Catrina DeMicelli's Blog

THOUGHT FOR THE DAY...

2012-02-15T01:47:00.001-08:00

We tend to forget that happiness doesn't
come as a result of getting something we don't have,
but rather of recognizing and appreciating what we do have.

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2012-02-15T01:42:00.000-08:00

* The 409 escalators in the London subway cover a distance every week which is approximately equivalent to several trips around the globe! *

* It is impossible to hum if your nose is plugged. *

* One in five long-term love relationships began with one or both partners being involved with others. *

* When someone looks at a new love, the neural circuits that are usually associated with social judgment are suppressed. *

* Couples' personalities converge over time to make partners more and more similar. *

* When withdrawing money from an ATM, the 'whirring' sound before your money pops out is actually a recording. The actual mechanism is so far back that you can't hear it. *
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First Aid: 10 Medicine-Cabinet Must-Haves

2012-02-15T01:33:00.000-08:00

Most people aren’t prepared to handle a health problem or medical emergency in their home. To find out if you have the right first-aid supplies, take a peek in your medicine cabinet. Read on to learn which 10 items will keep your family safe and pain-free...

Whether it’s a common cut or something scarier like chest pains, you need the right items to handle a medical emergency.

But most people aren't well-prepared.

“People either have no first-aid kit, or the materials are insufficient or expired,” says Manoj Singh, M.D., assistant professor of family medicine at the University of Cincinnati College of Medicine in Ohio.

Just as important: You need to be able to find them quickly.

That's why experts advise that you keep emergency supplies in one place: either in a traditional first-aid kit or a designated medicine cabinet.

Here are the top 10 items medical experts say should be within reach in any healthy home. They’re available at your local drugstore.

1. Plain bar or hand soap
This may seem obvious, but the old-fashioned soap-and-water combo is still the best way to clean minor cuts and scrapes.

“Rubbing alcohol, hydrogen peroxide and witch hazel all damage your skin, and they don’t clean wounds any better,” says Joanne Watson, M.D., a family physician at Patient First near Baltimore, Md.

Here’s another eye-opener: Plain soap works just as well as antibacterial soap, Watson says.

(Plus, it may be safer – the Food and Drug Administration [FDA] is currently reviewing the safety of triclosan, the active ingredient in many antibacterial soaps, after concerns it might alter hormones or cause antibiotic-resistant bacteria.)

2. An assortment of plain adhesive bandages/Band-Aids
For minor injuries, the simpler, the better.

“The wound just needs to be clean, so there’s no need for antibiotic-impregnated or other fancy bandages,” Watson says.

Make sure you have a variety of sizes to handle various wounds, and stockpile gauze pads and paper tape (for securing the pads).

On larger wounds, a pad will cover, protect and absorb any drainage from it.

3. An elastic wrap
Also called an ACE bandage (based on the best-known brand name), “these are excellent for giving support to a sprained joint,” says Jennifer Zimmer, M.D., an internal medicine specialist at the Baylor Regional Medical Center in Plano, Texas.

Just be sure to apply the wrap correctly:

If wrapping a foot or ankle, start at the bottom of the foot and wrap it several times around until you reach the ankle, then criss-cross the bandage in a figure-8 pattern behind the heel and secure it at top with some tape.

If it’s too loose, it won’t supply helpful compression; if it’s too tight, it can restrict circulation.

(Remove it if the body part feels numb or tingly, gets cold or turns blue.)

If you aren’t sure, ask your doctor.

(For minor sprains, also keep an ice pack in your freezer and remember the acronym “RICE”: Rest, Ice, Compression, Elevation.)

4. Aspirin
Sure, it’s an age-old headache remedy.

But the real reason you need aspirin is for a medical emergency.

“If you have chest pain, chew 325 mg of uncoated aspirin,” Singh advises.

“Heart attacks can happen any time, and taking aspirin as soon as possible helps reduce the damage.”

Here's how: Heart attacks are usually caused by a blood clot in a coronary artery.

If you take aspirin (and chew it so it enters your system quickly), its blood-thinning properties can help break down the clot and limit the injury to your heart, Singh says.

Of course, call 911 first.

Since chest pain isn’t the only signal of a heart attack (especially in women), read Women: How to Recognize a Heart Attack and What to Do and Is It Heartburn or a Heart Attack?

