Personal Health

 

Friday, November 17, 2006

 

Report calls for "activity-friendly" communities

 

Reuters Health

Friday, November 17, 2006

Sidewalks, parks and neighborhood stores could be part of the solution to the ever-expanding U.S. waistline, according to a new report.

Writing in the American Journal of Preventive Medicine, researchers offer a top-10 list of ways to turn sedentary cities and suburbs into "activity-friendly" communities. The point, they say, is to fight obesity by encouraging people to get more incidental activity into their daily lives.

One of the main goals is to give people reasons to get out of their cars. This includes building more sidewalks and intermingling residential and commercial buildings so that more people will walk to the store or the movie theater instead of driving.

"The number of hours we spend in our car everyday detracts from our physical, social and mental health," Dr. Laura Brennan Ramirez, the report's lead author, said in a statement.

"Our dependence on the car is overwhelming," added Brennan Ramirez, an adjunct assistant professor of community health at Saint Louis University School of Public Health.

She and her colleagues arrived at their recommendations through a systematic review of research into the community features that encourage physical activity. They then had a panel of experts pare these features down into a top-10 list.

Among the recommendations:

·        Along with better sidewalks and bike lanes, communities should improve mass transportation so that people can walk to the train station, for instance, instead of driving door to door.

·        Improve community aesthetics. People will be more likely to walk if their surroundings are clean and offer some sights to see.

·        More schools should require gym classes, while workplaces could offer activity incentives, like flexible schedules or on-site gyms.

·        Public policies should divert some of the funds that go to highways toward projects like creating roadway bike lanes. Cities should direct funds toward maintaining parks and other recreational areas.

The current anti-walking design of many U.S. communities is a particular problem for older adults and children, Brennan Ramirez noted.

"We haven't really designed our communities well for older adults, particularly once they get to the point that they can't drive," she said. "In addition, given concerns about the soaring childhood obesity rates, not having schools located within the neighborhood is a major problem."

Source: American Journal of Preventive Medicine, December 2006.

Panic Attacks Exacerbate Diabetes Symptoms

 

HealthDay News

Friday, November 17, 2006

FRIDAY, Nov. 17 (HealthDay News) -- Repeated panic attacks in people with diabetes can lead to poorer control of the illness, more severe health complications, and a reduced quality of life, U.S. researchers report.

In their previous research, a team at the Group Health Cooperative in Seattle concluded that depression was associated with these same problems.

"But because panic and depression often go hand in hand, we weren't certain that patients who have panic, independent of depression, would also have these indicators," study lead author Evette Ludman said in a prepared statement.

For this new study, she and her colleagues surveyed nearly 4,400 people with diabetes.

Reporting in the November issue of General Hospital Psychiatry, the researchers found that 193 patients (4.4 percent) reported panic episodes that affected their behavior. Among those 193 patients, 54.5 percent also had symptoms of depression.

The patients who reported panic attacks had average HbA1c levels -- a measure of long-term glucose control -- of 8.1 percent, compared to 7.7 percent for those who did not suffer panic attacks. The usual treatment goal is to keep these levels below 7 percent.

The people with panic attacks reported an average of 4.2 diabetes symptoms, compared with 2.4 symptoms for people with no panic episodes.

Panic attacks may interfere with diabetes patients' self-care and their ability to follow their treatment regimens, resulting in poorer outcomes, the researchers said. Doctors should look for -- and treat -- signs of panic and depression in diabetes patients in order to improve their quality of life.

More information

The U.S. National Institute of Mental Health has more about diabetes and depression.

 

Study: Chocolate milk good for athletes

 

By Eddie Pells

AP National Writer

The Associate Press

Friday, November 17, 2006

It comes in only one flavor — no Fierce Grape or Riptide Rush available — and you certainly won't see your favorite basketball star gulping it down on the sideline during a timeout. But a group of scientists recently discovered that one of the most effective drinks to help athletes recover after exercise is the same thing moms across America have been giving their kids for years. A simple glass of chocolate milk.

To be forthright, the study by the scientists from Indiana University was supported in part by the Dairy and Nutrition Council.

Still, their findings are compelling.

The small group of fit athletes who took part in the study were asked to work out strenuously on a stationery bicycle, then drink low-fat chocolate milk, a fluid-replacement drink like Gatorade and a carbohydrate replacement drink like Endurox R4. A few hours later, they were asked to cycle again until they reached exhaustion.

The test was repeated three times — once with each kind of drink — and the data showed that the cyclists were able to go between 49 and 54 percent longer on the second stint after drinking chocolate milk than when they drank the carbohydrate drink. The difference between the milk and the fluid-replacement drink was not significant.

"My way of explaining it is, there's really nothing magic about the powder in a can that you mix with water," cycling coach Scott Saifer said of the carbohydrate drink. "It's water, carbs, proteins, maybe minerals and electrolytes. What's in chocolate milk? The same thing. There's no reason it shouldn't be as good for recovery as a carb drink."

The milk folks tout their product as a less-costly and healthier alternative to the more traditional energy drinks.

They have some data to back up the physiology of the issue. Among their points are that milk also provides much-needed calcium and might be more efficiently absorbed into the system than the other drinks.

The cost analysis also works in their favor.

To get 75 grams of carbohydrate, you'd need about 18 ounces of chocolate milk, three scoops of a carb drink or about 17 ounces of a fluid-replacement drink. The milk option would cost around 49 cents, which is about 95 cents less than the carb drink and about 9 cents less than a 17-ounce serving of Gatorade.

(Prices were calculated on the basis of a sale-priced $3.50 gallon of chocolate milk, an eight-pack of 20-ounce bottles of Gatorade on sale for $5.50 and a 56-scoop container of Endurox priced at $26.95.)

This latest study by the milk industry is an attempt to get people thinking about one of the world's most basic products in new ways. Of course, it could also be viewed as little more than a ploy to cut into the multibillion-dollar sports-drink market. (According to brandchannel.com, Gatorade topped $2 billion in sales in 2001.)

Dietician Mary Lee Chin, who does public-relations work for the Western Dairy Council, says that either way, there's nothing wrong with this sales pitch.

"It's not like you're talking about some beverage that's really outlandish and recommending that," she said. "Milk should be part of everyone's diet anyhow. It's the fact that you already have a nutritional benefit, and then there's this additional replenishment benefit as an added bonus."

The Indiana study netted different results than an earlier study that found participants exercised 55 percent longer after drinking Endurox than they did after drinking Gatorade. The Indiana study concluded the aberration may have been because of methodological differences in the experiments — most notably that subjects in the other study exercised at a more strenuous pace than in the Indiana study.

Chin acknowledged the Indiana study was not conclusive, but believes the findings merit a more expansive study.

As for the prospect of chugging down a glass of chocolate milk on a hot day after an extensive workout ... well, that's a matter of personal preference.

"If it tastes good enough that you want to reach for a bottle and drink it, it's a good exercise drink," said Saifer, who prefers a fruit and yogurt smoothie to quench his thirst. "If it tastes nasty and you don't want to drink it, there's no way it can help you."

Eye Tests Predict Later Vision Trouble for Preemies

 

HealthDay News

Friday, November 17, 2006

FRIDAY, Nov. 17 (HealthDay News) -- Having youngsters undergo eye tests at two-and-a-half years of age can help predict vision problems when they're 10 years old, Swedish researchers report.

Previous studies have found that refractive errors (problems with the degree of light that reaches the back of the eye) are more common in children born preterm (before 35 weeks of gestation) than in full-term children.

In this new study, researchers at Uppsala University Hospital checked for refractive errors in 198 preterm children at 6 months, 2.5 years, and 10 years of age. The researchers assessed the development of astigmatism (an unequal curve in one of the eye's refractive surfaces) and for anisometropia (a difference in refractive power between the two eyes that can lead to partial vision loss).

Reporting in the November issue of Archives of Ophthalmology, they found that 108 children had astigmatism at 6 months, 54 at 2.5 years, and 41 at 10 years. They also found that 15 children had anisometropia at 6 months, 17 at 2.5 years, and 16 at age 10.

"The presence of astigmatism and anisometropia at 2.5 years of age were the strongest risk factors for having astigmatism and anisometropia at 10 years of age," the study authors wrote.

"In this population-based study, we found that a refractive error at 2.5 years of age predicts that refractive error will also be present at 10 years of age," the team concluded.

"Recommendations for follow-up examinations must include all aspects of visual function, i.e., visual acuity, contrast sensitivity and visual fields, as well as the refraction, strabismus and perceptual problems. All preterm children should be included in such follow-up examination for refractive error, irrespective of the retinopathy of prematurity stage," the researchers wrote.

Retinopathy of prematurity (ROP) is a condition where there is abnormal development of blood vessels in the retina. The smaller the baby is at birth, the greater the risk of ROP.

More information

The Nemours Foundation has more about premature babies.

 

Diabetics often rate their health as fair or poor

 

Reuters Health

Friday, November 17, 2006

Adults with diabetes are more than three times more likely to rate their overall health as fair or poor than are adults without diabetes, according to a report published Thursday in the Morbidity and Mortality Weekly Report, published by the Centers for Disease Control and Prevention.

This likely reflects the harmful effects of diabetes and its complications on quality of life, note the authors of the report from the CDC's Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion.

Consistent with prior studies, self-reports of fair or poor health were associated with several health risk factors such as smoking and obesity. "Persons with diabetes should quit smoking through smoking cessation programs and control their weight through exercise and a healthy diet," the report states.

Self-rated fair or poor health was also associated with certain indicators of diabetes severity, such as having the disease for a long time and having to take insulin to control blood sugar.

Certain subgroups of diabetics such as older persons, women, Hispanics, people with less than a high school education, and those with no health insurance were also more apt to describe their health as fair or poor.

To gauge the prevalence of self-rated fair or poor health among US adults with diabetes, the CDC investigators analyzed 1996-2005 data from the Behavioral Risk Factor Surveillance System.

During 2005, an estimated 49.3 percent of adults 18 years of age or older with diabetes described their health as fair or poor. After adjusting for age, the prevalence of fair or poor health among adult diabetics was 46.7 percent -- more than three times the rate among adults without diabetes (14.2 percent).

Among adult diabetics aged 18 to 44 years, the prevalence of self-rated fair or poor health rose from 35.6 percent in 1996 to 43.4 percent in 2005.

These findings "underscore the need for continued interventions to promote healthy behaviors and prevent diabetes and interventions for persons with diabetes to help them better manage their diabetes and prevent diabetes complications, which can increase their perceived quality of life," the authors state. Diabetes affects nearly 21 million Americans.

Source: Morbidity and Mortality Weekly Report, November 17, 2006.

Superfoods, anti-ageing products will be hot

 

Reuters

Friday, November 17, 2006

Amazonian superfoods and anti-ageing elixirs are likely to set the trend on supermarket shelves next year, a report said on Thursday.

Exotic drinks and beauty products based on indigenous resources from the Amazon and personal grooming items for older men are among the top 10 growth areas predicted by trendspotters at Mintel.

Many of the forecast trends are based on growing consumer calls for ethical and environmentally friendly products.

"Consumers all round the world are being asked to take a stand and make fundamental changes to their lifestyle, for the sake of the planet's future," said Mintel's David Jago.

The survey said beauty products containing Amazonian botanicals believed to have strong health benefits have already caught on in France and are likely to feed into the fashion for food and cosmetics using natural ingredients in the UK.

Male baby boomers, now reaching retirement age, are seen as a new growth market for the beauty industry.

Teenagers are another key target because of the potential to cultivate brand loyalty that lasted into adulthood.

Packaging is also a strong theme, with manufacturers expected to use more biodegradable or refillable packets.

Mintel forecast consumer concern about the world's natural resources and how their goods are made would continue to push ethical labelling like Fairtrade into the mainstream.

"This will also help to highlight local and seasonal products, symbolizing a return to fresher ingredients that have more of a community-orientated tie," it said.

Women fare worse than men early after heart attack

 

Reuters Health

Friday, November 17, 2006

Women who suffer a first heart attack have a greater chance of dying in the first year after the event than their male counterparts, a Dutch study shows.

While the poorer outcome for women may largely be explained by women's older age when they have a heart attack, women still seem to have a higher risk of early death even after accounting for a number of other risk factors.

Moreover, there seems to be "an excess mortality among younger women compared with men," Dr. Huiberdina L. Koek from University Medical Center Utrecht in The Netherlands and colleagues report in the American Journal of Cardiology.

These findings suggest that "special care must be applied to women," in particular, women younger than 40 years old, they write. These women may need more intensive monitoring in the first 30 days after heart attack and perhaps a greater willingness to adopt "more aggressive" therapeutic interventions.

The findings are based on a look at the records of 21,565 adults hospitalized for heart attack in 1995 in The Netherlands. In "crude" analyses across all ages, the likelihood of dying within 28 days was 70 percent higher in women compared to men. At 5 years, the risk of death was 52 percent higher in women relative to men.

Overall, age was a "strong determinant of mortality," with a 6 percent to 8 percent increase in risk of dying with every 1-year increase in age.

Once age was factored into the calculations, women remained at higher risk of death after a heart attack at 28 days and 1 year, although their risk was significantly attenuated. At 5 years, women were no longer at greater risk of dying - actually, they were at lower risk of dying, the authors report.

Numerous reasons have been given for the worse short-term prognosis of women, including older age and more simultaneous illnesses such as diabetes. Also, younger women in particular might wait longer before going to the hospital, might be less likely to be diagnosed with heart attack and might be less likely to receive clot-busting therapy.

"The lower long-term mortality in women might reflect the well-established survival advantage of women in the general population," Koek and colleagues say.

Source: American Journal of Cardiology, October 15, 2006.

Health Tip: Bacterium or Virus?

 

HealthDay News

Friday, November 17, 2006

(HealthDay News) -- Bacterial and viral infections require different courses of treatment, even though both infections can make you feel sick. It's important to remember that antibiotics can only help treat bacterial infections, not those that are viral.

Here are some indicators of whether your infection is bacterial or viral, courtesy of the National Information Program on Antibiotics:

Illnesses caused by a virus typically don't last more than 10 days, while those caused by bacteria can cause symptoms for more than two weeks. Symptoms like dry cough, runny nose, sore throat, aches, and chills are usually caused by viruses. In adults, sore throat without a high fever is usually caused by a virus. Frequent cough, persistent high temperature, and colored nasal discharge are symptoms usually caused by bacteria, especially if they last more than two weeks.

 

Campaign promotes nutrition label smarts

 

By Megan Rauscher

Reuters Health

Friday, November 17, 2006

The U.S. Department of Health and Human Services and the Food and Drug Administration have announced the availability of two new tools designed to help consumers use the Nutrition Facts label on foods to make healthy and nutritious food choices.

The tools are "Make Your Calories Count," an interactive online learning program, and a new Nutrition Facts Label brochure. Both are available and downloadable at http://www.fda.gov.

"These tools will empower consumers to be better informed to make better and wiser food choices," Dr. Andrew C. von Eschenbach, Acting FDA Commissioner, said at a news briefing announcing the self-help aids.

"We are also committed to our partnership with the food industry to help make certain that we are providing helpful options," he added, "so that we can begin to stem the problem of obesity in this country and the problems associated when people misuse food."

"Make Your Calories Count" provides information to assist in planning a healthy diet while managing calorie intake. Sections of the program include: Size Up Your Servings and Calories; See What's In It For You; and Judge If It's Right For You.

"As part of the program, we are introducing the general guide to calories," Amy Odegaard, of the FDA's Center for Food Safety and Applied Nutrition, explained. Basically, the guide denotes a single-food item with 40 calories as low-calorie; one with 100 calories as moderate-calorie; and a food with 400 calories as a high-calorie.

"This is a simple tool that consumers can use when choosing a food item," Odegaard said. The program includes an animated "Labelman" who guides consumers through a series of educational exercises on the food label.

Another section of the program zeros in on nutrients and introduces a quick guide to percent daily value (%DV). The guide deems any nutrient at 5%DV or less as low in that particular nutrient, whereas 20%DV or more of a particular nutrient is considered high.

"For simplicity," Odegaard said, "the program presents two nutrients that should be limited -- saturated fat and sodium -- and two nutrients that should be consumed in adequate amounts -- fiber and calcium."

The third module is designed to be "a little more complex," Odegaard said, "because it asks the consumer to compare and evaluate the serving size, calories and nutrients on similar products to determine which product is the better choice for them."

Certain Fatty Acid May Cut Dementia Risk

 

By Steven Reinberg
HealthDay Reporter

HealthDay News

Friday, November 17, 2006

 

FRIDAY, Nov. 17 (HealthDay News) -- Adding further weight to the theory that fish may be brain food, new research found that people with diets rich in fish have a significantly lower risk of dementia and Alzheimer's disease.

The key appears to be docosahexaenoic acid (DHA), an omega-3 polyunsaturated fatty acid that appears to affect dementia risk and to be important for the proper functioning of the central nervous system.

"If you have a high level of DHA, a fatty acid found in fish, it reduced your risk of dementia by about half," said study lead researcher Dr. Ernst J. Schaefer, senior scientist and director of the Lipid Metabolism Laboratory at the Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University in Boston.

It's known that omega-3 fatty acids protect the heart and the circulatory system. "Just as fish is good for your heart, it's probably good for your brain as well," Schaefer said.

Fatty fish like mackerel, lake trout, herring, sardines, albacore tuna and salmon are high in DHA.

The study findings are published in the November issue of the Archives of Neurology.

In the study, Schaefer and his colleagues collected data on DHA levels and dementia in 899 men and women who were part of the Framingham Heart Study. Over nine years of follow-up, 99 people developed dementia, including 71 with Alzheimer's disease.

The researchers found that people with the highest blood levels of DHA had a 47 percent lower risk of developing dementia and a 39 percent lower risk of developing Alzheimer's, compared with those with lower DHA levels.

Levels of DHA in the blood vary by how much the liver converts alpha-linolenic acid, an essential fatty acid, to DHA and also by the amount of DHA in the diet, the researchers noted.

People with the highest blood levels of DHA said they ate an average of two to three servings of fish a week. People with lower DHA levels ate substantially less fish, the researchers reported.

Schaefer thinks the same benefit can be realized by taking fish-oil supplements. "Everything that we know suggests that supplements would be as effective as eating fish," he said. "Since low fish intake appears to be a risk factor for developing dementia, either eat more fish or use one or two fish oil capsules a day."

However, Schaefer added that a randomized clinical trial is still needed to see if DHA really protects the brain from dementia.

Martha Clare Morris is an epidemiologist at Rush University Medical Center in Chicago and author of an accompanying editorial in the journal. "This is the first study to link blood levels of DHA to protection against Alzheimer's disease," she said, adding that recent animal studies have shown that DHA reduces amyloid plaques -- a hallmark of Alzheimer's -- in the brain and also improves memory.

"There is a lot of animal and biochemical evidence to support what this new study shows," Morris said.

But, she said, she's not sure there is enough data to suggest the value of fish oil supplements. "It looks like the protective benefits from omega-3 fatty acids are at a very low level. There is very little evidence that you get better protection from higher intake," she said. "Whether fish oil supplements are protective is yet to be seen."

Another expert thinks clinical trials are needed to see if DHA really protects against Alzheimer's.

