The American Voice Institute of Public Policy Presents

Personal Health

Joel P. Rutkowski, Ph.D., Editor
April 14, 2004

 

 

 

Important Medical Disclaimer: The content displayed in Personal Health is designed to educate and inform. Under no circumstances is it meant to replace the expert care and advice of a qualified physician. Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate. Accuracy cannot be guaranteed. Personal Health assumes no responsibility for how information presented is used.

Personal Health for the Week of February 21-27

PERSONAL HEALTH

 

PERSONAL HEALTH

 

FRIDAY, FEBRUARY 27, 2004

  1. Exercise Program Aimed at Sedentary Women
  2. Folate Strategy in U.S. Works Better Than Thought
  3. Kids' Cuisine is Far From Lean
  4. 21 Pounds Enough to Raise Breast Cancer Risk
  5. Antidepressant Relieves PMS
  6. FDA OKs First-Of-A-Kind Colon Cancer Drug
  7. Arthritis Drugs Work Better Together
  8. The Air We Breathe
  9. Panel Urges Stricter Limits on Acne Drug
  10. Night-Time Leg Cramps
  11. Early Data Could Have Shown HRT Risks: Researchers
  12. Shedding Those Pregnancy Pounds
  13. 'Drink Lots of Fluids': Unproven, Perhaps Dangerous
  14. Could Listeriosis Become Thing of the Past?
  15. Low Vitamin C May Up Asthma Risk: Study
  16. New Treatment for Blacks With Heart Failure to Be Tested
  17. 'Probiotic' Baby Formula Deemed Safe in Study
  18. Telling the Difference Between Good, Bad Fats
  19. UK Says Two-View Mammogram Ups Cancer Detection
  20. Sterol-Packed O.J. a Cholesterol Buster

    THURSDAY, FEBRUARY 26, 2004

  21. HIV / AIDS
  22. Kids Who Bulk Up Run Higher Diabetes Risk
  23. Hunger Sharpens Your Taste Buds
  24. Food, Drink Sales Not Hurt by Smoking Ban –Study
  25. New Target for Tumor-Killing Drugs Found
  26. Study May Bring Sickle Cell Breakthrough
  27. Blood Pressure Drugs Work Same for All
  28. Thirst Doesn't Always Guide Need for Water: Sports Experts
  29. Genetic Key to Type 2 Diabetes Identified
  30. Superbug Deaths Climb in Britain
  31. A Sleeping Pill As a Stroke Aid?
  32. Nutritional Boost Helps Elderly Ward Off Colds
  33. TV Ads Add Pounds to Our Kids
  34. CDC Says U.S. Asthma Rates Rose in 2002
  35. For Teens, It's Often Not Just Rewards
  36. Mom's Smoking Tied to Adult Children's Lung Disease
  37. Study: Weight Gain Tied to Breast Cancer
  38. ECG Signs Identify Diabetics with High Death Risk
  39. States Take on Fighting Childhood Obesity
  40. FDA Approves Heart Device for Children
  41. FDA Approves First-Of-A-Kind Cancer Drug

    WEDNESDAY, FEBRUARY 25, 2004

  42. Secondhand Smoke Can Hide in Your Home
  43. Oral Sex Shown to Be Linked to Mouth Cancer
  44. No-Smoking Sections Are No Help
  45. STDs Unevenly High in Teens, Young Adults
  46. Deciphering a Cholesterol Drug
  47. New Protein Blocker of HIV Replication Identified
  48. High Blood Pressure in Lungs Boosts Death Risk in Sickle Cell Patients
  49. Study May Bring Sickle Cell Breakthrough
  50. Diabetes Raises Risk of Serious Liver Problems
  51. Kids Who Bulk Up Run Higher Diabetes Risk
  52. Low-Fat Diet Slows Prostate Cancer Growth, in Mice
  53. Survey: American Lives Still Unhealthy
  54. Drug Fights Abnormal Openings in Crohn's Disease
  55. Study: Weight Gain Tied to Breast Cancer
  56. Childhood Weight Changes Predict Sugar Problem
  57. Reading Is Fundamental

    TUESDAY, FEBRUARY 24, 2004

  58. Half of Young Americans to Get Sex Diseases –Study
  59. Brother, How Can I Stop Sneezing?
  60. TV, Eating Out Makes Kids Fat, Studies Agree
  61. When Trouble Melts Like Lemon Drops
  62. Hormone Therapy May Affect Hearing, Study Shows
  63. Long Soaking May Help Dry Hands
  64. Pregnancy Not Usually Bad for Fatigue Syndrome
  65. Women Use More Meds Than Thought
  66. Researcher Warns of Ear Piercing Infections
  67. Hormone Therapy May Trigger Asthma
  68. Walking Program Helps People with Heart Failure
  69. Beating Multiple Myeloma
  70. Gene That Helps in Your 40s Can Hurt in Your 80s
  71. Halting Damage of Hysterectomy
  72. Very-Low-Calorie Diet Controls Teens' Diabetes
  73. Old Standby Reduces Heart Attack Damage
  74. Home Blood Pressure Checks Help Guide Therapy
  75. More Kids, More Pounds for Parents

    MONDAY, FEBRUARY 23, 2004

  76. Macrobiotics Dieters Stick With Carbs
  77. Stress Seems to Block Deep Sleep
  78. HHS Issues Health Care Disparities Report
  79. Experts: Chicken Safe from Bird Flu, if Cooked
  80. Audit: U.S. Inmates Get Poor Health Care
  81. Self-Renewing Spinal Nerve Cells Created
  82. AP Poll: Drugs Costly for U.S. Families
  83. Study Adds Asthma to Hormone Replacement Ills
  84. Super Antioxidants
  85. Study: No-Smoking Areas Offer Partial Protection
  86. 'Good' Carbs Cut Heart Disease Risk
  87. That Candy Bar Tastes Sweeter When You're Hungry
  88. Healthy Heart Habits May Keep 'Mini Strokes' at Bay
  89. Interferon Protects Against SARS Virus, in Monkeys
  90. New Proof That Early Detection Aids Breast Cancer Fight
  91. Alternative Therapies Popular with Cancer Patients
  92. Swollen Glands
  93. Stroke, Heart Risk Not Raised by Migraine Drugs
  94. Testicle Self-Examination
  95. Eye Disease Could Be Detected Sooner

    SUNDAY, FEBRUARY 22, 2004

  96. Nations to Discuss Biotech Safety Rules
  97. Journal Regrets Vaccine-Autism Link Study

    SATURDAY, FEBRUARY 21, 2004

  98. The Gender Differences of Heart Disease

Friday, February 27, 2004

Exercise Program Aimed at Sedentary Women

By Kathleen Doheny
HealthDay Reporter
HealthDayNews
Friday, February 27, 2004

FRIDAY, Feb. 27 (HealthDayNews) -- Only 45 percent of American adults are active enough to meet the minimal guidelines to get at least 30 minutes of physical activity most days of the week.

The American Heart Association (news - web sites) is out to change that, and its next focus will be American women. The association is launching an updated version of "Choose to Move," a 12-week behavior modification program designed to ease women who are too busy to exercise into a more active lifestyle. The program began in 1998.

This year's version will be available online March 11 and by mail the third week in March for women who have already registered.

The program was developed by the Cooper Institute for Aerobics Research in Dallas and includes a handbook suggesting easy ways to get more active. Everyday activities like walking to the store instead of driving, or climbing stairs instead of taking elevators, are examples.

Suggestions for healthy meals and snacks are also given. The stories of three fictional women who become more active and healthy provide additional inspiration for changing unhealthy lifestyles.

"The handbook really speaks to women and is inspirational," says Dr. Rita Redberg, professor of medicine at the University of California, San Francisco, National Center of Excellence in Women's Health and a volunteer and spokeswoman for the American Heart Association.

"Cooper [researchers] spent a lot of time talking to women and trying to decide how to overcome obstacles we all have to eating a healthy diet and doing a little more physical activity. The program is only designed to get you started.

"A new part of this year's program is [that] we are going to do follow-up for a year on some of the women who participate," Redberg says. "They can send in postcards and let us know how they are doing. One of the things we got from least year's program is that women want to stay in touch."

A fitness expert says the program sounds like a very good start for inactive women. "If someone can do something for 12 weeks, that is a significant commitment to habit change," says Richard Cotton, a San Diego-based exercise physiologist and a spokesman for the American Council on Exercise.

Women contemplating the program should be ready for a lifestyle change, he suggests. Research has shown, and his experience with his fitness clients bears it out, that you need to be ready to change before a habit change can take hold.

Another important suggestion to making physical activity a habit, Cotton says, is to pay more attention to your body when you are working out or fitting in physical activity. "You walk into a gym and everyone is watching CNN," he says. "It's a mind-body disconnect."

He tells people, "Stay in touch with breathing and the movement of your body while exercising. It will ingrain the habit faster."

Another way to get and stay more physically active? "You have to connect your physical activity [and its importance to you] to a deeper value you have," Cotton says. That might be staying healthy so you'll be around for your children, your grandchildren, or your aging parents, he says.

For women with families, it might mean they exercise so they'll have the energy to keep up with family demands. For those with careers, it could mean ensuring enough energy to put in a productive week without feeling exhausted.

More information

To register, go online at the American Heart Association or telephone 1-888-My-Heart.

For more information on getting active, try the Centers for Disease Control and Prevention or the American Council on Exercise.

Back to the Top

Folate Strategy in U.S. Works Better Than Thought

By Anthony J. Brown, MD
Reuters Health
Friday, February 27, 2004

NEW YORK (Reuters Health) - A folate fortification strategy recently implemented in the US may have decreased the rate of neural tube defects (NTDs) to a greater extent than reviously thought, new research suggests.

NTDs are common birth defects that affect the spinal cord or brain of the growing baby. Numerous reports have shown that the risk of NTDs increases dramatically if the mother's diet doesn't include enough folate, a B vitamin also known as folic acid.

In 1998, the US Food and Drug Administration (news - web sites) mandated that folate be added to certain grain products in the hopes of reducing NTD rates. A study reported in 2001, based on birth registry data, indicated that this intervention reduced the rate of NTDs by 19%, a significant reduction, but lower than the reductions predicted by studies conducted in the early 1990s.

The present report suggests that the 2001 study may have underestimated the impact of folate fortification. This is based on the finding that after 1998 a marked drop occurred in the percentage of patients with a high blood level of maternal alpha-fetoprotein (AFP), a test result linked to NTDs.

"The data from our study suggest that the reduction in NTD incidence is actually greater than that seen at birth," lead author Dr. Mark I. Evans, from St. Luke's Roosevelt Hospital in New York, told Reuters Health. "The reason, of course, is that we are diagnosing these cases prenatally and many of the couples are choosing to terminate the pregnancy."

In the current study, reported in the medical journal Obstetrics and Gynecology, AFP values from 27,020 pregnancies in 1997 were compared with values from 34,099 pregnancies in 2000. Between the two periods, the percentage of patients with high values fell by 32 percent.

"The take-home message is that folic acid fortification is working even better than the birth registry data suggest," Evans noted. "It is a very important public health measure to reduce the incidence of birth defects."

Source: Obstetrics and Gynecology, March, 2004.

Back to the Top


Kids' Cuisine is Far From Lean

By Amanda Gardner
HealthDay Reporter
HealthDayNews
Friday, February 27, 2004

FRIDAY, Feb. 27 (HealthDayNews) -- The nation's leading table-service chain restaurants score dismally when it comes to providing healthy food choices for kids.

In fact, says a new study from the Center for Science in the Public Interest (CSPI), families might do better eating at fast-food establishments for all the nutritional value they're getting.

The study found loads of calories, bad fats and salt in items on kids' menus at restaurants such as Applebee's, Chili's and Outback Steakhouse. The study was released Tuesday at a briefing in Washington, D.C.

"The trans fat, saturated fat and sodium that are in these meals are stunningly bad," says Samantha Heller, senior clinical nutritionist at New York University Medical Center in New York City, who was not involved with the research. "I think what parents need to understand is that letting your children eat this kind of food over time is like putting a loaded gun to their head."

Part of the problem, though, is that the consequences are not immediate, Heller says.

"The problem with these junk foods or restaurant foods is that they look good and they taste good and you don't see the harmful results for many years. And that's why people tend to think it's OK, because you don't see an immediate bad result," Heller adds. "You're not physically ill or breaking out in hives."

This does not bode well for the burgeoning waistlines of the nation's children. According to the U.S. Centers for Disease Control and Prevention (news - web sites), the number of overweight and obese youth has almost doubled in the past 20 years.

Moreover, CSPI states, kids are getting a third of their calories from various chain restaurants. Studies show that kids eat nearly double the calories when they eat out versus eating at home.

In response to the study, the National Restaurant Association issued a statement saying: "This is yet another stale and worn-out attempt by CSPI to sensationalize an issue and feed the media and consumers with negative messages that vilify the food industry. The fact is that every day, our nation's 878,000 restaurants provide numerous options to accommodate all types of eating plans -- South Beach, Atkins, low-calorie, vegetarian, just to name a few. And, as the industry of choice and hospitality, restaurants have been incredibly responsive to meet the dietary needs and requests of all consumers, including using alternative food preparation methods -- baked, grilled, broiled, poached or steamed."

"CSPI seems to continually forget in their various attempts to target foods that 'calories in' is only one part of the equation to living a healthy lifestyle," the statement adds. "Balance and moderation in diet, complemented by physical activity, is key to healthier living. And, dietary experts maintain that there are no 'good foods' or 'bad foods,' and that all foods can be part of a balanced diet."

For the study, CSPI analyzed children's menus at 20 of the nation's leading table-service chain restaurants. French fries were available on all but one menu. Hamburgers were offered on 85 percent of menus. Many menus offered complimentary biscuits or cornbread and dessert.

The independent laboratory commissioned by CSPI analyzed typical foods from Applebee's, Chili's, Cracker Barrel, Denny's, Olive Garden, Outback Steakhouse and Red Lobster.

Many of the menu choices met the government's daily recommendation (1,500 calories and 17 grams of saturated fat or more) in one meal.

In many cases, the children's meals surpassed those of adults in health dangers, CSPI says. Outback's Boomerang Cheese Burger with Fries, for instance, has 840 calories and 31 grams of saturated-plus-trans fat, the group says. An adult would have to consume a sirloin steak, a filet mignon and three pats of butter to achieve the same level of decadence.

Other key points, according to CSPI:

  • The worst kids' menu item was Outback's Spotted Dog Sundae with chocolate sauce and 730 calories and 27 grams of bad fat. A cheeseburger, fries, Coke and sundae at Outback provides 1,700 calories and 58 grams of bad fat -- or enough for three and a half days.
  • Applebee's grilled cheese sandwich has 520 calories and 14 grams of bad fat. Add fries with that and you have 900 calories and more than a day's quota of bad fat.
  • Chili's Little Chicken Crispers provide 360 calories and eight grams of bad fat. With fries, that comes to 710 calories and 15 grams of bad fat, the same as two McDonald's Quarter Pounders.
  • A cheeseburger and fries at Denny's will net you 760 calories and 39 grams of saturated fat.

There were a few lite notes in the study. Red Lobster's new menu offers a free appetizer of fresh carrot sticks and cucumbers or applesauce. It also offers three new, lower-calorie entrees: Snow Crab Legs, Grilled Mahi-Mahi and Grilled Chicken, all with steamed vegetables.

Macaroni Grill and Cracker Barrel offer grilled chicken (with a vegetable side, the Cracker Barrel meal has only 160 calories and one gram of saturated fat) and Olive Garden offers a relatively healthful Spaghetti & Tomato Sauce kids' meal (420 calories and 2 grams of saturated fat), the report states.

Dramatic nutritional differences between similar items at different restaurants prompted CSPI to call for nutritional information to be provided on menus. Legislation requiring such information is pending in five states and the District of Columbia. This week, Sen. Tom Harkin (D-Iowa) announced his plan to introduce the Menu Education and Labeling Act (MEAL) in the Senate. Rep. Rosa DeLauro (D-CT) introduced similar legislation in the House last year.

While much of the change must come from these higher levels, individual consumers can also make a difference, health experts say.

"People can go to their local restaurant where they probably know the manager and request healthier food options," Heller says. "It's a local restaurant even if it's a chain. The people working there are local and you get to know them."

And eating habits on the home front can make a difference when eating out. "If children are used to eating healthy choices at home, they are more likely to make healthy choices when eating out," Heller says.

More information

Go to CSPI for the full report on children's restaurant menus. For more on children's nutrition, visit USDA/ARS Children's Nutrition Center at Baylor College of Medicine.

Back to the Top


21 Pounds Enough to Raise Breast Cancer Risk

American Cancer Society
Friday, February 27, 2004

Women who have gained more than 20 pounds since age 18 have a higher risk of developing breast cancer after menopause than women who have kept their girlish figure. The finding was published by American Cancer Society (news - web sites) researchers in the journal Cancer Epidemiology Biomarkers and Prevention (Vol. 13, No. 2: 220-224).

"These findings further illustrate the importance of maintaining a healthy body weight throughout life," said lead researcher Heather Spencer Feigelson, PhD, MPH. "Even modest weight gain - was associated with increased risk of postmenopausal breast cancer."

Researchers have long known that being overweight increases the likelihood that a woman will develop breast cancer. But the new study puts the risk into very real terms: pounds on the scale.

ACS researchers questioned more than 62,000 postmenopausal women about their height, current weight, weight at age 18, and use of hormone replacement therapy (HRT). After accounting for other breast cancer risk factors -- like family history of the disease, exercise, and alcohol use -- they found that women who had gained 21-30 pounds since age 18 had a 40% higher risk of breast cancer than women who'd stayed within 5 pounds of their teenage weight. Those who had gained more than 70 pounds had double the risk. (Lesser weight gain, between 6-20 pounds, had little effect on risk, less than 10%.)

The findings applied only to women who had never used HRT or who were no longer using it. Among women who were using HRT at the time of the study, weight gain did not appear to influence risk, probably because HRT "trumps" weight as a factor in breast cancer development. Both HRT and excess fat raise estrogen levels, which increases the risk of breast cancer. But the researchers said HRT raises estrogen so much that even a lot of extra weight has only a minimal effect by comparison.

Fortunately, there are steps women can take to lower their risk of breast cancer. In addition to maintaining a healthy body weight, the ACS also recommends staying physically active, limiting alcohol consumption, and staying away from hormone therapy, if possible. Regular screenings are also important, since they can detect breast tumors when they are small and more easily treated.

Back to the Top


Antidepressant Relieves PMS

Reuters Health
Friday, February 27, 2004

NEW YORK (Reuters Health) - For women with severe premenstrual syndrome, the antidepressant drug sertraline brings relief -- and it makes no difference if they take the drug continuously or just before their periods.

Dr. Ellen W. Freeman, of the University of Pennsylvania School of Medicine, Philadelphia, and colleagues assigned 167 women with premenstrual mood problems to receive continuous sertraline (also known as Zoloft), intermittent sertraline, or an inactive placebo.

The study, published in the American Journal of Psychiatry, showed that women's premenstrual symptom scores were significantly more improved in both sertraline groups than in the placebo group. Mood and physical symptoms were significantly more improved in the sertraline groups.

The investigators report that improvement with sertraline occurred swiftly in the first month of treatment.

Improvement with placebo also occurred, but gradually. However, it was similar to improvement with sertraline in the third month.

Improvements in family relationships, social activities, and sexual functioning were more often reported by patients who received sertraline compared with placebo-treated patients.

"The conclusion from these data is that the decision between full-cycle and premenstrual dosing for women with severe PMS ... can be based on patient/physician preference and individual experience of side effects," the authors write.

Source: American Journal of Psychiatry, February 2004.

Back to the Top


FDA OKs First-Of-A-Kind Colon Cancer Drug

By Paul Elias
AP Biotechnology Writer
The Associated Press
Friday, February 27, 2004

SAN FRANCISCO - Genentech Inc. began shipping its widely anticipated colon cancer-fighting drug just hours after the government approved the novel biotechnology treatment.

Avastin is designed to choke the blood supply that feeds tumors and is the first drug of its kind to be approved by the FDA (news - web sites). When used with chemotherapy, has been found to extend the life of the sickest patients by an average of about five months.

Some 30 other experimental drugs based on similar technology are in various states of human testing and large drug makers such as Novartis, Bayer and Pfizer are in advanced development. Genentech also said it's experimenting with Avastin in several other forms of cancer, including kidney and lung.

The idea is that tumors must form a network of blood vessels to survive — and that shutting down that process, called angiogenesis, could fight cancer in a manner completely differently than other treatments.

That theory was pioneered by Harvard University's Dr. Judah Folkman, who made front-page news in 1998 with reports that his anti-angiogenesis drugs had cured mice of cancer. But attempt after attempt to make such drugs work in people failed.

Genentech Inc. saw its stock plummet as recently as 2002 when the drug failed to help breast cancer patients.

But in May, the South San Francisco-based company surprised Wall Street when it announced that Avastin showed promise after doctors tried it in the sickest of colon cancer patients.

Analysts expect the drug, which will cost each patient about $4,400 per month, to surpass $1 billion in sales in the next few years.

In a study of 800 people, half received intravenous Avastin in addition to routine chemotherapy. Not only was tumor growth delayed in those getting Avastin, but the Avastin patients lived about 20 months, five months longer than those getting standard treatment.

It was the first time in three decades of research that an anti-angiogenesis drug was proven to help people.

Avastin occasionally causes some serious side effects, including formation of holes in the colon that may require surgery to fix, impaired wound healing and internal bleeding, the FDA said. More common side effects are high blood pressure, fatigue, blood clots, diarrhea, appetite loss and increased risk of infection because of decreased white blood cells.

On the Net:

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

Genentech Inc.: http://www.gene.com/

Back to the Top


Arthritis Drugs Work Better Together

Reuters Health
Friday, February 27, 2004

NEW YORK (Reuters Health) - Etanercept and methotrexate, two drugs commonly used to treat rheumatoid arthritis (RA), work better together than alone, new research suggests. In addition, using them together doesn't increase the risk of side effects.

The results, which are reported in The Lancet, stem from a study of 686 patients with RA who were treated with etanercept (Enbrel), methotrexate, or both drugs for 1 year. On average, the patients had RA for about 6.5 years.

The treatment response was evaluated using standard criteria set forth by the American College of Rheumatology. Moreover, an x-ray scoring system was used to assess disease progression at 1 year.

Dr. Lars Klareskog, from the Karolinska Institute in Stockholm, and colleagues found that treatment with both drugs was significantly better than either agent alone at reducing disease activity, improving functional disability, and slowing disease progression.

"Concurrent initiation and use of the combination of etanercept and methotrexate brings us closer to the goals of antirheumatic treatment, specifically the achievement of clinical remission and repair of structural damage," Klareskog's team concludes.

In a related editorial, Dr. Armin Shnabel, from Sana Rheumazentrum Baden-Wurttemberg in Germany, comments that despite the encouraging findings, "a sizeable number of patients" treated with both drugs still had active inflammation.

The critical factor to improving treatment for RA may be timing, he notes, adding that a number of trials are in the works that, unlike the current study, involve patients with newly diagnosed RA.

Source: Lancet, February 26, 2004.

Back to the Top


The Air We Breathe

HealthDayNews
Friday, February 27, 2004

(HealthDayNews) -- Since most people spend more time indoors than out, the air quality of the indoor environment can play an important role in maintaining good health, according to Health Canada.

Here's how to keep indoor air quality healthy:

  • Control the humidity and let more air into your home to prevent moisture from building up on walls and windows.
  • Repair leaky roofs, walls and basements.
  • Get rid of moldy surfaces with a solution of bleach and water -- about one cup of bleach per gallon of water.
  • Keep your home clean and dust-free.
  • Buy a hygrometer to measure indoor humidity. This way you'll know whether you need a humidifier.
  • Regularly clean and disinfect humidifiers and air conditioners.
Back to the Top


Panel Urges Stricter Limits on Acne Drug

By Lisa Richwine
Reuters
Friday, February 27, 2004

GAITHERSBURG, Md. (Reuters) - A powerful acne drug that can cause serious birth defects needs even tighter restrictions to make sure pregnant women do not take it, a U.S. advisory panel ruled on Friday.

The panel recommended a mandatory, centralized registry of all patients taking the prescription drug, sold by Roche under the name Accutane, and its generic rivals. Prescribers and pharmacists also should register with the system, which if adopted would make Accutane one of the most restricted medicines.

The program, backed by Roche and generic companies, would require proof of a negative pregnancy test before pharmacists could refill monthly prescriptions.

The Food and Drug Administration (news - web sites) is considering new limits because women have continued to get pregnant while taking Accutane, despite various safeguards that were periodically strengthened and mostly voluntary.

The FDA will weigh the panel's recommendations and try to work out a tougher plan with Roche and generic producers of the widely used medicine.

"Doing nothing and making no change is not an acceptable course of action," said Dr. Sandra Kweder, deputy director of the FDA's Office of New Drugs.

In a one-year period after the safety measures were strengthened in 2002, 120 pregnancies were reported, compared with 127 during a similar period with looser restrictions. Fetuses exposed to Accutane can die or develop defects such as heart and nervous system anomalies.

Under the current pregnancy prevention plan for Accutane, women are supposed to have two negative pregnancy tests before starting therapy, and another each month of therapy, which typically lasts four to six months.

