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Bulging disk........sodium deficiency......walking.

Editor-in-Chief

Bruce A. Ferrell, MD, Professor of Medicine and Geriatrics

Q I was told I have a bulging disk in my lower back. Is that the same as a herniated disk?

A No, but those two terms do get misused frequently. Bulging disks are quite common, especially as we get older. Disks are jelly-like cushions with hard outer layers between the vertebrae. If a disk is bulging, it's usually the outer layer that is protruding beyond its usual size and shape. Picture a hamburger patty that is is too big for the bun. A bulging disk can be detected with an MRI, and may exist without causing any discomfort.

A herniated disk, however, is one in which that outer layer has been cracked, allowing the soft inner cartilage to protrude. A herniated disk is more likely than a bulging disk to cause pain, especially if the cartilage pushes against a nerve in the spine.

Q I always hear about cutting back on sodium, especially for heart health. But is it possible to have too little sodium in your diet?

A Sodium, found in table salt and many other products, often gets a bad rap. While too much can be dangerous and contribute to high blood pressure, sodium is an important element for good health.

But to answer your question, yes, it is possible to consume an insufficient amount of sodium. Athletes and others who lose a lot of sodium and other minerals (primarily potassium, calcium and magnesium) through perspiration, are smart to replenish those minerals with sports drinks and other sources. The average person, however, probably consumes enough sodium in an everyday diet to make sodium supplementation unnecessary. The American Heart Association recommends no more than 2,400 mg of sodium intake per day. People with heart disease or heart disease risk factors should try to consume no more than 1,500 mg.

However, there are other circumstances that can lead to sodium deficiency. When sodium levels in the body are abnormally low, the condition is called hyponatremia. Older adults are at higher risk of hyponatremia if they take medications such as heart failure, kidney failure or underactive thyroid.

Drinking too much water compared to the amount of sodium you consume may also lead to hyponatremia. Nausea and fatigue are among the signs of sodium deficiency. And because brain cells are especially vulnerable to an unhealthy ratio of fluid to sodium, headaches and feelings of disorientation are common signs of hyponatremia.

If you have concerns about hyponatremia, blood and urine tests can be done to determine your sodium levels. So talk with your doctor if you have any questions about your sodium intake.

Q Is walking every day really enough to help me lose weight?

A No, but it certainly can help. Weight gain and loss depend on how many calories you consume and how many you burn. So if you eat fewer calories AND exercise more, you will lose weight. But burning more calories with walking or other physical activity won't help you lose weight if you continue to consume more calories than you expend.

Exercise must be combined with lower calorie consumption to achieve substantial weight loss. Walking every day for 30 minutes will burn about 150 calories. So in a week, you could burn 1,050 calories just by walking. One pound equates to about 3.500 calories, so an everyday, 30-minute walk could help you lose a third of a pound a week, provided you don't start eating more. Now, if you cut out 350 calories a day from your diet and combine that with the 150 calories expended during your walk, you have 500 fewer calories in your system at the end of the day, or 3.500 fewer at the end of the week. Losing one pound a week is a very realistic goal. The key is to make smarter food choices and regular exercise habits that you stick with.
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Title Annotation:ASK THE DOCTOR
Publication:Healthy Years
Geographic Code:1USA
Date:Apr 1, 2014
Words:656
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