"This shows in a prospective study that DHA is the only plasma lipid to cut the risk for developing dementia a decade or more later," said Greg M. Cole, a neuroscientist at the Greater Los Angeles VA Healthcare System and associate director of the Alzheimer's Disease Research Center at UCLA's David Geffen School of Medicine.

This apparent protection is associated with eating fish, Cole said. "Other studies have pointed to fish intake as protective but have been far less clear that the omega-3 fatty acids in fish were the factor associated with risk reduction," he said. "This matters because if it is the fat, you could take fish oil supplements and avoid mercury contamination issues."

More information

The Alzheimer's Association can tell you more about Alzheimer's disease.

 

Use of skin bleaching products can be risky

 

Reuters Health

Friday, November 17, 2006

Complications from the use of skin lightening products are a serious problem for men and women of African descent, a study shows.

In a group of 46 people, Dr. Antoine Petit of the Hopital Saint Louis, Paris and colleagues identified two with insufficient adrenal gland function that was likely due to use of one product called clobetasol, which is illegal in France.

Others had hyperpigmentation, stretch marks, skin atrophy (degeneration) and infections that could have been related to use of skin lightening products, while many reported being unable to stop trying to lighten their skin even though they wanted to.

"This particular feature of skin lightening is akin to addictive behavior, sometimes associated with real psychological suffering," Petit and colleagues write in the Journal of the American Academy of Dermatology.

Skin lightening appears to be a common practice among dark skinned individuals in most of the world, and has been linked to side effects ranging from disfiguring scarring to system-wide health problems, the researchers note. However, they add, there have been few reports on complications due to use of these products from industrialized nations such as France and the United States.

To investigate, Petit and colleagues examined 46 patients of African descent who had changes in their skin that could have been due to use of skin lightening products. These included excessive darkening of the skin on the finger joints, atrophy of the skin, stretch marks and infections.

Twenty five of the men and women in the study reported using skin lightening products, 12 said they were attempting to stop using the products, 7 said they had used them in the past but no longer did, and two said they had never used the products.

On average, people reported having used skin lighteners for 14 years, with time of use ranging from one to 38 years.

All people who reported lightening their skin said they had used at least two products in combination, generally glucocorticoids (use of which could theoretically lead to diabetes and high blood pressure), hydroquinone, or clobetasol.

Nine people referred to skin lightening as a "true drug," while many reported having difficulty stopping the use of these products even if they were unsatisfied with their effects. Frequently patients would look for more powerful products to cope with the hyperpigmentation side effects they experienced.

While some participants in the study did have high blood pressure and diabetes, it was impossible to determine if it was due to the use of skin lightening products. But the researchers did find two cases of adrenal insufficiency that they attributed to clobetasol use, noting that people in the study used up to 480 grams weekly, while 50 grams weekly is enough to affect adrenal gland function.

"There is an urgent need to inform dark-skinned persons of the nature and side effects of the products used for skin lightening, especially clobetasol," the researchers conclude.

"Clinical as well as epidemiological and psychological aspects of skin lightening deserve further studies to improve the prevention and management of skin lightening side effects."

Source: Journal of the American Academy of Dermatology, November 2006.

High Blood Pressure During Pregnancy Boosts Disease Risk Later in Life

 

By Kathleen Doheny
HealthDay Reporter

HealthDay News

Friday, November 17, 2006

 

FRIDAY, Nov. 17 (HealthDay News) -- Women who experience high blood pressure during pregnancy have a higher risk of stroke, heart and kidney disease later in life, a new study found.

The study calls into question the commonly held belief that high blood pressure during pregnancy is a fleeting problem with no adverse effects on later health, said Dr. Vesna Garovic, lead author of the report and an assistant professor of internal medicine at the Mayo Clinic in Rochester, Minn.

The study, which included nearly 5,000 women, isn't the first to report the association, Garovic said. "But this is the largest study and the first study to include multiracial subjects," she said.

"High blood pressure in pregnancy appears to be an under-recognized risk factor for cardiovascular disease later in life," Garovic said. About 10 percent of pregnancies are affected by high blood pressure, she said.

The study findings were presented Thursday at the American Society of Nephrology's annual meeting, in San Diego.

Garovic and her colleagues analyzed data from 4,782 women who all had a high family risk of high blood pressure and were participating in the National Heart, Lung, and Blood Institute Family Blood Pressure Program study from 2000 to 2005. The average age of the women when the data was analyzed was 54. They reported their own health conditions.

The researchers looked at three groups: 718 women who had no history of a pregnancy lasting more than six months; 3,421 women who had normal blood pressure throughout their pregnancies; and 643 women who had hypertension during pregnancy. Women were white, black, Hispanic and Japanese. Most had a brother or sister with high blood pressure.

Women who had high blood pressure during pregnancy had twice the risk of stroke as those who had normal pressure during pregnancy. They also had 1.5 times the risk of heart attack and 1.5 times the risk of developing high blood pressure after age 40, the researchers found.

Those who suffered from high blood pressure during pregnancy were also more likely to have small amounts of the protein albumin in their urine, which is an early sign of kidney disease, Garovic said.

High blood pressure is common as people get older, but the study authors found it struck earlier in women who had experienced the condition during pregnancy. "In women with a history of hypertension in pregnancy, 50 percent of them had high blood pressure by age 52," Garovic said. "In women with normal tension pregnancies, 50 percent of them had high blood pressure by age 60."

The findings of this study, as well as other recent research that came to the same conclusions, fly in the face of conventional thinking, Garovic said. Her research and other recent studies suggest the effects of pregnancy-related high blood pressure are more long-lasting and serious than believed.

Exactly why the elevated blood pressure boosts risk later in life isn't known, but Garovic said the conditions may share risk factors such as obesity. The women with high blood pressure during pregnancy tended to be obese compared with the women who did not get it, the study found.

Or, the high blood pressure during pregnancy may induce long-term metabolic and blood vessels abnormalities, leading to cardiovascular problems later, she said.

Physicians should ask women about their blood pressure status during pregnancies during routine exams, Garovic said. And, if the doctors don't ask, women should volunteer the information so they can be followed appropriately.

"This research is monumental," said Dr. Nieca Goldberg, chief of women's cardiac care at Lenox Hill Hospital in New York City, and author of The Women's Healthy Heart Program. She was not involved in the study.

"It's going to set a new tone for us for evaluating risk factors for heart disease for women. What is really important about studies like this is, we are starting to look at women's health throughout their life cycle. For a long time, we thought conditions during pregnancy stayed there and had no effect on later life health."

More information

To learn more about high blood pressure during pregnancy, visit the March of Dimes.

 

HPV and smoking a risky combo for women

 

Reuters Health

Friday, November 17, 2006

Women who smoke and carry human papillomavirus type 16 (HPV-16) are at greater risk for "cervical cancer in situ" than their peers with only one of the two factors, according to a study. Cervical cancer in situ or CIS denotes cancer that is confined to the surface layer of the cervix.

The risk of CIS was particular high in smokers with high levels of HPV-16, lead author Dr. Anthony S. Gunnell, from the Karolinska Institute in Stockholm, and colleagues note. HPV-16 is one of several types of HPV that have been linked to cervical cancer.

"Our initial analyses centered on whether smoking was an independent risk factor for cervical cancer," Gunnell said in a statement. "Clearly, both exposures need to be present at the same time for there to be an interaction."

The new findings are based on a comparison of HPV-16 status (in stored cervical smears) and smoking among 375 women with CIS and 363 controls.

Current smokers positive for HPV-16 were more than 14 times more likely to have CIS than HPV-negative current smokers. In nonsmokers, HPV-16 positivity only increased the risk of cancer by 5.6-fold.

Current smoking coupled with a high HPV-16 load raised the risk of CIS by 27-fold compared with HPV-16-negative smokers. In nonsmokers, the elevated risk with a high HPV-16 load was just 5.9-fold.

"We were surprised to see this dramatically increased risk among women with high viral loads who smoked," Gunnell commented.

A significant correlation between smoking duration and HPV-16 positivity was noted, the researchers state.

"Our study would imply a synergistic action between HPV and smoking that would greatly increase the likelihood of women developing cervical cancer if they are HPV-positive smokers. This would put them in a risk group worthy of careful monitoring," Gunnell emphasized.

Source: Cancer Epidemiology, Biomarkers and Prevention November 2006.

Bad Diet? Urine Test May Tell

 

HealthDay News

Friday, November 17, 2006

FRIDAY, Nov. 17 (HealthDay News) -- A simple test to check potassium levels in urine may help doctors assess and improve patients' eating habits, a Canadian study finds.

Diet plays a key role in overall health, especially when it comes to risks for heart disease, stroke, and cancer risk. But there is no simple, objective and inexpensive way for family doctors to assess a patient's diet, according to the researchers.

Current methods rely on asking patients to report their eating habits on questionnaires or to record their food consumption for several or more days. These approaches are time-consuming, and patients often fail to provide accurate information.

Blood and urine tests provide alternative ways to assess a person's diet. In this study, researchers focused on urinary potassium as a potentially useful marker of a healthy diet. They noted that foods promoted by current dietary guidelines are good sources of potassium, and evidence suggests that a diet high in potassium reduces the risk of developing a number of health problems.

The researchers collected urine samples from 220 people, ages 18 to 50, who also provided information about their eating habits over the previous year. The participants' blood pressure, heart rate, weight and height were also checked.

The study found a link between increased levels of potassium in the urine, a healthier diet, and lower weight, blood pressure and heart rate.

"These findings suggest, for the first time, that the amount of potassium in the urine is a valid, objective indicator of diet quality," researcher Dr. Andrew Mente, of the Prosserman Center for Health Research in Toronto, said in a prepared statement.

"This urinary marker is a simple, objective, universally available measure of diet quality that may aid physicians in providing effective dietary counseling. Physicians can now establish targets for therapy, monitor the effectiveness of dietary interventions over time, and provide effective dietary counseling to patients at risk because of poor food choices," Mente said.

The study was to be presented Friday at the annual meeting of the American Society of Nephrology, in San Diego.

More information

The U.S. Food and Drug Administration has more about healthier eating.

 

Infant massage may ease crying, sleep problems

 

Reuters Health

Friday, November 17, 2006

Just like their stressed-out parents, babies may take comfort from a gentle massage, a research review suggests.

Infant massage has long been used in many Asian and African cultures to ease babies' colic and fussiness, help them sleep, and even aid their growth and development. There is growing interest in infant massage among parents in Western countries as well.

To assess the science behind the practice, UK researchers analyzed 23 clinical trials in which infants younger than 6 months were randomly assigned to receive massage or not.

They found that across nine of the studies, gentle massage appeared to improve infants' sleep patterns, ease crying, and strengthen mother-child bonding. Some studies found that massage lowered babies' levels of certain stress hormones.

Given this apparent hormonal effect, it's "not surprising" that massage seemed to improve sleep and crying, according to the researchers, led by Angela Underdown of the University of Warwick in Coventry, England.

On the other hand, the nine studies showed no benefits for infants' growth and development. And the researchers considered the rest of the 23 trials to have a "high risk of bias" because of concerns about their methodology; some reports, for instance, lacked information about how the study was designed and conducted.

Overall, the results offer "tentative support" for teaching parents and caregivers infant massage -- though there's not enough evidence to universally recommend the practice, the investigators note in the latest issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research.

The trials included in the review were conducted in China, North America, Great Britain and Israel, and included 598 healthy, full-term infants. In some studies, researchers provided the massage, while parents did in others. Most looked at the effects of daily massage over a period of weeks.

It's not clear how often, when or for how long babies should receive massage to get the most benefits. Underdown and her colleagues recommend that future studies examine these questions.

Source: Cochrane Library, online October 18, 2006.

Exercise Key to Seniors' Independence: Study

 

HealthDay News

Friday, November 17, 2006

FRIDAY, Nov. 17 (HealthDay News) -- Structured exercise programs can help keep sedentary seniors from losing their independence, new research shows.

"Compared with those who received health education [only], participants in the physical activity group had a lower risk of becoming unable to walk 400 meters," or about a quarter-mile, said lead researcher Dr. Marco Pahor of the University of Florida, Gainesville.

The study, conducted at four centers across the United States, also found it's largely safe for many older adults to start a moderate exercise program.

The study was funded by the U.S. National Institute on Aging (NIA) and included 424 people, ages 70 to 89, who exercised less than 20 minutes a week and had low scores on three physical performance assessments -- walking speed, balance and the ability to get out of chair. They also had to walk 400 meters (about a quarter of a mile) within 15 minutes without sitting or using a cane or any other kind of assistive device.

Half the participants were assigned to a control group that took part in a "successful aging" health-education program that offered information about nutrition, foot care, medications, preventive services, and other health topics. It also included arm-and-shoulder flexibility exercises led by an instructor.

The other participants were enrolled in an exercise program that included individualized counseling and supervised and home-based exercises that focused on areas such as endurance, strengthening, flexibility and balance.

After 6 months and 12 months, seniors in the exercise group had significantly higher physical performance scores than those in the control group and were more likely to maintain their walking speed through the 400-meter walking test.

The findings, published in the November issue of the Journal of Gerontology: Medical Sciences, were to be presented Friday at a meeting of the Gerontological Society of America.

The researchers said their findings from this pilot study confirm the feasibility and safety of testing this kind of exercise program in a larger study.

"As U.S. life expectancy rises, functional decline and disability among older people are growing public health and clinical concerns," Dr. Richard J. Hodes, NIA director, said in a prepared statement.

"This pilot study helps us to understand better the relationship between exercise training and mobility, which is a key to maintaining older adults' independence and quality of life, and provides a basis for designing more definitive large-scale clinical trials," Hodes said.

More information

The American Medical Association has more about fitness for older adults.

 

Thursday, November 16, 2006

 

Neighborhood parks boost girls' physical activity levels

 

By Anne Harding

Reuters Health

Thursday, November 16, 2006

Young girls who live within a half-mile of a park are more physically active than those with no parks near their homes, a new study shows.

And the more amenities like tennis or basketball courts, playgrounds, and running tracks in these neighborhood parks, the more vigorously active the girls were, Dr. Deborah A. Cohen of the RAND Corporation in Santa Monica, California, and colleagues found.

While the current study could not determine whether or not the girls were actually spending time in their local parks, Cohen noted in an interview with Reuters Health, the findings make it clear that environment did play a role in their physical activity levels.

The current study included 1,556 sixth-grade girls living in six US cities. For six days, each wore a device called an accelerometer that measured the amount and intensity of her physical activity. The researchers also mapped out the number of parks near each study participant's home.

Living within a half-mile of a park was tied to increased activity and physical activity rose with the number of parks. However, parks further away from a girl's home had no effect, the researchers found.

For example, a girl who lived within a half-mile of 3.5 parks would be 10 percent more active, on average, than a girl who had no parks in her neighborhood.

The researchers also found that living close to parks with facilities such as gyms, swimming pools and walking paths was associated with even more intense physical activity compared to living near parks without such amenities. Parks with streetlights and floodlights were also linked to more physical activity than unlit parks.

There are two schools of thought on physical activity and environment, Cohen notes; either that a person's surroundings have no effect on physical activity or that aspects of a person's environment -- like living in a neighborhood with no sidewalks or where being outside isn't safe -- play a role.

"This study supports the idea that the environment matters," she said. "If the environment didn't matter, we wouldn't see an association."

Cohen pointed out that 43 percent of girls in the current study had no parks within a half-mile radius of their homes, making it clear that "there's a long way to go" before parks' potentially health-promoting effects are universally available.

Source: Pediatrics, November 2006.

Diabetes Dragging Down America's Health: Reports

 

By Steven Reinberg and E.J. Mundell
HealthDay Reporters

HealthDay News

Thursday, November 16, 2006

 

THURSDAY, Nov. 16 (HealthDay News) -- Half of the estimated 21 million adult Americans with diabetes now rate themselves as having only "fair" or "poor" health, and people between 18 and 44 years of age are increasingly affected, a new report from the U.S. Centers for Disease Control and Prevention finds.

In fact, people with diabetes are three times more likely than others to say their health is flagging, the CDC report found.

The news is troubling because "fair or poor health among persons with diabetes is also associated with the presence of diabetes-related complications such as lower extremity amputation, blindness, kidney failure, and cardiovascular disease," noted the editors of the CDC journal Morbidity and Mortality Weekly Report, which will publish the findings Friday.

In the study, CDC researchers looked over 2005 data from the federal Behavioral Risk Factor Surveillance System, an ongoing survey of adult Americans' health and health risk factors. Among the poll's questions: "Would you say that, in general, your health is excellent, very good, good, fair, or poor?"

According to the survey, almost half (49.3 percent) of those with diabetes said they were only in "fair" or "poor" health -- a number three times higher than that of people without diabetes.

The rate of fair/poor health among people 45 and older with diabetes has remained stable over the past 10 years, hovering around 50 percent. But the CDC noted that health complaints are rising among younger Americans. Among people with diabetes aged 18 to 44, reports of fair/poor health rose from about 36 percent in 1996 to 43.4 percent by 2005, the researchers found.

Race and availability of insurance were also key to health. Hispanic Americans, especially, are 60 percent more likely than whites to note poor health linked to diabetes, and a lack of health insurance boosted the likelihood of poorer health by 70 percent, the study found.

Diabetes care is becoming an increasing burden on the U.S. health care system, according to two other government reports released Wednesday.

Between 1996 and 2003, the number of adult diabetes patients soared from 9.9 million to 13.7 million, and their individual annual spending on prescription drugs jumped almost 86 percent, from $476 to $883.

According to the reports, from the Agency for Healthcare Research and Quality, overall care for patients with diabetes -- including treatment in and out of hospital and for other illnesses such as congestive heart failure -- averaged more than $10,000 annually.

The new diabetes statistics come on the heels of good and bad news from the federal government's annual Health, United States report for 2006, issued Wednesday.

That report found that diabetes continues to be a growing threat, especially among older adults. Eleven percent of adults aged 40 to 59, and 23 percent of those 60 and older, have diabetes.

The report also focuses on the problem of chronic pain.

According to the report, 25 percent of adults say they've experienced pain that lasts at least one day, and 10 percent say they've lived with pain that persists a year or more.

"We are living longer, and we have more chronic conditions," said lead author Amy Bernstein, chief of the analytic studies branch at the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics. "Diabetes rates are increasing, obesity rates are increasing. And, as people live longer, they get more chronic conditions, including pain."

According to the report, 21 percent of adults aged 65 and older said they had experienced pain in the past month that lasted for more than 24 hours. And almost three-fifths of adults 65 and older said their pain had lasted a year or more.

Between the periods 1988-1994 and 1999-2002, the percentage of adults who took a narcotic drug to alleviate pain in the past month rose from 3.2 percent to 4.2 percent.

The news from the report wasn't all bad, however. Despite the rise in obesity and diabetes, life expectancy for Americans reached a record 77.9 years in 2004, up from 77.5 in 2003 and 75.4 in 1990. In addition, since 1990, the gap in life expectancy between men and women has narrowed from seven to just over five years. Among women, life expectancy is just over 80 years, and it's almost 75 for men. Also, the gap in life expectancy between white and blacks has narrowed from seven years in 1990 to five years in 2004.

At the same time, infant mortality dropped to 6.8 deaths per 1,000 births in 2004, down from 6.9 deaths per 1,000 births in 2003.

Heart disease remains the nation's leading killer, but deaths from heart disease fell 16 percent between 2000 and 2004, according to the report. And deaths from cancer -- the number 2 killer -- fell 8 percent. The death rate for heart disease was 217 deaths per 100,000 in 2004; the death rate for cancer was 186 per 100,000.