Roche's research showed those recommendations, as well as advice for women to use two forms of contraception during therapy, were not always followed.

The panel voted 16-8 to back a plan from Roche and generic firms for a mandatory registry, and added a few other requirements.

"We are not at odds in any way" with the panel's advice, Roche spokeswoman Carolyn Glynn said. Details for implementing the new program need to be worked out, but "we're all looking at the same goals," she said.

Some panel members said the mandatory system would be too burdensome, and there was no evidence it would reduce pregnancies. Even the stricter system cannot fully regulate patients' behavior regarding contraception, some cautioned.

"We don't go home with them, and we can't control what they do," said panel member Dr. Roselyn Epps, head of pediatric dermatology at Children's National Medical Center in Washington.

Few drugs have tight restrictions on prescribing, but the FDA increasingly has searched for ways to manage safety risks of important medicines, rather than keeping them from patients entirely. Dermatologists hail Accutane as a wonder drug for treating severe acne. Critics charge it is overprescribed for more mild cases.

One tightly controlled drug is thalidomide, a medicine notorious for causing birth defects and now used to treat cancer and leprosy.

Accutane is known generically as isotretinoin. The three generic makers are Barr Pharmaceuticals, Ranbaxy Laboratories Ltd. and Mylan Laboratories Inc. .

Roche said its Accutane sales fell to $144 million in 2003 from $380 million in 2002 after generic competition debuted.

Back to the Top


Night-Time Leg Cramps

HealthDayNews
Friday, February 27, 2004

(HealthDayNews) -- If leg cramps wake you during the night, there's no cause for alarm.

In most cases, the spasms are innocuous and are caused by simple muscle fatigue or an imbalance of chemicals such as sodium, potassium, phosphorous, calcium and magnesium in the blood, according to Calgary Health Region in Canada.

Night-time cramps usually subside by themselves, but sometimes applying heat, massaging the leg or stretching the muscle by pulling your toes up toward you will help.

If you get cramps while you are pregnant or after you've been sweating heavily, you should talk to your doctor.

Back to the Top


Early Data Could Have Shown HRT Risks: Researchers

By Stephen Pincock
Reuters Health
Friday, February 27, 2004

LONDON (Reuters Health) - The potential risks of hormone replacement therapy could have been exposed much earlier if data from trials conducted by pharmaceutical companies had been made publicly available, according to an article in the British Medical Journal (BMJ) this week.

The two authors remind readers that the US Women's Health Initiative (WHI) trial was stopped in 2002 when data showed that after 5 years the balance of benefits from combined hormone replacement therapy did not compensate for an increased risk of heart-related events.

In the journal, Klim McPherson, professor in public health epidemiology at Churchill Hospital in Oxford, argues that small, randomized trials conducted for the purposes of licensing drugs should record data on adverse results and be made public.

The case of hormone replacement therapy is a good example of the benefits this would have, he says in his article, co-written with Elina Hemminki, a research professor at Finland's National Research and Development Center for Welfare and Health.

The WHI study and others "might not have been so necessary if better use had been made of existing evidence," the authors write.

As far back as 1997, McPherson and Hemminki had published an analysis of 23 small trials of hormone replacement therapies, many of which were used to provide evidence for licensing and were not publicly available.

Their results, which showed a higher risk of cardiovascular events in women taking HRT, conflicted with what observational data had shown. "We were ridiculed," the authors write.

To strengthen their findings, the authors sought data from six further studies, finally succeeding only when they resorted to the Finnish High Court, which rejected objections from the companies.

This new, pooled data showed that the use of HRT increased the risk of heart disease by 78 percent, the duo say. This was in the range of risk reported by the WHI trial in 2002.

McPherson and Hemminki say regulators should require that efficacy studies record all outcomes, and that the studies are maintained in registers of clinical trials that can be made available to independent scientists and regulators when concerns arise.

"This is not a great deal to ask, given the importance of the questions," McPherson told Reuters Health.

Source: British Medical Journal, February 28, 2004.

Back to the Top


Shedding Those Pregnancy Pounds

HealthDayNews
Friday, February 27, 2004

FRIDAY, Feb. 27 (HealthDayNews) -- Weekly classes that provide a structured program of nutrition and exercise education help new mothers shed weight more effectively than a single information session does, claims a Saint Louis University study in the current issue of the Journal of Women's Health.

"The study demonstrates that women who complete a structured diet and physical activity intervention during the early postpartum period successfully lose weight. Those given general advice about diet and exercise do not," principal investigator Mary L. O'Toole, a professor of obstetrics, gynecology and women's health, says in a prepared statement.

This study focused on women who were overweight when they became pregnant. The researchers wanted to determine how best to prevent the women from becoming obese after they had their babies.

"Obesity has become such a severe problem that we need to identify times when people are at risk of becoming obese and prevent it from happening," O'Toole says.

"The postpartum period is a time we know women tend to retain the weight they gained during pregnancy and start in a downward spiral," she says.

The study included 40 new mothers who had gained more than 33 pounds during pregnancy and were more than 11 pounds heavier than before they became pregnant. About half the women attended 12 weekly nutrition and physical activity strategy sessions. The other women received a single 60-minute session on diet and exercise.

The women's weight loss was tracked over a year.

The women who attended the weekly sessions lost an average of 16 pounds, while those who received the single session lost an average of slightly less than 3 pounds.

More information

The U.S. National Women's Health Information Center has more about obesity.

Back to the Top


'Drink Lots of Fluids': Unproven, Perhaps Dangerous

By Alison McCook
Reuters Health
Friday, February 27, 2004

NEW YORK (Reuters Health) - There is no evidence to support the common wisdom that drinking plenty of fluids helps someone with a cold or flu, according to Australian researchers.

Instead, some research suggests, downing lots of fluids during an illness may even be dangerous in some cases.

Study author Dr. Chris B. Del Mar explained that when people become very ill with a respiratory illness, their bodies sometimes secrete a hormone that causes them to retain water. Consequently, if they were to drink liters of water and other fluids, they might run the risk of problems resulting from a "waterlogging of the brain," according to Del Mar.

So why do so many people, including doctors, recommend drinking plenty of fluids when ill? "It's not really clear," Del Mar noted. "All we know is that the idea arose in ancient times, and has been carried on ever since without anyone really challenging it."

To investigate whether the theory that drinking fluids helps with colds and the flu was closer to fact or fiction, Del Mar and colleagues at the University of Queensland searched archives of past studies into the topic. They report their findings in this week's issue of the British Medical Journal.

According to the report, not a single study has compared the effects of drinking lots of fluids versus low fluid intake in people with respiratory infections. Instead, the researchers discovered reports of ill people developing dangerously low levels of sodium in the blood, a condition that can be prevented by restricting, rather than encouraging, fluid intake.

In two reports, for instance, between 31 and 45 percent of children experienced a drop in blood levels of sodium during a bout of moderate to severe pneumonia.

Hopefully, Del Mar noted, these findings will encourage researchers to conduct studies in which they ask some sick people to drink lots of fluids and instruct others to drink only as much as they want, and compare the outcomes.

Meanwhile, Del Mar said, the best advice to give someone with a cold is to simply wait it out, perhaps turning to an antihistamine to help with the sniffles, and acetaminophen to reduce an unpleasant fever.

"As a doctor I check that they haven't anything more serious, and then reassure them they will get better whatever treatment they use," Del Mar said.

British Medical Journal, February 28, 2004.

Back to the Top


Could Listeriosis Become Thing of the Past?

HealthDayNews
Friday, February 27, 2004

FRIDAY, Feb. 27 (HealthDayNews) -- Purdue University researchers have identified a previously unknown protein on the surface of intestinal cells, a finding that may help scientists develop a way to prevent foodborne Listeria monocytogenes infection and other disease.

"This research reveals a detailed mechanism that allows interaction of Listeria with a cell-surface protein, or receptor, on intestinal cells. Knowing the entryway into the cell will allow us in the future to develop a method to prevent that interaction," Arun Bhunia, a microbiologist in the food science department, says in a prepared statement.

"Listeria often is implicated in patients with weakened immune systems, so we think this research could also give us clues as to how other diseases work. This receptor is not unique for Listeria, so it also could be used by other organisms to take advantage and get inside a host cell to cause disease," study author Jennifer Wampler, a postdoctoral student, says in a prepared statement.

Listeria causes about 2,500 recorded cases of foodborne illness each year in the United States. It's the deadliest foodborne disease, with a fatality rate of 20 percent. It's especially dangerous for the elderly, pregnant women, and people with weakened immune systems, such as those with HIV (news - web sites).

The study appears in the February issue of Infection and Immunity.

More information

The U.S. Centers for Disease Control and Prevention (news - web sites) has more about Listeria.

Back to the Top


Low Vitamin C May Up Asthma Risk: Study

By Merritt McKinney
Reuters Health
Friday, February 27, 2004

NEW YORK (Reuters Health) - Children with low levels of vitamin C may be more likely to develop asthma, researchers report.

In a nationwide study, children with asthma tended to have lower blood levels of the vitamin than children with healthy lungs. Despite this association, however, it is too soon to say that a lack of adequate vitamin C causes asthma, the study's lead author told Reuters Health.

"These results, along with results from other studies, support the hypothesis that certain vitamins may prevent or ameliorate asthma," Dr. Robert A. Wise of Johns Hopkins University School of Medicine in Baltimore told Reuters Health.

But Wise cautioned that the findings do not prove that vitamin supplements can prevent or treat asthma.

"Vitamin C may only be a marker for other unmeasured micronutrients or exposures," he said. Clinical trials will be necessary to determine whether vitamin C can prevent or treat asthma.

Vitamin C and other antioxidants target a process called oxidation in which cell-damaging substances called free radicals accumulate. Scientists have been interested in finding out whether antioxidants influence the effect of oxidation and inflammation in the lungs and airways.

To investigate a possible link between antioxidants and asthma, Wise's team evaluated information from more than 4,000 children in a national health survey. Results of the study appear in the American Journal of Epidemiology.

All children in the study underwent testing to measure blood levels of vitamins A, C and E. Levels of antioxidants called carotenoids, a group of compounds that produce the red, yellow and orange colors found in many fruits and vegetables, were also measured.>

Wise's team found that children with lower levels of vitamin C and carotenoids were more likely to have asthma. Only vitamin C and a carotenoid called alpha-carotene were associated with asthma risk, however, once researchers accounted for things that are known to influence asthma risk, such as age, obesity, socioeconomic level, parental asthma and exposure to secondhand smoking.

Despite the association between blood levels of vitamin C and asthma risk, children with and without asthma did not differ significantly in the amount of vitamin C they consumed, according to the report.

One possible explanation, the authors suggest, is that the surveys used to measure vitamin intake were not accurate. Another possibility is that vitamin C may be processed differently in children with asthma, which may lead to reduced blood levels of the vitamin.

Source: American Journal of Epidemiology, February 15, 2004.

Back to the Top


New Treatment for Blacks With Heart Failure to Be Tested

HealthDayNews
Friday, February 27, 2004

FRIDAY, Feb. 27 (HealthDayNews) -- The Medical College of Georgia is taking part in a national study examining whether a special combination of drugs can help blacks with heart failure live longer and healthier lives.

The African American Heart Failure Trial is the first prospective study of heart failure treatment aimed specifically at blacks. Patients will receive isosorbide dinitrate, a drug that helps keep blood vessels open by increasing levels of the vasodilator nitric oxide, along with hydralazine, an antioxidant and vasodilator that helps protect nitric oxide.

Previous research has indicated this combination may be particularly beneficial for blacks with heart failure.

Study volunteers will be closely monitored for 18 months and undergo extensive medical evaluation. Eligible subjects include male and female blacks, age 18 and older, in stage three or four heart failure who have not been hospitalized in the past three months. The study is sponsored by the drug industry.

For more information about the study, phone study coordinator Helen Fain at 760-721-9684.

Nearly 5 million Americans are affected by congestive heart failure, a condition in which the heart is no longer able to pump enough oxygen-rich blood throughout the body. Hypertension and heart attack are major causes of heart failure. Blacks are twice as likely as whites to experience heart failure and also have higher death rates from heart failure.

More information

The American Heart Association (news - web sites) has more about heart failure.

Back to the Top


'Probiotic' Baby Formula Deemed Safe in Study

By Amy Norton
Reuters Health
Friday, February 27, 2004

NEW YORK (Reuters Health) - Infant formula fortified with "good" bacteria appears safe, and may help ease babies' irritability, new research suggests.

The study, funded by Nestle USA, a maker of infant formula, adds to evidence that so-called probiotic foods may have digestive and immune system benefits, according to the authors.

These are, however, benefits that breast feeding has already been shown to have, an expert not involved in the study pointed out.

Beneficial bacteria dwell by the trillions in the human body, helping to defend it from disease-causing bugs. People have long gotten an added boost of good bacteria from foods such as yogurt and other fermented dairy products.

Though not approved in the U.S., probiotic infant formulas have been marketed in Europe, Asia and South America for a number of years, with no apparent ill effects. Still, there's been little study of the products' long-term safety, according to the authors of the new study.

Their investigation of formula supplemented with two types of bacteria -- Bifidobacterium lactis and Streptococcus thermophilus -- found it to be safe among 78 infants who consumed it for seven months, on average. In a key measure of safety, the infants' growth was no different from that of 40 babies on regular formula.

In addition, parents of babies on the designer formula reported less colic or irritability, and less antibiotic use than those whose babies were on regular formula, Dr. Jose M. Saavedra and his colleagues at Johns Hopkins University in Baltimore found.

Saavedra, who is also medical director of Nestle USA's nutrition division, and his team report the results in the American Journal of Clinical Nutrition (news - web sites).

Friendly bacteria that reside in the gut are thought to promote health in a number of ways. They compete with illness-causing bacteria for space and nutrients, helping to crowd the bad bugs out. They also secrete enzymes that aid in digestion, and may affect the workings of immune-system cells in the gut.

Some studies have shown probiotics help treat or prevent diarrhea caused by rotavirus infection, which is a common cause of diarrhea in children. There's also some evidence that probiotics might cut the risk of certain allergies.

However, breast feeding -- the preferred source of infant nutrition -- has already been linked to better digestion, less diarrhea and a lower risk of allergies and certain infections.

And one of the things breast milk does is promote the growth of beneficial bacteria in the digestive tract, Dr. Frank Greer of the University of Wisconsin in Madison said in an interview.

According to Greer, who is on the American Academy of Pediatrics' nutrition committee, it would have been helpful to have a comparison group of breast-fed babies in this study.

"Because ultimately," he said, "what they're trying to do is make formula more like breast milk."

And Greer said that while he liked the fact that the study looked at infant growth, he was unimpressed by the small differences between groups in parents' reports of irritability and antibiotic use.

Antibiotic use, which Saavedra's team says could be a marker of the fortified formula's immune system benefits, was actually higher among babies who got a high level of probiotic supplements in the formula compared with those on a low probiotic dose, Greer noted.

Source: American Journal of Clinical Nutrition, February 2004.

Back to the Top


Telling the Difference Between Good, Bad Fats

HealthDayNews
Friday, February 27, 2004

FRIDAY, Feb. 27 (HealthDayNews) -- There's a lot of discussion about good fats and bad fats, but it may be difficult for you to remember which ones you can eat and which ones you should avoid.

The February issue of the Mayo Health Letter offers some advice. It says you should avoid the following fats:

  • Saturated fat. This fat raises blood cholesterol, especially low-density lipoprotein (LDL), commonly referred to as the "bad" cholesterol. Saturated fat is found in red meat, poultry skin, butter, cheese, full-fat dairy products, coconut oil and palm oil.
  • Trans fat, which is also called hydrogenated or partially hydrogenated vegetable oil. Trans fat is found in margarine and shortening and foods -- such as cookies, crackers and other commercially baked goods -- made with these ingredients. Trans fat raises LDL cholesterol and lowers high-density lipoprotein (HDL), the "good" cholesterol.

Instead of those fats, the Mayo Health Letter suggests you use:

  • Monounsaturated fat, which is found in olive, peanut and canola oils, avocados and most nuts. This fat lowers LDL cholesterol.
  • Polyunsaturated fat. This is found in vegetable oils such as safflower, sunflower, corn, soy and cottonseed oil. This fat also helps lower LDL cholesterol. But polyunsaturated fat is more susceptible to chemical changes that may influence the risk of some diseases.
  • Omega-3 fat, which is found in fatty cold water fish, canola oil, flaxseed, soybeans, tofu, walnuts and fish oil capsules. Omega-3 fat helps increase levels of HDL cholesterol and may help lower triglycerides.

More information

The American Heart Association (news - web sites) has more about fats.

Back to the Top


UK Says Two-View Mammogram Ups Cancer Detection

Reuters Health
Friday, February 27, 2004

LONDON (Agence de Presse Medicale) - The number of breast cancers detected in Britain shot up 13 percent to 9,848 last year - largely because of improved mammography, according to the Department of Health.

Detection rates have been steadily increasing since 1998, when only 7,561 cases were detected, but officials say that the latest increase can be largely attributed to the introduction of two-view mammography.

This involves taking two x-ray views of each breast at the screening appointment. Research has shown that this technique can increase the detection rate of small cancers by 42 percent, the department said in a statement.

It said that by December 2003, 86 percent of local screening services were doing two-view mammographies. Last year, they screened 1.3 million women and detected 13 percent more cancers than the previous year. Over 50 percent of these were small cancers, which might not have been found by self-examination or by general practitioners.

Back to the Top


Sterol-Packed O.J. a Cholesterol Buster

By E.J. Mundell
HealthDay Reporter
HealthDayNews
Friday, February 27, 2004

FRIDAY, Feb. 27 (HealthDayNews) -- Now in your grocer's juice section: lowered cholesterol.

According to researchers, two glasses a day of orange juice enriched with natural plant sterols can reduce blood levels of LDL -- the bad cholesterol -- by an average of 12 percent over 10 weeks.

The specially fortified juice has been sold throughout the United States since last fall under the brand name Minute Maid Heart Wise. "It could be a meaningful consideration for patients who either have modest cholesterol elevations and who don't want to be on medication for the rest of their lives. Or, alternatively, [it could be used] as an adjunct to medications that have reached their maximum effectiveness," says Dr. Robert H. Eckel, chairman of the American Heart Association (news - web sites)'s Council of Nutrition, Physical Activity and Metabolism.

Scientists have long recognized the cholesterol-busting power of plant sterols, found naturally in many fruits, vegetables, nuts, grains and legumes. Margarine spreads enriched with sterols have been available to health-conscious U.S. consumers for five years under the brand names "Benecol" and "Take Control."

In a study to be published in the March 8 issue of Arteriosclerosis, Thrombosis and Vascular Biology, researchers at the University of California, Davis Medical Center examined whether orange juice might also be effective in delivering daily doses of sterol goodness. The study received private funding from The Coca Cola Co. -- makers of Minute Maid Heart Wise -- as well as public funding from the U.S. National Institutes of Health (news - web sites).

The researchers had 72 individuals with mildly elevated levels of blood cholesterol drink two 8-ounce glasses of orange juice per day, first at breakfast and then again with dinner, over a period of 10 weeks. Half of the group drank the sterol-enriched juice, while the other half consumed unfortified juice.

Testing the participants' blood cholesterol levels throughout the study, "we got about an average 12 percent decrease in LDL," says lead researcher and pathologist Sridevi Devaraj. She believes "this is the first study that shows that a non-fat orange juice beverage, if you add plant sterols and have it with your regular meal -- you don't have to go on a diet -- reduces your LDL cholesterol."

The sterol-enriched juice appeared to have no significant effect on levels of either HDL (good) cholesterol or unhealthy blood fats known as triglycerides.

Consuming sterols via an enriched food product makes sense, Devaraj says, because the compounds are found in such small quantities naturally in foods. "In the average diet, even if you're a vegetarian, you can only get up to about 300 milligrams [of sterols] per meal," she says. In comparison, one 8-ounce glass of fortified orange juice supplies a full gram's worth of the compounds.

Commenting on the study, Eckel stresses the juice's effects remain modest, and shouldn't be considered a replacement for standard anti-cholesterol medications in individuals with high levels of cholesterol.

However, a couple glasses a day of Heart Wise might help those with mildly raised cholesterol avoid medication, he says.

"Let's take someone who's within 10 percent of reaching their goal without medication. If your LDL goal is 130, you're a middle-aged guy with hypertension but no heart disease, and your LDL cholesterol is 140, maybe a plant sterol-loaded orange juice would be all you need," Eckel says.

Orange juice contains other healthy nutrients such as vitamin C, folate and potassium. And Devaraj believes the new juice will appeal to cholesterol-conscious consumers turned off by the fat content in Benecol and Take Control.

But Eckel warns that drinking too much sugar- and carbohydrate-rich orange juice can also lead to weight gain. Juices such as Heart Wise "should [only] be included as part of an overall heart-healthy diet. This is not a product we're going to use in large volumes, encouraging extra calories," he says.

According to the American Heart Association, 105 million Americans have total blood cholesterol levels of 200 mg/dL or above, increasing their risk for cardiovascular disease. Experts advise a combination of healthy diet, exercise and, if necessary, drug therapy, to keep cholesterol levels within healthy limits.

More information

To learn more about controlling cholesterol, visit the American Heart Association and the University of Michigan.

Back to the Top

Thursday, February 26, 2004

HIV / AIDS

HealthDayNews
Thursday, February 26, 2004

(HealthDayNews) -- Acquired immunodeficiency syndrome (AIDS (news - web sites)) is a disease caused by the human immunodeficiency virus (HIV (news - web sites)), which is passed from person to person through exchange of body fluids like blood, semen and vaginal fluid.

According to Seton Hall University in New Jersey, risk factors for infection include:

  • Sex of any type with an infected person.
  • A history of a sexually transmitted disease, such as herpes, gonorrhea or syphilis.
  • Multiple sex partners.
  • Sex with a prostitute, either male or female.
  • Sex with a man if you are male.
  • Shared use of needles and syringes to inject drugs.
  • Blood product transfusions between 1978 and 1985.

If you have one or more of the above risk factors, you should be tested for HIV infection.

Back to the Top


Kids Who Bulk Up Run Higher Diabetes Risk

By Janet McConnaughey
Associated Press Writer
The Associated Press
Thursday, February 26, 2004

It isn't just the fat kids who are in danger of becoming diabetics as adults. Children who are skinny as babies but start bulking up early are at risk even if they aren't overweight, a study found.

That is true of all children whose weight gain outstrips their growth rate early on, but "it seems to be more pronounced in those who were initially slim or skinny," said Dr. Harshpal Singh Sachdev, a pediatrics professor at Maulana Azad Medical College in New Delhi.

He said it may be possible to stem diabetes by making sure that children who bulk up sooner and faster than most get additional exercise and a sound diet.

Sachdev was a lead researcher in the 30-year study published in Thursday's New England Journal of Medicine (news - web sites). He and his colleagues measured 1,492 children in India and tracked them until adulthood.

Toddlers grow up faster than they grow out, so they usually slim down. They tend to "rebound" around age 6, starting to bulk up again.

But 21 percent of those who began their rebound between ages 2 and 5 developed diabetes or impaired glucose tolerance as adults, compared with 12 percent to 14.5 percent of those whose rebounds began later.

The diabetes and glucose-intolerance rate was as high as 27 percent among children who were skinny as babies but rebounded quickly.

None of the children in the study were actually overweight.

Doctors should reconsider the idea that small babies should get extra calories to encourage rapid growth, said Dr. Francine Kaufman, a pediatric endocrinologist at Children's Hospital-Los Angeles and past president of the American Diabetes Association.

"We need to look at not overfeeding some of these children," she said.

Dr. William H. Dietz of the Centers for Disease Control and Prevention (news - web sites)'s division of nutrition and physical activity, said the study may have little effect on medical practice, since rebound often goes unnoticed until it has occurred, and "it's not clear to me that anyone knows how to prevent early rebound."

He agreed that additional exercise and good nutrition might help children who rebound early avoid diabetes later. And pediatricians should look more carefully at how children's body mass index — a ratio of weight to height — is changing, he said.

But, he said, it is more important to focus on children who already are overweight.

The study also may be more applicable to developing countries than to the United States and Europe, he said, since many of the children in this study were undernourished during early childhood.

On the Net:

http://www.nejm.com

http://www.diabetes.org

Back to the Top


Hunger Sharpens Your Taste Buds

HealthDayNews
Thursday, February 26, 2004

THURSDAY, Feb. 26 (HealthDayNews) -- This likely won't be much comfort to dieters, but hunger may actually heighten your ability to taste food, says a University of Malawi study in the current issue of BMC Neuroscience.

The study, which found that missing breakfast increases sensitivity to sweet and salty tastes, says this boost in taste may be caused by an increased sensitivity of the taste receptors on the tongue or by a change in the way you perceive the same taste stimuli.

Sixteen male volunteers skipped breakfast and then sipped sugar, salt, or quinine solutions of different concentrations. They were asked to rate the fluids as sweet, salty, or bitter. They repeated the taste tests an hour after they had lunch.

The study found that when the volunteers were hungry, they were more sensitive to the presence of salt and sugar in the drinks. But hunger didn't increase their ability to detect bitterness. This difference could be due to the different roles of the tastes.

Sweet and salty tastes are indicators of edible substances, while a bitter taste indicates a substance, possibly toxic, that should not be eaten.

