The American Voice Institute of Public Policy presents

Personal Health

Joel P. Rutkowski, Ph. D., editor
October 25, 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 Rapid advances in medicine may cause information contained here to become outdated, invalid or subject to debate.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 June 12-18

 

  1. Early Intervention Helps Kids With Autism
  2. Smokers, Quit Early to Regain Health
  3. Tumor-Starving Protein Identified
  4. Many Doctors Practice With No Insurance
  5. Being Heavy Cuts Angioplasty Complications
  6. Eat Low-Carb While Increasing Fiber Intake
  7. Waiting Too Long to Have a Baby May Not Be Wise
  8. GAO: Narcotics Easy to Buy on Internet
  9. Study Finds Many Kids Deficient in Vitamin D
  10. High School Smoking Rate Drops, CDC Says
  11. Better Nutrition Could Save Millions of Kids-Study
  12. Exercise, Fish Oil Keep Arteries Clear
  13. New Method Predicts Speed of Biological Clock
  14. Teen Dieting May Lead to Adult Obesity
  15. South Beach Diet Attracting Vegetarians
  16. Liposuction Cuts Fat But Not Heart, Blood Pressure Risks
  17. Study: Leg Blood Clots Recur More in Men
  18. Childhood Shots Not Tied to Allergic Diseases
  19. Feds Find No Decline in Obesity Rates
  20. Mouth Rinse May Work Just as Well as Flossing
  21. Study: MS Patients Can Be Helped by Yoga
  22. Being Downsized May Increase Stroke Risk
  23. Elderly Suicides Linked to Illnesses
  24. Physician, Slim Thyself
  25. Study Offers Best Alcohol Interventions in College
  26. Calcium Seems to Protect Against Colorectal Cancer
  27. Study Shows How Lean Teen-Agers Stay That Way
  28. Inflammatory Enzymes Linked to Cancer
  29. Feds Find No Decline in Obesity Rates
  30. Genetic Makeup May Reduce Drug Benefit, Study Says
  31. Eye Drops Can Delay Glaucoma in Blacks
  32. Fitness Boosts Removal of 'Bad' Cholesterol
  33. Women More Likely to Die From Aortic Dissection
  34. Study: Cholesterol-Lowering Drugs Cut Glaucoma Risk
  35. Blacks Urged to Get Checked for Kidney Disease
  36. Teens Suffering From Rebound Headache
  37. Exercise Doesn't Help Some With Heart Woes
  38. Study Finds Fruit Helps Ward Off Vision Problems
  39. Here's a New Way to Reduce Cholesterol
  40. Doctors Say They Must Model Healthy Diet
  41. Being Bilingual Could Protect Your Brain
  42. Act Fast on Chest Pain to Preserve Heart, Experts Say
  43. Abdominal Fat Predicts High Blood Pressure
  44. Atkins-Weary Baker Pitches 'Da Vinci Diet'
  45. High-Fiber Cereal Cuts Excess Insulin Production
  46. Bush Rejects Calls on Stem-Cell Research
  47. Yet More Evidence Echinacea Does Not Fight Colds
  48. Parents Flocking to Baby Fitness Classes
  49. Device May Reduce Mastectomy for Breast Cancer
  50. Trim Down to Fight Prostate Cancer
  51. New Treatment Promising in Type 2 Diabetes
  52. Race Alone Shouldn't Decide Blood Pressure Therapy
  53. Breast Cancer Factors Similar for Blacks and Whites
  54. Vitamin C Rich Diet May Cut Arthritis Risk

 

 

Friday, June 18, 2004

 

Early Intervention Helps Kids With Autism

 

HealthDayNews

Friday, June 18, 2004

FRIDAY, June 18 (HealthDayNews) -- Early intervention reduces the impact of autism, says a University of Michigan expert on the disorder.

Children encouraged to speak at an early age can make real progress against the condition, said Catherine Lord, director of the university's Autism and Communication and Disorders Center, which has been conducting a longitudinal study of children with autistic spectrum disorders (ASD).

"One-third make incredible progress, with almost all children making real gains, even if they continue to have significant difficulties. About 5 percent of the children we have followed do not have symptoms of autism at age 9," Lord said in a prepared statement.

The study began when the children were 2 years old, continuing on as they grew. Most of the study participants are now in their teens.

Lord said that children in the study who had developed some simple speech skills prior to the first time they were evaluated at age 2 were far more likely to overcome their autism disorder.

The study has also revealed that, contrary to the popular belief that half of autistic children will never speak, just 14 percent of autistic children are unable to talk by age 9, and nearly 40 percent are able to speak fluently.

Lord said that another 10 percent of the children in the study are doing well, but still have some mild social difficulties and or repetitive behaviors or interests. Another 10 percent clearly have behaviors associated with autism but are able to compensate enough to spend much of their time in mainstream activities and classes.

The remaining children do improve but continue to have ASD-associated behaviors and difficulties, Lord said.

More information

Learn more about the disorder from the Autism Society of America.

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Smokers, Quit Early to Regain Health

 

By Alison McCook

Reuters Health

Friday, June 18, 2004

NEW YORK (Reuters Health) - People who quit smoking before the age of 35 can eventually live as long and healthy lives as people who never smoked, a new study shows.

"If you quit by age 35, you avoid nearly all of the harm smoking has on lifespan and quality of life," study author Dr. Donald H. Taylor, Jr., told Reuters Health.

However, it takes time to regain that lost health, the report notes; only people who had quit at least 15 years before the study began lived as many years in good health as never-smokers.

Taylor also cautioned that people should not believe that it's okay to smoke until you are 35. "The problem is that once you start (smoking), it is hard to quit," he said.

In the report, Taylor and his co-author Dr. Truls Ostbye, both at Duke University in North Carolina, said that many people focus on how smoking can kill, but less attention is paid to how smoking can affect your quality of life, and cause you to live fewer years in good health.

To investigate, Taylor and Ostbye reviewed interviews collected from middle-aged and older people, in which they were asked about their health and smoking status. The more than 20,000 participants were then re-contacted over several years, to see if their health had changed.

Research has shown that the way people describe their health predicts their future health, so Taylor and Ostbye used participants' estimations of their health to predict how many more years they would live, and live in good health.

The investigators found that people who were smokers tended to lose more years of healthy life than non-smokers. However, people who had quit smoking at least 15 years before the first interview - between the ages of 35 and 45 --tended to live as many years in good health as people who had never smoked.

Smokers also appeared to live fewer years than non-smokers, regardless of their health status, the authors report in the journal Health Services Research.

Taylor explained that, in order to regain the health they had as non-smokers, people need to butt out for good before they develop health problems. "You can avoid most of the harm by quitting before having a negative health event," Taylor said. "You can't wait until you have a heart attack to quit and reap these benefits."

Taylor added that smokers may be more likely to quit, and people may be less likely to never start smoking, if they hear more messages about how the habit can hurt health.

"The message that smoking kills people is so common that it may not have much impact. Perhaps we need to begin to focus on the debilitating effects of smoking on quality of life," Taylor said.

Source: Health Services Research, June 2004.

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Tumor-Starving Protein Identified

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Friday, June 18, 2004

FRIDAY, June 18 (HealthDayNews) -- Researchers in Colorado say they have identified a protein that thwarts the growth of new blood vessels that feed and enlarge tumors.

The protein, called fibulin-5, occurs naturally in the body, but researchers say a slightly altered version proved even more effective in arresting blood vessel growth.

The protein works by choking off the nutrient and oxygen supply to tumors, preventing the cancer from growing and spreading to other parts of the body. Researchers believe it could one day be developed as a drug to treat cancer patients.

If further testing bears out its effectiveness, fibulin-5 may join an emerging class of drugs that inhibit angiogenesis, the sprouting of new blood vessels.

"If you can block angiogenesis, you can essentially starve a tumor," explained William P. Schiemann, assistant professor in the cell biology program at National Jewish Medical and Research in Denver and a co-author of the paper, which appears in the June issue of the journal DNA and Cell Biology.

Since the protein can be detected in blood serum and urine, it may also serve as a useful marker in diagnosing cancer status, said Emmanuel Hilaire, a technology transfer specialist at National Jewish.

If fibulin-5 is dropping, it might signal a tumor is preparing to grow or spread, he explained. "You should be able to detect that difference by developing a diagnostic kit."

Harvard University's Dr. Judah Folkman, whose pioneering research in angiogenesis has spawned a booming field of laboratory investigation, said the article is very important because of its many, rather immediate implications.

The study will likely garner great interest, Folkman believes, since it's the first to demonstrate the anti-angiogenic effects of fibulin-5.

"This paper announces a new direction in which many labs may want to follow up immediately," he asserted.

Fibulin-5, a member of a family of proteins that regulate tissue development and repair, interacts with endothelial cells, which are specialized cells that are capable of forming new blood vessels.

To spur new blood vessel growth, cancer cells release special molecules signaling angiogenesis to begin. One of them is called vascular endothelial growth factor (VEGF).

Schiemann and postdoctoral fellow Allan R. Albig wanted to know more about fibulin-5's function. "We approached it with the hypothesis that it's likely regulating some aspect of angiogenesis," Schiemann said.

In cell cultures, the authors showed fibulin-5 levels plummet when endothelial cells begin to form blood vessels. High levels of the protein, they discovered, could prevent new blood vessel growth by frustrating the ability of endothelial cells to move and proliferate.

The study showed that fibulin-5 inhibits blood vessel growth in two ways. For one, it tells the endothelial cells to pay no attention to the incoming pro-angiogenic factor VEGF. Simultaneously, it boosts levels of thrombospondin-1, a naturally occurring protein that can inhibit angiogenesis.

"It prevents acceleration and puts on the brakes," Folkman said. "It's unusual to see a single molecule do two things like that."

The fibulin-5 discovery also may have applications in clinical areas other than cancer. As an example, Folkman cites a 1999 mouse study led by Harvard's Dr. Karen Moulton, an instructor in surgery, showing that the angiogenesis inhibitor endostatin significantly reduced plaque buildup.

Since fibulin-5, like endostatin, is found in the walls of the arteries, "It raises the speculation of whether atherosclerotic plaques have a fibulin deficiency," Folkman said.

In February, the U.S. Food and Drug Administration (news - web sites) approved Avastin, a treatment for colorectal cancer and the first drug to choke tumor growth by preventing new blood vessels from forming.

But the scientific quest for the next angiogenesis inhibitor is in full throttle. In the United States, roughly 30 angiogenesis inhibitors are being tested and about 62 different trials are being conducted, Folkman said. Worldwide, at least 50 agents that block blood vessel growth are being tested, he said.

"I think it's important that in order to really develop effective therapies that you're going to have to come at these problems from more than one direction," Schiemann said. "I think you greatly increase your chances of success."

More information

The National Institutes of Health (news - web sites) can answer your questions about how angiogenesis works.

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Many Doctors Practice With No Insurance

By Jill Barton

Associated Press Writer

The Associated Press

Friday, June 18, 2004

WEST PALM BEACH, Fla. - Dr. Rene Loyola, a surgeon for 29 years, refuses to buy malpractice insurance because of the high cost of premiums. He has put just about everything he owns in his wife's name to protect it from potential lawsuits. The practice, called "going bare," is most rampant in Florida, where health officials say more than 3,000 of the state's 89,000 licensed physicians have dropped their coverage.

Doctors say their only other options were to leave the state, or leave the profession.

But critics, including trial lawyers and patient advocates, call the choice irresponsible, arguing that going bare does nothing to solve the insurance crisis or help legitimate victims of wrongdoing.

"You can't hide all of your assets and you can't hide all of your wages forever. One way or another, we'll find a way to represent these medical malpractice victims because they deserve it," said Alexander Clem, president of the Academy of Florida Trial Lawyers.

Doctors who practice without insurance insist that they sympathize with legitimate victims of malpractice, but they say skyrocketing awards from juries and frivolous claims have ruined the system for everyone.

"If I really injure somebody and do something wrong, I want them to be compensated for it," said Dr. Alan Routman, an orthopedic surgeon in Broward County who dropped his coverage. "But I don't want some crackpot jury to decide that I should lose everything I've worked for my whole life because of it."

A jury in one recent case awarded $63 million for a baby born with severe brain damage after a risky forceps delivery in Palm Beach County. The case ultimately was settled for less, and other such awards are often overturned on appeal. Even so, insurance companies say such cases are forcing them out of the malpractice insurance business. Several stopped writing malpractice policies in Florida in recent years, and others have had to obtain more insurance for themselves to help cover large jury awards and settlements.

As a result, rates are soaring to a point of crisis in at least 19 states, according to the American Medical Association. While the AMA cautions doctors against going bare because it creates risks for them and their patients, the group makes no clear recommendation against it.

Several states, such as Massachusetts, Pennsylvania and Colorado, require doctors to have insurance, and most hospitals, even in Florida, require a minimum level of liability coverage. Even doctors who are bare in Florida have to prove to the state that they have $250,000 in assets to cover any claim against them.

"Nobody would elect to practice without insurance if they could help it. It poses a risk to everyone and it just shows how desperate the situation is," said Dr. Donald J. Palmisano, president of the AMA.

Florida lawmakers tried to repair the malpractice system last year, but neither doctors nor lawyers liked their solution. Both sides now are pushing amendments they hope to ask voters to approve in November. Doctors want to limit attorneys' fees to rein in frivolous suits and prolonged court fights. Lawyers want to bar doctors from practicing if they've had three malpractice judgments against them, and give patients more access to records of doctors' mistakes.

Until lawmakers fix the soaring insurance rates and set limits on the awards patients and lawyers can reap, doctors say going bare is the only defense against a broken system.

For many, it makes more financial sense.

Routman's policy last year would have cost $94,835 for $250,000 worth of coverage, even though he's had no settlements or judgments against him in 18 years of private practice.

"It's ridiculous to pay that kind of money," he said. "If you had a $250,000 house and you have to pay $95,000 in windstorm insurance, you wouldn't pay it. You'd take your chances and hope a hurricane doesn't hit."

In comparison, Routman's brother, an ear, nose and throat specialist in Birmingham, Ala., has $5 million worth of coverage and pays $5,000 a year.

"That's what insurance is supposed to be," Routman said, coverage for "an outrageous amount of money, so that the patients who have been injured get something."

Other doctors, particularly those in high-risk surgical specialties and obstetrics, have no choice but to go bare. Loyola, a general and vascular surgeon, said he was essentially told by insurers that he is uninsurable.

To help defend themselves, doctors are limiting their practices. Some refuse to take emergency room patients because of the complications often involved in treating trauma patients. Others have stopped performing high-risk surgeries.

In Palm Beach County, so many neurosurgeons have stopped treating trauma patients that they have to be transported to neighboring Broward County for care. Similar shortages have been reported across the state.

While doctors blame the trial lawyers and frivolous lawsuits, they acknowledge patients will suffer the most if the system remains broken. Patients can choose to avoid seeing doctors without insurance. All doctors are required to post signs in their offices explaining their lack of coverage and, as an added measure, many ask patients to sign a form to make sure they understand what's at stake.

