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Thursday, September 18, 2008
Monday, June 2, 2008
Water is vital, but how much should you drink?
ATLANTA, Georgia (CNN) -- Very few people question the importance of water in a healthy diet, but lately the needed quantity has been called into question.
Illness, pregnancy and breast feeding are also factors that will increase our bodies' need for fluids.
The conventional wisdom of eight, 8-ounce glasses a day has been tossed aside, leaving one to wonder what food group myths might topple next.
The apple-a-day thing? The medicinal aspects of Mom's chicken soup?
"There has been research out there for a while that the eight, 8-ounce glasses a day has no research to back up it at all," Food Network dietitian Ellie Krieger told CNN.
"People just latched onto this number because it was really easy to remember. And I think people feel that if they're not drinking eight glasses of water, then they are not doing well for their bodies, and that is not necessarily true. "
But what is true is that our bodies are made up of a good deal of water. It makes up on average 60 percent of our body weight. And it seems to enable our basic functions.
Not only does it moisten tissues -- such as those around the mouth, eyes and nose -- it also cushions our joints, regulates our body temperature, helps our bodies get nutrients, and flushes out waste products.
Whew, talk about multitasking!
Illness, pregnancy and breast feeding are also factors that will increase our bodies' need for fluids.
The conventional wisdom of eight, 8-ounce glasses a day has been tossed aside, leaving one to wonder what food group myths might topple next.
The apple-a-day thing? The medicinal aspects of Mom's chicken soup?
"There has been research out there for a while that the eight, 8-ounce glasses a day has no research to back up it at all," Food Network dietitian Ellie Krieger told CNN.
"People just latched onto this number because it was really easy to remember. And I think people feel that if they're not drinking eight glasses of water, then they are not doing well for their bodies, and that is not necessarily true. "
But what is true is that our bodies are made up of a good deal of water. It makes up on average 60 percent of our body weight. And it seems to enable our basic functions.
Not only does it moisten tissues -- such as those around the mouth, eyes and nose -- it also cushions our joints, regulates our body temperature, helps our bodies get nutrients, and flushes out waste products.
Whew, talk about multitasking!
But if the rule of eight is out, how do we know we're getting enough to keep us flowing?
"The general guideline is to pay attention to your thirst," Krieger said. "Your thirst is actually a good guide of how well hydrated you are and if you drink according to your thirst, you will stay hydrated."
She also had more good news: Liquids other than water count.
"So if you drink coffee or tea, even if it's caffeinated, it counts towards hydration," she said. "So do fruit juices and milk and soups and things like that."
Less caffeine -- which can dehydrate -- is better than more, in the fluid count.
Krieger says a good rule of thumb for moderately active women in temperate climates is that they need about nine 8-ounce glasses of fluids a day.
"Ideally," she adds, "you want at least half of that to be water."
Some conditions ramp up our water needs.
Obviously temperature is one thing, whether from a seasonal shift or a thermostat redial. The hotter your surroundings, the more you will sweat out your inner water supply and the more fluids you will need to consume. Turning up your own inner temperature through exercise will also increase the need to refuel the fluids.
Experts at the Mayo Clinic suggest that water is fine after short exercise sessions but recommend drinking a sports drink during longer, more intense workouts. Those drinks contain sodium and will reduce your risk of developing hyponatremia, a rare yet possibly life-threatening condition that occurs when you drink too much water.
It happens when the kidneys can't flush out the excess water, making the electrolyte content in the blood diluted. That leads to low sodium levels in the blood. This is very uncommon and mainly seen in endurance athletes, such as marathon runners.
Illness, pregnancy and breast feeding are also factors that will increase our bodies' need for fluids.
And don't forget, those fluids can also be found in food.
"It is a very good idea to eat water-rich food like fruits and vegetables and dairy and lean protein even," says Krieger. "Those are foods that are great for your body that are going to keep lean and healthy and keep hydrated."
So the quest for hydration is pretty easy to pursue, and Krieger gives hope to those of us who don't beat a constant path to the water cooler.
She also had more good news: Liquids other than water count.
"So if you drink coffee or tea, even if it's caffeinated, it counts towards hydration," she said. "So do fruit juices and milk and soups and things like that."
Less caffeine -- which can dehydrate -- is better than more, in the fluid count.
Krieger says a good rule of thumb for moderately active women in temperate climates is that they need about nine 8-ounce glasses of fluids a day.
"Ideally," she adds, "you want at least half of that to be water."
Some conditions ramp up our water needs.
Obviously temperature is one thing, whether from a seasonal shift or a thermostat redial. The hotter your surroundings, the more you will sweat out your inner water supply and the more fluids you will need to consume. Turning up your own inner temperature through exercise will also increase the need to refuel the fluids.
Experts at the Mayo Clinic suggest that water is fine after short exercise sessions but recommend drinking a sports drink during longer, more intense workouts. Those drinks contain sodium and will reduce your risk of developing hyponatremia, a rare yet possibly life-threatening condition that occurs when you drink too much water.
It happens when the kidneys can't flush out the excess water, making the electrolyte content in the blood diluted. That leads to low sodium levels in the blood. This is very uncommon and mainly seen in endurance athletes, such as marathon runners.
Illness, pregnancy and breast feeding are also factors that will increase our bodies' need for fluids.
And don't forget, those fluids can also be found in food.
"It is a very good idea to eat water-rich food like fruits and vegetables and dairy and lean protein even," says Krieger. "Those are foods that are great for your body that are going to keep lean and healthy and keep hydrated."
So the quest for hydration is pretty easy to pursue, and Krieger gives hope to those of us who don't beat a constant path to the water cooler.
"The people who are walking around with huge bottles of water all day long probably don't need to be doing that," she said. "They are probably not hurting themselves, but it's probably not helping them as much as they think it is, and it's a psychological crutch."
Of course as psychological crutches go, how bad can a hefty bottle of water really be? Probably no couch time needed for that!
Of course as psychological crutches go, how bad can a hefty bottle of water really be? Probably no couch time needed for that!
Monday, July 16, 2007
Report finds fewer teens having intercourse, more using condoms
WASHINGTON (AP) -- Fewer high school students are having sex these days, and more are using condoms. The teen birth rate has hit a record low.More young people are finishing high school, too, and more little kids are being read to, according to the latest government snapshot on the well-being of the nation's children. It's good news on a number of key wellness indicators, experts said of the report being released Friday.
"The implications for the population are quite positive in terms of their health and their well-being," said Edward Sondik, director of the National Center for Health Statistics. "The lower figure on teens having sex means the risk of sexually transmitted diseases is lower."
In 2005, 47 percent of high school students -- 6.7 million -- reported having had sexual intercourse, down from 54 percent in 1991. The rate of those who reported having had sex has remained the same since 2003.
Of those who had sex during a three-month period in 2005, 63 percent -- about 3 million -- used condoms. That's up from 46 percent in 1991.
The teen birth rate, the report said, was 21 per 1,000 young women ages 15-17 in 2005 -- an all-time low. It was down from 39 births per 1,000 teens in 1991.
"This is very good news," said Sondik. "Young teen mothers and their babies are at a greater risk of both immediate and long-term difficulties."
The birth rate in the 15-19 age group was 40 per 1,000 in 2005, also down sharply from the previous decade.
Education campaigns that started years ago are having a significant effect, said James Wagoner, president of Advocates for Youth, a Washington-based nonprofit group that focuses on prevention of teen pregnancy and sexually transmitted diseases.
"I think the HIV/AIDS epidemic and the efforts in the '80s and '90s had a lot to do with that," Wagoner said of the improved numbers on teen sex, condoms and adolescent births.
"We need to encourage young teens to delay sexual initiation and we need to make sure they get all the information they need about condoms and birth control," he said.
The report was compiled from statistics and studies at 22 federal agencies, and covered 38 key indicators, including infant mortality, academic achievement rates and the number of children living in poverty.
Other highlights:
• The percentage of children covered by health insurance decreased slightly. In 2005, 89 percent of children had health insurance coverage at some point during the year, down from 90 percent the previous year.
• The percentage of low birthweight infants (born weighing less than 5 pounds, 8 ounces) increased. It was 8.2 percent in 2005, up from 8.1 percent in 2004.
• More youngsters are getting reading time. Sixty percent of children ages 3-5 (and not in kindergarten) were read to daily by a family member in 2005, up from 53 percent in 1993.
• The percentage of children who had at least one parent working year round and full-time increased to 78.3 percent in 2005, up from 77.6 percent the previous year.
• More young people are completing high school. In 2005, 88 percent of young adults had finished high school -- up from 84 percent in 1980. The report was released by the Federal Interagency Forum on Child and Family Statistics -- a consortium of federal agencies that includes the National Institute of Child Health and Human Development, the Census Bureau and the Administration for Children and Families.
Surviving summer camp -- for parents and kids
For parents, sending kids off to summer camp is an emotional balancing act: There's the prospect of fresh air and friendships, competition and camaraderie, but there's also the worry of insect bites, injuries and allergies.The health and well-being of their kids is a concern of multitudes of parents, as more than six million American children head off to summer camp this year, their care thrust into the hands of teenaged counselors and skilled administrators. While there are no national safety standards for camps, and no data on how many campers are actually hurt or get sick, some reliable data suggests kids are in pretty safe hands, with just one adverse health event for every 1,000 camper days.
But parents remembering their own camp days should be aware the camp experience may be changing.
One interesting health trend is the increasing number of potential bunkmates with Attention Deficit Hyperactivity Disorder. "Five years ago, many camps wouldn't even accept kids with special behavioral needs or medications, but now do if the behaviors aren't too extreme," said Jeffrey Solomon, executive director of the National Camp Association. As a result, many camps hire and train staff to cater to the needs of kids who might need a little extra attention and supervision taking medications.
ADHD often presents a summertime dilemma for some parents who wonder if they should pack for camp the medication used primarily to help a child stay focused in school.
"You'd like the kids to have a break from ADHD medication," said Dr. Benjamin Siegel, professor of psychiatry at Boston University School of Medicine and a member of the American Academy of Pediatrics. Siegel, himself a camp doctor for 20 years, said exceptions would include kids who have more significant behavioral problems, or have anxiety or depression as well as ADHD.
He stressed any psychiatric problems should always be brought to the attention of camp staff.
Adults may recall routine camp checks for impetigo, a skin infection caused by strep or bacteria, and most camps still do that. But the emergence of a dangerous, drug-resistant staph germ has summer camps paying attention to another threat: superbugs.
While there's no evidence of increases in outbreaks of drug resistant infections at camps, emergency room doctors warn we are seeing an increase in MRSA -- a superbug known as Methicillin-resistant Staphylococcus aureus -- all over the country.
Dr. Denise Dowd, a member of the American Academy of Pediatrics Injury, Poison and Violence Prevention Committee, said she treats at least three cases a day in the emergency room.
A serious "superbug" infection can start as an innocent-looking insect or mosquito bite, but counselors need to be vigilant about anything that worsens or spreads, as it could be a sign of a serious staph infection. Simple handwashing -- something kids may forget to do at camp -- can greatly reduce the spread of dangerous germs.
Another trend is more campers with food allergies, particularly peanut allergies. "The peanut butter-and-jelly camp sandwich we grew up with is gone," explained Solomon, as camps strive to monitor not only what's served in camp cafeterias, but what's received in care packages.
Parents concerned about overweight kids can take comfort in another trend: better camp food. "While 20 years ago, 20 percent of our camps had salad bars, now well over 80 percent have them. And as a result campers are eating less carbs, and healthier meals," Solomon said.
What if your child hates more than bug juice, and wants to come home?
Experts say by age 9, kids should have mastered separation, and 80 percent of first-time campers join right in. But camp personnel are becoming more sensitive to another trend: the number of campers from divorced families.
"Some children from divorced families are perfectly comfortable, but if there's any trauma around the divorce, those kids bring with them to camp their family struggles," Siegel said. He said camp staff are increasingly trained to identify and pay attention to kids from painful family situations, to help them adjust.
As a final safety consideration, while many parents may feel like they're on holiday as well when the kids go to camp, one of the most important things to remember is, your child or camp needs to be able to reach you at all times. "It's extremely important for kids to have continuous emergency contacts at all times," said Dowd, in case things do go wrong.
The one thing that hasn't changed at America's summer camps, some of which are more than 100 years old, is the opportunity for your child to have fun.
"Kids really look forward to camp and friendships there," said Siegel. "It's a wonderful opportunity for them to grow."
Thursday, July 12, 2007
Filmmaker Michael Moore, whose new documentary "Sicko" takes on America's health care system, faced off Tuesday with CNN chief medical correspondent a
Moore criticized a report Gupta did on CNN Monday on "Sicko."
"He said the facts were fudged," Moore said, referring to Gupta, on CNN's "Larry King Live."
"That's a lie. None of the facts are fudged."
Moore and Gupta shouted and argued over data Gupta used and data Moore used. Moore said his staffers backed up the film's facts to Gupta before the report aired and that Gupta aired it knowing his facts were wrong.
Gupta disputed that.
"We try and look for some of the best sources we can possibly find," he said. "Michael has a lot of different numbers. ... You're sort of cherry-picking data from different reports."
Both agreed, however, on the basic premise of "Sicko": Problems abound in America's health-care system and need to be fixed.
"I thought it was a good movie, and I wanted to say that," Gupta said. "I think it strikes at the irrefutable fact -- it's broken. We get it."
He praised Moore for raising awareness of the issue.
However, Gupta said he was concerned that the movie -- which notes that other developed nations such as France and Canada have universal health care --suggests that health care in those countries is free.
While patients may not pay for services at the doctor's office, they do pay high taxes to fund such a system, something Gupta said he was concerned that "Sicko" audiences might not realize.
Moore responded by saying Americans pay more in copays, deductibles and insurance premiums. "We [America] have a system built on profit," the moviemaker said.
He asked Gupta if the current system, which requires him to receive approval from an insurance company before performing some procedures, is cumbersome to him.
"It's a shameful system, especially when I'm dealing with some of my patients," Gupta said.
But he questioned Moore's apparent solution -- putting health care in the hands of the Bush administration, which Moore fiercely criticized in the past, particularly in his film "Fahrenheit 9/11."
"The government actually used to do things right," Moore said in response. "The problem is who we put in power."
"I thought it was a good movie, and I wanted to say that," Gupta said. "I think it strikes at the irrefutable fact -- it's broken. We get it."
He praised Moore for raising awareness of the issue.
However, Gupta said he was concerned that the movie -- which notes that other developed nations such as France and Canada have universal health care --suggests that health care in those countries is free.
While patients may not pay for services at the doctor's office, they do pay high taxes to fund such a system, something Gupta said he was concerned that "Sicko" audiences might not realize.
Moore responded by saying Americans pay more in copays, deductibles and insurance premiums. "We [America] have a system built on profit," the moviemaker said.
He asked Gupta if the current system, which requires him to receive approval from an insurance company before performing some procedures, is cumbersome to him.
"It's a shameful system, especially when I'm dealing with some of my patients," Gupta said.
But he questioned Moore's apparent solution -- putting health care in the hands of the Bush administration, which Moore fiercely criticized in the past, particularly in his film "Fahrenheit 9/11."
"The government actually used to do things right," Moore said in response. "The problem is who we put in power."
Moore has adamantly opposed the war in Iraq and said the government should reprioritize -- a position he took many years before skepticism of the war's success abounded in Washington.
"I am sorry we've taken so much time trying to correct [Gupta's] facts here tonight instead of talking about the real issue" -- the ailing health care system, Moore said.
"I am sorry we've taken so much time trying to correct [Gupta's] facts here tonight instead of talking about the real issue" -- the ailing health care system, Moore said.
My conversation with Michael Moore
Last night on Larry King, I had a chance to sit and discuss health care with a man I admire. It is true. Michael Moore has been able to get people talking about health care policy in a way that I haven't seen in a long time. It is important, because we both agree on the need to fix the health care system. It is shameful and heartbreaking that so many people don't have access to what most consider a basic human right. An uninsured person in this country is forced to make impossible decisions every day, such as choosing between food and medications. They live with the constant fear of getting sick or injured and then suddenly finding themselves in financial ruin. Even for the insured, the system seems broken and antiquated. Most everyone who reads this, whether you are a doctor or a patient, agrees that the time has come for a change.Michael Moore and I agree on these points. In fact, after the segment ended on Larry King last night, we chatted for a couple of moments off the air. It was friendly and he seemed appreciative that we had a chance to discuss some of these issues. He reminded me that we are both from Michigan, although he favors the Spartans and I am a die hard Wolverine fan. He also reminded me that he has been working on Sicko for a long time and wanted to be recognized for his efforts. And, I do recognize that. Sincerely.I also think, though, that it is important to get the facts absolutely right and to be transparent about the sources of those facts. Michael knows that I took issue with the "cherry picking" of some numbers to try and bolster his argument. He cited an unsourced BBC report when talking about per capita Cuban spending. That same report also talked about US per capita health spending, but he apparently didn't like that number, so instead he used a projected number from a different study. I worry that comparing apples and oranges purposely, and perhaps needlessly, muddy the argument. To be clear, I got a number wrong in my original report, substituting the number 25, instead of 251. It was not deliberate, but an error of transcription. I felt awful it happened. I did correct it and apologize.I also worry that Michael, who is an accomplished film maker, tried to leave people with the impression that health care is free in many other nations and there is a state of utopia. True, Michael did talk about increased taxes in his film, but he also kept calling it "free," which made it nebulous. No question, there are many valuable things to learn from other health care systems, but we should know all things before wholeheartedly endorsing one system over another. We should know that taxes will be much higher, as is the case in France where they are crippled by their health care system. We should also know that a significant number of people in these countries still buy supplemental insurance, apparently unhappy with what the government alone can provide. We should also remember that Medicare, an example of a limited national health care plan in the United States, is expected to go bankrupt by the year 2020. If there is a new national health care plan, we want it to be around for a very long time and to provide the sort of health care that we deserve. Personally, I believe that adopting a much more prevalent prevention model is an important first step. Keeping people from getting sick in the first place may cost more in the short run, but it is medically and morally the right thing to do.Judging by the response over the past few days, people are very passionate about these health care issues. I think I can safely speak for Michael, when I say, that is the best news of all. I was a bit baffled, though, that Michael took such issue with my reporting in Iraq. I reported on a group of Navy doctors who worked hard to address the consequences of those booms and explosions we watched on television. They risked their lives everyday to save and improve the lives of others. I think about them everyday. I wish Michael would've watched some of that reporting before being so critical.Although Michael accused me of it, I have never shilled for a corporate sponsor and I never will. What I will do is try and present solid reporting on the complexities of a health care system in disrepair, no matter who it makes uncomfortable - be they powerful vested interests or filmmakers.On a final note, Michael has told people at Health that he regularly receives nasty email and even death threats. As I have been thrust into this world over the past couple of days, I understand what he is talking about. If you want to contribute to the discussion, please try and keep your comments constructive.
Woman drops 110 pounds, 8 dress sizes
Three years ago Sharon Twitchell was miserable.
Carrying 227 pounds on her tiny 5'2" frame, the 51-year-old mother and wife could barely squeeze into her plus-size clothing.Twitchell is the first of eight CNN.com I-Reporters who shared their weight loss stories with CNN. Over the next several weeks, we'll reveal their secrets, the defining moments that motivated them to lose a combined total of 1,167 pounds and how the weight loss has changed their lives.
"I was wearing a size 22 and getting my clothes at stores where the biggest size was a 24. I asked myself, 'Where are you going to buy your clothes after you get bigger than a size 24?'" said Twitchell.
Adding to her misery, Twitchell says her ballooning weight was also wreaking havoc on her 31-year marriage.
"We were literally just co-existing together, like roommates," recalled Twitchell.
"Friends asked my husband to e-mail them a picture of us. Later, I discovered that he had sent them an old photograph taken when I was much smaller. Even though he loved me, he was embarrassed at how much weight I had gained."
Afraid she would have to purchase clothing from online stores catering to larger women, Twitchell told her husband she'd had enough and was ready to make a change.
"I was wearing a size 22 and getting my clothes at stores where the biggest size was a 24. I asked myself, 'Where are you going to buy your clothes after you get bigger than a size 24?'" said Twitchell.
Adding to her misery, Twitchell says her ballooning weight was also wreaking havoc on her 31-year marriage.
"We were literally just co-existing together, like roommates," recalled Twitchell.
"Friends asked my husband to e-mail them a picture of us. Later, I discovered that he had sent them an old photograph taken when I was much smaller. Even though he loved me, he was embarrassed at how much weight I had gained."
Afraid she would have to purchase clothing from online stores catering to larger women, Twitchell told her husband she'd had enough and was ready to make a change.
Initially, Twitchell made an appointment with her physician in hopes that he would write her a prescription for a pill to help her lose weight. Instead, she says she saw the "w" begin to form on his lips and knew he was going to recommend she try Weight Watchers.
Uncomfortable with the thought of going to actual meetings, Twitchell lost 30 pounds on her own and eventually joined the online Weight Watchers POINTS program on October 26, 2004. She also bought an elliptical machine and a recumbent bicycle and started working out six days a week.
The pounds melted off.
Ten months and another 80 pounds later, she reached her goal weight on August 26, 2005.
Twitchell says she hasn't been this size since before her first daughter was born. She now weighs 117 pounds and wears a size 2 or 4, depending on the store.
How has this changed her life?
"I have a marriage again," says Twitchell, who recently retired and relocated with her husband from New Jersey to their new home in the mountains of western North Carolina.
"When I finally reached my goal (weight), my wedding ring was two sizes too big. I had already had it resized twice and the jeweler was hesitant that I might lose more weight. Rather than resize it, my husband bought me a new beautiful diamond ring and when he gave it to me he said this was a renewal of our wedding vows," she recalled.
Uncomfortable with the thought of going to actual meetings, Twitchell lost 30 pounds on her own and eventually joined the online Weight Watchers POINTS program on October 26, 2004. She also bought an elliptical machine and a recumbent bicycle and started working out six days a week.
The pounds melted off.
Ten months and another 80 pounds later, she reached her goal weight on August 26, 2005.
Twitchell says she hasn't been this size since before her first daughter was born. She now weighs 117 pounds and wears a size 2 or 4, depending on the store.
How has this changed her life?
"I have a marriage again," says Twitchell, who recently retired and relocated with her husband from New Jersey to their new home in the mountains of western North Carolina.
"When I finally reached my goal (weight), my wedding ring was two sizes too big. I had already had it resized twice and the jeweler was hesitant that I might lose more weight. Rather than resize it, my husband bought me a new beautiful diamond ring and when he gave it to me he said this was a renewal of our wedding vows," she recalled.
Twitchell says her husband keeps telling people that he's got his wife back. This August, the couple will celebrate their 33rd wedding anniversary and they couldn't be happier.
"If I can lose 110 pounds, anyone can," says Twitchell.
"If I can lose 110 pounds, anyone can," says Twitchell.
Overweight kids face early stigma, long-term problems
NEW HAVEN, Connecticut (AP) -- Overweight children are stigmatized by their peers as early as age 3 and even face bias from their parents and teachers, giving them a quality of life comparable to people with cancer, a new analysis concludes.Youngsters who report teasing, rejection, bullying and other types of abuse because of their weight are two to three times more likely to report suicidal thoughts as well as to suffer from other health issues such as high blood pressure and eating disorders, researchers said.
"The stigmatization directed at obese children by their peers, parents, educators and others is pervasive and often unrelenting," researchers with Yale University and the University of Hawaii at Manatoa wrote in the July issue of Psychological Bulletin.
The paper was based on a review of all research on youth weight bias over the past 40 years, said lead author Rebecca M. Puhl of Yale's Rudd Center for Food Policy and Obesity.
"The stigmatization directed at obese children by their peers, parents, educators and others is pervasive and often unrelenting," researchers with Yale University and the University of Hawaii at Manatoa wrote in the July issue of Psychological Bulletin.
The paper was based on a review of all research on youth weight bias over the past 40 years, said lead author Rebecca M. Puhl of Yale's Rudd Center for Food Policy and Obesity.
It comes amid a growing worldwide epidemic of child obesity. By 2010, almost 50 percent of children in North America and 38 percent of children in the European Union will be overweight, the researchers said.
While programs to prevent childhood obesity are growing, more efforts are needed to protect overweight children from abuse, Puhl said.
"The quality of life for kids who are obese is comparable to the quality of life of kids who have cancer," Puhl said, citing one study. "These kids are facing stigma from everywhere they look in society, whether it's media, school or at home."
Even with a growing percentage of overweight people, the stigma shows no signs of subsiding, according to Puhl. She said television and other media continue to reinforce negative stereotypes.
"This is a form of bias that is very socially acceptable," Puhl said. "It is rarely challenged; it's often ignored."
The stigmatization of overweight children has been documented for decades. When children were asked to rank photos of children as friends in a 1961 study, the overweight child was ranked last.
Children as young as 3 are more likely to consider overweight peers to be mean, stupid, ugly and sloppy.
A growing body of research shows that parents and educators are also biased against heavy children. In a 1999 study of 115 middle and high school teachers, 20 percent said they believed obese people are untidy, less likely to succeed and more emotional.
"Perhaps the most surprising source of weight stigma toward youths is parents," the report says.
Several studies showed that overweight girls got less college financial support from their parents than average weight girls. Other studies showed teasing by parents was common.
"It is possible that parents may take out their frustration, anger and guilt on their overweight child by adopting stigmatizing attitudes and behavior, such as making critical and negative comments toward their child," the authors wrote, suggesting further research is needed.
Lynn McAfee, 58, of Stowe, Pennsylvania, said that as an overweight child she faced troubles on all fronts.
"It was constantly impressed upon me that I wasn't going to get anywhere in the world if I was fat," McAfee said. "You hear it so often, it becomes the truth."
Her mother, who also was overweight, offered to buy her a mink coat when she was 8 to try to get her to lose weight even though her family was poor.
"I felt I was letting everybody down," she said.
Other children would try to run her down on bikes to see if she would bounce. She had a hard time getting on teams in the playground.
"Teachers did not stand up for me when I was teased," McAfee said.
A study in 2003 found that obese children had much lower quality of life scores on issues such as health, emotional and social well-being, and school functioning.
"An alarming finding of this research was that obese children had (quality of life) scores comparable with those of children with cancer," the researchers reported.
Sylvia Rimm, author of "Rescuing the Emotional Lives of Overweight Children," said her surveys of more than 5,000 middle school children reached similar conclusions.
"The overweight children felt less intelligent," Rimm said. "They felt less popular. They struggled from early on. They feel they are a different species."
Parents should emphasize a child's strengths, she said, and teachers should pair up students for activities instead of letting children pick their partners.
McAfee, who now works for the Council on Size and Weight Discrimination, said her childhood experiences even made her reluctant to see a doctor when she needed one. She recalled one doctor who said she looked like a gorilla and another who gave her painkillers and diet pills for what turned out to be mononucleosis.
"The amount of cruelty I've seen in people has changed me forever," McAfee said.
The Yale-Hawaii research report recommends more research to determine whether negative stereotypes lead to discriminatory behavior, citing evidence that overweight adults face discrimination. It also calls for studying ways to reduce stigma and negative attitudes toward overweight children.
"Weight-based discrimination is as important a problem as racial discrimination or discrimination against children with physical disabilities," the report concludes. "Remedying it needs to be taken equally seriously..."
While programs to prevent childhood obesity are growing, more efforts are needed to protect overweight children from abuse, Puhl said.
"The quality of life for kids who are obese is comparable to the quality of life of kids who have cancer," Puhl said, citing one study. "These kids are facing stigma from everywhere they look in society, whether it's media, school or at home."