5. An accurate thermometer
You need a good thermometer to monitor fevers, which could indicate infection in a wound or worsening of any illness, Zimmer says.

She recommends digital thermometers because they're easier to read than ones with mercury.

And toss ear thermometers and fever strips – they aren’t as precise.

Remember, it’s not a fever until body temperature goes above 100.5˚.

“Everyone thinks that any temperature above 98.6˚ is a fever,” Watson says. “Some schools send kids home when they have a temperature of 99˚, which is perfectly normal.”

6. An antihistamine
Benadryl (diphenhydramine) can relieve the symptoms of allergic reactions – whether they’re from ragweed, dust, insect bites or a specific food. Doctors often recommend it because it works quickly, says a pharmacy expert Suzy Cohen, R.Ph.

But if you have a severe allergic reaction – difficulty breathing, tongue or lip swelling – don’t count on a pill. Call 911 and get to an emergency room immediately.

7. A topical antibacterial ointment
After cleaning a wound, apply an antibacterial cream like Neosporin, Bacitracin or Polysporin, which will help reduce healing time and infection risk.

You can also use antibacterial ointment on burns.

But don’t use butter, oil, salve or cocoa butter because they raise infection risk, Watson says.

“On unbroken skin, use a cold pack,” she says. “And if the burn blister is broken, just wash with plain soap, apply a little antibacterial ointment, and wrap lightly with a bandage.”

8. Mild pain relievers
When someone in your family has a headache or other minor ache, you don’t want to scramble for a painkiller.

Ibuprofen (Advil) or acetaminophen (Tylenol) are fine for minor pains, but remember to have kids’ varieties on hand if needed, Singh notes.

“Check the dosage, because children take doses based on their weight.”

9. Hydrocortisone cream
This contains an inflammation-reducing steroid hormone, and can take the itch out of insect bites, poison oak and ivy, and some rashes.

Apply a small amount, and don’t use it for more than a few days at a time without consulting your doctor.

Long-term use can raise risk of side effects, notes Debra Wattenberg, M.D., assistant clinical professor of dermatology at Mount Sinai Hospital in New York.

10. Emergency contact phone numbers
In case of a medical emergency, tape the contact information for your doctor, pharmacy and the local Poison Control Center (for ingestion of or exposure to toxins) to the inside of your medicine cabinet or first-aid kit.

Toss These… Today!
Now that you know what should be in your medicine cabinet, here’s what to throw out.
The following products do more harm than good:

Mercurochrome and betadine
Experts now say that these old-school, wound-cleansing antiseptics can delay healing.

“The new, fragile cells responsible for a wound’s healing are easily damaged by the toxic effects of these agents,” Singh says.

Syrup of ipecac. The American Pediatric Association no longer recommends taking this to induce vomiting after swallowing something dangerous, Singh says. “By causing vomiting, there’s a risk of [inhaling stomach contents into the lungs].”

Rather than wasting time on a risky and possibly ineffective treatment, call 911 or poison control if a family member has swallowed a toxic substance.

Anything old, smelly, runny or outdated
Experts advise that you clean out your medicine cabinets once a year.

To avoid contaminating the environment, follow label instructions when disposing expired drugs, according to the FDA. When in doubt, talk to your pharmacist.

Nancy Gottesman is a health and nutrition writer in Santa Monica, California.
How Much Do You Know About Child Safety?
Protecting your child is likely a natural instinct for you, but how much do you know about kid safety? Walking into stores filled with child safety gates, car seats and other products can be overwhelming.

Chocolate: Ancient Viagra

2012-02-15T01:20:00.001-08:00

Back in the 1500s, the Aztecs believed chocolate enhanced vitality in every sense. According to historical accounts, the Emperor Montezuma drank nothing but cocoa all day, especially before entering the bedroom. After chocolate reached Europe, it was considered an aphrodisiac and became a favorite drink of Casanova, the infamous Italian-born womanizer.

In recent years, chocolate hasn’t been pitted against Viagra in scientific tests but it has been shown to bestow health benefits that could help to explain its aphrodisiac reputation. Ingredients in cocoa dilate blood vessels, improve blood flow and trigger feel-good brain chemicals.

There is a catch, though. Most of today’s chocolate candy bears little resemblance to the potions consumed by Montezuma and Casanova.