More information

The Nemours Foundation has more about taste buds.

Back to the Top


Food, Drink Sales Not Hurt by Smoking Ban –Study

By Paul Simao
Reuters
Thursday, February 26, 2004

ATLANTA (Reuters) - A tough anti-smoking law passed in El Paso, Texas has had no significant impact on restaurant and bar revenues there, according to a study published on Thursday by the Centers for Disease Control and Prevention (news - web sites).

Researchers from the Atlanta-based CDC and the Texas Department of Health reached that conclusion after analyzing sales tax reports and mixed beverage receipts collected in El Paso between 1990 and 2002.

A ban on smoking in public areas and workplaces went into effect in the city on Jan. 2, 2002. Authorities in El Paso, which has more than 560,000 residents, levy fines of up to $500 for violations.

Five states and more than 70 other municipalities, including New York City, have instituted similar anti-smoking bans despite complaints that such measures hurt sales in restaurants and bars.

But the El Paso study found that restaurants and bars did not lose business because of the smoking ban.

"These findings are consistent with the results of studies in other municipalities that determined smoke-free indoor air ordinances had no effect on restaurant revenues," the researchers said in their study.

Some 440,000 Americans die each year from lung cancer and other diseases related to smoking and other tobacco use, making it the leading preventable cause of death in the United States, according to the federal government.

Anti-smoking advocates on Thursday applauded the study's findings and urged government officials to enact smoking bans in every state and community in the nation.

"The new study underscores why the public, policy makers and the media should treat with skepticism the claims of economic doom and gloom made by opponents of smoke-free laws," William Corr, executive director of the Washington-based Campaign for Tobacco-Free Kids, said in a statement.

U.S. health officials want to cut the cigarette smoking rate in half to 12 percent or less by the end of the decade, although none of the 50 states are on track to meet that goal, according to the CDC.

Back to the Top


New Target for Tumor-Killing Drugs Found

HealthDayNews
Thursday, February 26, 2004

THURSDAY, Feb. 26 (HealthDayNews) -- New research offers evidence that a particular molecule may provide a target for the development of drugs to treat a wide variety of tumors, including some that are resistant to conventional therapies.

The research, published online in Cancer Cell, found that the insulin-like growth factor 1 receptor (IGF-1R) is necessary for the survival of tumor cells and that using selective small molecules to inhibit IGF-1R may be a potential anticancer treatment.

Many previous studies have suggested that IGF-1R is a factor in cancer development in humans. IGF-1R is present in a broad range of tumor types. But it hasn't been regarded as a likely target for cancer drugs because many normal cells also contain IGF-1R.

In this new research, scientists from Dana-Farber Cancer Institute in Boston and Novartis Institutes for Biomedical Research Basel demonstrated that inhibiting IGF-1R had powerful effects against many kinds of cancer cells grown in the laboratory.

The scientists also identified two small molecules that are selective inhibitors of IGF-1R. These molecules offer potential for drug development.

"These results suggest that IGF-1R function is critically required for tumor cell survival, but dispensable for survival of normal cells in adult animals," study author Dr. Constantine S. Mitsiades says in a prepared statement.

"The preclinical activity of IGF-1R inhibitors against a broad spectrum of tumor cells and, importantly, their ability to sensitize tumor cells to a wide range of anticancer agents, highlight the major role of IGF-1R signaling for human malignant cells, and suggest that the molecular pathway of IGF-1R is an attractive potential target for development of anticancer therapies," Mitsiades says.

More information

The American Academy of Family Physicians (news - web sites) has more about cancer treatments.

Back to the Top


Study May Bring Sickle Cell Breakthrough

By Janet McConnaughey
Associated Press Writer
The Associated Press
Thursday, February 26, 2004

A rare, deadly lung condition is so common among people with sickle cell anemia that testing for and treating it could help many patients live longer, healthier lives, a study found.

Experts called the study a major advance in the fight against sickle cell disease, an inherited blood disorder that affects 70,000 to 100,000 Americans.

"The paper will change the standard of care for sickle cell patients across the country," said Dr. Clint Joiner, director of the sickle cell center at the Cincinnati Children's Hospital Medical Center.

One-third of sickle cell patients have the lung condition, which makes them 10 times more likely to die within 18 months, doctors at the National Institutes of Health (news - web sites) and Howard University reported in Thursday's New England Journal of Medicine (news - web sites).

Doctors must now find the best ways to treat sickle cell patients who also have pulmonary hypertension, or high blood pressure in the lungs. It is a condition in which narrowed, thickened blood vessels in the lungs keep the body from getting enough oxygen.

Researchers do not know if pulmonary hypertension caused the increase in deaths among the 195 patients they studied, or was a sign of severe sickle cell disease. But it was present in 63 patients, or 32 percent.

All 195 were in stable condition at the start. Within 18 months, nearly 20 percent of those with both conditions were dead, compared to fewer than 2 percent of those without pulmonary hypertension.

The numbers indicate that patients with sickle cell disease should be tested for pulmonary hypertension, said Dr. Mark T. Gladwin of the National Institutes of Health, lead researcher for the study.

"If they have high blood pressure in the lungs, they should intensify their therapy. And consider treatment with drugs to lower blood pressure in the lungs," he said.

He and other doctors said tests of various therapies for both sickle cell and pulmonary hypertension are urgently needed.

"I think the number of deaths could be cut by 30 percent or more, easily" if all patients were screened and treated, said Dr. Elliott P. Vichinsky, director of the sickle cell center at the Children's Hospital and Research Center in Oakland. Other doctors wouldn't go that far.

And Dr. Johnson Haynes Jr. of the sickle cell center at the University of South Alabama cautioned that any treatments should be done as part of controlled tests, until the best ones are found.

Sickle cell disease got its name because a defect in hemoglobin, which carries oxygen, turns blood cells into hard sickles rather than soft doughnuts. The hemoglobin cannot carry as much oxygen as normal cells to start with, leading to chronic anemia and jaundice, and the sickled cells stack up in and block small blood vessels, causing a host of other ailments.

Sickle cell disease, which mostly affects blacks, used to be a childhood death sentence. Now, half of all patients make it past the age of 50, and doctors are learning what the disease does to the older body.

On the Net:

http://www.nejm.com

http://sicklecelldisease.org

http://www.SCInfo.org/sicklept.htm

Back to the Top


Blood Pressure Drugs Work Same for All

HealthDayNews
Thursday, February 26, 2004

THURSDAY, Feb. 26 (HealthDayNews) -- Contrary to findings emphasized in some previous research, a new American study says blacks and whites respond similarly to common blood pressure drugs.

The study, in the March issue of Hypertension, raises doubts about the use of different blood pressure drugs to treat blacks and whites.

Study author Dr. Ashwini Sehgal, of Case Western Reserve University School of Medicine, notes doctors are taught that blacks respond better to certain blood pressure drugs, such as diuretics, while whites respond better to other blood pressure drugs, such as beta blockers.

He and his colleagues examined data from all clinical trials on blood pressure drugs over the past 20 years. They concluded blacks and whites are more alike than different when it comes to treating high blood pressure.

The researchers examined changes in blood pressure after 9,307 whites and 2,902 blacks were treated with common blood pressure drugs. They found that, for each drug, blacks and whites responded similarly about 90 percent of the time.

More information

The American Medical Association has more about hypertension.

Back to the Top


Thirst Doesn't Always Guide Need for Water: Sports Experts

By Merritt McKinney
Reuters Health
Thursday, February 26, 2004

NEW YORK (Reuters Health) - Are you getting enough water? Relying on thirst to tell you may not always be the best guide, sports medicine experts say.

Earlier this month, the Institute of Medicine (news - web sites) said people can generally depend on thirst to let them know how much fluid to drink each day, but the American College of Sports Medicine (ACSM) is emphasizing that this may not be optimal during prolonged exercise or hot weather.

"Our fluid intake is mostly behavioral," said Dr. W. Larry Kenney, the president of the ACSM. "On a daily basis, people drink when they eat meals, when they get a little thirsty, when they walk past a water fountain."

Most of the time, people can safely rely on thirst to judge how much fluid they need, but "during heavy or prolonged exercise or long summer periods of hot weather, thirst doesn't accurately tell the body how much fluid has been lost via sweating," Kenney told Reuters Health. Under those circumstances, drinking should be encouraged, said Kenney, who is a professor of physiology and kinesiology at Pennsylvania State University.

To prevent drinking too little or too much water, Kenney advised exercisers to weigh themselves before and after exercising.

"Strive to drink enough to get back to beginning body weight," he said.

The Institute of Medicine report declared that, despite concerns about being properly "hydrated," most Americans consume plenty of fluids each day. The Institute, an independent group of experts that advises the federal government on health issues, recommends that women consume about 2.7 liters of water a day and that men drink about 3.7 liters per day.

According to the Institute, water contained in food, coffee, beer and other drinks all count toward the recommended daily amount.

In line with the ACSM recommendation, the Institute of Medicine noted that people who are very physically active or who live in hot climates may need to drink more water.

In the mid-1990s, the sports medicine group issued recommendations on exercise and fluid replacement. The group advises exercisers to eat a nutritionally balanced diet and drink adequate fluids during the day before exercise or an athletic event. About 2 hours before exercising, people should drink about 500 milliliters of fluid, according to the guidelines.

During exercise, people should drink early and at regular intervals to make sure that they replace all water lost through sweating, according to the ACSM. To make drinking more appealing, the group recommends consuming cold water. Flavored drinks may also encourage athletes to drink enough fluid, the guidelines note.

For people who exercise for less than an hour, there is little evidence that sports drinks with electrolytes and carbohydrates are necessary, according to the ACSM. Sports drinks may be appropriate for people exercising for longer than an hour, however, the group notes in the recommendations.

Back to the Top


Genetic Key to Type 2 Diabetes Identified

By Steven Reinberg
HealthDay Reporter
HealthDayNews
Thursday, February 26, 2004

THURSDAY, Feb. 26 (HealthDayNews) -- Mutations in proteins that turn genes on and off in the pancreas and liver may make you more likely to develop late-onset type 2 diabetes, researchers report.

Late-onset type 2 diabetes is the result of poor regulation of blood sugar. Today in the United States there is an epidemic of type 2 diabetes, primarily due to obesity.

Diabetes can lead to heart attacks, stroke and poor circulation, which can lead to amputation of the feet or legs. Diabetes can also lead to problems with vision that can cause blindness. Kidney and nerve problems are also common complications.

Now researchers find that alterations in proteins that control the function of genes in the liver and pancreas also play a major role in type 2 diabetes.

"We are making major advances in understanding the genetic problems that lead to type 2 diabetes," says lead researcher Dr. Duncan Odom, a postdoctoral fellow at the Whitehead Institute in Cambridge, Mass., which is affiliated with the Massachusetts Institute of Technology (news - web sites). "Diagnosing and predicting your probability of getting diabetes is going to be much easier in the next few years."

Recent studies have shown there are special proteins, called transcription factors, that regulate how genes are turned and off.

Mutations in the transcription factors that control the genes that manage insulin production and blood sugar can cause problems in liver and pancreatic cells, which in turn can cause type 2 diabetes, Odom explains.

Working with human liver and pancreatic tissue, the researchers studied which genes these transcription factors affect. Their findings appear in the Feb. 27 issue of Science.

"We found that one of these transcription factors plays a role in many liver and pancreatic genes, which was unexpected," Odom says. This transcription factor, called HNF4-alpha, controls about half of all the genes needed in forming the pancreas and liver, the researchers report.

Without HNF4-alpha, the liver and pancreas cannot function normally, Odom says. In addition, mutations in HNF4-alpha make it more likely for someone to develop type 2 diabetes.

"This transcription factor [HNF4-alpha] is the key to diabetes," Odom says. HNF4-alpha is a carrier of other transcription factors. If there are problems in any of these transcription factors, they create problems in HNF4-alpha, he adds.

"People who have mutations in any of these transcription factors will have late-onset type 2 diabetes," Odom says.

Odom says that other research, which is expected to be published next month, shows that mutations in the genes that control HNF4-alpha make you much more likely to develop type 2 diabetes if you are obese.

Odom believes that "if you can bring HNF4-alpha back to its normal behavior, you might be able to treat diabetes more effectively." He speculates it might be possible to develop a drug that can do just that.

There are other transcription factors linked to diabetes, Odom says. And his team is continuing to investigate them to see what role they play in diabetes and in how the liver and pancreas function.

"We hope that this investigation will give us really good insights into what causes diabetes and provide additional targets for therapy," he says.

Dr. Rohit N. Kulkarni, an investigator at the Joslin Diabetes Center and an assistant professor of medicine at Harvard Medical School (news - web sites), says "this new data is really important."

This study, together with others that show that mutations in these transcription factors increase the probability of getting type 2 diabetes, indicate these transcription factors are significant in human disease, Kulkarni says.

These factors provide a target that scientists can focus on to treat diabetes, particularly mutations in HNF4-alpha, which seems to be the key one, he adds.

More information

The National Institute of Diabetes and Digestive and Kidney Diseases has a page on risk factors for type 2 diabetes, as well as how to prevent getting the disease.

Back to the Top


Superbug Deaths Climb in Britain

By Emma Ross
AP Medical Writer
The Associated Press
Thursday, February 26, 2004

LONDON - Deaths in Britain from an increasingly drug-resistant superbug are 15 times higher than they were a decade ago, according to new figures released Thursday.

Health authorities have become increasingly worried over the past 50 years about the spread of the bacteria, called methicillin-resistant staphylococcus aureus, or MRSA.

It is a superbug version of the staph germ, meaning most of the traditional antibiotics no longer work against it.

Staph is commonly carried on the skin or in the nose of healthy people and mostly causes mild infections such as pimples and boils.

Gradually, chiefly through improper use of antibiotics, the bacteria have become immune to many conventional antibiotics.

Most of time, the superbug infections have been found in hospital intensive care units, burn units or surgical wards. MRSA infection usually develops in hospitalized patients who are elderly or very sick or who have an open wound or a tube going into their body. It causes pneumonia, blood poisoning and urinary tract infections.

But more recently, it has been seen among military recruits, sports teams and particularly in prisons and jails.

In Britain, the number of people dying directly or indirectly from that superbug has increased from 51 in 1993 to 800 in 2002, the Health Protection Agency said Thursday.

Laboratory reports of blood poisoning caused by the superbug also increased from 210 in 1993 to 5,309 in 2002.

Countries around the world have reported similar increases in such infections for many years.

The agency said part of the explanation for the increase is that older people are living longer because of medical advances.

"Although many of these infections can be prevented, they cannot be totally eradicated as they are the price we pay for advances in medical treatments, which often allow patients who are severely sick and vulnerable to infection to survive," said Dr Georgia Duckworth, an expert on the superbug with the health agency.

Some strains of staph have also acquired resistance to vancomycin, a drug considered the "last line of defense" when all other antibiotics have failed.

Although new antibiotics are constantly being developed, some experts fear it is only a matter of time until virtually every drug is useless.

Back to the Top


A Sleeping Pill As a Stroke Aid?

By Randy Dotinga
HealthDay Reporter
HealthDayNews
Thursday, February 26, 2004

THURSDAY, Feb. 26 (HealthDayNews) -- Could a sleeping pill help stroke patients?

In a new report, French researchers say a woman who took the insomnia drug Ambien recovered some of the speech abilities she had lost earlier after having suffered a stroke. When she stopped taking the drug, her speech problems returned.

The woman's recovery may be a fluke, but the scientists hope the drug could help some stroke patients. And an American neurologist says there's a small chance the case could boost knowledge about the brain.

According to the report in the Feb. 26 issue of the New England Journal of Medicine (news - web sites), the 52-year-old woman suffered a stroke that left her unable to form complete words and limited her speech comprehension. Aphasia, the inability to speak properly and fully comprehend language, commonly affects patients after strokes disrupt the circuitry of their brain.

Three years after her stroke, the woman developed sleep problems and took a 10-milligram dose of the prescription sleeping pill Ambien, also known as zolpidem. "To the amazement of the patient and her family, ingestion of the first dose was followed by a dramatic improvement in her speech, which persisted until the patient went to bed later that night," the report says.

The next morning, the woman's speech difficulties returned. But future tests found that doses of Ambien continued to improve her speaking abilities about 20 minutes after she took the drug. And, luckily, the drug didn't make her fall asleep.

Brain tests showed the drug boosted blood circulation to several parts of the brain by 35 percent to 40 percent. Strokes, by contrast, disrupt blood flow and can starve the brain of oxygen.

This isn't the first time Ambien, technically a depressant, has done more than help patients sleep. In 1997, doctors reported that a catatonic patient, unable to speak or gesture, temporarily recovered with the help of the drug.

The possibility of a new benefit of Ambien came as a surprise to its manufacturer, Sanofi-Synthelabo Inc. "This has never been explored clinically, so we don't know if this is a reality or not," says company spokeswoman Joelle Sissmann. "Therefore we don't have much comment."

Sanofi-Synthelabo has sold an estimated 10 billion Ambien pills. The drug has become popular because it allows patients to enjoy a good night's sleep and awaken feeling refreshed, Sissmann says.

What's next? Dr. James Grisolia, a neurologist at Scripps Mercy Hospital in San Diego, isn't sure. "This could lead the way to a better understanding of nerve circuits underlying speech, but it could also fizzle away as most interesting case reports do," he says.

More information

Get more details on aphasia from the National Aphasia Association and the Academy of Aphasia.

Back to the Top


Nutritional Boost Helps Elderly Ward Off Colds

By Alison McCook
Reuters Health
Thursday, February 26, 2004

NEW YORK (Reuters Health) - A nutritional supplement containing antioxidants, vitamins and minerals appears to boost immune system functioning in the elderly, new research indicates.

Elderly participants who downed the specially formulated supplement for around 6 months experienced fewer days with cold symptoms, and were more likely to show a strong immune response to a flu vaccine - a sign their bodies were well primed to fight off future infections.

Study author Dr. Bobbi Langkamp-Henken told Reuters Health that supplements are particularly important for the elderly, many of whom become deficient in the nutrients they need to stay healthy due to decreased mobility, diet restrictions resulting from chronic disease and chewing or swallowing problems, she said.

"A healthy, well-balanced diet that includes a variety of foods would be the ideal way to get the nutrients we need to stay healthy. Unfortunately, this is not always possible" for many elderly, Langkamp-Henken said.

The supplement featured in the current study contained a variety of nutrients that previous studies have suggested may increase immune functioning in seniors, such as zinc and selenium, she noted.

The formula is not yet commercially available, but Langkamp-Henken said she hopes that these findings encourage people to distribute it on a wide scale. The supplement was developed by Abbott Laboratories, who also funded the research.

During the study, Langkamp-Henken and her team followed 34 people over the age of 65 for 183 days, half of whom consumed an 8-ounce dose of the nutrition-boosting formula every day. Participants noted how many days they experienced cold symptoms.

Reporting in the Journal of the American Geriatrics Society, Langkamp-Henken and her team found that, as a group, people who received the formula experienced a total of 78 sick days, compared with more than 150 sick days among the un-supplemented group.

In addition, people who received the supplement were more likely than others to show a large increase in infection-fighting antibodies after being vaccinated against the flu.

Langkamp-Henken, who is based at the University of Florida in Gainesville, said the supplement may help boost immune function among a large number of seniors because it contains many different nutrients, thereby addressing people's individual needs.

Source: Journal of the American Geriatrics Society, January 2004.

Back to the Top

TV Ads Add Pounds to Our Kids

By Amanda Gardner
HealthDay Reporter
HealthDayNews
Thursday, February 26, 2004

THURSDAY, Feb. 26 (HealthDayNews) -- Word from the front in the battle against childhood obesity in America seems to grow more unsettling by the day.

Now comes news that advertising basically provides a super-size conduit from junk food straight to your child's waistline.

That's the conclusion of a new report from the Kaiser Family Foundation, titled The Role of the Media in Childhood Obesity. The review of more than 40 studies turned up the not-surprising finding that children who spend the most time with the media are the most likely to be overweight.

"Media" here refers primary to television, says Vicky Rideout, vice president of the Kaiser Family Foundation, but, "advertisers are increasingly seeking other ways to put messages in front of kids."

There is a big push on the Internet, for instance, with food companies devising Web sites just for children, and "advergames" where kids can play games about candy and other unhealthy foods. According to Nielsen ratings, some sites can attract 800,000 kids per month. If a child plays a game for 12 minutes, "that's like a 12-minute commercial," Rideout says. "Plus advertisers can get information about the kids and target them."

In addition, there is increasing product placement in movies and video games. "Kids are a high-priority target for food companies and marketers," Rideout says. "A great deal of marketing expertise and firepower are being aimed at them to eat foods."

The study's findings strike a chord with nutrition experts.

"The advertisers and food companies themselves are truly trying to dodge responsibility for this," says Samantha Heller, senior clinical nutritionist at New York University Medical Center in New York City. "Their hunger is for money and they're playing on the hunger of children for sweets and unhealthy foods by seducing them with appealing commercials that specially target children."

According to the U.S. Centers for Disease Control and Prevention (news - web sites), the proportion of children aged six to 11 who are overweight has more than doubled since 1980. During the same time period, the rate for adolescents has tripled.

Being overweight, of course, brings with it the risk of a host of serious health problems, including diabetes and cardiovascular disease.

The Kaiser report does not involve original research but is, according to the authors, the first time so much research from a variety of disciplines has been brought together in one place.

According to research cited in the report, the typical American child is bombarded with about 40,000 ads a year on television alone. The majority of ads targeted to children are for candy, cereal, soda and fast food.

Many of those ads use children's beloved TV and movie characters, everything from SpongeBob Cheeze-Its to Scooby-Doo cereals and Teletubbies Happy Meals, the report says.

Children faced with this onslaught are more likely to choose unhealthy foods, studies show. Some of the blame rests with parents. "One study showed that parents were feeding children six months to two years [of age] junk food, all the stuff we're saying is so bad for them," Heller says.

Much of the research in the new study also revealed an association between the amount of time spent lounging in front of the television and a child's body weight.

But contrary to conventional wisdom, this does not seem to be because television is taking the place of physical activity. The evidence suggests those children who don't watch as much TV may be engaging in other sedentary activities such as reading or talking on the phone. One study did find that watching television and videos lowered children's metabolic rates to a level below that of sleeping.

Conversely, when television time is reduced, children are more likely to lose some of that extra fat.

Children also tend to snack while using media such as television, the research shows.

But if media can have this much negative influence on children's nutrition and health, it should also have the potential of playing a positive role in reducing childhood obesity, the report states. This would take the form of programs that teach children about healthy eating, for instance.

Policy options, such as regulating food ads and expanding public education campaigns, could also attack the problem, the study says.

Possibilities include targeting advertisers and food companies by writing local, state and federal representatives. The food industry could also find ways to be part of the solution, Rideout says.

Parents have to bear much of the responsibility, Heller says. "Children's taste preferences begin to be developed at very young ages, between 2 and 3. That's the first place to make the change," she says. "Try to get them to have good eating habits very early on. That would also mean that parents have to start to learn what healthy eating is and to be role models for it."

When children get to be 3 or 4 years old, parents need to keep them away from the television as much as possible. "That way children will not be as likely to be as taken in by advertising," Heller says. "The difficulty lies in that parents can't use the television as a babysitter, which I can certainly understand wanting to do."

"It's a very tough nugget," she continues. "We have the right of free speech and advertising and we're a capitalist society. How do you stop this flood of advertising and bad food to children? It's hard."

More information

For more on children's nutrition, visit the USDA/ARS Children's Nutrition Center at Baylor College of Medicine. For more on childhood obesity, visit the American Obesity Association.

Back to the Top


CDC Says U.S. Asthma Rates Rose in 2002

By Daniel Yee
Associated Press Writer
The Associated Press
Thursday, February 26, 2004

ATLANTA - The number of Americans with asthma rose about 4 percent in 2002, and minority groups have a more difficult time controlling disease than whites, federal officials said Thursday.

About 7.5 percent of Americans reported having asthma in 2002 — the most recent year figures are available, the Centers for Disease Control and Prevention (news - web sites) said. That is up from 7.2 percent a year earlier — an increase of more than 4 percent.

About 16 million Americans have asthma, the CDC said.

Experts said they do not know why asthma rates are on the rise, although it is possible that the disease is diagnosed more often, said Jeanne Moorman, one of the study's authors.

Asthma has been on the rise since 1980. Between 1980 and 1996, cases nearly doubled from 3 percent to 5.5 percent of the population. CDC researchers do not compare those numbers with the most recent data because they have changed their survey questions since 1996.

Blacks, Hispanics, American Indians and Alaskan natives all had higher rates of asthma-control problems than whites and Asians. These groups were more likely to visit the hospital and report asthma attacks and disturbed sleep, the CDC said.

Asthma has no known cause, although some theories link it to diet and air pollution. Another is that children now are not exposed to enough germs in early life to mature their immune systems.

On the Net:

CDC study: http://www.cdc.gov/mmwr

Back to the Top


For Teens, It's Often Not Just Rewards

By Serena Gordon
HealthDay Reporter
HealthDayNews
Thursday, February 26, 2004

THURSDAY, Feb. 26 (HealthDayNews) -- Teenage behavior can leave parents shaking their heads and wondering what could possibly be motivating their adolescent's actions.