Even with a growing percentage of overweight people, the stigma shows no signs of subsiding, according to Puhl. She said television and other media continue to reinforce negative stereotypes.
"This is a form of bias that is very socially acceptable," Puhl said. "It is rarely challenged; it's often ignored."
The stigmatization of overweight children has been documented for decades. When children were asked to rank photos of children as friends in a 1961 study, the overweight child was ranked last.
Children as young as 3 are more likely to consider overweight peers to be mean, stupid, ugly and sloppy.
A growing body of research shows that parents and educators are also biased against heavy children. In a 1999 study of 115 middle and high school teachers, 20 percent said they believed obese people are untidy, less likely to succeed and more emotional.
"Perhaps the most surprising source of weight stigma toward youths is parents," the report says.
Several studies showed that overweight girls got less college financial support from their parents than average weight girls. Other studies showed teasing by parents was common.
"It is possible that parents may take out their frustration, anger and guilt on their overweight child by adopting stigmatizing attitudes and behavior, such as making critical and negative comments toward their child," the authors wrote, suggesting further research is needed.
Lynn McAfee, 58, of Stowe, Pennsylvania, said that as an overweight child she faced troubles on all fronts.
"It was constantly impressed upon me that I wasn't going to get anywhere in the world if I was fat," McAfee said. "You hear it so often, it becomes the truth."
Her mother, who also was overweight, offered to buy her a mink coat when she was 8 to try to get her to lose weight even though her family was poor.
"I felt I was letting everybody down," she said.
Other children would try to run her down on bikes to see if she would bounce. She had a hard time getting on teams in the playground.
"Teachers did not stand up for me when I was teased," McAfee said.
A study in 2003 found that obese children had much lower quality of life scores on issues such as health, emotional and social well-being, and school functioning.
"An alarming finding of this research was that obese children had (quality of life) scores comparable with those of children with cancer," the researchers reported.
Sylvia Rimm, author of "Rescuing the Emotional Lives of Overweight Children," said her surveys of more than 5,000 middle school children reached similar conclusions.
"The overweight children felt less intelligent," Rimm said. "They felt less popular. They struggled from early on. They feel they are a different species."
Parents should emphasize a child's strengths, she said, and teachers should pair up students for activities instead of letting children pick their partners.
McAfee, who now works for the Council on Size and Weight Discrimination, said her childhood experiences even made her reluctant to see a doctor when she needed one. She recalled one doctor who said she looked like a gorilla and another who gave her painkillers and diet pills for what turned out to be mononucleosis.
"The amount of cruelty I've seen in people has changed me forever," McAfee said.
The Yale-Hawaii research report recommends more research to determine whether negative stereotypes lead to discriminatory behavior, citing evidence that overweight adults face discrimination. It also calls for studying ways to reduce stigma and negative attitudes toward overweight children.
"Weight-based discrimination is as important a problem as racial discrimination or discrimination against children with physical disabilities," the report concludes. "Remedying it needs to be taken equally seriously..."
Nurses confront violence on the job
BOSTON, Massachusetts (CNN) -- Nurses understand that they have a tough job, but getting attacked and abused is not what former Boston area emergency room nurse Ellen MacInnis says she signed up for.
"It was very frightening," said the 18-year veteran. An angry and frustrated patient had grabbed MacInnis' hand, dug her nails in and made a chilling threat. "If you have children, I'll find them and I'll kill them."
This was not the only time MacInnis was assaulted on the job. Last summer, an intoxicated, H.I.V.-infected female patient tried to hit her and wound up covering her in blood.
MacInnis said the thought that her life was in danger never occurred to her until after the situation was under control. "Then it sort of hit me," she said, "And I fell apart."
Nurses are often on the receiving end of physical assaults, because they are typically the first and most frequent medical personnel by the bedside of ill and sometimes angry or frustrated patients.
Emergency rooms seem to be the hot spots for violent assaults, according to experts interviewed for this article, but general practice nurses are not immune.
Fifty percent of nurses surveyed by the Massachusetts Nurses Association (MNA) -- a union of registered nurses -- and the University of Massachusetts said they had been punched at least once in a two-year period. Some reported being strangled, sexually assaulted or stuck with contaminated needles.
In the past, the biggest problems reported by nurses had to do with back injuries or work related asthma, but that's changed, said Evelyn Bain, head of the MNA's Occupational Health and Safety Office.
"Workplace violence has really just been head and shoulders above that," said Bain.
It's not just a problem in Massachusetts. A national survey, conducted last year by the Emergency Nurses Association, a national association for emergency room nurses, found 86 percent of its nurses reported being a victim of workplace violence during the prior three years; 19 percent said it happened frequently. Watch how nurses cope with violent patients »
Boston-area psychiatric emergency room nurse Karen Coughlin said she was forced to restrain a disturbed female patient who had fashioned a switchblade-like knife out of a harmonica. Another time she had to fight off an aggressive, violent male patient.
"He had gone after me," she said. "I really thought he was going to kill me."
This became almost routine, she said.
"I've been punched, I've been kicked, I've been spit at," she added.
Coughlin had always stood up to the tough challenges of her job, but her family was scared.
"My son asked me, did anybody try to kill you today?" she said.
Coughlin, who claims she hasn't seen this level of violence in her 23 years on the job, started questioning her work environment. "My kids shouldn't have to ask me that, you know."
The MNA claims budget cuts, resulting in a shortage of nurses, are partly to blame for this problem. The Massachusetts Hospital Association (MHA), an organization representing hospitals and health systems, agrees that violence in the workplace is a problem, but officials there don't blame staffing levels.
Karen Nelson, senior vice president of clinical affairs at MHA, says assaults on nurses are more a product of a violent society, where mass shootings are no longer rare, than a nursing shortage. She calls the push to hire more nurses "a knee-jerk reaction."
Nelson said stepped-up security and safety training for nurses is a more practical solution. Many nurses are being trained to recognize a potentially violent situation and then find ways to deescalate it.
MacInnis, who had to undergo a debilitating cocktail treatment to prevent contamination from the H.I.V-infected blood, supports a proposed law in Massachusetts that would toughen safety guidelines at hospitals across the state.
"Legislation will be helpful," she said. But the MHA said legislation would only duplicate what the federal Occupational Safety and Health Administration and other regulatory agencies already require.
"It's pretty much redundant with existing rules, regulations, standards," said Nelson.
As this issue is debated in Massachusetts and in other states, more nurses are standing up to their attackers and reporting assaults, according to Bain of the MNA.
In the past, some nurses and hospitals have tolerated a lot of abuse by patients, she said. Nurses were sometimes discouraged from taking action and told that unruly and sometimes violent patients were part of the job. They were guided by a duty to help and heal sick patients, not prosecute them.
Now, the MNA is encouraging nurses to press charges. "Perpetrators should be held accountable," said Bain.
This was not the only time MacInnis was assaulted on the job. Last summer, an intoxicated, H.I.V.-infected female patient tried to hit her and wound up covering her in blood.
MacInnis said the thought that her life was in danger never occurred to her until after the situation was under control. "Then it sort of hit me," she said, "And I fell apart."
Nurses are often on the receiving end of physical assaults, because they are typically the first and most frequent medical personnel by the bedside of ill and sometimes angry or frustrated patients.
Emergency rooms seem to be the hot spots for violent assaults, according to experts interviewed for this article, but general practice nurses are not immune.
Fifty percent of nurses surveyed by the Massachusetts Nurses Association (MNA) -- a union of registered nurses -- and the University of Massachusetts said they had been punched at least once in a two-year period. Some reported being strangled, sexually assaulted or stuck with contaminated needles.
In the past, the biggest problems reported by nurses had to do with back injuries or work related asthma, but that's changed, said Evelyn Bain, head of the MNA's Occupational Health and Safety Office.
"Workplace violence has really just been head and shoulders above that," said Bain.
It's not just a problem in Massachusetts. A national survey, conducted last year by the Emergency Nurses Association, a national association for emergency room nurses, found 86 percent of its nurses reported being a victim of workplace violence during the prior three years; 19 percent said it happened frequently. Watch how nurses cope with violent patients »
Boston-area psychiatric emergency room nurse Karen Coughlin said she was forced to restrain a disturbed female patient who had fashioned a switchblade-like knife out of a harmonica. Another time she had to fight off an aggressive, violent male patient.
"He had gone after me," she said. "I really thought he was going to kill me."
This became almost routine, she said.
"I've been punched, I've been kicked, I've been spit at," she added.
Coughlin had always stood up to the tough challenges of her job, but her family was scared.
"My son asked me, did anybody try to kill you today?" she said.
Coughlin, who claims she hasn't seen this level of violence in her 23 years on the job, started questioning her work environment. "My kids shouldn't have to ask me that, you know."
The MNA claims budget cuts, resulting in a shortage of nurses, are partly to blame for this problem. The Massachusetts Hospital Association (MHA), an organization representing hospitals and health systems, agrees that violence in the workplace is a problem, but officials there don't blame staffing levels.
Karen Nelson, senior vice president of clinical affairs at MHA, says assaults on nurses are more a product of a violent society, where mass shootings are no longer rare, than a nursing shortage. She calls the push to hire more nurses "a knee-jerk reaction."
Nelson said stepped-up security and safety training for nurses is a more practical solution. Many nurses are being trained to recognize a potentially violent situation and then find ways to deescalate it.
MacInnis, who had to undergo a debilitating cocktail treatment to prevent contamination from the H.I.V-infected blood, supports a proposed law in Massachusetts that would toughen safety guidelines at hospitals across the state.
"Legislation will be helpful," she said. But the MHA said legislation would only duplicate what the federal Occupational Safety and Health Administration and other regulatory agencies already require.
"It's pretty much redundant with existing rules, regulations, standards," said Nelson.
As this issue is debated in Massachusetts and in other states, more nurses are standing up to their attackers and reporting assaults, according to Bain of the MNA.
In the past, some nurses and hospitals have tolerated a lot of abuse by patients, she said. Nurses were sometimes discouraged from taking action and told that unruly and sometimes violent patients were part of the job. They were guided by a duty to help and heal sick patients, not prosecute them.
Now, the MNA is encouraging nurses to press charges. "Perpetrators should be held accountable," said Bain.
Despite the safety concerns, most nurses are relatively satisfied with their jobs. The ENA says its survey indicates that 64 percent of emergency room nurses are very or somewhat satisfied with their job, and 75 percent expect to be in the nursing profession in 10 years.
MacInnis, who now works in a different unit at the same hospital, says nursing is in her blood. "It is what we do; we take care of people."
MacInnis, who now works in a different unit at the same hospital, says nursing is in her blood. "It is what we do; we take care of people."
Tuesday, July 10, 2007
Talking about you know what after kids arrive
(Parenting.com) -- Whether you have minor problems in bed or a love life dusty with disuse, here's the secret to connecting Ten years ago, before kids and mortgages and All That, my husband and I were experts in the language of love. If sex is a form of communication, well, back then we were on the unlimited calling plan. We may not have always verbally expressed ourselves, but we always conveyed what we meant, physically or emotionally.Then we had a baby.
Suddenly, I was not only uninterested in sex, I was also strangely confused about how to tell my husband. So while in some ways our daughter's birth brought us closer than ever, in other ways we started to grow apart.
I just didn't know how to explain to J.B. how tired I was, how my body hurt from being pinched and pulled by our baby, and how by the end of the day I couldn't imagine sharing it with anyone else. We both became prickly and defensive: I was sure that when J.B. wrapped his leg over mine at night it meant he was coming on to me (again); when I turned my back and pretended to be asleep, he assumed I no longer found him attractive.
Bye-bye, language of love.
Whether it's right after the birth of a baby or a few years down the line, it seems like lots of happily married couples hit the sexual skids when they become parents. And most of them have heard sex therapists on TV and read articles and books, and know they should talk it out.
But there's the rub. Sex is a socially charged and highly personal issue that remains a bit taboo despite our seeming openness. And talking about not having sex? Chances are, the subject comes up when one of you wants it and the other doesn't. Bad time to talk. And who wants to crack open that can of worms later on when it's over? Besides, isn't sex supposed to be fun and spontaneous -- like it used to be? Won't talking about it spoil the magic?
"Where's the magic if you're not having sex?" says Valerie Raskin, M.D., author of Great Sex for Moms: Ten Steps to Nurturing Passion While Raising Kids. But how do you start talking? What do you say? And how do you say it so you don't end up bruising egos or booting one of you to the couch? My husband and I started by paying attention to the distinction between how we talked about sex and the details of what we were talking about. To begin:
How to talk
Just leap in.
Nichole Cook, of Pittsburgh, mom of Eleanor, 8, Odessa, 7, and Izabelle, 6, was embarrassed into silence not long after Eleanor was born: One time during sex she squirted breast milk all over her husband. "I was mortified. I thought it was gross -- and totally not normal." Rather than telling him how she felt, though, Cook simply avoided sex altogether for the next couple of weeks.
While talking about sex can be awkward, no one yet has actually died of embarrassment. Dr. Raskin suggests breaking the ice simply by acknowledging how hard it is.
That's what Cook did, a few weeks later. "I was really nervous, but I finally just said, 'That was really embarrassing for me.'" As it turned out, her husband hadn't even noticed and didn't think it was a big deal anyway. "After that, we just made sure we had a towel handy. Now it's something we laugh about."
Rather than letting things build up, talking about it now makes room for more openness later.
Choose the right place and tone
One of the worst fights J.B. and I had about sex was right after a failed attempt at it. I really wanted to be in the mood -- even though I wasn't at all -- so we got partway into the act before I admitted that things weren't working. We lay in bed trying to "talk" about what had happened. But we were so upset that we ended up blaming, and J.B. stormed angrily out of the room.
Thus, we discovered the importance of environment for having a fruitful discussion of our sex life. Choose a night when nothing else is planned and wait until the kids are asleep. Turn off the TV and the phone. This isn't an inquisition. It's an opportunity to reconnect with each other, to steal an intimate moment in a chaotic life. It's about how you show and share love, about something that should be fun and pleasurable.
J.B. and I have had some of our best talks late at night on our front stoop. We turn off the porch light, pour some wine, and sit side by side. There's something about not looking directly at each other (and the wine, maybe) that lets things flow. It may cut awkwardness to merge your heart-to-heart with an activity -- try talking while hiking, or walking, or sorting through your penny jar.
Acknowledge the problem
This is not the same as agreeing on the cause of the problem. It's just a way to get the conversation rolling. Dr. Raskin calls this "outing the secret -- even though it's not really a secret." Begin by stating the obvious: "I know things aren't like they used to be," or "I know we haven't been having sex very much lately." Often, acknowledging this reality, without judgment, can bring a couple closer.
After that big fight, I realized that my husband and I had let things go far too long. While Ramona was napping the next day, I simply said: "I'm having a hard time with sex these days. I hate the way it's come between us, and it must really suck for you, too." The fact that I wasn't trying to deny or make excuses helped J.B. feel comfortable.
After listening to J.B., I realized he wasn't as angry about the situation as I'd thought. It annoyed him that I'd initiated sex when I didn't really want it, but he'd needed to leave the room to cool down because he simply couldn't change gears and talk rationally while he was still aroused. This not only helped me understand why he became so agitated but also made it easier for me to talk about what I was experiencing physically.
Asking and listening without getting defensive is an important part of this process. Repeat what your partner's saying and ask if you're understanding correctly. Ask, "Is there more you want me to know?"
Look forward, not back
Agree to make a fresh start. Don't pull out old fights; avoid generalizing or labeling. Saying things like "You never want sex" or "You're a sex fiend!" is just talking negatively about the past. We all say dumb things; don't waste time fighting about whether they're true.
It's also a bad idea to compare yourself to other couples. What's right for them isn't necessarily what's right for you. When Holly Wing's husband saw a poll in a magazine that claimed most of its readers had sex a lot more often than they did each month, he kept referring to it -- comparing their own not-nearly-so-much stats. Wing, a Berkeley mom of 2-year-old Clio, then started to counter with her own statistics, and before long they were locked in battle. "Instead of solving any problems, we were just getting really good at fighting!"
So stick to what you're feeling ("I feel sad that we're having trouble finding the time to make love") rather than accusations about how you measure up to others.
Stay positive
"I don't want to talk about sex we haven't had anymore," Wing told her husband after another fight. "If you want to have sex seventeen times a month, well, then, let's go for it!" she said, naming his wildly optimistic ideal. Of course they didn't meet the goal, but the effort did help. Wing felt that her husband realized how hard it is to make time for (and want) frequent sex rather than just complaining about it. And he appreciated her willingness to give it a try.
Shooting for high numbers may not be your solution, but the attitude is admirable. Remind each other that you'll get through this and that you both want to work it out. Instead of saying, "You never woo me anymore," try "Remember that poem you wrote me on our honeymoon? That got me hot!" And if your conversation falls apart and you revert to blaming -- stop. Don't try to win. Just end it and try again later when you've both cooled down.
What to talk about
That there's love behind your lovemaking.
If you state explicitly, right up front, that you love and respect each other, and that in talking about this you're only talking about the way you show your love, you're both likely to feel more comfortable expressing your feelings. And keep reminding each other of your love and your mutual desire for each other's happiness -- that should be the backdrop to your conversation.
The meaning of sex
You can't figure out how to fix your love life if you don't know what you want it to be. So discuss what physical intimacy represents to yourselves and in your relationship.
Women, for instance, often misunderstand the ways in which sex is important for many men. It's not just a matter of stereotypical gotta-have-it male urges but can be a critical form of emotional expression. For whatever combination of reasons, many men feel and express love physically, so they may experience a lack of sex as rejecting not only them but their offering of love as well.
The definition of sex
It's a good idea to talk openly about what actually constitutes "sex" to each of you. Is it only intercourse, or does it include other kinds of touching? A husband whose sex drive is at low ebb may be delighted to find that his wife will think him no less a man if he gives her a massage -- with or without "extras" -- instead of a more "demanding" service.
For Cook and her husband, sharing an understanding that she no longer felt sexual about her breasts was a breakthrough. "I felt like they were just for my kids, not him," she says. With that off the table, they were able to talk about what did still work for both of them.
That it's not him. Or you
Many factors mess with parents' love life, only rarely sexual skills or prowess. The list includes exhaustion, a light-sleeping child, hormones, embarrassment about weight gain, lack of time, difficulty shifting gears from parent to lover.
When Heidi Johnecheck, of Petosky, Michigan, mother of Max, 4, and Jaxon, 2, found a magazine article that listed ten reasons it's physically hard for moms to have sex -- everything from vaginal dryness to sheer exhaustion -- she tore it out and gave it to her husband. "As much as I'd tried to tell him, he just couldn't comprehend what 'I don't feel like it' meant," she says, and he took it personally. "But the article showed that it wasn't just me or just him."
Specific ways to make things better
Johnecheck and her husband decided to tackle one simple problem head-on: They made a kid-free visit to a local sex shop to buy some lubricants. "We actually made a date together," Johnecheck says, "and decided to just be silly and have fun with it."
Brainstorming about what might help you get back in the swing of things is a great way to move things forward. At the top of the list for most couples? "More private time," says Dr. Raskin. And while scheduling "date night" can help, think about it broadly. If nights out are expensive and infrequent, what about finding time in the mornings (when women's testosterone levels are highest, resulting in higher libido)? What about Saturday-afternoon naptime (when you'll both be less tired than at night)?
Technique
This is not the time to be shy or coy. Be specific about yourself ("I'm finding that it takes me a lot longer to get excited lately"). If you want more mood setting than "Okay, the baby's asleep. Let's do this," ask for it: "First I'd like you to sit through a chick flick with me and hold my hand."
Your body and your life have changed since you had a child. Maybe there's something in particular that you do want that you never did before. Just say it: harder, softer, faster, slower, touch me here. And if you say what you do want your husband to do instead of just what you don't, he'll likely be turned on, too.
For me and J.B., when I finally could say "Not tonight" without worrying it would turn into a fight, a funny thing happened. It became easier for me to say yes. Because once I knew he understood my feelings, we started to address some of the underlying issues: I needed more time for myself, more romance, and more help with our daughter.
Those first years after the birth of Ramona were tough. But four years later I now see talking about sex as just another opportunity for expanding our intimacy -- in and out of the bedroom.
While talking about sex can be awkward, no one yet has actually died of embarrassment. Dr. Raskin suggests breaking the ice simply by acknowledging how hard it is.
That's what Cook did, a few weeks later. "I was really nervous, but I finally just said, 'That was really embarrassing for me.'" As it turned out, her husband hadn't even noticed and didn't think it was a big deal anyway. "After that, we just made sure we had a towel handy. Now it's something we laugh about."
Rather than letting things build up, talking about it now makes room for more openness later.
Choose the right place and tone
One of the worst fights J.B. and I had about sex was right after a failed attempt at it. I really wanted to be in the mood -- even though I wasn't at all -- so we got partway into the act before I admitted that things weren't working. We lay in bed trying to "talk" about what had happened. But we were so upset that we ended up blaming, and J.B. stormed angrily out of the room.
Thus, we discovered the importance of environment for having a fruitful discussion of our sex life. Choose a night when nothing else is planned and wait until the kids are asleep. Turn off the TV and the phone. This isn't an inquisition. It's an opportunity to reconnect with each other, to steal an intimate moment in a chaotic life. It's about how you show and share love, about something that should be fun and pleasurable.
J.B. and I have had some of our best talks late at night on our front stoop. We turn off the porch light, pour some wine, and sit side by side. There's something about not looking directly at each other (and the wine, maybe) that lets things flow. It may cut awkwardness to merge your heart-to-heart with an activity -- try talking while hiking, or walking, or sorting through your penny jar.
Acknowledge the problem
This is not the same as agreeing on the cause of the problem. It's just a way to get the conversation rolling. Dr. Raskin calls this "outing the secret -- even though it's not really a secret." Begin by stating the obvious: "I know things aren't like they used to be," or "I know we haven't been having sex very much lately." Often, acknowledging this reality, without judgment, can bring a couple closer.
After that big fight, I realized that my husband and I had let things go far too long. While Ramona was napping the next day, I simply said: "I'm having a hard time with sex these days. I hate the way it's come between us, and it must really suck for you, too." The fact that I wasn't trying to deny or make excuses helped J.B. feel comfortable.
After listening to J.B., I realized he wasn't as angry about the situation as I'd thought. It annoyed him that I'd initiated sex when I didn't really want it, but he'd needed to leave the room to cool down because he simply couldn't change gears and talk rationally while he was still aroused. This not only helped me understand why he became so agitated but also made it easier for me to talk about what I was experiencing physically.
Asking and listening without getting defensive is an important part of this process. Repeat what your partner's saying and ask if you're understanding correctly. Ask, "Is there more you want me to know?"
Look forward, not back
Agree to make a fresh start. Don't pull out old fights; avoid generalizing or labeling. Saying things like "You never want sex" or "You're a sex fiend!" is just talking negatively about the past. We all say dumb things; don't waste time fighting about whether they're true.
It's also a bad idea to compare yourself to other couples. What's right for them isn't necessarily what's right for you. When Holly Wing's husband saw a poll in a magazine that claimed most of its readers had sex a lot more often than they did each month, he kept referring to it -- comparing their own not-nearly-so-much stats. Wing, a Berkeley mom of 2-year-old Clio, then started to counter with her own statistics, and before long they were locked in battle. "Instead of solving any problems, we were just getting really good at fighting!"
So stick to what you're feeling ("I feel sad that we're having trouble finding the time to make love") rather than accusations about how you measure up to others.
Stay positive
"I don't want to talk about sex we haven't had anymore," Wing told her husband after another fight. "If you want to have sex seventeen times a month, well, then, let's go for it!" she said, naming his wildly optimistic ideal. Of course they didn't meet the goal, but the effort did help. Wing felt that her husband realized how hard it is to make time for (and want) frequent sex rather than just complaining about it. And he appreciated her willingness to give it a try.
Shooting for high numbers may not be your solution, but the attitude is admirable. Remind each other that you'll get through this and that you both want to work it out. Instead of saying, "You never woo me anymore," try "Remember that poem you wrote me on our honeymoon? That got me hot!" And if your conversation falls apart and you revert to blaming -- stop. Don't try to win. Just end it and try again later when you've both cooled down.
What to talk about
That there's love behind your lovemaking.
If you state explicitly, right up front, that you love and respect each other, and that in talking about this you're only talking about the way you show your love, you're both likely to feel more comfortable expressing your feelings. And keep reminding each other of your love and your mutual desire for each other's happiness -- that should be the backdrop to your conversation.
The meaning of sex
You can't figure out how to fix your love life if you don't know what you want it to be. So discuss what physical intimacy represents to yourselves and in your relationship.
Women, for instance, often misunderstand the ways in which sex is important for many men. It's not just a matter of stereotypical gotta-have-it male urges but can be a critical form of emotional expression. For whatever combination of reasons, many men feel and express love physically, so they may experience a lack of sex as rejecting not only them but their offering of love as well.
The definition of sex
It's a good idea to talk openly about what actually constitutes "sex" to each of you. Is it only intercourse, or does it include other kinds of touching? A husband whose sex drive is at low ebb may be delighted to find that his wife will think him no less a man if he gives her a massage -- with or without "extras" -- instead of a more "demanding" service.
For Cook and her husband, sharing an understanding that she no longer felt sexual about her breasts was a breakthrough. "I felt like they were just for my kids, not him," she says. With that off the table, they were able to talk about what did still work for both of them.
That it's not him. Or you
Many factors mess with parents' love life, only rarely sexual skills or prowess. The list includes exhaustion, a light-sleeping child, hormones, embarrassment about weight gain, lack of time, difficulty shifting gears from parent to lover.
When Heidi Johnecheck, of Petosky, Michigan, mother of Max, 4, and Jaxon, 2, found a magazine article that listed ten reasons it's physically hard for moms to have sex -- everything from vaginal dryness to sheer exhaustion -- she tore it out and gave it to her husband. "As much as I'd tried to tell him, he just couldn't comprehend what 'I don't feel like it' meant," she says, and he took it personally. "But the article showed that it wasn't just me or just him."
Specific ways to make things better
Johnecheck and her husband decided to tackle one simple problem head-on: They made a kid-free visit to a local sex shop to buy some lubricants. "We actually made a date together," Johnecheck says, "and decided to just be silly and have fun with it."
Brainstorming about what might help you get back in the swing of things is a great way to move things forward. At the top of the list for most couples? "More private time," says Dr. Raskin. And while scheduling "date night" can help, think about it broadly. If nights out are expensive and infrequent, what about finding time in the mornings (when women's testosterone levels are highest, resulting in higher libido)? What about Saturday-afternoon naptime (when you'll both be less tired than at night)?
Technique
This is not the time to be shy or coy. Be specific about yourself ("I'm finding that it takes me a lot longer to get excited lately"). If you want more mood setting than "Okay, the baby's asleep. Let's do this," ask for it: "First I'd like you to sit through a chick flick with me and hold my hand."
Your body and your life have changed since you had a child. Maybe there's something in particular that you do want that you never did before. Just say it: harder, softer, faster, slower, touch me here. And if you say what you do want your husband to do instead of just what you don't, he'll likely be turned on, too.
For me and J.B., when I finally could say "Not tonight" without worrying it would turn into a fight, a funny thing happened. It became easier for me to say yes. Because once I knew he understood my feelings, we started to address some of the underlying issues: I needed more time for myself, more romance, and more help with our daughter.
Those first years after the birth of Ramona were tough. But four years later I now see talking about sex as just another opportunity for expanding our intimacy -- in and out of the bedroom.