Patients who sue a doctor without insurance could receive little or no compensation, and they could meet only frustration when they try for a settlement.

Marc Singer of Singer Xenos Wealth Management has advised more than 1,000 doctors on going bare. He said he tells them to consult with a bankruptcy attorney instead of a defense attorney if a claim is made against them.

Then, settlement negotiations begin at zero and go up; rather than starting with an insurance company's deep pockets and working down to a lower figure.

"When a doctor has zero insurance and offers $50,000, all of a sudden, that settlement is acceptable," Singer said. "Lawyers stimulate a lot of litigation. Some of it is legitimate and a lot of it is not. They're either going to take the more modest settlements or they're not going to get anything."

Florida law protects many assets from legal judgments. Singer said doctors can protect their homes, retirement plans, annuities, life insurance and salaries. Anything more could be given to patients who win legal claims.

But many doctors believe going without insurance is a backward way to fix the problems.

"Doctors are going bare to try to avoid lawsuits and to try to protect their assets. They're not going bare with any idea of how to protect the patient," said Dr. Gordon Baskin, who specializes in gastroenterology and internal medicine.

He refuses to drop his insurance, which now costs $34,000 a year. A decade ago, he paid about half that amount for four times the coverage.

"The fact is doctors are human, and doctors make mistakes, and when that happens, how are you going to take care of your patient?" Baskin asked. "The only way is if you have the assets and the insurance company behind you."

On the Net:

Florida Agency for Health Care Administration:

http://www.fdhc.state.fl.us/index.shtml

American Medical Association: http://www.ama-assn.org/

Association of Trial Lawyers of America (news - web sites): http://www.atlanet.org/

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Being Heavy Cuts Angioplasty Complications

Reuters Health

Friday, June 18, 2004

NEW YORK (Reuters Health) - Innumerable studies have laid out the dire health consequences of obesity, but there's one situation where being overweight seems helpful: coronary angioplasty.

Analysis of data from the New York State Angioplasty Registry indicates that people who are moderately to severely obese are less likely than others to suffer major adverse events or to die after undergoing catheter-balloon procedures to open clogged coronary arteries.

At the Weill Cornell Medical College in New York, Dr. Robert M. Minutello and colleagues studied the impact of body mass index (BMI) -- a measure of weight in relation to height -- on in-hospital outcomes after angioplasty by reviewing data on more than 95,000 patients.

For the study, published in the American Journal of Cardiology, patients were classified according to BMI as being underweight, healthy weight, overweight, moderately obese, severely obese, or very severely obese.

The researchers report that a U-shaped relationship was found between body mass index and risk of major adverse coronary events. In-hospital deaths were higher among underweight and very severely obese patients than among the others.

Furthermore, underweight and severely obese patients were at greater risk for the combination of death, heart attack, or emergency surgery than patients with moderate or severe obesity.

Minutello's team suggests that the poorer outcome in underweight patients is not so surprising, but the reasons why overweight patients fare well is more puzzling. One possibility is that these patients may have larger blood vessels, making the procedure easier, but that is not proven.

All in all, the researchers call for "further studies to determine the factors responsible for the evidently protective effect of moderate and severe obesity."

Source: American Journal of Cardiology, May 15, 2004.

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Eat Low-Carb While Increasing Fiber Intake

HealthDayNews

Friday, June 18, 2004

FRIDAY, June 18 (HealthDayNews) -- Don't let a low-carb diet blind you to the benefits of good carbohydrates such as fiber.

A high-fiber diet may reduce your risk of a number of health problems, including diabetes, coronary artery disease, high cholesterol, obesity, and some gastrointestinal disorders, says an article in the June issue of the Mayo Clinic Women's HealthSource.

The article suggests the following ways for you to increase fiber in your diet:

More information

 

The Harvard School of Public Health has more about fiber.

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Thursday, June 17, 2004

 

Waiting Too Long to Have a Baby May Not Be Wise

 

By Alison McCook

Reuters Health

Thursday, June 17, 2004

NEW YORK (Reuters Health) - Women who delay having a child until their late 30s can't necessarily rely on artificial techniques to help them become pregnant, a new study shows. The author says that assisted reproductive technologies like in vitro fertilization cannot compensate fully for the loss of fertility that occurs with age.

Based on computer calculations, Dr. Henri Leridon found that if women postpone trying to conceive for the first time from age 30 to age 35, assisted reproductive technologies (ARTs) will make up for only half of the fertility they lose over the course of those 5 years.

And for women who decide to postpone conception from 35 to 40 years, ART will make up for less than 30 percent of her lost fertility, the investigator notes in the journal Human Reproduction.

The computer model shows that, among 100 women who decide to conceive at age 35, more than 80 will naturally become pregnant. Another 4 will likely conceive after 2 rounds of in vitro fertilization (IVF), and the rest will likely remain childless, Leridon told Reuters Health.

"The message to women is: up to about 35 years, if you want a child, be patient. Even if you do not succeed in one year, your chances of success are still substantial," Leridon said.

"Beyond that age, be impatient," he advised.

Leridon, who is based at the French National Institute of Health and Medical Research (INSERM) in Paris, explained that some of the decline in fertility can be compensated for using ART. "But ART cannot remove all effects of age and give to a woman aged 40 years the fertility of a 20-year-old," he noted.

To determine how well ART helps couples recover some of the fertility they lose with age, Leridon used a computer model that charted women's chances of conceiving naturally, which gradually declined as they aged.

Based on the model, Leridon found that three-quarters of women who try to conceive naturally for the first time at age 30 will become pregnant within one year. For women who wait until 35, 66 percent will conceive within one year, and for those who start at age 40 the success rate is only 44 percent.

If women failed to conceive after 2 years, the model predicted that their chances of conception using ART would also decline with age.

"Do not wait too long before consulting for infertility," Leridon warned, "because the effectiveness of medical techniques is also decreasing as you grow older."

Source: Human Reproduction, July 2004.

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GAO: Narcotics Easy to Buy on Internet

By Mark Sherman

Associated Press Writer

The Associated Press

Thursday, June 17, 2004

WASHINGTON - Narcotics are easily bought without a prescription from online U.S. pharmacies, say congressional investigators who sometimes found stricter standards from Internet outlets in Canada.

"It seems that the key thing here is having your credit card," Robert Cramer, a senior investigator with the General Accounting Office (news - web sites), said Thursday at a Senate Governmental Affairs subcommittee hearing on the risks of buying medications online.

Agency employees who posed as patients purchased the painkiller hydrocodone the generic version of Vicodin from eight Web sites in the United States. The employees were not required first to see a doctor or provide a prescription, Cramer said.

In addition, they paid three to 16 times what the painkiller costs at local pharmacies, suggesting that the Internet drug operations are catering to people who cannot get medications conventionally.

Investigators found widespread problems purchasing prescription medicines from many foreign countries. Some drugs were counterfeit; many arrived without instructions or patient warnings.

Opponents of legalizing prescription drug imports cite the potential danger from drugs purchased on the Internet as a reason for their opposition. The Food and Drug Administration (news - web sites) says it cannot guarantee the safety of the foreign products.

Former New York Mayor Rudolph Giuliani (news - web sites) said his research, funded by the pharmaceutical industry, shows that U.S. government inspectors look at only about 10 percent of packages containing pharmaceuticals that are sent from abroad. "It is pretty much right now a wide open system," Giuliani told senators.

Yet congressional investigators said they ran into few problems with medicines purchased from Canadian Web sites.

All 18 Canadian sites required consumers to supply a physician-written prescription before filling orders. That was the case for five of 29 U.S. pharmacies; no other foreign pharmacies did.

Sen. Carl Levin, D-Mich., who advocates drug imports from Canada and elsewhere, said the GAO's work led him to conclude "medicines purchased from Canada are as safe or safer than those purchased in the United States."

Several bills would strengthen federal regulation of domestic Internet pharmacies and inspections of pharmaceutical manufacturing plants abroad.

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Study Finds Many Kids Deficient in Vitamin D

By Amy Norton

Reuters Health

Thursday, June 17, 2004

NEW YORK (Reuters Health) - Vitamin D deficiency may be a common but unrecognized problem among U.S. adolescents, new study findings suggest.

Researchers found that among 11- to 18-year-olds living in Boston, nearly one-quarter were deficient in vitamin D, a nutrient that aids in calcium absorption and is vital for healthy bone development.

That so many adolescents were low on the vitamin is both surprising and "very concerning," according to lead study author Dr. Catherine M. Gordon of Children's Hospital Boston.

"The problem occurred at a much higher rate than we expected," she told Reuters Health, noting that "we shouldn't have vitamin D deficiency in this country."

That's because the problem is preventable with an adequate diet and time outdoors. The body naturally synthesizes vitamin D when the skin is exposed to the sun, and milk and certain other foods, including many breakfast cereals, are fortified with the vitamin.

But U.S. children increasingly fill up on soft drinks at the expense of milk, and spend more time in front of the TV or computer than outdoors.

Gordon pointed out that her study found that soft drink, juice and iced tea intake were related to a greater risk of vitamin D deficiency. On the other hand, adolescents who said they drank milk and ate cereal were less likely to be low on the vitamin.

The findings are published in the Archives of Pediatrics & Adolescent Medicine.

For the study, the researchers analyzed blood samples from 307 healthy adolescents who had routine physical exams between 2001 and 2003. They found that 24 percent of the children were vitamin D deficient, and nearly 5 percent were severely deficient.

African-American adolescents had the highest prevalence of vitamin D deficiency, with 36 percent affected. Sunlight, the researchers note, is less efficient at triggering vitamin D synthesis in darker skin.

Gordon and her colleagues did find lower rates of vitamin D deficiency in the summer and fall -- but even during these sun-filled months, 12 to 17 percent of adolescents were low on the vitamin.

To guard against the problem, children and teens should get regular outdoor activity and consume vitamin D-fortified foods, according to Gordon. She noted that for children who turn their noses up at milk, there are some juices available that contain added vitamin D.

Multivitamins are also a good option, she said, particularly for kids whose diets may be lacking in a number of nutrients.

The findings also pose the question of whether children and teens should be routinely screened for vitamin D deficiency, Gordon pointed out. As it stands, deficiency may be suspected in children with a history of bone fractures, but most kids will never be screened for vitamin D status.

The high rate of deficiency among healthy adolescents in this study suggests screening "is something we need to look at," Gordon said.

Source: Archives of Pediatrics & Adolescent Medicine, June 2004.

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High School Smoking Rate Drops, CDC Says

By Daniel Yee

Associated Press Writer

The Associated Press

Thursday, June 17, 2004

ATLANTA - Smoking among U.S. high school students has fallen to about one in five the lowest level in at least a generation in a drop-off the government attributes to anti-smoking campaigns and higher cigarette taxes.

The Centers for Disease Control and Prevention (news - web sites) reported Thursday that nearly 22 percent of high school students said they were smokers in 2003. That is down from more than 36 percent in 1997, and the lowest level since the CDC began keeping track in 1975.

The drop was so dramatic that for the first time in more than two decades, the percentage of high school smokers is lower than the percentage of adult smokers. That was seen as an especially encouraging sign by the government.

In fact, the CDC study found that anti-tobacco efforts have been successful across the board, from curbing the number of first-time smokers to reducing the ranks of the heaviest smokers.

"We are reaching all the youth. If we can stop youth from becoming addicted smokers, eventually we can stop this epidemic," said Terry Pechanek, associate director of science for the CDC's Office on Smoking and Health. "We're making the progress we've been working toward for the last 40 years."

Dr. John Banzhaf III, who helped mastermind lawsuits against the tobacco industry, said the study illustrates "probably the most dramatic progress which has been made in terms of any public health problem, at least in recent memory."

"The question would be whether we have the political will to continue to do it," said Banzhaf, executive director of Action on Smoking and Health (news - web sites) and professor of public interest law at George Washington University Law School.

The CDC said that anti-tobacco efforts such as TV ads and school campaigns have been highly successful. Some of the programs were funded by the $206 billion settlement that tobacco companies and states reached in 1998.

Another big reason fewer teenagers are lighting up is the cost of a pack of cigarettes, the CDC said. The agency said cigarette prices went up 90 percent from 1997 to 2003, mostly because of tax increases.

Students were classified as current smokers if they had lit up in the preceding 30 days.

The study found that the percentage of heavy smokers those who lit up 20 days or more per month fell to 9.7 percent from 16.8 percent in 1999.

Also, fewer students are trying cigarettes: A little more than 58 percent of students in 2003 said they had tried smoking, down from more than 70 percent in 1999.

Still, the government noted that other studies recently have warned that the rate of decline in student smoking may be slowing.

The CDC blamed that on several factors, including more depictions of smoking in movies and a near doubling of spending on tobacco advertising from cigarette makers ($5.7 billion in 1997 to $11.2 billion in 2001). Also, states are spending less money from the tobacco settlement on smoking prevention.

Trend-setting states that had well-funded programs and subsequent decreases in student smoking now have had those programs crippled by budget cuts, causing a rise in student smoking rates in those areas, said Matt Barry of the Campaign for Tobacco-Free Kids.

Philip Morris spokeswoman Jennifer Golisch said the nation's No. 1 cigarette maker is "very happy" about the study's results. "As a manufacturer of a product intended for adults, we believe we have a responsibility to help prevent kids from smoking," she said.

Golisch said Philip Morris does not place its cigarettes in movies or on TV, though some filmmakers or TV producers have used Philip Morris products without its permission. She also said the company is spending less on cigarette advertising, in part because of restrictions contained in the tobacco settlement.

On the Net:

CDC info: http://www.cdc.gov

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Better Nutrition Could Save Millions of Kids-Study

Reuters

Thursday, June 17, 2004

WASHINGTON (Reuters) - Malnutrition is to blame for more than half of all the deaths of children around the world -- including deaths caused by diarrhea, pneumonia, malaria and measles, researchers said on Thursday.

Poor nourishment leaves children underweight and weakened and vulnerable to infections that do not have to be fatal, the team at the World Health Organization (news - web sites) and Johns Hopkins University in Baltimore found.

They estimated that feeding all children worldwide an adequate diet would prevent about 1 million deaths a year from pneumonia, 800,000 from diarrhea, 500,000 from malaria, and 250,000 from measles.

"Malnutrition does not have to be severe to have a significant impact on child health and survival," said Laura Caulfield, an associate professor with the Bloomberg School's Center for Human Nutrition who led the study.

"Our analysis shows that even children who were small, but whose weight would not classify them as malnourished, were twice as likely to die as children in our reference group."

Her group analyzed the data from 10 studies of childhood deaths around the world, and used complex formulas to extrapolate the effect of weight on the likelihood of death.

They estimate that 52.5 percent of all deaths in young children were attributable to undernourishment, with nearly 45 percent of measles deaths and more than 60 percent of deaths from diarrhea associated with low weight and poor nutrition.

"These findings underscore the need to make the improvement of the nutritional status of children a priority," they wrote in their study, published in the American Journal of Clinical Nutrition (news - web sites).