It turns out it actually takes quite a bit to motivate a teen, because the reward center in an adolescent's brain isn't fully developed and isn't as responsive as the reward center in adults.

That's the conclusion of a study in the Feb. 25 issue of the Journal of Neuroscience.

And these findings may explain why teens are more apt to drink alcohol, use drugs or engage in unsafe sex, because these activities require little effort for a seemingly greater reward.

"Adults have readily active motivation in the brain," says study co-author James Bjork, a research fellow in the laboratory of clinical studies at the National Institute on Alcohol Abuse and Alcoholism. But, he says, "it may take exceptionally strong incentives to get kids jazzed up."

Bjork and his colleagues compared MRI scans of 12 teenagers between the ages of 12 and 17 to MRI scans of 12 adults between the ages of 22 and 28. While undergoing the MRI scans, the study volunteers were asked to play a game. If they could hit a target on a screen, they were rewarded with 20 cents, $1 or $5. If they couldn't hit the target, they would lose money.

In both the teens and adults, the MRI images showed that in anticipation of a potential gain, the ventral stratium, right insula, dorsal thalamus and dorsal midbrain sections of the brain were activated. And the ventral stratium, which is believed to be a reward center in the brain, showed increased activation as the reward amount increased for both groups.

But, the right ventral stratium showed less activation in teens than in adults. According to Bjork, other research has shown this area of the brain is responsible for motivation.

"That region of the brain controls how much an organism is willing to work to get a reward," Bjork says. "The data show that adolescents are just as happy and excited at the prospect of winning as adults, but they differed in the expenditure of effort for that reward."

For parents, these findings show "there might be a normal developmental reason why it's so tough to get your teen off the couch," Bjork says. Additionally, he says, the findings could explain why teens are drawn to risky behavior such as alcohol and drugs, because they offer a strong reward for very little effort.

Dr. Ramon Solhkhah, director of child and adolescent psychiatry at St. Luke's-Roosevelt Hospital Center in New York City, says the findings "give us information about how teenagers prove rewards in a different way than adults do."

He says it's important to realize their brains are still developing, and they are not just small adults. Teens rarely consider long-term consequences, he says.

"Their sense of the future is processed differently than an adult's. It appears [teens] do much better with short-term consequences, so the high they get from using drugs may be more powerful than the potential long-term health consequences," Solhkhah explains.

He recommends telling your teen how things will affect him or her now, rather than in the future. Don't tell your child that smoking will give him lung cancer in 30 years, he says, because it won't mean anything to your teen. Instead, he says, focus on here and now. For example, tell your child how smoking can stain teeth or make it difficult to participate in athletics.

More information

The University of Minnesota's College of Human Ecology offers advice about your teen's behavior. The National Clearinghouse for Alcohol and Drug Information discusses the importance of setting rules for your teen.

Back to the Top


Mom's Smoking Tied to Adult Children's Lung Disease

By Amy Norton
Reuters Health
Thursday, February 26, 2004

NEW YORK (Reuters Health) - The effects of a mother's smoking on her children's lungs may be permanent, possibly furthering the risk of serious lung disease in children who take up the habit themselves, new research suggests.

The UK study found that the adult children of female smokers had smaller lung volumes compared with the children of non-smokers, regardless of whether they themselves smoked.

What's more, among adults who did smoke, those whose mothers smoked had a higher risk of developing chronic obstructive pulmonary disease (COPD), a group of serious lung diseases that includes emphysema.

The study, in the American Journal of Respiratory and Critical Care Medicine, looked at 2,000 men and women in their 30s, 40s and 50s whose parents had reported their own smoking habits in a study in the 1970s.

The children of women who in the earlier study said they were current smokers and had started before pregnancy were considered as having been exposed to maternal smoking. They were assumed to have been exposed in the womb.

Smoking during pregnancy is already tied to low birth weight and poorer infant and childhood growth, but research suggests that as children get older these effects may diminish, Dr. Mark N. Upton, the lead author of the new study, told Reuters Health.

Whether children can "grow out" of early effects on their lung volume has been unknown. To investigate Upton and his colleagues at the University of Bristol and University of Glasgow conducted respiratory tests that gauge lung volume, and found that participants exposed to maternal smoking appeared to have smaller lungs, regardless of their own smoking status.

"Our results suggest that the effects of maternal smoking on lung size are permanent," Upton said.

Moreover, if children take up smoking themselves, the findings suggest, a mother's smoking may add to the risk of their developing COPD. In this study, a smoker's risk of COPD climbed 70 percent with every 10 cigarettes his or her mother smoked per day.

According to Upton, the findings provide yet another reason for women to quit smoking before pregnancy, but also suggest that it's not "too late" to quit after giving birth.

That's because there was a relationship, albeit weak, between fathers' smoking and poorer lung function among smokers -- indicating that parents' smoking can cause long-range harm after birth as well.

In addition, Upton said, smokers who know their mothers were lighting up when they were young children should be aware that they may face a higher COPD risk. For these smokers, he added, believing "it will never happen to me" is now more difficult.

Source: American Journal of Respiratory and Critical Care Medicine, February 15, 2004.

Back to the Top


Study: Weight Gain Tied to Breast Cancer

By Daniel Yee
Associated Press Writer
The Associated Press
Thursday, February 26, 2004

ATLANTA - The amount of weight a woman gains after age 18 is a strong signal as to whether she will get breast cancer later in life, according to new research released Wednesday by the American Cancer Society (news - web sites).

In one of the largest studies of weight and breast cancer to date, researchers said older women who gained 20 to 30 pounds after high school graduation were 40 percent more likely to get breast cancer than women who kept the weight off.

The risk doubled if a woman gained more than 70 pounds, said Heather Spencer Feigelson, senior epidemiologist with the American Cancer Society.

"Breast cancer is strongly dependent on body weight," Feigelson said. "Even modest amounts of weight gain lead to a significantly increased risk of breast cancer."

Weight gain and body mass have long been known to be risk factors for breast cancer.

The cancer society estimates weight contributes to between one-third and one-half of all breast cancer deaths among older women.

Fat tissue makes estrogen, and estrogen can help breast cancer grow. Weight gain also is the second leading cause of all cancers, according to research the Atlanta-based society published last year in the New England Journal of Medicine (news - web sites).

But the cancer society researchers wanted to examine more specifically the link between weight gain amounts and breast cancer, and this was the first in such a large group.

"The more fat you have — fat cells are capable of synthesizing estrogen — the heavier you are, the higher your estrogen levels," said Dr. Paul Tartter, associate professor of surgery at Columbia University, who was not a researcher in the study. "There's no question that estrogen is the common denominator of most of our risk factors for breast cancer."

The cancer society study included 1,934 breast cancer cases among 62,756 women involved in a separate long-term cancer prevention study.

Post-menopausal women ages 50 to 74 were asked their weight when the study began in 1992 and their weight when they were 18 years old. Surveys were sent to the women in 1997, 1999 and 2001 to inquire about any new cancers.

Women taking estrogen hormones were not included in the study.

Lean post-menopausal women not taking hormone replacement therapy produce very little estrogen and had the lowest cancer risk in the study, Feigelson said.

On the Net:

Cancer study: http://cebp.aacrjournals.org/

Back to the Top


ECG Signs Identify Diabetics with High Death Risk

By David Douglas
Reuters Health
Thursday, February 26, 2004

NEW YORK (Reuters Health) - A computerized electrocardiogram, or ECG, can show which people with type 2 diabetes have a particularly high risk of dying, researchers report.

As is well known, diabetes increases the odds of developing heart disease, and more and more people are becoming diabetic. These facts, as Dr. Peter Okin of Cornell Medical Center, New York, told Reuters Health, "make more accurate identification of diabetic patients at increased risk of dying a clinical priority."

In light of this, Okin and colleagues looked at signs on the ECG that are associated with mortality risk in the general population to see if they would be of use in diabetics.

They examined digital ECG readings obtained from a study of 994 Native Americans with type 2 diabetes. The participants were followed for an average of five years, during which time there were 56 heart-related deaths and 155 deaths from all causes, according to the investigators' report in the medical journal Diabetes

After taking into account age and other factors, two feature on the ECG were significant predictors of death. One, known as ST segment depression, conferred a three-fold high risk of cardiovascular mortality. Both ST segment depression and another ECG sign, called the QT interval, doubled the risk of all-cause mortality.

Computerized ECG equipment is widely available and accurate, Okin commented.

"These findings provide impetus for further study to examine whether more aggressive treatment of diabetic patients with these ECG markers of risk can reduce mortality," he added.

Source: Diabetes, February 2004.

Back to the Top


States Take on Fighting Childhood Obesity

By Alicia Chang
Associated Press Writer
The Associated Press
Thursday, February 26, 2004

ALBANY, N.Y. - The school vending machine — a source of money for schools and unhealthy calories for kids — is under heavy attack by state lawmakers across the country.

About two dozen states are considering total bans or limits on vending machine products. About 20 states already restrict students' access to junk food until after lunch.

Last year, California became the first state to ban soft drink sales at elementary and junior high schools. Proponents pushing for a similar law in New York say the state could potentially see savings in Medicaid costs.

"As a former teacher, I think it's the responsibility of our schools and educators to teach good habits to our children," said Assemblywoman Sandra Galef, a Westchester County, N.Y., Democrat and co-sponsor of the bill.

Childhood obesity has become a major public health concern as the ranks of overweight children in the United States tripled over the last three decades. Obesity has been associated with diabetes, heart disease, high blood pressure and arthritis.

Critics argue that by focusing on school vending machines, states ignore other ways to help children lose weight like promoting a balanced diet and increasing physical education and nutrition classes in schools.

New York already prohibits the sale of candy and soda from school vending machines until the last lunch period. Galef's proposal goes a step farther with an outright ban of junk food and carbonated drinks in school vending machines, and by encouraging schools to stock machines with healthier alternatives like granola bars, fresh fruit, bottled water and milk.

The New York State School Board Association cautioned that more research is needed to determine the fiscal impact of the proposed law on school districts, which heavily rely on vending machine sales to pay for computers, sports programs and after-school activities.

Annual income from contracts between schools and vendors varies, with some schools raising as much as $100,000 a year, according to the National Conference of State Legislatures' Health Policy Tracking Service.

Hawaii wants to banish vending machines from public schools unless vendors replace fatty food with healthy choices. Massachusetts supports a ban on soft drinks in its public and charter schools. Utah favors getting rid of junk food in vending machines in its elementary schools.

Minnesota proposes that school districts sell milk and fruit drinks at a lower price than non-nutritional drinks. Vermont wants districts to adopt guidelines for nutrition in vending machines. In Indiana, where some districts make up to $300,000 a year from vending machine contracts, there is mixed reaction to a bill requiring that at least half the choices be healthy.

The National Soft Drink Association says parents and local school districts, not states, should determine what children eat and drink in school. The trade group says soft drink companies already offer a variety of drinks to students including bottled water, juice and sports drinks.

"We don't believe that a restrictive approach where you single out a particular food or beverage is going to work," said association spokeswoman Kathleen Dezio.

Besides states, cities and individual school districts are taking the obesity issue into their own hands.

Last September, New York City banished hard candy, doughnuts and soda from vending machines in the nation's largest school system, serving about 1 million children. School vending machines will continue to sell cookies, potato chips and pretzels, among other snacks, along with all-juice drinks and water. Earlier this month, the Philadelphia school district, which serves 214,000 students, decided to halt soda sales in vending machines effective this July.

Back to the Top


FDA Approves Heart Device for Children

Reuters
Thursday, February 26, 2004

WASHINGTON (Reuters) - The U.S. Food and Drug Administration (news - web sites) said on Thursday it had granted a special exemption for a miniature heart device to keep alive children waiting for a heart transplant.

It approved a humanitarian device exemption for the specially designed left ventricular assist device, which helps keep a dying heart pumping.

"Use of the device may allow children with severe left ventricle failure to survive long enough to receive a heart transplant," the FDA said in a statement,

The exemption means the company does not have to directly show that the device would be safe in children. Tests on similar devices used on adults suggested it would be safe for children, the FDA said.

Left ventricular assist devices, or LVADs, are frequently used in adults, but this would be the first one approved for use in children. This particular device is called the DeBakey VAD Child, made by privately owned MicroMed Technology, Inc., of Houston.

The exemption is used to make devices available on a limited basis for patients with rare medical conditions -- those that affect fewer than 4,000 people annually in the United States.

"It is estimated that fewer than 100 children a year will be candidates for the new device," the FDA said.

Back to the Top


FDA Approves First-Of-A-Kind Cancer Drug

By Lauran Neergaard
AP Medical Writer
The Associated Press
Thursday, February 26, 2004

WASHINGTON - The first drug that promises to attack cancer by choking off its blood supply won federal approval Thursday, a treatment for advanced colon cancer called Avastin.

It's not a cure, cautioned the Food and Drug Administration (news - web sites): Avastin can extend patients' lives by a median of five months, meaning half do better and half worse.

But it's a significant development. Few other drugs for advanced stages of this cancer have provided even that much benefit.

Also important, Avastin becomes the first drug proved to work according to a novel theory that tumors must form a network of blood vessels to survive — a process called angiogenesis — and that shutting down that process could fight cancer in a completely new way.

Avastin's approval marks "a milestone in a new form of cancer therapy," said Dr. Judah Folkman of the Harvard-affiliated Children's Hospital of Boston, who pioneered the anti-angiogenesis theory 30 years ago.

Manufacturer Genentech Inc. "is to be congratulated for elegant scientific work that has converted a theory into a therapy," Folkman said.

It was a long, hard road. Folkman made front-page news in 1998 with reports that his anti-angiogenesis drugs had cured mice of cancer. But early attempts to make such drugs work in people kept failing.

That may be because doctors initially tested them in the most difficult of patients, those who had failed numerous chemotherapies, said Dr. Louis Fehrenbeacher, head of Kaiser Permanente's cancer study program who helped test Avastin. Tumors that survive repeated treatment seem to be the hardiest, and anti-angiogenesis will do its best work earlier in the disease, he said.

Indeed, Avastin is approved as a first-line treatment for metastatic colon cancer, where the cancer has just spread throughout the body.

In a study of 800 people, half received intravenous Avastin in addition to routine chemotherapy every two weeks. Not only was tumor growth delayed in the Avastin patients, but they lived a median of 20 months, five months longer than those getting standard treatment.

That's a 30 percent increase in survival, which is very exciting, said FDA Commissioner Mark McClellan.

Some patients did better. Fehrenbeacher points to some of his who have lived almost three years.

Avastin is a monoclonal antibody, a substance that seeks out and binds to one of the more than 20 chemicals known to help tumors' blood vessels grow. The one Avastin targets is called vascular endothelial growth factor, or VEGF. When Avastin binds to it, VEGF can't stimulate blood vessel growth, thus keeping tumors from growing by denying them nourishing blood.

Genentech said it will begin shipping Avastin in three days. The wholesale cost will be $4,400 per month; in the study, most patients underwent 10 months of Avastin therapy.

FDA's decision marks the second new treatment approved for advanced colorectal cancer in as many weeks. Erbitux, the drug at the center of the stock-trading scandal that brought Martha Stewart (news - web sites) to trial, works in a different way, by blocking growth of the colon tumor itself, not its blood supply. FDA is allowing it to sell based on studies proving tumor shrinkage; no one yet knows whether Erbitux will actually help patients live longer.

Scientists are working to see if Avastin can treat other cancers, too. It failed as a last-ditch breast cancer treatment, but studies are under way to see if it helps in earlier stages of that disease and lung cancer, Fehrenbeacher said.

In all, 30 anti-angiogenesis drugs now are being tested in people around the world, Folkman said — including one he developed, called endostatin, that is showing promising results in a handful of patients with some rare cancers.

As for Avastin, the FDA cautioned that it occasionally causes some serious side effects including holes in the colon, impaired wound healing and internal bleeding.

More common side effects are high blood pressure, fatigue, blood clots, diarrhea, appetite loss and increased risk of infection because of decreased white blood cells.

Back to the Top


Wednesday, February 25, 2004

Secondhand Smoke Can Hide in Your Home

HealthDayNews
Wednesday, February 25, 2004

WEDNESDAY, Feb. 25 (HealthDayNews) -- Secondhand tobacco smoke contaminants lurking in household dust and on furniture and other surfaces can expose children to levels that are equivalent to several hours of active smoking, says a study in the current issue of Tobacco Control.

The study also says that making adults smoke outside doesn't fully protect children from the harmful effects of tobacco smoke.

Researchers compared 49 homes that included children between 2 and 12 months old. Nonsmokers lived in 15 of the homes. Of the remaining 34 homes, 17 were occupied by smokers who tried to protect their children by smoking outdoors. The other 17 homes were occupied by smokers who made no attempt to protect their children from secondhand smoke.

Dust and surface wipe samples were collected from the living room and the child's bedroom in each of the homes. Urine and hair samples were taken from the children. Nicotine monitors were placed in the living room and the child's bedroom of each home.

Levels of tobacco contaminants in the dust, air and surface samples of homes where adults smoked outdoors were up to seven times higher than in homes of nonsmokers. Tobacco contaminant levels in the homes of indoor smokers were up to eight times higher than in the homes where adults went outside to smoke.

Infants are particularly at risk from these indoor tobacco contaminants because they spend most of their time indoors and are close to contaminated sources, the study authors say.

More information

The American Lung Association has more about secondhand smoke and children.

Back to the Top


Oral Sex Shown to Be Linked to Mouth Cancer

Reuters
Wednesday, February 25, 2004

LONDON (Reuters) - Although the risk is small and it is more likely to result from heavy drinking and smoking, scientists have uncovered evidence that oral sex can cause mouth cancer.

Researchers had suspected that a sexually transmitted infection that is linked to cervical cancer could also be associated with tumors in the mouth.

Now a study by researchers working for the International Agency for Research on Cancer (IARC) in Lyon, France seems to have confirmed it.

"Oral sex can lead to oral tumors," New Scientist magazine said Wednesday, referring to the latest research.

The scientists studied more than 1,600 patients from Europe, Canada, Australia, Cuba and the Sudan with oral cancer and more than 1,700 healthy people.

They found that patients with oral cancer containing a strain of the human papilloma virus (HPV) known as HPV16 were three times more likely to report having had oral sex than those without the virus strain.

"The researchers think both cunnilingus and fellatio can infect people's mouths," the magazine added.

Raphael Viscidi, a virologist who worked on the research, believes the findings substantiate the link between HPV and oral cancer.

"This is a major study in terms of size," he said. "I think this will convince people."

High consumptions of alcohol and cigarettes are estimated to cause 75-90 percent of all cases of oral cancer. The combination of tobacco smoke and alcohol are thought to produce high levels of cancer causing agents.

Scientists are currently working on vaccines to prevent cervical cancer, which is more common, but they might also be effective against oral cancer.

"It is thought the vaccines would prevent oral infections as well," the magazine added.

Back to the Top


No-Smoking Sections Are No Help

HealthDayNews
Wednesday, February 25, 2004

WEDNESDAY, Feb. 25 (HealthDayNews) -- There may not be much point in choosing the no-smoking section when you go out to a club or restaurant.

An Australian study in the current issue of Tobacco Control found smoking sections offer little or no protection from the detrimental health effects of secondhand smoke.

At the most, they halve levels of secondhand smoke, which is much less than nonsmokers might reasonably expect, the study authors say.

They studied 17 social and gaming clubs in and around Sydney. All the clubs had no-smoking areas, which were either designated sections or separate rooms. The researchers measured levels of atmospheric nicotine, particulate matter and carbon dioxide in the smoking and no-smoking areas.

Levels of nicotine and particulate matter were much lower in the no-smoking areas than in the smoking areas. But the researchers found a wide variation in these reduction levels, leading them to suspect there's no guarantee of a favorable impact on non-smokers.

There was little difference in levels of atmospheric nicotine and particulate matter between separate no-smoking rooms and designated no-smoking areas.

"No-smoking areas may provide some reduction in the level of exposure of individuals to environmental tobacco smoke. However, the reduction may be marginal or trivial," the study authors write.

They conclude regulations permitting clubs, bars, and casinos to allow smoking, provided there are designated non-smoking areas, are ineffective in protecting nonsmokers from secondhand smoke.

More information

The U.S. National Cancer Institute (news - web sites) has more about the health dangers of secondhand smoke.

Back to the Top


STDs Unevenly High in Teens, Young Adults

By Mark Sherman
Associated Press Writer
The Associated Press
Wednesday, February 25, 2004

WASHINGTON - Teenagers and young adults account for nearly half the cases of sexually transmitted diseases in the United States though they make up just a quarter of the sexually active population, according to the first extensive national estimate of STDs among young Americans.

Researchers at the federal Centers for Disease Control and Prevention (news - web sites) estimate that 9.1 million cases of eight sexually transmitted diseases occurred in people aged 15 to 24 in the year 2000. There were 18.9 million new cases overall, said the report in Perspectives on Sexual and Reproductive Health, a journal published by the not-for-profit Alan Guttmacher Institute.

Another article by CDC researchers that appears in the same journal, released Tuesday, estimates the lifetime medical cost of those 9.1 million cases at $6.5 billion. "The overall cost burden of STDs is so great that even small reductions in incidence could lead to considerable reductions in treatment costs," the article said.

Three diseases — human papillomavirus, trichomoniasis and chlamydia — accounted for 88 percent of new cases in 15-to-24-year-olds, the researchers said.

Untreated, HPV can cause cervical cancer or genital warts. The health effects of trichomoniasis, a parasite, are not well known. Chlamydia can lead to infertility.

Both studies said that the lack of symptoms in these and other sexually transmitted diseases is a major obstacle to diagnosis and treatment. They called for increased screening for the diseases and other preventive measures, including notifying sex partners.

Other diseases included in the study were: gonorrhea, syphilis, genital herpes, hepatitis B and HIV (news - web sites).

A separate report on STDs, also released Tuesday, said that only comprehensive sex education — that teaches both abstinence and birth control — will reduce their spread.

While calling abstinence "the surest way to avoid STDs," the report said that improved sex education, including instruction on proper condom use, is essential.

"Most youth do not use condoms every time they have sex, and most have not been taught the correct way to use a condom," said the report by the School of Journalism and Mass Communication at the University of North Carolina. The report was based on the work of a group of health experts and a separate youth panel.

Citing statistics that more than half of high school students have had sex, 17-year-old panel member Shawn Carney of Phelps, N.Y., said, "We've got to get real about sex to deal with STDs."

The Bush administration is proposing to double the amount of money it spends on "abstinence, only" programs for teens. One organization involved in the study was Advocates for Youth, a group that has clashed with the Bush administration over sex education.

The CDC acknowledges that condoms are effective against the spread of HIV, an incurable disease that is often fatal and requires extensive treatment, and in reducing the risk of gonorrhea, chlamydia and trichomoniasis.

But since 2002, the CDC has toned down its emphasis on condom use in favor of abstinence.

On the Net:

Alan Guttmacher Institute: http://www.agi-usa.org/

UNC report on STDs: http://www.jomc.unc.edu/youthandSTDs/ourvoices.html

Back to the Top


Deciphering a Cholesterol Drug

HealthDayNews
Wednesday, February 25, 2004

WEDNESDAY, Feb. 25 (HealthDayNews) -- One part of the action of the anti-cholesterol drug ezetimibe (Zetia) has been discovered by scientists at Thomas Jefferson University in Philadelphia.

The scientists found that treating hypercholesterolemic mice with the drug disrupts a complex of two proteins -- caveolin 1 and annexin 2 -- in the intestine.

The researchers also used "anti-sense" molecules to prevent the formation of the complex of the two proteins in zebrafish. This resulted in impaired cholesterol absorption in the intestines of the zebrafish.

The results suggest these two proteins are integral components of an unidentified cholesterol transport system in the intestine. If scientists can gain a better understanding of cholesterol transport and absorption in the intestine, they may be able to develop better ways to treat obesity, diabetes, and cardiovascular disease.

The study was published the Feb. 23-27 issue of the Proceedings of the National Academy of Sciences (news - web sites).

More information

The American Heart Association (news - web sites) has more about LDL cholesterol.

Back to the Top


New Protein Blocker of HIV Replication Identified

By Patricia Reaney
Reuters
Wednesday, February 25, 2004

LONDON (Reuters) - Scientists have identified a protein in monkeys that blocks the replication of the HIV virus (news - web sites) that causes AIDS (news - web sites) and could provide a new method to stop the deadly infection in humans.

Although a similar protein in people is less potent than it is in monkeys, researchers at the Dana-Farber Cancer Institute in Boston, Massachusetts said it could be a potential new weapon against the illness that afflicts 40 million people worldwide.

"The discovery is important not only because there is a new way to intervene in HIV (news - web sites) infection but there is also a sense that we have suddenly got some insight into a potential role for what have previously been very mysterious cell components," Dr Joseph Sodroski said in an interview Wednesday.

The protein, called Trim5-alpha, prevents HIV from shedding a protective coating and inserting its genetic material into the infected cell, combining with the cell's own DNA. If the virus does not complete this integration process relatively quickly it decays and becomes non-infectious.

Trim5-alpha is a very specific inhibitor of HIV. Sodroski and his colleagues believe its potency may differ in individuals, which could explain why some people infected with the virus proceed to AIDS more quickly than others. It may also be possible for scientists to find a way to increase its potency.