Probe: Eye infection tied to recalled contact lens solution
NEW YORK (Reuters) -- Results of an ongoing investigation confirm a "strong association" between use of a particular type of contact lens solution -- Advanced Medical Optics Complete MoisturePlus Multi-Purpose Solution -- and increased risk of a rare but serious eye infection called Acanthamoeba keratitis, or AK.Earlier this year, the company voluntarily recalled this product and called on consumers to stop using it after data showed a higher risk of eye infections.
AK is a painful infection of the cornea that can cause corneal scarring and sometimes blindness. Doctors at the University of Illinois at Chicago Cornea Service noticed a sharp increase in the number of AK cases in contact lens wearers beginning in 2003, with a total of 63 cases identified through the end of 2006. This compares to the "two or three cases a year we would normally expect to see," Dr. Charlotte Joslin noted in a university statement.
They investigated 30 AK cases, comparing them with 39 matched "controls" who wore soft contact lens without developing the infection. Joslin and colleagues found that those with AK infection were significantly more likely to report having exclusively used AMO Complete MoisturePlus Multi-Purpose Solution than those without AK infection (55.2 percent versus 10.5 percent).
AK is a painful infection of the cornea that can cause corneal scarring and sometimes blindness. Doctors at the University of Illinois at Chicago Cornea Service noticed a sharp increase in the number of AK cases in contact lens wearers beginning in 2003, with a total of 63 cases identified through the end of 2006. This compares to the "two or three cases a year we would normally expect to see," Dr. Charlotte Joslin noted in a university statement.
They investigated 30 AK cases, comparing them with 39 matched "controls" who wore soft contact lens without developing the infection. Joslin and colleagues found that those with AK infection were significantly more likely to report having exclusively used AMO Complete MoisturePlus Multi-Purpose Solution than those without AK infection (55.2 percent versus 10.5 percent).
Users of this particular contact lens solution had a greater than 16-fold higher risk of developing AK.
However, the researchers note in the American Journal of Ophthalmology that nearly 39 percent of AK cases reported no use of AMO Complete MoisturePlus Multi-Purpose Solution or used it in combination with other solutions, suggesting that this is not the only risk factor for infection.
The current investigation provides some evidence that re-using contact lens solution, rubbing lenses during cleaning, and showering with lenses on increase the risk of eye infections in contact lens users.
However, the researchers note in the American Journal of Ophthalmology that nearly 39 percent of AK cases reported no use of AMO Complete MoisturePlus Multi-Purpose Solution or used it in combination with other solutions, suggesting that this is not the only risk factor for infection.
The current investigation provides some evidence that re-using contact lens solution, rubbing lenses during cleaning, and showering with lenses on increase the risk of eye infections in contact lens users.
Omega-3 fatty acids key to cell health
ATLANTA, Georgia (CNN) -- The name sounds like something out of a science fiction novel, but omega-3 fatty acids are a necessary part of our diet. "Every cell in the body requires omega-3 to function normally," says Dr. Andrew Stoll, author of "The Omega-3 Connection." "They are a class of fats, good fats that are actually as essential as vitamins to our health."
Researchers discovered that omega-3 protects the heart about 30 years ago. Doctors now know that the compound controls inflammation and protects cells by forming part of the cell membrane. "We know that omega-3 can protect the heart, the lungs, the kidneys, really every organ system that we know of, including the brain," says Stoll.
The problem is that most Americans don't get enough of the compound in their diet. Part of the reason, Stoll says, is they don't eat enough fish.
Fatty fish such as salmon, mackerel, herring and sardines are the best sources of omega-3 for the diet. For most patients, Stoll recommends one or two servings of the cooked fish a week. Unlike other fish, which store the compound in their liver, the four recommended varieties store the compound in their muscles, which are eaten by humans.
Researchers discovered that omega-3 protects the heart about 30 years ago. Doctors now know that the compound controls inflammation and protects cells by forming part of the cell membrane. "We know that omega-3 can protect the heart, the lungs, the kidneys, really every organ system that we know of, including the brain," says Stoll.
The problem is that most Americans don't get enough of the compound in their diet. Part of the reason, Stoll says, is they don't eat enough fish.
Fatty fish such as salmon, mackerel, herring and sardines are the best sources of omega-3 for the diet. For most patients, Stoll recommends one or two servings of the cooked fish a week. Unlike other fish, which store the compound in their liver, the four recommended varieties store the compound in their muscles, which are eaten by humans.
While certain fish are loaded with omega-3 and protein, they also contain some mercury, dioxins and PCBs. "It's a difficult situation to balance out," explains Stoll. "You need to eat some fish to be healthy, but if you eat too much fish, you're putting yourself at risk. ... So most Americans just can't eat enough fish to get omega-3 in their diet."
Stoll cautions pregnant women, those who are nursing and young children from eating any fish. He says toxins can be harmful to developing babies and youngsters.
Stoll suggests taking a daily fish oil supplement instead or finding another source. Vegetarians, for instance, can get the compound from specially enriched omega-3 eggs.
Stoll cautions pregnant women, those who are nursing and young children from eating any fish. He says toxins can be harmful to developing babies and youngsters.
Stoll suggests taking a daily fish oil supplement instead or finding another source. Vegetarians, for instance, can get the compound from specially enriched omega-3 eggs.
Flaxseed is another source of a different type of omega-3. Stoll says it's a good way to increase your fiber, but flax doesn't offer the same benefits of the compound found in fatty fish. He also warns that the bodies of two-thirds of the population cannot convert the omega-3 found in flaxseed.
According to Stoll, "Taking more than three tablespoons a day of raw flaxseed or ground flaxseed can inhibit the uptake of iodine in the thyroid, which can produce a goiter or enlargement of the thyroid gland."
While Stoll doesn't call omega-3 a dietary miracle, he does say, "We need it for optimal health. ... If you have very little omega-3 in your diet, you will be prone to inflammatory disorders."
While Stoll doesn't call omega-3 a dietary miracle, he does say, "We need it for optimal health. ... If you have very little omega-3 in your diet, you will be prone to inflammatory disorders."
Expert tips help you avoid the ill in grill
You've lit the grill, marinated the meat, and gathered your family and friends for a savory feast -- summer tradition at its best. But beware: You may have invited more guests than you thought.
Summer is peak season for food-borne illnesses, which strike 76 million people a year, according to the Centers for Disease Control and Prevention. A 2004 CDC report found nearly half of all E. coli and salmonella cases took place between July and September.
To make sure you send guests home with yummy leftovers instead of food poisoning, follow these simple tips from the food safety experts:
The prep
The first lesson in grilling: Hot foods must stay hot (above 140 degrees), and cold foods must stay cold (below 40 degrees), says Kathleen L. D'Ovidio, Ph.D., assistant professor of food science in the Food Science and Management Department at Delaware Valley College in Doylestown, Pennsylvania. Any temperature in between is a danger zone where all kinds of bacteria, including salmonella, E. coli, and Campylobacter love to breed.
Follow this rule especially when thawing and marinating meat. Keep meat in the fridge, not on the counter. Also, put your meat in a dish with sides to keep it from dripping on other things such as produce, says Janet Anderson, a nutrition and food science professor at Utah State University. Health.com: The smart woman's summer survival guide
Any sauce that touches raw meat should be treated like raw meat, Anderson says. Add final touches of flavor with sauce that hasn't been used yet, or if you must use the marinade, boil it for at least a minute before spreading it on cooked meat,Before cooking, fill your kitchen sink with hot, soapy water, Anderson says. That way dirty trays and utensils go straight into the sink, and you're not tempted to use them again. You also should have a ready washcloth for sanitizing any surface that raw food has touched.
If you're grilling at a beach or park where you don't have ready access to a sink, bring a water jug, soap, and paper towels, D'Ovidio says. Disposable towelettes and antibacterial gel work in a pinch, but they're not as effective as soap and water. Health.com: Healthy, handy options to help beat the bugs
While you grill
Internal cooking temperature is the key to grilling safely, Anderson says, and using a meat thermometer is crucial. "Just looking at the outside of the meat or cutting it open does not tell you enough."
Ground meat must be cooked to a higher internal temp (160 degrees) than steak because microorganisms have been introduced to the inside of the food and are not just on the surface, D'Ovidio says. And contrary to popular belief, hot dogs should always be cooked to kill a certain bacteria called Listeria. Health.com: Staying safe in the sun
Grill over medium heat, Anderson says. High heat will burn your meat and make you think the inside is done before it actually is. When you're through cooking, don't put cooked food on plates or trays that held raw food. This is one of the biggest mistakes that home grillers make.
The leftovers
Leave food out for no longer than two hours. "If it stays out longer than that, you have to toss it," D'Ovidio says. "If you have a 90 degree-plus day, don't let food sit out for more than an hour."
Put food out in small amounts, keeping the rest in the fridge or cooler. Other perishables such as mayonnaise, potato salad, or chicken salad should be kept in big bowls of ice.
Finally, when you're ready to store leftovers in the fridge, put small pieces in a single layer in a shallow container, so they will cool down as quickly as possible, Anderson says.
To make sure you send guests home with yummy leftovers instead of food poisoning, follow these simple tips from the food safety experts:
The prep
The first lesson in grilling: Hot foods must stay hot (above 140 degrees), and cold foods must stay cold (below 40 degrees), says Kathleen L. D'Ovidio, Ph.D., assistant professor of food science in the Food Science and Management Department at Delaware Valley College in Doylestown, Pennsylvania. Any temperature in between is a danger zone where all kinds of bacteria, including salmonella, E. coli, and Campylobacter love to breed.
Follow this rule especially when thawing and marinating meat. Keep meat in the fridge, not on the counter. Also, put your meat in a dish with sides to keep it from dripping on other things such as produce, says Janet Anderson, a nutrition and food science professor at Utah State University. Health.com: The smart woman's summer survival guide
Any sauce that touches raw meat should be treated like raw meat, Anderson says. Add final touches of flavor with sauce that hasn't been used yet, or if you must use the marinade, boil it for at least a minute before spreading it on cooked meat,Before cooking, fill your kitchen sink with hot, soapy water, Anderson says. That way dirty trays and utensils go straight into the sink, and you're not tempted to use them again. You also should have a ready washcloth for sanitizing any surface that raw food has touched.
If you're grilling at a beach or park where you don't have ready access to a sink, bring a water jug, soap, and paper towels, D'Ovidio says. Disposable towelettes and antibacterial gel work in a pinch, but they're not as effective as soap and water. Health.com: Healthy, handy options to help beat the bugs
While you grill
Internal cooking temperature is the key to grilling safely, Anderson says, and using a meat thermometer is crucial. "Just looking at the outside of the meat or cutting it open does not tell you enough."
Ground meat must be cooked to a higher internal temp (160 degrees) than steak because microorganisms have been introduced to the inside of the food and are not just on the surface, D'Ovidio says. And contrary to popular belief, hot dogs should always be cooked to kill a certain bacteria called Listeria. Health.com: Staying safe in the sun
Grill over medium heat, Anderson says. High heat will burn your meat and make you think the inside is done before it actually is. When you're through cooking, don't put cooked food on plates or trays that held raw food. This is one of the biggest mistakes that home grillers make.
The leftovers
Leave food out for no longer than two hours. "If it stays out longer than that, you have to toss it," D'Ovidio says. "If you have a 90 degree-plus day, don't let food sit out for more than an hour."
Put food out in small amounts, keeping the rest in the fridge or cooler. Other perishables such as mayonnaise, potato salad, or chicken salad should be kept in big bowls of ice.
Finally, when you're ready to store leftovers in the fridge, put small pieces in a single layer in a shallow container, so they will cool down as quickly as possible, Anderson says.
Mental health providers: Find one to suit your needs
Choosing mental health providers can be challenging. Try to match your needs with their experience and specialty. See what issues to consider and which questions to ask.
If you've never consulted mental health providers before, you may not know how to find one who suits your specific needs. Here are some issues and tips to think about, along with questions to ask potential mental health providers.
Consider the types of mental health providers
You may not realize just how many types of mental health providers are available until you start looking for one. Should you see a family practice doctor? A psychiatrist? Psychologist? Social worker? Does it even matter?
Several considerations can help guide your decision in choosing among the various types of mental health providers:
The severity of your symptoms
Your medication needs
The provider's level of expertise
Your health insurance coverage
In general, the more severe your symptoms or diagnosis, the more expertise and training to look for in your potential mental health providers. If you may need medications, for instance, you may want to consult a psychiatrist, who by law can prescribe medications and may have more experience with the wide range of psychiatric medications available. On the other hand, if you're dealing with teenage conflicts, you may want to consult a marriage and family therapist. You may even need to see several types of mental health providers to meet various needs.
Know if your health insurer selects mental health providers
Sometimes, you may not have a choice of mental health providers. Your health insurance company may dictate which type of mental health providers you can visit. It may even refer you to specific mental health providers. Your insurance company or Medicare or Medicaid can tell you what types of mental health providers it provides coverage for and what your benefit limits are. Some insurance plans, for instance, authorize more visits to a nurse, social worker or psychologist than to a psychiatrist, whose fees are usually higher.
Do some legwork to find mental health providers
Finding mental health providers takes some legwork. If you have depression or another serious mental illness, it can be difficult finding mental health providers on your own. You may not have the energy, focus or motivation. Instead, ask your primary care doctor, family or friends for help.
Here are some ways to find mental health providers:
Seek a referral or recommendation from your other health care providers, such as a family doctor, gynecologist or pediatrician.
Ask trusted friends, family or clergy.
Check phone book listings under such categories as community service numbers, counselors, physicians, psychologists or social services organizations.
Ask your health insurance company for a list.
Ask your company's employee assistance program for a referral.
Contact a local or national mental health organization or medical society.
Use a referral service from a national professional association for doctors or therapists.
Learn the characteristics of mental health providers
Your legwork doesn't stop once you have some potential mental health providers in mind. Before scheduling your first appointment, think about whether you have preferences or needs regarding:
Gender
Age
Religion
Language
Cultural background
Don't feel bad about ruling out some mental health providers based on these criteria. Your comfort level is important since you may be establishing a long-term relationship. Even tone of voice or appearance may matter to you. Although you usually won't know how mental health providers look ahead of time, some clinics, organizations or associations post pictures and biographies online, if you feel those characteristics are important to know.
Ask mental health providers lots of questions
Once you've found a few mental health providers who seem like they may suit you, it's time to call and ask a few more questions. In some cases, a receptionist may be able to answer most of your questions. You may be able to directly ask some mental health providers questions on the phone, or they may ask you to come in for an initial session.
Here are some issues to consider asking mental health providers about, either on the phone or at your first appointment:
Their education, training, licensure and years in practice. Licensing requirements can vary widely by state. You can double-check credentials by contacting your state's licensing boards.
Office hours, fees, length of sessions and which insurance providers they work with, or if they work with Medicare or Medicaid.
Their treatment approach and philosophy, to make sure it suits your style and needs.
Whether they specialize in certain disorders or age groups. Some, for instance, work only with adolescents. Others specialize in eating disorders or substance abuse.
Don't hesitate to ask lots of questions. Finding the right match is crucial to establishing rapport and making sure you're getting the best treatment.
Evaluate progress with your mental health provider
Once you choose a mental health provider, make sure the match is working. If you don't feel comfortable after the first visit, talk about your concerns at your next session. Or consider finding a new mental health provider. As time goes by, think about how you feel and whether your needs are being met. Don't feel compelled to stay with a mental health provider if you're not comfortable.
The process of choosing a mental health provider and the treatment itself can be hard work or downright painful. But it can also be rewarding. You may resolve long-standing conflicts, overcome personal challenges and ultimately enjoy your life more.
Consider the types of mental health providers
You may not realize just how many types of mental health providers are available until you start looking for one. Should you see a family practice doctor? A psychiatrist? Psychologist? Social worker? Does it even matter?
Several considerations can help guide your decision in choosing among the various types of mental health providers:
The severity of your symptoms
Your medication needs
The provider's level of expertise
Your health insurance coverage
In general, the more severe your symptoms or diagnosis, the more expertise and training to look for in your potential mental health providers. If you may need medications, for instance, you may want to consult a psychiatrist, who by law can prescribe medications and may have more experience with the wide range of psychiatric medications available. On the other hand, if you're dealing with teenage conflicts, you may want to consult a marriage and family therapist. You may even need to see several types of mental health providers to meet various needs.
Know if your health insurer selects mental health providers
Sometimes, you may not have a choice of mental health providers. Your health insurance company may dictate which type of mental health providers you can visit. It may even refer you to specific mental health providers. Your insurance company or Medicare or Medicaid can tell you what types of mental health providers it provides coverage for and what your benefit limits are. Some insurance plans, for instance, authorize more visits to a nurse, social worker or psychologist than to a psychiatrist, whose fees are usually higher.
Do some legwork to find mental health providers
Finding mental health providers takes some legwork. If you have depression or another serious mental illness, it can be difficult finding mental health providers on your own. You may not have the energy, focus or motivation. Instead, ask your primary care doctor, family or friends for help.
Here are some ways to find mental health providers:
Seek a referral or recommendation from your other health care providers, such as a family doctor, gynecologist or pediatrician.
Ask trusted friends, family or clergy.
Check phone book listings under such categories as community service numbers, counselors, physicians, psychologists or social services organizations.
Ask your health insurance company for a list.
Ask your company's employee assistance program for a referral.
Contact a local or national mental health organization or medical society.
Use a referral service from a national professional association for doctors or therapists.
Learn the characteristics of mental health providers
Your legwork doesn't stop once you have some potential mental health providers in mind. Before scheduling your first appointment, think about whether you have preferences or needs regarding:
Gender
Age
Religion
Language
Cultural background
Don't feel bad about ruling out some mental health providers based on these criteria. Your comfort level is important since you may be establishing a long-term relationship. Even tone of voice or appearance may matter to you. Although you usually won't know how mental health providers look ahead of time, some clinics, organizations or associations post pictures and biographies online, if you feel those characteristics are important to know.
Ask mental health providers lots of questions
Once you've found a few mental health providers who seem like they may suit you, it's time to call and ask a few more questions. In some cases, a receptionist may be able to answer most of your questions. You may be able to directly ask some mental health providers questions on the phone, or they may ask you to come in for an initial session.
Here are some issues to consider asking mental health providers about, either on the phone or at your first appointment:
Their education, training, licensure and years in practice. Licensing requirements can vary widely by state. You can double-check credentials by contacting your state's licensing boards.
Office hours, fees, length of sessions and which insurance providers they work with, or if they work with Medicare or Medicaid.
Their treatment approach and philosophy, to make sure it suits your style and needs.
Whether they specialize in certain disorders or age groups. Some, for instance, work only with adolescents. Others specialize in eating disorders or substance abuse.
Don't hesitate to ask lots of questions. Finding the right match is crucial to establishing rapport and making sure you're getting the best treatment.
Evaluate progress with your mental health provider
Once you choose a mental health provider, make sure the match is working. If you don't feel comfortable after the first visit, talk about your concerns at your next session. Or consider finding a new mental health provider. As time goes by, think about how you feel and whether your needs are being met. Don't feel compelled to stay with a mental health provider if you're not comfortable.
The process of choosing a mental health provider and the treatment itself can be hard work or downright painful. But it can also be rewarding. You may resolve long-standing conflicts, overcome personal challenges and ultimately enjoy your life more.
Anti-smoking pill shows promise in curbing drinking
WASHINGTON (AP) -- A single pill appears to hold promise in curbing the urges to both smoke and drink, according to researchers trying to help people overcome addiction by targeting a pleasure center in the brain.
The drug, called varenicline, already is sold to help smokers kick the habit. New but preliminary research suggests it could gain a second use in helping heavy drinkers quit, too.
Much further down the line, the tablets might be considered as a treatment for addictions to everything from gambling to painkillers, researchers said.
Several experts not involved in the study cautioned that there is no such thing as a magic cure-all for addiction and that varenicline and similar drugs may find more immediate use in treating diseases including Alzheimer's and Parkinson's.
Pfizer Inc. developed the drug specifically as a stop-smoking aid and has sold it in the United States since August under the brand name Chantix. Varenicline works by latching onto the same receptors in the brain that nicotine binds to when inhaled in cigarette smoke, an action that leads to the release of dopamine in the brain's pleasure centers. Taking the drug blocks any inhaled nicotine from reinforcing that effect.
A study published Monday suggests not just nicotine but alcohol also acts on the same locations in the brain. That means a drug like varenicline, which makes smoking less rewarding, could do the same for drinking. Preliminary work, done in rats, suggests that is the case.
"The biggest thrill is that this drug, which has already proved safe for people trying to stop smoking, is now a potential drug to fight alcohol dependence," said Selena Bartlett, a University of California, San Francisco neuroscientist who led the study. Details appear this week in the journal Proceedings of the National Academy of Sciences.
Pfizer provided the drug for the study, but was not otherwise involved in the research.
More often than not, smoking and drinking go together -- an observation pub-goers have made for hundreds of years. That a single drug could work to curb both addictions isn't a given -- nor is it surprising, said Christopher de Fiebre, an associate professor of pharmacology and neuroscience at the University of North Texas Health Science Center at Fort Worth.
"This is an extremely important paper and hopefully it will convince the major funding agencies that they need to examine the interactions between nicotine and alcohol to a greater extent than they have done to date," said de Fiebre, who was not connected with the study.
Much further down the line, the tablets might be considered as a treatment for addictions to everything from gambling to painkillers, researchers said.
Several experts not involved in the study cautioned that there is no such thing as a magic cure-all for addiction and that varenicline and similar drugs may find more immediate use in treating diseases including Alzheimer's and Parkinson's.
Pfizer Inc. developed the drug specifically as a stop-smoking aid and has sold it in the United States since August under the brand name Chantix. Varenicline works by latching onto the same receptors in the brain that nicotine binds to when inhaled in cigarette smoke, an action that leads to the release of dopamine in the brain's pleasure centers. Taking the drug blocks any inhaled nicotine from reinforcing that effect.
A study published Monday suggests not just nicotine but alcohol also acts on the same locations in the brain. That means a drug like varenicline, which makes smoking less rewarding, could do the same for drinking. Preliminary work, done in rats, suggests that is the case.
"The biggest thrill is that this drug, which has already proved safe for people trying to stop smoking, is now a potential drug to fight alcohol dependence," said Selena Bartlett, a University of California, San Francisco neuroscientist who led the study. Details appear this week in the journal Proceedings of the National Academy of Sciences.
Pfizer provided the drug for the study, but was not otherwise involved in the research.
More often than not, smoking and drinking go together -- an observation pub-goers have made for hundreds of years. That a single drug could work to curb both addictions isn't a given -- nor is it surprising, said Christopher de Fiebre, an associate professor of pharmacology and neuroscience at the University of North Texas Health Science Center at Fort Worth.
"This is an extremely important paper and hopefully it will convince the major funding agencies that they need to examine the interactions between nicotine and alcohol to a greater extent than they have done to date," said de Fiebre, who was not connected with the study.
In fact, the University of California researchers, together with the National Institute on Alcohol Abuse and Alcoholism, are now planning the first studies in humans of the drug's effectiveness in curbing alcohol cravings and dependence, Bartlett said. That the drug is already Food and Drug Administration-approved should speed things along.
"This is a drug that people are actually using. That's not trivial -- not at all," said Mark Egli, co-leader of the medications development program at the NIAAA, part of the National Institutes of Health. "There is plenty of animal research that looks pretty cool but there is no way those drugs are ever going to be used by human beings."
In the new study, researchers trained rats to drink alcohol and measured the effect of varenicline once the animals became the laboratory equivalent of heavy drinkers. They found the drug curbed their drinking. Even when stopped, the animals resumed drinking but didn't binge.
Just as varenicline doesn't work for all smokers, it's highly unlikely it would for all drinkers.
"Is this going to be a cure-all? No, not for smoking or alcoholism because both diseases are more complicated than a single target or single genetic issue," said Allan Collins, a professor of pharmacology at the University of Colorado who was not connected to the study.
Still, Collins, who's worked on the topic for decades, called the drug's potential use in treating alcoholism a "no-brainer." And Egli said it supports the emerging view that there is a common biological basis for addictions to both alcohol and tobacco.
As for Pfizer, the New York company has yet to decide whether to seek broader FDA approval for the drug, a spokesman said.
"Without having considerable more data on this it would be very difficult for us to say we might pursue it or not. It's almost a wait-and-see," said Pfizer's Stephen Lederer.
"This is a drug that people are actually using. That's not trivial -- not at all," said Mark Egli, co-leader of the medications development program at the NIAAA, part of the National Institutes of Health. "There is plenty of animal research that looks pretty cool but there is no way those drugs are ever going to be used by human beings."
In the new study, researchers trained rats to drink alcohol and measured the effect of varenicline once the animals became the laboratory equivalent of heavy drinkers. They found the drug curbed their drinking. Even when stopped, the animals resumed drinking but didn't binge.
Just as varenicline doesn't work for all smokers, it's highly unlikely it would for all drinkers.
"Is this going to be a cure-all? No, not for smoking or alcoholism because both diseases are more complicated than a single target or single genetic issue," said Allan Collins, a professor of pharmacology at the University of Colorado who was not connected to the study.
Still, Collins, who's worked on the topic for decades, called the drug's potential use in treating alcoholism a "no-brainer." And Egli said it supports the emerging view that there is a common biological basis for addictions to both alcohol and tobacco.
As for Pfizer, the New York company has yet to decide whether to seek broader FDA approval for the drug, a spokesman said.
"Without having considerable more data on this it would be very difficult for us to say we might pursue it or not. It's almost a wait-and-see," said Pfizer's Stephen Lederer.
Study: Selenium supplements may raise diabetes risk
WASHINGTON (Reuters) -- People who take selenium supplements in the hope of preventing diabetes may actually worsen their odds, U.S. researchers said Monday.
An unusually well-controlled trial showed that people who took selenium pills raised their risk of diabetes by more than half, compared with similar people taking placebos.
The trial is one of a few surprising studies that have found vitamin and mineral supplements can sometimes do more harm than good.
"I would not advise patients to take selenium supplements greater than those in multiple vitamins," said Dr. Saverio Stranges of Warwick Medical School in Britain, who led the study.
Stranges, formerly of the State University of New York at Buffalo, and colleagues were studying another idea -- whether selenium supplements could prevent skin cancer.
But there was research suggesting the mineral might help prevent diabetes.
The Stranges team looked at 1,202 people taking selenium for the skin cancer trial who did not have diabetes at the beginning of the study.
Half took a 200 microgram selenium supplement and half received a placebo pill for an average of 7.7 years.
Reporting in the Annals of Internal Medicine, the researchers said 58 of 600 people taking selenium and 39 of 602 taking placebos developed type-2 diabetes over the 7.7 years.
That is an increase in relative risk of about 50 percent.
About 60 percent of Americans take multivitamin pills, many of which contain between 33 and 200 micrograms of selenium, in addition to the selenium taken in from food and the air.
The higher a person's normal blood level of selenium, the worse the risk of diabetes, the researchers said.
An unusually well-controlled trial showed that people who took selenium pills raised their risk of diabetes by more than half, compared with similar people taking placebos.
The trial is one of a few surprising studies that have found vitamin and mineral supplements can sometimes do more harm than good.
"I would not advise patients to take selenium supplements greater than those in multiple vitamins," said Dr. Saverio Stranges of Warwick Medical School in Britain, who led the study.
Stranges, formerly of the State University of New York at Buffalo, and colleagues were studying another idea -- whether selenium supplements could prevent skin cancer.
But there was research suggesting the mineral might help prevent diabetes.
The Stranges team looked at 1,202 people taking selenium for the skin cancer trial who did not have diabetes at the beginning of the study.
Half took a 200 microgram selenium supplement and half received a placebo pill for an average of 7.7 years.