Paying for needed care remains a problem for millions, however. According to the federal data, the United States spent an average of $6,280 per person on health care in 2004. However, 7 percent of people under 65 said they didn't get needed care in the past year because of the cost.

More information

You can read the entire Health, United States, 2006 report on the nation's well-being at the U.S. National Center for Health Statistics.

 

Elderly dying from falls more often

 

By Mike Stobbe

AP Medical Writer

The Associate Press

Thursday, November 16, 2006

 

The death rate from falling has risen dramatically for elderly people since the 1990s, said federal health officials, speculating that it's because people are living longer with chronic conditions like cancer and heart disease.

"Since people are not dying as much from chronic diseases, they're more likely to die from a fall," said Judy Stevens, an epidemiologist with the U.S. Centers for Disease Control and Prevention.

Falling is the 14th leading cause of death among the elderly.

But Stevens, lead author of the study reported Thursday in CDC's Morbidity and Mortality Weekly Report, had good news to offer too.

Women's hip fracture injury rates have dropped in recent years, probably because of osteoporosis screenings and bone-building treatments.

"I think they're strongly contributing," Stevens said.

The researchers noted a marked decline in hip fractures after 1996. One possible explanation: In 1998, the Medicare program began reimbursing doctors to do bone density screenings on elderly people, according to the National Osteoporosis Foundation.

The CDC research is believed to be one of the first national studies to show a decline in hip fractures in elderly women. It also provides the newest federal data on elderly deaths from falls since 1996.

Older people fall for a variety of reasons. Like young people, sometimes they trip on something, said Dr. Jeff Lesesne, a geriatrics specialist at Atlanta's Emory University.

But he said many falls are associated with conditions of aging: vision loss; deterioration of the inner ear and other changes that affect balance; and loss of strength that prevents seniors from recovering from a stumble.

Many fall when they first stand up, Lesesne observed. Some incontinent patients slip on their own urine, he added.

CDC researchers looked at death certificate data from 1993-2003 and counted cases in which falls were listed as a primary or underlying cause of death.

They found more than 13,700 older adults died from falls in 2003. That translated to a rate of about 37 deaths per 100,000 people who were 65 and older.

The rate in 1993 was about 24 per 100,000 — meaning such deaths increased by 55 percent in the 10-year span.

The rate for men rose by about 45 percent in that time, from about 32 to 46 per 100,000. The rate for women rose 60 percent, from 19.5 to 31 per 100,000.

"I think it comes back to the issue of longevity. Women are living longer. There are even more frail women living to older ages than frail men," Stevens said.

The report also looked at nonfatal injuries during a smaller time frame, from 2001-05. Those too have been increasing, though at a rate of just 3 percent.

And in a separate measurement, the hospitalization rate for hip fractures fell from nearly 918 per 100,000 in 1993 to 776 per 100,000 in 2003. The decline was driven by a 21 percent reduction in hip fractures in women, researchers found.

On the Net:

CDC tips for preventing falls: http://www.cdc.gov/ncipc/duip/fallsmaterial.htm

 

Nanotechnology Holds Promise Against Brain Cancer

 

HealthDay News

Thursday, November 16, 2006

THURSDAY, Nov. 16 (HealthDay News) -- Tiny "nanoparticles" can be loaded with high concentrations of drugs to kill brain cancer, U.S. researchers report.

Researchers at the University of Michigan (U-M) Comprehensive Cancer Center incorporated the drug Photofrin into nanoparticles (about one-billionth of a meter in size) that would target brain tumors.

Photofrin is drawn through the bloodstream to tumors. Doctors then use a special laser light to activate the drug, which collapses the blood vessels that feed the tumor. Without its blood supply, the tumor starves.

The drug has been used to treat several types of cancer, but "free" Photofrin therapy can damage healthy tissue. Nanoparticles allow direct delivery of Photofrin to the tumor, the researchers explained.

As reported in the current issue of Clinical Cancer Research, the researchers found that rats with cancer that received traditional Photofrin therapy survived 13 days, while rats treated with the Photofrin/nanoparticle method survived an average of 33 days, and another 40 percent remained disease-free six months after treatment.

"Thinking outside the box is a must for developing brain cancer treatments," study author Alnawaz Rehemtulla, a professor of radiology and radiation oncology, said in a prepared statement.

"Drugs don't get into the brain when delivered the normal way, which explains in part why some current treatments for brain tumors are generally not effective. Targeting the tumor vasculature with nanoparticles containing a payload will overcome these issues," Rehemtulla said.

Further research is needed before this nanoparticle treatment method can be tested in humans.

More information

The U.S. National Cancer Institute has more about brain tumors.

 

Popular painkiller may pose heart danger: study

 

By Maggie Fox, Health and Science Editor

Reuters

Thursday, November 16, 2006

Researchers looking at the safety of various arthritis and headache remedies said on Thursday they had found some more evidence that the popular analgesic naproxen may cause heart problems.

The researchers themselves cautioned about reading too much into their findings, and outside experts discounted them.

Nonetheless, the researchers said they thought it was important to present their evidence to help experts sort out what the real dangers are.

The issue is important because companies have been forced to withdraw several drugs in a new class called COX-2 inhibitors because they may cause strokes and heart attacks, and drug makers face multi-million dollar liability suits.

And the U.S. Food and Drug Administration has ordered strict warnings to be put on packages of painkillers known as non-steroidal anti-inflammatory drugs or NSAIDS, including naproxen, a popular NSAID sold over-the-counter by Bayer under the brand name Aleve.

The warning labels were ordered because of some studies that suggested NSAIDS might also raise heart risks.

"Particularly for safety data, 'truth' may come in small doses. We firmly believe that results from trials should be published regardless of the direction, magnitude, or statistical significance of the observed results," said Barbara Martin of the John Hopkins University School of Public Health, who worked on the study.

Writing in the Public Library of Science journal PLoS Clinical Trials, Martin and colleagues said they looked at data from a trial designed to see if Celebrex might help prevent Alzheimer's disease in high-risk patients.

The 2,500 elderly volunteers were given either COX-2 inhibitor Celebrex, naproxen or a placebo for up to 3-1/2 years. It was stopped when concerns rose over the safety of COX-2 inhibitors.

The trial showed no increased or decreased heart risk for Celebrex, known generically as celecoxib, compared to placebo.

But it did show an increased risk for naproxen.

Over three years, 5.5 percent of the patients getting Celebrex had a stroke, heart attack or were diagnosed with congestive heart failure, while 5.6 percent of those getting a placebo did.

In comparison, 8.25 percent of the naproxen patients had such a serious cardiovascular incident or death.

Dr. Steve Nissen of the Cleveland Clinic in Ohio said the trial's findings were "completely unreliable."

"The stopping of the study early was improper and it led to erroneous conclusions," Nissen said in a telephone interview.

"We know from very large epidemiological (population) studies and all sorts of studies that naproxen is a safe drug, perhaps the best of the NSAIDS," added Nissen, an outspoken expert on the safety of NSAIDS and COX-2 inhibitors.

Just last week, a much smaller study led by Dr. Michael Schiff of the Denver Arthritis Clinic suggested that naproxen did not raise the risk of heart attack and stroke.

"We don't have the full answers," Nissen said. He has a safety trial with 21,000 patients under way to compare naproxen with Celebrex and placebo.

New Links Detailed Between Diet, Cancer Risk

 

By Rick Ansorge
HealthDay Reporter

HealthDay News

Thursday, November 16, 2006

THURSDAY, Nov. 16 (HealthDay News) -- What you choose to eat might determine your risk of developing some common cancers.

That's the conclusion of several new studies presented this week at an American Association for Cancer Research meeting in Boston.

Women who eat high amounts of soy, especially as children, may have a significantly lower risk of breast cancer, according to one study. Other studies show that men who eat a fish-rich diet may have a decreased risk of colorectal cancer and that male smokers who eat foods containing high amounts of vitamin E -- such as nuts, whole grains and green leafy vegetables -- may have a decreased risk of developing tobacco-related cancers.

Together, this research offers some of the strongest evidence to date of a link between diet and cancer, the study authors said.

"This is the first study to look at childhood soy exposure and the later risk of breast cancer. It suggests that there really is a biologic effect for soy, and we're excited about that," said lead researcher Dr. Larissa Korde, of the U.S. National Cancer Institute.

"The more we know about cancer, the more it's clear that diet is related to cancer," added Dr. Alan Kristal, of the Fred Hutchinson Cancer Research Center in Seattle, who moderated the meeting's diet and cancer session but was not connected with the three studies. "But the relationship is complex. Diet and cardiovascular disease is simple compared to diet and cancer because the risk factors differ for different cancers."

In their study, Korde's team examined diet and lifestyle factors in 1,563 Asian-American women, 597 of whom had breast cancer and 966 of whom did not.

The researchers found a 58 percent lower risk of breast cancer in women who ate the most soy as children -- an average of a little over two servings per week -- compared to women who ate the least soy -- an average one-quarter serving per week. They also found a 25 percent lower risk of breast cancer in women who ate the most soy as adolescents and adults.

A recent review of 18 epidemiological studies showed a more modest overall reduction in risk: 14 percent.

However, the new study looked at women of Chinese, Japanese and Filipino ancestry because "it is a population that has a very different diet and lifestyle than most Americans," Korde explained.

Asians consume much more soy than Americans do and breast cancer rates in Asian countries are four to seven times lower than they are in the United States, she said. But after Asians migrate to the United States, it usually takes only three generations for their breast cancer rates to catch up to those of American white women.

Korde's team used food-frequency questionnaires to study the women's diets. They also interviewed the women about other lifestyle factors, such as whether or not they lived in mostly Asian or non-Asian neighborhoods, shopped in Asian or non-Asian grocery stores and read Asian or non-Asian newspapers. They also interviewed 255 of their mothers to get additional information about their daughters' childhood exposures.

"We found that soy was more important than these other measures of acculturation," Korde said.

Although scientists don't know exactly how soy affects breast cancer risk, animal models suggest that a soy component -- isoflavones -- may have protective, estrogen-like effects. "The hypothesis is that exposure to estrogen-like substances early in life can cause changes in developing breast tissue that decreases its sensitivity to carcinogenesis later in life," Korde said.

That may explain why soy seemed to be especially protective in women who ate high amounts of tofu, miso and natto between the ages of and 5 and 11, she said.

The timing of exposure to hormones or hormone-like substances may have a critical effect on breast cancer risk, Korde added. "For example, obesity earlier in life seems to decrease the risk of premenopausal breast cancer (because fat tissue also secretes estrogens). But it's been well-documented that hormone replacement therapy increases the risk of post-menopausal breast cancer."

Although Korde called the study findings "very promising," she cautioned that it's premature to tell American women and girls to start eating more soy. "Before we can make any recommendations, the findings need to be replicated by other studies," she said.

Other studies presented at the meeting also showed that eating certain foods may reduce the risk of certain cancers. In a new analysis of data from the 22,071 participants in the Physicians' Health Study, researchers from the Harvard School of Public Health found that men who ate fish five times a week or more had a 40 percent lower risk of developing colorectal cancer than men who ate fish less than once a week.

"We already know that eating fish can reduce the risk of sudden cardiac death, and this might provide another reason to add fish to your diet," study author Megan Phillips, of the Harvard School of Public Health, said in a statement.

Previous research has shown that high fish consumption may reduce women's risk of renal cell carcinoma -- the most common form of kidney cancer -- by 44 percent.

In a study of 280 smokers, researchers from Columbia University found that higher blood levels of vitamin E from food were associated with lower levels of oxidative damage in white blood cells, which is a marker of increased cancer risk. But the effect was only seen in male smokers, and it appeared to be most significant in men with a beneficial form of a common "detoxifying" gene: GSTM1.

"This suggests that while working toward the goal of quitting smoking, which is the very best way to prevent development of smoking-related cancers, it could be helpful to eat a diet rich in vitamin E," study author Frederica P. Perera said in a statement. "We don't know why this relationship was not found in women, but a good diet is beneficial to health in many ways."

Kristal, who is also professor of epidemiology at the University of Washington, called the new studies "interesting."

"They show that the relationship between diet and cancer is a complicated story," he said. "Diet interacts with many other factors, such as genes and other exposures you might have such as smoking."

"If you look at sum total of studies on diet and cancer, what you come away with is that it's important to prevent obesity, avoid toxins like excess alcohol, and eat a balanced diet that's moderate in fat and high in whole grains, fruits and vegetables," Kristal said.

More information

To learn more about soy and health, head to the U.S. Food and Drug Administration.

Health Tip: Thrombus vs. Embolus

 

HealthDay News

Thursday, November 16, 2006

(HealthDay News) -- Blood clots are clumps formed when blood coagulates. Such clots have different names, depending on where they are located and how they formed.

A blood clot that forms in a blood vessel or in the heart and does not move to another area of the body is called a thrombus, according to the U.S. National Library of Medicine. If the clot forms in a vessel or the heart but moves to another part of the body, it is called an embolus.

Blood clots can cause complications by attaching to the wall of a blood vessel and blocking the flow of blood to or from that vessel. Such a blockage prevents surrounding tissues from receiving necessary blood and oxygen, which can permanently damage or even kill those tissues.

Higher Resting Heart Rate May Boost Death Risk

 

HealthDay News

Thursday, November 16, 2006

THURSDAY, Nov. 16 (HealthDay News) -- A long-term rise in a man's resting heart rate increases his risk of dying, French researchers report.

Their study of more than 4,300 men, aged 42 to 53, found that those whose resting heart rate increased over five years were nearly 50 percent more likely to die over a 20-year span than men whose rate stayed the same or decreased.

A long-term decrease in resting heart rate reduced death risk by nearly 20 percent, the study found. The findings were to be presented at the American Heart Association's annual meeting in Chicago.

Resting heart rate is an indicator of how hard the heart is working to maintain adequate blood flow. A resting heart rate of 60 to 80 beats per minute (bpm) is normal. People in excellent physical condition have a resting heart rate of about 40 to 50 bpm.

The researchers concluded that resting heart rate and its changes may be an independent risk factor for death.

"We don't know why resting heart rate does down or up over time. It might be related to lifestyle changes, such as less activity," study author Dr. Xavier P. Jouven, of the Hopital Europeen Georges Pompidou INSERM in Paris, said in a prepared statement.

"We also cannot say for sure whether the increase in resting heart rate is only a marker for some other disease process or whether it is directly associated with mortality," Jouven said.

More research needs to be done to learn more about resting heart rate's role as a health indicator, he said.

More information

The U.S. Food and Drug Administration has more about the healthy heart.

Low Cholesterol Lowers Risk for Aggressive Prostate Cancer

 

HealthDay News

Thursday, November 16, 2006 

THURSDAY, Nov. 16 (HealthDay News) -- Men with low blood cholesterol levels are at lowered risk of high-grade and possibly advanced prostate cancer, researchers report.

Lower cholesterol does not lower a man's overall risk for prostrate cancer, however, concludes a U.S. study presented this week at the annual meeting of the American Association for Cancer Research, in Boston.

Previously, the researchers found that men who used cholesterol-lowering statin drugs were about 50 percent less likely to have advanced prostate cancer. It's known that cholesterol plays a role in a number of factors that can influence the start of cancer.

In this new study, researchers at Johns Hopkins University and elsewhere investigated whether a low plasma cholesterol level is associated with lower prostate cancer risk overall. They also examined the link between plasma cholesterol level and stage and grade of prostate cancer.

The study included 698 men with prostate cancer and 698 prostate cancer-free men in a control group. The team measured each man's plasma concentration of total cholesterol.

"Men with low plasma cholesterol had a lower risk of high-grade and possibly advanced prostate cancer, but not prostate cancer overall," the researchers wrote.

More information

The American Cancer Society has more about prostate cancer.

 

Ovarian cancer rates lower in sunny latitudes

 

By Amy Norton

Reuters Health

Thursday, November 16, 2006

 

Women in the sunnier regions of the world have a much lower risk of ovarian cancer than those who dwell in colder climates, a new study has found.

The findings, say researchers, suggest that sun exposure -- and, more precisely, vitamin D production in the body -- help prevent this cancer.

The study, which appears in the December issue of the American Journal of Preventive Medicine, is the latest to tie latitude to cancer risk. Others have found that rates of breast cancer and colon cancer, for example, are higher among people living in higher latitudes, where annual sun exposure is limited.

The theory is that vitamin D explains the link. Sunlight triggers vitamin D synthesis in the skin, so a person's stores of the vitamin depend, in part, on where he or she lives. Moreover, a growing number of studies have linked vitamin D intake and vitamin D levels in the blood to cancer risk.

One recent study found that adults who took 400 IU of vitamin D per day were half as likely as people who took no vitamin D supplements to develop pancreatic cancer.

Lab research has also shown that the vitamin helps thwart cancer cell growth and proliferation.

It's particularly important to find ways to lower ovarian cancer risk because there's no good way to detect it early, said Dr. Cedric F. Garland of the University of California San Diego, the lead author of the new study.

To investigate the possible role of sun exposure in ovarian cancer, he and his colleagues examined data on ovarian cancer rates in 175 countries and correlated it with information on latitude, UV radiation and atmospheric levels of ozone -- which affects UV transmission.

Overall, Garland's team found, ovarian cancer rates were highest in higher-latitude regions in both hemispheres. In addition, greater UV exposure and lower ozone levels were both linked to lower ovarian cancer rates.

The findings show only an association between latitude and ovarian cancer, and not that vitamin D fights the disease. Many other factors, from genes to lifestyle habits to reproductive choices, differ among women living in low- and high-latitude nations -- with countries farther from the equator being more developed and affluent in general.

And no one is recommending that women bask in the sun, or move to Florida, to prevent ovarian cancer, Garland said. "We don't want anyone to burn," he advised.

However, the body of evidence on cancer and vitamin D suggests that modest sun exposure and use of vitamin D supplements could offer a cancer defense, according to the researcher.

A person with medium-tone skin, he said, could get enough vitamin D by spending about 15 minutes in the sun each day, with 50 percent of the skin exposed -- less time for a fair-skinned person, more for someone with dark skin.

But since many people get little sun, Garland recommended that adults take 2,000 IU of vitamin D a day, which is the "tolerable upper intake level" set by U.S. health officials.

That limit exists because of the risk of vitamin D toxicity, which causes elevated calcium levels in the blood and problems such as nausea, weight loss, fatigue and kidney dysfunction.

Source: American Journal of Preventive Medicine, December 2006.

Red Wine Compound Could Boost Endurance

 

By Steven Reinberg
HealthDay Reporter

HealthDay News

Thursday, November 16, 2006

THURSDAY, Nov. 16 (HealthDay News) -- Athletes and non-athletes alike may want to raise a glass to resveratrol, an ingredient in red wine that researchers say doubled the physical endurance of mice in a new study, while protecting them against diabetes and obesity.

Mice given high doses of the compound were able to run twice as far on treadmills than they normally could, French researchers reported.

Resveratrol might even help the rodents live longer, they say.

"The compound resveratrol, found in the skin of red grapes and cranberries, was known to activate SIRT1, an enzyme known to be involved in lifespan extension," explained lead researcher Dr. Johan Auwerx, from the Institute of Genetics and Molecular and Cellular Biology in Illkirch, France.