Chocolate Pitfalls

The Aztec version of chocolate was a drink made with crushed cocoa beans seasoned with chili and sometimes vanilla. It wasn’t sweet and most of us may well pass on a goblet of Montezuma’s brew.

Europeans added sugar and later, milk, and eventually, the most popular versions of chocolate were made with unhealthy fats and sweeteners. In the process, the amount of beneficial cocoa declined, but healthy chocolate has been making a come-back.

The Best Stuff

The more cocoa a chocolate contains, the more potential aphrodisiac qualities and health benefits it possesses. Many wrappers proudly state a percentage of cocoa, or cacao, in big letters. Look for 60 percent or 70 percent cocoa, or more, and check the list of ingredients.

The best fat in chocolate is cocoa butter. It comes from cocoa beans (and was in Montezuma’s concoction) and contains a combination of saturated and oleic fat. The oleic kind is the same as the predominant fat in olive oil, and the fat in cocoa butter doesn’t raise cholesterol, which is a good thing.

Cocoa butter costs more than vegetable oils, so the vegetable variety is often used. However, the vegetable fats are processed, or “hydrogenated,” to turn them from liquid to solid and to extend shelf life. The processing turns the vegetable fat into a transfat, the worst artery-clogging fat in any of our food.

Chocolates with brightly colored fillings are another not-so-healthy option. They aren’t likely to contain much cocoa but they are rich in calories. Chocolate truffles made with cocoa-based fillings are a better option.

Raw Organic Chocolate

More raw organic brands are becoming available, and are likely to be richer in healthy nutrients, such as antioxidants, potassium, and magnesium. Raw chocolate is made without high heat that can damage nutrients whereas cocoa beans used for regular chocolate are roasted at high temperatures.

Raw chocolate can also contain enzymes, which help your body to use all the nutritional goodies. The taste of raw chocolate is a bit different from what most of us are used to, but it’s definitely delicious.

Health food stores and Web sites sell raw chocolate. Or, you can easily make your own with a chocolate kit that contains raw cocoa butter, raw cocoa powder and crunchy chocolate “nibs,” (pieces of cocoa-bean flesh after its hull has been removed) or healthy dried berries. The kits are available in some stores and online at NavitasNaturals.com.

Drinking Healthy Cocoa

A cup of cocoa a few times a week can help to lower your blood pressure and protect your heart, especially if it’s a nutritionally rich version without unhealthy additives. Try this:

Heat (don’t boil) a cup of low-fat milk with a teaspoon of honey, in the microwave or in a pan on the stove. Once the milk-honey mixture is at a good drinking temperature, stir in an unsweetened, raw organic cocoa powder.

If you want to try an Aztec recipe, there’s a blend called xocolatl (Aztec for chocolate) at DagobaChocolate.com.

Will any of these work as aphrodisiacs? You’ll have to be the judge.

Drugs for Men Treat Other Sex Woes

2012-02-15T01:18:00.001-08:00

Most studies looking at whether erectile dysfunction drugs can help men overcome premature ejaculation problems agree that the pills make a difference, but much of the research is flawed, according to a new review of the evidence.

Of the 14 studies included in the review, 11 found that the medications helped extend the length of time men could have intercourse before orgasm, but Dr. Anastasios Asimakopoulos, lead author of the report, urged caution in interpreting the findings.

"There is still inadequate evidence to propose the use of (these types of drugs) in treating (premature ejaculation)," he wrote in an email to Reuters Health.

The drugs, which go by the brand names Viagra, Levitra, and Cialis, are intended to treat men who have problems getting and keeping an erection.

There's been an interest in also using them to address the problem of premature ejaculation, because one of the side effects of the drugs is a delay in ejaculation, the authors write in the Journal of Sexual Medicine.

Asimakopoulos, from the University of Tor Vergata in Rome, Italy, said that anywhere from 4 to 39 percent of men suffer from premature ejaculation.

His group collected data from 14 studies that measured the effect of medications on extending the time during intercourse before orgasm, technically referred to as the "intravaginal ejaculatory latency time."

Nine of the studies used an erectile dysfunction drug by itself, while four combined the drug with an antidepressant medication, and one combined the drug with behavioral therapy.

Most of the studies asked men to use a stopwatch before and after treatment, to measure if they were able to extend the time having sex.