Reporting in the Annals of Internal Medicine, the researchers said 58 of 600 people taking selenium and 39 of 602 taking placebos developed type-2 diabetes over the 7.7 years.
That is an increase in relative risk of about 50 percent.
About 60 percent of Americans take multivitamin pills, many of which contain between 33 and 200 micrograms of selenium, in addition to the selenium taken in from food and the air.
The higher a person's normal blood level of selenium, the worse the risk of diabetes, the researchers said.
"The U.S. public needs to know that most people in this country receive adequate selenium from their diet," Dr. Joachim Bleys, Dr. Ana Navas-Acien and Dr. Eliseo Guallar, all of Johns Hopkins University in Baltimore, wrote in a commentary.
"By taking selenium supplements on top of an adequate dietary intake, people may increase their risk for diabetes."
The original cancer trial found that those who took selenium had a somewhat lower risk of dying from cancer, although the supplements did not lower the risk of getting skin cancer in the first place.
Another surprising study found that smokers who took beta-carotene supplements raise their risk of cancer.
"By taking selenium supplements on top of an adequate dietary intake, people may increase their risk for diabetes."
The original cancer trial found that those who took selenium had a somewhat lower risk of dying from cancer, although the supplements did not lower the risk of getting skin cancer in the first place.
Another surprising study found that smokers who took beta-carotene supplements raise their risk of cancer.
Dealing with summer bummers: bug bites, heat rash, ocean itch
Scratching from bug bites or poison ivy? Feeling queasy after the office picnic? Welcome to summer: You hit the great outdoors, and sometimes it hits you right back. But don't let mosquitos or spoiled potato salad keep you inside. Just follow these brilliant ideas -- from Philip Hagen, M.D., assistant professor of medicine at the Mayo Clinic College of Medicine, and Erin M. Welch, M.D., assistant professor of dermatology at the University of Texas Southwestern Medical Center -- and you'll be all set for the season.
Problem: Poison ivy
Solution: Lotion up
The itchy three-leaf plant grows as ground cover, shrubs, and vines throughout much of the United States. Before venturing into a potentially poison ivy-laden brush or wood, slick on a lotion such as Ivy Block, which creates a barrier between your skin and the plant's irritating oil. If you've got the telltale rash -- a streaky pattern that appears wherever the leaves brushed against your skin -- soak the area in Domeboro, an astringent that helps dry the blisters and soothe the inflammation. A 20-minute rinse with soapy water helps, too.
One more thing: You're contagious right after you've been exposed, so don't scratch and then touch someone else or share a towel. After rinsing well, you can't spread it.
Problem: Food poisoning
Solution: Hydrate early, often
If the succulent shrimp salad at the office outing sent you straight to the loo, sip a sports drink. It'll replace the electrolytes you're losing from vomiting and diarrhea. Until you feel better, avoid solid foods and drink clear juices, broths, water, and more sports drinks.
One more thing: Don't take antidiarrheal medicine. Experts say that it's healthier to let the diarrhea carry the toxins out of your system. Health.com: Smart woman's summer survival guide
Problem: Insect bites
Solution: Wear protection
Spray repellents with DEET or picaridin on exposed skin and clothes. For extra protection when you're in the woods, try Sawyer Premium Insect Repellent Clothing Treatment, a bug killer you can apply to clothing, tents, and other gear. Too late? Soothe itchy bites with a paste of 3 teaspoons baking soda and 1 teaspoon water, topical Benadryl, nonprescription hydrocortisone cream, or an oatmeal bath made with 1 cup oatmeal (put it in a tied-off pantyhose leg to rein in the mess) to a bath full of water.
One more thing: Don't scratch; it can lead to infections. If you're tempted, keep your fingernails too short to do damage. Health.com: Beat the bugs
Problem: Ocean itch
Solution: Rinse with vinegar
An itchy, bumpy red rash around your swimsuit line that pops up a couple of days after ocean swimming is probably "sea bather's eruption" -- stings from tiny, larval jellyfish. Up to 15 percent of ocean swimmers may get this in the summer. To prevent the rash, remove your suit immediately after swimming and before you shower. Then rinse your body with a solution of ¼ cup white vinegar to 1½ cups water. If you get the rash anyway, apply the vinegar-and-water solution and use hydrocortisone cream two to three times a day to relieve the itch.
One more thing: Jellyfish larvae usually stick in your swimsuit. So don't shower with your suit on or let it dry while you're wearing it; both activate the jellyfish larvae's stingers.
Problem: Altitude sickness
Solution: Take it slow
Hiking or camping above an altitude of 9,000 feet can lead to nausea, headache, shortness of breath, and difficulty sleeping. To nix the sickness, it's best to acclimate yourself by spending a day (or two) first at 3,000 to 6,000 feet, then at 6,000 to 8,000 feet, and finally at 9,000 to 10,000 feet. There's no quick fix for short trips -- if you feel sick, it's time to go back down. Also, you should avoid caffeine and nicotine because they worsen the fluid loss and faster heartbeat that occur naturally as you go up in altitude.
One more thing: Planning to be at 10,000-plus feet for several days? Ask your doctor about the drug Diamox, which helps prevent altitude sickness. Health.com: How to stay safe in the sun
Problem: Heat rash
Solution: Hit the showers
Solution: Lotion up
The itchy three-leaf plant grows as ground cover, shrubs, and vines throughout much of the United States. Before venturing into a potentially poison ivy-laden brush or wood, slick on a lotion such as Ivy Block, which creates a barrier between your skin and the plant's irritating oil. If you've got the telltale rash -- a streaky pattern that appears wherever the leaves brushed against your skin -- soak the area in Domeboro, an astringent that helps dry the blisters and soothe the inflammation. A 20-minute rinse with soapy water helps, too.
One more thing: You're contagious right after you've been exposed, so don't scratch and then touch someone else or share a towel. After rinsing well, you can't spread it.
Problem: Food poisoning
Solution: Hydrate early, often
If the succulent shrimp salad at the office outing sent you straight to the loo, sip a sports drink. It'll replace the electrolytes you're losing from vomiting and diarrhea. Until you feel better, avoid solid foods and drink clear juices, broths, water, and more sports drinks.
One more thing: Don't take antidiarrheal medicine. Experts say that it's healthier to let the diarrhea carry the toxins out of your system. Health.com: Smart woman's summer survival guide
Problem: Insect bites
Solution: Wear protection
Spray repellents with DEET or picaridin on exposed skin and clothes. For extra protection when you're in the woods, try Sawyer Premium Insect Repellent Clothing Treatment, a bug killer you can apply to clothing, tents, and other gear. Too late? Soothe itchy bites with a paste of 3 teaspoons baking soda and 1 teaspoon water, topical Benadryl, nonprescription hydrocortisone cream, or an oatmeal bath made with 1 cup oatmeal (put it in a tied-off pantyhose leg to rein in the mess) to a bath full of water.
One more thing: Don't scratch; it can lead to infections. If you're tempted, keep your fingernails too short to do damage. Health.com: Beat the bugs
Problem: Ocean itch
Solution: Rinse with vinegar
An itchy, bumpy red rash around your swimsuit line that pops up a couple of days after ocean swimming is probably "sea bather's eruption" -- stings from tiny, larval jellyfish. Up to 15 percent of ocean swimmers may get this in the summer. To prevent the rash, remove your suit immediately after swimming and before you shower. Then rinse your body with a solution of ¼ cup white vinegar to 1½ cups water. If you get the rash anyway, apply the vinegar-and-water solution and use hydrocortisone cream two to three times a day to relieve the itch.
One more thing: Jellyfish larvae usually stick in your swimsuit. So don't shower with your suit on or let it dry while you're wearing it; both activate the jellyfish larvae's stingers.
Problem: Altitude sickness
Solution: Take it slow
Hiking or camping above an altitude of 9,000 feet can lead to nausea, headache, shortness of breath, and difficulty sleeping. To nix the sickness, it's best to acclimate yourself by spending a day (or two) first at 3,000 to 6,000 feet, then at 6,000 to 8,000 feet, and finally at 9,000 to 10,000 feet. There's no quick fix for short trips -- if you feel sick, it's time to go back down. Also, you should avoid caffeine and nicotine because they worsen the fluid loss and faster heartbeat that occur naturally as you go up in altitude.
One more thing: Planning to be at 10,000-plus feet for several days? Ask your doctor about the drug Diamox, which helps prevent altitude sickness. Health.com: How to stay safe in the sun
Problem: Heat rash
Solution: Hit the showers
You're dining alfresco -- and suddenly you feel like you're body's covered in needles? It could be heat rash, a condition also known as "prickly heat." The red bumps or tiny fluid-filled blisters pop up when sweat glands get plugged up under your clothing or in the folds of skin under your breasts or arms. The best cure is a cool shower; the rash should disappear in a couple of hours. You can try an antihistamine like Benadryl for the itch. But avoid greasy ointments, which will plug up the glands even more.
One more thing: Wear loose cotton clothing that helps keep you cool.
One more thing: Wear loose cotton clothing that helps keep you cool.
Monday, July 9, 2007
U.S. Recalls More Chinese Products
(BEIJING) — A former department head at China's drug regulation agency was sentenced to death Friday on charges of bribery, as U.S. regulators ordered a recall of three more Chinese-made products deemed dangerous to children.
The developments were the latest in widening concerns about the safety of Chinese goods both at home and abroad.
Cao Wenzhuang, a department director at the State Food and Drug Administration, was given the death sentence with a two-year reprieve on charges of accepting bribes and neglecting official duties, his lawyer Gao Zicheng said.
While the sentence was unusually harsh given the charges, such suspended death sentences usually are commuted to life in prison if the convict is deemed to have reformed.
Cao, who oversaw the pharmaceutical registration department, had been secretary to Zheng Xiaoyu, the head of the agency, in the 1980s. Zheng was sentenced to death in May for taking bribes to approve substandard medicines, including an antibiotic blamed for at least 10 deaths.
In the pharmaceuticals department, Cao, 45, had the power to approve pharmaceutical production in China from 2002 to 2006.
He was charged with accepting $307,000 in bribes from two medical companies based in Jilin and Guangdong provinces that were seeking approval to sell their products. He also was charged with neglecting his duties in approving drugs.
"Cao does not admit to taking any bribes," Gao, the lawyer, said in a telephone interview. It wasn't immediately clear if Cao would appeal.
Meanwhile, the U.S. Consumer Product Safety Commission on Thursday announced three recalls that cover jewelry the agency said could cause lead poisoning, and a magnetic building set and plastic castles with small parts that it said could choke children.
Some 20,000 of Essentials for Kids Jewelry sold by Future Industries, of Cliffwood Beach, N.J., were recalled because the metal jewelry sets contain high levels of lead that can be toxic if ingested by young children, the agency said.
Additionally, 800 Mag Stix Magnetic Building Sets sold by Kipp Brothers, of Carmel, Ind., and 68,000 Shape Sorting Toy Castles sold by Infantino LLC, of San Diego, were pulled because they posed choking hazards to young children.
The U.S. agency routinely issues such recalls. Since a large share of products sold in the U.S. are made in China, the majority of the recalls involve Chinese-made products.
The orders add to the lengthening list of recent U.S. government actions to ban, recall or restrict Chinese imports — from juice to toothpaste — because they are suspected of containing high levels of toxins.
China has responded by stepping up enforcement of health and safety rules in the export industries that drive its economic growth. But Beijing also heatedly defends its record as a supplier of reliable goods and has complained that safety warnings may be driven by protectionism.
The country is currently overhauling its chaotic food and drug safety mechanisms, which are handicapped by competition between government agencies, murky laws and corruption.
Under Zheng's 1998-2005 tenure as top drug regulator, his agency approved six medicines that turned out to be fake, and the drug-makers used falsified documents to apply for approvals, state media has reported.
His death sentence was unusually heavy even for China, which is believed to carry out more court-ordered executions than all other nations combined — and likely indicates the leadership's determination to confront the recent scares involving unsafe food and drugs.
Cao Wenzhuang, a department director at the State Food and Drug Administration, was given the death sentence with a two-year reprieve on charges of accepting bribes and neglecting official duties, his lawyer Gao Zicheng said.
While the sentence was unusually harsh given the charges, such suspended death sentences usually are commuted to life in prison if the convict is deemed to have reformed.
Cao, who oversaw the pharmaceutical registration department, had been secretary to Zheng Xiaoyu, the head of the agency, in the 1980s. Zheng was sentenced to death in May for taking bribes to approve substandard medicines, including an antibiotic blamed for at least 10 deaths.
In the pharmaceuticals department, Cao, 45, had the power to approve pharmaceutical production in China from 2002 to 2006.
He was charged with accepting $307,000 in bribes from two medical companies based in Jilin and Guangdong provinces that were seeking approval to sell their products. He also was charged with neglecting his duties in approving drugs.
"Cao does not admit to taking any bribes," Gao, the lawyer, said in a telephone interview. It wasn't immediately clear if Cao would appeal.
Meanwhile, the U.S. Consumer Product Safety Commission on Thursday announced three recalls that cover jewelry the agency said could cause lead poisoning, and a magnetic building set and plastic castles with small parts that it said could choke children.
Some 20,000 of Essentials for Kids Jewelry sold by Future Industries, of Cliffwood Beach, N.J., were recalled because the metal jewelry sets contain high levels of lead that can be toxic if ingested by young children, the agency said.
Additionally, 800 Mag Stix Magnetic Building Sets sold by Kipp Brothers, of Carmel, Ind., and 68,000 Shape Sorting Toy Castles sold by Infantino LLC, of San Diego, were pulled because they posed choking hazards to young children.
The U.S. agency routinely issues such recalls. Since a large share of products sold in the U.S. are made in China, the majority of the recalls involve Chinese-made products.
The orders add to the lengthening list of recent U.S. government actions to ban, recall or restrict Chinese imports — from juice to toothpaste — because they are suspected of containing high levels of toxins.
China has responded by stepping up enforcement of health and safety rules in the export industries that drive its economic growth. But Beijing also heatedly defends its record as a supplier of reliable goods and has complained that safety warnings may be driven by protectionism.
The country is currently overhauling its chaotic food and drug safety mechanisms, which are handicapped by competition between government agencies, murky laws and corruption.
Under Zheng's 1998-2005 tenure as top drug regulator, his agency approved six medicines that turned out to be fake, and the drug-makers used falsified documents to apply for approvals, state media has reported.
His death sentence was unusually heavy even for China, which is believed to carry out more court-ordered executions than all other nations combined — and likely indicates the leadership's determination to confront the recent scares involving unsafe food and drugs.
A Medical Hope for Infertile Women
(LYON, France) — Doctors have removed eggs from young female cancer patients and — for the first time — brought the eggs to maturity before freezing them, giving the girls a better chance to one day have children. Previously, scientists had thought viable eggs could only be obtained from girls who had undergone puberty.
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"We didn't expect young girls to have eggs that could withstand the process of maturation," which involves adding hormones, said Dr. Ariel Revel, who led the research at the Hadassah Hospital in Israel.
The research will be presented Tuesday at the annual meeting of the European Society of Human Reproduction and Embryology in Lyon.
In related work, Canadian doctors on Monday announced the first birth of a baby from eggs matured in a laboratory, frozen, thawed and then fertilized — a key development that holds promise for infertile women.
The year-old baby girl was born to a woman in Canada, doctors told the conference. Three other women are pregnant from eggs that had been matured in a lab, frozen, thawed and then implanted, they said.
The 20 women involved in the study are infertile with an average age of about 30. None have a history of cancer. Until now, doctors did not know whether eggs matured in a lab could withstand the fertilization process, adding that the research is still in early stages. "It has the potential to become one of the main options for fertility preservation," said Dr. Hananel Holzer, the study's lead author and an assistant professor in the department of obstetrics and gynecology at McGill University in Montreal.
In the study involving young girls with cancer, Revel surgically extracted the eggs and then artificially matured them in a laboratory, with the idea of re-implanting them one day should the patient wish to have children. To obtain the eggs, Revel and his colleagues performed surgery on 18 patients ages 5 to 20. Of 167 eggs, 41 were successfully matured, including some from prepubescent donors. They were then indistinguishable from those of older women, Revel said.
"Any advance that enables young women to have children one day after having cancer is positive," said Simon Davies, head of Teenage Cancer Trust, a charity based in Britain. Davies was not linked to the research. But as the extraction of eggs is an invasive operation, Davies said more information was needed about potential risks to young women fighting cancer. There might also be ethical concerns, as the decision to remove eggs from very young girls would likely be made by the parents, not the patient.
Experts think cancer treatments can affect female fertility. Chemotherapy usually affects all body cells, attacking not only the cancer, but other areas including the ovaries — for which it is often deadly.
Unlike men, who produce sperm throughout their lifetime, women only have a set number of eggs from their birth, which decreases as they age. Young girls who undergo aggressive chemotherapy treatments often experience a sharp drop in the number of their eggs, and some become completely infertile. The cure rate for childhood cancer can be as high as 90 percent, and doctors are investigating options for preserving patients' fertility. Another experimental method involves removing a thin layer of ovarian tissue for re-implantation later, but trials so far have resulted in only a handful of pregnancies worldwide. Immature eggs from adult women have previously been matured in the laboratory, but until now, no one had ever tried it with eggs from young girls.
The real test will come when the girls on whom the treatment was performed might be ready to have children. "We will only know the final chapter of this story in about 10 years, when we hope to close the circle of this research," Revel said.
None of the eggs has yet been thawed, and experts are unsure if the process of artificial insemination could result in other problems such as chromosomal abnormalities. Additional surveillance, such as amniocentesis screenings to check the baby's development, probably would be necessary.
tiiQuigoWriteAd(755774, 1290760, 180, 200, -1);
"We didn't expect young girls to have eggs that could withstand the process of maturation," which involves adding hormones, said Dr. Ariel Revel, who led the research at the Hadassah Hospital in Israel.
The research will be presented Tuesday at the annual meeting of the European Society of Human Reproduction and Embryology in Lyon.
In related work, Canadian doctors on Monday announced the first birth of a baby from eggs matured in a laboratory, frozen, thawed and then fertilized — a key development that holds promise for infertile women.
The year-old baby girl was born to a woman in Canada, doctors told the conference. Three other women are pregnant from eggs that had been matured in a lab, frozen, thawed and then implanted, they said.
The 20 women involved in the study are infertile with an average age of about 30. None have a history of cancer. Until now, doctors did not know whether eggs matured in a lab could withstand the fertilization process, adding that the research is still in early stages. "It has the potential to become one of the main options for fertility preservation," said Dr. Hananel Holzer, the study's lead author and an assistant professor in the department of obstetrics and gynecology at McGill University in Montreal.
In the study involving young girls with cancer, Revel surgically extracted the eggs and then artificially matured them in a laboratory, with the idea of re-implanting them one day should the patient wish to have children. To obtain the eggs, Revel and his colleagues performed surgery on 18 patients ages 5 to 20. Of 167 eggs, 41 were successfully matured, including some from prepubescent donors. They were then indistinguishable from those of older women, Revel said.
"Any advance that enables young women to have children one day after having cancer is positive," said Simon Davies, head of Teenage Cancer Trust, a charity based in Britain. Davies was not linked to the research. But as the extraction of eggs is an invasive operation, Davies said more information was needed about potential risks to young women fighting cancer. There might also be ethical concerns, as the decision to remove eggs from very young girls would likely be made by the parents, not the patient.
Experts think cancer treatments can affect female fertility. Chemotherapy usually affects all body cells, attacking not only the cancer, but other areas including the ovaries — for which it is often deadly.
Unlike men, who produce sperm throughout their lifetime, women only have a set number of eggs from their birth, which decreases as they age. Young girls who undergo aggressive chemotherapy treatments often experience a sharp drop in the number of their eggs, and some become completely infertile. The cure rate for childhood cancer can be as high as 90 percent, and doctors are investigating options for preserving patients' fertility. Another experimental method involves removing a thin layer of ovarian tissue for re-implantation later, but trials so far have resulted in only a handful of pregnancies worldwide. Immature eggs from adult women have previously been matured in the laboratory, but until now, no one had ever tried it with eggs from young girls.
The real test will come when the girls on whom the treatment was performed might be ready to have children. "We will only know the final chapter of this story in about 10 years, when we hope to close the circle of this research," Revel said.
None of the eggs has yet been thawed, and experts are unsure if the process of artificial insemination could result in other problems such as chromosomal abnormalities. Additional surveillance, such as amniocentesis screenings to check the baby's development, probably would be necessary.
A New Diet Equation
No diet has ever been able to defy the laws of thermodynamics. Whether you go low carb, low fat, low this or low that, the only way to lose weight is to burn more calories than you consume. Even the new "it" diet, volumetrics—which uses fancy terms such as energy density and satiety to describe why filling up on certain low-calorie, water-based foods like celery makes you less hungry—can't miraculously melt away fat. But new research indicates that where on your body you pack on extra kilograms may provide a clue to determining which diet will work best for you.It is already widely accepted that even the most rigorously adhered-to diet will not produce the same results from person to person. Some of us are simply genetically predisposed to burn more calories more efficiently than others. Restricting those calories, as you do on a diet, will similarly lead to differing results. But the biggest wild card in the diet game may be how you crank out insulin.
As digestion breaks down much of what we eat into sugary, energy-rich fuel that helps keep us on the go, insulin triggers the body to store excess sugar floating around the bloodstream as fat. Insulin was particularly important in our caveman days, when we needed the energy from one meal to last as long as possible, until we had hunted down the next. "Insulin is the hormone of feast," says Gary D. Foster, director of the center for obesity research and education at the Temple University School of Medicine in Philadelphia.
But nowadays, with food so plentiful that groups like Weight Watchers are making a fortune promoting portion control, our insulin is often forced to work overtime, sweeping up the excess carbohydrates we pour into our system from candy bars or fruit juice or starchy foods like pasta. Sometimes insulin can do such a good job of responding to a spike in blood sugar that it causes those levels to quickly drop. This in turn can lead to feelings of hunger shortly after a big meal. For this reason, many scientists think insulin's ride on the blood-sugar roller coaster may be a stimulus for overeating and, as a result, weight gain. It would be nice if there were an easy way to determine how aggressive your particular insulin response is, and now it appears there is.
In a study of 73 obese adults published last month in the Journal of the American Medical Association (J.A.M.A.), Dr. David Ludwig, director of the obesity program at the Children's Hospital Boston, and his colleagues looked at high- and low-insulin secretors. People who rapidly secrete a lot of insulin after eating a little bit of sugar tend to carry their excess weight around their waist—the so-called apple shape. People who secrete less insulin carry their excess fat around their hips—the pear shape. Those differences are more than aesthetic. The study found that high-insulin, apple-shaped people will not lose as much weight on a diet that restricts fat calories as they will on a low-glycemic-load diet—one that restricts simple carbohydrates from sugary and starchy foods like cookies and potatoes. Low-secreting, pear-shaped people will do equally well on either type of diet. But the results went deeper than simply how much weight was lost.
Over the course of six months, high-secreting, apple people lost an average of 6 kg on a low-glycemic diet and just 2.3 kg on a low-fat diet. Low-secreting, pear people lost about 4.5 kg on both diets. At the end of 18 months, however, the pear-shaped people had gained back half of the weight they had lost on either diet. Apple-shaped people gained back almost 1.4 of the 2.3 kg they lost on the low-fat diet but kept off all the weight they lost on the low-glycemic diet. While the study is revealing, almost nothing about it is simple. It's not clear just what the mechanism is that links body shape and insulin levels—a crucial detail if scientists are going to understand the full implications of their findings. More important, nothing suggests that apple-shaped people should simply dash out to sign up for an Atkins-type low-carbohydrate diet.
True, a large report published in J.A.M.A. earlier this year showed that regardless of body shape, Atkins produces the greatest short-term weight loss. ("If you want to look good in your wedding gown, I would go for Atkins," says Dr. Anastassios Pittas, assistant professor of medicine at Tufts University School of Medicine.) But adherents tend to fall off the low-carb wagon and quickly gain back unwanted kilograms. What's more, the Atkins diet allows only a small fraction of calories to come from carbs, compared with 40% on the new study's low-glycemic regimen. The more balanced diet allows—indeed, encourages—people to eat whole-grain cereals and other complex carbs that take longer to digest and thus don't cause the rapid fat production that accompanies spikes in blood sugar. Atkins' more restrictive regimen may reduce fat even faster, but people lose weight on both diets. "Atkins just does it with a bludgeon instead of a chisel," says Ludwig.
What's clearer from the study is that apple-shaped people should probably not choose low-fat diets, because the white rice or other types of simple carbs they are still allowed to eat may have a yo-yo effect on blood-sugar levels, making them hungrier sooner. The study didn't evaluate whether these people would do better on an Ornish-style vegetarian diet that restricts fat intake and has dieters make up the difference by eating lots of complex carbs, such as brown rice and oats—which are high in fiber and tend to make people feel fuller longer—as well as low-sugar fruits like blueberries.
For apple-shaped people hunting for the right diet, a blood test to determine insulin levels may help confirm which regimen will work best for them. But for pears, it remains a toss-up. So until scientists find out more about their body shape, they'll have to lose the old-fashioned way: eating less.
How We Get Addicted
I was driving up the Massachusetts Turnpike one evening last February when I knocked over a bottle of water. I grabbed for it, swerved inadvertently--and a few seconds later found myself blinking into the flashlight beam of a state trooper. "How much have you had to drink tonight, sir?" he demanded. Before I could help myself, I blurted out an answer that was surely a new one to him. "I haven't had a drink," I said indignantly, "since 1981."
It was both perfectly true and very pertinent to the trip I was making. By the time I reached my late 20s, I'd poured down as much alcohol as normal people consume in a lifetime and plenty of drugs--mostly pot--as well. I was, by any reasonable measure, an active alcoholic. Fortunately, with a lot of help, I was able to stop. And now I was on my way to McLean Hospital in Belmont, Mass., to have my brain scanned in a functional magnetic-resonance imager (fMRI). The idea was to see what the inside of my head looked like after more than a quarter-century on the wagon.
Back when I stopped drinking, such an experiment would have been unimaginable. At the time, the medical establishment had come to accept the idea that alcoholism was a disease rather than a moral failing; the American Medical Association (AMA) had said so in 1950. But while it had all the hallmarks of other diseases, including specific symptoms and a predictable course, leading to disability or even death, alcoholism was different. Its physical basis was a complete mystery--and since nobody forced alcoholics to drink, it was still seen, no matter what the AMA said, as somehow voluntary. Treatment consisted mostly of talk therapy, maybe some vitamins and usually a strong recommendation to join Alcoholics Anonymous. Although it's a totally nonprofessional organization, founded in 1935 by an ex-drunk and an active drinker, AA has managed to get millions of people off the bottle, using group support and a program of accumulated folk wisdom.
While AA is astonishingly effective for some people, it doesn't work for everyone; studies suggest it succeeds about 20% of the time, and other forms of treatment, including various types of behavioral therapy, do no better. The rate is much the same with drug addiction, which experts see as the same disorder triggered by a different chemical. "The sad part is that if you look at where addiction treatment was 10 years ago, it hasn't gotten much better," says Dr. Martin Paulus, a professor of psychiatry at the University of California at San Diego. "You have a better chance to do well after many types of cancer than you have of recovering from methamphetamine dependence."
That could all be about to change. During those same 10 years, researchers have made extraordinary progress in understanding the physical basis of addiction. They know now, for example, that the 20% success rate can shoot up to 40% if treatment is ongoing (very much the AA model, which is most effective when members continue to attend meetings long after their last drink). Armed with an array of increasingly sophisticated technology, including fMRIs and PET scans, investigators have begun to figure out exactly what goes wrong in the brain of an addict--which neurotransmitting chemicals are out of balance and what regions of the brain are affected. They are developing a more detailed understanding of how deeply and completely addiction can affect the brain, by hijacking memory-making processes and by exploiting emotions. Using that knowledge, they've begun to design new drugs that are showing promise in cutting off the craving that drives an addict irresistibly toward relapse--the greatest risk facing even the most dedicated abstainer.