These results, published in the Nov. 16 issue of Cell, add to findings from a recent study that showed that resveratrol improved health and lengthened survival of mice placed on a high-calorie diet.

While studies have so far been limited to mice, the French team said they had also found a genetic link to energy expenditure in humans that looks like it might be similarly affected by resveratrol.

"Our study shows that activation of SIRT1 by resveratrol is a very promising and well-tolerated approach to treat common metabolic diseases, such as obesity and type 2 diabetes," Auwerx said.

The study involved obese mice with a condition that mimicked type 2 diabetes.

Auwerx's team found that resveratrol activated the SIRT1 gene, inducing the activity of mitochondria, the tiny energy factories within cells. By activating mitochondria, resveratrol causes the cells to burn more energy than they normally could.

Burning more energy protects against fat accumulation and type 2 diabetes, the research team explained. Increasing mitochondria activity also improves the performance of certain tissues, most especially skeletal muscles.

"That is why we saw a spectacular increase in endurance in the mice, which doubled the distance they run," Auwerx explained.

"We showed this not only in cultured cells and mice, but also, more importantly, the first time in humans, where we linked the SIRT1 gene with energy expenditure," Auwerx said.

Resveratrol or its analogs could prove useful in treating several diseases that are characterized by abnormal mitochondrial activity, Auwerx said. "In the first case, you can think about applications in the treatment of obesity and type 2 diabetes," he said. "Many more diseases could benefit from increased mitochondrial activity, most notably neurodegenerative disorders, such as Parkinson's disease and Huntington's," he added.

This study was paid for by Sirtris Pharmaceuticals, which developed the compound used in the experiments.

But if you think that drinking more wine or taking resveratrol supplements might turn you into a super-athlete, think again, said Sirtris CEO Dr. Christoph Westphal.

"Native resveratrol from red wine or nutraceuticals cannot reach therapeutic levels in man," he said. "You would need to drink hundreds of glasses of red wine or take hundreds of nutraceutical pills in a day to get a therapeutic dose."

According to Westphal, the company has completed two phase 1 studies with 85 human volunteers of an improved formulation of resveratrol which reaches therapeutic levels in man and is safe.

In addition, Sirtris has started giving diabetic patients its resveratrol compound in a 28-day phase 1 trial to test the safety of the drug and to see how it affects glucose levels.

"We are also initiating a phase 1 study in a rare, very severe mitochondrial disorder called MELAS," Westphal said. The condition -- "mitochondrial myopathy, encephalopathy, lactacidosis, stroke" (MELAS) -- is a progressive neurodegenerative disorder.

One expert was cautious about the findings.

"This is an important addition to the body of work that is showing that you can activate anti-aging genetic pathways," said David Sinclair, an associate professor of pathology at Harvard Medical School, and a cofounder of Sirtris.

He called the study an important sep in the development of new drugs to fight heart disease, Alzheimer's and age-relate other woes. "In five years, we should know if the results obtained in mice can be achieved in people," he said.

The compound's usefulness against diabetes remains unproven, Sinclair said. "A mouse is not a human," he said. "It would be amazing if it worked in humans. But we will have to wait and see."

Another expert expressed similar skepticism.

"It's clear that the authors of the Cell paper want to strongly argue that their data show a causal link between activation of SIRT1 and the effects of resveratrol," said Matt Kaeberlein, an assistant professor of pathology at the University of Washington. "While all of their data is consistent with this model, and the data is compelling, there really is no causal evidence that the effects of resveratrol in mice require SIRT1 activation," he said.

Kaeberlein suggested that to really test their theory, the researchers should have experimented with mice that did not have the SIRT1 gene, to see whether these mice would respond to resveratrol when fed a high-fat diet.

"Also, there is abundant evidence that resveratrol acts on proteins other than SIRT1, so it's premature to conclude that everything seen in this paper is due to effects on SIRT1," he said.

More information

There's more on resveratrol at Oregon State University.

 

Wednesday, November 15, 2006

 

Take an aspirin with that flame-broiled burger

 

By Megan Rauscher

Reuters Health

Wednesday, November 15, 2006

You might want to cook the holiday turkey in the oven instead of on the grill, according to results of a study released this week that found that women who favor flame-broiled foods may be at much higher risk for developing breast cancer than women who do not.

Can't give up that flame-broiled taste? Then it might be wise to take an aspirin with your char-broiled meal, as the findings also suggest that aspirin may negate the potentially harmful effects of flame-broiled foods.

"Cooking meat at high temperatures in direct heat over an open flame can lead to the production of cancer-causing chemicals known as heterocyclic amines, or HCAs," Dr. Kala Visvanathan from Johns Hopkins University, explained at a cancer prevention conference sponsored by the American Association for Cancer Research.

By studying the eating patterns of 312 women with breast cancer and 316 women who were cancer free, Visvanathan's team found that breast cancer was increased a significant 74 percent in women who ate flame-broiled foods more than twice per month compared with women who never ate flame-broiled foods.

"We saw similar results for increased meat consumption" in general, Visvanathan said. Women who ate more than 64 grams per day compared with those who ate less than or equal to 64 grams per day had a 43-percent higher risk of breast cancer.

However, a woman's ability to activate cancer-causing HCAs modified the risk of developing breast cancer. The NAT2 enzyme, short for N-acetyltransferase, activates HCAs, Visvanathan explained. Slow NAT2 metabolizers tend to produce less active HCAs than fast NAT2 metabolizers.

Visvanathan reported that women who were "rapid metabolizers" of NAT2 who ate more flame-broiled food and consumed more meat daily were much more likely to develop breast cancer than slow metabolizers who never ate flame-broiled food and meat.

Interestingly, in rapid NAT2 metabolizers who consumed flame-broiled food or a lot of meat, aspirin completely attenuated the increased risk of breast cancer, the researcher said.

"When we think of the biological mechanism," Visvanathan noted, "there is some experimental data to explain this, but we still need to explore this further." Some laboratory studies have suggested that aspirin may inhibit NAT2 activity. Overall, the relationship among aspirin, flame-broiled food consumption and NAT2 activity is "intriguing," Visvanathan said.

Health Tip: Signs of Carbon Monoxide Poisoning

 

HealthDay News

Wednesday, November 15, 2006

(HealthDay News) -- Carbon monoxide is an invisible, odorless gas that is emitted by stoves, gas cooking ranges, heating systems, and by burning wood and coal.

If the toxic gas builds up in a confined, unventilated space, it can cause serious illness and death.

If you suspect carbon monoxide buildup in your home, you must evacuate all people and pets immediately.

Here are warning signs of carbon monoxide poisoning, courtesy of the U.S. Centers for Disease Control and Prevention:

Headache. Dizziness or lightheadedness. Nausea or vomiting. Pain in the chest. Confusion or disorientation. Unconsciousness.

You can buy battery-operated carbon monoxide detectors for your home. The battery should be replaced when you change the time on your clocks each spring and fall, the CDC says.

Study explains "obesity paradox" in heart treatment

 

Reuters

Wednesday, November 15, 2006

Heavier patients with clogged heart arteries have lower death rates in the short term than their leaner counterparts because they get more aggressive treatment, a study said on Wednesday.

This so-called obesity paradox could occur because overweight patients were younger and doctors might be more willing to perform invasive treatments on them, said the study's author, Benjamin Steinberg, a visiting medical student at Johns Hopkins University.

The analysis of 130,139 patients found that heavier patients did better because doctors were more likely to follow standard treatment guidelines, including performing surgeries like angioplasty, which may improve their outcomes.

"The curve for mortality continued to trend down from lightest weight to heaviest weight; we would have expected to see a "U" shape with normal weight doing better," Steinberg said. His study was presented at the American Heart Association annual meeting in Chicago.

All the patients had coronary artery disease, a build up of fatty deposits in the cells lining the wall of the artery that blocks blood flow. It is the number one cause of death in the United States, according to the National Institutes of Health.

Fewer of the obese and overweight patients in the study died while in the hospital: 3.1 percent of overweight, 2.4 percent of obese and 5.4 percent of normal-weight patients.

"So while we need to focus on reducing the rates of obesity, we have to be mindful that other patients deserve just as aggressive treatment," he said.

The percentage of overweight young people in the United States has roughly tripled since 1980 to 16 percent of the population, according to the U.S. Centers for Disease Control and Prevention.

On Sunday, a study at the heart association meeting found that kids are showing signs of narrowing and hardening of the arteries, conditions normally associated with adults.

Migraines Linked to Heart Risk in Men

 

By Amanda Gardner
HealthDay Reporter

HealthDay News

Wednesday, November 15, 2006

WEDNESDAY, Nov. 15 (HealthDay News) -- Men who suffer from migraine headaches appear to be at an increased risk for cardiovascular disease, mostly due to a higher risk of having a heart attack, researchers report.

But the advice to men with or without migraines is the same, experts say: Pay attention to heart risk factors such as elevated blood pressure and cholesterol.

"Migraine has been associated with major risk factors for cardiovascular disease such as hypertension and elevated cholesterol, so patients with migraine should focus on traditional risk factors until we understand why migraine is linked with cardiovascular disease," said study author Dr. Tobias Kurth, an assistant professor of medicine at Brigham and Women's Hospital and Harvard Medical School, both in Boston.

Kurth presented his findings Wednesday at the annual meeting of the American Heart Association (AHA), in Chicago.

"Migraine is not so much a risk factor, but a sort of risk marker," added Dr. Gerald Fletcher, AHA spokesman and a professor of medicine at the Mayo Clinic College of Medicine in Jacksonville, Fla. "This should alert physicians and the public that this could be a problem."

This is only the second study to find a correlation between migraine and heart disease. Previous research by the same team of investigators found an association in women who experienced migraines with "aura," or visual disturbances preceding the attack.

This time, the researchers followed more than 20,000 men participating in the Physicians' Health Study, all of whom were free of heart disease at the beginning of the study.

Over the next 15.7 years, 7.2 percent of participants reported having migraines.

Compared with men who did not report migraines, migraine sufferers had a 42 percent increased risk of heart attack, the study found. This was similar to the relative risk found in the study of women.

Overall, men with migraines were at 24 percent increased risk of major cardiovascular events, with heart attacks being the leading reported problem.

"This translated into an additional risk of two major events per 10,000 men per year," Kurth said. "The absolute risk increase is rather on the low side."

Men with migraine had a 12 percent increased risk of ischemic stroke and a 7 percent increased risk of cardiovascular death. However, the authors said neither figure was statistically significant, meaning it could have occurred by chance.

Also, the average age of the participants was 56, so the findings cannot be extrapolated to younger men. In general, migraines occur more frequently among younger people.

The researchers had no information on migraine aura in these men, so it's unclear if the findings are restricted to that type of migraine or not.

Other questions remain.

"We don't know what the possible mechanisms are," Kurth said. "Migraine is associated with other risk factors such as hypertension and cholesterol, and there is an association between migraine and inflammatory markers. Whether these factors really cause the association is unknown at this point."

"Until we know more, the things that should be considered are major [heart] risk factors," he continued. "If you have this marker for increased risk and you have other risk factors, those should be modified and treated."

More information

There's more on migraine at the U.S. National Institute of Neurological Disorders and Stroke.

 

Religious observance may keep older people healthy

 

By Anne Harding

Reuters Health

Wednesday, November 15, 2006

A new study adds to mounting evidence that older people who regularly attend religious services are healthier than those who don't.

Among 1,174 highly functioning men and women in their 70s, those who went to a church, synagogue or mosque at least once a week had a significantly slower decline in their lung function over the following years than their peers who didn't go to services regularly, Dr. Joanna Maselko, now at Temple University in Philadelphia, and her colleagues report.

Maselko, who conducted the study while at the Harvard School of Public Health in Boston, used peak expiratory flow rate (PEFR), which measures the volume of air a person is able to expel from the lungs, to gauge lung function in the study participants.

At the study's outset, in 1988, 65 percent of female participants and 51 percent of men reported attending religious services regularly. Over the follow-up period, which averaged 4.6 years, PEFR declined twice as much in the people who didn't attend church services regularly compared with those who did.

While the more religious individuals were more physically active and also less likely to smoke, these differences didn't account for their better lung function.

People experience a steady decline in lung function as they age, and impaired lung function is a key early warning sign of many health problems, making pulmonary health and excellent gauge of overall health, Maselko told Reuters Health.

Religious service attendance likely protects people by giving them a supportive community, she added in an interview. "In the US, social isolation among the elderly is a huge problem," she said. "That's associated with all sorts of health problems, mental and physical."

Religion can also offer older people a psychological resource for coping with end of life issues, she added, while meditating, praying and singing at religious services may have benefits in and of itself. "The next step in the research is to try to unpack these things."

"I don't think the take-home message is if you don't go to church you should start," she added. "It's too early to really say this us what you should do, this is what you shouldn't do." Instead, she said, the findings provide additional evidence that "there's something there."

Source: Annals of Behavioral Medicine, November 2006.

Drug-Coated Stents Can Keep Leg Arteries Clear

 

HealthDay News

Wednesday, November 15, 2006

WEDNESDAY, Nov. 15 (HealthDay News) -- Drug-coated stents, the tiny mesh tubes that surgeons use to prop open arteries in the upper body, may also help restore and maintain blood flow to the lower legs, a small new study finds.

It can be difficult to treat clogged arteries in the lower leg because the arteries are smaller and can have a heavy buildup of fatty plaque. After treatment to remove plaque, the arteries often re-clog (restenosis), according to background information in the article.

The one-year study of 10 patients concluded that drug-coated (drug-eluting) stents may be a safe and effective way to restore and maintain blood flow through tiny clogged vessels in the lower legs.

The study, to be presented Wednesday at the American Heart Association's meeting in Chicago, found that drug-coated stents prevented restenosis in 90 percent of the patients.

"(Restenosis) is a very common problem that is associated with significant morbidity and mortality. It is something that we need to do a better job of treating. This is an exciting first step toward getting some answers to a difficult problem," study lead author Dr. Arthur G. Grant, an interventional cardiology fellow at Ochsner Medical Center in New Orleans, said in a prepared statement.

More information

The U.S. Food and Drug Administration has more about stents.

Long-term pain hits 1 in 10 Americans, CDC reports

 

Reuters

Wednesday, November 15, 2006

One in 10 U.S. adults suffer pain that lasts a year or more, according to government statistics released on Wednesday.

But Americans are living longer, with life span at a record average of just short of 80 years, according to the annual report on the nation's health from the Centers for Disease Control and Prevention.

"At birth, life expectancy for females is just over 80 years and nearly 75 for males.

The gap in life expectancy between white and black Americans also has narrowed from seven years in 1990 to five years in 2004," the CDC said in a statement.

"Life expectancy at birth reached a record 77.9 years in 2004, up from 77.5 in 2003 and from 75.4 in 1990."

But the bad news is that fully a quarter of American adults say they have suffered a day-long bout of pain in the past month, according to the National Center for Health Statistics, part of the CDC.

Lower back pain is among the most common complaints, along with migraine or severe headache, and joint pain, aching or stiffness, the survey found.

"We chose to focus on pain in this report because it is rarely discussed as a condition in and of itself -- it is mostly viewed as a byproduct of another condition," said Amy Bernstein, the researcher who led the study.

More than a quarter of adults interviewed said they had experienced low back pain in the past three months.

Migraines or severe headaches affected 15 percent of adults in the past three months, and 4.2 percent of adults had used a narcotic drug in the past month for pain relief.

The report found that U.S. health care spending averaged $6,280 per person in 2004.

Infant mortality fell to 6.8 deaths per 1,000 live births in 2004, down slightly from 6.9 deaths in 2003.

For adults, heart disease remains the leading killer, but deaths from heart disease fell 16 percent between 2000 and 2004, the report found.

Deaths from cancer -- the No. 2 killer -- dropped by 8 percent.

But diabetes is worsening and 11 percent of adults aged 40-59 years have diabetes - 23 percent of those 60 and older, according to the report, available on the Internet at (http://www.cdc.gov/nchs/hus.htm ).

New Model Predicts Glaucoma Risk

HealthDay News

Wednesday, November 15, 2006

WEDNESDAY, Nov. 15 (HealthDay News) -- Researchers say they've developed a model that predicts which patients would most benefit from treatments that ward off glaucoma.

The model uses five key risk factors in order to predict glaucoma risk. These factors are age; pressure within the eye; cup/disc ratio (a measure of the appearance of the optic nerve head); thickness of the cornea; and "pattern standard deviation" -- a measure derived from computerized field vision tests.

"When you enter these five factors -- and our model is based on the average of factors between the two eyes -- you can determine an individual's risk of developing glaucoma during the next five years," lead researcher Mae Gordon, professor in the department of ophthalmology at Washington University School of Medicine, St. Louis, said in a prepared statement.

"We have found that you can assess risk two ways," said Gordon. "We can enter the raw data, and our model will calculate the risk. We've also put together a simplified points system that assigns a certain number of points to the various risk factors. Adding up those points then provides doctors with an estimate of a patient's risk of progressing from elevated intraocular pressure to glaucoma."

Elevated eye pressure increases the risk for open-angle glaucoma, one of the most common forms of glaucoma and one of the leading causes of blindness in the world, affecting about 70 million people.

The findings were slated for presentation Tuesday at the annual meeting of the American Academy of Ophthalmology, in Las Vegas.

More information

The U.S. National Eye Institute has more about glaucoma.

Happy people may suffer fewer colds

By Amy Norton

Reuters Health

Wednesday, November 15, 2006

 

 Staying positive through the cold season could be your best defense against getting sick, new study findings suggest.

In an experiment that exposed healthy volunteers to a cold or flu virus, researchers found that people with a generally sunny disposition were less likely to fall ill.

The findings, published in the journal Psychosomatic Medicine, build on evidence that a "positive emotional style" can help ward off the common cold and other illnesses.

Researchers believe the reasons may be both objective -- as in happiness boosting immune function -- and subjective -- as in happy people being less troubled by a scratchy throat or runny nose.

"People with a positive emotional style may have different immune responses to the virus," explained lead study author Dr. Sheldon Cohen of Carnegie Mellon University in Pittsburgh. "And when they do get a cold, they may interpret their illness as being less severe." [

Cohen and his colleagues had found in a previous study that happier people seemed less susceptible to catching a cold, but some questions remained as to whether the emotional trait itself had the effect.

For the new study, the researchers had 193 healthy adults complete standard measures of personality traits, self-perceived health and emotional "style." Those who tended to be happy, energetic and easy-going were judged as having a positive emotional style, while those who were often unhappy, tense and hostile had a negative style.

Afterward, the researchers gave them nasal drops containing either a cold virus or a particular flu virus that causes cold-like symptoms. Over the next six days, the volunteers reported on any aches, pains, sneezing or congestion they had, while the researchers collected objective data, like daily mucus production.

Cohen and his colleagues found that based on objective measures of nasal woes, happy people were less likely to develop a cold.

What's more, when happy folks did develop a cold, their self-rated symptoms were less severe than would be expected based on objective measures.

When the researchers weighed other factors that could explain the relationship -- like volunteers' perception of their general health, their self-esteem and tendency to be optimistic -- happiness itself still seemed to protect against cold symptoms.

In contrast, people with negative dispositions were not at increased risk of developing a cold based on objective measures -- though they did tend to get down about their symptoms.

"We find that it's really positive emotions that have the big effect," Cohen said, "not negative ones."