The researchers also suspect it could be the first of more Trim proteins in humans which determine the susceptibility of cells to viruses and other infectious agents.

"We may be tapping into a system of innate or intrinsic resistance to viruses," added Sodroski, who reported the finding in the science journal Nature.

If a treatment targeting the protein is developed, the researchers envision it being used along with existing AIDS drugs that work at different points in the replication process.

"It could be used in various settings," said Sodroski.

Possible examples could be to stop someone exposed to the virus from becoming infected or to limit the ability of the virus to infect new cells in someone who is already HIV positive.

"Identification of this HIV-blocking factor opens new avenues for intervening in the early stage of HIV infection, before the virus can gain a toehold," Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (news - web sites) (NIAID) in the United States which supported the research, said in a statement.

"Basic discoveries like this provide the scientific springboard to future improvements in therapies for HIV disease," he added.

Back to the Top


High Blood Pressure in Lungs Boosts Death Risk in Sickle Cell Patients

By Kathleen Doheny
HealthDay Reporter
HealthDayNews
Wednesday, February 25, 2004

WEDNESDAY, Feb. 25 (HealthDayNews) -- Almost a third of American adults with sickle cell disease develop high blood pressure in their lungs.

And that health threat boosts the risk of death, compared to sickle cell patients without that complication, a new study finds.

To catch the condition early, adults with sickle cell should consider having an echocardiogram, a test that uses sound waves to evaluate the heart and assess pulmonary artery pressures, says study author Dr. Mark Gladwin. He is a lung specialist at the National Institutes of Health (news - web sites), and his report appears in the Feb. 26 issue of the New England Journal of Medicine (news - web sites).

Gladwin's team followed 195 patients, average age 37, for an average of 18 months. They screened each with Doppler echocardiography to assess the pressures within their pulmonary arteries, which carry blood to the lungs. It detected high blood pressure in the lungs in 32 percent of the patients.

Over the next two years, 20 percent of those with pulmonary hypertension died, while all but two of those without it survived.

Sickle cell anemia afflicts about 72,000 Americans, according to the American Sickle Cell Anemia Association, primarily those of African descent. The chronic, often fatal anemia is marked by severe attacks of pain in the joints, leg ulcers and failure of many organs. Blood vessels are blocked when red blood cells become rigid as they are robbed of oxygen, forming a sickle shape.

While it has long been known that pulmonary hypertension develops in sickle cell patients and others with chronic anemias, the new study suggests the hypertension may be a major cause of sudden death in sickle cell patients. In pulmonary hypertension, the vessels that supply the lungs narrow and can't carry as much blood.

What happens in sickle cell and other anemias, Gladwin says, is that "in the plasma the hemoglobin destroys nitric oxide, and nitric oxide is a critical dilator of blood vessels. I call it the WD40 of blood vessels."

Pulmonary hypertension "is a single, independent predictor of mortality" in sickle cell patients, Gladwin says. But it's not known if it is the cause of death or a marker for something else that causes death. It could explain the high number of sudden deaths among sickle cell patients, he says.

Other experts call the new study exciting and hope it will lead to better screening and testing of sickle cell patients.

"A lot of these patients have pulmonary hypertension and are asymptomatic," says Dr. Claudia R. Morris, a pediatric emergency department physician and clinical researcher at Children's Hospital and Research Center in Oakland, Calif.

"To get an echo [echocardiogram] is very easy," she says.

Dr. Elliott Vichinsky wrote a commentary on the new study in the same issue of the journal, and is director of the Northern California NIH Sickle Cell Center in Oakland. He says, "I think this study could change the landscape of survival for 30 percent of sickle cell patients."

If the pulmonary hypertension is detected early, Vichinsky says, patients "can be started early on therapy such as transfusion." Eventually, the death rate might decline, he adds.

"I think every adult with sickle cell needs an echo every year," Vichinsky says. But he and Gladwin agree that persuading insurance plans to pay for the test, which Gladwin estimates costs $500 to $800, is not always easy or possible.

Currently, Vichinsky suspects most sickle cells patients are not being screened at all for lung hypertension.

More information

For more information on sickle cell, visit the American Sickle Cell Anemia Association or the National Library of Medicine.

Back to the Top


Study May Bring Sickle Cell Breakthrough

By Janet McConnaughey
Associated Press Writer
The Associated Press
Wednesday, February 25, 2004

A rare, deadly lung condition is so common among people with sickle cell anemia that testing for and treating it could help many patients live longer, healthier lives, a study found.

Experts called the study a major advance in the fight against sickle cell disease, an inherited blood disorder that affects 70,000 to 100,000 Americans.

"The paper will change the standard of care for sickle cell patients across the country," said Dr. Clint Joiner, director of the sickle cell center at the Cincinnati Children's Hospital Medical Center.

One-third of sickle cell patients have the lung condition, which makes them 10 times more likely to die within 18 months, doctors at the National Institutes of Health (news - web sites) and Howard University reported in Thursday's New England Journal of Medicine (news - web sites).

Doctors must now find the best ways to treat sickle cell patients who also have pulmonary hypertension, or high blood pressure in the lungs. It is a condition in which narrowed, thickened blood vessels in the lungs keep the body from getting enough oxygen.

Researchers do not know if pulmonary hypertension caused the increase in deaths among the 195 patients they studied, or was a sign of severe sickle cell disease. But it was present in 63 patients, or 32 percent.

All 195 were in stable condition at the start. Within 18 months, nearly 20 percent of those with both conditions were dead, compared to fewer than 2 percent of those without pulmonary hypertension.

The numbers indicate that patients with sickle cell disease should be tested for pulmonary hypertension, said Dr. Mark T. Gladwin of the National Institutes of Health, lead researcher for the study.

"If they have high blood pressure in the lungs, they should intensify their therapy. And consider treatment with drugs to lower blood pressure in the lungs," he said.

He and other doctors said tests of various therapies for both sickle cell and pulmonary hypertension are urgently needed.

"I think the number of deaths could be cut by 30 percent or more, easily" if all patients were screened and treated, said Dr. Elliott P. Vichinsky, director of the sickle cell center at the Children's Hospital and Research Center in Oakland. Other doctors wouldn't go that far.

And Dr. Johnson Haynes Jr. of the sickle cell center at the University of South Alabama cautioned that any treatments should be done as part of controlled tests, until the best ones are found.

Sickle cell disease got its name because a defect in hemoglobin, which carries oxygen, turns blood cells into hard sickles rather than soft doughnuts. The hemoglobin cannot carry as much oxygen as normal cells to start with, leading to chronic anemia and jaundice, and the sickled cells stack up in and block small blood vessels, causing a host of other ailments.

Sickle cell disease, which mostly affects blacks, used to be a childhood death sentence. Now, half of all patients make it past the age of 50, and doctors are learning what the disease does to the older body.

On the Net:

http://www.nejm.com

http://sicklecelldisease.org

http://www.SCInfo.org/sicklept.htm

Back to the Top


Diabetes Raises Risk of Serious Liver Problems

By Megan Rauscher
Reuters Health
Wednesday, February 25, 2004

NEW YORK (Reuters Health) - Men with diabetes have about a two-fold greater risk of developing liver cancer and other chronic liver diseases compared with nondiabetic men, new research suggests.

The same may hold true in women, but the study did not have enough women to reach firm conclusions.

"Our study provides evidence that diabetes is an important risk factor for chronic liver disease including (liver cancer)," Dr. Hashem B. El-Serag from the Houston VA Medical Center in Texas told Reuters Health. The study is also the first to show that diabetes precedes, rather than follows, the development of these diseases, he added.

Using the computerized records of the Department of Veterans Affairs (news - web sites), investigators studied all patients with a hospital diagnosis of diabetes between 1985 and 1990. They matched each diabetic patient to three nondiabetic patients and tracked them through 2000. Nearly all of the subjects were men and most had type 2 diabetes. None of the subjects had liver disease when first diagnosed with diabetes.

As reported in the medical journal Gastroenterology, the rates of chronic non-alcohol related liver disease and liver cancer were significantly higher in diabetic than in the nondiabetic patients.

The increased risk "seems to be independent of age, gender, ethnicity, or (other) illnesses," El-Serag noted, and is higher in patients with diabetes for 10 years or more.

This study, Dr. Adrian M. Di Bisceglie from Saint Louis University School of Medicine points out in an editorial, "provides evidence that long-standing diabetes is followed by the development of liver disease and (liver cancer), suggesting a causative role for diabetes mellitus."

The current study supports the team's earlier findings from the same group of patients in which diabetes raised the risk of acute liver failure by 44 percent.

In light of the present findings, El-Serag and colleagues recommend regular liver blood tests in diabetic patients. Further studies are needed to examine the association between diabetes and liver disease in women and to clarify the mechanisms behind the link, the authors note.

Source: Gastroenterology, February 2004.

Back to the Top


Kids Who Bulk Up Run Higher Diabetes Risk

By Janet McConnaughey
Associated Press Writer
The Associated Press
Wednesday, February 25, 2004

It isn't just the fat kids who are in danger of becoming diabetics as adults. Children who are skinny as babies but start bulking up early are at risk even if they aren't overweight, a study found.

That is true of all children whose weight gain outstrips their growth rate early on, but "it seems to be more pronounced in those who were initially slim or skinny," said Dr. Harshpal Singh Sachdev, a pediatrics professor at Maulana Azad Medical College in New Delhi.

He said it may be possible to stem diabetes by making sure that children who bulk up sooner and faster than most get additional exercise and a sound diet.

Sachdev was a lead researcher in the 30-year study published in Thursday's New England Journal of Medicine (news - web sites). He and his colleagues measured 1,492 children in India and tracked them until adulthood.

Toddlers grow up faster than they grow out, so they usually slim down. They tend to "rebound" around age 6, starting to bulk up again.

But 21 percent of those who began their rebound between ages 2 and 5 developed diabetes or impaired glucose tolerance as adults, compared with 12 percent to 14.5 percent of those whose rebounds began later.

The diabetes and glucose-intolerance rate was as high as 27 percent among children who were skinny as babies but rebounded quickly.

None of the children in the study were actually overweight.

Doctors should reconsider the idea that small babies should get extra calories to encourage rapid growth, said Dr. Francine Kaufman, a pediatric endocrinologist at Children's Hospital-Los Angeles and past president of the American Diabetes Association.

"We need to look at not overfeeding some of these children," she said.

Dr. William H. Dietz of the Centers for Disease Control and Prevention (news - web sites)'s division of nutrition and physical activity, said the study may have little effect on medical practice, since rebound often goes unnoticed until it has occurred, and "it's not clear to me that anyone knows how to prevent early rebound."

He agreed that additional exercise and good nutrition might help children who rebound early avoid diabetes later. And pediatricians should look more carefully at how children's body mass index — a ratio of weight to height — is changing, he said.

But, he said, it is more important to focus on children who already are overweight.

The study also may be more applicable to developing countries than to the United States and Europe, he said, since many of the children in this study were undernourished during early childhood.

On the Net:

http://www.nejm.com

http://www.diabetes.org

Back to the Top


Low-Fat Diet Slows Prostate Cancer Growth, in Mice

Reuters Health
Wednesday, February 25, 2004

NEW YORK (Reuters Health) - A low-fat diet slows the growth of prostate cancer and improves survival in mice that are also treated with hormone therapy, new research indicates.

Prostate cancer (news - web sites) is stimulated to grow by male hormones (androgens), such as testosterone. Therefore, dropping the level of these hormones can inhibit cancer growth. This treatment, whether achieved with drugs or surgery, is known as androgen deprivation.

Although androgen deprivation initially reduces the amount of cancer in patients with prostate cancer, tumors inevitably become insensitive to the hormones and so androgen deprivation makes no difference, Dr. William J. Aronson and colleagues, from the University of California at Los Angeles, note. Once this occurs, there is no treatment known to prolong survival.

The researchers previously showed that blood from men on a low-fat diet slowed the development of prostate cancers grown in a lab dish. In their current study, they injected prostate cancer tumor cells into mice, which were given a high-fat diet until tumors became noticeable.

Twenty animals underwent castration, which produces androgen deprivation. Ten continued to receive the high-fat diet, while the other 10 were placed on a low-fat diet.

Cancers began to increase in size after just 9 weeks in the high-fat group compared with 18 weeks in the low-fat group, according to the report in the medical journal Cancer Research.

In addition, animals in the low-fat group survived about 8 weeks longer than those in the high-fat group.

"Future pre-clinical studies are needed to address the impact of various fatty acid compositions that may play a role in tumor progression," Aronson's group writes.

Even though further studies are required to confirm these findings, Aronson suggested in a UCLA press statement that it is reasonable for men with prostate cancer to switch to a low-fat diet.

"I think dietary fat reduction... in combination with existing treatments, (can) perhaps increase survival times for patients," he said.

Source: Cancer Research, February 15, 2004.

Back to the Top


Survey: American Lives Still Unhealthy

By Harry R. Weber
Associated Press Writer
The Associated Press
Wednesday, February 25, 2004

ATLANTA - Americans still don't seem to get the message. The latest government figures offer more proof that many people are leading unhealthy lifestyles.

The majority of U.S. adults are overweight, nearly one in five are daily smokers, and one in five consumed at least five alcoholic drinks in a day at least once in a year, according to government's national health survey.

"It's almost as if the elements are conspiring against us to lead unhealthy lifestyles," said Dr. Dan Blumenthal, chairman of community health and preventive medicine at Morehouse School of Medicine.

"We are faced with a constant barrage of advertising on television about fast food. We live in a world where we are encouraged to drive more and walk less and spend more time in front of our televisions."

The data, for the years 1999-2001, examines the health behavior of 96,000 adults 18 years old and over and is broken down among gender, race, education and income. It is contained in a report released Wednesday by the Centers for Disease Control and Prevention (news - web sites) in Atlanta and the National Center for Health Statistics outside Washington.

The study found that Asian adults are more likely than other race groups to have healthy behavior in terms of alcohol use, smoking and body weight. Black adults have higher rates of leisure-time physical inactivity and obesity than white adults.

Black men are more likely than white men to be smokers, but among women the reverse is true, the study says.

The study data says adults with higher levels of education and income generally have more favorable health behavior.

The levels in each category have remained about the same since the numbers for earlier years were released. The study started in 1997.

The latest data found that obesity rates are about the same for men and women, with men slightly more likely than women to be smokers, and men more likely than women to be physically active in their leisure time.

Thirty-nine percent of adults don't engage in any physical activity during their leisure time, the data indicated.

"This trend has been happening in the past decade and it looks like this still continues," said Frank Hu, an associate professor of nutrition and epidemiology at the Harvard School of Public Health. "It strikes me that physical inactivity and obesity continue to be the most important public health challenges in this country."

Among the positives in the report, the data showed that about one in four Americans abstain from drinking, more than 40 percent of smokers attempted to quit in the past year and 40 percent of Americans are in a healthy weight range.

Dr. Joseph Hobbs, chairman of the Medical College of Georgia's family medicine department, said what worries him is that the numbers could actually be much higher. He noted that the data was self-reported by the participants.

On the Net:

http://www.cdc.gov/nchs

Back to the Top


Drug Fights Abnormal Openings in Crohn's Disease

Reuters
Wednesday, February 25, 2004

BOSTON (Reuters) - A drug that fights inflammation can help treat problems associated with the digestive-tract illness Crohn's disease, medical researchers reported on Wednesday.

Sustained use of the drug infliximab can help close abnormal openings in the bowel that appear in many people with Crohn's, a long-term inflammation that can eat away the lining of the digestive tract, according to a study published in the New England Journal of Medicine (news - web sites).

Infliximab is sold by Centocor Inc. in the United States under the brand name Remicade.

The study found that prolonged treatment with the drug closed off the openings, called fistulas, and kept them closed in 36 percent of volunteers who received it every eight weeks.

Fistulas appear in up to 43 percent of people with Crohn's, and the stubbornness of the disease, which affects about half a million people in the United States, makes the openings difficult to treat.

In contrast with the group receiving infliximab, the success rate was 19 percent among patients who got a placebo during the year-long study.

However, the study only involved people who showed an initial response to the drug, and 31 percent did not.

"The impact can be remarkable for those who do respond," said author Bruce Sands of Massachusetts General Hospital.

Infliximab is already prescribed to patients with severe cases of Crohn's but no fistulas. The study was done at 45 medical centers in North America, Europe and Israel. Centocor, a subsidiary of Johnson & Johnson, paid for the research, and at least 10 of the 18 researchers have financial ties to the company.

Back to the Top


Study: Weight Gain Tied to Breast Cancer

By Daniel Yee
Associated Press Writer
The Associated Press
Wednesday, February 25, 2004

ATLANTA - The amount of weight a woman gains after age 18 is a strong signal as to whether she will get breast cancer later in life, according to new research released Wednesday by the American

In one of the largest studies of weight and breast cancer to date, researchers said older women who gained 20 to 30 pounds after high school graduation were 40 percent more likely to get breast cancer than women who kept the weight off.

The risk doubled if a woman gained more than 70 pounds, said Heather Spencer Feigelson, senior epidemiologist with the American Cancer Society.

"Breast cancer is strongly dependent on body weight," Feigelson said. "Even modest amounts of weight gain lead to a significantly increased risk of breast cancer."

Weight gain and body mass have long been known to be risk factors for breast cancer.

The cancer society estimates weight contributes to between one-third and one-half of all breast cancer deaths among older women.

Fat tissue makes estrogen, and estrogen can help breast cancer grow. Weight gain also is the second leading cause of all cancers, according to research the Atlanta-based society published last year in the New England Journal of Medicine (news - web sites).

But the cancer society researchers wanted to examine more specifically the link between weight gain amounts and breast cancer, and this was the first in such a large group.

"The more fat you have — fat cells are capable of synthesizing estrogen — the heavier you are, the higher your estrogen levels," said Dr. Paul Tartter, associate professor of surgery at Columbia University, who was not a researcher in the study. "There's no question that estrogen is the common denominator of most of our risk factors for breast cancer."

The cancer society study included 1,934 breast cancer cases among 62,756 women involved in a separate long-term cancer prevention study.

Post-menopausal women ages 50 to 74 were asked their weight when the study began in 1992 and their weight when they were 18 years old. Surveys were sent to the women in 1997, 1999 and 2001 to inquire about any new cancers.

Women taking estrogen hormones were not included in the study.

Lean post-menopausal women not taking hormone replacement therapy produce very little estrogen and had the lowest cancer risk in the study, Feigelson said.

On the Net:

Cancer study: http://cebp.aacrjournals.org/

Back to the Top


Childhood Weight Changes Predict Sugar Problem

Reuters Health
Wednesday, February 25, 2004

NEW YORK (Reuters Health) - Findings from a new study suggest that children destined to develop impaired glucose tolerance, a problem that can lead to diabetes, do not start out life being overweight. Rather, these kids start out being thinner than normal only to experience a rapid increase in their body weight later in childhood and adolescence.

Previous reports have suggested that the risk of type 2 diabetes is elevated in people with low birth weights who become obese later as adults. However, it was unclear if their obesity actually begins during childhood and at what age.

"Understanding the origin of obesity may be especially important in developing countries, where type 2 diabetes is rapidly increasing yet public health messages still focus on reducing childhood 'undernutrition,"' study author Dr. Harshpal Singh Sachdev, from Maulana Azad Medical College in New Delhi, India, and colleagues note.

To investigate, the researchers assessed glucose tolerance in 1492 young adults from India who had height and weight measurements taken at regular intervals throughout childhood and adolescence. These measurements were used to calculate the body mass index (BMI). A BMI of 26 or higher is typically considered overweight.

The findings are reported in this week's New England Journal of Medicine (news - web sites).

Nearly 11 percent of subjects had impaired glucose tolerance and 4.4 percent had diabetes, the researchers note. Subjects destined for such problems typically had a low BMI between birth and 2 years, an increase in BMI that began at a young age (called early rebound), and an accelerated increase in BMI until adulthood.

Although subjects who developed glucose impairments had an increase in BMI between 2 and 12 years, none were obese at 12 years, the authors point out. During this early period, a rise in the BMI by 1 degree from the norm was associated with a 36 percent increase in the risk of impaired glucose tolerance or diabetes in adulthood.

"The association of adult obesity and its complications with birth weight, rebound of the BMI, and overweight during adolescence suggests that these periods may prove critical for the prevention of early overweight and its effects on adult disease," Dr. William H. Dietz, from the Centers for Disease Control and Prevention (news - web sites) in Atlanta, notes in a related editorial.

Source: The New England Journal of Medicine, February 26, 2004.

Back to the Top


Reading Is Fundamental

HealthDayNews
Wednesday, February 25, 2004

(HealthDayNews) -- According to the European Journal of Neurology, reading not only changes the way we see the world, it even changes us.

In a careful neurological exam of 41 women, matched for every trait except the ability to read, there was a distinct area of the corpus callosum, one of the structures that joins the left and right halves of the brain, that is thick in those who could read and thin in those who couldn't.

It appears that this learned ability has a direct effect on the structure of the brain itself, and even helps to bring the two hemispheres together.

Back to the Top


Tuesday, February 24, 2004

Half of Young Americans to Get Sex Diseases –Study

By Maggie Fox, Health and Science Correspondent
Reuters
Tuesday, February 24, 2004

WASHINGTON (Reuters) - Half of all young Americans will get a sexually transmitted disease by the age of 25, perhaps because they are ignorant about protection or embarrassed to ask for it, according to several reports issued on Tuesday.

The reports, publicized by two nonprofit sexual and youth health groups, said there were 9 million new cases of STD among teens and young adults aged 15 to 24 in 2000.

They said the U.S. government's policy of preferring abstinence-only education would only increase those rates.

"For the 27 million young Americans under the age of 25 who have had sex, the stakes are simply too high to talk only about abstinence," James Wagoner, president of Advocates for Youth, said in a statement.

"Given the prevalence of STDs, young people need all the facts -- including medically accurate information on condoms."

The reports, released jointly by Advocates for Youth -- a nonprofit group advocating for sex education, and the sexual health-oriented Alan Guttmacher Institute, pull together information from several different publications.

They include a Centers for Disease Control and Prevention (news - web sites) report in the latest issue of the journal Perspectives on Sexual and Reproductive Health, and a University of North Carolina report based on interviews with teens and young adults.

"Approximately 18.9 million new cases of STD occurred in 2000, of which 9.1 million (48 percent) were among persons aged 15 to 24," the CDC report reads.

It said three diseases -- human papillomavirus or genital wart virus, a parasitic infection called trichomoniasis and chlamydia -- accounted for 88 percent of all new cases of STDs in 15- to 24-year-olds. Wart virus is the major cause of cervical cancer while chlamydia can cause infertility.

Potential Causes

The CDC report did not comment on potential causes, but the Guttmacher Institute did.

"It is not surprising that teens and young adults contract a disproportionate number of infections," said Guttmacher's Sharon Camp. "Most young people are sexually active, and many are ill equipped to prevent STDs or seek testing and treatment."

She said sex education that includes information on condoms is vital to preventing STDs.

"Although abstaining from sexual activity is guaranteed to prevent STDs, some adolescents and virtually all young adults will eventually choose to have sex," Camp said.

"Before they do, they need realistic sex education that teaches them how to prevent STDs and unwanted pregnancies. It is essential to have medically accurate information about condoms and other contraceptive methods, and guidance on how to access appropriate prevention, testing and treatment services."

Teens 15 and older who have had sex have the highest STD rates of any age group in the country, and the United States has the highest STD rate of any industrialized country, according to CDC and World Health Organization (news - web sites) figures.

The University of North Carolina report attacked federal policies that encourage abstinence-only education.

"Abstinence is, of course, the only 100 percent effective prevention strategy," Shawn Carney, a 17-year-old member of the UNC youth panel, said in a statement.

"But with 70 percent of young people having sex by the age of 18, we need to hear about more than abstinence. We need to know how to prevent STDs when we do have sex later in life."

Back to the Top


Brother, How Can I Stop Sneezing?

HealthDayNews
Tuesday, February 24, 2004

(HealthDayNews) -- If you want to protect your child from allergies, consider getting her either a brother or a dog, says a study in the Journal of Clinical Immunology.

When 13,922 people around the world were examined as part of the European Community Respiratory Health Survey, researchers found that people who don't have allergies usually had either a brother or a dog.

Also, sharing a bedroom with a sibling seemed to protect against allergies to cats.

In case you're interested, having a brother was slightly more useful than having a dog, but the difference wasn't really that great.

Back to the Top


TV, Eating Out Makes Kids Fat, Studies Agree

By Maggie Fox, Health and Science Correspondent
Reuters
Tuesday, February 24, 2004

WASHINGTON (Reuters) - Excessive television watching and fat-laden fast food menus are working together to make U.S. children fatter and fatter, two separate reports said on Tuesday.

The reports by non-profit groups, the Kaiser Family Foundation and the Center for Science in the Public Interest, were issued a day after the American Psychological Association published a new policy recommending legal limits on advertising aimed at children.

The Kaiser Foundation, which studies family health issues, said research had not pinpointed precisely why television watching is so strongly linked with childhood obesity. But experts told a briefing that evidence pointed strongly to advertising for junk and snack foods.

The CSPI, which publishes frequent reports on the fat and calorie content of popular foods, criticized kid's menus at restaurants that feature deep-fried foods, sugary drinks and calorie-laden desserts.