"Addictions," says Joseph Frascella, director of the division of clinical neuroscience at the National Institute on Drug Abuse (NIDA), "are repetitive behaviors in the face of negative consequences, the desire to continue something you know is bad for you."
Addiction is such a harmful behavior, in fact, that evolution should have long ago weeded it out of the population: if it's hard to drive safely under the influence, imagine trying to run from a saber-toothed tiger or catch a squirrel for lunch. And yet, says Dr. Nora Volkow, director of NIDA and a pioneer in the use of imaging to understand addiction, "the use of drugs has been recorded since the beginning of civilization. Humans in my view will always want to experiment with things to make them feel good."
That's because drugs of abuse co-opt the very brain functions that allowed our distant ancestors to survive in a hostile world. Our minds are programmed to pay extra attention to what neurologists call salience--that is, special relevance. Threats, for example, are highly salient, which is why we instinctively try to get away from them. But so are food and sex because they help the individual and the species survive. Drugs of abuse capitalize on this ready-made programming. When exposed to drugs, our memory systems, reward circuits, decision-making skills and conditioning kick in--salience in overdrive--to create an all consuming pattern of uncontrollable craving. "Some people have a genetic predisposition to addiction," says Volkow. "But because it involves these basic brain functions, everyone will become an addict if sufficiently exposed to drugs or alcohol."
That can go for nonchemical addictions as well. Behaviors, from gambling to shopping to sex, may start out as habits but slide into addictions. Sometimes there might be a behavior-specific root of the problem. Volkow's research group, for example, has shown that pathologically obese people who are compulsive eaters exhibit hyperactivity in the areas of the brain that process food stimuli--including the mouth, lips and tongue. For them, activating these regions is like opening the floodgates to the pleasure center. Almost anything deeply enjoyable can turn into an addiction, though.
Back when I stopped drinking, such an experiment would have been unimaginable. At the time, the medical establishment had come to accept the idea that alcoholism was a disease rather than a moral failing; the American Medical Association (AMA) had said so in 1950. But while it had all the hallmarks of other diseases, including specific symptoms and a predictable course, leading to disability or even death, alcoholism was different. Its physical basis was a complete mystery--and since nobody forced alcoholics to drink, it was still seen, no matter what the AMA said, as somehow voluntary. Treatment consisted mostly of talk therapy, maybe some vitamins and usually a strong recommendation to join Alcoholics Anonymous. Although it's a totally nonprofessional organization, founded in 1935 by an ex-drunk and an active drinker, AA has managed to get millions of people off the bottle, using group support and a program of accumulated folk wisdom.
While AA is astonishingly effective for some people, it doesn't work for everyone; studies suggest it succeeds about 20% of the time, and other forms of treatment, including various types of behavioral therapy, do no better. The rate is much the same with drug addiction, which experts see as the same disorder triggered by a different chemical. "The sad part is that if you look at where addiction treatment was 10 years ago, it hasn't gotten much better," says Dr. Martin Paulus, a professor of psychiatry at the University of California at San Diego. "You have a better chance to do well after many types of cancer than you have of recovering from methamphetamine dependence."
That could all be about to change. During those same 10 years, researchers have made extraordinary progress in understanding the physical basis of addiction. They know now, for example, that the 20% success rate can shoot up to 40% if treatment is ongoing (very much the AA model, which is most effective when members continue to attend meetings long after their last drink). Armed with an array of increasingly sophisticated technology, including fMRIs and PET scans, investigators have begun to figure out exactly what goes wrong in the brain of an addict--which neurotransmitting chemicals are out of balance and what regions of the brain are affected. They are developing a more detailed understanding of how deeply and completely addiction can affect the brain, by hijacking memory-making processes and by exploiting emotions. Using that knowledge, they've begun to design new drugs that are showing promise in cutting off the craving that drives an addict irresistibly toward relapse--the greatest risk facing even the most dedicated abstainer.
"Addictions," says Joseph Frascella, director of the division of clinical neuroscience at the National Institute on Drug Abuse (NIDA), "are repetitive behaviors in the face of negative consequences, the desire to continue something you know is bad for you."
Addiction is such a harmful behavior, in fact, that evolution should have long ago weeded it out of the population: if it's hard to drive safely under the influence, imagine trying to run from a saber-toothed tiger or catch a squirrel for lunch. And yet, says Dr. Nora Volkow, director of NIDA and a pioneer in the use of imaging to understand addiction, "the use of drugs has been recorded since the beginning of civilization. Humans in my view will always want to experiment with things to make them feel good."
That's because drugs of abuse co-opt the very brain functions that allowed our distant ancestors to survive in a hostile world. Our minds are programmed to pay extra attention to what neurologists call salience--that is, special relevance. Threats, for example, are highly salient, which is why we instinctively try to get away from them. But so are food and sex because they help the individual and the species survive. Drugs of abuse capitalize on this ready-made programming. When exposed to drugs, our memory systems, reward circuits, decision-making skills and conditioning kick in--salience in overdrive--to create an all consuming pattern of uncontrollable craving. "Some people have a genetic predisposition to addiction," says Volkow. "But because it involves these basic brain functions, everyone will become an addict if sufficiently exposed to drugs or alcohol."
That can go for nonchemical addictions as well. Behaviors, from gambling to shopping to sex, may start out as habits but slide into addictions. Sometimes there might be a behavior-specific root of the problem. Volkow's research group, for example, has shown that pathologically obese people who are compulsive eaters exhibit hyperactivity in the areas of the brain that process food stimuli--including the mouth, lips and tongue. For them, activating these regions is like opening the floodgates to the pleasure center. Almost anything deeply enjoyable can turn into an addiction, though.
New Dangers of Secondhand Smoke
Researchers have known that secondhand smoke can be just as dangerous for nonsmokers as smoking is for smokers, but now there's fresh evidence quantifying just how hazardous the after burn from cigarettes can be, and how quickly it affects your body. Scientists at the Oregon Department of Health documented for the first time an hourly buildup of a cancer-causing compound from cigarette smoke in the blood and urine of nonsmokers working in bars and restaurants in the state. Reporting in the American Journal of Public Health, the researchers found that waitstaff and bartenders working a typical night shift gradually accumulated higher levels of NNK, a carcinogen in cigarette smoke, at the rate of 6% each hour they worked. NNK is known to be involved in inducing lung cancer in both lab rats and smokers.
"We were somewhat surprised by the immediacy of the effect and the fact that we could measure the average hourly increase," says Michael Stark, the lead author of the study and a principal investigator at the Mulmomah County Health Department in Oregon.
Previous studies conducted in homes where one family member smoked, or in work environments where some employees lit up, had found that nonsmokers in these environments on average increased their risk of developing lung cancer, as well as other health conditions such as heart disease and respiratory ailments, by 20%. And the Surgeon General, in a comprehensive report last year on the health effects of secondhand smoke, determined that there is "no risk-free level of exposure to secondhand smoke." But until now, it wasn't clear how quickly the carcinogens became absorbed.
The authors are confident that the increases in NNK in the workers they tested most likely came from their exposure to smoke — the study included a control group of similar subjects in restaurants where no smoking was allowed, and these workers showed no differences in the amount of NNK in their urine before and after their shifts.
The findings only underscore what public health officials have been arguing for decades — that cordoning off smokers in indoor environments or relying on ventilation systems in restaurants and bars is not enough. "There is experimental evidence from studies where you put nonsmokers in a room, blow smoke into the room and measure their artery function, that you see the platelets get sticky, which can cause clots and lead to a heart attack, and the ability of the arteries to dilate decreases very rapidly," says Dr. Matthew McKenna, director of the office on smoking and public health for the Centers for Disease Control.
All of which could mean more time loitering outside buildings and in alleyways for smokers intent on grabbing a puff. Thirteen states now prohibit smoking in restaurants altogether (most of these include bars as well), and while 11 states still put no restrictions on lighting up, individual cities within those states — such as Austin in Texas, for example — have passed legislation banning smoking in eating establishments and other public areas. Many of these regulations are the direct result of grassroots advocacy efforts; "It's been a very effective strategy," says McKenna." If the discussion moves to a centralized place like the state legislatures, opponents can concentrate their efforts and water down the argument for a ban. But if there are 40 municipalities working on smoking bans at the same time, it's difficult for opponents to fight so many battles at the same time."
More states are also passing laws to override a loophole — known as a pre-emption — that prevents cities and local municipalities from passing more restrictive laws than the state. It's just getting harder to refute the scientific evidence; in a study done in Scotland several months after that nation instituted a ban on smoking in public places, researchers found that following the ban, bar patrons showed stronger lung capacity and reduced levels of inflammation (a red flag for a number of chronic diseases, including heart disease and asthma). "We made it pretty clear that the science on this is pretty irrefutable," says McKenna. And if smokers have fewer places to smoke, that message may finally get heard.
"We were somewhat surprised by the immediacy of the effect and the fact that we could measure the average hourly increase," says Michael Stark, the lead author of the study and a principal investigator at the Mulmomah County Health Department in Oregon.
Previous studies conducted in homes where one family member smoked, or in work environments where some employees lit up, had found that nonsmokers in these environments on average increased their risk of developing lung cancer, as well as other health conditions such as heart disease and respiratory ailments, by 20%. And the Surgeon General, in a comprehensive report last year on the health effects of secondhand smoke, determined that there is "no risk-free level of exposure to secondhand smoke." But until now, it wasn't clear how quickly the carcinogens became absorbed.
The authors are confident that the increases in NNK in the workers they tested most likely came from their exposure to smoke — the study included a control group of similar subjects in restaurants where no smoking was allowed, and these workers showed no differences in the amount of NNK in their urine before and after their shifts.
The findings only underscore what public health officials have been arguing for decades — that cordoning off smokers in indoor environments or relying on ventilation systems in restaurants and bars is not enough. "There is experimental evidence from studies where you put nonsmokers in a room, blow smoke into the room and measure their artery function, that you see the platelets get sticky, which can cause clots and lead to a heart attack, and the ability of the arteries to dilate decreases very rapidly," says Dr. Matthew McKenna, director of the office on smoking and public health for the Centers for Disease Control.
All of which could mean more time loitering outside buildings and in alleyways for smokers intent on grabbing a puff. Thirteen states now prohibit smoking in restaurants altogether (most of these include bars as well), and while 11 states still put no restrictions on lighting up, individual cities within those states — such as Austin in Texas, for example — have passed legislation banning smoking in eating establishments and other public areas. Many of these regulations are the direct result of grassroots advocacy efforts; "It's been a very effective strategy," says McKenna." If the discussion moves to a centralized place like the state legislatures, opponents can concentrate their efforts and water down the argument for a ban. But if there are 40 municipalities working on smoking bans at the same time, it's difficult for opponents to fight so many battles at the same time."
More states are also passing laws to override a loophole — known as a pre-emption — that prevents cities and local municipalities from passing more restrictive laws than the state. It's just getting harder to refute the scientific evidence; in a study done in Scotland several months after that nation instituted a ban on smoking in public places, researchers found that following the ban, bar patrons showed stronger lung capacity and reduced levels of inflammation (a red flag for a number of chronic diseases, including heart disease and asthma). "We made it pretty clear that the science on this is pretty irrefutable," says McKenna. And if smokers have fewer places to smoke, that message may finally get heard.
New Insight Into Male Infertility
So many things can go wrong when a couple is trying to conceive, it seems a miracle that babies are ever born at all. There could be a shortage of sperm, an egg may not be in the right place and fibrous growths located along the reproductive tract can prevent the two key players from ever meeting. But now it may be possible to spot at least one of these problems easily and early: a new study suggests that a simple home test may be all it takes to help men detect a protein that could be weakening their sperm. The chemical that is the cause of so much woe is known as macrophage migration inhibitory factor or MIF, a protein found in the immune system that seems to help sperm cells grow into strong swimmers—and that's critical. Weak sperm do not survive long in the wild environment of the reproductive tract. There may be millions of the tiny cells released, but to reach the egg they must withstand the acidic environment of the vagina, fight through a thick layer of cervical mucus and then race the other sperm to penetrate the egg's protective layer. Men are responsible for almost 40% of conception problems, and MIF, researchers believe, may play a role in most of the cases. "It is all about sperm,"says chemist Yousef Al-Abed, the lead researcher of the just-released MIF paper. "They need to be in good shape to do their jobs."
In the study, which appears in the most recent issue of Molecular Medicine, Al-Abed analyzed semen samples from 68 infertile and 28 fertile males who had abstained from sex for a period of three to five days. All of the participants, the research revealed, exhibited what Al-Abed calls the Goldilocks effect: those who had abnormally high or low levels of MIF were infertile. In the ones whose levels were high, sperm were produced but quickly died; in the ones whose levels were low, sperm survived but were often malformed. Only the men whose MIF concentrations were just right produced healthy and viable sperm. The paper does not specify just how MIF has the effect it does and indeed Al-Abed concedes he doesn't yet know. But the mere fact that the protein levels are so closely associated with sperm viability makes a strong circumstantial case that there's some causation going on.
While this is a novel find, MIF itself is hardly a new discovery. Scientists isolated the protein more than 40 years ago and found that it played a role in causing the swelling and inflammation found in diseases like arthritis. Al-Abed and his team are hard at work trying to figure out if this or some other mechanism is what damages sperm, but they're already trying to make use of what they know so far. Within the two years, they hope to develop a home-testing kit that can help men measure their MIF levels if they even suspect a problem. Further down the line, it may be possible for doctors to administer MIF to men who don't produce enough, or chemically counteract it in those who produce too much. It might even be possible for the protein to serve as a form of male contraception, one that could be used as either an injection or spermicidal gel. "MIF is still not well-resolved,"Al-Abed admits. But its power to do harm—as well as good—is becoming clearer.
In the study, which appears in the most recent issue of Molecular Medicine, Al-Abed analyzed semen samples from 68 infertile and 28 fertile males who had abstained from sex for a period of three to five days. All of the participants, the research revealed, exhibited what Al-Abed calls the Goldilocks effect: those who had abnormally high or low levels of MIF were infertile. In the ones whose levels were high, sperm were produced but quickly died; in the ones whose levels were low, sperm survived but were often malformed. Only the men whose MIF concentrations were just right produced healthy and viable sperm. The paper does not specify just how MIF has the effect it does and indeed Al-Abed concedes he doesn't yet know. But the mere fact that the protein levels are so closely associated with sperm viability makes a strong circumstantial case that there's some causation going on.
While this is a novel find, MIF itself is hardly a new discovery. Scientists isolated the protein more than 40 years ago and found that it played a role in causing the swelling and inflammation found in diseases like arthritis. Al-Abed and his team are hard at work trying to figure out if this or some other mechanism is what damages sperm, but they're already trying to make use of what they know so far. Within the two years, they hope to develop a home-testing kit that can help men measure their MIF levels if they even suspect a problem. Further down the line, it may be possible for doctors to administer MIF to men who don't produce enough, or chemically counteract it in those who produce too much. It might even be possible for the protein to serve as a form of male contraception, one that could be used as either an injection or spermicidal gel. "MIF is still not well-resolved,"Al-Abed admits. But its power to do harm—as well as good—is becoming clearer.
Two Fixes for Bad Backs
In your own hands exercises to stretch and strengthen, plus rest and anti-inflammatories may fix a bad back, without having to go under the knife.As a neurosurgeon, I spend more than half my time helping patients cope with a surprisingly unremarkable problem: back pain. Despite the life-and-death challenges of treating complex brain tumors, vascular malformations and spinal trauma, it is this most commonplace of ills that consumes more than half my patient hours and that can be one of the most stubborn conditions for any neurosurgeon to manage.
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Often the source of persistent back woes is sciatica, caused by a herniated, slipped or protruding disc that impinges on the sciatic nerve, sending pain all the way down the leg. Back pain, including sciatica, is one of the leading causes of workplace absenteeism and is the fifth leading cause of expenditures in U.S. hospitals each year. Given the ubiquity of the condition, you'd think doctors might have reached some consensus on the best ways to treat it, but you'd be wrong--and a new study released in late May may only make things less clear.
Patients with sciatica often complain not only of symptoms in the leg and back, but also of numbness and sometimes weakness. The pain can be absolutely unbearable, even likened to childbirth by one Mrs. Gupta, who is looking over my shoulder as I write this. Sometimes patients come into my office vigorously kneading their thigh in the hope it will bring some relief. They occasionally report that they are taking multiple pain medications--causing some of them to doze off as I try to take a medical history. People like this are tired of suffering and want the quickest fix possible. Often that means surgery. Around the world, approximately 1.5 million people each year undergo operations to relieve pressure on the sciatic nerve, a procedure that usually brings them the relief they seek. But new research suggests that over the course of time, surgery may be no better than nonoperative therapeutic methods.
In the study, published in the New England Journal of Medicine, researchers followed 283 patients who had suffered with sciatic pain for at least six weeks. Half of them were scheduled for surgery, and the other half were told to get conservative treatments--principally rest, gentle stretching and back-strengthening exercises, and, when needed, anti-inflammatories. Using various scales to measure dysfunction and disability, the investigators found that 95% of participants in both groups reported significant recovery after one year. That's good news for sciatica sufferers who are concerned about the risks of surgical complications, which can include bleeding or, worrisomely, accidental nerve damage that may only exacerbate the pain. What's more, surgery can cost a few thousand dollars, will leave you sore for a few weeks and requires a couple of months for full recovery.
So why would you opt for an operation at all? Speed, for one thing. In most cases, pain relief and perceived recovery come faster via a trip to the operating room than through exercise and medications. In fact, even in the current study, 39% of the patients who were initially assigned to receive conservative care opted for surgery anyway because they could no longer tolerate the pain.
Which course is right for you depends on the nature of your case. If you are getting progressively weaker or have pain that is searing and uncontrollable with conventional pain medications, you may need to go under the knife. Short of such extreme cases, most surgeons will wait a few weeks before pulling out the scalpel--often just long enough for patients to notice improvement with less invasive techniques. Whichever direction you choose to go, it's nice to know that if you must have a problem like sciatica, at least it's one of those rare conditions that have not just one good solution, but two. And in case you're curious, Mrs. Gupta opted for the operation and has never felt better. *
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Often the source of persistent back woes is sciatica, caused by a herniated, slipped or protruding disc that impinges on the sciatic nerve, sending pain all the way down the leg. Back pain, including sciatica, is one of the leading causes of workplace absenteeism and is the fifth leading cause of expenditures in U.S. hospitals each year. Given the ubiquity of the condition, you'd think doctors might have reached some consensus on the best ways to treat it, but you'd be wrong--and a new study released in late May may only make things less clear.
Patients with sciatica often complain not only of symptoms in the leg and back, but also of numbness and sometimes weakness. The pain can be absolutely unbearable, even likened to childbirth by one Mrs. Gupta, who is looking over my shoulder as I write this. Sometimes patients come into my office vigorously kneading their thigh in the hope it will bring some relief. They occasionally report that they are taking multiple pain medications--causing some of them to doze off as I try to take a medical history. People like this are tired of suffering and want the quickest fix possible. Often that means surgery. Around the world, approximately 1.5 million people each year undergo operations to relieve pressure on the sciatic nerve, a procedure that usually brings them the relief they seek. But new research suggests that over the course of time, surgery may be no better than nonoperative therapeutic methods.
In the study, published in the New England Journal of Medicine, researchers followed 283 patients who had suffered with sciatic pain for at least six weeks. Half of them were scheduled for surgery, and the other half were told to get conservative treatments--principally rest, gentle stretching and back-strengthening exercises, and, when needed, anti-inflammatories. Using various scales to measure dysfunction and disability, the investigators found that 95% of participants in both groups reported significant recovery after one year. That's good news for sciatica sufferers who are concerned about the risks of surgical complications, which can include bleeding or, worrisomely, accidental nerve damage that may only exacerbate the pain. What's more, surgery can cost a few thousand dollars, will leave you sore for a few weeks and requires a couple of months for full recovery.
So why would you opt for an operation at all? Speed, for one thing. In most cases, pain relief and perceived recovery come faster via a trip to the operating room than through exercise and medications. In fact, even in the current study, 39% of the patients who were initially assigned to receive conservative care opted for surgery anyway because they could no longer tolerate the pain.
Which course is right for you depends on the nature of your case. If you are getting progressively weaker or have pain that is searing and uncontrollable with conventional pain medications, you may need to go under the knife. Short of such extreme cases, most surgeons will wait a few weeks before pulling out the scalpel--often just long enough for patients to notice improvement with less invasive techniques. Whichever direction you choose to go, it's nice to know that if you must have a problem like sciatica, at least it's one of those rare conditions that have not just one good solution, but two. And in case you're curious, Mrs. Gupta opted for the operation and has never felt better. *
Seven thoughts that can make you thin
(Oprah.com) -- You know those suggestive little voices that whisper in your ear ... and suddenly you're knee-deep in ice cream? Change the sabotaging, discipline-destroying thoughts, and you can change your life -- or at least your weight.You're out to lunch and you've ordered the grilled cheese. Don't say, "I ordered the grilled cheese, so why not get the fries, too?" Instead, think this to yourself: "One treat at a time. I'm indulging in grilled cheese, so I'll trade the fries for a salad."
University of Toledo psychology professor Janet Polivy calls it the "what the hell" effect and says it causes people to devour so much food that they feel they'll never get back on track.
To prevent this scenario from playing over and over, Polivy says, you have to redefine your idea of healthy eating. Allow yourself the occasional treat, as long as it's accompanied by smarter food choices like fresh fruit and vegetables.
University of Toledo psychology professor Janet Polivy calls it the "what the hell" effect and says it causes people to devour so much food that they feel they'll never get back on track.
To prevent this scenario from playing over and over, Polivy says, you have to redefine your idea of healthy eating. Allow yourself the occasional treat, as long as it's accompanied by smarter food choices like fresh fruit and vegetables.
If there is a treat nearby, don't fall into the "I'll have just one" trap. Instead, say to yourself: "If I can't stop at one or two cookies, I shouldn't have any at all." It's okay to eat your favorite foods, provided you're the type who can stop after a small amount.
"One cookie could turn into 1,000 calories or more if you proceed to eat the whole bag," warns Stephen Gullo, PhD, president of the Institute for Health and Weight Sciences. He suggests that you take a step back and honestly assess how you've reacted to your favorite foods in the past. You may discover that chocolate chip cookies trigger uncontrollable cravings but one square of dark chocolate appeases your sweet tooth quite nicely.
Even if a loved one as close as your husband comments on your weight, say to yourself: "I want to get in shape for myself, not him."
Whether or not you need to shed a few pounds, acting in response to someone else's hurtful remarks will breed self-doubt and lower your self-esteem, says Marlene Schwartz, PhD, co-director of the Yale Center for Eating and Weight Disorders in New Haven, Connecticut.
To reset your weight loss goals so they revolve solely around you, sit down and figure out how you could benefit from changing your lifestyle. (Writing your thoughts out on paper might help.) If you identify areas that need improvement, talk to your spouse about how he can play a part: Plan low-fat weekly menus together in lieu of eating out, or take walks after dinner instead of watching TV.
Alternatively, if you're exercising, eating right, and feeling pretty healthy the way you are, Schwartz says, "tell him that this is his problem, not yours."
In the dead of winter, it can be hard to stay motivated. Don't put getting in shape off until summer. Instead, think this to yourself: "By eating more now, I'm creating a lot of extra work for myself when spring rolls around."
A study by scientists at the National Institutes of Health tracked 195 people through the holidays and found an average weight gain of about a pound. By the following year, most had gained another half pound, and the researchers predicted that the trend would only continue.
To prevent this outward creep, Gullo says, keep thoughts of summer in your house all year long by hanging a bikini or skimpy sundress on the back of the bathroom door, and visualize yourself wearing it every time you head for the leftovers. He also proposes committing to a regular exercise program in the fall, "before the winter blahs set in."
If being overweight is a prevalent trait in your family, say to yourself: "I can't change my DNA, but I can change my fate."
"Genetics helps determine your natural weight range, but you have some control over where you fall within that range," says Edward Abramson, PhD, an expert on obesity, dieting, and weight disorders and the author of Body Intelligence. Rather than aiming for a size 2, aim for health: If being overweight is a family trait, diabetes, heart disease, and other obesity-related illnesses could be, too, Schwartz says.
Walk to the grocery store, choose the stairs over the escalator, and take good care of the body you were born with. "It's important to distinguish between body size and body health," she says. "Research shows that people who are overweight and physically fit can live longer than people who are ideal weight and not physically fit." Oprah.com: Find out more about body health
So you've had a fantastic workout. Does that mean it's time to reward yourself with a bacon double cheeseburger? Not exactly. If you're tempted, say to yourself: "After busting my butt at the gym, my body deserves the VIP treatment."
"Most people overestimate the number of calories they've burned," says Brian Wansink, PhD, a professor of marketing, applied economics, and nutritional science at Cornell University and author of Marketing Nutrition.
To burn off a bacon double cheeseburger, the average 140-pound woman has to jog at a rate of five miles per hour for more than 60 minutes. Recast your concept of reward: Instead of seeking food, take a luxurious bubble bath, rent a guilty-pleasure movie, buy a new pair of shoes, or lose yourself in a good novel.
We've all experienced that mid-afternoon energy slump. Instead of reaching for a candy bar, remind yourself that you need food that will help you go the distance. Candy and other sweets have little nutritional value, and they destabilize blood sugar, causing you to have more cravings later on, Gullo says.
To head off a snack attack, he suggests, "reprogram yourself to seek out a mini-meal 30 minutes before you usually hit a slump." By eating before you're famished, you should be able to resist the sweet stuff and choose foods with enough protein, fat, and complex carbs to keep you sated and energized until dinner. Some of Gullo's top picks: bran crackers with low-fat cheese, a hard-boiled egg, or a cup of low-fat yogurt.
"One cookie could turn into 1,000 calories or more if you proceed to eat the whole bag," warns Stephen Gullo, PhD, president of the Institute for Health and Weight Sciences. He suggests that you take a step back and honestly assess how you've reacted to your favorite foods in the past. You may discover that chocolate chip cookies trigger uncontrollable cravings but one square of dark chocolate appeases your sweet tooth quite nicely.
Even if a loved one as close as your husband comments on your weight, say to yourself: "I want to get in shape for myself, not him."
Whether or not you need to shed a few pounds, acting in response to someone else's hurtful remarks will breed self-doubt and lower your self-esteem, says Marlene Schwartz, PhD, co-director of the Yale Center for Eating and Weight Disorders in New Haven, Connecticut.
To reset your weight loss goals so they revolve solely around you, sit down and figure out how you could benefit from changing your lifestyle. (Writing your thoughts out on paper might help.) If you identify areas that need improvement, talk to your spouse about how he can play a part: Plan low-fat weekly menus together in lieu of eating out, or take walks after dinner instead of watching TV.
Alternatively, if you're exercising, eating right, and feeling pretty healthy the way you are, Schwartz says, "tell him that this is his problem, not yours."
In the dead of winter, it can be hard to stay motivated. Don't put getting in shape off until summer. Instead, think this to yourself: "By eating more now, I'm creating a lot of extra work for myself when spring rolls around."
A study by scientists at the National Institutes of Health tracked 195 people through the holidays and found an average weight gain of about a pound. By the following year, most had gained another half pound, and the researchers predicted that the trend would only continue.