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Exercise, Fish Oil Keep Arteries Clear

HealthDayNews

Thursday, June 17, 2004

THURSDAY, June 17 (HealthDayNews) -- A combination of prolonged exercise and fish oil can dramatically reduce levels of a fat that can cause hardening of the arteries, a leading cause of heart disease, researchers say.

The study found that people who do prolonged, aerobic exercise have muscle cells that are able to quickly break down and reduce levels of a fat called triglycerides. Taking a fish oil supplement can reduce triglyceride levels even more, according to researchers at the University of Missouri-Columbia.

"Fat in the bloodstream is a primary contributor to atherosclerosis, or partial blockage of the arteries," researcher Tom Thomas, professor of nutritional science at the university, said in a prepared statement.

"The results of this research demonstrate that it is very beneficial for active people to take fish oil if they're concerned about their triglyceride levels after eating a fatty meal," Thomas said.

He and his colleagues studied triglyceride levels in recreationally active men after they'd eaten high-fat meals.

One group ate a fatty meal after they exercised. A second group ate a high-fat meal after taking a four-gram fish oil supplement. A third group ate a high-fat meal after exercising and taking the fish oil supplement. A control group ate a high-fat meal only.

The study found a 38 percent decline in peak triglyceride levels in the men who took a fish oil supplement before they ate a high-fat meal. Peak triglyceride levels dropped 50 percent in the men who exercised and took a fish oil supplement before they ate a high-fat meal.

These findings may help scientists find ways to minimize the reliance on drugs in order to treat heart disease. The study will be published this summer in the journal Metabolism.

More information

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

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Wednesday, June 16, 2004

 

New Method Predicts Speed of Biological Clock

 

By Patricia Reaney

Reuters

Wednesday, June 16, 2004

LONDON (Reuters) - Scientists have developed a method that aims to predict how fast a woman's biological clock is ticking and when she is likely to go through menopause.

By measuring the volume of ovaries with ultrasound, researchers in Scotland said Thursday that they can predict the reproductive age of a woman aged 25 to 51, or how many eggs she may has left, which could dramatically change fertility treatments.

"What we have done is to come up with a method that may allow us to predict for a woman what ovarian reserves she has and at what age she is likely to experience the menopause," said Dr Hamish Wallace, a pediatric oncologist and lecturer at the University of Edinburgh.

Women are born with an estimated 800,000 eggs but the number dwindles with age. At about 37, when there are about 25,000 eggs left, the decline speeds up and the ovaries shrink until most of the eggs are depleted and menopause occurs.

The age of menopause is generally around 50, plus or minus seven or eight years. Knowing a woman's reproductive lifespan will enable doctors to predict how long she will be fertile and whether she will have an early menopause.

Dr Thomas Kelsey, a computer expert at the University of St Andrews, said the main benefit of the research will be to improve fertility treatment and planning and to provide doctors with information about the likely success of such treatments.

"The ultrasound measurement is taken to work out the volume of the ovaries. If the ovaries are larger than average for her age, then she is likely to have a later menopause and if they are smaller she is likely to have an earlier one. Essentially we try to quantify by how much, by how many years," he said in an interview.

Wallace and Kelsey, who reported their research in the journal Human Reproduction, showed a strong relationship between ovarian volume and the number of egg cells.

"It is going to be useful for couples who have fertility problems because it is an easy way for the fertility clinics to work out essentially whether it is worth doing IVF (in-vitro fertilization) or whatever treatment," Kelsey added.

If a woman has many more fertile years it may be better to try to conceive naturally or to space out fertility treatments or, if the egg supply is low, not to waste time.

But the method will not work for women taking oral contraception because it decreases the size of the ovaries or for women suffering from polycystic ovarian syndrome, a disorder that causes infertility.

The researchers are conducting clinical studies on women who have been treated for cancer, which can impair fertility, to provide information on their fertility.

They are also planning long-term studies to follow young women until they reach the menopause.

"It opens the door to the possibility of screening women for early ovarian aging. These women may be at increased risk to their general health from the effects of having an early menopause," Wallace added in a statement.

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Teen Dieting May Lead to Adult Obesity

 

By Randy Dotinga
HealthDay Reporter

HealthDayNews

Wednesday, June 16, 2004

WEDNESDAY, June 16 (HealthDayNews) -- New research suggests that the dieting habits of teenage girls offer a crystal ball into their futures. The news isn't good: Those who try the hardest to lose weight as adolescents are most likely to become obese adults.

The reason for the link isn't entirely clear. But it's possible that early dieting may disrupt the metabolism of teen girls, setting them up for obesity later in life, said study co-author Joanne Ikeda, co-director of the University of California, Berkeley's Center for Weight & Health.

"There's a subset of the population who are vulnerable to weight cycling, to yo-yo dieting," said Ikeda, a registered dietician. "I'm not saying every person who diets has a risk of weight 300, 400 or 500 pounds. But we really don't know how to identify that subset of the population that is at risk of gaining tremendous amounts of weight."

Ikeda and her colleagues surveyed 149 obese women from 2000 to 2001. All the participants had attended two annual conferences for large women, and all had a body mass index of 30 or higher, classifying them as having crossed from overweight to obese. Their mean BMI, a ratio of weight to height, was 46; some weighed more than 500 pounds.

The findings of the survey, which was co-sponsored by the National Association to Advance Fat Acceptance, appear in the June 2004 issue of the Journal of the American Dietetic Association.

The researchers found that women who started dieting before age 14 -- two thirds of all the women surveyed -- were more than twice as likely to have dieted more than 20 times compared to women who began dieting later.

More than eight in 10 of those who began dieting before age 14 said they were never able to maintain permanent weight loss.

It's not known how much the women weighed as teens, but Ikeda said most reported they weren't severely overweight at the time.

The study findings suggest that the obese women are no strangers to dieting, Ikeda said, rebutting the common perception that "fat people are lazy gluttons, that they're basically people who sit on the couch all the time and eat potato chips."

In fact, she said, "my experience has been that they have tried seriously repeated times to lose weight."

And what of the idea that dieting can lead to weight gain? There may be some truth to it, especially in diets that virtually starve people, said Julie Miller Jones, professor of nutrition and food science at the College of St. Catherine in Arden Hills, Minn.

"There is some thought that continuous dieting, particularly with rather severe caloric restriction, forces the metabolism to be more efficient -- to lose less energy as heat and capture more for fueling the body. And the net result is that it is harder to lose weight and keep it off," Jones said.

The problem, she added, is that fad diets often focus on quick weight loss, which requires great reductions in calories, instead of "the rather unpopular way to lose weight -- very slowly." Ideally, people shouldn't lose more than a pound of weight a week, she said.

Both Ikeda and Jones said teens who decide to diet must do so carefully and with an eye toward proper nutrition. In some cases, a diet may not be necessary at all.

"Rather than putting an adolescent on a diet, I'd like to sit down and talk about what they're eating and how they're spending their time," Ikeda said. "Forget about the diet business."

More information

To learn more about proper weight loss, visit the National Women's Health Information Center.

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South Beach Diet Attracting Vegetarians

 

By Coralie Carlson

Associated Press Writer

The Associated Press

Wednesday, June 16, 2004

MIAMI BEACH, Fla. - The South Beach Diet is known for producing svelte bikini-clad bodies on its namesake sands, but now the diet's promise to melt away belly fat is drawing an unlikely group into the low-carb craze: vegetarians.

For years low-carb and vegetarian diets have been on opposite ends of the eating spectrum when an Atkins dieter orders a bunless burger, a vegetarian orders a burgerless bun.

But Dr. Arthur Agatston, a Miami Beach cardiologist who created the South Beach Diet, said he developed a vegetarian version of his plan long before it became a best-selling book and diet to the stars.

Now about 4,000 vegetarians use his diet's Web site, which offers meatless meal plans and recipes. Vegetarian Times magazine featured the diet in its January edition. And vegetarians inundate Agatston with calls when he appears on radio and talk shows.

"I have been surprised that so many vegetarians have called," he said.

He isn't the only one.

"I get, 'What do you mean? Isn't that low-carb? How do you do low-carb and be a vegetarian?'" said Deborah Pavek, a 42-year-old vegetarian in Salt Lake City who lost 13 pounds after nearly two months on the diet.

David Patlak, a 6-foot-5 retired Coast Guard officer, said he has kept off 50 pounds on Agatston's plan. The Floridian lives mostly a vegetarian lifestyle but can't help indulging occasionally on South Beach's famous stone crabs.

A family history of obesity and a weakness for sugar had contributed to his previous weight of 300 pounds.

"We were just eating sugar," he said of him and his wife, Maryanne. "Whether it was in root vegetables, whether it was in vegan chocolate, or it was in vegan desserts."

Part of the allure of the South Beach Diet is that it allows more carbs followers call it modified-carb, not low-carb than some other diets.

"I haven't done Atkins because I don't eat meat and there's no way I could eat all that tofu," said Jann Marks, 45, of the Chicago suburb of Darien. But she's lost 15 pounds on the South Beach Diet and is "not eating a ton of tofu."

So what does a South Beach vegetarian eat?

Lots of vegetables, beans, legumes and soy products. Fruit and whole-grain foods like whole-wheat pasta and old-fashioned oatmeal are allowed in moderation in the second and third phases of the diet.

If the vegetarian eats eggs and dairy products, those are allowed too as long as dairy is low-fat.

The first phase of the three-phase diet is the most restrictive, cutting out all fruit, bread, pasta, rice, potatoes and baked goods. It lasts for two weeks and promises eight to 13 pounds of weight loss.

Vegetarians might not see a dramatic weight loss in the first phase, said South Beach dietitian Marie Almon, because they are eating more carbohydrates than meat eaters.

In the next two phases, more fruit and other carbs are reintroduced.

Dawn Jackson, a dietitian and spokeswoman for the American Dietetic Association, said the South Beach Diet is generally healthy even for vegetarians because it helps people make better food choices.

But she suggests most vegetarians could just "take their current diet and just make modifications to it."

Vegetarians might be turning toward the popular diet because, like other Americans, many are getting fatter.

"It is more in the era of processed carbs that people say they're a vegetarian and they're still overweight," Agatston said.

"Ice cream is vegetarian," notes Lynne Forti, 41, of Middleboro, Mass., who dropped 10 pounds in two months on the South Beach Diet. "There's a lot of things that are vegetarian that aren't necessarily good for you."

The 48-year-old Patlak says he's replaced root vegetables with green leafy ones and the vegan deserts with a homemade yogurt-based pudding.

He's gained so much confidence and motivation from the weight loss he's made other changes in his life including running for Congress.

On the Net:

South Beach Diet: http://www.southbeachdiet.com

American Dietetic Association: http://www.eatright.org

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Liposuction Cuts Fat But Not Heart, Blood Pressure Risks

 

By Gene Emery

Reuters

Wednesday, June 16, 2004

BOSTON (Reuters) - Liposuction may let doctors extract body fat, but it doesn't trim the risk of heart disease or diabetes the same way losing weight would, researchers at Washington University School of Medicine in St. Louis reported.

Although volunteers lost 12 percent of their body weight -- most of it fat tissue -- their blood pressure, insulin levels, cholesterol levels and other risk factors for heart and blood sugar problems remained unchanged.

"They're still obese. But had they lost that same amount of weight by dieting, they would have exhibited considerable improvements in their cardiovascular risk factors," Samuel Klein, director of the university's Center for Human Nutrition, told Reuters.

The finding means liposuction is no substitute for weight loss produced by diet and exercise, he said.

Liposuction is performed on nearly 400,000 people in the United States each year, making it the most common cosmetic operation in the country.

Because the risk of heart disease and diabetes is tied to the amount of body fat a person carries, some doctors had suggested that liposuction might reduce those risks.

But the new study in Thursday's New England of Medicine has dashed those hopes.

It "provides useful objective evidence that even large-volume liposuction has little effect on insulin sensitivity or cardiovascular risk factors," said David Kelley of the University of Pittsburgh Medical Center, in a Journal editorial.

Although liposuction reduces the number of fat cells in the body, it doesn't reduce the plumpness of the remaining cells. Klein said it now appears that the size of the fat cells may be more important than previously recognized.

"It may be necessary to shrink fat cells and reduce fat content in other tissues," he said.

"It is striking that the amount of fat loss achieved by liposuction in our diabetic and nondiabetic subjects did not improve any of these metabolic outcomes," such as reducing blood pressure, the researchers wrote.

The average weight among the eight volunteers with no diabetes went from 220 pounds down to 206 pounds and they lost nearly 6 inches off their 44-inch waistline. For the seven patients with diabetes, about 17 pounds of fat tissue and 5 inches was removed from their waistlines, but they still had bellies averaging 43 inches.

Klein said the authors of earlier studies might have been misled into thinking the liposuction had broader health benefits because people who have the surgery often take other steps to further reduce their weight, steps that might cut the risk of heart disease and diabetes. It was that supplemental weight loss effort that probably produced the health benefits.

"This study is definitive," said Klein. "After liposuction, people tend to change their lifestyle. When we prevented that from happening, we showed there was no metabolic benefit for liposuction."

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Study: Leg Blood Clots Recur More in Men

 

The Associated Press

Wednesday, June 16, 2004

BOSTON - Dangerous blood clots in the legs recur far more often in men than in women, a study found.

The finding is something of a paradox: Men and women are known to run similar risks for having their first clot. It is unclear why men would have a higher risk of another clot.

In any case, the findings suggest that some women may be able to take anti-clotting drugs for a shorter amount of time after their first clot. The drugs can cause excessive bleeding.

The study, led by researchers at the Medical University of Vienna, was published in Thursday's New England Journal of Medicine (news - web sites). They looked at 826 patients for an average of three years after an initial episode of deep-vein thrombosis, as these blood clots are called.

Twenty percent of the men developed a second clot, compared with just 6 percent of the women. After adjusting for age and other factors, the risk of another episode was more than triple for men.

Deep-vein thrombosis occurs in up to two people in 1,000. The clots form mostly in the legs, but also occur in the arms or other areas. They cause pain and swelling and can kill if they break away and lodge in the lungs.

Deep-vein thrombosis can follow surgery, injuries, childbirth and lying or sitting still for an extended period, such as during a long airline flight.

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Childhood Shots Not Tied to Allergic Diseases

 

Reuters Health

Wednesday, June 16, 2004

NEW YORK (Reuters Health) - Allergic diseases have risen over the past few decades in developed countries, and some people have blamed this on the increase in mass immunizations that has occurred. However, that notion seems to be unfounded.

UK researchers have shown that routine childhood vaccinations are not associated with an increased risk of asthma or eczema.

Dr. Tricia M. McKeever at the University of Nottingham and colleagues examined data on a birth cohort of 29238 children who had been followed for up to 11 years.

As reported in the American Journal of Public Health, the researchers did find a certain association between overall population rates of diphtheria, polio, pertussis and tetanus (DPPT) immunization and measles, mumps and rubella (MMR) vaccination and the incidence of asthma and eczema.

However, this affected only "a minority of children who rarely seek care" from a general practitioner, meaning they were less likely than the average child to have been given routine vaccinations. So, if anything, this suggests the opposite conclusion, that lack of immunization is tied to greater odds of allergic disease.

