue, as many face ongoing challenges accessing essential needs such as food, housing, transportation, and healthcare. During my assessment of some of the low-income individuals, I found that several individuals eat only once a day to save money for rent. Many reported choosing to go hungry rather than risk homelessness. Some have been living in their cars for nearly a year, while others rely on the homes of friends to shower and change clothes. It is heartbreaking to witness the difficult situations people endure every day to stay alive.

The rising cost of living has multiple impacts on health and well-being. According to Grewal et al. (2024), increasing housing costs—one of the key components of living expenses—can have both direct and indirect health consequences. Their study indicates that:

• Financial strain from high housing and living expenses contributes to increased stress, anxiety, and depression, particularly among renters and low-income individuals.
• Food insecurity often results when households must prioritize rent or transportation over nutrition, leading to poor dietary intake and higher risks of chronic diseases.
• Limited access to healthcare arises when individuals cannot afford medical visits, medications, or preventive care due to competing financial demands.
• Housing instability or homelessness can expose individuals to unsafe environments, lack of sanitation, and interrupted social support networks, which worsen both physical and mental health outcomes.

Overall, Grewal et al. (2024) emphasize that the effects of rising housing and living costs are unequally distributed, disproportionately affecting low-income individuals who already face multiple barriers to health. This highlights the need for comprehensive policy approaches that integrate housing affordability, income support, and healthcare access as essential strategies to promote health equity.

Source: https://doi.org/10.1186/s12889-024-18360-w

Research reports that American women are disproportionately affected, with the highest obesity rates among all groups in the U.S. About 80% are classified as overweight or obese.

Disparities in weight loss

Research indicates that African American (AA) women tend to lose less weight compared to their Caucasian counterparts.

Contributing Factors

The contributing factors to the disparities are;

• Limited access to nutritious food
• Inadequate health insurance
• Lack of safe spaces for physical activity

Barriers to Weight Management

Challenges that hinder weight management efforts include:

• Personal beliefs
• Limited time
• Family dynamics
• Lack of motivation
• Financial constraints

Cultural Influence on Body Image

Cultural norms within the AA community, which often embrace larger body sizes and promote a positive body image, can also influence health behaviors. While fostering a positive body image has psychological benefits, it may reduce motivation to maintain a healthy weight. In Black culture, obesity and being overweight are often considered acceptable and carry little to no stigma. Cultural perspective may partially explain why general health promotion efforts are less effective in this community. The study reports that many Black female students aim to embody the culturally valued “thick and curvy” figure, consuming specific foods to shape their bodies while avoiding activities that might result in weight loss.

Why it may be difficult to seek care

A deep-rooted distrust of the healthcare system makes it difficult for many AA women to seek medical advice or treatment.

Physical inactivity as a health risk factor

Underestimating body weight can reduce engagement in healthy behaviors, such as regular physical activity. Physical inactivity is a major contributor to non-communicable diseases and mortality, emphasizing the need to address these issues within the AA community.

Our connections with family, friends, and colleagues are crucial. Individuals who have strong social connections and supportive relationships are more likely to adopt healthy lifestyles and effectively cope with stress, anxiety, and depression, especially during difficult times. A supportive network of family members, close friends, and colleagues provides a sense of belonging and emotional support.

  Ways to create meaningful impacts are;

1.Showing kindness: Providing a listening ear, checking in on them, offering assistance, or simply sharing a smile can profoundly influence the overall well-being of others.

2. Promoting physical activity: Encouraging others to participate in physical activities such as organizing sports events, walking or running together, or engaging in group activities can enhance physical and social well-being.

3. Spreading awareness and education: Educating others about healthy lifestyle choices, including proper nutrition, exercise, and stress management, can empower them to make positive life changes.

4. Promoting a healthy diet: Sharing recipes, discussing healthy eating habits, organizing cooking classes, and advocating for nutritious foods can encourage healthier dietary choices.

5. Supporting access to healthcare: Being present for others during difficult times is crucial and can significantly improve their lives. Providing transportation to healthcare facilities encourages them to seek professional help when needed, and assisting with paperwork can make access easier.

6. Advocating for policy changes: Supporting policies and initiatives that promote public health, such as mental health services, water regulation, and access to healthcare, can have a broad impact on the well-being of entire communities.

7. Assisting those with chronic illnesses: Offering understanding and support to individuals with chronic health conditions can help them manage their conditions and enhance their quality of life.