To prevent this outward creep, Gullo says, keep thoughts of summer in your house all year long by hanging a bikini or skimpy sundress on the back of the bathroom door, and visualize yourself wearing it every time you head for the leftovers. He also proposes committing to a regular exercise program in the fall, "before the winter blahs set in."
If being overweight is a prevalent trait in your family, say to yourself: "I can't change my DNA, but I can change my fate."
"Genetics helps determine your natural weight range, but you have some control over where you fall within that range," says Edward Abramson, PhD, an expert on obesity, dieting, and weight disorders and the author of Body Intelligence. Rather than aiming for a size 2, aim for health: If being overweight is a family trait, diabetes, heart disease, and other obesity-related illnesses could be, too, Schwartz says.
Walk to the grocery store, choose the stairs over the escalator, and take good care of the body you were born with. "It's important to distinguish between body size and body health," she says. "Research shows that people who are overweight and physically fit can live longer than people who are ideal weight and not physically fit." Oprah.com: Find out more about body health
So you've had a fantastic workout. Does that mean it's time to reward yourself with a bacon double cheeseburger? Not exactly. If you're tempted, say to yourself: "After busting my butt at the gym, my body deserves the VIP treatment."
"Most people overestimate the number of calories they've burned," says Brian Wansink, PhD, a professor of marketing, applied economics, and nutritional science at Cornell University and author of Marketing Nutrition.
To burn off a bacon double cheeseburger, the average 140-pound woman has to jog at a rate of five miles per hour for more than 60 minutes. Recast your concept of reward: Instead of seeking food, take a luxurious bubble bath, rent a guilty-pleasure movie, buy a new pair of shoes, or lose yourself in a good novel.
We've all experienced that mid-afternoon energy slump. Instead of reaching for a candy bar, remind yourself that you need food that will help you go the distance. Candy and other sweets have little nutritional value, and they destabilize blood sugar, causing you to have more cravings later on, Gullo says.
To head off a snack attack, he suggests, "reprogram yourself to seek out a mini-meal 30 minutes before you usually hit a slump." By eating before you're famished, you should be able to resist the sweet stuff and choose foods with enough protein, fat, and complex carbs to keep you sated and energized until dinner. Some of Gullo's top picks: bran crackers with low-fat cheese, a hard-boiled egg, or a cup of low-fat yogurt.
Could nerve-snip spur weight loss?
WASHINGTON (AP) -- An old ulcer operation is getting new attention as a possible alternative obesity surgery: a quick snip of a nerve that helps control hunger.
It's far from clear whether cutting the vagus nerve really helps -- initial pilot studies in a few dozen patients have just begun. Skeptics abound, and even proponents say it wouldn't lead to nearly as much weight loss as more traumatic operations that shrink the stomach and reroute intestines.
It's part of a hunt for middle-ground options for people scared of today's surgery, or those not quite fat enough to qualify for it.
"By no means do I think this is a panacea," cautions Dr. Robert Lustig of the University of California, San Francisco, who, along with University of Rochester surgeons, is studying the method.
"But I think this will be a rational alternative for a cadre of patients that are sort of in the middle there. With as much obesity as we have in this country, that's a big middle."
More than 177,000 people underwent obesity surgery last year, according to the American Society for Metabolic and Bariatric Surgery. The most popular method is gastric bypass, stapling the stomach to create a tiny pouch. Options include placing an adjustable band around the stomach, or cutting off the stomach's side and rerouting the intestines.
Surgery can produce life-altering weight loss, if recipients adhere to diet and exercise advice, but each method comes with varying degrees of pain and risk, including a rare chance of death. So doctors are searching for alternatives.
Enter the vagus nerve, which snakes from the brain to the abdomen, with fibers reaching into multiple organs with different effects. Among them: The nerve spurs gastric acid production, and in the 1970s, surgery to cut where it attaches to the front and back of the stomach brought ulcer sufferers great relief -- after they recovered from open-abdominal surgery. Once better acid-reducing medications came along, this arduous operation was abandoned.
It's part of a hunt for middle-ground options for people scared of today's surgery, or those not quite fat enough to qualify for it.
"By no means do I think this is a panacea," cautions Dr. Robert Lustig of the University of California, San Francisco, who, along with University of Rochester surgeons, is studying the method.
"But I think this will be a rational alternative for a cadre of patients that are sort of in the middle there. With as much obesity as we have in this country, that's a big middle."
More than 177,000 people underwent obesity surgery last year, according to the American Society for Metabolic and Bariatric Surgery. The most popular method is gastric bypass, stapling the stomach to create a tiny pouch. Options include placing an adjustable band around the stomach, or cutting off the stomach's side and rerouting the intestines.
Surgery can produce life-altering weight loss, if recipients adhere to diet and exercise advice, but each method comes with varying degrees of pain and risk, including a rare chance of death. So doctors are searching for alternatives.
Enter the vagus nerve, which snakes from the brain to the abdomen, with fibers reaching into multiple organs with different effects. Among them: The nerve spurs gastric acid production, and in the 1970s, surgery to cut where it attaches to the front and back of the stomach brought ulcer sufferers great relief -- after they recovered from open-abdominal surgery. Once better acid-reducing medications came along, this arduous operation was abandoned.
Yet surgeons at the time noticed, and subsequent animal studies confirmed, that these vagotomies could trigger weight loss. In addition to a less acidic stomach's slower digestion, the vagus helps control appetite-stimulating brain hormones and signals our bodies to store more fat, Lustig explains.
Since doctors today can snip the nerve far less invasively, through just five pencil-sized cuts in the abdomen, it was time to test in the obese.
Thirty patients had a vagus snip at UCSF or the University of Rochester. The study isn't complete. But of the 11 who are a year past surgery, all but one are shedding pounds, losing an average of 18 percent of excess weight so far, Lustig and Rochester's Dr. Thad Boss reported at last month's bariatric society meeting.
They suffered no serious side effects, and went home hours later with little pain.
"Every patient who had the vagus nerve cut says they're not hungry," adds Lustig -- although the one who didn't respond got hungry again six weeks after surgery, perhaps because the nerve healed.
That's less than half the weight loss of standard surgeries, warns Dr. Neil Hutcher of Bon Secour St. Mary's Hospital in Richmond, Virginia, and a past president of the bariatric society.
"I have my doubts that vagotomy alone is going to be a significant weapon," says Hutcher, who often cuts the nerve during standard gastric bypasses for a different reason -- to help those patients avoid the side effect of heartburn-causing acid buildup.
But, when Greensboro, North Carolina, surgeons added a vagotomy to 25 patients getting bands on their stomachs, the nerve-snip seemed to make that usually more modest operation about as effective as a gastric bypass -- with 43 percent loss of excess weight at six months, and counting.
Other doctors are testing whether implants that treat epilepsy by stimulating the vagus nerve also might trigger weight loss, with mixed results so far.
For now, Boss stresses that vagus nerve-snipping remains highly experimental. He and Lustig will track their 30 patients for 18 months to check if ultimate weight loss is enough to warrant further study, and who responds best.
The goal is to help people like Garth Michaels of Walnut Creek, California, who twice backed out of standard obesity surgery, fearful of side effects and a long recovery. Thirteen months after he volunteered for the vagotomy experiment, he has dropped 66 pounds, to 246.
That's a much more gradual loss than with regular surgery, but Michaels says having his hunger curbed help him finally learn to exercise. He spends a half-hour on an exercise bike most days. And he learned to avoid former diet saboteurs -- french fries, sweets -- that caused foul burping after his vagotomy, in favor of fruits and vegetables.
"I will lose more, there's no doubt about it," says Michaels, 56, whose goal is 175 pounds. "It has given me such hope."
Since doctors today can snip the nerve far less invasively, through just five pencil-sized cuts in the abdomen, it was time to test in the obese.
Thirty patients had a vagus snip at UCSF or the University of Rochester. The study isn't complete. But of the 11 who are a year past surgery, all but one are shedding pounds, losing an average of 18 percent of excess weight so far, Lustig and Rochester's Dr. Thad Boss reported at last month's bariatric society meeting.
They suffered no serious side effects, and went home hours later with little pain.
"Every patient who had the vagus nerve cut says they're not hungry," adds Lustig -- although the one who didn't respond got hungry again six weeks after surgery, perhaps because the nerve healed.
That's less than half the weight loss of standard surgeries, warns Dr. Neil Hutcher of Bon Secour St. Mary's Hospital in Richmond, Virginia, and a past president of the bariatric society.
"I have my doubts that vagotomy alone is going to be a significant weapon," says Hutcher, who often cuts the nerve during standard gastric bypasses for a different reason -- to help those patients avoid the side effect of heartburn-causing acid buildup.
But, when Greensboro, North Carolina, surgeons added a vagotomy to 25 patients getting bands on their stomachs, the nerve-snip seemed to make that usually more modest operation about as effective as a gastric bypass -- with 43 percent loss of excess weight at six months, and counting.
Other doctors are testing whether implants that treat epilepsy by stimulating the vagus nerve also might trigger weight loss, with mixed results so far.
For now, Boss stresses that vagus nerve-snipping remains highly experimental. He and Lustig will track their 30 patients for 18 months to check if ultimate weight loss is enough to warrant further study, and who responds best.
The goal is to help people like Garth Michaels of Walnut Creek, California, who twice backed out of standard obesity surgery, fearful of side effects and a long recovery. Thirteen months after he volunteered for the vagotomy experiment, he has dropped 66 pounds, to 246.
That's a much more gradual loss than with regular surgery, but Michaels says having his hunger curbed help him finally learn to exercise. He spends a half-hour on an exercise bike most days. And he learned to avoid former diet saboteurs -- french fries, sweets -- that caused foul burping after his vagotomy, in favor of fruits and vegetables.
"I will lose more, there's no doubt about it," says Michaels, 56, whose goal is 175 pounds. "It has given me such hope."
A workout for your mind... and body!
Like any good journalist, I try to go into a story with an unbiased view. "Just the facts, ma'am" is my motto. But before I even arrived at the Mayo Clinic, in Rochester Minnesota, to produce a story on a treadmill built into a desk, I was rather skeptical. The story was simple. A doctor named James Levine, had designed a piece of office equipment for the Mayo Clinic that not only housed a computer and a phone, but a full-sized treadmill. The idea was to keep moving while doing your desk job. Now I don't know about you, but the idea of walking at the same time you're writing a report or taking an important phone call was a little iffy for me. How was that possible? How could you concentrate? Yet when I arrived at Dr. Levine's office (equipped with two desks and two treadmills), he was already typing a manuscript while putting in his daily walk on the machine. He was doing it -- why couldn't the rest of us? "Why not do the interview from the other treadmill?" he said. Ok! I was up for it! I had worn flats. I was ready. First off, I found that the machine's tread moves slowly, about one mile an hour. And it's more of a natural movement; your feet just kind of get into it. After about 10 minutes you don't even feel like you're walking at all. It's very peaceful...very "Zen" like. I loved it. Not only was I doing the interview on the treadmill, (the photographer was on the treadmill with me!!!) but my heart rate seemed to go down. My mind was clearer. I was relaxed!!!! The treadmill desk is a just part of a master plan of Levine's called the "Office of the Future.†He envisions a workplace equipped with exercise machines, including walking paths employees could use while working in an office setting. He's even patterned the "Suit of the Future," made out of lightweight material that you can wear to exercise in and then walk right into a boardroom meeting and not even kick up a sweat. It's all designed to help sedentary workers get active without losing precious time. Levine says that on the average, an employee can burn about 150 calories an hour using the treadmill desk. Some doctors will tell you, you can get just as much exercise and burn just as many calories by taking a 20-minute walk for lunch. But Levine says in today's workplace, many employees never get to leave their cubicles. His thought: If they can't get to exercise, bring the exercise to them. Levine has already found a major corporation that will be providing the machines to its workers on a trial basis. As for my treadmill experience? After about 20 minutes on the machine, I had gotten my interview and a pretty nice workout. I felt refreshed and ready to take on more work. It was invigorating and fun, and all it took was a little bit of energy to get on the machine and keep going. No longer a skeptic, I'll be calling my boss to see if we can have a few treadmill desks in our office!Would you want a treadmill at your desk? Do you know of other ways for office workers to keep fit at work?
CDC: Antidepressants most prescribed drugs in U.S.
ATLANTA, Georgia (CNN) -- Dr. Ronald Dworkin tells the story of a woman who didn't like the way her husband was handling the family finances. She wanted to start keeping the books herself but didn't want to insult her husband.
Antidepressants such as Paxil, Prozac and Lexapro are among America's most-prescribed drugs.
The doctor suggested she try an antidepressant to make herself feel better.
She got the antidepressant, and she did feel better, said Dr. Dworkin, a Maryland anesthesiologist and senior fellow at Washington's Hudson Institute, who told the story in his book "Artificial Unhappiness: The Dark Side of the New Happy Class." But in the meantime, Dworkin says, the woman's husband led the family into financial ruin.
"Doctors are now medicating unhappiness," said Dworkin. "Too many people take drugs when they really need to be making changes in their lives."
DEPRESSION SYMPTOMS
Could you be depressed? Not everyone who is depressed experiences every symptom. Some people experience a few symptoms, some many.
Persistent sad, anxious, or "empty" mood
Feelings of hopelessness, pessimism
Feelings of guilt, worthlessness, helplessness
Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
Decreased energy, fatigue, being "slowed down"
Difficulty concentrating, remembering, making decisions
Insomnia, early-morning awakening, or oversleeping
Appetite and/or weight loss or overeating and weight gain
Thoughts of death or suicide; suicide attempts
Restlessness, irritability
Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
Source: National Institute of Mental Health
For Dworkin, the proof is in the statistics. According to a government study, antidepressants have become the most commonly prescribed drugs in the United States. They're prescribed more than drugs to treat high blood pressure, high cholesterol, asthma, or headaches. CNN's Elizabeth Cohen discusses the CDC study on antidepressants »
In its study, the U.S. Centers for Disease Control and Prevention looked at 2.4 billion drugs prescribed in visits to doctors and hospitals in 2005. Of those, 118 million were for antidepressants.
Many psychiatrists see this statistic as good news -- a sign that finally Americans feel comfortable asking for help with psychiatric problems.
"Depression is a major public health issue," said Dr. Kelly Posner, an assistant professor at Columbia University College of Physicians and Surgeons in New York City. "The fact that people are getting the treatments they need is encouraging."
She added that 25 percent of adults will have a major depressive episode sometime in their life, as will 8 percent of adolescents. "Those are remarkably high numbers," Posner said.
While Posner says genuine depression is driving the prescription numbers, Dr. Robert Goodman, an internist in New York City, says the real force behind skyrocketing antidepressant prescription rates is pharmaceutical marketing to doctors and to consumers. "You put those two together and you get a lot of prescriptions for antidepressants," he said.
He questions whether all those prescriptions are necessary. "It's hard to believe that number of people are depressed, or that antidepressants are the answer," he said.
Goodman is the founder of a group called "No Free Lunch," a group that encourages doctors to reject gifts from pharmaceutical companies. He added that patients sometimes see ads for antidepressants on television and ask doctors for the drugs -- and that studies show these requests work.
In a study published two years ago in the Journal of the American Medical Association, actors pretending to be patients went to doctors in the San Francisco area and said they were depressed.
The "patients" who asked for an antidepressant were significantly more likely to get a prescription for one than patients who didn't ask for an antidepressant.
Don't miss
MayoClinic.com: Health Library
Healthology: Health Video Library
"Patients' requests have a profound effect on physician prescribing in major depression and adjustment disorders," concluded the study's authors.
Antidepressants such as Paxil, Prozac and Lexapro are among America's most-prescribed drugs.
The doctor suggested she try an antidepressant to make herself feel better.
She got the antidepressant, and she did feel better, said Dr. Dworkin, a Maryland anesthesiologist and senior fellow at Washington's Hudson Institute, who told the story in his book "Artificial Unhappiness: The Dark Side of the New Happy Class." But in the meantime, Dworkin says, the woman's husband led the family into financial ruin.
"Doctors are now medicating unhappiness," said Dworkin. "Too many people take drugs when they really need to be making changes in their lives."
DEPRESSION SYMPTOMS
Could you be depressed? Not everyone who is depressed experiences every symptom. Some people experience a few symptoms, some many.
Persistent sad, anxious, or "empty" mood
Feelings of hopelessness, pessimism
Feelings of guilt, worthlessness, helplessness
Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
Decreased energy, fatigue, being "slowed down"
Difficulty concentrating, remembering, making decisions
Insomnia, early-morning awakening, or oversleeping
Appetite and/or weight loss or overeating and weight gain
Thoughts of death or suicide; suicide attempts
Restlessness, irritability
Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
Source: National Institute of Mental Health
For Dworkin, the proof is in the statistics. According to a government study, antidepressants have become the most commonly prescribed drugs in the United States. They're prescribed more than drugs to treat high blood pressure, high cholesterol, asthma, or headaches. CNN's Elizabeth Cohen discusses the CDC study on antidepressants »
In its study, the U.S. Centers for Disease Control and Prevention looked at 2.4 billion drugs prescribed in visits to doctors and hospitals in 2005. Of those, 118 million were for antidepressants.
Many psychiatrists see this statistic as good news -- a sign that finally Americans feel comfortable asking for help with psychiatric problems.
"Depression is a major public health issue," said Dr. Kelly Posner, an assistant professor at Columbia University College of Physicians and Surgeons in New York City. "The fact that people are getting the treatments they need is encouraging."
She added that 25 percent of adults will have a major depressive episode sometime in their life, as will 8 percent of adolescents. "Those are remarkably high numbers," Posner said.
While Posner says genuine depression is driving the prescription numbers, Dr. Robert Goodman, an internist in New York City, says the real force behind skyrocketing antidepressant prescription rates is pharmaceutical marketing to doctors and to consumers. "You put those two together and you get a lot of prescriptions for antidepressants," he said.
He questions whether all those prescriptions are necessary. "It's hard to believe that number of people are depressed, or that antidepressants are the answer," he said.
Goodman is the founder of a group called "No Free Lunch," a group that encourages doctors to reject gifts from pharmaceutical companies. He added that patients sometimes see ads for antidepressants on television and ask doctors for the drugs -- and that studies show these requests work.
In a study published two years ago in the Journal of the American Medical Association, actors pretending to be patients went to doctors in the San Francisco area and said they were depressed.
The "patients" who asked for an antidepressant were significantly more likely to get a prescription for one than patients who didn't ask for an antidepressant.
Don't miss
MayoClinic.com: Health Library
Healthology: Health Video Library
"Patients' requests have a profound effect on physician prescribing in major depression and adjustment disorders," concluded the study's authors.
Many NY restaurants ignore new calorie count rule
NEW YORK (AP) -- New Yorkers may have tasted the difference as new rules took effect barring trans fats -- but they couldn't always see the effect of a requirement that restaurants list calorie counts on menus.
Subway is one of few New York restaurants obeying the new law on posting calorie counts on menus.
Sunday was the start date of New York City's first-in-the-nation ban on the fats -- and the requirement that restaurants post calorie counts. But visits to many restaurants suggested they were in no rush to comply with the second rule.
McDonald's Corp. and Burger King Holdings Inc. were among chains that ignored the rule requiring that certain fast food restaurants list the counts next to menu items in type that is at least as large as the price.
City officials were not planning to issue fines for violations of the new rules until October 1. Before then, the New York Restaurant Association hopes a lawsuit in federal court will get the calorie rule thrown out.
Since New York passed the trans fat ban last year, Philadelphia, Pennsylvania; Montgomery County, Maryland; and the Boston, Massachusetts suburb of Brookline have followed with similar measures that take effect later this year or in 2008. Several other states and cities including California and Chicago, Illinois, are also considering trans fat prohibitions.
Most New York fast-food chains have reversed their initial opposition to the trans fat ban and implemented it ahead of Sunday's deadline, the city Health Department reported.
The first phase of the trans fat regulation applies to oils, shortening and margarines used for frying and spreading -- not to baked goods or prepared foods, or oils used to deep-fry dough or cake batter. These are covered by the second phase of the regulation, which takes effect on July 1, 2008.
In the lawsuit over posting calorie content, the eateries argued that their First Amendment rights were being violated, and complained that the rule would turn each of their menu boards into a cluttered mess.
Don't miss
Don't miss
At one Burger King restaurant on Sunday, the nutritional information including calories was posted on a wall where few customers waiting to order their food appeared to notice it.
If they had, they could have learned that a triple Whopper with cheese has 1,230 calories -- 1,070 without mayonnaise -- and a king-size chocolate shake has 1,260. The recommended daily calorie intake for an adult woman is about 1,800.
Lowell Stephens, a manager at the Burger King, said the information had been posted in the restaurant for at least a year and a half.
"A lot of people know that it's there," he said. "They can read it any time."
But when the city does start cracking down, posting the calories on a chart on the wall won't be good enough. City health officials have said that the information must be on the menus themselves, not on hard-to-see material tucked somewhere else in the store.
"It needs to be at the point of purchase," Health Department spokesman Andrew Tucker said Sunday. "The point being that customers can actually see it when they're deciding what to order."
Some restaurant companies said they hoped the city would accept compromise measures.
Starbucks Inc. spokesman Brandon Borrman said the chain's 220 New York City coffee shops would offer nutritional information on spiral-bound flip books set up on the same counters where customers get their milk and sugar.
Borrman said putting calorie counts on the menu would be problematic.
"The menu boards become very visually complex when you do that," he said.
But some chains said they would comply with the calorie rule.
One of them was the Subway sandwich shop chain, which began putting up new menus including calorie counts at its 340 New York City locations in the past few days.
"We've always been upfront about our nutritional information," said Les Winograd, a spokesman with the chain, which is owned by the Milford, Connecticut-based Doctor's Associates Inc. "We wanted to put our best foot forward."
Foods that pack a nutritional punch
Sources: USDA, National Institutes of Health | ||
| Calcium Calcium is key to strong bones and teeth, as well as proper nerve and muscle function, and while milk is instantly considered as a source of calcium, there are many other foods that can help you get the calcium you need: Milk, other dairy products Cornmeal Wheat flour Collards Rhubarb Sardines Spinach Soybeans Turnip greens Salmon, canned with bone Kale | Vitamin C Vitamin C helps your body repair itself, fight off diseases and infections and even has shown some indications of fighting off cancer. Here are some of the foods that pack the highest Vitamin C punch: Oranges/orange juice Peppers (sweet and chili) Grapefruit juice Papayas Strawberries Broccoli Brussels sprouts Peas Kiwi fruit Sweet potato | Fiber Fiber keeps digestion on track and has been shown to help prevent heart attacks, intestinal problems and several types of cancer. Barley Bulgur Beans Peas Wheat flour, whole-grain Oat bran Dates Tomato products Raspberries Cornmeal Artichokes |
| Anti-oxidants Anti-oxidants are chemicals that may help prevent a host of ailments including cancer, heart disease and Alzheimer's. Beans Blueberries Cranberries Artichokes Blackberries Prunes Russet potatoes Pecans Apples Cinnamon | Folic acid Folic acid promotes cell division and growth, red cell development and helps prevent some birth defects and can help reduce the risk of some types of cancer. Turkey/chicken giblets Lentils Cowpeas/Black eyed peas Orange Juice Beans (specifically kidney, pinto, navy) Chickpeas Okra Spinach Asparagus Beef liver | Iron Iron helps carry oxygen through our bodies. If you don't get enough you can become anemic, which will make you feel tired, and weak. Mollusks, clams Turkey or chicken giblets Enriched whole wheat flour Enriched rice Soybeans Tomato products Spinach Liver Beef Jerusalem-artichokes, raw Baking chocolate, unsweetened squares |
Sunday, July 8, 2007
Sexual health
When sex toys turn green — for health, that is
Concern about effects of common chemical leads consumers to seek options
It is, perhaps, a measure of just how mainstream sex toys have become that there are now budding consumer and environmental awareness campaigns being waged over them.
The biggest controversy is about the materials from which many toys are made.
Most vibrators, dildos and “love dolls,” for instance — especially the soft, pliable “jelly” type — use some form of plastic. In an effort to make the materials softer and more lifelike, PVC plastics suppliers incorporate one or more members of a family of compounds called phthalates (FAY-lates). To hear some environmentalists tell it, using a vibrator that includes phthalates is akin to bathing in DDT. Alarmed, some sex toy retailers, most prominently San Francisco-based Good Vibrations, are banning toys that include phthalates. But to hear the chemical industry tell it, phthalates are about as benign as mountain spring water. So what is a sex toy consumer to do?
Phthalates are ubiquitous. They are used in perfumes, hair sprays, plastic raincoats, carpet backing, paints, medical devices and many other items. They are responsible for that “new car smell,” which goes to show you how much plastic is used in cars.
Now they are showing up in people. As the fact of new car smell indicates, phthalates “off-gas,” meaning that they escape from the plastic in the form of a gas. So we breathe them. They also can escape their bond with the plastic by seeping out in an oily film, and we can absorb this through our skin, our mouths, our mucous membranes. A 2004 study by the Centers for Disease Control and Prevention of urine samples from 2,540 people ages 6 and older found phthalate metabolites (what’s left after our bodies chew it up) in more than 75 percent of the subjects.
What scientists cannot yet say is whether or not all this exposure is bad for us. “There is consensus that exposure is widespread in the general population,” explains Antonia M. Calafat, whose CDC lab did the study. While there is no cumulative buildup — phthalates are metabolized quickly by the body and excreted — “there is also consensus that phthalates are toxic in animals. There is no consensus at present whether the phthalates are causing adverse health effects in humans.”
Part of the uncertainty lies in the absence of human testing. You can’t ethically give people a dose of something you think might harm them, after all. And much of the testing done in animals, or on cells, uses doses of phthalates many times the typical exposure people experience. Further complicating matters is that there are grades of PVC-phthalate combinations (including food grade), with the lower the grade usually meaning the more smell and oily feel.
A quiet revolution
Despite the uncertainty, concern over phthalates has created a quiet revolution in the sex toy business. Fueled by Internet chatter and some media stories (including an article on About.com), sex toy consumers are asking questions of store owners and managers.
“When you open a jelly toy that reeks you have a visceral response to it,” says Anne Semans, marketing director of Babeland, a chain of sex shops based in Seattle. “And people say ‘Well, why take a chance?’” Semans says that in lieu of reliable expert opinion, the employees try to educate consumers about the ingredients of toys and point out alternative options, but leave the ultimate decisions to shoppers. Given the preference some consumers have for the jelly-style toys, she says, there are no plans to ban phthalate-carrying items from the shelves.
Not so at Good Vibrations. Since 1994, Good Vibrations has recommended the use of a condom over many phthalate-containing toys not only because of the phthalates, but because they can be difficult to clean, and has decided to phase out the material.
Now, says Carol Queen, staff sexologist, “There is enough [science] there to make us say, ‘Let’s be on the safe side and not worry anymore.’” She expects the stores will be phthalate-free in several months.
Richard Longhurst, founder of U.K.-based LoveHoney, a major online retailer, believes fears are overblown. “Despite the brouhaha, the issue is more important to the media and some vocal retail outlets in the U.S. than to consumers,” he argues. “You could chop eight of my fingers off and I could still count on one hand the number of customer inquiries we’ve ever had about phthalates.”
He blames media coverage for fanning concern, “but having said that, if there’s a risk — however remote — and there’s an alternative material, why not use it?”
Spendier options
One of the most popular alternative materials is silicone. Not only are silicone toys phthalate-free, but surgical grade silicone is dishwasher safe and practically indestructible. Still, there is a downside.
One of the most popular alternative materials is silicone. Not only are silicone toys phthalate-free, but surgical grade silicone is dishwasher safe and practically indestructible. Still, there is a downside.