The U.S. Centers for Disease Control and Prevention (news - web sites) says that since 1980 the proportion of overweight children ages 6 to 11 has more than doubled. It estimates that 10 percent of young children aged 2 to 5 and 15 percent of 6- to 9-year-olds are overweight.

The Kaiser Foundation studied whether time spent watching television and movies and playing computer and video games really contributes to this, as many believe. Its experts reviewed more than 40 studies on the subject.

"While media is only one of many factors that appear to be affecting childhood obesity, it's an important piece of the puzzle," Vicky Rideout, a Kaiser vice president, told a briefing.

Couch Potato Effect Not To Blame

The studies did not compellingly support the so-called "couch potato" theory -- that kids who watch TV are not out exercising and playing.

"One of the possibilities is food advertising. It seems to be a strong possibility," added Elizabeth Vandewater, an expert on human development at the University of Texas in Austin.

"We know that advertising works, and it works well," she added.

Psychologist Dale Kunkel of the University of California at Santa Barbara agreed. "It works especially well on young children," he said.

Dr. Tom Robinson, a pediatrician at Stanford University in California who studies obesity, tried reducing how much TV kids watched to see if they became less fat. They did.

Two of his studies on a total of 1,100 children aged 8 to 10 showed that when TV watching was reduced, the children -- who were growing -- gained less weight.

Turning off the television slowed down obesity more than anything else, including exercise programs and diets, Robinson said. "It amazed me that we saw these effects," he said.

The Kaiser experts said the typical child sees about 40,000 ads a year on TV, most for candy, cereal, soda and fast food.

And fast food, said the CSPI, is certainly making children fatter. "We found that most meals have 600 or 1,000 calories -- that's half a days worth or more for kids aged 4 to 8," the CSPI's Jayne Hurley told a news conference.

"Any kid who eats a cheeseburger, fries Coke and sundae will be sitting down to an amazing 1,700 calories and three and a half days' worth of bad fat. Of course, who would know that? Menus don't have to list nutrition information."

Back to the Top


When Trouble Melts Like Lemon Drops

HealthDayNews
Tuesday, February 24, 2004

(HealthDayNews) -- You're thirsty. And your choice of the moment only includes a stick of sugar-free chewing gum or a sugar-free lemon drop. Which should you take?

According to the Journal of Dental Research, go with the lemon drops. Chewing gum will increase your flow of saliva to about one teasponful per minute -- for about a minute. After 20 minutes of chewing, the flow has dropped off by 80 percent. By contrast, sucking on a lemon drop will keep the flow of saliva at about a teaspoonful per minute for the full 20-minute period.

These statistics don't apply if you swallow the gum or chew the lemon drop.

Back to the Top


Hormone Therapy May Affect Hearing, Study Shows

Reuters
Tuesday, February 24, 2004

WASHINGTON (Reuters) - Hormone replacement therapy, already blamed for raising the risk of stroke, heart attack, some kinds of cancer and even Alzheimer's disease (news - web sites), may also cause hearing loss, researchers said on Tuesday.

The study is a small one and will need to be verified, but it suggests that women taking HRT did anywhere from 10 to 30 percent worse on hearing tests than women of the same age not taking hormones.

Robert Frisina and colleagues at the University of Rochester Medical Center ran three different hearing tests on 32 women aged between 60 and 86 who took HRT and 32 who did not.

The HRT group heard more poorly in general but especially in complex situations such as understanding someone amid a loud backdrop like a cocktail party.

"It's important to alert women that there could be another significant side effect of hormone-replacement therapy," Frisina said in a statement.

"These results are very surprising. We thought hormones would help women hear better, because of the presence of estrogen receptors in the ear. This is the opposite of what we were expecting."

Frisina and colleagues presented their study at a meeting of the Association for Research in Otolaryngology in Daytona, Florida.

Back to the Top


Long Soaking May Help Dry Hands

HealthDayNews
Tuesday, February 24, 2004

TUESDAY, Feb. 24 (HealthDayNews) -- Done correctly, soaking in water can help ease the dry skin that plagues the hands of so many people during winter, says a skin expert at the National Jewish Medical and Research Center in Denver.

"The most important treatment for dry skin is to put water back in it," Noreen Nicol, the hospital's chief clinical officer, says in a prepared statement.

"The best way to do that is to soak in a bath or shower. Then you must seal in the absorbed water with a thick layer of moisturizer. At National Jewish, the 'soak and seal' hydration method is a fundamental element of our therapy for atopic dermatitis patients with severely dry and cracked skin," Nicol says.

She notes that moisturizer is 10 times more effective when it's applied to skin that has been soaked in water. That's because the moisturizer can soak more deeply into the top layer of skin, creating a more effective barrier against water loss.

Soaking hands for only a short time and then drying them doesn't allow enough time for the water to soak in, so the moisture inside the skin evaporates more easily. Skin can become more susceptible to harsh soaps and other irritants. However, applying moisturizer immediately after drying your hands helps reduce this water loss.

Let your hands soak for 15 to 20 minutes, Nicol advises. Then pat your skin dry and immediately apply a thick layer of occlusive moisturizer to seal in the water your skin has absorbed. This 'soak and seal' should be done just before you go to bed.

More information

The American Osteopathic College of Dermatology has more about dry skin.

Back to the Top


Pregnancy Not Usually Bad for Fatigue Syndrome

Reuters Health
Tuesday, February 24, 2004

NEW YORK (Reuters Health) - In most women with chronic fatigue syndrome, pregnancy is associated with no change or an improvement in related symptoms, new research suggest.

As the name implies, chronic fatigue syndrome (CFS) involves severe bouts of tiredness, which are not relieved by sleep and severely impact usual activities of living. Although the illness is not completely understood, it is thought to occur after certain viral infections.

Dr. Richard S. Schacterle and Dr. Anthony L. Komaroff, from Harvard Medical School (news - web sites) in Boston, note that "our study offers some reassurance to women with CFS who fear adverse consequences of pregnancy."

The findings also indicate that most infant outcomes are not adversely affected when the mother has CFS. Nevertheless, a higher rate of miscarriages and developmental delays was noted in pregnancies involving maternal CFS.

In the study, reported in the Archives of Internal Medicine (news - web sites), 86 women were surveyed about 252 pregnancies that occurred before or after the onset of CFS. On average, each subject had had 2.9 pregnancies.

During pregnancy, 41 percent of women reported no change in CFS symptoms, 30 percent reported an improvement and 29 percent reported a worsening, the investigators note. The corresponding percentages after pregnancy were 30, 20, and 50 percent.

CFS seemed to have little effect on the occurrence of most pregnancy complications. However, the miscarriage rate in pregnancies after CFS onset was 30 percent, much higher than the 8 percent rate seen in pregnancies before CFS onset. Moreover, the rate of infant developmental delays or learning disabilities was significantly higher for pregnancies after the onset of CFS.

Although the link with miscarriage may be a cause for concern, the authors believe that it could be explained by other factors, especially differences in maternal age and birth history between pregnancies that occurred before and after CFS onset.

However, they conclude that this and other possible associations should be investigated "by larger prospective studies with control populations."

Source: Archives of Internal Medicine, February 23, 2004.

Back to the Top

Women Use More Meds Than Thought

By Kathleen Doheny
HealthDay Reporter
HealthDayNews
Tuesday, February 24, 2004

TUESDAY, Feb. 24 (HealthDayNews) -- Women take more medications and herbal supplements than experts think, new research finds, and they're not likely to tell their doctors about everything that's in their medicine closet.

Such omissions could jeopardize their health and increase the chances of adverse drug interactions or drug ineffectiveness, says study author Timothy Tracy, a professor of experimental and clinical pharmacology at the University of Minnesota College of Pharmacy. His report appears in the Feb. 24 issue of the American Journal of Obstetrics and Gynecology (news - web sites).

In a sample of 567 women from five rural clinics who went to see their gynecologist, 92 percent took prescription medications and 96.5 percent used over-the-counter medicines. In addition, 59.1 percent used herbal supplements.

Among the most common prescription drugs taken by the women were antibiotics, birth control pills, antidepressants and blood pressure medicine.

Over-the-counter drugs most often taken included painkillers, vitamins and antacids.

Peppermint, cranberry, aloe, herbal tea, ginseng, echinacea and St. John's wort were most commonly cited as herbals taken.

Drug interactions between prescription drugs, over-the-counter medicines and herbal remedies can be dangerous. St. John's wort, for instance, can interfere with the effectiveness of birth control pills.

When it came to telling their doctors about their complete medical regimen, however, the women fell short.

"One of the things that surprised us the most is the number of medications they didn't tell their gynecologist about," Tracy says. "They tended to talk about medications either prescribed by that doctor or for diseases treated by that doctor."

For instance, they might not tell a gynecologist about blood pressure drugs, which were prescribed by their internist, but would mention birth control pills.

While the survey sample included only rural women, Tracy says previous research has found usage patterns are pretty similar in urban women.

The lack of communication surprised Tracy. "You would think that when you go to a provider and they say, what medications are you taking, women would tell all the medications."

The sheer number of prescription drugs used by the patients surprised Tracy, too. In the youngest bracket, women under age 38, 26 percent took four or more prescription medicines in the past year. In the 38-to-55 bracket, 45 percent took four or more, and in the 56 and older bracket, 57 percent took four or more prescription drugs.

The study results don't surprise Michael Cohen, president of the Institute for Safe Medication Practices. "What this study shows is patients often don't understand what the doctor is saying," Cohen says. "When he asks, are you taking any medications, they think any obstetrical medications [if the gynecologist is asking]."

Women, he adds, "need to understand there can be adverse interactions from medications prescribed by their physicians." It's crucial that each doctor know about all the medicines, both prescription and nonprescription, as well as herbal remedies, that a patient is taking.

Tracy says doctors may have to question patients more closely to get the answers they need. Ideally, he says, they should ask specifically about prescription medicines, over-the-counter drugs and herbal supplements, rather than simply asking the patient what medicines she is taking.

More information

For information about how to take medications safely, visit the Institute for Safe Medication Practices, which also has a page on frequently asked questions about medication dangers.

Back to the Top

Researcher Warns of Ear Piercing Infections

Reuters
Tuesday, February 24, 2004

CHICAGO (Reuters) - Ear cartilage is more prone to a nasty infection than the earlobe during jewelry piercing, and can cause a disfiguring collapse of the ear as the cartilage dissolves, researchers said on Tuesday.

An investigation into a two-month outbreak at a jewelry stand in an Oregon shopping mall found bacteria living in sinks that infected the ears of as many as 25 customers.

Inexperienced employees spread the bacteria, Pseudomonas aeruginosa, to a spray bottle that was supposed to hold disinfectant and contaminated the piercing equipment, said a report published in the Journal of the American Medical Association (news - web sites).

Infections of the ear cartilage do not heal well because of a lack of blood circulation in the area compared to the earlobe, the report said. Some of the victims in the study lost part of their ears.

"The ear loses its ability to hold its shape and so the ear kind of crinkles up and becomes quite unsightly," said study author William Keene of the Oregon Department of Human Services.

"It doesn't affect your hearing. It doesn't affect long term health," he said. "But cosmetically it is quite unfortunate."

Back to the Top


Hormone Therapy May Trigger Asthma

HealthDayNews
Tuesday, February 24, 2004

TUESDAY, Feb. 24 (HealthDayNews) -- Postmenopausal women who used hormone therapy are at increased risk for developing asthma, says a study in the Feb. 23 issue of the Archives of Internal Medicine (news - web sites).

But hormone therapy does not increase the risk of chronic obstructive pulmonary disease (COPD), the study adds.

Researchers at Brigham & Women's Hospital in Boston analyzed data from the Nurse's Health Study, which enrolled 121,700 married female registered nurses, aged 30 to 55, in 1976. Participants in the Nurse's Health Study were sent questionnaires once every two years. The nurses were asked about their medical history, diet and lifestyle, exercise and hormone use.

From 1988 to 1996, the nurses were sent follow-up questionnaires that asked them about new asthma and COPD diagnoses.

In this new study, researchers found current use of estrogen alone was associated with a 2.29 times greater risk of asthma. Women who used estrogen plus progestin had a similar increased rate of newly diagnosed asthma.

"Postmenopausal hormone use was associated with an increased rate of newly diagnosed asthma, but not newly diagnosed COPD. Female reproductive hormones may contribute to the onset of asthma among adult women, but do not appear to hasten the development of COPD," the study authors write.

More information

The U.S. Food and Drug Administration (news - web sites) has more about hormones and menopause.

Back to the Top


Walking Program Helps People with Heart Failure

Reuters Health
Tuesday, February 24, 2004

NEW YORK (Reuters Health) - A progressive walking exercise program at home can decrease symptoms experienced by people with heart failure, according to results of a study published in the American Heart Journal.

"Hospital-based exercise programs using a bicycle ergometer or a combination of exercise modalities have shown positive benefits in heart failure, but may not be readily accessible to many patients," Dr. Teresita Corvera-Tindel, of the Veterans Affairs Health Center System, in Los Angeles, California, and colleagues note.

To evaluate an alternative, they looked at the benefits of a 12-week home-based progressive walking exercise program for people with heart failure.

The investigators compared 42 patients assigned to the program with 37 control patients who continued with their usual activities. The patients were an average of 62.2 years old.

The training group exercised once a day, 5 days a week. Exercise duration started at 10 minutes and intensity was 40 percent of maximal heart rate. This was progressively increased to 60 minutes and 65 percent maximal heart rate in the last 6 weeks.

No major problems were seen during exercise training. Nineteen patients (51.4 percent) in the training group and five patients (15.6 percent) in the control group experienced minor clinical events. No subjects withdrew early from the study because of adverse events.

At the end of the study, patients in the training group achieved significantly longer walking distances within 6 minutes than the control group (1337.1 feet versus 1264 feet). Their overall symptom ratings were also reduced.

These findings, the researchers conclude, "provide support for the safety and efficacy of home-based exercise."

Source: American Heart Journal, February 2004.

Back to the Top


Beating Multiple Myeloma

HealthDayNews
Tuesday, February 24, 2004

TUESDAY, Feb. 24 (HealthDayNews) -- A discovery by U.S. researchers may help lead to new ways to treat multiple myeloma, an incurable cancer of immune cells called plasma cells found in the blood and in bone marrow.

The study, in the February issue of Cancer Cell, identified a frequent and common abnormal cellular event that occurs in about half of all cases of multiple myeloma. This finding provides scientists with a potential treatment target.

In this U.S. National Cancer Institute (news - web sites)-led study, scientists focused on a cancer-causing gene called c-maf. They found c-maf was present in about half of all myeloma cases but was absent from normal plasma cells.

The study also found c-maf increases production of factors that directly promote tumor cell growth and the factors that promote tumor cell growth indirectly by increasing adhesion of pathological tumor cells to other types of cells within the bone marrow.

The scientists say they also determined that inhibiting c-maf function in myeloma cells blocked tumor formation in mice.

"Our results indicate that overproduction of c-maf is one of the most common abnormal events associated with myeloma. Further, our finding that inhibition of c-maf blocks myeloma proliferation and tumor formation makes c-maf an intriguing and exciting novel target for future therapies," research team leader Dr. Louis M. Staudt, of the National Cancer Institute, says in a prepared statement.

More information

The American Cancer Society (news - web sites) has more about multiple myeloma.

Back to the Top


Gene That Helps in Your 40s Can Hurt in Your 80s

By Alison McCook
Reuters Health
Tuesday, February 24, 2004

NEW YORK (Reuters Health) - A genetic variation that can save your life in middle age may also reduce your chances of surviving into your hundreds, Italian researchers report.

These seemingly paradoxical findings appear to stem from the gene's influence on levels of so-called "bad" cholesterol, or LDL cholesterol. The investigators found that people with a particular form of the gene had significantly lower levels of LDL cholesterol.

A high level of LDL cholesterol is an established risk factor for heart disease. Previous research has shown that the gene form linked to low LDL cholesterol occurs commonly among adults, but is only rarely present in healthy, elderly adults.

This pattern suggests that the low cholesterol gene can protect your heart in middle age, but may also interfere with your ability to reach a ripe old age.

If so, something that is a risk factor at one age can act as the opposite at another, a variation that researchers should keep in mind, study author Dr. Giovanna De Benedictis of the University of Calabria told Reuters Health.

"Risk factors are age-specific," De Benedictis said. "Therefore, results established for a population segment of a certain age cannot be directly assumed for a population segment of a different age, such as oldest old persons."

The gene featured in the current study influences body levels of apolipoprotein B, or apoB, a protein that transports LDL cholesterol around the body. In the report, published in the journal BMC Medical Genetics, De Benedictis and her team compared apoB gene forms to LDL cholesterol levels in 409 people between 20 and 102 years of ages.

The investigators found that people who carried the short form of the apoB gene, which occurs only rarely among the very old but commonly among younger adults, had significantly lower levels of LDL cholesterol.

De Benedictis explained that changes in how the body responds to cholesterol with age likely explains why the apoB gene can hurt you in old age but save your life in your 40s and 50s.

Although high levels of cholesterol can put your heart at risk, your body needs cholesterol to carry out important functions, such as making hormones and cell walls, she said.

Our bodies change dramatically as we age, she added, and very low levels of cholesterol that protected us from heart disease in middle age may become hazardous to our health in our 80s and 90s.

"A gene which lowers cholesterol may become detrimental in (extreme old age), by lowering the level of cholesterol under a critical threshold," the researcher summed up.

BMC Medical Genetics, 2004.

Back to the Top


Halting Damage of Hysterectomy

HealthDayNews
Tuesday, February 24, 2004

TUESDAY, Feb. 24 (HealthDayNews) -- A robotic-assisted procedure is as effective as full surgery for correcting post-hysterectomy sagging vagina, says a Mayo Clinic study in the February issue of Urology.

This is the first study in the United States to examine the feasibility of this method of repairing vaginal vault prolapse, or collapsed vaginal walls.

"The benefit to the patient is dramatic. It's fast, markedly less painful and a strong repair, with much quicker recovery," Dr. Daniel Elliott, one of the study authors, says in a prepared statement.

The procedure is called robotic-assisted laparoscopic sacrocolpopexy. It's used to pin back in place the top of a vagina that has fallen down within the vaginal canal or outside the vaginal opening. About 10 percent of women who have a hysterectomy experience sagging of the vagina that requires surgical repair.

This study included the first five women to undergo the robotic-assisted surgery at the Mayo Clinic.

More information

The U.S. National Women's Health Information Center has more about hysterectomy.

Back to the Top


Very-Low-Calorie Diet Controls Teens' Diabetes

Reuters Health
Tuesday, February 24, 2004

NEW YORK (Reuters Health) - A high-protein, low-carb, very-low-calorie diet is effective short-term treatment for obese adolescents with type 2 diabetes, according to a new study.

The rate of type 2 diabetes has risen exponentially among adolescents, Dr. Steven M. Willi and colleagues from the Medical University of South Carolina, Charleston, point out in the medical journal Diabetes Care, but there are few studies comparing the relative merits of diet, exercise, insulin, and other drug therapies in treating such patients.

The team evaluated the ability of a ketogenic, very-low-calorie diet to reduce weight, reduce high blood sugar levels, and decrease the dependence on anti-diabetes medications in 20 obese teens -- 5 males and 15 females -- with type 2 diabetes.

The diet consisted of about 100 grams of protein and less than 30 grams each of fat and carbohydrates per day, which delivered between 680 and 800 calories. That translates to approximately 13 ounces of lean meat and 3 cups of vegetables. The participants also needed to take in 8 cups of fluid and supplemental salt daily.

Mean daily blood glucose levels fell from 162 to 100 mg/dL within three days of beginning the diet, and all but one teen managed to discontinue all antidiabetic therapy.

After voluntarily stopping the diet after an average of 60 days, participants' average weight loss was 25 pounds (9.3 percent of total body weight), the researchers report.

In fact, the average body weight was still significantly reduced two years later. This amounted to a 5.4 percent reduction, compared with a 3.7 percent increase in an age-matched control group.

Average blood pressure also fell during the diet, and none of the patients experienced side effects such as nausea and cramps reported in previous trials of the diet in youngsters, Willi's team found.

The investigators call for further studies, but conclude that "the very-low-calorie diet has the potential to improve diabetes control over the short term and perhaps empower diabetic individuals over the long term."

Source: Diabetes Care, February 2004.

Back to the Top


Old Standby Reduces Heart Attack Damage

By Ed Edelson
HealthDay Reporter
HealthDayNews
Tuesday, February 24, 2004

TUESDAY, Feb. 24 (HealthDayNews) -- Researchers say they have a miracle drug capable of preventing the inflammatory process that can push heart attack victims over the edge into death.

That drug is insulin.

"We have been putting this together in bits and pieces over the last four years," says research leader Dr. Paresh Dandona, a professor of medicine at the University of Buffalo, N.Y. "This is a hormone that is known to lower blood sugar, but nobody knew it had this amazing anti-inflammatory activity."

Proof of that ability comes from a study whose results appear in the Feb. 24 issue of Circulation.

"We actually succeeded in demonstrating that damage to the heart muscle is markedly reduced by giving insulin in the hours after a heart attack," Dandona says.

The study included 32 patients who came to the emergency department of Millard Fillmore Hospital in Buffalo suffering from heart attacks. Half of them were given standard treatment for a heart attack, including a clot-dissolving drug. The other half had an infusion of insulin in addition to conventional treatment.

Over the next 48 hours, the doctors monitored blood levels of two significant molecular markers of inflammation, C-reactive protein (CRP) and serum amyloid A (SAA). They also monitored levels of creatinine kinase, a protein that is released by damaged heart muscle cells.

Concentrations of CRP and SAA were reduced by 40 percent and 50 percent, respectively, in the patients who received the insulin infusion, while creatinine kinase readings indicated that heart muscle damage was reduced by 50 percent, the researchers report.

Insulin has several beneficial effects, Dandona says. One is to block the production of plasminogen activator inhibitor, a molecule that lessens the effect of clot-dissolving drugs. Another is to reduce the damage caused by free radicals, molecules that attack the heart muscle.

One of the striking aspects of the insulin treatment is its low cost "in an era when every new medication costs thousands of dollars," Dandona says. "We used 120 units of insulin per patient. The cost was $1.50."

The insulin treatment is now in routine use for heart attack patients brought to the Buffalo hospital, Dandona says.

"Now we are trying to sell this idea to clinicians," he says.

The selling effort includes additional, larger clinical studies.

"We have scheduled a consortium meeting in New York City at the end of March to discuss this with other medical leaders," Dandona says.

A second study appearing in the same issue of Circulation finds yet another inflammatory biomarker that can cause heart trouble. The study, led by researchers at the Baylor College of Medicine, found the marker, called Lp-PLA2, doubled the risk of a coronary event even in people who had low levels of LDL, the so-called "bad" cholesterol.

More information

The signs and symptoms that indicate the need for immediate help for a heart attack are described by the American Heart Association, which also has a page on treatments.

Back to the Top


Home Blood Pressure Checks Help Guide Therapy

Reuters Health
Tuesday, February 24, 2004

NEW YORK (Reuters Health) - Adjusting your blood pressure (BP) pills based on measurements taken at home could offer advantages over conventional office-based BP testing, Belgian researchers report.

The findings, which are reported in the Journal of the American Medical Association (news - web sites), indicate that the two approaches are similar in terms of patient well-being and effects on the heart. The home approach results in less intensive drug therapy and slightly lower costs than the office strategy, but also provides less BP control.

Further studies are needed to determine the normal range of home BP, including the threshold for starting or stopping drug therapy, lead author Dr. Jan A. Staessen, from the University of Leuven and colleagues note. "Until such prospective data are available, management of (high BP) exclusively based on home BP cannot be recommended."

In the study, 400 patients with high BP were randomly selected to participate in the home or office BP program for 1 year. With each, blood pressure was measured on a regular basis and then reported to a doctor who adjusted the patient's drugs based on a standard treatment protocol.

Nearly 26 percent of patients in the home BP group were able to stop their BP pills compared with just 11 percent in the office group. Despite this difference, the percentage of patients who went on to require two or more drugs in each group was similar.

The final BP-- measured at home, in the office, and elsewhere -- was significantly higher in the home BP group than in the office group, the researchers note.

Reported symptoms and heart effects were comparable in the two groups. There was a slight but significant cost saving with the home strategy compared with the office strategy.

The researchers conclude that the findings "support a step-wise strategy for the evaluation of BP in which self-measurement and ambulatory monitoring are complementary to conventional office measurement."

Source: Journal of the American Medical Association, February 25, 2004.

Back to the Top


More Kids, More Pounds for Parents

HealthDayNews
Tuesday, February 24, 2004

TUESDAY, Feb. 24 (HealthDayNews) -- Children add joy to their parents' lives, but they can also add inches to their parents' waistlines.

The more children a person has, the greater the risk a man or woman will become obese, says a Duke University Medical Center study in the January/February issue of the Journal of Women's Health.

The researchers analyzed a large database of middle-aged Americans and concluded that women have an average 7 percent increased risk of obesity per child, while men have an average 4 percent increased risk of obesity per child.

The Duke study suggests this child-related weight gain may be linked to a busier lifestyle for parents that leaves them less time for exercise, while, at the same time, they eat more fast foods.

"As families grow, parents need to be educated about the importance of exercise and a healthy diet," study co-author Dr. Lori Bastian, an associate professor of medicine at Duke and research associate at the Durham VA Medical Center, says in a prepared statement.