So can a grumpy person fight the common cold by deciding to be happy? Conventional wisdom holds that personality traits -- unlike fleeting emotions -- are "very stable and difficult to change," Cohen said.

However, he noted, some recent research suggests that emotional traits are more amenable to change than traditionally believed.

Source: Psychosomatic Medicine 2006.

Antibiotics usually useless for bronchitis: study

 

By Will Dunham

Reuters

Wednesday, November 15, 2006

There is no evidence antibiotics help the vast majority of patients with acute bronchitis, and doctors should stop routinely prescribing them, researchers reported on Wednesday.

Acute bronchitis, an inflammation of the main airways to the lungs marked by an irritating cough, is one of the most common conditions treated by primary-care doctors, occurring in about 5 percent of adults each year.

Two Virginia Commonwealth University doctors, writing in the New England Journal of Medicine, said an exhaustive review of existing research studies and clinical trials turned up no evidence to support prescribing antibiotics for short-term bronchitis.

This is because, they stated, almost all cases are viral infections and do not respond to antibiotics.

They also found little evidence that cough medicine, also prescribed in most acute bronchitis cases, had any value.

Dr. Richard Wenzel, chairman of the Department of Internal Medicine at VCU's School of Medicine, said doctors prescribe antibiotics to 70 percent to 80 percent of patients with acute bronchitis for treatment lasting 5-10 days.

Wenzel said doctors generally should send home patients with acute bronchitis empty handed. Wenzel estimated that only a few percent of acute bronchitis cases might have a bacterial cause necessitating antibiotics.

Doctors say most cases will go away on their own after a few days or a week, and recommend rest and drinking lots of fluids.

'Not Needed'

"We think that for the most part antibiotics are not needed," Wenzel said in an interview.

Wenzel, who wrote the paper with VCU colleague Dr. Alpha Fowler, said he had several concerns about the routine prescription of antibiotics in these cases, aside from the fact they do not help most acute bronchitis patients.

Wenzel cited the cost of the many millions of pointless doses of the antibiotics as well as side effects from antibiotics such as diarrhea, gastric upset, rash, headaches and muscle aches.

Wenzel said the unnecessary prescriptions also contribute to the problem of bacteria becoming resistant to antibiotics, thus rendering them less useful for treatment of infections.

"I hope that doctors will pause ... and spend a few minutes to say (to patients) why it's unnecessary to take an antibiotic," Wenzel added.

"Now I know that I'm floating against the pressures of managed care to move people through. And sometimes I sort of see the obvious -- what's easier for a physician: take 30 seconds to write a prescription, or take five or 10 minutes to say why you don't need one?" Wenzel said.

BMI and waist size predict pre-diabetic state

 

By David Douglas

Reuters Health

Wednesday, November 15, 2006

 

Both body mass index (BMI) and waist circumference appear to be useful in predicting cardiovascular risk and metabolic abnormalities in people who are insulin resistant, a prediabetic condition, according to Californian researchers.

Dr. Gerald M. Reaven and colleagues at Stanford University School of Medicine hypothesized that BMI, the ratio of weight to height, and waist circumference might be equally effective in identifying insulin-resistant patients with cardiovascular disease risk factors.

To investigate further, the researchers examined 261 apparently healthy volunteers who had responded to advertisements about the study. Of this group, 133 were classified as obese, defined as having a BMI of 30 or greater.

As reported in the American Journal of Cardiology, the team found that several metabolism factors worsened as a function of increased obesity. Some of these included insulin sensitivity, a prediabetic condition in which normal insulin levels do not produce an adequate insulin response, and related metabolic cardiovascular risk factors, such as elevated triglycerides.

This was true regardless of whether BMI or waist circumference was used as the measure of excess fat.

However, increases in total and "bad" LDL cholesterol and decreases in "good" HDL-cholesterol concentrations were seen only in subjects with higher BMI values.

Summing up, Reaven told Reuters Health that it appears that "either BMI or waist circumference can be used by clinicians to help indicate whether a particular patient may be insulin resistant and at increased cardiovascular risk."

"However," he concluded, "since most patients have their height and weight determined when they see a physician, and it is easy to calculate BMI from these simple measurements, why not just stick with BMI?"

Source: American Journal of Cardiology, October 15, 2006.

Flu vaccine helps cut heart attacks, deaths: study

 

By Julie Steenhuysen

Reuters

Wednesday, November 15, 2006

 

Getting a flu shot can reduce the incidence of death, heart attack or unplanned procedures to open clogged heart arteries in patients with coronary artery disease, Polish researchers said on Wednesday.

The study adds to a growing body of evidence suggesting that people with heart trouble should get a flu shot every year.

"We know that people die of flu who have underlying cardiopulmonary disease. It's only logical that if you are able to prevent flu with vaccine, you can prevent these deaths," said Dr. Arnold Monto, professor of epidemiology at the University of Michigan.

"Flu puts these people over the edge," said Monto, who serves on the World Health Organization's Influenza Pandemic task force.

The study, which was conducted in Poland and presented at the American Heart Association meeting in Chicago, involved 658 patients with coronary artery disease. Of those, 325 received an active flu vaccine and 333 received a placebo.

After 296 days, patients who did not receive the vaccine were nearly twice as likely to have a heart attack, undergo an unplanned angioplasty to open blocked arteries or die from heart-related causes.

Monto said the study was significant because it compared groups who received the vaccine and groups who did not.

He said such a trial would be considered unethical in the United States because of U.S. guidelines recommending that heart patients get flu shots.

Flu is responsible for 36,000 deaths and 225,000 hospitalizations in the United States each year, yet only one in three adults with heart disease got flu shots last year, according to the American College of Cardiology.

"The study reinforces the principle that patients who have underlying cardiac disease -- particularly coronary artery disease -- are somewhat protected by having the influenza vaccine," said Dr. Leroy Rabbani, a cardiologist at Columbia University Medical Center in New York,

Rabbani said other studies have shown a link between inflammation and heart attacks. "Anything that can decrease the opportunity for infection such as flu vaccine will be beneficial," he said.

The American Heart Association and the American College of Cardiology in September issued a scientific advisory asking heart doctors to give flu shots to their patients.

Coronary artery disease occurs when the arteries that supply blood to the heart muscle become hardened and narrowed. It is the most common type of heart disease and the leading cause of death in the United States in both men and women.

Tuesday, November 14, 2006

 

Study questions radiation after prostate removal

 

Reuters

Tuesday, November 14, 2006

Using radiation to try to halt the spread of advanced prostate cancer after the gland itself has been surgically removed does not appear to add much to overall survival rates, a study said on Tuesday.

About a third of the 230,000 cases of prostate cancer diagnosed in the United States each year result in removal of the gland, and of those the cancer has spread in 38 to 52 percent of patients, said the report from the University of Texas Health Science Center in San Antonio.

For the past four decades, radiation treatments have often been used in cases where the cancer has spread but the effect of such therapy on survival has not been tracked, said the report published in this week's Journal of the American Medical Association.

The Texas researchers said they looked at 425 men with cancer beyond the prostate after the gland had been removed from 1988 to 1997. About half of the men were treated with radiation beam therapy and the others were not.

At the end of the study 71 in the radiation group had died compared to 83 in the non-radiation group, a difference not considered significant, the study said.

In another prostate-related study in the same issue, researchers at the Urological Sciences Research Foundation and the University of California, Los Angeles, reported that testosterone treatments to combat what is sometimes called male menopause do not appear to complicate prostate problems also common in older men.

The finding was based on 44 men with low blood levels of testosterone, some of whom were given injections of the hormone while others received an inert substance.

After six months of treatment, no changes were observed in their prostates or in cancer incidence or severity and there were only slight changes in urination-related problems, said the study.

"These preliminary data suggest that in aging men with late-onset hypogonadism (reduced secretion of hormones from sex glands), six months of testosterone replacement therapy normalizes serum androgen levels but appears to have little effect on prostate tissue androgen levels and cellular functions," the report said.

It added that establishing safety generally would require tests on a larger scale.

Blood testosterone levels decline with age, and many older men may as a result suffer depression, sexual dysfunction, diminished lean body mass, muscle volume and strength and reduced bone mineral density -- changes that have sometimes been called male menopause, the study said.

You May Be What Your Grandmother Eats

 

By Alan Mozes
HealthDay Reporter

HealthDay News

Tuesday, November 14, 2006

TUESDAY, Nov. 14 (HealthDay News) -- Could your grandma's dining habits be influencing your genes? A new study in pregnant mice suggests they might.

The study found that a female mouse's diet while pregnant influences the genetics of not only her pups, but her pup's pups.

"This is a mouse model study, so it is not directly relevant to humans," cautioned study co-author Dr. David I. K. Martin, a researcher with the Children's Hospital Oakland Research Institute in Oakland, Calif. "However, what this study does tell us is that it is possible that not just the diet but other environmental agents that a mother is exposed to could affect not only the health of her child but also the health of her grandchildren."

"And this is the first study to nail down this kind of cross-generational effect on a specific gene," he added.

His team published its findings in this week's issue of Proceedings of the National Academy of Sciences.

Martin, who conducted his work alongside colleagues at the Victor Chang Cardiac Research institute in Sydney, Australia, focused on a strain of mice that possesses a specific gene involved in the determination of coat color, as well as obesity and the tendency to develop diabetes and cancer.

The authors point out that the mice -- known as Avy (or "viable yellow agouti") mice -- are as genetically identical to one another as identical twins would be. This enables scientists to more easily isolate and compare genetic behavioral differences that could result from exposing the mice to a wide range of dietary factors.

In this instance, the researchers offered some female Avy mice a standard lab diet throughout their pregnancy. The diet contained foods typically consumed by humans.

A second pool of mice was offered additional supplementation for one week in the middle of their pregnancy. Supplements included folate, choline, betaine, vitamin B12, zinc, and methionine.

At birth, pups' coat color was assessed in terms of shades of yellow and brown. The scientists used these as markers for specific gene activities.

Mice exposed to the supplements in utero had browner coats, the researchers found.

Subsequent breeding of females from this "first generation" of brown-coated mice revealed a carry-over affect to the next generation. Despite this time consuming a supplement-free diet throughout their pregnancy, these grandchildren of the original mouse were also born with similarly brown coats.

Having identified a clear effect of diet on the gene behavior of two generations of mice, Martin and his colleagues said they're not yet sure how far downstream such environmental influences might go.

"This could go in humans for decades," Martin postulated, "because the generation time in humans is now about 30 years. So, 100 years from now -- when a grandchild is 70 years old -- society could still be dealing with the effects that stem from a mother who is pregnant now and is exposed to something that affects the fetus."

Dr. Marcus Pembrey, an emeritus professor of pediatric genetics with the Institute of Child Health at University College London, said the findings weren't all that surprising.

"We've published evidence of similar trans-generational effects in humans, but not with this same gene," he said. "So this is a further piece of evidence that changes in nutrition can affect the activity of genes in descendants as well as in the fetus being exposed."

Martin stressed that the current work in mice is not proof that similar long-term dietary effects are at play in humans.

"It's really not possible to do this kind of research with humans, because we can't do experimental manipulations of this kind among people," he said. "So, it would not be responsible to prescribe that anyone take any course of action based on this study."

Pembrey agreed. "It would be very important to say that we are a long way off from interpreting these mouse findings in relation to humans," he said. "Yes, this trans-generational effect has been observed in people, but as yet we do not know what the molecular mechanism is -- let alone which genes are involved."

"What I could advise is to eat a healthy diet," offered Martin. "But I would not advise that anyone run out to take vitamins, or not to take vitamins, based on this work."

More information

For more on inherited genes, visit the U.S. Institutes of Health.

 

N.J. launches campaign for better health

 

By Angela Delli Santi

Associated Press Writer

The Associate Press

Tuesday, November 14, 2006

A statewide campaign promoting healthier diets and exercise kicked off Tuesday, as educators and nutritionists attempt to counteract an obesity epidemic among New Jersey children and adults.

The new campaign, "Get Moving, Get Healthy New Jersey," is a multiyear effort intended to change the way New Jerseyans think about diet and exercise in much the same way public perceptions about cigarette smoking and using seat belts progressed over time, said Kathleen Morgan, who chairs a family and community health program at Rutgers University and is spearheading the project.

Though they are still figuring out how to deliver their message, the gist is clear: Motivate children and adults to eat better and exercise more.

Americans are growing heavier every year, and New Jerseyans are no exception, evidence shows. More than half of all New Jersey adults are overweight or obese, as defined by their amount of body fat, and the state has the highest incidence of obesity in low-income 2-to 5-year-olds in the country, according to statistics presented by Morgan.

Not surprisingly, less than 40 percent of adults statewide are frequently physically active, and more than two-thirds eat less than five servings of fruit and vegetables a day, Morgan said.

Overweight and obesity raise the risk of developing a host of physical and emotional ailments, including diabetes, heart disease, high blood pressure and depression.

"Our whole goal is working with families in an educational format that will improve their lives and help them to make choices that will change their lives and improve their health," said Morgan.

To find out what approaches might work best, Rutgers researchers surveyed 4,000 residents in five New Jersey counties about their health and how to help them achieve healthier lifestyles. Focus groups are planned to help researchers hone their approaches. The first outreach to targeted audiences is scheduled for next summer.

Research cited by Morgan shows that children and their parents rely increasingly on processed meals, families seldom eat together, and that restaurant portions have grown in tandem with patrons' waistlines.

The program hopes to show parents how to cook nutritionally but quickly, teach children to cut back on empty calories found in sugar-laden sodas and to encourage children and adults to become at least moderately active.

Rutgers has evidence that obesity education programs can work.

Two years ago, the university and health insurer Horizon Blue Cross Blue Shield of New Jersey teamed up on a school-based program called "Shape It Up." The 45-minute interactive workshop taught elementary children about nutrition and exercise.

Students who attended the program reported more positive attitudes about eating fruits and vegetables and about exercise, said Saira A. Jan, director of clinical programs, pharmacy management at Horizon and an associate pharmacy professor at Rutgers.

The 89,000 students who completed the program over two years showed a 23 percent increase in nutrition-related knowledge, as measured in pre- and post-tests, she said.

However, measures of students' nutrition and leisure-time habits at the time of the program showed:

·        51 percent exercised less than five times a week; and 20 percent exercised two days a week or less.

·        60 percent drank at least one soda a day.

·        92 percent watched a least an hour of television a day; 62 percent watched at least two hours; 37 percent watched three hours, and 22 percent watched four hours or more a day.

·        79 percent played video or computer games for a least an hour a day; 43 percent for two hours or more; 26 percent for three hours or more, and 17 percent for four or more hours daily.

Angioplasty no help for heart attack victims who wait

 

By Julie Steenhuysen

Reuters

Tuesday, November 14, 2006

In a surprise finding, heart attack survivors with mild symptoms who wait three days or more to seek medical help will not benefit from widely used procedures to open clogged arteries, U.S. researchers said on Tuesday.

Artery-clearing procedures called angioplasties are recommended for almost all heart attack patients with completely blocked arteries who seek treatment within the first 12 hours of a heart attack.

The early treatment restores blood flow to the heart, preserving the heart muscle and reducing the risks of death and heart failure, a chronic condition in which the heart pumps blood less efficiently. But about 30 percent of acute heart attack patients arrive at the hospital after the 12-hour treatment window has closed.

Many doctors had assumed some benefit would extend to patients who sought help beyond the treatment window.

Researchers, writing in the New England Journal of Medicine, said surgically restoring blood flow after three days was no better than standard drug therapy at reducing the risk of death, a second heart attack or heart failure.

"It's not what I expected. We had expected a 25 percent reduction in events with angioplasty," said the study's lead author, Dr. Judith Hochman of New York University School of Medicine. "There is absolutely no benefit."

The findings were the subject of heated debate among cardiologists gathered at the American Heart Association meeting in Chicago, where the data were presented.

"It is shaking the meeting up. I think people expected both of those trials to be positive," said Paul Armstrong, professor of medicine at the University of Alberta.

"One of the things clinical trials do is teach us to be honest and prevent treatment for things not indicated," he said.

The finding applies only to stable heart attack survivors who wait too long to seek treatment, a group that represents some 100,000 patients per year in the United States.

Hochman said the research underscores the need for patients to seek treatment early for a heart attack.

"This is disappointing, but on the other hand, it shows how good medical therapy has gotten," she said. "Beta-blockers, ACE inhibitors, statins, aspirin -- these are critical life-saving medicines."

The four-year study involved 2,166 stable heart attack survivors on five continents. Patients were randomly assigned by computer to receive medical therapy alone or medical therapy plus balloon angioplasty and stenting.

The procedure involves fishing a catheter through the artery, inflating a balloon in the blocked vessel and inserting a tiny, wire-mesh tube or stent to keep the artery open.

The study found no statistically significant difference between the two groups in the occurrence of death, heart attacks or heart failure in up to five years of follow-up.

Dubbed TOSCA-2 and published in the journal Circulation, the study originally started as an independent trial funded by the National Institutes of Health and was later merged with the larger trial, known as OAT.

The TOSCA-2 study looked at 381 Canadian and international patients who were treated with either drugs or angioplasty to see how long their arteries stayed open and whether angioplasty helped improve the heart's pumping efficiency.

It found that 83 percent of arteries stayed open in patients treated with angioplasty, compared with only 25 percent in the medication group, but the treatment did not improve the heart's pumping ability.

Morgan Stanley analyst Glenn Reicin said he does not expect the studies to have a major negative effect for device makers. He noted that only 8 percent of patients in the study received the newer drug-eluting stents, which are infused with drugs to prevent stented arteries from clogging with scar tissue.

Shares of Boston Scientific Corp. fell as much as 3.4 percent earlier on Tuesday, then recovered to close up 8 cents at $15.94. Johnson & Johnson, maker of the Cypher stent, closed up about 1 percent at $66.56 after trading as low as $65.31 in the session.

Health Tip: Signs That You Have Kidney Stones

 

HealthDay News

Tuesday, November 14, 2006

(HealthDay News) -- Kidney stones are hard particles that form in the urinary tract, and can cause very painful symptoms if they become stuck and difficult to pass.

Here are some common signs of kidney stone formation, courtesy of the University of Maryland Medical Center:

Persistent pain on one side of the back -- around the waist area -- that may travel to the groin. The pain may subside temporarily but return. Discomfort that is not alleviated by any change in position. Nausea and vomiting. Bloody urine. Frequent sensation of needing to urinate, or pain or burning while urinating. Fever and chills, which could signal an infection that needs a doctor's treatment.

 

Diabetics fare better with drug-eluting stents

 

By Ransdell Pierson and Julie Steenhuysen

Reuters

Tuesday, November 14, 2006

Diabetics who received drug-eluting stents had far fewer heart attacks and considerably less re-clogging of the tiny devices than those who received bare-metal stents, according to an Asian study described on Tuesday.

The study also showed that stent recipients who did not require insulin to control their diabetes had far fewer deaths, heart attacks and other complications than those who did require insulin.

Patients with type 1 diabetes, a likely hereditary form of the disease in which the body makes little or no insulin to control blood sugar, must take insulin. Many patients with type 2 diabetes, a form of the disease that is closely linked to obesity and typically develops in adulthood, do not require insulin.

The findings are important, researchers said at the annual meeting of the American Heart Association in Chicago, because no previous published study has compared the effect of drug-coated stents among patients who require insulin and those who do not.