Thus the investigators conclude that these and other findings indicate that "current vaccination practices do not have an adverse effect on the incidence of allergic diseases."

They comment that this important, "because a perception that vaccination is harmful may have an adverse impact of the effectiveness of immunization programs."

Source: American Journal of Public Health. June 2004.

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Feds Find No Decline in Obesity Rates

By Tara Burghart

Associated Press Writer

The Associated Press

Wednesday, June 16, 2004

CHICAGO - Despite the sounding of the alarm in recent years, the latest government figures show no decline in the U.S. obesity rate, with 31 percent of adults and 17 percent of youngsters seriously overweight.

The measurements, taken over two years starting in 2001, are about equal to the 1999-2000 figures. In late 2001, then-Surgeon General David Satcher warned about the dangers of obesity.

The latest estimates were based on body measurements of 4,390 adults and 4,258 children. The survey, conducted regularly since 1960, is considered more reliable than studies in which participants report their own girth because people consistently underestimate their weight.

The findings appear in Wednesday's Journal of the American Medical Association (news - web sites).

"The level of obese and overweight Americans remains at alarming levels," said Allison Hedley, a researcher at the Centers for Disease Control and Prevention (news - web sites) who led the study.

Before 1999, the results from the National Health and Nutrition Examination Survey were released in large chunks such as 1988-94. But because obesity has become such a national concern, the data are being released every two years.

The survey found that obesity rates in several categories between 1999-2000 and 2001-2002 rose slightly, but in a statistically insignificant way. Because the time span is small, it would be wrong to conclude that obesity is leveling off, Hedley said.

Obesity is defined as having a body-mass index of 30 or above. The index is a measure of weight relative to height.

Patrick O'Neil, director of the weight management center at the Medical University of South Carolina, said he was most bothered by the numbers of overweight children.

The study found that 31.5 percent of children ages 6 through 19 were overweight in 2001-02, and 16.5 percent were seriously overweight, or obese.

"We're producing a new generation that's even more vulnerable to obesity and all of its health consequences by virtue of the fact they're starting out more overweight than previous generations," O'Neil said.

On the Net:

JAMA: http://jama.ama-assn.org

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Mouth Rinse May Work Just as Well as Flossing

By Alison McCook

Reuters Health

Wednesday, June 16, 2004

NEW YORK (Reuters Health) - People who don't floss their teeth may get the same benefit from regularly rinsing their mouth with the antiseptic Listerine, according to recent study findings.

However, these results should not encourage people to abandon flossing, and, ideally, people should brush, floss and use Listerine, a study author told Reuters Health.

Rinsing with Listerine is "another way to improve oral health," said Christine Charles, director of oral care at Pfizer, which sells Listerine. "We definitely don't want people to toss the floss."

However, she noted that, realistically, most people do not floss. Indeed, in a recent survey of 300 dentists, 90 percent said that their patients do not floss every day, the recommended regimen to protect mouths from the plaque that can cause gum disease.

In one recent study, published in the Journal of the American Dental Association, Charles and her colleagues found that, among 326 people who brushed and either flossed or rinsed with Listerine, Listerine-users showed the same improvements in plaque and gum inflammation called gingivitis as flossers. All participants had mild to moderate gingivitis at the outset of the study.

In another, similarly designed study published in the American Journal of Dentistry, Charles and her team found that, among 301 participants, Listerine-users showed the same improvements in gingivitis as flossers, and an even greater reduction in plaque after 3 and 6 months of use.

In both studies, flossers and Listerine-users had healthier teeth than people who brushed and rinsed with an inactive solution.

In an interview, Charles said that Listerine contains essential oils that get between teeth and kill the germs that brushing does not reach. Listerine works best when it follows brushing and flossing, she said, which break up sheets of bacteria on teeth so that Listerine can penetrate and kill even more germs.

Ideally, people should keep their teeth clean by brushing regularly, flossing once per day and rinsing with Listerine twice daily, Charles said.

However, for people who don't floss and never will, recent studies suggest that Listerine may be a "fairly easily done, pleasant way of helping" keep teeth clean, Charles said.

In April, Pfizer received approval from the American Dental Association to publicize the fact that Listerine may work as well as dental floss to consumers, and plans to begin with television advertisements.

Source: Journal of the American Dental Association, March 2003.

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Study: MS Patients Can Be Helped by Yoga

 

The Associated Press

Wednesday, June 16, 2004  

PORTLAND, Ore. - People with multiple sclerosis can significantly reduce fatigue levels by doing just six months of yoga, according to a new study by Oregon scientists.

Fatigue can be a common, and potentially disabling, symptom of MS.

But researchers at Oregon Health & Science University found that yoga has no effect on alertness or cognitive function for M-S patients.

The findings are in the current issue of the journal Neurology.

The study examined 69 MS patients in three groups: one taking weekly lyengar yoga classes along with home practice, another taking a weekly exercise class using a stationary bicycle along with home exercise, and a third group placed in a waiting list to serve as a control.

Although the yoga and aerobic exercise programs produced no significant changes in alertness, attention or other measures of cognitive function in MS patients compared with the waiting-list groups, the study found there were improvements in two fatigue tests.

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Being Downsized May Increase Stroke Risk

 

By Merritt McKinney

Reuters Health

Wednesday, June 16, 2004

NEW YORK (Reuters Health) - Losing a job is always tough, but for people nearing retirement age, it may also be harmful to their health, results of a new study suggest.

People who lost a job close to retirement age were more than twice as likely to have a stroke as people of the same age who had not lost a job, researchers report.

"Our study has established that, for workers nearing retirement, the loss of a job is a salient experience associated with negative effects on health, including increased risk of stroke," Dr. William T. Gallo at Yale University School of Medicine in New Haven, Connecticut, told Reuters Health.

"The public, in particular older workers, physicians and occupational health care providers should be aware that involuntary unemployment in the years leading up to retirement may be a credible risk factor for adverse health events," Gallo said.

This is not the first time that Gallo and his colleagues have found that job loss can have a negative impact on health.

Previously, the researchers reported an association between job loss and a decline in physical function and an increase in symptoms of depression, Gallo said. He also noted that there is some evidence of a link between job loss and the development of depression in a spouse, he said.

In the current study, Gallo and his colleagues compared 457 workers who lost their job with 3,763 people who were still working. The average age of participants in the study was 55.

During the 6-year study, people who had lost a job were not more likely to have a heart attack. But the odds of having a stroke were more than doubled in people who had lost a job, even after the researchers took into account risk factors for stroke.

The study appears in the American Journal of Industrial Medicine. It was funded by the National Institute on Aging and the Claude D. Pepper Older Americans Independence Center at Yale.

The study did not examine how being laid off may increase the risk of stroke, but Gallo and his colleagues speculate that losing a job close to retirement age leads to stress, anxiety and symptoms of depression, which may increase the risk.

Gallo and his colleagues plan to follow the participants for several more years to measure the long-term health effects of job loss.

Source: American Journal of Industrial Medicine, May 2004.

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Elderly Suicides Linked to Illnesses

HealthDayNews

Wednesday, June 16, 2004

WEDNESDAY, June 16 (HealthDayNews) -- Increased suicide risk among elderly people is associated with many common illnesses that affect older people, says a new Canadian study.

Researchers studied the prescription records in the province of Ontario for 1,329 people 66 years and older who committed suicide between Jan. 1, 1992 and Dec. 31, 2000.

Of those people (1,012 men, 317 women), the most common methods of suicide were: firearms (28 percent); hanging (24 percent), and self poisoning (21 percent). The illnesses associated with the largest increases in suicide risk among these elderly people were depression, bipolar disorder and severe pain.

Several other chronic illnesses also associated with increased suicide risk were seizure disorder, congestive heart failure, and chronic lung disease. Treatment for multiple illnesses was strongly associated with increased suicide risk.

Most of the people who committed suicide saw a doctor in the month before they died -- half of them in the preceding week.

"Our findings have important implications for prevention because most elderly patients who commit suicide visit a physician shortly beforehand, and many of them have clinically recognizable features of depression at the time," the study authors wrote.

"Physicians, nurses, and other health care professionals should be alert to the possible threat of suicide in elderly patients with chronic illness, particularly in patients with multiple illnesses, symptoms of depression, or other risk factors for suicide," they added.

Their findings are published in the June issue of the journal Archives of Internal Medicine (news - web sites).

More information

The National Institute of Mental Health has more about older people, depression and suicide.

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Physician, Slim Thyself

By Peggy Peck

Reuters Health

Wednesday, June 16, 2004

CHICAGO (Reuters Health) - Obesity is a major public health concern in the United States and doctors are not exempt from the problem.

At a meeting of the American Medical Association's House of Delegates here, an informal after-lunch survey showed that 280 members were overweight or obese, while just 140 were normal weight or less.

Based on obesity guidelines from the Centers for Disease Control and Prevention (news - web sites), 1 percent of delegates were underweight and 33 percent were normal weight, while 47 percent were overweight and 19 percent obese.

The delegate survey came just a day after the AMA sponsored an educational forum on the growing concern about obesity.

Asked to comment on the "size" of the AMA House, Trustee Dr. Ronald Davis of Detroit -- who noted that his weight is normal -- said, "Doctors do hard work that requires long hours and many don't get the physical activity that they should get."

Nonetheless, Dr. Davis said there is no doubt that the AMA could do more about promoting fitness among its members.

"We have made an effort to promote healthy food and I think that is working. I don't think I've ever seen as much fruit as I have at this meeting," he said. But he added that he has also seen a good deal of "eggs, bacon and sausage."

Davis, who is a preventive medicine specialist, said the AMA plans to concentrate on fitness in much the same way that it attacked smoking. He said that currently less than 5 percent of physicians smoke, which is a tribute to the anti-smoking efforts of the organization. He noted that in addition to the survey, the AMA has "handed out pedometers to encourage members to walk."

Dr. John F. Schneider of Flossmoor, Illinois, a member of the AMA's Council on Scientific Affairs said the Council plans to follow-up the baseline survey data from this meeting with surveys in December and in June 2005.

One AMA member who got a head start on the new obesity awareness campaign is AMA President Dr. John Nelson of Salt Lake City. Nelson weighs 42 pounds less than he did when elected in June 2003. He told Reuters Health that he has been following a low-carbohydrate diet.

Beyond tracking the fitness of its delegates, the AMA approved a series of resolutions aimed at tackling the national obesity problem including one that asks for legislation to require that fast food restaurants provide lists of the nutritional content of all foods, including total calories, fats and carbohydrates.

The AMA also wants school cafeterias to provide full nutrition information and ingredient lists.

In a related action the AMA approved a recommendation that all elementary schools be required to have at least 30 minutes of free play or physical exercise daily.

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Study Offers Best Alcohol Interventions in College

HealthDayNews

Wednesday, June 16, 2004

WEDNESDAY, June 16 (HealthDayNews) -- Promoting strategies such as drinking less or picking a designated driver, rather than urging total abstinence, is more effective when dealing with college students mandated to take part in alcohol interventions, a new study says.

Along with promoting these types of "harm reduction" strategies, providing students with an opportunity to discuss alcohol-related information in a non-judgmental format can also help reduce their use of alcohol, the researchers found.

"Harm-reduction approaches make a great deal of sense in both college-student populations generally and with mandated students more specifically," researcher Mark Wood, an associate professor of psychology at the University of Rhode Island, said in a prepared statement. The work appears in the June issue of the journal Alcoholism: Clinical & Experimental Research.

The research also found that college students at high risk for alcohol-related problems seem to derive great benefit from motivational intervention, in conjunction with follow-up "booster sessions."

Targeting the social network of the students may also help to change their drinking behaviors and perceptions.

"College students typically drink in social situations with friends and roommates," researcher Tracy O'Leary Tevyaw said in a prepared statement.

"Mandated students drink on average more than students who are not mandated. However, mandated students typically report that their friends drink as much or more than they do," Tevyaw explained.

"Their perceptions about what constitutes 'normative drinking' are influenced by having peers who also drink heavily. If we can effect changes in these perceptions, as well as in the student's social network by offering a targeted intervention to their heavy drinking peers -- many of whose drinking is occurring under the radar -- we might see enhanced short- and long-term outcomes," she said.

Peer-directed targeted and universal intervention sessions may also prove effective, the researchers found.

More information

The U.S. National Institute on Alcohol Abuse and Alcoholism has information about the hidden consequences of college drinking.

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Tuesday, June 15, 2004

 

Calcium Seems to Protect Against Colorectal Cancer

 

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Tuesday, June 15, 2004

TUESDAY, June 15 (HealthDayNews) -- Taking calcium supplements helps prevent polyps in the colon, a risk factor for colorectal cancer.

And the supplements seem to offer the most protection against the advanced polyps most strongly associated with invasive colorectal cancer, according to a new study.

"In an earlier publication, we showed a reduction in polyps [with calcium intake]," said Dr. John A. Baron, a professor of medicine at Dartmouth Medical School, and senior author of the study that appears in the June 16 issue of the Journal of the National Cancer Institute (news - web sites).

"There was less than a 20 percent reduction, overall," he added. "Now, we find when we look at more advanced [polyps], it is a much more marked reduction, suggesting that calcium might have a more pronounced effect in preventing advanced [polyps]."

For advanced polyps, calcium might reduce the risk of colorectal cancer 35 percent to 45 percent, Baron said.

An estimated 106,370 new cases of colon cancer and 40,570 cases of rectal cancer will be diagnosed this year in the United States, according to the American Cancer Society (news - web sites), and about 56,730 deaths will result.

Most colon and rectal cancers begin as a polyp, a growth of tissue into the center of the colon or rectum. Removing polyps, also known as adenomas, early may prevent them from becoming cancerous, according to the Cancer Society.

In new the study, Baron's team analyzed data from 913 patients enrolled in the Calcium Polyp Prevention Study. Patients took either a 1,200 milligram supplement of calcium or a placebo, and had a follow-up colonoscopy -- an exam of the colon -- one and four years after they began the calcium therapy.

Compared with those on a placebo, people taking calcium supplements had fewer of all types of polyps. But the protective effect was most pronounced for the kind of advanced lesions that are most strongly associated with colon cancer. The risk for advanced polyps was reduced by about 35 percent, Baron said.

While it's not known exactly how the calcium may help prevent the polyps, researchers speculate that calcium prevents the irritating and cancer-promoting effect of bile acids and other fats in the bowel.

In an accompanying editorial in the journal, Ulrike Peters, now an assistant faculty member at the Fred Hutchinson Cancer Research Center in Seattle, but formerly a research fellow at the National Cancer Institute, writes that the beneficial effects of calcium supplements still have not been proven. But the protective role of calcium against colon cancer "looks very promising," she said.

For now, she added, those wanting to reduce their risk of colon cancer should follow the dietary recommendation for calcium -- 1,200 milligrams a day for those over 50 years of age, and 1,000 milligrams for those 19 to 50.

"We cannot really tell if there is a difference right now between [calcium from] supplementation and from food," she said. "That needs further investigation.

