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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
"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
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
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
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
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
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.
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