The study involved 1,510 diabetics -- more than two thirds of whom did not require insulin -- that received stents at 5 medical centers in Asia. Stents are tiny tubular scaffolds that prop open coronary arteries that have been cleared of plaque.

Some patients in the trial were treated with bare-metal stents, while others were given stents infused with either the drug sirolimus, the compound found on Johnson & Johnson's Cypher stent, or paclitaxel, the compound used with Boston Scientific Corp.'s top-selling Taxus stent.

The positive benefits of drug-eluting stents in diabetics comes amid a debate among doctors about the safety of the devices, which have been linked to an increased risk of blood clots forming long after they are implanted.

Despite those concerns, drug-eluting stents are especially favored by many cardiologists for diabetics because of their ability to inhibit restenosis -- subsequent formation of scar tissue which can clog stents and force cardiologists to insert replacement stents.

Diabetics, who are particularly prone to restenosis, represent about 25 percent of all stent procedures in the United States.

Among patients in the trial who required insulin to control their diabetes and who were given bare-metal stents, 40 percent died or had heart attacks or other severe complications within 9 months afterward.

That compared with only 10.8 percent of such insulin-dependent patients given sirolimus-coated stents, and 14.2 percent of those given the paclitaxel-coated variety.

By comparison, results were far better across the board for patients who did not require insulin. Among those given bare-metal stents, about 25 percent died or had heart attacks within 9 months -- versus 4.7 percent given sirolimus-coated stents and 6.2 percent given paclitaxel-coated ones.

Diabetic patients requiring insulin therapy have a higher risk of restenosis, greater need for repeat stent procedures and greater risk of death and heart attack than those who do not need insulin to control their diabetes, the trial concluded.

Arm Workouts Get Heart Patients' Legs Moving

 

HealthDay News

Tuesday, November 14, 2006

TUESDAY, Nov. 14 (HealthDay News) -- Exercising the arms help lower pain in the legs for people with peripheral artery disease (PAD), a U.S. study finds.

Aerobic arm workouts can also get patients up and walking better, too, researchers report.

In people with PAD, plaque builds up and narrows arteries in the extremities (usually the legs) and limits blood supply to the muscles. As a result, leg muscles can begin to cramp and hurt after patients walk just a short distance. The pain subsides after a few minutes of rest.

Previous research found that treadmill training benefited PAD patients.

This study found that patients who used an arm ergometer -- a table-top device that has bicycle-like pedals that are operated by the arms -- gained improved walking ability.

"This the first study showing that arm-only aerobics can provide results comparable to those seen with treadmill training," study author Diane Treat-Jacobson, an assistant professor at the University of Minnesota School of Nursing, said in a prepared statement.

The study included 35 PAD patients (average age 67) who were randomly divided into different groups: no exercise; treadmill exercise; arm ergometer exercise; and exercise with both arm ergometer and treadmill.

The patients in the exercise groups had hourlong workout sessions three times a week for 12 weeks. After that time, patients in all three groups showed improvements in the total distance they could walk and how far they could walk without pain.

The findings were to be presented Tuesday at the American Heart Association's annual meeting, in Chicago.

"We were happy to discover that upper-body aerobics can help patients with PAD increase the distance they can walk without pain. We need additional studies to confirm the results, better understand why and how this works, and also identify the best training regimen for patients," Treat-Jacobson said.

"In the meantime, our results provide evidence that aerobic upper-body exercise is a pain-free alternative for patients with PAD who cannot or do not wish to perform treadmill exercises because of leg pain or some other disability," she said.

More information

The Society for Vascular Surgery has more about PAD.

 

Soy and fish protect from cancer: study

 

Reuters

Tuesday, November 14, 2006

People who ate soy regularly as children have a lower risk of breast cancer, researchers reported on Tuesday.

And men who eat fish several times a week have a lower risk of colon cancer, a second team of researchers told a meeting in Boston of the American Association for Cancer Research.

The studies add to a growing body of evidence about the role of diet in cancer. Cancer experts now believe that up to two-thirds of all cancers come from lifestyle factors such as smoking, diet and lack of exercise.

Dr. Larissa Korde of the National Cancer Institute and colleagues at the University of Hawaii studied studied 597 Asian-American women with breast cancer and 966 women without the disease. The mothers of some of the women were also available to answer questions about what they fed their daughters as children.

The women who ate the most soy-based foods such as tofu and miso when aged 5 to 11 reduced their risk of developing breast cancer by 58 percent, the researchers found.

"Childhood soy intake was significantly associated with reduced breast cancer risk in our study, suggesting that the timing of soy intake may be especially critical," Korde said.

It is not clear how soy might prevent cancer, although compounds in soy called isoflavones have estrogen-like effects.

A second study presented at the same meeting showed that men who ate fish five times a week or more had a 40 percent lower risk of developing colorectal cancer compared to men who ate fish less than once a week.

Megan Phillips of the Harvard School of Public Health and colleagues analyzed data from 22,071 men volunteering for a large, ongoing study of physicians.

"We already know that eating fish can reduce the risk of sudden cardiac death, and this might provide another reason to add fish to your diet," said Megan Phillips, a doctoral student at the Harvard School of Public Health, who led the study.

Many kinds of fish are rich in omega-3 fatty acids, which in turn interfere with the cyclooxygenase-2 or COX-2 enzyme.

COX-2 affects inflammation, which may play a role in tumor growth.

Men who ate the most fish had a 40 percent lower risk of developing colorectal cancer over the next 19 years, the researchers found. Eating fish twice a week lowered the risk by 13 percent. Aspirin did not add any extra benefit or risk.

A separate study published on Monday found that eating red meat raised the risk of breast cancer in women.

Many Younger Stroke Survivors Lack Good Medical Care

HealthDay News

Tuesday, November 14, 2006

TUESDAY, Nov. 14 (HealthDay News) -- Younger stroke survivors have a tougher time getting medical care and affording prescription drugs compared to older patients, a U.S. study finds.

Researchers at the Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham interviewed nearly 3,700 stroke survivors. Of those, over 2,500 were 65 and older (average age 76) and nearly 1,200 were ages 45 to 64 (average age 56).

The younger stroke survivors were more likely to be black (19 percent vs. 10 percent), male (52 percent vs. 47 percent), and to not have health insurance (11 percent vs. 4 percent).

The study also found that the younger stroke survivors were more likely to report that they hadn't seen or talked with a general physician (14 percent vs. 10 percent) or a medical specialist (8 percent vs. 5 percent). The younger survivors were also more likely to say they could not afford prescription medications (15 percent vs. 6 percent).

"Lack of health insurance explained some of the reduced access to physician care among younger stroke survivors but not their more frequent problems with medication affordability," the study authors wrote.

They noted that treatments to prevent second strokes often include drugs to reduce blood pressure and cholesterol. These drugs are usually prescribed by a primary care doctor. So, reduced access to doctor care may increase the risk that younger stroke survivors will have a second stroke.

"Further research is needed to determine whether this younger high-risk population has adverse outcomes, such as death and cardiovascular events, or has increased long-term health care utilization due to reduced access to physician care and medications," the study authors wrote.

"Further work addressing access gaps, linking to related health outcomes and costs and demonstrating the effectiveness and cost-effectiveness of possible improvement strategies, is warranted," they added.

The study was posted online Monday in the journal Archives of Neurology and is expected to appear in the January print issue of the journal.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about stroke.

Chocolate addiction leads to sweet discovery

By Maggie Fox, Health and Science Editor

Reuters

Tuesday, November 14, 2006

They were so addicted, they just could not give up their favorite daily snack -- not even in the interest of science.

But chocolate lovers who flunked out of a Johns Hopkins University study on aspirin and heart disease helped researchers stumble on an explanation of why a little chocolate a day can cut the risk of heart attack.

It turns out chocolate, like aspirin, affects the platelets that cause blood to clot, Diane Becker of the Johns Hopkins University's School of Medicine and her colleagues discovered.

"What these chocolate offenders taught us is that the chemical in cocoa beans has a biochemical effect similar to aspirin in reducing platelet clumping, which can be fatal if a clot forms and blocks a blood vessel, causing a heart attack," Becker said in a telephone interview.

The 139 so-called chocolate offenders took part in a larger study of 1,200 people with a family history of heart disease. The study looked at the effects of aspirin on blood platelets.

Before they got the aspirin, the volunteers were asked to stay on a strict regimen of exercise, refrain from smoking and avoid caffeinated drinks, wine, grapefruit juice and chocolate.

Chocolate and the other foods are known to affect platelets.

"We knew they would offend," Becker said. "Some people said to us, 'I can do anything but I can't stay off my chocolate."'

"If people said, 'I will try my very best,' we said, 'OK do your very best, but it is crucial that you don't eat chocolate for 24 to 48 hours before you come in for testing."'

Yet some people failed even this test of self-control.

Going All The Way

"Nobody ate like a chocolate chip. If they were going to eat it, they ate some chocolate," Becker said.

"It went all the way from a chocolate chip cookie to someone who ate a gallon of chocolate ice cream with chocolate chunks and two chocolate-chip cookies at one sitting."

Becker cut them out of the aspirin study, but looked at their blood anyway.

Researchers ran platelet samples from both groups through a mechanical blood vessel system designed to time how long it takes for the platelets to clump together in a hair-thin plastic tube.

The blood of the chocolate eaters was slower to clot than the blood of the volunteers who resisted chocolate, Becker told a meeting of heart experts in Chicago.

In a urine test, the chocolate lovers had lower levels of a platelet waste product called thromboxane.

"Does it help a little bit? Yes," Becker said. "But it does not have anywhere near the magnitude of the effects of a single baby aspirin a day."

Nonetheless, Becker's team wants to study the effects of eating chocolate on a "free-living" population of volunteers. They will measure how much chocolate people eat and then watch them for several years to see if chocolate-eaters have a different rate of heart attacks, stroke and heart operations.

Other studies have suggested that dark chocolate contains more of the beneficial compounds linked with heart health, and experts note that the high sugar and fat content of most chocolate candy might cancel out some of the benefits.

Smoking Linked to Cognitive Decline in Heart Patients

By Amanda Gardner
HealthDay Reporter

HealthDay News

Tuesday, November 14, 2006

SUNDAY, Nov. 12 (HealthDay News) -- Three weeks after she underwent coronary artery bypass surgery, a 71-year-old former smoker realized she could no longer complete the notoriously difficult Sunday crossword puzzle in The New York Times.

"The operation made me dumber," she told researchers investigating smoking and cognitive decline. And, they said, she could no longer even finish the less-difficult Thursday puzzle.

The woman had quit smoking 20 years before her heart surgery but her previous habit probably affected her recovery, the researchers told a news conference Sunday at the annual meeting of the American Heart Association (AHA) in Chicago.

Their research shows that people with a history of smoking were twice as likely to experience cognitive decline as those who never smoked.

Among 240 patients who had undergone coronary artery bypass graft (CABG) surgery at Morristown Memorial Hospital in Morristown, N.J., 60 percent showed evidence of cognitive decline. Those with a history of smoking were more at risk.

Why?

"It probably has to do with the mechanisms of injury of smoking itself. Inhaling carbon monoxide over time is probably not good for the brain, and nicotine causes blood vessels to shrink and affects small vessels more than large vessels," said Dr. James P. Slater, a cardiac surgeon at Morristown Memorial Hospital. "During periods of stress, such as surgery, the vessels are not able to deliver as much blood, and therefore oxygen, to the brain."

"The injury may not be to the brain cells per se but to the microvasculature, or small blood vessels, in the brain," added Dr. Robert Bonow, past president of the AHA, chief of cardiology at Northwestern University Feinberg School of Medicine, and moderator of the news conference.

The findings do throw new light on the impact of heart surgery on different patients.

"Over the last decade, heart surgery itself has been implicated as the problem, and it's clear to us that patients bring their own risk to the table, and this risk is a behavioral risk," Slater said.

It's unclear how to remedy the problem, or even what to tell patients, especially if the risky behavior occurred two decades before, the doctors added.

The long-term effects of smoking on weight were the focus of a second study presented at the meeting Sunday. This research found that smokers and nonsmokers gained weight at the same rate over a period of 20 years, regardless of race or gender.

"If you quit, you may gain an extra 4 to 5 pounds, or, if you start, you may delay the onset of progressive weight gain by two to three years, but that's it," said Dr. Samuel Gidding of A.I. DuPont Hospital for Children in Wilmington, Del.

Also, he noted, over the two-decade timeframe of the study, the smoking starter and quitter groups were really populated by the same people bouncing back and forth.

"Because they are ping-ponging back and forth, ultimately, the rate of weight change is the same," Gidding said. "There's very little impact of smoking status on weight other than four to five pounds either way when you start or quit. And if you ping-pong back and forth, it becomes totally neutralized."

More information

For more on smoking and heart disease, visit the American Heart Association.

Monday, November 13, 2006

 

Blow to chest can be fatal in child athletes: study

 

By Susan Kelly

Reuters

Monday, November 13, 2006

 

 Children who play hockey, football, lacrosse or baseball risk sudden death from a hard blow to the chest even if they are clad in protective gear, researchers said on Monday.

Commercially available equipment may not adequately protect young athletes if the chest is hit in a manner that triggers an irregular heartbeat called ventricular fibrillation, according to a study presented at the annual American Heart Association meeting in Chicago.

"If the blow occurs directly over the heart at a particular time in the heart's cycle, the results can be catastrophic," said the report's lead author, Dr. Barry Maron, director of the Hypertrophic Cardiomyopathy Center at the Minneapolis Heart Institute Foundation.

The heart's electrical activity becomes disordered and its lower chambers contract in a rapid, unsynchronized way, allowing little or no blood to be pumped. Collapse and sudden death can follow unless immediate medical help is provided.

Such a rare but tragic blow can come from a ball, bat, hockey stick, puck or hard contact with another person, according to the study.

Of the 182 cases of ventricular fibrillation tracked by Maron since 1995, 47 percent occurred during practice or competition in organized sports. Thirty-nine percent of the children suffered fatal chest blows despite the presence of protective equipment. Their average age was 15 years.

The remaining 53 percent occurred during recreational sports or normal activities around the home.

Among the athletes were 14 hockey players, 10 football players, six lacrosse players and three baseball catchers. In 23 of the deaths, padding did not cover the chest at the time of the blows, and 10 deaths occurred when projectiles directly struck the chest protector.

The athletes wore standard, commercially available chest barriers made of polymer foam covered by fabric or a hard shell.

Further research conducted at the New England Medical Center and Tufts University School of Medicine in Boston found ventricular fibrillation could by caused by a baseball moving 30 mph (48 kph), but only if impact occurred directly over the heart during a 20-millisecond window when the lower heart chambers are relaxed.

The findings indicate a need for better chest protection to make the athletic field safer for young participants, Maron said.

Those involved with youth sports also must be taught to recognize when a child has suffered the potentially deadly heart rhythm -- known as commotio cordis -- so that prompt resuscitation and defibrillation can occur, he said.

"Hopefully, these data will represent a stimulus for developing a truly effective chest barrier that will be absolutely protective against the risk of these commotio cordis catastrophes," he said.

Diseased gums raise risk of pancreatic cancer

 

By Megan Rauscher

Reuters Health

Monday, November 13, 2006

Gum disease may increase the risk of developing deadly pancreatic cancer, even among those who have never smoked, according to research reported today in Boston at the American Association for Cancer Research's Frontiers in Cancer Prevention Research Meeting.

Two previous studies found positive associations between tooth loss or periodontitis (inflammation of the gums around the teeth) and pancreatic cancer. However, "residual confounding" by smoking and other known risk factors may have accounted for the findings.

To investigate further, Dr. Dominique S. Michaud of Harvard School of Public Health, Boston and colleagues analyzed 16 years of health data on nearly 52,000 male doctors in the Health Professionals Follow-up Study. This ongoing study, initiated in 1986, is looking at lifestyle factors related to cancer and other chronic diseases.

A total of 216 men developed pancreatic cancer during follow-up. After factoring out smoking, diabetes, obesity, physical activity, diet and other potentially confounding factors, men with a history of gum disease had a 63-percent higher risk of developing pancreatic cancer relative to men without periodontal disease.

Never smokers with gum disease fared even worse; "they had 2-fold increased risk in developing pancreatic cancer," Michaud told a gathering of reporters Monday.

"This is an important finding," Dr. Scott Lippman of The University of Texas M. D. Anderson Cancer Center in Houston said, noting that there have been a couple of small reports that "just dismissed" the gum disease/pancreatic cancer link as potentially related to smoking, given that smoking increases the risk of pancreatic cancer.

"This (new) study is the first clearly establishing the increased risk of pancreatic cancer with periodontal disease," regardless of smoking history, Lippman said.

Michaud's team also found that men with gum disease and recent tooth loss had a 2.7-fold increased risk of developing pancreatic cancer compared with those who reported neither gum disease nor tooth loss.

Periodontal disease may boost the risk of pancreatic cancer through "plausible mechanisms," Michaud and colleagues point out in meeting materials.

Gum disease results in chronic inflammation over many years, they explain, and people with gum disease harbor high levels of harmful bacteria in the mouth and gut and tend to have higher amounts of cancer-causing nitrosamines.

Pancreatic cancer, the fourth leading cause of death from cancer death in the United States, is one of the most deadly cancers, largely because it is often not detected until it has spread beyond the pancreas. Only about five percent of pancreatic cancer patients survive the first five years after being diagnosed.

Simple steps can speed heart attack care: study

 

By Julie Steenhuysen

Reuters

Monday, November 13, 2006

If U.S. hospitals implemented some simple, timesaving strategies, heart attacks patients could get quicker treatment and would be more likely to survive, according to a study released on Monday.

Heart attack patients have a better chance of survival if they get artery-clearing treatments within 90 minutes of the attack, but only about 20 percent of U.S. hospitals are able to meet that standard.

"We know that faster times are associated with better outcomes," said study author Dr. Harlan Krumholz of the Yale University School of Medicine.

"Right now, only about a third of the hospitals are able to treat even half of their patients in 90 minutes or less," he said at the annual scientific meeting of the American Heart Association.

In the study, which was published online in the New England Journal of Medicine, researchers evaluated 28 strategies for speeding the interval between arrival at the hospital and the time of treatment for patients with a common type of heart attack called ST-elevation myocardial infarction.

They found that simple steps, such as giving emergency department staff the authority to call in specialists without first consulting a cardiologist, could significantly shorten treatment times.

Researchers said the biggest timesaver would be to require heart catheterization specialists to arrive at the hospital within 20 minutes of being paged. The current standard is 30 minutes.

That change could save 19.3 minutes for patients waiting to receive a life-saving angioplasty, in which a balloon is inflated in the artery to restore blood flow to the heart.

The study also recommended: placing a single call to a central operator who alerts the catheterization lab, saving 13.8 minutes; having the emergency department alert the lab while the patient is transported to the hospital, saving 15.4 minutes; and always having an attending cardiologist on site, saving 14.6 minutes.

Using the study's findings, the American Heart Association and the American College of Cardiology have started a nationwide campaign to improve treatment times.

"Thirty-five percent of patients in America have an artery opened in 90 minutes or less. Our goal is 75 percent," said Dr. Steven Nissen, president of the American College of Cardiology.

"Everybody we've asked to do this has said this is the right thing to do. Payers want it. Government wants it. Hospitals want it. Physicians want it."