Dr. Arthur Schatzkin, lead author of the editorial and chief of the nutritional epidemiology branch of the NCI, agreed. "For a variety of health reasons people should try to make sure they are getting adequate intakes of calcium." Calcium helps with bone strength, for one thing. But he cautioned that "...we haven't proved that calcium prevents colon cancer."

Added Baron: "As always, talk to your doctor. It is really thought that calcium supplements are safe, but don't think you can take something like this and forget everything else. Remember, this is just one aspect of what might be done."

He advised people to get colorectal cancer screening tests, such as colonoscopies and occult blood testing. "Exercise is probably beneficial," he added, in helping to reduce colorectal cancer risk.

More information

To learn more about colorectal cancer, visit the National Cancer Institute.

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Study Shows How Lean Teen-Agers Stay That Way

 

By Michael Conlon

Reuters

Tuesday, June 15, 2004

CHICAGO (Reuters) - Most teen-agers overeat when they hit the fast food counter but lean youngsters stay that way by cutting back the rest of the day while their overweight peers do not, according to a U.S. study published on Tuesday.

"We don't know if this is an inherent problem that leads to obesity or develops as a consequence of obesity," said David Ludwig of Children's Hospital in Boston, an author of the study.

"It may be that years of overeating leads to a bit of a disconnect in the appetite mechanism," he said in an interview. "At the very least its either causing obesity or contributing to the maintenance of obesity."

The study, published in this week's Journal of the American Medical Association (news - web sites), was designed to find out why only some adolescents are obese although almost all eat fast food.

One part of the study involved 54 adolescents age 13 to 17 about evenly divided between overweight and lean who were given extra large fast food meals and told to eat as much as they wanted in one hour.

In a second part of the study researchers did a telephone survey of 51 members of the same group to find out how much they ate under unsupervised conditions over four days -- two when fast food was available and two days when it was not.

In the first part of the study, they all consumed calories equivalent to more than 61 percent of their estimated daily energy requirement and in general the overweight group ate more.

In the second part of the study, overweight teens consumed "significantly more total energy" on days when fast food was available -- something not observed among the lean group.

"This observation suggests that overweight individuals do not compensate completely for the massive portion sizes characteristic of fast food today," the study said. "These findings suggest that, at least, fast food consumption serves to maintain or exacerbate obesity in susceptible individuals."

Ludwig said one factor is that highly processed and tasty fast food goes down more easily. Consuming the equivalent to a 1,600-calorie fast food meal in vegetables and whole grains requires chewing and time, and would leave the body feeling full long before reaching the same level.

In a second paper published in the same issue, the U.S. Centers for Disease Control and Prevention (news - web sites) reported little change in the obesity epidemic in the United States, based on an update of information from a national probability sample.

"There is no indication that the prevalence of obesity among adults and overweight among children is decreasing," it said. "The high levels of overweight among children and obesity among adults remain a major public health concern."

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Inflammatory Enzymes Linked to Cancer

 

HealthDayNews

Tuesday, June 15, 2004

TUESDAY, June 15 (HealthDayNews) -- The first evidence that COX-2 enzymes, which are responsible for pain and inflammation, are also involved in causing DNA damage associated with cancer is outlined in a new University of Pennsylvania study.

This finding provides new insight into how aspirin, along with diets rich in fruits, grains and vegetables, seem to reduce the risk of some cancers. The study also suggests that COX-2 inhibitor drugs, such as the anti-arthritis drugs rofecoxib (Vioxx) and celecoxib (Celebrex), may help prevent the DNA damage caused by COX-2 enzymes.

The research was presented June 15 at the annual meeting of the American Society for Biochemistry and Molecular Biology / 8th International Union of Biochemistry and Molecular Biology Conference in Boston.

The same presentation also included data supporting earlier research that large quantities of vitamin C can increase DNA damage.

More information

The U.S. National Cancer Institute (news - web sites) has information about understanding cancer.

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Feds Find No Decline in Obesity Rates

 

By Tara Burghart

Associated Press Writer

The Associated Press

Tuesday, June 15, 2004

CHICAGO - Despite the sounding of the alarm in recent years, the latest government figures show no decline in the U.S. obesity rate, with 31 percent of adults and 17 percent of youngsters seriously overweight.

The measurements, taken over two years starting in 2001, are about equal to the 1999-2000 figures. In late 2001, then-Surgeon General David Satcher warned about the dangers of obesity.

The latest estimates were based on body measurements of 4,390 adults and 4,258 children. The survey, conducted regularly since 1960, is considered more reliable than studies in which participants report their own girth because people consistently underestimate their weight.

The findings appear in Wednesday's Journal of the American Medical Association (news - web sites).

"The level of obese and overweight Americans remains at alarming levels," said Allison Hedley, a researcher at the Centers for Disease Control and Prevention (news - web sites) who led the study.

Before 1999, the results from the National Health and Nutrition Examination Survey were released in large chunks such as 1988-94. But because obesity has become such a national concern, the data are being released every two years.

The survey found that obesity rates in several categories between 1999-2000 and 2001-2002 rose slightly, but in a statistically insignificant way. Because the time span is small, it would be wrong to conclude that obesity is leveling off, Hedley said.

Obesity is defined as having a body-mass index of 30 or above. The index is a measure of weight relative to height.

Patrick O'Neil, director of the weight management center at the Medical University of South Carolina, said he was most bothered by the numbers of overweight children.

The study found that 31.5 percent of children ages 6 through 19 were overweight in 2001-02, and 16.5 percent were seriously overweight, or obese.

"We're producing a new generation that's even more vulnerable to obesity and all of its health consequences by virtue of the fact they're starting out more overweight than previous generations," O'Neil said.

On the Net:

JAMA: http://jama.ama-assn.org

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Genetic Makeup May Reduce Drug Benefit, Study Says

 

Reuters

Tuesday, June 15, 2004

CHICAGO (Reuters) - Cholesterol-lowering drugs are less potent for some because of a genetic variation -- a finding that may one day lead to genetic screening to prescribe the correct drug dosage, researchers said on Tuesday.

A study of 1,500 people treated with a cholesterol-lowering statin drug found those with a common genetic variation governing cholesterol synthesis had a 22 percent smaller reduction in their total cholesterol after six months of therapy.

The researchers from Brigham and Women's Hospital and Harvard Medical School (news - web sites) said an analysis of 10 candidate genes turned up one -- a variation in the HMG-CoA reductase gene -- that produced the undesired effect.

"We recognize that these data ... provide strong clinical evidence that there may be promise in the concept of 'personalized medicine' and the use of genetic screening to target certain therapies," study author Daniel Chasman wrote in the Journal of the American Medical Association (news - web sites).

"Future studies must determine whether this difference can be offset by dose adjustment or the choice of an alternative ... therapy."

In an accompanying editorial, Susanne Haga of the U.S. Center for the Advancement of Genomics wrote that numerous factors go into an individual's response to a drug, including their genetic makeup.

"By guiding drug therapy, pharmacogenetic testing could help to prevent serious injuries, hospitalization, mortality, and health care costs associated with adverse drug responses, and avoid the cost and inconvenience of prescribing drugs to patients who are likely to be nonresponders," Haga wrote.

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Eye Drops Can Delay Glaucoma in Blacks

 

HealthDayNews

Tuesday, June 15, 2004

TUESDAY, June 15 (HealthDayNews) -- Daily pressure-lowering eye drops can delay or prevent the onset of glaucoma in black Americans at high risk for developing the disease.

That's the finding of a new study in the June issue of the journal Archives of Ophthalmology.

Glaucoma is caused by increasing pressure within the eye and affects more than 2.2 million Americans aged 40 and over. Experts estimate that half of individuals with glaucoma remain unaware they even have the disease.

The study in black Americans found that eye drops reduced the development of the most common form of glaucoma, primary open-angle glaucoma, by almost 50 percent. Just 8.4 percent of African-Americans who used the eye drops developed glaucoma, compared with 16.1 percent of those who did not receive the eye drops, the researchers report.

The findings indicate the urgency of identifying black Americans at higher risk for developing glaucoma so they can receive evaluation for possible treatment, the researchers said.

The Ocular Hypertension Treatment Study was funded by the U.S. National Eye Institute and the National Center on Minority Health and Health Disparities.

This study is a follow-up to a previous study that found treating people with elevated eye pressure could delay or prevent glaucoma. In that study, results for blacks were inconclusive.

More Information

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

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Fitness Boosts Removal of 'Bad' Cholesterol

 

By Merritt McKinney

Reuters Health

Tuesday, June 15, 2004

NEW YORK (Reuters Health) - Being physically fit boosts levels of "good" HDL cholesterol and improves the removal of "bad" forms of cholesterol, researchers in Australia report.

HDL cholesterol is known to be the main component of "reverse cholesterol transport" -- the removal of "bad" LDL cholesterol from the arteries and its excretion by the liver -- but "higher levels of HDL are not necessarily a reliable indicator of enhanced reverse cholesterol transport," the authors explain in the medical journal Arteriosclerosis, Thrombosis, and Vascular Biology.

"It is well known that regular exercise protects against heart disease," Dr. Dmitri Sviridov of the Baker Heart Research Institute in Melbourne told Reuters Health. Most likely, there are several mechanisms that account for the benefits of exercise, he said.

One of these mechanisms involves HDL, Sviridov noted.

He and his colleagues compared HDL levels in 25 elite athletes and 33 men who were not athletes but who participated in moderate exercise.

As expected, athletes had higher levels of HDL cholesterol than non-athletes, the researchers report. Athletes also had higher levels of a molecule called apoA-1 that transports HDL.

"We found that 'good cholesterol' is enhanced in people who exercise regularly and that may have a protective effect," Sviridov said. The researchers also uncovered evidence that high levels of fitness are associated with greater efficiency of the process of reverse cholesterol transport.

Sviridov's team believes that fitness not only promotes production of HDL, but also enhances reverse cholesterol transport.

Although athletes in the study had higher levels of HDL, the difference was not enormous, according to Sviridov.

"You don't have to be an Olympian to reap maximum benefits," he said. "Formation of 'good cholesterol' in people who exercise regularly without aiming at sporting glory is enhanced almost as much as in professional athletes."

Source: Arteriosclerosis, Thrombosis, and Vascular Biology, June 2004.

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Women More Likely to Die From Aortic Dissection

By Steven Reinberg
HealthDay Reporter

HealthDayNews

Tuesday, June 15, 2004

TUESDAY, June 15 (HealthDayNews) -- Although women are less likely to suffer from a life-threatening tear in the aortic wall called aortic dissection, they are more likely to die from it.

That's the conclusion of new German research that also found women don't seek medical help as rapidly as men do when aortic dissection occurs.

"We found that about two-thirds of the patients with aortic dissection who arrive at the hospital are men, and 30 percent were women," said lead author Dr. Christoph Nienaber, head of the cardiology division at University Hospital Rostock in Rostock, Germany. "This is basically the prevalence of the disease," he added.

"But the interesting, and unexpected, finding was that women present with chest pain later than men," Nienaber said. "For some reason, women don't react the same way to pain or they have a different perception of pain or they are not being taken care of by their husbands or live-ins," he commented.

Delayed diagnosis in women means more frequent death, Nienaber added. In addition, older women were more likely than men to refuse surgery, he said.

According to the American Heart Association (news - web sites), over 2,000 cases of aortic dissection are reported in the US each year. In a recent high-profile case, the actor John Ritter died suddenly last year after suffering an aortic tear.

Nienaber's team studied data from 732 men and 346 women enrolled in the International Registry of Acute Aortic Dissection, according to a report in the June 15 issue of Circulation.

According to the researchers, fewer women than men went for treatment within six hours of the start of symptoms, and a full 40 percent of women in the study waited more than 24 hours before seeking medical attention. The higher death rate for women with aortic dissection was especially true in the 66-75 age group.

In addition, they found that 32 percent of women who underwent surgery to repair the aortic tear died, compared with 22 percent of men.

Nienaber believes that doctors need to rethink the symptoms of aortic dissection. "Physicians need to realize that women have different and more diffuse symptoms than men do. And that's probably the major reason why the diagnosis is delayed," he said.

Aortic dissection causes immediate chest pain, according to the American Heart Association, and in almost two-thirds of the cases is linked to high blood pressure. But Nienaber said in women, other symptoms can include dizziness, shortness of breath, unconsciousness or stomach discomfort.

And he urged that "chest pain, irrespective of severity, needs to be clarified immediately. There is no reason to delay going to the emergency room or to your doctor."

Dr. Tyrone J. Krause, chief of thoracic and cardiothoracic surgery at UMDNJ-Robert Wood Johnson Medical School, took issue with some of the study's conclusions.

"I don't think the difference is gender-related. There is nothing specific about a woman that is more likely to make her die from an aortic dissection," he said.

In fact, he said, most patients who have an aortic dissection die when the dissection occurs.

"That's what happened to the actor John Ritter," he added.

"For those who actually get to the hospital alive, it comes down to the hospital making the diagnosis quick enough," Krause said. "Even then, another high percent will die even before they get operated on."

"It's hard to say that a delay in diagnosis causes a higher mortality rate," Krause said. "I wouldn't really put much stock in that."

More information

The American Heart Association can tell you more about aortic dissection.

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Monday, June 14, 2004

 

Study: Cholesterol-Lowering Drugs Cut Glaucoma Risk

 

Reuters

Monday, June 14, 2004

CHICAGO (Reuters) - Cholesterol-lowering drugs such as statins appear to reduce the risk of developing the most common type of glaucoma, a leading cause of blindness, researchers said on Monday.

Statins, which are prescribed for heart patients to reduce how much cholesterol the body makes, have previously been shown to cut the risk of age-related macular degeneration, a condition that affects the eye's retina that is the leading cause of blindness in most industrialized countries.

The latest study, published in the June issue of The Archives of Ophthalmology, compared a group of men over age 50 diagnosed with glaucoma with a group that had not been diagnosed and found a significant reduction in risk when cholesterol-fighting drugs had been used over a long period.

The drugs were found to reduce the incidence of open-angle glaucoma, in which the eye's drainage canals become clogged and pressure builds in the eyeball, causing damage to the optic nerve.

Open-angle glaucoma afflicts roughly 3 million Americans, half of whom are undiagnosed and may not know they have it. Glaucoma robs people of sight with little warning and, while it can be treated with medications and surgery in early stages, there is no cure once blindness sets in.

All types of cholesterol-lowering drugs, including statins, appeared to help reduce the incidence of open-angle glaucoma, said study author Gerald McGwin of the University of Alabama at Birmingham.

Recent research has also indicated long-term use of statins may also prevent various forms of cancer, including prostate and colon cancer, though the drugs have not been approved for such use.

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Blacks Urged to Get Checked for Kidney Disease

 

By Amanda Gardner
HealthDay Reporter

HealthDayNews

Monday, June 14, 2004

MONDAY, June 14 (HealthDayNews) -- John "Tony" Ward used to spend his days driving a truck as many as 18 hours a day, sneaking in fast-food meals whenever he had the time or inclination.