Some also asked the men to rate changes in their anxiety and sexual satisfaction.

Asimakopoulos and his colleagues ran into problems trying to compare the studies. For one, they didn't always agree on the definition of premature ejaculation.

He said that future studies should use the definition provided by the International Society for Sexual Medicine, which says the disorder involves an inability to last longer than one minute before ejaculating, and includes problems such as frustration or avoiding sexual intimacy.

The other stumbling block to the group's analysis was that fewer than half of the studies compared the drugs to a placebo, a standard for high-quality studies that helps researchers determine whether the drug itself is responsible for any effects seen.

Among four studies, including about 300 men, that did compare an erectile dysfunction medication to a placebo, Asimakopoulos found a positive effect.

After taking a placebo, men had intercourse lasting from about a minute to a little more than a minute and a half.

Among the men who used a medication, intercourse lasted from more than two and a half minutes to about six.

Similarly, the erectile dysfunction drugs, when combined with an antidepressant, worked better than an antidepressant alone.

Asimakopoulos said the results show that these drugs have "a high impact ... on prolonging ejaculatory times."

"There seems to be a global positive effect of these drugs in delaying ejaculation; however, the existing evidence is still partial and their role remains controversial," he said.

The drugs are worth further investigation for the treatment of premature ejaculation because antidepressants and topical anesthetics are the only alternatives demonstrated to be effective so far, the team notes in their report.

In future studies, Asimakopoulos said, researchers should not only use a standard definition of premature ejaculation and conduct studies comparing the drug to a placebo, but also shoot for developing a standard and more convenient method of measuring the disorder other than relying on a stopwatch.

Top 10 Foods to Fight Inflammation

2012-02-15T01:16:00.000-08:00

A fire roars inside you and you may not even know it. What’s worse: This out-of-control inflammation may lead to heart disease, cancer, diabetes and more. But dietary changes can help tame the flame. Read on for the 10 foods to start eating today...

Low-level, chronic inflammation lies so far below the skin’s surface that you can’t see it or feel it.

It’s the result of an immune system in overdrive, damaging healthy tissue and leading to chronic illnesses. Ongoing inflammation can trigger heart disease, cancer and diabetes, but it also can exacerbate asthma, acne and obesity — even ruin your mood, says California-based registered dietitian Evelyn Tribole, author of The Ultimate Omega-3 Diet (McGraw-Hill).

Within two decades, more than one-third of Americans will have an inflammatory disorder, Tribole says. And most of it stems from an unhealthy diet.

Fight Fire with Food
The typical Western diet – high in processed foods, refined starches, added sugars and animal fats and low in fruits, vegetables, whole grains and omega-3 fatty acids – fuels inflammation, according to a 2006 paper in the Journal of the American College of Cardiology.

But people in Greece, Italy and France have better eating habits and less chronic disease. In those Mediterranean countries, sweets, eggs and beef don’t star on the plate as often as in the U.S.

Their diet is naturally anti-inflammatory and includes low-fat and nonfat dairy foods, olive oil, potatoes, nuts, poultry, legumes, olives and wine, says Demosthenes Panagiotakos, a leading researcher on the Mediterranean diet and associate professor of Biostatistics & Epidemiology of Nutrition at Harokopio University of Athens, Greece.
So what does this mean for us in the West? Eat like a French, Italian or Greek woman — lots of fruits, veggies, green salads and fish — and drink red wine in moderation (up to 4 ounces daily for women and 8 ounces for men).

But lettuce and green beans alone won’t do it. To get a wide variety of nutrients, including fiber, antioxidants and anti-inflammatory compounds, chow down on fruits and vegetables of all kinds and colors.

And start at breakfast. If you wait until dinner to eat the 5-9 servings (a half cup each) recommended by the U.S. Department of Agriculture, you’ll be at the table a long time.

To get started on an anti-inflammatory path, consume more foods straight from the farm, fewer processed and fried foods or those loaded with butter, and use the 10 foods below in your meals:

1. Canola oil
We eat too little omega-3 and too much omega-6 fatty acids because of corn and soybean oils in margarine, candy, crackers and processed foods. That tips the balance of compounds involved in inflammation for the worse, Tribole says.

The fatty acids compete in the body for enzymes: Omega-3 fats yield anti-inflammatory compounds; omega-6 fats give us inflammation.