Krumholz said several hospital chains have signed on to the effort, including HCA Inc., Tenet Healthcare Corp., Kaiser Permanente, Premier Inc. and the Veterans Administration.

He said the biggest barrier to change is inertia and believes the study will give hospitals the tools they need to change.

FDA: Tamiflu patients need monitoring

 

BY Andrews Bridges

Associated Press Writer

The Associate Press

Monday, November 13, 2006

Patients who take Tamiflu should be closely monitored for signs of abnormal behavior, health officials said Monday in announcing an updated label for the flu drug.

The added precaution comes after reports of more than 100 new cases of delirium, hallucinations and other unusual psychiatric behavior in children treated with the drug. Most were Japanese children.

The Food and Drug Administration said a relationship between the drug and the behavior had not been established and that the updated label was "intended to mitigate a potential risk associated with Tamiflu." It recommends that close monitoring begin immediately after starting treatment with the drug.

FDA said it had received 103 reports, mostly from Japan, of injury and delirium among the millions of flu patients treated with Tamiflu. The changes bring the U.S. label more in line with the Japanese one, which already warned such abnormal behavior could occur. The previous FDA-approved label mentioned "seizure and confusion" seen in some patients.

Tamiflu is made by the Swiss pharmaceutical company Roche Holding AG. Roche spokesman Terence Hurley said there was no evidence the drug caused the rarely occurring adverse events.

Both Roche and the FDA also said that severe cases of the flu can spark the abnormal behavior flagged in the updated label.

The surprise change came three days before an FDA panel of outside experts was to discuss whether to recommend that the agency add the precautionary language to the Tamiflu label. In documents released Monday, FDA staff acknowledged that stopping treatment with Tamiflu could actually harm influenza patients if the virus is the cause of delirium, hallucinations and other abnormal behavior, such as aggression and suicidal thoughts.

Last year, the same advisory committee rejected making any such changes to the label. At that time, however, the committee did recommend that the FDA continue to monitor the drug's safety and return a year later with an update.

Health officials have been sensitive about taking any action that might dissuade people from taking Tamiflu, since the drug could play an important role in an outbreak of bird flu. The drug doesn't prevent flu but can reduce the length and severity of its symptoms.

Previously, Roche has cited studies from the United States and Canada that show the death rate of influenza patients who took Tamiflu was far below those who did not.

Most of the new cases of bizarre behavior are from Japan, where Tamiflu usage is the highest in the world. Between 2001 and 2005, Tamiflu was prescribed 24.5 million times in Japan, compared with just 6.5 million in the United States, which has more than twice the population, according to FDA. However, FDA believes U.S. usage could increase to Japanese levels.

The new cases occurred between Aug. 29, 2005, and July 6, 2006. The tally marks a sharp increase when compared with the 126 similar cases logged over more than five years between the drug's approval in 1999 and August 2005, the FDA said.

Even though severe cases of the flu can spark abnormal behavior, the number and nature of the newly reported cases — along with comments from doctors who believe the behavior was associated with the drug — keep the FDA from ruling out Tamiflu as the cause, according to agency documents.

Tamiflu is one of the few drugs believed effective in treating bird flu, which health officials fear could spark a pandemic should it mutate into a form easily passed from human to human.

According to the label, Tamiflu is for the treatment of uncomplicated acute illness due to flu in patients 1 year and older who have shown symptoms for no more than two days.

On the Net:

Food and Drug Administration: http://www.fda.gov

Tamiflu: http://www.tamiflu.com

Enriched cocoa snack bars cut cholesterol

 

Reuters Health

Monday, November 13, 2006

Snacking on cocoa-flavored bars enriched with phytosterols can significantly reduce cholesterol levels, a new study shows.

Phytosterols are plant-derived compounds that are structurally similar to the cholesterol found in mammals. Foods containing phytosterols have been shown to help cut cholesterol, and the US Food and Drug Administration has endorsed these products "as part of a dietary strategy to reduce the risk of coronary heart disease," Dr. John A. Polarus of the University of California at Davis and colleagues write in the November issue of the Journal of the American Dietetic Association.

But concerns have been raised, they add, that these foods could reduce levels of certain fat-soluble vitamins and antioxidants in the blood in addition to cutting cholesterol.

To examine the effect of a food enriched with phytosterols on blood levels of cholesterol and nutrients, the researchers randomly assigned 67 people with high cholesterol to eat two snack bars containing 1.5 grams of plant sterols each every day for six weeks or two bars that did not contain plant sterols. The enriched bar, Cocoa Via Crunch, was made by Hackett town, New Jersey-based Master foods, which helped fund the research.

Study participants who ate the sterol-enriched bars had a 4.7- percent reduction in total cholesterol and a 6-percent reduction in LDL cholesterol after six weeks, and also showed an increase in the amount of HDL or "good" cholesterol in relation to total cholesterol.

While the sterol-enriched bars did not affect participants' blood levels of vitamins A or E, they did reduce beta-carotene levels. Making sure to get plenty of carotenoid-rich foods while using plant sterol-containing products could be enough to offset this reduction, the researchers suggest.

They conclude: "In conjunction with a healthful diet and regular exercise, the inclusion of a novel food product, such as a chocolate product that contains plant sterols, can be a safe and effective means to lower both total and LDL cholesterol levels."

Source: Journal of the American Dietetic Association, November 2006.

Snail toxin may help nerve pain relief

 

The Associate Press

Monday, November 13, 2006

Toxins from cone snail venom may help point the way to better relief of severe nerve pain in people, researchers report.

Results were promising in tests on rats with a type of nerve pain similar to sciatica, according to researchers led by J. Michael McIntosh, a biology professor at the University of Utah.

McIntosh said he hopes this finding could lead to a new painkiller that could be taken orally, but it could take 10 years or more before the findings can be translated into a treatment for people.

The findings were published Monday in the online edition of Proceedings of the National Academy of Sciences.

The researchers found that the toxins from cone snails treated nerve pain by blocking molecules known as "a9a10 nicotinic acetylcholine receptors."

The a9a10 NA receptors are located in several parts of the body including dorsal root ganglia — a group of nerve cells near the spine that is involved in pain transmission.

Common pain relievers often fail with nerve pain, and stronger drugs such as morphine have side effects.

The researchers at Utah and Wake Forest University found that the toxin can stop nerve pain by blocking the receptor cells, pointing to a potential new target for drugs.

Previously, McIntosh was involved in research that led to development of Prialt, a pain treatment also based on cone snail toxins that is injected into fluid surrounding the spinal cord to treat severe pain from cancer, AIDS, injury, failed back surgery and certain nervous system disorders.

In a separate paper in the online edition of PNAS, researchers reported finding a natural painkiller produced in humans, termed opiorphin, which is several times as potent as morphine in reducing physical pain and chemical-induced inflammation.

Catherine Rougeot of the Pasteur Institute in Paris, and colleagues, discovered a potent pain killer in rats called sialorphin. Turning to people, they found a similar chemical, called opiorphin, in human saliva, that inhibits the same class of proteins as sialorphin.

Now they are trying to determine what triggers the natural release of opiorphin and whether it is a strong enough pain reducer to warrant development.

On the Net:

PNAS: http://www.pnas.org

 

Radioactive iodine linked to thyroid disease

 

Reuters Health

Monday, November 13, 2006

The long-term risk of developing a tumor in the thyroid gland or autoimmune thyroiditis, a progressive inflammatory disease of the thyroid, is increased after exposure to radioactive iodine in childhood, according to a re-analysis of data from children exposed to radiation from a nuclear test site in Nevada.

Since 1965, researchers have been studying children exposed to radioactive iodine from nuclear weapons testing at the Nevada Test Site from 1951 through 1962.

In 1993, Dr. Joseph L. Lyon, of the University of Utah School of Medicine, Salt Lake City, and colleagues, reported that among the 2,497 subjects examined, there was an association between radiation exposure from the Nevada Test Site and thyroid tumors.

The researchers have now used newly corrected dose estimates and disease outcomes to reassess the association. The new results are published in the current issue of the journal Epidemiology.

In children who received the highest radiation dose, the risk of thyroid tumors rose from 3.4-fold in the earlier evaluation to 7.5-fold. For thyroiditis, the risk increased from 1.1- to 2.7-fold, with a 4.9-fold excess risk for exposure to each Gy unit (gray = absorbed dose of radiation). The risk could not be estimated for malignant thyroid tumors.

"This is the first report of such a relationship in a U.S. population; hence, we believe that this (study group) represents a unique opportunity to provide further assessment of a range of exposures and disease end points among U.S. citizens," Dr. Lyon's team writes. "Further follow-up of this (study group may increase our understanding of the long-term health consequences of exposure to radioactive iodine regardless of its origin in reactors, accidents, or nuclear detonations."

Source: Epidemiology, November 2006.

Low-Carb Diet Can Be Heart-Healthy

 

By Ed Edelson
HealthDay Reporter

HealthDay News

Monday, November 13, 2006

WEDNESDAY, Nov. 8 (HealthDay News) -- A low-carbohydrate diet does not increase the risk of heart disease in women, a major new study finds.

However, while the regimen skimped on bread and other carbohydrate foods, it was not the fatty Atkins diet that most people associate with the term "low-carb diet."

In a 20-year study involving over 82,000 women, the incidence of coronary heart disease was roughly equal for women who ate low- and high-carbohydrate diets, researchers reported in the Nov. 9 New England Journal of Medicine.

Heart risk was also 30 percent lower for participants who got their protein and fat from vegetables rather than from meat, they noted.

The Atkins diet, which became popular after its introduction in the 1970s, allows for unlimited intake of animal fat.

"I feel the take-home message of the investigation is that neither the low-fat or low-carbohydrate dietary pattern is ideal," said researcher Thomas L. Halton, who led the study while a doctoral student at the Harvard School of Public Health. "Both have strengths and weaknesses. However, you can get the best features of both diets and eliminate the negative features of both diets by choosing healthy vegetable sources of fat and protein."

The real goal is "taking steps to reduce the glycemic load of the diet by substituting lower glycemic fruits, vegetables and whole grains as well as vegetable sources of fat and protein for refined, high-glycemic carbohydrates," said Halton, who now teaches part-time at Simmons College in Boston

In the study, researchers tracked the health of more than 82,802 women in the Nurses Health study followed for 20 years, looking especially at the incidence of coronary heart disease. The women filled out questionnaires on their eating habits, and this information was used to calculate their percentage of energy intake from carbohydrate, fat and protein.

"The main message I walked away with is that a diet rich in vegetable protein and vegetable fat appears to have a benefit in lowering heart disease risk," said Susan Moores, a nutritional consultant in St. Paul, Minn., and a spokeswoman for the American Dietetic Association.

The women in the study reported "not what people think of as a low-carbohydrate diet, more of a moderate-carbohydrate diet," Moores said. "When you look at the amount of carbohydrates in the diets of women reporting the lowest levels, they were not eating a low-carbohydrate diet like the Atkins diet."

It's difficult to make specific recommendations based on the study because "there are so many qualifiers and questions about the diets the women actually ate," she said. "And it is hard to draw the conclusion that an Atkins-type diet affects the risk of heart disease."

But it was satisfying to see the benefits of eating plant-based fats and proteins laid out in the report, Moores said. "We have talked about it for years, and it is so nice to see it validated for a large group of women,"

More information

Find out more about healthy eating at the American Dietetic Association.

 

Red meat linked to some breast cancers: study

 

By Michael Conlon

Reuters

Monday, November 13, 2006

Younger women who eat more red meat may be at higher risk of a certain kind of breast cancer, perhaps because of hormonal residues in beef cattle and other factors, according to a study published on Monday.

Data from a multiyear study involving the health histories of more than 90,000 U.S. nurses show that "in this population of relatively young, premenopausal women, red meat intake was associated with a higher risk of hormone receptor-positive breast cancer," said the study from Brigham and Women's Hospital and Harvard Medical School, Boston.

Hormone receptor-positive tumors are those that carry certain proteins to which hormones, in this case estrogen and progesterone, bind, helping them grow. Those kinds of tumors have been on the increase in the United States, especially among middle-aged women.

"Given that most of the risk factors for breast cancer are not easily modifiable, these findings have potential public health implications in preventing breast cancer and should be evaluated further," concluded the report published in the Archives of Internal Medicine.

The researchers said they had found that women who ate more than one and one-half servings of red meat per day had almost double the risk of hormone receptor-positive breast cancer compared with those who ate three or fewer servings per week.

The study began in 1989 when the women were surveyed on eating and other habits. Those in the red meat study were followed from 1991 through 2003. Only women who had not gone through menopause and were cancer-free were included in the analysis.

There are known to be cancer-causing compounds in cooked or processed red meat that increase breast tumors in laboratory animals and have been suspected of causing breast cancer in humans, the report said.

In addition "hormone treatment of beef cattle for growth promotion, which is banned in European countries but not in the United States, has been of concern," the report said.

"Although long-term health effects of hormone residues in beef have not been investigated, theoretically they may preferentially affect hormone receptor-positive tumors," it added.

Other potential factors involved with red meat include animal fat in general and a form of iron in meat which has been shown to play a role in the development of such tumors.

Health Tip: Got Hay Fever?

 

HealthDay News

Monday, November 13, 2006

(HealthDay News) -- Hay fever causes allergy symptoms like itchy eyes and ears, runny nose, cough and sneezing. The American Lung Association offers these suggestions on how to deal with these complaints:

When pollen counts are high, keep windows closed. During the warm days of summer, run the air conditioning to limit the allergens coming into your home. Use an air purifying device in the home. If you have to work outdoors, wear a dust mask to avoid breathing in allergens. Antihistamines or decongestants may help relieve symptoms. Inhaled steroids or allergy shots may also reduce symptoms, but must be prescribed by a doctor. Avoid using nasal sprays, as they can dry the nasal passages and eventually make allergy symptoms worse.

 

Most U.S. women in the dark about HPV: survey

 

By Megan Rauscher

Reuters

Monday, November 13, 2006

 

Awareness about human papillomavirus (HPV) infection and its link to cervical cancer, is relatively low among American women, according to a survey of 3,076 women 18 to 75 years of age.

Only 40 percent of women responding to the 2005 Health Information National Trends Survey had ever heard about HPV and, of those, less than 20 percent knew that HPV could sometimes lead to cervical cancer.

Sixty-four percent of women knew that HPV was sexually transmitted and 79 percent knew it could cause abnormal Pap smears.

"Therefore, one of our main findings is that being aware of HPV does not guarantee accurate knowledge," Dr. Jasmin A. Tiro, of the National Cancer Institute, Bethesda, Maryland, told the American Association for Cancer Research's Frontiers in Cancer Prevention Research Meeting in Boston.

Younger women, those with higher education levels, and those exposed to more health information were more likely to have heard about HPV. "But the only factors associated with having accurate knowledge -- knowing that it could lead to cervical cancer -- was an abnormal Pap test or testing positive on an HPV test," Tiro said.

"This suggests that most women are finding out about HPV after experiencing a negative consequence," she said.

HPV is a very common sexually transmitted infection but in most women there are no symptoms and infection often clears without treatment so most women do not have the opportunity to learn from their doctor that HPV can become persistent and then can develop into cervical cancer.

In June 2006, the US Food and Drug Administration approved the first vaccine to block infection by certain high-risk types of HPV. The vaccine is recommended for women 9 to 26 years of age.

This survey, Tiro noted, was performed before the HPV vaccine was approved, so it therefore provides good comparison data to measure future levels of HPV knowledge in the American population. A similar survey looking at HPV awareness is planned for 2007.

Summing up, Tiro said "we need to increase women's knowledge of HPV and cervical cancer before chances of them becoming infected so that they can protect themselves, because cervical cancer is one our greatest success stories from a screening perspective in that women do have options to prevent and detect cervical cancer early."

Sunday, November 12, 2006

 

Smoking Linked to Cognitive Decline in Heart Patients

 

By Amanda Gardner
HealthDay Reporter

HealthDay News

Sunday, November 12, 2006

 

SUNDAY, Nov. 12 (HealthDay News) -- Three weeks after she underwent coronary artery bypass surgery, a 71-year-old former smoker realized she could no longer complete the notoriously difficult Sunday crossword puzzle in The New York Times.

"The operation made me dumber," she told researchers investigating smoking and cognitive decline. And, they said, she could no longer even finish the less-difficult Thursday puzzle.

The woman had quit smoking 20 years before her heart surgery but her previous habit probably affected her recovery, the researchers told a news conference Sunday at the annual meeting of the American Heart Association (AHA) in Chicago.

Their research shows that people with a history of smoking were twice as likely to experience cognitive decline as those who never smoked.

Among 24 patients who had undergone coronary artery bypass graft (CABG) surgery at Morristown Memorial Hospital in Morristown, N.J., 60 percent showed evidence of cognitive decline. Those with a history of smoking were more at risk.

Why?

"It probably has to do with the mechanisms of injury of smoking itself. Inhaling carbon monoxide over time is probably not good for the brain, and nicotine causes blood vessels to shrink and affects small vessels more than large vessels," said Dr. James P. Slater, a cardiac surgeon at Morristown Memorial Hospital. "During periods of stress, such as surgery, the vessels are not able to deliver as much blood, and therefore oxygen, to the brain."

"The injury may not be to the brain cells per se but to the microvasculature, or small blood vessels, in the brain," added Dr. Robert Bonow, past president of the AHA, chief of cardiology at Northwestern University Feinberg School of Medicine, and moderator of the news conference.

The findings do throw new light on the impact of heart surgery on different patients.

"Over the last decade, heart surgery itself has been implicated as the problem, and it's clear to us that patients bring their own risk to the table, and this risk is a behavioral risk," Slater said.

It's unclear how to remedy the problem, or even what to tell patients, especially if the risky behavior occurred two decades before, the doctors added.

The long-term effects of smoking on weight were the focus of a second study presented at the meeting Sunday. This research found that smokers and nonsmokers gained weight at the same rate over a period of 20 years, regardless of race or gender.

"If you quit, you may gain an extra 4 to 5 pounds, or, if you start, you may delay the onset of progressive weight gain by two to three years, but that's it," said Dr. Samuel Gidding of A.I. DuPont Hospital for Children in Wilmington, Del.

Also, he noted, over the two-decade timeframe of the study, the smoking starter and quitter groups were really populated by the same people bouncing back and forth.

"Because they are ping-ponging back and forth, ultimately, the rate of weight change is the same," Gidding said. "There's very little impact of smoking status on weight other than four to five pounds either way when you start or quit. And if you ping-pong back and forth, it becomes totally neutralized."

More information

For more on smoking and heart disease, visit the American Heart Association.

 

Higher death rate seen for black U.S. heart patients

 

By Will Dunham

Reuters

Sunday, November 12, 2006

Black heart disease patients died at a much higher rate than equally sick white patients, researchers said on Sunday in the latest U.S. study showing racial disparity in disease survival.

Researchers speculated racial discrimination by doctors may have played a role, perhaps in the types of treatment given to white and black patients, but that is hard to prove.

The study involved data on 21,000 heart patients treated at Duke University medical facilities in Durham, North Carolina, between 1986 and 2004. More than 3,000 of the patients were black.

It found that among those diagnosed with serious coronary disease, black patients had a 36 percent survival rate and white patients a 46 percent survival rate. The patients were tracked for an average of nine years.

"We saw that there were significant differences in survival," said Duke cardiology fellow Dr. Kevin Thomas, who reported the results at an American Heart Association meeting in Chicago.