"McDonald's Burger King, Pizza Hut, anything that was there that was convenient that I could get my hands on. It was just a terrible lifestyle," said the 43-year-old father of two from Silver Spring, Md. Despite having diabetes, "I thought I was superhuman. Nothing can bring me down."

But something finally did bring Ward down: Kidney failure, which announced itself on March 10, 2002.

Ward is one of 20 million Americans suffering from kidney disease. About 400,000 people are on dialysis or have had a kidney transplant, the only treatments for kidney failure. That number has doubled in each of the last two decades. By 2010, as many people will be developing kidney failure as are dying of lung cancer, the leading cause of cancer death, said Dr. Thomas Hostetter, director of the National Kidney Disease Education Program, part of the National Institutes of Health (news - web sites) (NIH). This education program is being launched to help raise awareness of kidney disease and to encourage those at high risk to get tested.

The disease is an insidious one, often showing no symptoms until it is relatively advanced.

Ward is black, and blacks are four times as likely to develop kidney failure as whites. The reason? "African-Americans seem to have more diabetes and more hypertension than the normal population and those are the leading causes of kidney disease," said Dr. John Curtis, a professor of medicine at the University of Alabama at Birmingham.

The irony is that both of these lead-up conditions are largely preventable. "Both diabetes and blood pressure account for about 70 percent of underling kidney failure, and because it's so treatable it's really a tragedy," Hostetter said. "Not only could the kidney disease be prevented, but we also know that once people have some kidney disease, there are important things that can be done to slow the progression. There are a number of stations in the road where these disease processes can be interrupted."

In fact, Ward was diagnosed with diabetes about a decade before realizing he had kidney disease. He did nothing, however, to modify his lifestyle to control the diabetes.

As a result, he ended up on dialysis for about a year and, on Sept. 16, 2003, underwent a kidney transplant.

He was one of the lucky ones. Of about 100,000 people who develop kidney failure every year, only about 15 percent will get a replacement kidney, Hostetter said. The rest will have to stay on dialysis, which is less effective and much more limiting and expensive than a transplant.

Ward was able to get a transplant because his wife, who works for the NIH, donated a kidney to the Washington Regional Transplant Consortium (she couldn't donate to her husband because the organ wasn't a match). Her gift sent Ward to the top of the list.

Ward is now waiting for a pancreas (he's been on that list since October 2003) and his prognosis with two organs is good, as long as he keeps watching his diet, exercising and taking his immunosuppressive drugs to prevent his body from rejecting the new organs.

Both blacks and whites survive longer and better with a transplants than with dialysis, yet blacks, once again, are getting the short end of the stick, with fewer transplants than their white counterparts.

Part of the problem is a dearth of living related donors in the black community. "Often the relatives of African-Americans are found to have disease themselves -- not end-stage, necessarily, but hypertension or diabetes," Curtis said. That rules them out as organ donors.

The other problem is that the government will only pay for 3.8 years of immunosuppressive medications, even though organ recipients need to take them for the rest of their lives. Blacks are less likely to have supplemental insurance that will pay for the lifesaving medications, Curtis said.

The key is not to end up needing dialysis or a transplant. Tests for kidney disease are inexpensive, effective and available, Hostetter said.

"Kidney disease is a killer among African-Americans. When you have a check-up with your primary-care physician, ask to be tested for kidney disease as well as diabetes," Ward added. "If I had caught it in time, I would still be working full time. I wouldn't have the medical bills that I have right now."

More information

Visit the National Kidney Disease Education Program.

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Teens Suffering From Rebound Headache

 

By Lauran Neergaard

AP Medical Writer

The Associated Press

Monday, June 14, 2004

WASHINGTON - One after another, teenagers trickle into Dr. David Rothner's office with the same complaint: almost daily headaches, despite popping over-the-counter painkillers four, then six, then eight times a week. Many get a diagnosis of rebound headache, a vicious cycle where the more painkiller some people use, the more likely new headaches are to crop up between doses.

Headache specialists say it's not uncommon for adults to fall into that trap, and Rothner's check of records at the Cleveland Clinic suggests a surprising number of teens and preteens may, too.

Of 680 patients referred to the hospital's pediatric headache center, 22 percent were overusing nonprescription headache medicine meaning at least three doses a week for more than six weeks.

The worst was one patient who reached 28 doses in a single week.

"We have a lot of kids that are overusing OTC medicine," warns Rothner, a Cleveland Clinic pediatric neurologist who presented the data to the American Headache Society last week.

Overuse increases the risk of such side effects as stomach bleeding or kidney or liver damage, problems many people don't realize can occur even with over-the-counter drugs.

"Three days a week is probably excessive. That's not good for their health, let alone their headaches," says Dr. David Dodick, a neurologist at the Mayo Clinic in Scottsdale, Ariz. Parents should "do everything they can to get these kids off of the analgesics. That means they need better headache management."

Less appreciated, Rothner adds, is that overmedicating actually can worsen some kids' headaches, a syndrome called rebound headache that eventually can spur almost daily headaches.

Specialists have known for more than a decade that certain adults get rebound headache, although it's little-discussed outside of headache clinics.

Up to 32 percent of adults are thought to overuse painkillers for headaches, and true rebound headache is thought to hit 1.5 percent, Dodick says.

There's little data on children, although pediatric specialists say rebound headache is similar for them, too.

And while it strikes just a fraction of headache sufferers, it's unnecessary pain.

Doctors can't predict who's at risk, although people with migraine in the family seem most prone to rebound headache, says Dr. Jesus Eric Pina-Garza, a Vanderbilt University pediatric headache specialist.

Also, some specialists think months of painkiller use by migraine sufferers can transform their pain, until the rebound-prone experience a chronic tension-type headache. (Overusing any painkiller can trigger rebound headache, but over-the-counter drugs are the most widely used and thus most blamed.)

Lest anyone doubt rebound headache is real, Pina-Garza points to typical cases in his office: Youths whose parents have migraines but have never suffered a serious headache themselves until a week of high-dose painkillers after knee surgery or a sports sprain spurs headaches that they continue to medicate.

So how often should people use OTC painkillers for headache? Pina-Garza and Rothner say no more than twice a week. Dodick notes that new International Headache Society criteria say using any painkiller more than nine days a month can signal the person is a candidate for headache prevention therapy instead.

For daily headache, specialists first make sure there's no underlying disease cause. If OTC analgesic overuse is the suspect, they order patients to quit cold-turkey and customize treatment to break the rebound cycle. Pina-Garza uses small doses of prescription drugs that work differently, such as phenergan or Migranol nasal spray, to temper the resulting temporary pain spike. Rothner prefers low doses of amitriptyline, an old antidepressant used to prevent migraines.

Once the chronic rebound headache is gone, patients can get appropriate treatment for migraines or other periodic headaches.

For most people, "that's common sense that anybody that has pain will usually reach for an OTC medicine first," says Pina-Garza. "That's an acceptable practice if you get good relief" and don't do it too often.

For more than occasional headaches, the American Headache Society advises:

·        For proper treatment, tell your doctor all symptoms that accompany a headache, such as nausea or vomiting; how fast headaches arise; how disabling they are; and any other illnesses.

·        Watch for headache triggers, such as hunger, fatigue, dehydration and stress.

Editors Note: Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

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Exercise Doesn't Help Some With Heart Woes

 

By Kathleen Doheny
HealthDay Reporter

HealthDayNews

Monday, June 14, 2004

MONDAY, June 14 (HealthDayNews) -- Exercise has long been prescribed to reduce the risk of heart disease, but an international study has found that it doesn't help everyone.

The progress of atherosclerosis, a thickening of artery walls, is not slowed by exercise for those already on cholesterol-lowering medication.

But the study, which appears in the June 15 edition of the Annals of Internal Medicine, shouldn't discourage people from exercising, the authors and other experts say.

Researchers from Finland's University of Kuopio, the University of Freiburg in Germany and Louisiana State University in the United States assigned 140 middle-aged white men living in Finland to an exercise group or a "habitual activity group."

The exercise group was instructed to work out for 45 to 60 minutes five times a week and kept an exercise diary. The habitual activity group was not told to change exercise patterns and they kept no diaries.

At the beginning of the study, men in both groups had similar fitness levels and similar thickness of the walls of the carotid arteries (in the neck). Over the six-year study, they took a bicycle exercise test annually to measure breathing fitness and had ultrasounds annually to measure thickness of the carotid artery walls.

The exercise did not slow the progression of atherosclerosis, except in a subgroup of men not on cholesterol-lowering medication, they found.

Although the results might at first glance look disappointing, they should not discourage people from exercising, said Dr. Rainer Rauramaa, the lead author of the study and a professor of exercise medicine at the University of Kuopio in Finland.

"I agree the data might, at first glance, seem disappointing," Rauramaa said. "However, if you look at the results carefully, you can easily realize that regular exercise brought a significant reduction in the progression of atherosclerosis in clinically healthy, asymptomatic men who were NOT using [cholesterol lowering drugs]." And, he added, there are more people not using these drug than are using them.

The real effect of exercise might also have been diluted, he added, because some men in the habitual activity group actually exercised, and not all men in the exercise group actually did the recommended amount of exercise.

In the study, the men who exercised did a range of workouts, including walking, jogging, cross-country skiing, swimming and cycling.

The message, Rauramaa said, is not to give up on exercise.

"To those who already exercise: continue to do so," he said. "To those not yet engaged in regular exercise: you'd better change your bad habits."

Another expert agreed that the take-home message is not to give up on exercise. Dr. Ravi Dave, a cardiologist at Santa Monica UCLA Medical Center, noted that the study had a small sample size.

"It shouldn't be a message of 'exercise is futile,'" Dave said.

Exercise can help keep your weight under control, which can reduce the risk of high blood pressure, Dave said, and thus reduce heart disease risk.

In another study in the same issue, University of Washington researchers evaluated 300 Japanese-Americans and found that fat inside the abdomen predicts who will get high blood pressure.

Those who had the largest amount of abdominal fat were more than four times as likely to have high blood pressure during the 11-year follow-up.

The results are no surprise to Dave. "We know that obesity causes hypertension," he said. "You have generalized obesity and then the truncal kind, which is more concentrated in the stomach area. Generally Asians have the truncal obesity, the second kind, which is worse."

Dave said he could use the study results to advise his patients that "if you lose two inches from your waist [and thus reduce abdominal fat] you might improve your hypertension."

More information

To learn more about staying active at any size, visit the National Institute of Diabetes & Digestive & Kidney Diseases.

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Study Finds Fruit Helps Ward Off Vision Problems

 

Reuters

Monday, June 14, 2004

CHICAGO (Reuters) - Eating fruit regularly earlier in life may help ward off macular degeneration, the leading cause of vision loss in older adults, a study said on Monday.

But the report said there appeared to be no strong protective effect from vegetables, vitamins or carotenoids -- the compounds that make some fruits and vegetables red, orange or yellow -- as some earlier research had suggested.

The study from Brigham and Women's Hospital in Boston looked at data from 77,562 women and 40,866 men who were followed for from 12 to 18 years as part of long-term studies tracking them for a variety of health issues.

It found that both men and women who consumed three or more servings of unspecified fruit a day had a 36 percent decreased risk of developing macular degeneration.

"People are living longer, healthier lives and age-related illnesses, such as blindness, can significantly impact an otherwise healthy quality of life," said Eunyoung Cho, the study's lead author.

"Because there are a limited number of treatment options for age-related macular degeneration, clinicians and researchers have been focused on identifying factors that reduce risk and can ultimately save a person's eyesight," added Cho, saying the study was the first large-scale look at diet and preventing the condition.

The study, published in The Archives of Ophthalmology, is a preliminary one and more research is needed, the authors said.

The report said macular degeneration is the leading cause of vision loss among people 65 and older. There are no effective treatments for the condition in which the macula -- a small part of the retina -- deteriorates, causing a loss of central vision.

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Here's a New Way to Reduce Cholesterol

 

HealthDayNews

Monday, June 14, 2004

MONDAY, June 14 (HealthDayNews) -- Blocking the production of a key component of both high-density and low-density lipoproteins may offer a new way to reduce cholesterol and homocysteine levels, says a Canadian study.

Researchers created genetically altered mice that lacked either of the two different pathways through which mice, humans and other animals provide lipids for high-denisty lipoprotein (HDL) and low-density lipoprotein (LDL). The mice suffered no ill effects and had much lower than normal levels of cholesterol in their blood.

The alteration of one of the pathways in one group of mice also led to a 50 percent decrease of homocysteine in their blood.

The results suggest it may be possible to create drugs that block these pathways in humans to reduce the risk of cardiovascular disease, according to the study authors.

The research was presented June 13 at the annual meeting of the American Society for Biochemistry and Molecular Biology/8th International Union of Biochemistry and Molecular Biology Conference in Boston.

More information

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

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Doctors Say They Must Model Healthy Diet

 

By Lindsey Tanner

AP Medical Writer

The Associated Press

Monday, June 14, 2004

CHICAGO - "I'm Michael and I'm obese." Doctors laughed at the American Medical Association annual meeting when one of their own stood up Monday to admit his girth, but the subject was serious: physicians tackling the nation's obesity epidemic by addressing their own weight problems.

Dr. Michael Fleming the Shreveport, La., family physician who prompted the chuckles Monday said he has decided to wear a pedometer and take 10,000 steps daily. It is the same advice doctors give patients and a message the American Academy of Family Physicians (news - web sites) is relaying to its more than 90,000 members so they can serve as role models.

Fleming, the academy president, was one of several doctors who talked of personal responsibility at a brainstorming session to help set the agenda for a fall AMA meeting on obesity.

The informational session came during the AMA's annual meeting. Delegates took action later Monday on several obesity-related measures, including agreeing to advocate for at least 30 minutes of daily free play or physical education in elementary schools. In place of a resolution seeking AMA support for restricting snacks and soda in schools, the delegates voted to reaffirm existing AMA policies on healthy eating and exercise for children, which a committee said captures the spirit of the resolution.

Delegates also voted to reject a measure seeking encouragement by state and local governments of exercise-friendly areas in cities nationwide, referring the issue to the AMA's fall obesity meeting.

The separate informational obesity discussion, which drew an overflow crowd of more than 150 doctors, harkened to the AMA's stand in 1968 urging doctors to quit smoking themselves and post no-smoking signs in their offices to set an example. The AMA is seeking to give obesity the same attention.

Fleming said he was motivated by the memory of watching a doctor tell Fleming's grandfather years ago to quit smoking and then seeing the doctor put out his own cigarette.

Other doctors stood up to tell their own weight-loss stories not mentioning how they slimmed down, but urging others to follow suit.

Dr. John Seibel said he has managed to go from a body-mass index of about 31 to 24. Anything over 30 is obese, while above 25 is considered overweight.

"I find it much easier now to talk to my patients" about obesity, said Seibel, of Albuquerque, N.M.

Dr. John Kelly, a 78-year-old obesity specialist from Rochester, N.Y., said he had gained weight after a stroke but now has an acceptable BMI of 25.