"Obesity is a family problem because children follow the lead of their parents. A healthy lifestyle for one is a healthy lifestyle for all," Bastian says.

She says more research is needed to study what causes changes in parents' attitudes toward diet and exercise and to develop appropriate interventions.

More information

The U.S. Centers for Disease Control and Prevention (news - web sites) has more about exercise and a healthy diet.

Back to the Top

Monday, February 23, 2004

Macrobiotics Dieters Stick With Carbs

By Holly Hickman
Associated Press Writer
The Associated Press
Monday, February 23, 2004

ASHEVILLE, N.C. - In an age of low-carb diets and high-protein energy bars, Michael Rossoff is an anomaly. In his world, vegetables reign over excessive meat. He does not "got milk" — and counsels his clients to do the same.

For more than three decades, the respected whole foods counselor has practiced macrobiotics — a diet embraced by health-conscious eaters ranging from Gwyneth Paltrow and Madonna (news - web sites) to yogis and cancer patients.

"I haven't eaten red meat in 30 years," Rossoff declared during a recent interview. "I suppose the (Atkins) people haven't made much money off of me."

At 58, Rossoff is energetic, clear-eyed, smooth-skinned and "probably 25 pounds lighter" than his twin brother, who hasn't adopted the diet.

Macrobiotics was brought to the United States from Japan five decades ago by Michio and Aveline Kushi, founders of the thriving Kushi Institute near Boston. Rossoff studied for years with the Kushis and, as a senior macrobiotic counselor, draws a steady following at teach-ins and workshops.

The word "macrobiotics" is derived from "long life" in Greek. It is a holistic lifestyle concept anchored by a diet heavy on vegetables, grains, beans, soups and the bounty of the sea — including fish and sea vegetables. It eschews refined sugar, red meat, dairy, white flour, antibiotic-laced poultry and eggs.

Those who eat macrobiotically tend to follow the seasons — fresher, lighter fare in the summer versus more root vegetables, pressure-cooked grains, and oils in the winter.

As Rossoff puts it, "You don't wear shorts in the snow or a fur coat in Miami."

Practitioners strive for balance when creating meals. That balance extends beyond fat and calories and considers the "energetic properties" of food.

"Think of the Chinese concept of yin and yang," the idea of opposite energies in harmony, Rossoff says. Root vegetables come from deep in the ground and have a "grounding" effect on the body. Conversely, corn stalks grow high toward the sun, energetically imparting its lightness and vigor.

In macrobiotics, yin foods (such as leafy vegetables and fruits) have a cooling, expansive effect on the body. Refined sugar is extremely yin. At the opposite end of the spectrum, eggs and beef are extremely yang, those denser foods which have a heating, tightening effect on the body's internal workings.

"In that tradition," Rossoff explains, "brown rice would be considered the most balanced food, the one with equal parts yin and yang. So if brown rice lies in the middle, ideally you want to stay within that area to stay balanced."

That means eating foods that have been minimally processed and don't come in a box, says Jane Quincannon Stanchich, who along with her husband and fellow teacher Lino Stanchich relocated to Asheville from Miami, adding to the city's roster of macrobiotic teachers.

A mountain setting and tolerant attitudes cocoon Asheville, the largest city in western North Carolina, which attracts a wide spectrum of people leading holistic lifestyles. Other macrobiotic hubs include New York, San Francisco, and Austin, Texas.

Macrobiotics has become so popular among cancer patients that it is also known as "the anti-cancer diet." And it's being studied by institutions such as the Duke Comprehensive Cancer Center, the University of California San Diego Cancer Center, and the University of Texas M.D. Anderson Cancer Center.

Stanchich touts the diet's variety.

"There are so many vegetables, all sorts of whole grains like millet and kamut, fish, tofu, tempeh (a tofu product)," she says, adding that macrobiotic meals often exceed the government's recommended daily allowances of vitamins and minerals.

"And if you want something sweet, there are desserts sweetened with rice syrup, barley malt, or Rice Dream 'ice cream.' I never feel deprived."

Macrobiotics preaches that refined sugar may leach calcium from the bones, compromise the immune system and cause mood swings, especially in those prone toward depression. Eating sugar may cause cravings for foods from the other extreme of the yin/yang chart, and vice-versa.

"That's why we want a really sweet dessert after a steak dinner," Stanchich says. "Our body is craving balance, but a burger, fries, and a shake isn't what creates it."

Macrobiotics also emphasizes chewing food well.

"My husband wrote a book on this because he noticed that people in this country think chomping down a few times is chewing," she said. "It just creates digestive disorders... Stomachs can't chew."

All that chewing, rice, and calm eating may be what leads people to associate macrobiotics with a monkish lifestyle, Rossoff jokes.

Dr. Jane Teas of the University of South Carolina's School of Public Health is studying macrobiotics under a research grant from the Centers for Disease Control and Prevention (news - web sites). Her research shows people who eat macrobiotically report better energy and health, but with a caveat.

"The biggest cost is social isolation," she says, adding it isn't for everyone.

Teas tried the diet herself and thought the food tasted great.

But her husband and 12-year-old daughter thought otherwise. Experiencing tension while eating is very un-macrobiotic. Teas had to give up the diet to keep peace at the dinner table.

On the Net:

Michael Rossoff: http:// www.michaelrossoff.com

Macrobiotics and the Kushi Institute: http://www.macrobiotics.org

Jane and Lino Stanchich: http:// www.macrobioticconsultation.com

Back to the Top


Stress Seems to Block Deep Sleep

HealthDayNews
Monday, February 23, 2004

MONDAY, Feb. 23 (HealthDayNews) -- Stress may disrupt the natural rhythms of the body's nervous system during various stages of sleep, says a University of Pittsburgh study in the journal Psychosomatic Medicine.

The link between daytime stress and restless sleep is well established, but scientists are still investigating the exact ways that stress affects sleep.

This study found stressed sleepers wake up more often while they're sleeping and have fewer episodes of deep sleep.

Researchers monitored the heart rates of 59 healthy undergraduate students while they slept. Heart rate variations can provide clues about the activity of the involuntary nervous system, which directs the function of organs such as the heart and lungs.

To trigger stress during sleep, the researchers told half of the students they would have to deliver a 15-minute speech when they woke up. The topics would be chosen for them upon awakening, the students were told.

The researchers detected significant heart rate variations between the stressed and non-stressed students as they slept. The stressed group had changes in heart rate patterns during REM, or rapid-eye-movement, sleep -- the sleep phase when dreaming occurs -- and non-REM sleep.

The heart rate variability patterns detected in the stressed students were similar to those seen in people with insomnia. the study says, suggesting similar pathways of nervous system disruption.

More information

To learn more about insomnia, visit American Academy of Family Physicians.

Back to the Top


HHS Issues Health Care Disparities Report

The Associated Press
Monday, February 23, 2004

WASHINGTON - The government released the original version Monday of a report on disparities in health care for minorities, after an edited version drew complaints that it played down serious problems.

Health and Human Services (news - web sites) Secretary Tommy Thompson acknowledged this month that his department erred in making changes that included eliminating the conclusion that unequal care for minorities is a national problem. He promised to issue the original.

HHS published the edited version in December.

The original report, and a companion on health care quality, was posted Monday on the HHS Web site. Dr. Carolyn M. Clancy, director of HHS' Agency for Healthcare Quality and Research, said in an introductory message the posting was made "to avoid any further question" about the changes.

On the Net:

HHS reports on health care quality: http://www.qualitytools.ahrq.gov

Back to the Top


Experts: Chicken Safe from Bird Flu, if Cooked

By Christopher Doering
Reuters
Monday, February 23, 2004

WASHINGTON (Reuters) - U.S. consumers who eat poultry are not at risk for contracting bird flu found in chickens because the virus is destroyed when meat is cooked, two experts said on Monday.

Federal health officials downplayed the risk of bird flu to the food supply after a strain of the disease that is highly contagious to other birds was found on a Texas farm.

While the food supply appears secure, farm workers who handle live chickens are being closely monitored for the next 10 days because the virus can spread through handling sick chickens, and through the air in the presence of the chickens or from affected fecal matter on trucks or shoes.

The strain found in Texas, known as H5N2, is different from a kind found in Asia called H5N1 that has been blamed for the deaths of at least 22 people in recent weeks.

American consumers are safe from many pathogens -- including bird flu -- if they heat chicken to at least 160 degrees Fahrenheit, a temperature high enough to kill viruses.

"There is no scientific evidence of this virus being transmitted through the food supply to humans," said Lyle Vogel, a director with the American Veterinary Medical Association.

"It is well know and well established ... that any mild heating will kill the virus, even if it is a higher strain," he added.

The last time a highly pathogenic strain of bird flu was found in the United States was in 1984, according to the U.S. Agriculture Department. More than 17 million birds were killed then at a cost of nearly $65 million.

A milder strain of bird flu also was found this month in Pennsylvania, Delaware and New Jersey, prompting 30 countries to ban imports of some or all U.S. poultry.

"At this point we have no reason to believe the consumer has come in contact with" the bird flu virus, said Steve Cohen, a spokesman for USDA's Food Safety and Inspection Service.

The deaths in Asia have occurred from handling sick chickens, not eating them, Vogel said. "The people that are getting sick are those that are in direct contact with the chickens, not with the poultry parts," said Vogel.

Back to the Top


Audit: U.S. Inmates Get Poor Health Care

By Curt Anderson
Associated Press Writer
The Associated Press
Monday, February 23, 2004

WASHINGTON - The U.S. Marshals Service does a poor job of providing medical services to thousands of federal prisoners and doesn't adequately track those with contagious diseases such as tuberculosis, according to a Justice Department (news - web sites) audit.

In addition, the marshals significantly overpay for outside medical care, according to the report Monday by Inspector General Glenn A. Fine.

The Marshals Service has custody of about 40,000 prisoners awaiting trial on federal charges, sometimes for days, weeks or even years. That number represents an increase of 53 percent compared with five years ago, agency chief Benigno Reyna said in a letter to Fine.

Reyna agreed that prisoner health care should be better but said "increases in workload make this problematic" unless Congress approves requested staff increases. He added that the marshals have implemented programs that have saved more than $109 million over the last nine years.

Federal prisoners are provided health care at a local jail, federal prison or detention center, or at an outside medical facility for more serious illnesses. In fiscal year 2002, the marshals spent about $43 million for outside medical care.

The audit found that because the marshals do not always obtain the lowest rates allowed under federal law, the agency is spending about $7 million more than necessary, or roughly one-sixth of all the money spent on outside care. Reyna said the agency was developing a national managed care plan that would resolve many of the financial issues raised by the audit.

Procedures at jails and detention centers also need improvement, the auditors said. They cited one instance in Tucson, Ariz., in which a prisoner being transported died from appendicitis after his repeated complaints were essentially ignored.

Reyna replied that the marshals, with no medical expertise, must rely on local jail physicians and staff for medical care. Few of the nation's 3,618 jails meet standards for medical care set by certifying organizations, he said.

Tracking of communicable diseases among prisoners also needs to be improved, the audit found. There was scant evidence that marshals' district offices were complying with a policy to screen for tuberculosis and there was little documentation when tests were done.

In one incident cited by the audit, a deputy marshal had to be treated for tuberculosis after he was exposed to the disease by a prisoner. The prisoner had tested positive for tuberculosis, but his condition was not relayed to the deputy until later.

The marshals had no national policy for monitoring other disease such as AIDS (news - web sites) and hepatitis, auditors found.

Auditors also found fault with the contract personnel used by the Marshals Service to transport and guard prisoners at outside hospitals. Training was spotty and there were several instances of abuse, including one Illinois prisoner who was beaten for changing channels on a hospital television against a guard's orders.

In another case, a prisoner with tuberculosis escaped out a hospital window in South Carolina after a contract guard left the room. The prisoner later carjacked a woman and was eventually captured with no injury to the carjacking victim.

"The escape of a violent felon with a highly contagious disease into the community could have had far more serious consequences," the auditors said.

On the Net:

Justice Department inspector general: http://www.usdoj.gov/oig

Marshals Service: http://www.usmarshals.gov

Back to the Top

Self-Renewing Spinal Nerve Cells Created

HealthDayNews
Monday, February 23, 2004

MONDAY, Feb. 23 (HealthDayNews) -- A new method of creating an unlimited supply of spinal nerve cells has been developed by University of Rochester Medical Center scientists.

This self-renewing cell line offers scientists a constant supply of laboratory-produced spinal nerve cells. It could also be used someday to replace dead or dying spinal nerve cells in people with neurological diseases or damaged spinal cords.

The study, in the March issue of Nature Biotechnology, describes how the University of Rochester scientists created the cells and how they used the cells to re-grow parts of damaged spinal cords in laboratory animals.

The scientists created the special cells by placing a gene called telomerase, which gives stem cells the ability to live indefinitely, into progenitor cells. Normally, these progenitor cells give rise to specific types of spinal nerve cells. But the progenitor cells can only do this for a short time because they can't continuously divide.

But adding the telomerase gene to the progenitor cells allows them to continuously divide while still producing specific types of spinal nerve cells.

The scientists make it clear that much more research is required before any tests can be conducted using these cells in people with damaged spinal cords or neurological diseases.

More information

The American Association of Neurological Surgeons has information about spinal cord injuries.

Back to the Top

AP Poll: Drugs Costly for U.S. Families

By Will Lester
Associated Press Writer

The Associated Press
Monday, February 23, 2004

WASHINGTON - Almost a third of Americans say paying for prescription drugs is a problem in their families, and many are cutting dosages to deal with the crunch, according to a poll by The Associated Press.

Nearly two-thirds of those surveyed in the AP-Ipsos poll said the government should make it easier to buy cheaper drugs from Canada or other countries.

Carol Valentine of Melbourne, Fla., said she lost her job after having surgery and faces $600 to $700 in drug bills each month without any insurance to pay for them.

Without a local clinic's help paying for those drugs, "I'd be dead," said Valentine, who is 52 and disabled. "A lot of people I know skip meals because they can't afford medicine."

The poll conducted for the AP by Ipsos-Public Affairs found most Americans either take prescription drugs or someone in their family does. Of those, 33 percent said their families have trouble paying at times. Of those with such trouble, three-fourths say the solution often is to cut back on the dosage.

The high cost of prescription drugs will be an important issue in the presidential campaign, said eight in 10 in the poll. Almost half said it will be "very important."

"This still needs to be dealt with," said Carolyn Keenan, a 57-year-old assistant principal from Gibson Island, Md. "There are a lot of elderly people who do not think they're going to get the help they need."

In November, Congress passed a Republican-written Medicare prescription drug benefit that goes into effect in 2006. While it will help many seniors pay for medicine, it also increases the role of private insurance in the Medicare system. In early December President Bush (news - web sites) signed it into law.

Despite the new law and its $534 billion cost over the next decade, 52 percent of those polled said Democrats were more likely to make prescription drugs more affordable; 33 percent said Republicans would do better at it.

Two popular steps that could have made prescription drugs more affordable were forbidden by the new law:

  • Letting Americans import drugs from Canada, Mexico and other countries, an idea supported by 65 percent of those polled for the AP.
  • Giving the government authority to negotiate with pharmaceutical companies for lower drug prices, favored by 71 percent.

Both Democrats and Republicans have been looking for ways to turn the drug debate to their advantage.

Democrats have sharply criticized gaps where patients have to pick up the entire cost of medicine.

GOP strategists have advised those in their party to emphasize the new benefits rather than other changes in the Medicare program and to remind people that the changes are voluntary and only a start toward solving a problem affecting many seniors.

The complexity of the new law has left some people confused about whether they approve of it or not.

But the two big steps not taken — allowing imports and negotiating for lower prices — are more understandable than the bill that was passed, said Robert Blendon, an analyst of public opinion on health care.

"The Democrats are going to use this a lot," said Blendon, a Harvard professor of health policy.

"It will be a good topic for debate" in the election campaign, said Jonathan Stephens, a 32-year-old high school teacher from Lancaster, S.C. But, he added, "it's not going to be a horse they can ride to the White House on."

The AP-Ipsos poll of 1,000 adults was conducted Feb. 16-18 and has a margin of sampling error of plus or minus 3 percentage points.

On the Net:

AP Poll: http://www.ipsos.com/ap

Back to the Top

Study Adds Asthma to Hormone Replacement Ills

By Michael Conlon
Reuters
Monday, February 23, 2004

CHICAGO (Reuters) - Hormone replacement therapy, already linked to stroke, heart disease and breast cancer, may slightly raise the risk of developing asthma, researchers said Monday.

"This finding presents yet another factor women may need to consider when debating whether or not estrogen still has a role in the short-term treatment of menopausal symptoms," said R. Graham Barr, lead author of the study.

"The data suggest that for women who have severe asthma that develops late in life, they may want to consider a trial of stopping hormone replacement therapy to see if this alleviates their condition," he said.

The report from Brigham and Women's Hospital in Boston and Columbia University was based on a broad health study of thousands of nurses that began in 1976.

The new report, published in the Archives of Internal Medicine (news - web sites), found that use of estrogen alone was associated with a 2.29 times higher risk of asthma compared with women who had never used hormones.

Women who used estrogen plus progestin had a similar increased rate of newly diagnosed asthma, the study said.

"These findings need to be put in context," said Barr. "The fact of the matter is that developing asthma late in life is rare. So, although the data is compelling, we estimate that about 1 percent of women might be affected by this increased risk.

"The findings do, however, support an important role of female reproductive hormones in asthma," he added.

The researchers said they found no increased risk for chronic obstructive pulmonary disease among the hormone users. That condition most commonly refers to a combination of chronic bronchitis and emphysema.

Hormone replacement therapy grew rapidly in popularity but crashed after a series of alarming studies. U.S. prescriptions rose to 90 million in 1999 from 58 million in 1995 and remained stable through June 2002. Now they have fallen back to pre-1999 levels, according to a study published in January.

Estrogen/progestin combinations, primarily Wyeth's Prempro, accounted for most of the growth, that study said. But negative findings starting in July 2002 triggered an avalanche of bad news about the therapy.

The U.S. Food and Drug Administration (news - web sites) recommends that post-menopausal women preferring hormone therapy for hot flashes or vaginal dryness take the lowest possible dose for the shortest possible time.

Back to the Top


Super Antioxidants

HealthDayNews
Monday, February 23, 2004

MONDAY, Feb. 23 (HealthDayNews) -- A new family of antioxidants that are 100 times more effective than vitamin E has been developed by a team of international scientists.

Antioxidants are molecules that counteract the tissue and organ damage caused by a process called oxidation.

"Vitamin E is nature's antioxidant and people have been trying to improve upon it for more than 20 years with only marginal success. We have taken a very big step in the right direction," Ned. A. Porter, the Stevenson Chair of Chemistry at Vanderbilt University, says in a prepared statement.

He supervised development of the new family of antioxidants, which have only been tested in the test tube. But Porter and his colleagues say studies with biological molecules, such as cholesterol, suggest these new compounds have properties that could make them suitable for dietary supplements.

Studies in living animals will begin soon to determine the efficacy and safety of this new family of antioxidants.

The finding was published in the European journal Angewandte Chemie International Edition.

More information

The American Dietetic Association has more about antioxidants.

Back to the Top


Study: No-Smoking Areas Offer Partial Protection

By Patricia Reaney
Reuters
Monday, February 23, 2004

LONDON (Reuters) - Designated no-smoking areas in restaurants and clubs provide only partial or no protection against second-hand smoke, Australian researchers said on Tuesday.

Less than a week after Ireland announced it would become the first country in Europe to outlaw smoking in pubs, bars and restaurants, Professor Bernard Stewart of the South East Sydney Public Health United in Australia said that, at best, restricted smoking areas halve levels of environmental tobacco smoke.

"No-smoking areas may provide some reduction in the level of exposure of individuals to environmental tobacco smoke. However, the reduction may be marginal or trivial," Stewart said in a report in the journal Tobacco Control.

ETS, or second-hand smoke, is a complex mixture of more than 4,000 chemical compounds that are generated from smoking or burning tobacco products.

The British anti-smoking group ASH (Action on Smoking and Health (news - web sites)) said the Australian findings provide more evidence for other countries to ban smoking in public places.

"It adds ammunition to what is already established -- that environmental tobacco smoke is a major source of air pollution and has a major health impact on people," said Amanda Sandford, a spokeswoman for ASH.

"It is something we have been arguing for a long time," she added in an interview.

New York has already introduced a smoking ban and other European countries are considering similar measures. ASH called for legislation to prevent smoking in the workplace and in enclosed public places.

The Australian scientists measured atmospheric nicotine in 17 social and gaming clubs in and around Sydney. They found levels varied but, on average, if a person moved from a smoking to a non-smoking area it would reduce the amount of nicotine inhaled by about 53 percent.

In a separate study in the magazine, scientists in the United States said smoking outdoors reduces toddlers' exposure to tobacco smoke but it does not completely protect them because environmental smoke lingers in dust and on household surfaces.

"To our knowledge, this is the first study to document that surfaces, dust and air are contaminated in homes of smokers with infants," said Dr Georg (correct) Matt of San Diego State University in California.

The scientists compared amounts of environmental tobacco smoke (ETS) in 49 homes with children between one and two years old. Non-smokers lived in 15 of the houses and the remainder were occupied either by people who smoked indoors or those who tried to protect their children by smoking outside.

After taking samples of dust, indoor air and household surfaces, Matt and his team found levels of ETS were five to seven times higher in the homes of smokers to tried to protect their children than in houses occupied by non-smokers and three to eight times higher if the parents smoked indoors.

They said the findings were worrying for young children who spend much of their time indoors and are often close to contaminated surfaces such as carpets, floors and table tops.

Back to the Top


'Good' Carbs Cut Heart Disease Risk

By Steven Reinberg
HealthDay Reporter
HealthDayNews
Monday, February 23, 2004

MONDAY, Feb. 23 (HealthDayNews) -- While the debate rages on over low- and no-carbohydrate diets, a new study reiterates that a diet high in whole grains as well as fruits and vegetables significantly reduces the risk of heart disease.

"There is a lot of controversy right now about how much carbohydrate we should have in our diet verses fat and protein," says lead author Dr. Mark A. Pereira, an assistant professor of epidemiology at the University of Minnesota.

But this study, he says, reinforces the current dietary guidelines that suggest the base of your diet should be fiber-rich fruit, vegetables and grains.

Pereira and his colleagues collected data on 91,058 men and 245,186 women who participated in 10 studies in the United States and Europe. Each study looked at the foods the participants ate, and all studies measured the amount of fiber in the participants' diets.

During six to 10 years of follow-up, 5,249 people were diagnosed with heart disease and 2,011 participants died from it, the study says.

For each 10 grams of fiber consumed a day, the risk of heart disease was reduced by 14 percent, Pereira says. They also found a 27 percent decrease in the risk of dying from heart disease. The results, which appear in the Feb. 23 issue of the Archives of Internal Medicine (news - web sites), apply to both men and women.

The association between fiber and death from heart disease was particularly strong, the study says. For every 10 grams of cereal fiber consumed a day, the risk for death from heart disease was lowered by 25 percent. For every 10 grams of fruit fiber consumer daily, the risk dropped 30 percent.

However, the researchers did not find a link between vegetable fiber and reduced risk of heart disease. "We are not sure why that is," Pereira says.

The researchers determined the findings were independent of other factors that reduce the risk for heart disease, such as not smoking, exercising and weight control, he says.

"If you are concerned about your risk for heart disease, one of the key features of your diet should be plant-based foods," Pereira says. "In order to include 25 to 30 grams of fiber per day, your diet has to be primarily high-quality carbohydrates."

The benefits from grain come from whole grains -- not from highly processed grains, such as those found in white bread or white rice, he adds.

"We are not just talking about carbohydrate in general," Pereira says. "The key is to look at the quality of the carbohydrate. You can eat a very high-carbohydrate diet at fast-food restaurants, for example, but get almost no fiber, only lots of sugar and starch."

Dr. David L. Katz, director of the Yale Prevention Research Center at Yale University and author of The Way To Eat, says that "at another time, this might be a 'me-too' study, the term we somewhat disparagingly apply to studies that confirm what we already know."

But this is not any other time, Katz says: "It is the age of carbohydrate restriction. And in most instances, rapid weight loss is pursued on diets that toss out whole grains and fruits along with simple sugar and refined starch."

"Reducing intake of whole grains and fresh fruit is the last thing our population should be doing," he says. "We should not be cutting carbs wholesale, but rather cultivating health-promoting dietary patterns that prioritize wholesome carbohydrate foods but restrict highly processed carbohydrate foods."

"A diet rich in whole grains, fruits and vegetables, and otherwise moderate and balanced, is the tried-and-true formula for a better, healthier, longer life," Katz says.

More information

To learn more about healthy eating, check out offerings from the U.S. Department of Agriculture. For more on heart disease, visit the American Heart Association.

Back to the Top


That Candy Bar Tastes Sweeter When You're Hungry

By Alison McCook
Reuters Health
Monday, February 23, 2004

NEW YORK (Reuters Health) - Skipping a meal or two makes you more sensitive to the taste of your next sweet or salty snack, new research shows.

After a group of people went for about 15 hours without eating, they became better able to taste the miniscule amounts of sweet or salty flavors added to solutions, compared to when they tasted the same solutions on a full stomach.