"Physician bias may play a part in it. That's a very hard thing to get at," Thomas added.

Thomas noted that black patients in the study had more risk factors for worse survival rates than the white patients, including higher rates of diabetes, high blood pressure and kidney disease.

But the black patients also tended to be about a decade younger than the white patients, and younger age normally is associated with better medical outcomes in these cases, Thomas said.

Even when the researchers statistically accounted for those patient characteristics, the higher death rates for the black patients persisted, meaning other factors contributed to the disparity.

Researchers found little difference in the extent of coronary disease between blacks and whites. But they found that whites were 12 percent more likely to receive coronary bypass surgery than blacks within 30 days of cardiac catheterization, the initial diagnostic study.

Asked why this was the case, Thomas said, "Well, that's the million dollar question."

The study reinforced and amplified on previous research finding racial disparities in U.S. disease survival and types of treatment given to patients.

Coronary artery disease, in which the arteries supplying blood to the heart become hardened and narrowed, is the most common type of heart disease and the leading cause of death in the United States in both men and women.

Clogged Arteries Showing Up in Kids

 

HealthDay News

Sunday, November 12, 2006

SUNDAY, Nov. 12 (HealthDay News) -- Children with heart disease risk factors -- obesity, high blood pressure, diabetes and high cholesterol -- already show indications of fatty build-up in their arteries that could cause heart attacks when they're adults, Canadian researchers report.

"Primary prevention of heart disease must start in childhood. We need to start looking at and treating risk factors for heart disease in children," researcher Dr. Sanaz Piran, an internal medicine resident at McMaster University in Hamilton, Ont., said in a prepared statement.

Piran and her colleagues reviewed data on 3,630 children, ages 5 to 18, who took part in 26 studies in Australia, Finland, Italy, the Netherlands, Norway and the United States. Those studies used noninvasive methods to measure arterial blood flow and the thickness of artery walls in children with and without heart disease risk factors.

In many cases, children with heart disease risk factors showed early signs of atherosclerosis.

The review was expected to presented Sunday at the annual meeting of the American Heart Association, in Chicago. The findings highlight the need for parents and doctors to prevent and treat cardiovascular risk factors in children, the authors said.

"Diet and exercise are especially important to curb the escalating problem of childhood obesity," Piran said.

"Obesity puts children at risk for high blood pressure, diabetes and high cholesterol levels. Children's diets have changed dramatically, influenced by television commercials and the convenience of fast foods," she said. "Children are eating too much fatty and processed foods. Parents need to involve their kids in regular exercise activities and cut down on fatty meals, emphasizing healthy food such as vegetables."

Parents should not smoke in the presence of children and, if there's a family history of high cholesterol, children need to have their cholesterol levels checked, Piran said.

"The very things we recommend to adults should be recommended to parents for their children. There needs to be a family-oriented approach to cardiovascular prevention and to addressing these risk factors," she said.

More information

The American Heart Association has more about children's health.

 

Fast test catches heart blockages, U.S. study shows

 

Reuters

Sunday, November 12, 2006

A new kind of scan might be able to find blocked arteries quicker and with less trouble than existing tests, U.S. researchers reported on Sunday.

Tests in dogs show that the computed tomography or CT scan could track blood flow slowed by the narrowing of arteries, researchers told the American Heart Association meeting in Chicago.

They said the non-invasive test took less than half the time of exercise stress tests and echocardiograms now used to find early signs of dangerously clogged blood vessels.

Dr. Albert Lardo and colleagues at the Johns Hopkins University of School of Medicine in Baltimore are now testing the method in human volunteers.

"Because it takes less than 15 minutes to perform and does not require patients to be stabilized ahead of scanning, it could replace most other more time-consuming tests that help find blockages, including not only exercise stress testing and echocardiograms, but also positron electron tomography (PET) imaging or magnetic resonance imaging," Lardo said in a statement.

His colleague, Dr. Richard George, said current tests only show the worst blockages.

"Even when patients have a normal exercise stress test, they may still be in the early stages of atherosclerosis, when vessels start to clog, narrow and harden, gradually straining circulation," said George.

"The new technique could also help eliminate many unnecessary, invasive catheterization procedures when there is no underlying blockage, or become a practical test to verify if treatments with drugs therapies, surgical bypass or stented arteries have worked to improve blood flow," Lardo added.

Catheterization involves threading tubes into the blood vessels and injection of a chemical to act as a contrasting agent.

More than 1 million Americans have a cardiac catheterization procedures each year. They take up 45 minutes and recovery can take several hours. Infections, heart attacks and strokes are all possible side-effects of the procedure.

CT scans are X-rays souped up with the help of a computer to provide a three-dimensional image of the inside of the body.

Rheumatoid Arthritis Meds Won't Up Most Cancer Risk

 

HealthDay News

Sunday, November 12, 2006

SUNDAY, Nov. 12 (HealthDay News) -- Biologic therapy doesn't appear to increase the overall risk of cancer, other than skin cancers, in patients with rheumatoid arthritis, according to researchers who analyzed long-term data from a U.S. national registry.

Some previous studies have suggested that genetically-engineered biologics -- such as adalimumab, etanercept, infliximib, anakinra and abatacept -- may increase the risk of lymphoma and/or lung cancer in rheumatoid arthritis patients.

These drugs are commonly prescribed in order to control immune system abnormalities that cause joint inflammation.

In this study, researchers analyzed data on 13,000 people who took part in the U.S. National Data Bank of Rheumatic Disease between 1998 and 2005. Of those, 48 percent had taken biologics. Among these patients, there were 623 reported new cases of non-melanoma skin cancer and 537 reported cases of all other kinds of cancer.

The researchers compared those rates to rates of cancer in the U.S. general population and found that rheumatoid arthritis patients who used biologics did have an increased risk for melanoma and non-melanoma skin cancers but did not have a greater risk for other types of cancers.

"While longer follow-up may be required, this data shows the use of biologic therapy is not associated with increased risks of lymphoma, lung cancer or other cancers among those with rheumatoid arthritis," researcher Dr. Frederick Wolfe, project director, National Data Bank for Rheumatic Disease, said in a prepared statement.

The findings were presented this week at the annual scientific meeting of the American College of Rheumatology, in Washington, D.C.

Wolfe has received research funding from drug makers Amgen, Aventis, Bristol-Myers Squibb, and Centocor.

More information

The Arthritis Foundation has more about rheumatoid arthritis.

 

Diabetes threatens many of world's indigenous people

 

Reuters

Sunday, November 12, 2006

Diabetes poses a deadly threat to indigenous people across Asia, the Pacific and the Americas as Western lifestyles and diets replace traditional habits, medical experts warned on Monday.

Professor Martin Silink, head of the Brussels-based International Diabetes Foundation, said indigenous people had a greater genetic risk of contracting type 2 diabetes, which is often undiagnosed.

"They also have the genes that make the diabetes more damaging, so they are more prone to develop the serious complications of diabetes," Silink told Reuters.

About 230 million people -- or about six percent of adults worldwide -- have type 2 diabetes, but the problem was worse in developing nations and among indigenous people, where up to one in two adults will have the disease.

These findings were showcased at a gathering in Melbourne of diabetes experts from the United States, Canada, Australia and the Pacific islands.

Conference host Professor Paul Zimmet said diabetes was unknown in the Pacific before World War II, but now the region had some of the highest rates in the world and where the existence of indigenous communities were at risk.

In the Pacific nation of Nauru, the world's smallest republic with a population of 10,000 people, more than 30 percent of adults aged over 20 years have type 2 diabetes. But the number rises to one in two in adults aged 35 years and above.

Similar rates of between 25 to 50 percent of diseased adults are found in American and Canadian indigenous peoples as well as in Australia's Aborigine and Torres Strait Islander populations.

"It is a tragic situation, but not a lost one," Zimmet said.

"The world needs to act now if we are to deal with this problem, which threatens to consume world economies and bankrupt health systems. It could also mean the end of some of our treasured indigenous groups."

Globally, Silink said that every year saw between 7 to 8 million new cases of diabetes. Experts project more than 250 million people will suffer from the disease by 2025.

Silink said the International Diabetes Foundation was pushing for a U.N. resolution to make governments encourage more active lifestyles and better diets.

"There is a death due to diabetes every 10 seconds, and an amputation due to diabetes every 30 seconds. We are dealing with the biggest epidemic in world history," he added.

Study Highlights Older Women's Bone Risk

 

HealthDay News

Sunday, November 12, 2006

SUNDAY, Nov. 12 (HealthDay News) -- A number of factors predict an older woman's risk for bone fractures, according to a long-term U.S. study of more than 170,000 women, ages 50 to 99.

Postmenopausal women have reduced levels of estrogen, which results in weaker bones and an increased risk of fractures. In older women, fractures can have serious consequences, including reduced quality of life, ongoing health problems and death.

In this study, researchers tracked 170,314 postmenopausal women who took part in the U.S. National Osteoporosis Risk Assessment (NORA) study. The women had no prior diagnosis of osteoporosis and no history of taking osteoporosis-specific medications.

At the start of the study, the women completed a baseline survey and underwent a bone mineral density test. In follow-up surveys completed by the women at years one, two and five, nearly 8,000 of the women reported new fractures.

The researchers found that the strongest predictors of fracture in these women were a history of fracture after age 45; indications of osteoporosis and osteopenia (bone weakness) as detected by bone density testing; increasing age; poor/fair self-rated health; loss of height; and depression.

Black and Asian women were less likely to suffer fractures than white women, and the use of estrogen at the start of the study was associated with a lower fracture risk.

The findings were presented Saturday at the annual scientific meeting of the American College of Rheumatology, in Washington, D.C. Many of the researchers have financial or employment ties to pharmaceutical companies.

The study "confirms that risk factors traditionally associated with future fracture risk should be taken very seriously by physicians and patients alike," study principal investigator Dr. Ethel Siris, professor of clinical medicine, College of Physicians and Surgeons at Columbia University in New York, said in a prepared statement.

"It underscores the importance of assessing these risk factors periodically over time and of performing bone mineral density tests in menopausal women, according to current guidelines, something not being done for the majority of women in the U.S.," Siris said.

"The NORA data also reinforces the need for physicians to screen for depression during routine primary care, as this is a common and serious problem that also turns out to predict risk for fractures," she said.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about osteoporosis.

 

Most defibrillators buried with patients: study

 

Reuters

Sunday, November 12, 2006

Most patients with implantable heart defibrillators are buried with the devices still inside them, stymieing efforts by doctors and companies to retrieve and check the devices for evidence of malfunction, researchers said on Sunday.

Implantable cardioverter defibrillators, or ICDs, are stopwatch-sized devices that detect and deliver a shock to the heart to correct dangerous rhythms.

High-profile recalls of defective devices have raised awareness of ICD safety, but researchers said they do not know the true rate of malfunction because the devices are not routinely checked after death.

"Implantable pacemakers and defibrillators are rarely analyzed or returned to the manufacturer after a patient dies," said Dr. James Kirkpatrick of the University of Pennsylvania, who presented his study results at the American Heart Association meeting in Chicago.

Kirkpatrick said most devices now are buried with patients. Of those that are removed, 44 percent are disposed of as medical waste, while 22 percent are donated for animal use or for human use in developing nations.

The survey found that most of the 100 morticians surveyed (87 percent) would be willing to return the devices to manufacturers for analysis. Of the 160 ICD patients questioned, 82 percent said they would give their consent.

Recalls of defective devices have depressed ICD sales and dampened profits of device makers St. Jude Medical Inc., Boston Scientific Corp. and Medtronic Inc.

In August, JP Morgan analyst Michael Weinstein said the ICD market has fallen 12 percent in the United States and about 6.5 percent globally on weak demand for the devices.

The Heart Failure Society issued guidelines last month calling for the devices to be returned for analysis. All three companies said they would comply.

Kirkpatrick advocated the use of "Device Living Wills," in which patients would specify the destiny of their devices after death, as a means of helping to overcome barriers to routine device removal and analysis.

"Perhaps that would shed light on recalls and safety," he said.

Heart Failure Patients Can Waltz Their Way to Stronger Hearts

 

By Amanda Gardner
HealthDay Reporter

HealthDay News

Sunday, November 12, 2006

SUNDAY, Nov. 12 (HealthDay News) -- Why walk your way to better heart health when you can waltz?

That's the question posed by Italian researchers who've found that waltzing improves heart function and quality of life among chronic heart failure patients. The benefits appear at least as great, and sometimes greater, than the benefits gained from more traditional aerobic exercise.

"Why not?" said Dr. Louis E. Teichholz, division director of cardiology and chief of complementary medicine at Hackensack University Medical Center, in Hackensack, N.J. "The important thing about exercise is that you have aerobic exercise, and certainly this is good aerobic exercise, especially a waltz, where you're constantly moving."

Added Dr. Robert Myerburg, a professor of medicine and physiology at the University of Miami Miller School of Medicine: "For the person with heart disease, this might be a good way to do exercise to their level of tolerance, and it would be enjoyable for them. You could adjust the form of dance you're doing for the person who is mildly limited because of heart disease."

The Italian researchers presented their findings Sunday at the American Heart Association's annual meeting, in Chicago.

Explaining the rationale for the research, lead study author Dr. Romualdo Belardinelli told a Sunday AHA news conference, "The problem is that sometimes the adherence of cardiac patients to exercise training programs is not very high, so we have to find something that may capture their interest."

"Waltz dancing improves functional capacity and quality of life for chronic heart failure patients without important side effects. It may be considered in combination or as an alternative to exercise training in these patients," added Belardinelli, the director of cardiac rehabilitation and prevention at Lancisi Heart Institute in Ancona, Italy

In a previous study, the same researchers had found that slow and fast waltzes were safe and effective forms of exercise for people who suffered from heart disease and previous heart attacks.

This time, the investigators basically repeated that first study in 110 individuals with chronic heart failure, 89 of them men, with an average age of 59.

The study participants were randomly assigned to do traditional aerobic exercise, including cycling and treadmills, three times a week for eight weeks, or to do a dance program that alternated slow waltzes (five minutes) and fast waltzes (three minutes) for a total of 21 minutes. The dance sessions were also performed three times a week for eight weeks. A third group did not exercise and served as a control group.

Dancing improved both functional capacity of the heart and quality of life, especially in the area of emotions. There was no improvement at all in these areas among patients who did not exercise.

Cardiopulmonary fitness increased at similar rates in the routine aerobic group and in the dance group, with dancers experiencing slightly greater benefits.

Among the aerobic exercisers, oxygen consumption increased 16 percent, compared to 18 percent for the dancers. Anaerobic threshold, or the point above which muscles start to tire, increased 20 percent among exercisers and 21 percent among dancers. And, cardiocirculatory fitness increased 18 percent among the exercisers and 19 percent among the dancers.

People in the dancing group also saw improved elasticity in their arteries.

Finally, quality of life improved more in the dancing group than in the exercise group.

And dancing was safe; no one had to withdraw from the program.

"I don't think you could say this is better than good aerobic exercise," Teichholz said. "The major difference is people were happier doing it. In people with heart failure and in normal people, we need to think that exercise can take various forms, and dancing certainly in this study is shown not to be deleterious and actually to be helpful."

More information

The American Heart Association has more on exercise and heart health.

 

Saturday, November 11, 2006

 

Study suggests painkiller naproxen safe for heart

 

By Maggie Fox, Health and Science Editor

Reuters

Saturday, November 11, 2006

Naproxen, a common, over-the-counter pain reliever used for arthritis and other aches and pains, appears to be safe for the heart, despite warnings, researchers reported on Saturday.

A study of 41 healthy men and women showed naproxen, sold under the brand name Aleve by Bayer Consumer Care, "thins" the blood in much the same way as aspirin does.

This anti-clotting effect is seen on platelets, which are structures in the blood that help make clots.

Dr. Michael Schiff of the Denver Arthritis Clinic and Dr. Marc Hochberg of the University of Maryland School of Medicine studied the blood of the 41 volunteers when they took Aleve once or twice a day for a week, compared to a placebo and then compared to 81 mg low-dose aspirin.

The prescription dose of naproxen had already been shown to reduce platelet activity but this was the first test with over-the-counter doses.

The researchers measured a compound in the blood called serum thromboxane B2 and found that naproxen had similar effects to that of coated aspirin.

"This is good news. It is reassuring news," Schiff said in a telephone interview.

"These data, confirming that the over-the-counter dose of naproxen sodium has a measurable antiplatelet effect, add to the body of evidence about the safety of this compound," added Hochberg.

Naproxen is in a class of drugs called non-steroidal anti-inflammatory drugs, or NSAIDS.

In 2004, the Food and Drug Administration asked the makers of ibuprofen, naproxen and ketoprofen to add labeling with more warnings about gastrointestinal and heart risks of the drugs, and advising patients to take them only for a limited time.

This came after some of a new class of drugs called COX-2 inhibitors were found to greatly raise the risk of heart attacks and strokes.

The COX-2 inhibitors were ironically designed to be safer alternatives to aspirin, ibuprofen and other NSAIDs, which can cause sometimes fatal stomach bleeding.

Merck and Co. withdrew its arthritis drug Vioxx from the market in September 2004. It is facing more than 11,500 product liability lawsuits from people claiming to have been harmed by Vioxx.

Other studies then suggested naproxen might also be dangerous, although many experts have questioned this.

"We know from very large epidemiological (population) studies and all sorts of studies that naproxen is a safe drug, perhaps the best of the NSAIDS," said Dr. Steve Nissen of the Cleveland Clinic Foundation.

Nissen is currently testing 21,000 patients to compare the safety of naproxen, aspirin and another COX-2 inhibitor, Pfizer's Celebrex, known generically as celecoxib.

Lupus raises pregnancy death risk: study

Reuters

Saturday, November 11, 2006

Women with the immune disease lupus who become pregnant face a much higher risk of serious complications and even death, U.S. researchers reported on Saturday.

Their findings confirm evidence that had suggested pregnancy is dangerous for women with lupus, a chronic illness in which the immune system malfunctions and causes a range of symptoms including achy joints, fever, rash and hair loss.

The team at Duke University Medical Center in North Carolina studied more than 18 million hospital stays related to pregnancy and found that women with systemic lupus -- the most common and severe form -- had 20 times the risk of pregnancy-related death compared with women without the disease.

The disease also raised the risk of pregnancy complications such as blood clots and anemia.

"Pregnant women with lupus should never try to go through their pregnancy alone and simply hope for the best," said Dr. Megan Clowse, who led the study to be presented at a meeting in Washington of the American College of Rheumatology.

The Lupus Foundation of America estimates that about 1.5 million Americans -- 90 percent of them women -- have some type of lupus.

All women with systemic lupus, pregnant or not, have a higher-than-normal risk of death, but pregnancy appears to worsen the risk.

Clowse's team found that between 2000 and 2002, 13,500 women with systemic lupus gave birth and 44 of the women, or 0.3 percent, died.

Extrapolating this to the general population would translate to 325 deaths per 100,000 women -- compared to the normal rate of 14 pregnancy related deaths per 100,000 women, the researchers said.

"We don't want these results to scare women with lupus away from getting pregnant, especially if they have a mild form of the disease," Clowse said in a statement.

"But these women really must plan their pregnancies. They may need to change their medications before they get pregnant, and they really shouldn't conceive when their lupus is active."