About half the doctors attending the session raised their hands when asked if they exercised 30 minutes most days.

Some of the doctors ate high-calorie sweet rolls and muffins provided at the hotel. One doctor took the microphone and said more healthful food should be served at such meetings to set an example.

"We should start with ourselves" and offer food like bran muffins "instead of the hyper-cholesterol meals," said Dr. Mary Ellen Bradshaw, a public health specialist from Arizona.

But Dr. Paul Handel of Houston told participants, "The obesity epidemic is not the fault of Krispy Kreme or McDonald's. Unless we rekindle some sense of personal responsibility ... 20 years from now we will still be struggling to treat" the problem.

On the Net:

AMA http://www.ama-assn.org

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Being Bilingual Could Protect Your Brain

 

HealthDayNews

Monday, June 14, 2004

MONDAY, June 14 (HealthDayNews) -- Being fluent in two languages could protect against age-related cognitive decline, says a study in the June issue of Psychology and Aging.

Researchers from York University in Toronto compared the results of 154 bilingual and monolingual middle-aged and older adults on the Simon Task, which measures reaction time and aspects of cognitive function that decline with age.

All the bilingual people in the study had used two languages every day since the age of 10.

The study found that both older and younger bilingual people performed better than those who spoke just one language. Being bilingual offers widespread benefits across a range of complex cognitive tasks, the authors concluded.

More information

The U.S. National Institute on Aging has information about forgetfulness and aging.

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Act Fast on Chest Pain to Preserve Heart, Experts Say

 

Reuters

Monday, June 14, 2004

WASHINGTON (Reuters) - Aggressive new guidelines published on Monday call for quick treatment of a common form of heart attack marked by chest pain and shortness of breath.

The American Heart Association (news - web sites) and American College of Cardiology issued the joint guidelines for treating ST elevation myocardial infarction or STEMI, a severe heart attack in which an artery is completely blocked.

While heart attack patients may be unsure about their symptoms and wait to call an ambulance, every minute counts in this form of heart attack, said Dr. Elliott Antman of Harvard Medical School (news - web sites) and Brigham and Women's Hospital in Boston, who helped write the new guidelines.

"It is not unusual for patients to wait two hours or longer before seeking treatment, when they should get help as quickly as possible to minimize damage to their hearts," Antman said in a statement.

The Heart Association said an estimated 500,000 Americans have a STEMI every year.

"Treating this type of heart attack requires fast action, because if blood flow is not restored to the heart within 20 minutes, permanent damage will occur," Antman said.

"Speedy treatment not only means the difference between life and death, but also between disability and a return to an active lifestyle after a heart attack."

Antman said earlier guidelines were not always helpful to doctors trying to make fast decisions about treatment.

One crucial decision is whether to open the blocked artery with a clot-busting drug or by using tiny flexible tubes called stents that prop open blocked arteries.

The new guidelines, published in the journal Circulation and the Journal of the American College of Cardiology, distill this decision to four issues:

·        How much time has passed since the onset of symptoms?

·        How great is the risk of death?

·        How great is the risk of bleeding in the brain if clot-busting drugs are used?

·        How long will it take to get the patient into a cardiac catheterization lab for stenting?

The guidelines, found on the Internet at http:// www.americanheart.org and http://www.acc.org/, also recommend that patients take aspirin and drugs called beta-blockers after a heart attack.

"We also strongly endorse the use of angiotensin-converting enzyme (ACE) inhibitors for all patients to improve heart function," Antman said.

And all patients with low-density lipoprotein cholesterol or LDL of 100 or more should get cholesterol-lowering statin drugs, the guidelines say.

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Abdominal Fat Predicts High Blood Pressure

 

Reuters Health

Monday, June 14, 2004

NEW YORK (Reuters Health) - Greater amounts of fat in the abdomen point to an increased risk of developing high blood pressure, according to a new study.

Several studies have associated central obesity with hypertension, the authors explain in the Annals of Internal Medicine, but no forward-looking studies have investigated whether abdominal fat as measured by CT scans predicts who is likely to become hypertensive.

Dr. Tomoshige Hayashi and colleagues with the Veterans Affairs Puget Sound Health Care System and the University of Washington in Seattle examined the relationship between directly measured "visceral adiposity" and the risk of developing hypertension in 300 Japanese Americans between 34 and 76 years of age.

Higher amounts of fat in the abdominal area, greater body mass index (BMI), and larger waist circumference were all associated with a higher incidence of hypertension, the authors report.

After taking various factors into account, only the extent of fat in the abdomen remained a predictor of hypertension independent of age, sex, smoking status, and other recognized risk factors for high blood pressure.

"This finding is independent of fasting plasma insulin level," Hayashi's team found, "which suggests that the effect of visceral fat on the incidence of hypertension may be mediated by mechanisms not reflected by fasting plasma insulin level."

All in all, the researchers conclude, the role that abdominal fat plays in the development of high blood pressure deserves further investigation.

Source: Annals of Internal Medicine, June 15, 2004.

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Atkins-Weary Baker Pitches 'Da Vinci Diet'

By Ryan Lenz

Associated Press Writer

The Associated Press

Monday, June 14, 2004

PORTLAND, Maine - A baker who lost nearly half his customers to the low-carb craze has tapped Dan Brown's best-selling novel for an Atkins alternative called the "Da Vinci Diet" that he hopes will bring people back to bread.

A little math theory kneaded with biblical lore from "The Da Vinci Code" has transformed Stephen Lanzalotta into a dietary sage, answering the "carbohydrate question" with a series of lectures promoting a diet he has followed for decades to maintain a muscular 160 pounds into middle age.

Admittedly, he is neither a nutritionist nor a scholar his background is in biology and biochemistry. But Lanzalotta argues that people have been eating bread for too long for it suddenly to be the reason everyone is fat.

"Human civilization and grain have ties that go way back. No municipal society evolved without grain, no matter what it was," said Lanzalotta, who kneads his dough by hand like ancient breadmakers. "Not that I believe bread is one of the most sacred foods, but it is one of the most important things we can eat."

Lanzalotta argues that bread forms the building blocks of the body and, in moderation, can lead to more stable moods, clearer thought and a rock-hard body, right down to the washboard stomach of a Renaissance statue.

The Da Vinci Diet is not published and is revealed primarily through the baker's lectures. It consists mostly of Mediterranean foods the foods ancient thinkers and artists ate. Fish, cheese, vegetables, meat, nuts and wine, in addition to bread none are taboo at Da Vinci's table.

In his diet, Lanzalotta uses a complicated formula he created that relies on the value of phi, a number discovered by ancient mathematics, used to build the pyramids, and featured prominently in Brown's book.

The value, 1.618, is known as the "golden ratio." It has long fascinated artists, philosophers and mathematicians.

Taking into account factors including body type, the diet typically breaks down to 52 percent carbohydrates, 20 percent protein and 28 percent fat. That's fewer carbohydrates and more protein than current federal guidelines.

The formula also can help people choose the right foods without turning a finicky eye toward the bread humans have consumed for the ages, Lanzalotta said.

A little suspect? Maybe.

In his book "The Golden Ratio," Mario Livio, an astrophysicist and senior scientist on the Hubble Telescope, discusses the history of the number. But Livio questions whether a diet based on it is better for the body.

"I'm not surprised in the sense that the golden ratio has been incorporated into many things," Livio said. "But to claim that we are tuned precisely to the number, I don't think there is particularly strong evidence."

Lanzalotta is not alone in looking for a carbohydrate-considerate way to eat, said Dave Grotto, a spokesman for the American Dietetic Association.

Grotto agrees with Lanzalotta's claim that most new "Atkins friendly" processed snacks on grocery shelves are mostly nonnutritive filler low-carbohydrate cookies and treats that critics describe as tasting like cardboard.

"The bakery industry has been in essence turned on its head," Grotto said. "But the truth of the matter, we eat because we enjoy the taste of food. And some of that gets lost in translation in low-carb foods. Some of it is Godawful."

When low-carbohydrate diets took off amid an ever-fatter population, Lanzalotta was spending hours researching food, exploring radical dietary regimens, and finding ways to incorporate bread to make it healthy.

He actually understands why low-carb diets work and appreciates the discipline involved. The diet has its strong points, he said.

"I'm not suggesting that we eat more bread," Lanzalotta said. "I'm just trying to look at the problems with eating only meat."

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High-Fiber Cereal Cuts Excess Insulin Production  

Reuters Health

Monday, June 14, 2004

NEW YORK (Reuters Health) - People in danger of developing type 2 diabetes often have high levels of insulin; because they are "insulin resistant," glucose is not processed properly and the pancreas compensates by producing more insulin.

Now, a study in the medical journal Diabetes Care suggests that dietary fiber might prevent so-called hyperinsulinemia -- and perhaps help ward off full-blown diabetes.

Dr. Thomas M. S. Wolever, of the University of Toronto, Canada, and colleagues compared the effect of high-fiber cereal versus low-fiber cereal on glucose and insulin in 77 non-diabetic men, of whom 35 had normal fasting insulin levels while 42 had high levels.

Those with hyperinsulinemia were significantly heavier and had large waist circumferences than the normal-insulin group. Hyperinsulinemic men also had lower HDL ("good") cholesterol and a trend toward higher triglyceride levels.

The participants were studied on two occasions after 10- to 14-hour overnight fasts. The two test cereals contained the same amount of carbohydrate but different amounts of fiber.

In both groups of men, blood glucose levels rose less after they ate the high-fiber cereal than after the low-fiber cereal, Wolever and colleagues report.

Also, in the hyperinsulinemic men, the high-fiber intake reduced the rise in peak insulin compared with that seen after the low fiber meal. In the normal insulin men, the rise in insulin after eating was the same with both types of cereal.

While the results suggest dietary fiber helps control insulin responses, the team concludes that longer studies "are required before conclusions can be drawn as to whether a high-fiber breakfast cereal has any long-term benefits for the management of insulin resistance or obesity."

Source: Diabetes Care, June 2004.

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Bush Rejects Calls on Stem-Cell Research

By Scott Lindlaw

Associated Press Writer

The Associated Press

Monday, June 14, 2004

WASHINGTON - The White House rejected calls Monday from Ronald Reagan (news - web sites)'s family and others to relax President Bush (news - web sites)'s restrictions on stem-cell research in pursuit of potential cures for illnesses.

Bush signed an executive order in August 2001 that limited federal help to financing stem cell research on 78 embryonic stem cell lines then in existence. Because day-old embryos are destroyed when stem cells are extracted, the process is opposed by some conservatives who link it to abortion.

Shortly before Reagan's death, presumptive Democratic presidential nominee John Kerry (news - web sites) and 57 other senators asked Bush to relax the restrictions. Nancy Reagan has long argued that using stem cells from embryos could lead to cures for a number of diseases like the Alzheimer's that afflicted her husband. Bush opposes using embryos for stem cell research.

White House spokesman Scott McClellan said Bush continues to believe that his policy is the right one.

"The president came up with a policy that will allow us to explore the promise of stem-cell research, and do so in a way that doesn't cross a certain moral threshold that he set," McClellan said. "And I think he articulated his reasons for arriving at that decision. And that is his position, and that remains his position."

Moreover, he said, "we are still at a phase where we are conducting the basic research so that we can better understand the promise of stem-cell research. There's a lot we don't know at this point."

McClellan would not directly answer questions about whether Bush would be open to relaxing his policy if current "basic research" begins to show promise.

But, he said, "The president doesn't believe we should be creating life for the sole purpose of destroying life."

On the Net:

Alzheimer's Association: http://www.alz.org

Alzheimer's Disease International: http://www.alz.co.uk

Alzheimer's Foundation of America: www.alzfdn.org

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Yet More Evidence Echinacea Does Not Fight Colds

By Alison McCook
Reuters Health
Monday, June 14, 2004

 NEW YORK (Reuters Health) - Taking 300 milligrams per day of Echinacea at the first sign of a cold appears to do little to reduce symptoms or speed recovery, according to a report released Monday.

Echinacea, derived from the purple coneflower, is sold over the counter as an immune-system strengthener and cold remedy. Despite its popularity, recent studies have suggested that the herb may do little to prevent or treat the common cold.

Adding to the evidence, the current study found that people who were given Echinacea within 24 hours of their first cold symptoms reported equally severe symptoms as people who received a placebo drug, and both groups took the same amount of time to recover.

"There is currently no conclusive evidence that the root or herb portions of Echinacea are useful in the treatment of the common cold," study author Dr. Steven Yale of the Marshfield Clinic in Wisconsin told Reuters Health.

"I would not recommend the use of Echinacea for treatment of the common cold" until large studies clearly show it can shorten colds and ease symptoms, he added.

In 1997 alone, Americans spent around $27 billion out-of-pocket on alternative medicine. Some of that went to fighting and preventing common colds, which strike most adults between 2 and 4 times each year.

However, recent research has cast doubt on whether the herbal preparation can treat colds. A study published last year found that children who took Echinacea as soon as they developed a cold showed no difference in the severity or duration of cold symptoms than children who took a placebo pill. (http://nccam.nih.gov/health/alerts/echinacea/index.htm)

Another study published last month showed that Echinacea may also do little to prevent colds.

To further test the herbal medicine's prowess at fighting colds, Yale and his co-author Dr Kejian Liu randomly assigned 128 people to take capsules three times per day containing either 100 milligrams of Echinacea purpurea or a placebo within 24 hours after developing a cold, and continue to do so until their colds resolved.

Most people got over their colds after seven days, the authors write in the Archives of Internal Medicine (news - web sites). Those who took Echinacea had just as severe symptoms and suffered just as long as people on a placebo.

Yale explained that some studies have still shown that Echinacea may help prevent and treat colds. These conflicting results are likely due to differences between studies in the amount, type and part of the Echinacea plant used, he explained.

Despite the contradictory evidence, many people still turn to Echinacea, probably because they think it will work for them and is relatively safe, Yale said.

"However, it is important to recognize that herbs are drugs and may have serious side effects - including drug interactions - when taken with some prescription medications," he cautioned.

Source:  Archives of Internal Medicine, June 14, 2004.

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Parents Flocking to Baby Fitness Classes

By Kristen Gelineau

Associated Press Writer

The Associated Press

Monday, June 14, 2004

SEATTLE - As the country's population of overweight children swells, parents are flocking to baby exercise classes where tots as young as one day old can start getting fit.

While mainstream medical experts remain dubious, baby fitness advocates say getting babies and toddlers involved in exercise can set them up for a life of good health and improve motor skills and parent-child bonding.

"I have this little mantra and it goes like this: fit baby equals fit toddler equals fit child equals fit teen equals fit adult," said Helen Garabedian, author of "Itsy Bitsy Yoga: Poses to Help Your Baby Sleep Longer, Digest Better, and Grow Stronger." She also teaches an Itsy Bitsy Yoga class in Marlborough, Mass.

Yoga comes naturally to babies, who often learn the positions independently as they develop, said Garabedian, who works with babies as young as three weeks old. Babies will commonly move into "downward dog" just before they begin crawling, she said.

But do the kids really understand what they're doing?