In contrast, hunger had no influence on participants' abilities to detect bitter tastes, the report indicates.

"We have discovered that hunger increases sensitivity of taste to sweet and salty substances but it does not affect taste sensitivity to bitter substances," study author Dr. Yuriy Zverev told Reuters Health.

Zverev added that hungry people's taste buds may respond differently to salt, sweet and bitter because those tastes communicate different things about our food. Sweet and salty tastes are often signs that a particular food is edible, he explained, so when we are hungry, our bodies become more sensitive to what foods can fill our stomachs.

Once we are full, however, it is less important for us to be tuned into food, and we may consequently lose our sensitivity to the taste cues of what makes something edible. As he put it, "Biological significance of substances of nutritional value declines after a meal."

In contrast, a bitter tastes signals that the food is "not suitable for consumption and should be rejected," Zverev noted, and this is an important message to heed, regardless of whether or not we are hungry.

During the study, Zverev, who is based at the University of Malawi, asked 16 non-obese men to taste a number of substances that contained different concentrations of sweet, salty and bitter flavors. He measured the least amount of flavor needed for participants to correctly identify the taste when they were not hungry, and compared that to least flavored solution they could taste when hungry.

During periods of hunger, people could taste the sweet and salty flavors added to solutions that they rated as tasteless when well-fed, Zverev reports in the journal BMC Neuroscience.

Although the bodily processes that enable tasters to change their sensitivity to flavors when hungry are not clear, Zverev suggested that periods of hunger may result in changes in the taste buds themselves or the regions of the brain that process taste.

Source: BMC Neuroscience 2004.

Back to the Top


Healthy Heart Habits May Keep 'Mini Strokes' at Bay

By Kathleen Doheny
HealthDay Reporter
HealthDayNews
Monday, February 23, 2004

MONDAY, Feb. 23 (HealthDayNews) -- Take care of your heart by exercising regularly and eating healthfully and you may also keep your brain young as you age.

That's the conclusion of a new study in which researchers found brain damage caused by "mini-strokes" that are thought to be related to the aging process occur more extensively in people with common heart health risk factors, such as high blood pressure or high cholesterol.

"We didn't do an intervention study," says study author Dr. Ian Cook, an associate professor of psychiatry at the UCLA Neuropsychiatric Institute in Los Angeles. It appears in the March issue of the American Journal of Geriatric Psychiatry.

"We watched what happened [to the 29 subjects, who were 60 and older and healthy]," he says. "We found people who at the start of the study had higher risk factors [for heart disease] had more adverse changes in the brain [over time]."

However, a Harvard University professor calls the study's conclusion premature, citing the small number of patients involved in the research.

Cook concedes the study is small. But he says it is the first one to use precise measurements of the volume of brain damage caused by "mini-strokes," to evaluate the amount of subclinical structural brain disease, or SSBD. SSBD is a term used to encompass a range of brain damage that commonly occurs to people starting in middle age, and is often dismissed as normal aging.

In previous research, Cook's team had found that large amounts of SSBD damage are common in patients with dementia.

For the new research, Cook and his colleagues performed structural magnetic resonance imaging (MRIs) on all 29 subjects at the start of the study, and then administered follow-up MRIs two to six years later. The researchers then used computer-assisted analysis to measure increases in the volume of four types of SSBD -- cortical atrophy; central atrophy; deep white-matter hyperintensities; and periventricular hyperintensities.

Most of the study participants showed increased SSBD volume in the follow-up scans. And Cook found the amount of change in the white matter tissue was directly related to heart risk factors, such as high blood pressure or high cholesterol.

While some researchers had suspected that heart risk could contribute to greater damage from "mini-strokes", the new study offers more objective evidence, Cook says. "The new part is that rather than just rely on a subjective feel for how bad things are getting, we have real numbers," he says.

But Dr. Tobias Kurth, an instructor of medicine at Harvard Medical School (news - web sites), takes issue with Cook's conclusions. "I would not conclude from this paper that if you have cardiovascular risk factors you are at risk for observing these changes," he says. "It's a study of 29 subjects, so that highlights the biggest problem. It's a limited number of people. However, it's a very carefully conducted study."

While the overall conclusion may prove to be valid, Kurth says, "it's not a valid conclusion from this paper." He calls for more research on the subject.

While Cook acknowledges the current study sample was small, he stands by his conclusion.

"Within the limits of this small sample, it does appear that taking good care of your heart health will also result in good health for your brain," Cook says. "With that [care], probably you will have less problems with memory and other things that are thought to be common with aging but need not be."

More information

For more information on a heart healthy lifestyle, visit the American Heart Association. The heart association also offers information on strokes and "mini strokes".

Back to the Top


Interferon Protects Against SARS Virus, in Monkeys

Reuters Health
Monday, February 23, 2004

NEW YORK (Reuters Health) - Early treatment with a long-acting form of interferon, called pegylated interferon-alpha, seems to reduce lung damage caused by the virus that produces SARS (news - web sites), i.e., severe acute respiratory syndrome -- at least in macaque

The results suggest that preventive or early post-exposure treatment with interferon may protect health care workers and others exposed to the virus, Dr. Albert D. M. E. Osterhaus and colleagues note in an article in Nature Medicine.

Osterhaus, at Erasmus Medical Center in Rotterdam, Netherlands, and his team injected macaques with the SARS virus. Treatment with pegylated interferon begun three days before infection substantially reduced virus levels in the lungs four days after infection. The extent and severity of lung damage was reduced by 80 percent.

Although less effective than preventive use, interferon administered at one and three days after exposure still reduced lung damage to some extent, compared with that seen in untreated infected animals.

The authors theorize that the reduced level of protection was probably because therapy was started too close to the peak of viral infection in the lungs, which occurs at two days after exposure in macaques.

However, peak SARS virus infection in humans does not occur until about 16 days post-exposure. Therefore, the team theorizes that "the time interval during which effective postexposure treatment with pegylated interferon-alpha can be initiated may be longer in humans than in experimentally infected macaques."

They conclude that clinical studies with pegylated IFN-alpha are warranted if SARS re-emerges in humans.

Source: Nature Medicine, March 2004.

Back to the Top


New Proof That Early Detection Aids Breast Cancer Fight

By Serena Gordon
HealthDay Reporter
HealthDayNews
Monday, February 23, 2004

MONDAY, Feb. 23 (HealthDayNews) -- New research shows breast cancer screening can save lives; in some cases, up to 20 years later.

Two studies, appearing in the Feb. 23 online edition of Cancer, found that when breast cancer tumors are detected early, women have a better chance of survival.

One study followed women with breast cancer for 20 years to evaluate if the stage of the cancer at the time of diagnosis made any difference up to two decades later. The other study tracked the introduction of a mass screening program and found women with breast cancer detected at screening tended to have a better prognosis than women whose cancers were detected between screenings.

Nearly 216,000 women will be diagnosed with breast cancer in the United States this year, and more than 40,000 will die from the disease, according to the American Cancer Society (news - web sites). The society recommends that every woman over 40 have an annual mammogram to check for breast cancer.

"Our study's results show that the size and node status of a tumor continue to influence survival for many years after diagnosis," says Jane Warwick, a research fellow at Cancer Research UK in London and author of the first study. "This suggests that early detection is still conferring a benefit many years later."

Warwick and her colleagues examined more than 20 years of data from Swedish women, aged 40 to 74, diagnosed with breast cancer. The researchers looked at the effect that tumor size, tumor grade and lymph node involvement had on long-term survival. As time progressed, the researchers found the effects from these factors diminished, but did not disappear.

"The influence of these tumor attributes on survival was smaller in later years, but still present, contrary to the widespread belief that the tumor attributes at diagnosis no longer affect survival after 10 years or so," Warwick says.

"The classic predictors of prognosis are still good predictors 20 years down the line," says Dr. Jay Brooks, chief of hematology and oncology at the Ochsner Clinic Foundation Hospital in New Orleans.

Brooks says this information is important because it gives clinicians confirmation that they can continue to use tumor attributes when making treatment decisions five or 10 years after cancer diagnosis.

The other study followed the 1992 introduction of biannual breast cancer screening for women between the ages of 50 and 69 in one town in the Netherlands until 1999. The researchers also looked at women diagnosed with breast cancer between 1985 and 1992.

"With the introduction of the breast cancer screening program, much attention was paid to the expected increase in breast-conserving surgery and decrease in mortality rates," says study author Dr. Miranda Ernst, who was a surgical resident at St. Elisabeth Hospital in Tilburg, The Netherlands, at the time of the study.

During the 14-year study period, 1,400 women were diagnosed with breast cancer. Surprisingly, only 40 percent of the women had their cancer detected at screening, while nearly 30 percent were diagnosed between screenings.

The researchers didn't find any statistically significant change in the rate of breast-conserving surgery.

However, breast cancer screening still had a positive influence. According to Ernst, after the introduction of screening, women aged 50 to 69 had a better prognosis and smaller tumors than before screening was implemented.

Brooks says he was surprised by the large number of women who developed breast cancer between screenings in this study, and says it points to the need to be screened at a place that does a lot of breast cancer screenings.

"Mammograms should be done by people who do lots of them, because they're better at it," notes Brooks, who recommends getting your mammogram done at a center that does at least 200 mammograms a month.

More information

This article from the American Cancer Society (ACS) explains breast cancer in detail, and this article, also from the ACS, offers information on the early detection of breast cancer.

Back to the Top


Alternative Therapies Popular with Cancer Patients

By David Douglas
Reuters Health
Monday, February 23, 2004

NEW YORK (Reuters Health) - Insured cancer patients are quite likely to see a provider of complementary and alternative medicine, researchers report, but alternative medicine is not replacing conventional treatment.

Dr. William E. Lafferty of the University of Washington, Seattle, and colleagues note in the medical journal Cancer that insurance coverage of complementary therapy is increasing. In fact, Washington state requires that insurers cover visits to licensed alternative practitioners. However, little is known about usage by cancer patients.

To investigate, the researchers examined Washington state insurance claims data for the year 2000. From a total of 357,709 claimants, they identified 7915 with cancer.

Of this group, 7.1 percent had made a claim for naturopathy, acupuncture or massage and 11.6 percent had made a claim for chiropractic treatment.

"The use of naturopathic medicine was twice the level for patients with cancer compared to patients without cancer," Lafferty told Reuters Health.

"This use was greatest in patients receiving chemotherapy and in patients with metastatic illness. In fact, over 12 percent of women receiving chemotherapy saw a naturopathic physician during the year."

Overall, use of acupuncture was 1.4 times higher than that of claimants without cancer, but seeing chiropractors was slightly less common.

Alternative therapy added little to the overall cost of treatment, however. "The overall bills for alternative therapy were relatively small in comparison to the billed amount for conventional care, ranging from 1 to 2 percent of the total medical bills," Lafferty said

"Thus, alternative care is used as an adjunct to conventional care," he said. "Virtually no patients in the study received alternative care alone."

Source: Cancer, February 2004.

Back to the Top


Swollen Glands

HealthDayNews
Monday, February 23, 2004

(HealthDayNews) -- If your child has swollen glands, it could be a sign of an infection. Swollen glands are part of the body's defense system to prevent an infection from becoming more serious, according to The Children's Hospital of Philadelphia.

Your child should see the doctor if the swollen glands:

  • Are present for more than two weeks.
  • Are getting bigger or more numerous.
  • Are red, hot, tender, or discharging pus.
Back to the Top


Stroke, Heart Risk Not Raised by Migraine Drugs

Reuters Health
Monday, February 23, 2004

NEW YORK (Reuters Health) - So-called triptan drugs, such as Imitrex or Zomig, used for the treatment of migraine, do not increase the risk of stroke or heart attacks, investigators report.

There have been reports of strokes, heart attacks and irregular heart rhythms occurring after people have taken a triptan drug, Dr. Gillian C. Hall and colleagues explain in the medical journal Neurology.

To look into the matter, they examined data from the UK's General Practice Research database. The information included approximately 64,000 patients with a record of migraine between 1992 and 1999, and 77,000 similar individuals without migraine who were used for comparison.

A triptan was prescribed for 21.5 percent of migraine patients.

Hall, an independent researcher in Barnet, UK, and colleagues saw that there were fairly small increases in risk for stroke and heart disease in people with migraine compared with their migraine-free counterparts.

However, there were no significant differences between triptan-treated subjects and control subjects. The higher risk for stroke and heart attack mainly affected migraine patients who were not prescribed a triptan.

The researchers point out that patients with risk factors for heart disease or stroke were less likely to be prescribed a triptan. Therefore, they conclude, they cannot say triptans might not increase the risk for stroke or heart attack in migraine patients who already have risk factors for these conditions -- such as those with existing heart disease or uncontrolled high blood pressure.

Source: Neurology, February 24, 2004.

Back to the Top


Testicle Self-Examination

HealthDayNews
Monday, February 23, 2004

(HealthDayNews) -- Testicular tumors are among the more common cancers occurring in men under 40. Seton Hall University in New Jersey advises men to conduct regular self-examinations. Here's how:

  • Support the testicles in one hand and feel each with the other hand.
  • Gently roll each testicle between the thumb and the fingers. You'll feel a smooth tubular structure that covers the top, back and bottom of each testicle.
  • With your finger, delicately separate this tube from the testicle to examine the testicle itself.
  • Feel for any swelling or lumps.
  • If you detect anything unusual, see your doctor without delay.
Back to the Top


Eye Disease Could Be Detected Sooner

By Lauran Neergaard
AP Medical Writer
The Associated Press
Monday, February 23, 2004

WASHINGTON - Millions of middle-aged and older Americans unknowingly harbor one of three eye diseases that could blind them — diseases that could be detected in time to save at least some sight if they got regular eye exams.

Glaucoma, macular degeneration and diabetic retinopathy all sneak up on their victims, destroying vital eye cells before the person is aware there's anything wrong.

Risk increases with age. Indeed, the government predicts the number of people left blind or seriously visually impaired is likely to double in 30 years as the baby boom generation grays.

The elderly are most at risk of these diseases, but people in their 40s can get them, too.

Yet vision specialists say far too few people get regular comprehensive eye exams — not where you read the "E" on an eye chart, but where your eyes are dilated so the optometrist or ophthalmologist can spot any disease deep inside.

Now, the government has awarded the eye charity Prevent Blindness America a five-year grant to help fight age-related eye disease by funding free screenings for older people around the country. For locations, check http://www.preventblindness.org.

And a coalition of eye doctors and geriatric advocates has begun a campaign to teach people about who's at risk.

Eye exams aside, among the advice: Protect your eyes from sun; don't smoke, which damages eyes, too; and eat lots of vitamin-packed dark, leafy vegetables. Those steps may help prevent these diseases from ever forming, says Northwestern University ophthalmologist Dr. Susan Taub, who chairs the Better Vision Institute.

There are no national figures on how many people over 40 follow guidelines to get a comprehensive eye exam every year or two. Diabetics and others considered at high risk, such as those with affected relatives, are urged to get annual exams. Such exams cost about $125, and insurance seldom pays for middle-aged healthy people.

But some sobering statistics suggest skipping those exams costs vision. Glaucoma, for instance, affects more than 2.2 million Americans, half of whom are unaware they have it, according to the government. Up to a fifth of the nation's 13 million-plus type 2 diabetics already show signs of sight-stealing retinopathy at the time their diabetes is diagnosed, says the American Diabetes Association.

And while 1.7 million Americans have lost vision to advanced-stage macular degeneration, another 7.1 million are at very high risk because the disease has reached intermediate stages without symptoms, says the National Eye Institute.

Worse, a startling study of Medicare beneficiaries last year found that even people already diagnosed with these eye diseases skip exams: Over half had at least one 15-month gap between doctor visits.

Dr. Frank Weinstock, a geriatric ophthalmologist in Canton, Ohio, personally telephones diabetics and other high-risk patients who skip his exams.

"I may not be able to solve your problem, but if I don't see you, I don't stand a chance," he tells them. "I'm not trying to scare you, but you won't notice (vision loss) until it's too late."

The three diseases all blind differently:

  • Age-related macular degeneration, or AMD, steals vision from the center of the eye outward.

Age aside, people with light-colored eyes are most at risk, because the sun's damaging ultraviolet rays can penetrate the retina at the back of the eye more easily.

There are two types. In the "dry" form, light-sensitive cells in the macula, the center of the retina, gradually break down. The "wet" form is less common but causes more rapid damage, as blood vessels leak behind the retina.

Patients with intermediate-stage AMD can slow the damage by taking high doses of antioxidant vitamins plus the mineral zinc. Also, laser therapies can seal off the wet form's leakage; there is no treatment specifically for the dry form.

  • Glaucoma steals vision from the outside in, with gradual damage to the optic nerve that first destroys peripheral vision.

Here, for unknown reasons, people with darker eyes are most at risk, as are blacks and Hispanics, and diabetics.

Lost vision can't be restored but after diagnosis, eye drops or laser therapy almost always preserves remaining sight.

  • Diabetic retinopathy is a diabetes complication in which retinal blood vessels break, leak or become blocked, causing spotty vision. It can affect young people who have had diabetes from birth, but most diabetics are middle-aged or older and retinopathy risk increases with age. Lasers can seal off blood vessels about to harm vision, making close monitoring crucial.

Editor's Note: Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

Back to the Top

Sunday, February 22, 2004

Nations to Discuss Biotech Safety Rules

By Sean Yoong
S EAN YOONG
Associated Press Writer
The Associated Press
Saturday, February 21, 2004

KUALA LUMPUR, Malaysia - Government officials from more than 80 countries will meet in Malaysia to discuss guidelines for international trade of biotech goods such as genetically modified foods.

The Conference of Parties to the Cartagena Protocol on Biosafety, which starts Monday, will debate potential risks posed by new biotech products, as well as trade guidelines, including the labeling, transport and use of genetically modified organisms.

The five-day meeting is the first of its kind since the Cartagena Protocol, a U.N. multilateral biosafety accord, came into force last September.

"We're only at the beginning of trying to implement the protocol," said Philemon Yang, head of a panel organizing the meeting. "These are issues that humankind must deal with, so that we can use biotechnology in the best way for future generations."

The meeting comes as public debate grows about the safety of biotech goods — a key dispute between the United States and Europe.

Washington started action at the World Trade Organization (news - web sites) last August to get the European Union (news - web sites) to lift 6-year-old barriers on new genetically modified foods.

In a move toward easing their ban, EU governments are expected to implement strict labeling and traceability rules for products with genetically modified ingredients by April.

But the United States — which hasn't signed the Cartagena Protocol — is lobbying worldwide for loose or no labeling requirements, saying labeling violates international trade accords and is unnecessary.

A U.S. observer team is expected at the biosafety talks in Malaysia.

Environmentalists attending the conference have urged delegates to oppose the release of genetically modified organisms into the environment and to ensure that countries can reject the import of genetically modified products.

"There must be strong labeling standards for imports of GM commodities into countries so that consumers can choose to avoid GM foods," Greenpeace International said in a statement.

Planting of genetically engineered crops is increasing worldwide, and such crops are widely used in the United States. But many other countries have balked amid public fears about long-term environmental and health effects.

The Cartagena Protocol aims to protect the planet's diversity of life from biotechnology's possible threats by ensuring that countries are given sufficient information before agreeing to allow genetically modified organisms and products into their territories.

Back to the Top


Journal Regrets Vaccine-Autism Link Study

By Jane Wardell
Associated Press Writer
The Associated Press
Saturday, February 21, 2004

LONDON - A leading medical journal said Saturday it should not have published a controversial 1998 study that claimed a link between childhood vaccinations and autism.

The editor of the Lancet, Dr. Richard Horton, said Dr. Andrew Wakefield and a team of British scientists who conducted the study on the triple measles-mumps-rubella (MMR) vaccine didn't reveal that they were being paid by a legal aid service looking into whether families could sue over the immunizations.

Horton called it a "fatal conflict of interest."

Wakefield's study suggested that the MMR vaccine could put children at risk of autism — a developmental disorder often arising in the first few years of life — and inflammatory bowel disease.

The paper has since been discredited on scientific grounds, but some parents have clung to the findings and health officials say that vaccinations have fallen dangerously low since its publication.

Allegations to be published in The Sunday Times say Wakefield and his team at the Royal Free Hospital were being paid by the Legal Services Commission, a legal aid service which was considering whether families could sue over children believed damaged by the MMR injection.

"In my view, if we had known the conflict of interest Dr. Wakefield had in this work, I think that would have strongly affected the peer reviewers about the credibility of this work, and in my judgment it would have been rejected," Horton told the British Broadcasting Corp.

Wakefield defended his study in a statement to the editors of The Lancet.

"The clinical and pathological findings in these children stand as reported," he said. "My colleagues and I have acted at all times in the best medical interests of these children and will continue to do so."

The Legal Services Commission could not be reached for comment.

The allegations have led to calls for a public inquiry.

Health Secretary John Reid said the General Medical Council, the health industry's watchdog, plans to mount an investigation "as a matter of urgency."

Evan Harris, a lawmaker with the opposition Liberal Democrat party and a member of Parliament's science and technology committee, also called for an independent inquiry "given the importance attached to the work of the Royal Free Hospital group by the media in the MMR debate."

Back to the Top


Saturday, February 21, 2004

The Gender Differences of Heart Disease

By Amanda Gardner
HealthDay Reporter
HealthDayNews
Saturday, February 21, 2004

SATURDAY, Feb. 21 (HealthDayNews) -- For all the myriad differences between men and women, the gravest seems to be the divergence in how the genders experience heart problems -- specifically, heart attacks.

In women, heart attacks tend to occur later in life and are more severe.

"Women typically are around 10 years older when they have a heart attack, but they have more outside-of-the-hospital sudden cardiac death," says Jean C. McSweeney, a professor in the College of Nursing at the University of Arkansas for Medical Sciences.

"They are also more likely to die from the first heart attack and more likely to be disabled," she says.

Adds Dr. Nieca Goldberg, a cardiologist at Lenox Hill Hospital in New York City and spokeswoman for the American Heart Association (news - web sites): "There has been a misconception that women were immune to heart disease. Not only do women have heart attacks but they can be deadlier in women than in men."

"Younger women who have heart attacks have double the death rate compared to men the same age," says Goldberg, who is author of the book Women Are Not Small Men.

Such insights have led the American Heart Association to launch it's "Go Red For Women" campaign, designed to educate women about heart disease and how to reduce their risk. Heart disease is the No. 1 killer of American women, claiming nearly 500,000 lives each year.

One way to cut that risk: Know that warning signs of a heart attack can be very different in women than men.

In November, McSweeney published a study that identified several unusual early warning signs that appear to presage heart attacks in women.

The vast majority of the study participants (95 percent) reported experiencing new or different symptoms a month or so before their heart attack that went away after the attack. The most common symptoms were unusual fatigue (71 percent), sleep disturbances (48 percent), shortness of breath (42 percent), indigestion (39 percent) and anxiety (35 percent). About 44 percent of the women said the sleep disturbances were severe, while 42 percent described the fatigue as severe.

The most frequent acute symptoms were shortness of breath (58 percent), weakness (55 percent) and fatigue (43 percent).

Chest pain, long considered the classic heart attack symptom, was notably absent or was described differently by the women. Slightly less than 30 percent reported chest discomfort, but they described it as achiness, tightness or pressure, not pain. Forty-three percent reported no chest discomfort during the heart attack.

No one has yet to compare these findings to possible early symptoms in men. But since most of the previous research on heart attacks has been done on men, McSweeney says, "we assume the typical picture is more characteristic of men. This is the first time we have been able to get a typical picture of women."

What was particularly surprising was how early the signs appeared.

"We did not realize people were having these early warning symptoms as far out as they were having them. And that's very important for women, particularly because women are harder to diagnose than men," McSweeney says. "We think one of the reasons [for the difficulty in diagnosing] is that woman are having symptoms we haven't been looking for because they don't match the typical picture."

For women, stress testing is generally a better diagnostic tool than an electrocardiogram. Nuclear stress testing, which includes an imaging component, is even better, McSweeney says.

"Most of the diagnostic tests were developed with men and so, therefore, they're not quite as good as detecting diseases in women," she adds.

 

The bottom line is that doctors and patients alike need to be looking for different warning signs of heart attack in women.

"Traditionally, things uniquely female have not been emphasized," Goldberg says. "The only things uniquely discussed that were female were issues of breast or of the reproductive organs. After that, it was one size fits all."

McSweeney's study, published in Circulation, fits into a pattern of increased awareness on issues of female heart health.

"There is an increasing awareness and certainly the medical community is starting to embrace it by doing more investigation into the area," Goldberg says.

McSweeney and her colleagues are now working on a follow-up study that focuses on black and Hispanic women. Ninety-three percent of the women in her first study were white. "We are trying to get equal numbers [of blacks and Hispanics as whites]," McSweeney says. "We have reason to suspect there are racial differences."

"Many people in cardiovascular research and in the clinical area realize that women's death rates, the actual numbers, are increasing and that we have to do more research in this area," McSweeney says. "I'm very happy to say that it looks like more and more people are beginning to pay attention. We have a lot further to go but at least we're beginning to catch up."

More information

For more on women and cardiovascular disease, visit the National Heart, Lung, and Blood Institute, the National Coalition for Women With Heart Disease and the American Heart Association. The heart association has more on the "Go Red For Women" campaign.

Back to the Top