Phthalate-containing materials are used not only because they can be soft and pliable, but because they are cheap. Toys using them tend to be on the low end of the price scale. Silicone toys can be expensive by comparison because they can be difficult to manufacture and the material costs more. Tantus, a California-based company, for example, makes a wide range of high quality silicone toys. But vibrator prices start at around $50 and run up to $116.
Most cheaper sex toys are made in China by one of five large American companies. But the “brouhaha,” as Longhurst terms it, is forcing them to adapt. In business, perception is often more powerful than the facts, so even before the verdict on phthalates and humans is in, most big manufacturers are offering silicone versions of some toys, in addition to glass, metal and elastomer rubber (something like the neoprene in wet suits) that are phthalate-free.
Pressure 'predicts heart outcome'
A simple blood pressure measurement can predict a heart failure patient's chance of recovery, a study suggests.
A US team found low systolic blood pressure at the time of hospital admission was linked to higher death rates in heart patients.
They said their findings could help to lead to more targeted treatments for these patients.
The research is published in the Journal of the American Medical Association.
Just under one million people in the UK currently have heart disease, and the figure is rising.
It occurs if the heart becomes less efficient at pumping blood around the body. It can be treated with a variety of drugs, such as ACE inhibitors, or surgery, but has a poor prognosis.
To examine the association between systolic blood pressure and recovery, the researchers looked at 48,612 patients admitted to hospital for heart failure in US hospitals between 2003 and 2005.
There are two types of pressure that can be measured in blood:
- diastolic pressure measures the pressure in the arteries when the heart relaxes;
- systolic blood pressure shows the pressure in the arteries when the heart is forcing blood through them.
Both are used in blood pressure readings, where 120/80mmHg - the optimum level - would mean a systolic pressure reading of 120mmHg (millimetres of mercury) over a diastolic pressure of 80mmHg.
Systolic blood pressure taken at hospital admission was a strong independent predictor of mortality and morbidity 
Dr Gregg Fonarow
The researchers discovered that those with a low systolic pressure measurement, of less than 120mmHg, had a 7.2% risk of dying in hospital, compared to a 3.6% mortality risk in patients with normal systolic pressure (considered to be in the range of 120-139mmHg).
Patients with very high systolic pressure, of over 161mmHg, had just a 1.7% risk of dying in hospital.
Optimising treatment
The researchers also found the patients with high systolic pressure had a better chance of responding to treatment and a lower risk of dying in the 60 to 90 days after they had left hospital.
They found diastolic pressure was not such a good indicator of mortality.
More than 50% of the patients had a systolic rate higher than 140mmHg when they were admitted, and those with higher systolic blood pressure were more likely to be female and black.
Dr Gregg Fonarow, lead researcher and director of the Ahmanson-UCLA Cardiomyopathy Center, said: "Systolic blood pressure taken at hospital admission was a strong independent predictor of mortality and morbidity in this large, representative heart failure patient population.
"We hope the findings may help clinicians more effectively stratify risk and offer more targeted treatments based on a patient's systolic blood pressure level.
"To optimise treatment, we may need to medically approach heart failure patients differently depending if their systolic blood pressures are normal, low or high."
The scientists said they believed lower systolic blood pressure may indicate a more advanced version of the disease. They said clinical trials would reveal more about heart failure disease development.
Ellen Mason, a cardiac nurse for the British Heart Foundation, said: "It is an interesting study, and often people admitted to hospital with acute heart failure do have low blood pressures.
"I think the interesting thing is why people with higher blood pressure might fare better and how the processes going on in the body might be different.
"But it is important to remember that this study looked at very sick heart failure patients - for most people having a normal or low blood pressure is better, high blood pressure can cause heart failure and all kinds of other problems."
Skin cells 'fight child cancer'
Genetically modified skin cells could be used to fight a cancer which strikes the very young, a UK study suggests.
Scientists at UCL said they were able to stimulate the immune system of mice by injecting the animals' skin cells into a neuroblastoma tumour.
This type of tumour accounts for 15% of childhood cancer deaths. It is most frequently found in the under-fives.
But the authors, writing in the British Journal of Cancer, said clinical trials in humans were at least five years off.
Nerve cells
Once the skin cells were genetically modified they became "little factories" producing a sort of protein which helped the immune system, said lead researcher Dr Stephen Hart.
This study in mice adds to the growing body of evidence that kick-starting the immune system can work successfully against neuroblastoma Dr Bruce Morland
When they were injected into the tumour site, these cells apparently helped the mouse fight the cancer - with a treated mouse living 90 days or more longer than an untreated mouse.
Research in the past has show that genetically modified tumour cells can be turned against the tumour they came from, "but use of the patient's own skin cells would be much easier", Dr Hart wrote.
"These cells can be taken by a routine skin punch biopsy, grown in the lab then genetically modified before injecting into the tumour site."
Neuroblastoma is a cancer of specialised nerve cells, called neural crest cells. These cells are involved in the development of the nervous system and other tissues.
Prognosis for children diagnosed in the first 12-18 months of life is good, but if it comes back in older children it can be very hard to cure.
Fewer than 100 new cases are diagnosed each year, according to Cancerbackup.
Dr Bruce Morland, head of the Children's Cancer and Leukaemia Group, said: "we are delighted that scientists are finding out how to harness the potential of immunotherapy for this childhood cancer.
"This study in mice adds to the growing body of evidence that kick-starting the immune system can work successfully against neuroblastoma.
"However, we need to learn much more about this approach before we can be sure that it is a safe and effective treatment for children."
Heart patients unsure of symptoms
People at a high risk of having a heart attack do not know when to dial 999, heart specialists have warned.
They say patients with heart problems are waiting too long before seeking help because they cannot distinguish between angina pain and a heart attack.
Experts at Bristol Royal Infirmary recommend delaying only five minutes after taking a nitrate spray to relieve symptoms before calling an ambulance.
Writing in the BMJ, they admit current medical advice is "confused".
We advise our GPs to prescribe the spray to high risk patients, it costs next to nothing, they can carry it in their pocket and it lasts up to two years Dr Paul Walker, consultant cardiologist
A recent campaign by the British Heart Foundation urged people to call 999 immediately if they experienced chest pain, after research showed 40% of people would wait before calling for an ambulance.
But among people with heart disease, who commonly suffer from chest pains, messages have been more confused.
The BHF advises taking three doses of a glyceryl trinitrate (GTN) spray at five-minute intervals before calling for help - a wait of 15 minutes.
Manufacturers of GTN sprays also give varying advice regarding how long people should wait before seeking help.
The guidance takes into account the fact that overcaution in these patients would overwhelm emergency departments.
Urgency
However Dr Paul Walker, consultant cardiologist at Bristol Royal Infirmary, said patients suffering a heart attack needed quick attention and should not wait as long as 15 minutes.
ADVICE FOR HIGH-RISK PATIENTS Take two doses of your GTN spray Wait five minutes If pain has not resolved, call an ambulance immediately. Do not try to drive or contact a friend or relative first
He pointed to recent research which showed the average time from onset of symptoms to cardiac arrest is just 10 minutes.
Dr Walker also believes that GTN sprays should be prescribed more widely in patients with diabetes, high blood pressure and high cholesterol.
"People at high risk should take two sprays and wait five minutes and if their pain hasn't gone they should call an ambulance - they shouldn't call a friend or try to drive themselves.
"This should be standard advice."
He said GTN sprays were currently given routinely only to those who have already had a heart attack.
"We advise our GPs to prescribe the spray to high risk patients, it costs next to nothing, they can carry it in their pocket and it lasts up to two years."
GENERAL ADVICE Call 999 immediately if you experience any of the following symptoms:
Central chest pain
Pain in your arms, neck or jaw
Feeling sick or sweaty
Feeling short of breath
"There are four million people at high risk and 70% of deaths occur in those at high risk," he added.
Dr Mike Knapton, director of prevention and care at the British Heart Foundation said: "Calling 999 immediately when a person suspects they are having a heart attack is sound advice whether the individual has been previously diagnosed with heart disease or not.
"However, we acknowledge that advice can be confusing for people who know they have heart disease.
"Heart patients are prone to getting chest pain frequently - angina - and need clear guidance on how to distinguish angina pain from the symptoms of a heart attack."
"This is crucial as we know that heart disease patients tend to delay a long time before calling for an ambulance when they have a heart attack."
He said the BHF's specific advice to heart patients was given as a guide only and was intended to be used alongside one to one advice from a doctor about recognising patients' particular symptoms.
Dr Terry McCormack said the problem was that many people did not call the ambulance for hours or even days and altered advice would probably not change that.
He added that the idea of handing out GNT sprays more widely was "interesting" but he would like to see more evidence that it would be effective and beneficial.
Researchers found current "risk calculators" used by GPs to determine whether an individual would benefit from anti-cholesterol drugs statins are flawed because they are based on US data from 20 years ago.
Analysis of more than a million adults aged between 34 and 75 in the UK found that white middle-aged men have a lower risk of heart disease than previously thought but the risk in women from deprived areas is underestimated.
GPs 'bombarded' by drug companies
Drug companies are bombarding GPs with promotional materials and inducements, campaigners say.
A poll of 200 GPs by consumer group Which? found they received four visits per month on average from drug reps.
They also received five promotional mailings about new drugs a week, and inducements to attend conferences.
Which? said it raised questions about drugs patients were being given by GPs, but a drug industry spokesman said it was vital doctors were kept up to date.
It is right and proper that they inform GPs about new medicines, and how they might benefit their patients, so that doctors are kept up to date Richard Ley, Association of the British Pharmaceutical Industry
The Which? survey found one in four of the GPs questioned had been sponsored to attend a conference, seminar or training event in the UK in the last 12 months and 5% had been sponsored to attend an event abroad.
In just one month, one GP was offered nine conference places and 13 meals, and received nine visits from drug reps, 10 letters, 21 leaflets, two patient information booklets and one training DVD.
This amounted to 22 companies contacting her about 31 drugs.
Nearly half of the doctors told Which? there was a lack of information from independent sources, while just 7% said they trusted the information they received from drug firms.
'More sources'
Neil Fowler, of Which?, said: "When you get a prescription from your GP, you want to know you've been prescribed the right drugs, not drugs produced by the company that spent a lot of money on promotion and inducements.
"We want to see more sources of independent information on drugs so that GPs can make balanced decisions, more limits on the marketing of drugs, and transparency about funding."
Richard Ley, spokesman for the Association of the British Pharmaceutical Industry, said: "I make no apologies for the fact that pharmaceutical companies are in close contact with doctors about new medicines.
"It is right and proper that they inform GPs about new medicines, and how they might benefit their patients, so that doctors are kept up to date."
Mr Ley said the ABPI had a strict code of practice to ensure ethical dealings with doctors.
"If Which? has evidence of where that code of practice has possibly been breached, then we would want to see it," he said.
Childhood obesity: Where the road leads
My 10-year old cousin is a ticking time bomb. He's more than a little chunky -- actually, a lot more -- he's fat. His mealtime staples include french fries, processed chicken nuggets and of course, soda. Lots of soda. I stand by as my relatives feed him this toxic menu and I know he has friends who eat the same way.
The obesity epidemic in the United States is particularly glaring among our young people. Add asthma and mental illness and you've got the top three chronic illnesses setting millions of children on a perilous path. What you may find shocking is that many of these kids could die or be severely handicapped by their 30s or 40s, and some in their 20s. In fact, today we know that the number of children whose parents report that they are disabled by their illness -- that means staying home from school because they can't breathe, or have hypertension at age 10 -- has quadrupled since the 1960s.
Dr. James Perrin, a director at Massachusetts General Hospital for Children in Boston, says that unless we stem this trend, there will be millions of people in their 20s and 30s who will be living on public welfare, unable to find a job. And that doesn't even take into account the strain they will put on the health care system.
The reasons for the obesity problem among our youth are definitely complex, but television seems to be at the core. Kids are simply watching too much, and it is happening at the expense of exercise.
Even if you don't have children, this is the type of story that can make you wonder what's happening to kids today. The idea of an entire generation incapacitated, unable to work, or dying too soon is very scary... and very real.
Of course there are ways we can reverse the trend.
Parents can become more aware of what's going on with their kids - get them moving, not watching more TV. In fact, studies show that when families exercise together, the weight loss is more substantial than if children are left to their own devices.
There are other ways to curb the trend of childhood illness -- community centers, school exercise programs, and eating better are all examples.
But the real impact begins at home. What do you think?
The obesity epidemic in the United States is particularly glaring among our young people. Add asthma and mental illness and you've got the top three chronic illnesses setting millions of children on a perilous path. What you may find shocking is that many of these kids could die or be severely handicapped by their 30s or 40s, and some in their 20s. In fact, today we know that the number of children whose parents report that they are disabled by their illness -- that means staying home from school because they can't breathe, or have hypertension at age 10 -- has quadrupled since the 1960s.
Dr. James Perrin, a director at Massachusetts General Hospital for Children in Boston, says that unless we stem this trend, there will be millions of people in their 20s and 30s who will be living on public welfare, unable to find a job. And that doesn't even take into account the strain they will put on the health care system.
The reasons for the obesity problem among our youth are definitely complex, but television seems to be at the core. Kids are simply watching too much, and it is happening at the expense of exercise.
Even if you don't have children, this is the type of story that can make you wonder what's happening to kids today. The idea of an entire generation incapacitated, unable to work, or dying too soon is very scary... and very real.
Of course there are ways we can reverse the trend.
Parents can become more aware of what's going on with their kids - get them moving, not watching more TV. In fact, studies show that when families exercise together, the weight loss is more substantial than if children are left to their own devices.
There are other ways to curb the trend of childhood illness -- community centers, school exercise programs, and eating better are all examples.
But the real impact begins at home. What do you think?
Fit Buddies finale!
Stacia Deshishku, Director of coverage, CNN/US:
Wow. It's been 12 weeks since we embarked on this journey. At the outset I was hoping for significant weight loss - though I've lost only 10 pounds - but look at these AMAZING stats:
- My body fat has been reduced by 10 percent
- My chest is down 4.25 inches - my hips down 5.75 inches!
- My thigh is down a whopping 6 inches - multiply that by two legs and we are talking a foot smaller!
- My waist is 4.5 inches smaller (I'm still aiming for that 35-25-36 I had in high school! - it's good to have "stretch goals")
- My resting heart rate has gone from 84 beats per minute to 60. My heart rate while working out has dropped dramatically from 140 bpm to 90!
- I started out only able to do 10 push-ups. This time I completed 50! (In fact, I doubled that. My trainer said I did only 40 - I swore I had done 50. So the only way to solve it was to do the 50 again - which I did!!!)
- The wins just go on and on
I'm so proud of myself. I simply feel better - physically and psychologically. I've come to understand that I really can do this. I can balance my eating habits with my exercise routine without changing my life so much that I no longer recognize me or set myself up to attempt to maintain unrealistic goals. This is soooo livable and reasonable!
Robert asked me this afternoon whether I now love working out. Truthfully, the answer is no. But I do like the way it makes me feel. Sure, I like the way my clothes are literally hanging off of me. But I really like that I know I can run a mile - the idea of a half-marathon isn't so out of the realm of possibility these days. In fact, who knows what I can do. The sky is the limit. Thank you, Sanjay. Thank you, Fit Nation. Thank you, Robert. Most importantly, thank you to my Fit Buddies - Eddie and Matt - for giving me such unflagging support and motivation throughout this journey.
Ed Lavandera. CNN Correspondent:
When we started this Fit Nation adventure back in April, I said my goal was to learn new habits and some techniques that would get me on the right weight-loss track. Not only have I reached those goals but I've also lost 30 pounds along the way.
Some new eating habits I try to stick to each day:
-- A good dose of protein in the morning sticks with me longer and helps me eat more sensible meals later in the day.
-- I look to eat my carbs for breakfast or lunch and try to avoid them at dinner.
-- All this has helped me cut down on snacking too much between meals.
New workout habits I think about each day:
-- Mix up the exercise as much as possible. I ride my bike; I use weights now; I'm on the elliptical machine.
-- Get outside and surround yourself with other people who want to exercise.
-- Break a sweat every day.
The formula to losing weight is simple: Eat Less, Move More = Weight Loss. Unfortunately, there is no simple formula for developing good habits and staying motivated. That's the struggle, but I've never felt better about overcoming this challenge.
Matt Sloane, CNN Medical producer:
Its been a turbulent ride! The first few weeks, I was very comitted. Then, I suffered a bit.
Missed several workouts, some because of work, some because of a cold, but each missed workout and bite of bad food in the past would have derailed me.
Robert said in an earlier blog that I was not a superstar in either the gym or with my eating but that I was following a moderate plan I could adopt for the long term. I truly believe that to be the case, and I've never been this thrilled to be mediocre.
The truth is, if I had adopted an extreme exercise regimen with Robert, and then stopped being able to go, I would have quit completely without his encouragement. If I had adopted a strict eating regimen and then had a string or barbecues or special events, I would have derailed.
Instead, I eat pretty well but allow myself things I want when I REALLY want them. Turns out I don't REALLY want them that often. I may not workout as much as Eddie, but I do enjoy going to the gym now. I know my way around, I learned some exercises I can do at home, and now I even own some small at-home fitness tools.
Either way, I've lost about 15 pounds, and gained two really great friends! Fit Buddies might be over, but my weight-loss journey has just begun.
Stay tuned to the blog... The four of us might just surprise you with updates now and then. I wish you success in your Fit Nation.
Robert Dothard, trainer:
The health and fitness industry is full of promises, from pills and shakes that promise weight loss with little or no effort, to drugs that cause horrific side effects and can put your health at risk. I can proudly state that it is also an industry with a passionate group of professionals all over the world who stand ready to help you, at whatever level of health and fitness you find yourself. That's even if you don't have a Stacia-like "bring it on" attitude, or if you are not the "McGyver" of fitness, like Ed, who can be in a town covered in floodwaters, yet still find a way somehow to get his workout on, or even if you are not like Matt, with every reason to train, like the start of a brand new life with his fiancee, not to mention, at his young age, there is almost nothing he cannot accomplish, if he is truly committed!
The Fit Buddies' stories are not unique. It can be YOUR story as well, if you are truly committed to the process. If you have been following as part of Fit Nation, congratulations. You have taken the first step, getting information, from an established and trusted source.
Now YOU have to take ACTION!
I would encourage you to keep trusting CNN Medical News. If taking action stops you, contact the nationally certified trainer in your area.
Good luck, and good health
Wow. It's been 12 weeks since we embarked on this journey. At the outset I was hoping for significant weight loss - though I've lost only 10 pounds - but look at these AMAZING stats:
- My body fat has been reduced by 10 percent
- My chest is down 4.25 inches - my hips down 5.75 inches!
- My thigh is down a whopping 6 inches - multiply that by two legs and we are talking a foot smaller!
- My waist is 4.5 inches smaller (I'm still aiming for that 35-25-36 I had in high school! - it's good to have "stretch goals")
- My resting heart rate has gone from 84 beats per minute to 60. My heart rate while working out has dropped dramatically from 140 bpm to 90!
- I started out only able to do 10 push-ups. This time I completed 50! (In fact, I doubled that. My trainer said I did only 40 - I swore I had done 50. So the only way to solve it was to do the 50 again - which I did!!!)
- The wins just go on and on
I'm so proud of myself. I simply feel better - physically and psychologically. I've come to understand that I really can do this. I can balance my eating habits with my exercise routine without changing my life so much that I no longer recognize me or set myself up to attempt to maintain unrealistic goals. This is soooo livable and reasonable!
Robert asked me this afternoon whether I now love working out. Truthfully, the answer is no. But I do like the way it makes me feel. Sure, I like the way my clothes are literally hanging off of me. But I really like that I know I can run a mile - the idea of a half-marathon isn't so out of the realm of possibility these days. In fact, who knows what I can do. The sky is the limit. Thank you, Sanjay. Thank you, Fit Nation. Thank you, Robert. Most importantly, thank you to my Fit Buddies - Eddie and Matt - for giving me such unflagging support and motivation throughout this journey.
Ed Lavandera. CNN Correspondent:
When we started this Fit Nation adventure back in April, I said my goal was to learn new habits and some techniques that would get me on the right weight-loss track. Not only have I reached those goals but I've also lost 30 pounds along the way.
Some new eating habits I try to stick to each day:
-- A good dose of protein in the morning sticks with me longer and helps me eat more sensible meals later in the day.
-- I look to eat my carbs for breakfast or lunch and try to avoid them at dinner.
-- All this has helped me cut down on snacking too much between meals.
New workout habits I think about each day:
-- Mix up the exercise as much as possible. I ride my bike; I use weights now; I'm on the elliptical machine.
-- Get outside and surround yourself with other people who want to exercise.
-- Break a sweat every day.
The formula to losing weight is simple: Eat Less, Move More = Weight Loss. Unfortunately, there is no simple formula for developing good habits and staying motivated. That's the struggle, but I've never felt better about overcoming this challenge.
Matt Sloane, CNN Medical producer:
Its been a turbulent ride! The first few weeks, I was very comitted. Then, I suffered a bit.
Missed several workouts, some because of work, some because of a cold, but each missed workout and bite of bad food in the past would have derailed me.
Robert said in an earlier blog that I was not a superstar in either the gym or with my eating but that I was following a moderate plan I could adopt for the long term. I truly believe that to be the case, and I've never been this thrilled to be mediocre.
The truth is, if I had adopted an extreme exercise regimen with Robert, and then stopped being able to go, I would have quit completely without his encouragement. If I had adopted a strict eating regimen and then had a string or barbecues or special events, I would have derailed.
Instead, I eat pretty well but allow myself things I want when I REALLY want them. Turns out I don't REALLY want them that often. I may not workout as much as Eddie, but I do enjoy going to the gym now. I know my way around, I learned some exercises I can do at home, and now I even own some small at-home fitness tools.
Either way, I've lost about 15 pounds, and gained two really great friends! Fit Buddies might be over, but my weight-loss journey has just begun.
Stay tuned to the blog... The four of us might just surprise you with updates now and then. I wish you success in your Fit Nation.
Robert Dothard, trainer:
The health and fitness industry is full of promises, from pills and shakes that promise weight loss with little or no effort, to drugs that cause horrific side effects and can put your health at risk. I can proudly state that it is also an industry with a passionate group of professionals all over the world who stand ready to help you, at whatever level of health and fitness you find yourself. That's even if you don't have a Stacia-like "bring it on" attitude, or if you are not the "McGyver" of fitness, like Ed, who can be in a town covered in floodwaters, yet still find a way somehow to get his workout on, or even if you are not like Matt, with every reason to train, like the start of a brand new life with his fiancee, not to mention, at his young age, there is almost nothing he cannot accomplish, if he is truly committed!
The Fit Buddies' stories are not unique. It can be YOUR story as well, if you are truly committed to the process. If you have been following as part of Fit Nation, congratulations. You have taken the first step, getting information, from an established and trusted source.
Now YOU have to take ACTION!
I would encourage you to keep trusting CNN Medical News. If taking action stops you, contact the nationally certified trainer in your area.
Good luck, and good health
Marriage good for your health?
"The last time I felt free was before I was married," said a friend who has been with her husband for 40 years.
"Great..." I said as I smiled and nodded politely.
I'm getting married on Saturday - and everyone has advice. My mother tells me not to get too stressed out before the wedding. Other people give me directives: to breathe, to enjoy the day and to be sure to have someone save us some cake. Trusted friends share their wisdom on how to keep a marriage happy. My doctor-friend lists off the health benefits of being blissfully wed.
It's true. Married people were healthier for nearly every measure of health, says a 2004 CDC study. Married couples live longer lives, suffer less from heart disease, back pain, headaches and serious psychological distress. They are also less likely to smoke and drink heavily.
More recently, an Ohio State University study out this year found that depressed people gain more from being married than single people. They fared better on depression tests than when they were single, but they do report less-happy marriages overall.
The one area where married people did worse? Weight gain. No surprise there. I must admit that this trend started long before the nuptials for me. I like to call it happy fat. It makes me feel better. In the long run, middle-aged married men tipped the scales the most. From ages 45 to 64, three out of four married men were overweight or obese. Single men and women who had never been married were the leanest groups.
Interestingly enough, cohabitation didn't earn the same health benefits. People with live in partners tended to score similar to divorced or separated people in terms of health.
But a bad marriage can have serious negative effects on your health. Just one example, marital stress is as strong a marker as work stress when it comes to your risk of heart disease according to Dr. Richard Stein of the American Heart Association.
What is it about marriage that leads to better health? Do you think single or married people have higher levels of stress? Why do you think live-in partners don't share the same health benefits? Do you have any advice on maintaining a happy marriage?
"Great..." I said as I smiled and nodded politely.
I'm getting married on Saturday - and everyone has advice. My mother tells me not to get too stressed out before the wedding. Other people give me directives: to breathe, to enjoy the day and to be sure to have someone save us some cake. Trusted friends share their wisdom on how to keep a marriage happy. My doctor-friend lists off the health benefits of being blissfully wed.
It's true. Married people were healthier for nearly every measure of health, says a 2004 CDC study. Married couples live longer lives, suffer less from heart disease, back pain, headaches and serious psychological distress. They are also less likely to smoke and drink heavily.
More recently, an Ohio State University study out this year found that depressed people gain more from being married than single people. They fared better on depression tests than when they were single, but they do report less-happy marriages overall.
The one area where married people did worse? Weight gain. No surprise there. I must admit that this trend started long before the nuptials for me. I like to call it happy fat. It makes me feel better. In the long run, middle-aged married men tipped the scales the most. From ages 45 to 64, three out of four married men were overweight or obese. Single men and women who had never been married were the leanest groups.
Interestingly enough, cohabitation didn't earn the same health benefits. People with live in partners tended to score similar to divorced or separated people in terms of health.
But a bad marriage can have serious negative effects on your health. Just one example, marital stress is as strong a marker as work stress when it comes to your risk of heart disease according to Dr. Richard Stein of the American Heart Association.
What is it about marriage that leads to better health? Do you think single or married people have higher levels of stress? Why do you think live-in partners don't share the same health benefits? Do you have any advice on maintaining a happy marriage?
Farm bill will shape what we eat
When Americans gathered to celebrate the Fourth of July in the early days of the Republic, they may have dined on onion pie, pea soup and Johnny cakes (cornbread). Now, we're more likely to grill hamburgers and hot dogs.
You don't have to go back centuries to find significant changes in the American diet. You just have to go back three decades - to around the time of the Bicentennial.
The per capita daily supply of added fats and oils has increased 38 percent since the 1970s, according to the U.S. Economic Research Service.
Typically, you'll find these added fats in processed foods such as cookies and fast food favorites such as french fries and donuts. A lot of artery-clogging trans fats comes from these added fats and oils, primarily soybean oil.
As the added fats in our diets shot up since the 1970s, so too did the U.S. obesity rate. The percent of children considered overweight or obese has doubled since the 1970s, from 15 percent to 30 percent.
What may surprise you is that the U.S. government has paid billions in subsidies to soybean growers, prompting overproduction of the primary source of these added fats and trans fats in our diets.
The result has been lower prices for less healthy foods.
By contrast, fruits and vegetables are considered "specialty crops" by Congress and ineligible for subsidies. The price of produce has continued to rise.
"We need to create an environment where it's easy to eat healthy. Right now, if price is your chief concern, the rational choice is to eat crappy food," says Dr. David Wallinga, director of the food and health program for the Institute for Agriculture and Trade Policy in Minneapolis.
This summer, Congress is working on the Farm Bill, a massive piece of legislation that will have a profound influence not only on what farmers plant but also what we eat for years to come. And that will play a role in the nation's health.