Three-year-old Jasper Dean seems to. During the cool-down portion of his class in Seattle, Jasper sits in his mother's lap, eyes closed and legs crossed while serenely chanting, "Ohm." He then places his hands together, bows his head and murmurs, "Namaste."

"He has lots of energy, so it's a good place for him to run around and learn about his body," said his mother, Cindy Hazard, 40, of Seattle, who has been practicing yoga for five years.

At Christine Roberts' Nurturing Pathways class in Kirkland, babies as young as two months participate in various movement and stretching activities. The class uses music and props to keep the babies focused and helps improve their eye tracking and coordination, Roberts said.

"It's so good for them," she said. "We try to make it the whole meal deal for the brain and the body."

At a recent session, 7-month-old Jonah Justice muscles his way across a colorful workout mat, his tongue emitting a fine trail of drool as he pulls himself forward with his chubby arms.

"Look at how strong he is!" his 28-year-old mother, Tanya Justice, squeals in glee as Jonah finally reaches her.

Even though such classes are fun, medical experts say they do little to make babies physically fit. Very young children aren't capable of the sustained exercise needed to improve cardiovascular health, strength and flexibility, said Dr. Eric Small, chair of the American Academy of Pediatrics committee on sports medicine and fitness, and author of the book, "Kids and Sports."

"Fitness is an adult concept," Small said.

Nationwide, 30 percent of children and adolescents ages 6-19 are considered overweight or obese, according to government figures. Despite that, the academy doesn't recommend fitness classes for babies, arguing the fragility of an infants' bones can set them up for injury.

But Bonnie Prudden, who wrote the book "How to Keep Your Child Fit from Birth to Six," argues that babies' muscles can be strengthened through exercise. Prudden created a YMCA swim program for infants in the 1950s, and her research on childhood fitness helped create the President's Council on Youth Fitness during the Eisenhower administration.

"Every movement they're making in the water is exercise," said Vera Garibaldi, who teaches babies as young as one day old in a "waterbabies" aquatic class in Bellevue.

At a recent class, Garibaldi blows on 6-month-old Ethan Lux's face, triggering an automatic reflex that causes him to hold his breath. Then she dunks him under the water where he kicks his tiny legs and propels himself upward, breaking the surface wide-eyed and smiling.

On the Net:

Itsy Bitsy Yoga: http://www.itsybitsyyoga.com/

Seattle Holistic Center: http://www.seattleholisticcenter.com/

Waterbabies: http://www.waterbabies.net/

Nurturing Pathways: http://www.nurturingpathways.com/

American Academy of Pediatrics: http://www.aap.org/

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Device May Reduce Mastectomy for Breast Cancer

Reuters Health

Monday, June 14, 2004

NEW YORK (Reuters Health) - A new way of delivering radiation, known as balloon brachytherapy, may allow some women with breast cancer to avoid mastectomy and instead undergo an operation that spares the breast, new research suggests.

Previous reports have shown that this limited surgery, called breast-conserving therapy, when followed by radiation is just as good as mastectomy at improving patient survival.

Unfortunately, because radiation typically takes 6 weeks to administer and is only offered at special centers, many women are forced to undergo mastectomy simply because they don't have the time to travel to one of these centers for treatment.

Usually, radiation is given from the outside in -- that is, by an external beam of radiation. Balloon brachytherapy, by contrast, delivers radiation from the inside out, according to the report in the Archives of Surgery.

The procedure involves the insertion of a balloon device, called the MammoSite catheter, through the skin incision and into the area where the cancer was removed. The balloon is then inflated and radioactive material is poured in to provide radiation to the area. After treatment is completed, the balloon is deflated and the device is removed.

By reducing the radiation treatment time to just 1 week, balloon brachytherapy may help women with logistic problems of time and distance opt for breast-conserving therapy and avoid mastectomy.

In the current study, Dr. Kambiz Dowlatshahi, from Rush University Medical Center in Chicago, and colleagues describe the short-term outcomes of 112 women treated with balloon brachytherapy.

The subjects adjusted quickly to the breast distension caused by the device and rated the cosmetic outcome as high. There was no evidence of cancer recurrence during follow-up.

There were some complications with the new technique. Four women had a punctured or ruptured balloon that required replacement before treatment could be completed, the investigators point out.

Also, seven women developed a wound infection that required drainage and antibiotics, the researchers note.

Less serious complications included temporary reddening of the skin and blisters. After the device was removed, 10 women had ultrasound-detected fluid collections that were drained with a needle, Dowlatshahi's team reports.

"Brachytherapy with the MammoSite catheter has distinct advantages compared with (standard radiation), including a much shorter treatment time that enables working women and those at a distance from radiation centers to consider breast conservation," the researchers conclude.

Source: Archives of Surgery, June 2004.

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Trim Down to Fight Prostate Cancer

By Karen Pallarito
HealthDay Reporter

HealthDayNews

Monday, June 14, 2004

MONDAY, June 14 (HealthDayNews) -- If you're a man who is suffering from prostate cancer, check to see if there's a spare tire hanging around your middle.

Two recent studies suggest obesity is a risk factor for aggressive prostate cancer. The findings, published in the Journal of Clinical Oncology, may help explain why black men, who are more likely to be obese than white men, have worse prostate cancer outcomes.

Dr. Stephen J. Freeland, a clinical instructor at Johns Hopkins School of Medicine and lead author of one of the two studies, concedes there's no consensus about obesity being a risk for developing prostate cancer. "But once diagnosed, the obese men's disease is usually a more aggressive disease," he said.

The findings give men a potentially important clue about the disease's progression. That's an insight that bears repeating during National Men's Health Week, June 14-20.

"I think the study findings do reinforce the message that men should maintain a healthy weight," said Ralph Coates, associate director for science in the U.S. Centers for Disease Control and Prevention (news - web sites)'s Division of Cancer Prevention and Control.

And as Dr. Alfred Neugut, a professor of medicine and epidemiology at Columbia University in New York City, wrote in an editorial in the same issue of the journal, the two studies present "a provocative thesis relating obesity to prostate cancer aggressiveness and outcome."

The prostate is a walnut-sized gland that surrounds the urethra, the passageway that expels urine from the bladder. The prostate makes the milky liquid contained in semen.

The American Cancer Society (news - web sites) estimates that about 230,900 new cases of prostate cancer will be diagnosed in the United States this year and about 29,900 men will die of the disease.

While prostate cancer usually grows at a slow pace, sometimes it can spread quickly. Yet even with the latest diagnostic methods, it is difficult to tell which cancers will progress sluggishly and which will proceed rapidly, the society notes.

Freeland's study examined data on 1,106 men who had prostate cancer surgery. A man with a body mass index (BMI) of 35 or higher -- the equivalent of carrying 245 pounds on a 5-foot, 10-inch frame -- had almost a 60 percent risk of cancer recurrence within three years, or more than twice the rate of normal weight men.

A similar study led by Dr. Christopher L. Amling, an assistant professor of urology at Navy Medical Center in San Diego, included 3,162 prostate cancer patients and defined obesity as a BMI of 30 or higher -- say a man who is 5 foot 10 inches and weighs 215 pounds. Men in that category were 20 percent more likely to have a recurrence of prostate cancer.

Scientists don't know why obesity worsens the progression of prostate cancer. But the authors suspect hormonal changes may play a role, since obesity has been linked to lower levels of sex hormones.

Experts also can't agree on what causes prostate cancer to begin with. Could excess weight be a trigger? While there's some evidence that a diet high in fat and low in fruits and vegetables may influence a man's risk of developing the disease, there's no evidence to confirm that obesity is a risk factor.

"I think that we can't really say for sure what the prostate cancer risk factors are," Coates said.

Scientists also are investigating other possible culprits, including smoking, physical inactivity and unsafe sex.

For now, the best advice for a healthy prostate is the same advice men have been hearing for years about maintaining a healthy heart: Lose weight if you need to, eat a diet that includes plenty of fruits and vegetables and whole grains, exercise regularly and quit smoking.

Those lifestyle changes couldn't hurt, since men are 10 times more likely to die from heart disease than prostate cancer, Coates said.

There is also a lack of consensus on whether men should be routinely screened for prostate cancer.

"The CDC's position on screening is it's not clear whether the benefits outweigh the harms, and therefore we encourage informed decision making," Coates said.

But as a urologist, Freeland considers screening a must for men over 50 with a life expectancy of 10 years or more.

"I think the literature that supports screening in terms of reducing the risk of dying from prostate cancer is only now starting to mature," he said. "We will see more data that screening is beneficial."

More information

Check with the American Cancer Society to learn more about detecting, treating and preventing prostate cancer.

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Saturday, June 12, 2004

 

New Treatment Promising in Type 2 Diabetes

 

By Megan Rauscher

Reuters Health

Saturday, June 12, 2004

NEW YORK (Reuters Health) - In a study of type 2 diabetic patients, treatment with an investigational drug called liraglutide administered by injection once daily, improved control of blood sugar levels without increasing weight, European investigators report.

Commenting on his team's findings, Dr. Sten Madsbad from Hvidovre Hospital in Denmark told Reuters Health that insulin and other anti-diabetes drugs "also improve glycemic control, but increase weight. The present trial is the first to demonstrate long term improvement in glycemic control with a concomitant weight loss in type 2 diabetic patients."

Madsbad and his colleagues tested various doses of liraglutide in 193 people with type 2 diabetes, comparing the experimental treatment with either an inactive placebo or a standard drug, glimepiride.

Long-term glucose control improved in all but the lowest liraglutide dosage group, the team reports in the medical journal Diabetes Care. The improvements were seen after one week and maintained throughout the 12-week trial.

Also, there were "fewer hypoglycemic events in the liraglutide arm," Madsbad added, meaning that the drug was less likely than the standard treatment to drive down blood sugar too far, to dangerously low levels.

Moreover, patients taking liraglutide did not gain weight, and in fact some lost weight. Body weight increased "slightly" among those taking glimepiride.

Thus the researchers conclude that the agent "shows considerable promise as a once-daily therapy in type 2 diabetes."

Source: Diabetes Care, June 2004.

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Race Alone Shouldn't Decide Blood Pressure Therapy

 

Reuters Health

Saturday, June 12, 2004

NEW YORK (Reuters Health) - It has long seemed that some blood pressure medications work better than others for people of different racial backgrounds, but a new study shows that race by itself is a poor predictor of response to a particular treatment.

"The long-held paradigm of using race as a major criterion upon which to select therapy should be abandoned," Dr. John M. Flack from Wayne State University, Detroit, told Reuters Health. "A much greater source of variability in blood pressure response was within the groups, not between them."

Flack and his colleagues used data collected during a clinical trial of one type of blood-pressure lowering drug -- the angiotensin-converting enzyme (ACE) inhibitor quinapril -- to determine the influence of race on blood pressure response.

The team reports in the medical journal Hypertension that blood pressure lowering with quinapril treatment was, on average, greater for whites than blacks. However, the response varied widely for both white and black participants, and the range overlapped substantially.

Increasing age and obesity, as well as gender, accounted for much of the apparent racial differences in blood pressure response to quinapril treatment, the researchers note.

"The results of these analyzes highlight the potential pitfalls of comparing blood pressure responses between race groups without adequate adjustment for a range of potential confounding variables," the team concludes.

Flack noted that few patients are adequately controlled with a single drug, however, and other types of drugs are added to lower blood pressure to target levels.

Even so, doctors have to start somewhere when they begin a patient on blood pressure medication, Dr. Barry J. Materson from University of Miami School of Medicine, notes in a related editorial.

Rather than "random initial drug selection," he suggests that consideration of race and age "is a simple, cost-free, and relatively accurate way of guiding the choice of single-drug therapy for patients with stage 1 hypertension."

Source: Hypertension, June 2004.

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Breast Cancer Factors Similar for Blacks and Whites

Reuters Health

Saturday, June 12, 2004

NEW YORK (Reuters Health) - Having fewer children and not breastfeeding have both been shown to increase the risk of breast cancer. Now, new research indicates that the impact of these risk factors is similar for black and white women.

The findings, which appear in the medical journal Cancer, also suggest that blacks could experience a more rapid rise in breast cancer rates than whites if current childbearing trends continue.

Specifically, young black women seem to be having fewer and fewer children and breastfeeding rates were lower among blacks than whites.

Dr. Giske Ursin, from the University of Southern California in Los Angeles, and colleagues analyzed data from 2950 white and 1617 black women diagnosed with breast cancer between 1994 and 1998. A healthy comparison group consisting of 3012 white and 1656 black women were identified through random telephone dialing.

Each pregnancy reduced the risk of breast cancer among women between 35 and 49 years of age by 10 percent in blacks and by 13 percent in whites -- not a significant difference. The risk reductions observed among older women were less pronounced, but once again similar between the racial groups.

In whites and blacks, the risk of breast cancer fell as the duration of breastfeeding increased. However, breastfeeding was much less common among young black women than among their white peers. Blacks tended to have more children than whites, but in both groups there seemed to be a trend toward having fewer children.

The authors conclude that there are "only slight differences between white women and African-American women in terms of the effects of reproductive factors on breast (cancer) risk."

They also point out that "breastfeeding, and doing so for a longer duration, could reduce the risk of breast (cancer) and should be encouraged, especially among young African-American women."

Source: Cancer, June 7th  online, 2004.

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Vitamin C Rich Diet May Cut Arthritis Risk

By Anthony J. Brown, MD

Reuters Health

Saturday, June 12, 2004

NEW YORK (Reuters Health) - Consumption of foods high in vitamin C appears to protect against inflammatory polyarthritis, a form of rheumatoid arthritis involving two or more joints, new research suggests.

The findings, which appear in the Annals of the Rheumatic Diseases, stem from a study of more than 20,000 subjects who kept diet diaries and were arthritis-free when the study began. The analysis focused on 73 subjects who developed inflammatory polyarthritis during follow-up between 1993 and 2001, and 146 similar subjects who remained arthritis-free.

Dr. Dorothy J. Pattison, from the University of Manchester in the UK, and colleagues found that low intake of fruits, vegetables, and vitamin C raised the risk of inflammatory polyarthritis. For example, subjects who consumed the lowest amounts of vitamin C were three times more likely to develop the condition than their peers who consumed the highest amounts.

Although lower intake of fruits and vegetables seemed to increase the arthritis risk, the trends were not statistically significant, the researchers point out. Similarly, low intake of vitamin E and beta-carotene was only weakly linked with an increased risk of inflammatory polyarthritis.

The findings contrast with a recent report linking high doses of vitamin C with worsening disease in guinea pigs with osteoarthritis, the more common type of arthritis that occurs with aging.

In an interview with Reuters Health, Pattison said that these opposite findings may reflect the fact that rheumatoid arthritis and osteoarthritis are caused by different physiologic problems. With rheumatoid arthritis, an autoimmune disease, the body attacks itself, she explained. In contrast, osteoarthritis involves a degenerative process that worsens over time.

Pattison added that her group has a study being reviewed for publication that looks at the effect of meat consumption on the risk of arthritis.

Source: Annals of the Rheumatic Diseases, July 2004.

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