Groups that follow the Farm Bill don't expect any big policy changes. What do you think Congress should do in the Farm Bill to promote healthy diets?
And as you enjoy your Independence Day, you can take comfort in your dietary connection to our ancestors. Apple pie was popular back in 1776, and Thomas Jefferson dazzled visitors to Monticello by making ice cream using ice harvested from the Rivanna River.
You don't have to go back centuries to find significant changes in the American diet. You just have to go back three decades - to around the time of the Bicentennial.
The per capita daily supply of added fats and oils has increased 38 percent since the 1970s, according to the U.S. Economic Research Service.
Typically, you'll find these added fats in processed foods such as cookies and fast food favorites such as french fries and donuts. A lot of artery-clogging trans fats comes from these added fats and oils, primarily soybean oil.
As the added fats in our diets shot up since the 1970s, so too did the U.S. obesity rate. The percent of children considered overweight or obese has doubled since the 1970s, from 15 percent to 30 percent.
What may surprise you is that the U.S. government has paid billions in subsidies to soybean growers, prompting overproduction of the primary source of these added fats and trans fats in our diets.
The result has been lower prices for less healthy foods.
By contrast, fruits and vegetables are considered "specialty crops" by Congress and ineligible for subsidies. The price of produce has continued to rise.
"We need to create an environment where it's easy to eat healthy. Right now, if price is your chief concern, the rational choice is to eat crappy food," says Dr. David Wallinga, director of the food and health program for the Institute for Agriculture and Trade Policy in Minneapolis.
This summer, Congress is working on the Farm Bill, a massive piece of legislation that will have a profound influence not only on what farmers plant but also what we eat for years to come. And that will play a role in the nation's health.
Groups that follow the Farm Bill don't expect any big policy changes. What do you think Congress should do in the Farm Bill to promote healthy diets?
And as you enjoy your Independence Day, you can take comfort in your dietary connection to our ancestors. Apple pie was popular back in 1776, and Thomas Jefferson dazzled visitors to Monticello by making ice cream using ice harvested from the Rivanna River.
Are boardwalk delicacies the next target?
I love going to the beach. Not only is it a time to relax and enjoy the sun and surf, but the boardwalk offers a lot of goodies that you don't find in many other places: taffy, cotton candy, greasy pizza by the slice, buckets of french fries. Ah the joy. Or is it?
As I was wandering through the crowd, munching on a funnel cake, the reasons for the obesity epidemic became pretty obvious. Look at what we are eating! And the place was loaded with skimpy suits on zaftig bodies, squeezing a lot of girth into little pieces of material. Wow. Half-naked bodies don't lie. We are a fat nation, not a fit nation. For years, we Americans have let fatty, high-calorie foods add pounds to our bodies. We've fed our children junk instead of home-cooked meals. Then we've sat around and ignored the consequences. Now, millions of Americans have type 2 diabetes and face major heart problems. We are no longer just the land of the free and the home of the brave, we are the country of the chubby. It's not a title we should be proud of. Because as the U.S. gets heavier, we are faced with serious issues that begin to affect our health-care system and our economy. Something needs to be done and soon. Many experts believe it's up to the states to begin the fight.
Every year, the University of Baltimore puts out a report card, giving grades to states, based on how well they attack the obesity issue. This year, the state of California received top honors. It's true, former Mr. Universe (and California Gov.) Arnold Schwarzenegger is no slouch when it comes to physical fitness. But it takes more then a buff state official to get an "A" from the University of Baltimore
California received the high grades in part because of programs including "First 5 California." The group's main goal is to make sure that all children in the Golden State get proper care in their first five years of life. Officials believe that a child's positive health habits are formed early and that healthy children will grow into healthy adults. But "First 5" officials don't think that their job is done after the age of 5. Childhood obesity is still a problem in tots to teens, from San Diego to San Francisco. So in an effort to get the word out to parents, "First 5" has been actively working on an awareness campaign that lets parents know it's up to them to keep their kids fit.
Today you can drive along Sunset Boulevard and see billboards reminding parents that obesity can hurt their children. Flick on the TV in Santa Monica or Fresno and a commercial appears with an adorable child asking her parent to stop and get (instead of fast food) some grease or a heart attack - stark reminders that every bite of food makes a difference in a child's health. "First 5" director Kris Perry says it's about good decision-making. "We're trying to convey to (parents) that these little choices all day long -- a cookie here, a doughnut there, a glass of juice, some chips -- by the end of the day your child has consumed far more calories then they really needed." The campaign has become so popular that comedian Adam Sandler, appearing on "Late Night with David Letterman," joked that the ads prompted him and his daughter to put down their cheeseburgers.
It's campaigns such as these that obesity experts say work. California is lucky because the state has the money to run the ads. But Ken Stanton, co-author of the University of Baltimore reports, says other governments can do their part. For example, look at New York City's ban on trans fats, or Arkansas' fight against vending machines in schools.
So are the boardwalks at places like Ocean City, Maryland, or Myrtle Beach, South Carolina, the next targets? Will they banish soft-serve ice cream and chicken wings forever? Probably not. But as states begin to look at how they can impact their residents and their diets, you may see fewer people standing in lines waiting for those buckets of fries and more buff bathing beauties on the beach.
Do you think states should do more? If so, what can they do to curb obesity in this country?
As I was wandering through the crowd, munching on a funnel cake, the reasons for the obesity epidemic became pretty obvious. Look at what we are eating! And the place was loaded with skimpy suits on zaftig bodies, squeezing a lot of girth into little pieces of material. Wow. Half-naked bodies don't lie. We are a fat nation, not a fit nation. For years, we Americans have let fatty, high-calorie foods add pounds to our bodies. We've fed our children junk instead of home-cooked meals. Then we've sat around and ignored the consequences. Now, millions of Americans have type 2 diabetes and face major heart problems. We are no longer just the land of the free and the home of the brave, we are the country of the chubby. It's not a title we should be proud of. Because as the U.S. gets heavier, we are faced with serious issues that begin to affect our health-care system and our economy. Something needs to be done and soon. Many experts believe it's up to the states to begin the fight.
Every year, the University of Baltimore puts out a report card, giving grades to states, based on how well they attack the obesity issue. This year, the state of California received top honors. It's true, former Mr. Universe (and California Gov.) Arnold Schwarzenegger is no slouch when it comes to physical fitness. But it takes more then a buff state official to get an "A" from the University of Baltimore
California received the high grades in part because of programs including "First 5 California." The group's main goal is to make sure that all children in the Golden State get proper care in their first five years of life. Officials believe that a child's positive health habits are formed early and that healthy children will grow into healthy adults. But "First 5" officials don't think that their job is done after the age of 5. Childhood obesity is still a problem in tots to teens, from San Diego to San Francisco. So in an effort to get the word out to parents, "First 5" has been actively working on an awareness campaign that lets parents know it's up to them to keep their kids fit.
Today you can drive along Sunset Boulevard and see billboards reminding parents that obesity can hurt their children. Flick on the TV in Santa Monica or Fresno and a commercial appears with an adorable child asking her parent to stop and get (instead of fast food) some grease or a heart attack - stark reminders that every bite of food makes a difference in a child's health. "First 5" director Kris Perry says it's about good decision-making. "We're trying to convey to (parents) that these little choices all day long -- a cookie here, a doughnut there, a glass of juice, some chips -- by the end of the day your child has consumed far more calories then they really needed." The campaign has become so popular that comedian Adam Sandler, appearing on "Late Night with David Letterman," joked that the ads prompted him and his daughter to put down their cheeseburgers.
It's campaigns such as these that obesity experts say work. California is lucky because the state has the money to run the ads. But Ken Stanton, co-author of the University of Baltimore reports, says other governments can do their part. For example, look at New York City's ban on trans fats, or Arkansas' fight against vending machines in schools.
So are the boardwalks at places like Ocean City, Maryland, or Myrtle Beach, South Carolina, the next targets? Will they banish soft-serve ice cream and chicken wings forever? Probably not. But as states begin to look at how they can impact their residents and their diets, you may see fewer people standing in lines waiting for those buckets of fries and more buff bathing beauties on the beach.
Do you think states should do more? If so, what can they do to curb obesity in this country?
Should older pregnant moms get genes screened?
Most experts agree that the best time - biologically speaking - for a woman to get pregnant is when she's in her mid-20's, but today more women than ever are choosing to have children after age 35 and even 40. Given the news reports of some celebrities having babies later in life (actress Holly Hunter had twins at 47 and Jane Kaczmarek had her third child at 46), as well as the occasional report of grandmothers having babies, some women may think that having a baby later in life isn't a big deal.
The numbers bear it out: More women than ever over the age of 40 are having babies - more than 103,000 in 2004 - twice as many as in 1990, according to the U.S. Centers for Disease Control and Prevention.
But the reality is that having babies later in life can be more difficult and brings along increased risks for the mom-to-be and the baby.
However, modern medicine can help. In addition to in-vitro fertilization, or IVF, doctors have the technology to test embryos for genetic defects before they are implanted.
It's called "PGD" - preimplantation genetic diagnosis. When an embryo is divided into just eight cells, one cell is removed and tested for genetic defects.
This is used when parents may carry a gene for a genetic disorder such as Huntington's disease or sickle-cell disease. PGD could be recommended to parents of any age because they could pass the gene for these disorders to their child.
Older moms have older eggs. Dr. Dorothy Mitchell-Leef, a reproductive specialist in Atlanta told me, "Women in their 40's have a double set of problems: Their eggs are aging and they don't have as many as they used to have." As the eggs age, the chromosomes don't divide as well - which increases the risk of having three chromosomes or just one when there are supposed to be a pair.
So the same basic technique used in PGD can also be used for screening genetic defects that can lead to miscarriages or Down syndrome, which is the result of chromosome abnormalities. This is called PGD for aneuploidy screening.
A new study presented at the European Society of Human Reproduction and Embryology and published in the New England Journal of Medicine this week says using PGD for screening in older moms decreases their chance of carrying the baby to term. (Full Story).
Why the lower birth rate? The invasiveness of extracting a cell may be damaging the embryo, or reducing the overall genetic information in the embryo could be contributing to birth failures.
I spoke with several fertility experts who were not surprised at these results. But as Dr. Marcelle Cedars from the University of California, San Francisco put it, "Women above a certain age ask for it (the screening) and we spend a lot of time talking them out of it." Now doctors have a study to point to that confirms what they believed already: Screening embryos just because the mom is older doesn't increase her chance of having a healthy baby - as a matter of fact, it can decrease the chance.
While the experts I spoke with agreed with the study results, other reports say not all fertility experts agree with the findings. If you're in your late 30s or 40s and are trying to get pregnant (and don't have a family history of debilitating disorders), would you insist on screening your embryo before implantation?
The numbers bear it out: More women than ever over the age of 40 are having babies - more than 103,000 in 2004 - twice as many as in 1990, according to the U.S. Centers for Disease Control and Prevention.
But the reality is that having babies later in life can be more difficult and brings along increased risks for the mom-to-be and the baby.
However, modern medicine can help. In addition to in-vitro fertilization, or IVF, doctors have the technology to test embryos for genetic defects before they are implanted.
It's called "PGD" - preimplantation genetic diagnosis. When an embryo is divided into just eight cells, one cell is removed and tested for genetic defects.
This is used when parents may carry a gene for a genetic disorder such as Huntington's disease or sickle-cell disease. PGD could be recommended to parents of any age because they could pass the gene for these disorders to their child.
Older moms have older eggs. Dr. Dorothy Mitchell-Leef, a reproductive specialist in Atlanta told me, "Women in their 40's have a double set of problems: Their eggs are aging and they don't have as many as they used to have." As the eggs age, the chromosomes don't divide as well - which increases the risk of having three chromosomes or just one when there are supposed to be a pair.
So the same basic technique used in PGD can also be used for screening genetic defects that can lead to miscarriages or Down syndrome, which is the result of chromosome abnormalities. This is called PGD for aneuploidy screening.
A new study presented at the European Society of Human Reproduction and Embryology and published in the New England Journal of Medicine this week says using PGD for screening in older moms decreases their chance of carrying the baby to term. (Full Story).
Why the lower birth rate? The invasiveness of extracting a cell may be damaging the embryo, or reducing the overall genetic information in the embryo could be contributing to birth failures.
I spoke with several fertility experts who were not surprised at these results. But as Dr. Marcelle Cedars from the University of California, San Francisco put it, "Women above a certain age ask for it (the screening) and we spend a lot of time talking them out of it." Now doctors have a study to point to that confirms what they believed already: Screening embryos just because the mom is older doesn't increase her chance of having a healthy baby - as a matter of fact, it can decrease the chance.
While the experts I spoke with agreed with the study results, other reports say not all fertility experts agree with the findings. If you're in your late 30s or 40s and are trying to get pregnant (and don't have a family history of debilitating disorders), would you insist on screening your embryo before implantation?
Tangible Fit Nation results!
For almost three months now, we've been asking you to go to CNN.com/Fitnation to take the Fit Nation Challenge.
You see, Dr. Sanjay Gupta is trying to reverse what seems to be an unstoppable trend - our growing waistlines. Even if you exercise regularly, it can be hard to feel that you're making a difference in the obesity epidemic. To that end, we felt it was so important to quantify your impact. And today, just when I was starting to lose the sight of the Fit Nation Tour in my rearview mirror, I got a happy surprise.
Yesterday afternoon, I checked on the Fit Nation site to see how we are doing. As of 3 p.m. Thursday, the hours people had pledged in weekly exercise had added 1,784,320 hours to their lives.
Fast-forward to this morning. A link to our Fit Nation page was featured on the front page of CNN.com! I wondered whether more people reading about Fit Nation would help us get even more hours.
My jaw hit the floor!!
Our new total was 2,227,840 hours!! Not only did we surpass the 2 million hour mark - that's twice what we initially set out to do - but we FLEW past it, adding more than 500,000 hours last night alone!
I believe this shows the appetite (pardon the pun) people have for solving the obesity problem. I hope, if you haven't already, you will make a pledge today. Thanks to you, we've added more than 254 years of life. I'd call that a tangible impact.
You see, Dr. Sanjay Gupta is trying to reverse what seems to be an unstoppable trend - our growing waistlines. Even if you exercise regularly, it can be hard to feel that you're making a difference in the obesity epidemic. To that end, we felt it was so important to quantify your impact. And today, just when I was starting to lose the sight of the Fit Nation Tour in my rearview mirror, I got a happy surprise.
Yesterday afternoon, I checked on the Fit Nation site to see how we are doing. As of 3 p.m. Thursday, the hours people had pledged in weekly exercise had added 1,784,320 hours to their lives.
Fast-forward to this morning. A link to our Fit Nation page was featured on the front page of CNN.com! I wondered whether more people reading about Fit Nation would help us get even more hours.
My jaw hit the floor!!
Our new total was 2,227,840 hours!! Not only did we surpass the 2 million hour mark - that's twice what we initially set out to do - but we FLEW past it, adding more than 500,000 hours last night alone!
I believe this shows the appetite (pardon the pun) people have for solving the obesity problem. I hope, if you haven't already, you will make a pledge today. Thanks to you, we've added more than 254 years of life. I'd call that a tangible impact.
The savvy parent's guide to sun safety
Myth No. 1: A suntan's fine, as long as you don't burn.
Reality: While even one sunburn may double the chance of eventually developing melanoma (the most serious type of skin cancer), your kids are still at risk even if they never burn. "The more sun you get, the more likely you are to develop certain skin cancers," says Martin Weinstock, M.D., chairman of the American Cancer Society's Skin Cancer Advisory Group, no matter what your skin tone. "Any tan indicates damage to your skin."
Myth No. 2: A beach umbrella blocks the sun.
Reality: It's not foolproof. Sand reflects 17 percent of UV radiation, so you're still exposed, says Dr. Weinstock. Nevertheless, it's smart to stay in the shade when the sun's rays are high; just make sure you're also slathered with sunscreen.
Myth No. 3: Sun can't penetrate through windows.
Reality: Glass filters out only one kind of radiation -- UVB rays. But UVA rays, which penetrate deeper, can still get through. That's why many adults have more freckles on their left side than their right -- it's from UV exposure on that side through the car window when driving. To protect yourself, apply sunscreen to any exposed areas (like your hands, forearms, and face) before getting into your car, especially in the spring and summer months, says Anthony Mancini, M.D., head of pediatric dermatology at Children's Memorial Hospital in Chicago, Illinois. If you're buying a new car, consider one with tinted windows, which keep out almost four times more UVA light than regular ones. You don't need to worry about putting on sunscreen when indoors unless you or your child spends most of your time near a window (for example, if your child's desk is right next to one). Parenting.com: TLC for sunburned skin
Myth No. 4: Too much sunscreen causes vitamin D deficiency.
Reality: You may have read that extra exposure to sunshine is needed to help your body make vitamin D. But according to the ACS, the American Academy of Dermatology, and the Skin Cancer Foundation, both kids and adults get plenty of this nutrient through multivitamins, vitamin D--rich foods (like milk and fortified orange juice), and everyday sun exposure. Also, even if you're wearing sunscreen, small amounts of UV rays still penetrate your skin, and that's more than enough to help your body produce vitamin D. Parenting.com: Sun protection 101
Myth No. 5: If it's cool or cloudy outside, you don't need sunscreen.
Reality: According to the Skind Cancer Foundation, up to 80 percent of the sun's UV rays can pass through clouds. This is the reason people often end up with serious sunburns on overcast days if they've spent time outside with no sun protection. Even in the winter months, you need to beware: Snow can reflect up to 80 percent of UV rays, increasing exposure. This is especially true if your family's on a ski vacation -- the higher your altitude, the greater your UV exposure. Parenting.com: Your print-and-save guide to warm-weather safety
Myth No. 6: 80 percent of sun damage occurs before age 18.
Reality: Contrary to previous estimates, recent studies show that we get less than 25 percent of our total lifetime sun exposure before age 18. That means you get the majority of it later on. So while you absolutely should be vigilant about protecting your kids, make sure you take care of yourself, too. While 83 percent of parents arm their kids with sunscreen and protective clothing whenever they're outdoors, only two-thirds practice what they preach, according to a 2005 AAD survey. "Remember, kids don't always pay attention to what you say -- it's more about what you do," says Dr. Weinstock. "If you're making them wear sunscreen but baking yourself, you're sending them a mixed message they may carry into adulthood."
Fireworks injury scar fades, memory doesn't
ATLANTA, Georgia (CNN) -- The scar has faded over his left eye, but the fireworks injury that Tony Wittmann suffered when he was 17 taught him a lesson that he hasn't forgotten. Sparklers burn at temperatures up to 2,000 degrees Fahrenheit (about 1,100 Celsius).
"Teenagers being teenagers, we were shooting bottle rockets at each other from about 200 yards away," he remembers. "One hit above my eye and stuck in my forehead and exploded."Emergency room doctors were able to stitch up the torn the tissue around his eye, but Wittmann was pretty shaken up. "I thought at first, 'I'm 17 and I'm blinded for life.' Once I calmed down, I realized I was OK, but it took all the fun out of the day."
Wittmann, now a 42-year-old firefighter and paramedic in Shawnee, Oklahoma, uses the story to explain the dangers of fireworks to his young sons. "I try to tell them to learn from my mistake."
Every year at this time, he and his colleagues expect to be sent on a fireworks emergency call. "Either a roof will be set on fire or someone will get burned," he said. "I don't think you'll ever get an injury-free season."
Health Minute: Watch more the dangers of fireworks »
Unfortunately, that's true not just in Oklahoma, but in the rest of the United States as well.
Don't miss
The Consumer Product Safety Commission keeps track of injury rates nationwide. Nancy Nord, the commission's acting chairwoman, says fireworks injuries are common. "Over 9,000 people are injured each year because of fireworks, on average seven people die," she said.
The agency estimates that half the injuries occur among children. "Little kids love sparklers," Nord says. "But sparklers burn at temperatures up to 2,000 degrees [Fahrenheit], and sparklers are the biggest cause of injury for children under 5."
Burns, lacerations and eye injuries are some of the most common injuries reported.
Despite the risks, fireworks are more popular than ever. Bill Weimer, vice president of Phantom Fireworks in Youngstown, Ohio, says this is the busiest time of the year for sales.
Don't miss
His company is the operator of the largest chain of fireworks stores in the country and expects to make 95 percent of its yearly sales between Memorial Day and July 4. Three years ago, The Wall Street Journal estimated the six-week revenue to amount to $100 million, a figure Weimer doesn't dispute.
But along with increased profits, he contends, "Fireworks products are safer today than ever before. Most of the injuries unfortunately are due to misuse and abuse."
He strongly encourages people to read the directions and follow the rules. "This product is wonderful family entertainment, but at the same time, you have to respect the fact that [fireworks] burn to function. ...Parents should watch their kids like hawks."
Top Health Stories
ATLANTA, Georgia (AP) -- The globe-trotting tuberculosis patient who sparked an international public health incident in May said Friday that he was tricked into a federal quarantine.
TB patient Andrew Speaker set off an international health scare when he traveled to Europe for his wedding in May.
Andrew Speaker, a 31-year-old Atlanta, Georgia, attorney, said he would have gladly gone into isolation if health officials had asked him to. Instead, he said they asked him to swing by a New York City hospital for testing after his European vacation, then posted armed guards outside his door."They tried to trick me when it was unnecessary," Speaker said from a Colorado hospital where he has been under treatment for a month.
Speaker, the first person quarantined by the U.S. government since 1963, disclosed new details about the discussions he had with health officials while in Europe, and about an aborted plan in which he would have driven to Denver, Colorado, for treatment after he returned.
He said he has no current plans to sue health officials at the U.S. Centers for Disease Control and Prevention or other government agencies.
"I'm worried about people coming after me," he said in a lengthy interview with The Associated Press.
Speaker became the focus of a CDC investigation -- and an international uproar -- when he proceeded in May with a long-planned wedding trip to Europe after health officials said they advised him not to fly because of his TB.
CDC officials also said a May 22 test result indicated Speaker had extensively drug-resistant tuberculosis, or XDR-TB, which is extremely difficult to treat. But Speaker's doctors said this week that subsequent testing has shown the less-dangerous multidrug-resistant TB.
Speaker said the XDR diagnosis escalated news coverage and made him internationally vilified. In a two-page statement posted Friday on his law firm blog, he said: "I can only hope that this news calms the fears of those people that were on the flights with me."
He also noted that an early May CDC lab result -- from a test that looks for evidence of drug resistance in TB bacteria genes -- showed the less-dangerous TB. Watch the controversy surrounding Speaker's case »
CDC officials said that test is experimental and had to be confirmed with more standard testing. They stand by the May 22 test, and said the public health response should be the same regardless.
The quarantine order was driven in part because Speaker flew to Europe after state and local health officials advised him not to travel in commercial aircraft, then he flew home from Italy after a CDC official repeated and emphasized the same message, CDC spokesman Tom Skinner said.
"He had shown a history," Skinner said Friday. "He had left to go, and he had left to come back, against orders."
Speaker argued that county health officials told him he was not a danger to his fiancee or others, and did not forbid him from traveling.
"They said, 'You don't need to be sequestered.' How can they turn around later and say, 'You should have been in isolation'?" Speaker said.
In Rome, Italy, Speaker said he got a message to call CDC official Dr. David Kim. It was then that Speaker said he first heard of the XDR diagnosis.
Kim asked him to cancel a planned train trip to Florence and said he would get back to the couple with news of travel arrangements back to the United States for treatment, Speaker said Friday.
They stayed in Rome. When Speaker called Kim the next night, Kim offered only two options: Go into isolation in Italy, or pay for a private air ambulance. Speaker said he couldn't afford the air ambulance, and didn't want to spend as long as two years in an Italian hospital.
Indiana couple accuses Veggie Booty maker of poisoning son
NEW YORK (AP) -- The parents of an Indiana toddler have sued the makers of Veggie Booty, claiming the recalled snack poisoned their child.
The snack had been recalled last week after the company found a seasoning made with imported Chinese ingredients tested positive for bacteria.
Refund info
Robert's American Gourmet says consumers who purchased Veggie Booty Snack Food and Veggie Booty Super Veggie Tings Crunchy Corn Sticks and still have the products in their homes should discard the contents and contact the company at 1-800-626-7557 for reimbursement. Information is also available at the company Web site http://www.robscape.com.The lawsuit, filed in federal court in New York by David and Ashlee Allen, of Valparaiso, Indiana, says their 18-month-old son, Xavier, ate a bag of Veggie Booty on May 20. It alleges that three days later, he had a bout of "severe, bloody diarrhea," and was found to have salmonella poisoning at a hospital.
Robert's American Gourmet Inc. had a duty to make food "that was fit for human consumption ... and that was free of pathogenic bacteria," said the suit, which seeks unspecified damages. "The defendant breached this duty."
A telephone message left Friday with the company, based in Sea Cliff on Long Island, was not immediately returned.
The company recalled its Veggie Booty Snack Food last week after it was associated with 54 cases of salmonella poisoning in 17 states. Many of those sickened reported eating Veggie Booty.
The recall was expanded on Monday to include Super Veggie Tings Crunchy Corn Sticks Snack Food, since it uses the same seasoning. A company official said a spray-on seasoning made with imported Chinese ingredients that was used on both baked products had tested positive for bacteria.
Experts: Pills becoming the new marijuana on campus
ATLANTA, Georgia (CNN) -- The prescription drugs allegedly found in Al Gore III's possession this week are favorites among young people, according to drug abuse experts, who say prescription drugs may soon overtake street drugs in popularity.
Some young people perceive that prescription drugs are safer than street drugs, experts say.
"I wouldn't be surprised if right now at this point in time, there are more kids abusing prescription drugs than abusing marijuana," said Joseph A. Califano Jr., chairman and president of CASA, the National Center on Alcohol and Substance Abuse at Columbia University. Gore was arrested on charges of possessing -- in addition to marijuana -- Vicodin, Xanax, Valium and Adderall.
According to a CASA report, between 1993 and 2005 the proportion of college students abusing Vicodin and other opiods went up 343 percent, about 240,000 individuals. The numbers increased 450 percent, or by 170,000 students, for tranquilizers such as Xanax and Valium, and 93 percent, or 225,000 students, for stimulants, including Adderall.
Prescription drug abuse is particularly common among upper middle class students, according to Lisa Jack, a clinical psychologist at Augsburg College in Minneapolis, Minnesota.
"It just goes to show that where you're from doesn't matter," Jack said.
And young people don't have to go far to get these drugs. "Prescription drugs are very easy for kids to get," Califano said. "They can get them from the Internet. They can get them from their parents' medicine cabinets. They can get them from their friends."
He said often students get them from friends who were prescribed these drugs legitimately.
"Kids sell them to each other," Jack said. "Drug trading happens all the time."
Experts say it's particularly a problem with Adderall, a drug prescribed legitimately to millions of young people with attention-deficit hyperactivity disorder.
According to CASA, more than a third of children ages 11-18 in Wisconsin and Minnesota who'd been prescribed Adderall and other ADHD medications reported being approached to sell or trade their drugs.
And often they say yes, according to one Canadian study that found one out of four teens who'd been legitimately prescribed Ritalin gave or sold some of their drugs.
Another appeal to prescription drugs, besides the easy access, is that young people often perceive them as safer.
"They don't have to go to the streets and deal with some guy they don't know and get marijuana where they don't know what's in it," Califano said. "Also, they see their parents using these drugs, so they seem safe."
Jack said prescription drugs can be more challenging to treat than addiction to street drugs. "In traditional drug abuse, addicts can say, 'I've been using meth or coke or pot,' and an addiction specialist knows what to do," she said. But with prescription drugs, "sometimes the kids don't even know what they've been taking. They just pass the pills around."
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