“It’s like a biological game of musical chairs, where there’s always a shortage,” Tribole explains. “In the case of fatty acids, the dominant fats win the enzyme.”

Diet fix: Limit highly processed foods (always a good idea). Dress your salad and sauté your meats and veggies in omega-3 rich canola oil. Eat other plant sources of omega-3 fats including walnuts and ground flaxseed.

2. Grass-fed beef
Humans are at the top of the food chain and the diet your food eats affects your inflammation levels.
Today, most cows are fed high-calorie corn and grain – high in inflammatory omega-6 – to fatten them quickly. But the meat from leaner cattle grazing on grass have higher levels of vital nutrients — vitamin E and omega-3s.

A 2004 study from California State University, Chico examined lipid composition of 36 cattle fed on grain, grass and a combination of both. The beef from grass-fed bovines was lower in saturated fatty acids and omega 6 and 40% higher in omega-3 fatty acids.

Diet fix: It may be more expensive, but worth it for your health to dine on grass-fed beef. The American Institute for Cancer Research recommends no more that 18 ounces of lean beef weekly. More than that raises your colon cancer risk. Less is probably better – maybe two portions per week – because it frees your plate for even more disease-fighting foods.

3. Oily fish
The American Heart Association (AHA) recommends eating omega-3 rich oily fish at least twice weekly because they decrease the risk of sudden cardiac death and slow growth of arterial plaque.

Diet fix: Choose salmon, tuna, trout, herring, sardines and mackerel for the most potent, anti-inflammatory omega-3 fatty acids. But pregnant women should avoid King mackerel because of its high mercury content.

4. Nuts
Nuts have long been linked with less coronary heart disease than other high-calorie foods.

A 2005 study in the American Journal of Epidemiology of more than 6,000 people found those who ate the most nuts and seeds had the lowest levels of inflammatory markers in their blood.
The high content of the amino acid arginine may be responsible for the inflammation-soothing effect of nuts.

Diet fix: Snack on some walnuts, pistachios or almonds. But measure a one-ounce serving (about one-fourth cup) to keep calories in check.

5. Cocoa
A number of studies have shown that cocoa can reduce the risk of heart disease.

When researchers in Spain gave 42 men and women skim milk mixed with cocoa powder twice daily for four weeks, participants had lower levels of inflammatory markers in their blood compared to the four-week period in which they drank plain skim milk.

Another 2006 study from the University of California, Davis showed that drinking cocoa improved blood flow and decreased lipid levels in 32 post-menopausal women.

The beneficial ingredient is flavanols, which reduce inflammation and blood clotting. Cocoa has a rich concentration of them.

Diet fix: Enjoy a cup or two of steamy hot cocoa made with real cocoa and skim or low-fat milk to hold down the calories and saturated fats. And don’t think a chocolate bar carries the same health boost; the candy is high in saturated fat.

6. Cranberries
Laboratory studies suggest that cranberries may inhibit growth and proliferation of breast, colon, lung and prostate tumors. Researchers suspect that one protective mechanism is the anti-inflammatory action of this antioxidant-packed red berry. It’s also been shown to reduce the oxidation of low-density lipo-proteins (LDL or "bad" cholesterol) levels.
Diet fix: Toss dried cranberries into a green salad or your morning bowl of oatmeal.

7. Cherries
When healthy men and women supplemented their diets with sweet Bing cherries for 28 days, several blood markers of inflammation decreased, according to a 2006 study in the Journal of Nutrition.

An earlier study also suggests that cherry consumption relieves arthritis symptoms.

Laboratory studies show the anti-inflammatory properties of anthocyanins – compounds responsible for the cherry’s rich red color – but researchers suspect there are many more anti-inflammatory chemicals in this juicy red fruit.

Diet fix: Enjoy a dessert or snack of fresh cherries in season and dried all year long.

8. Grapes
The antioxidant resveratrol found in the skin of grapes (and red wine and peanuts) also fights inflammation and cancer. Drinking Concord grape juice may lower inflammatory markers in the blood of people with stable coronary artery disease, according to a double-bind study published in 2004 in the journal Arteriosclerosis, Thrombosis and Vascular Biology.

Diet fix: Keep red grapes washed and at eye level in the refrigerator. (Fruit is healthier than juice because it has more fiber and less sugar.) Put them on the homework table when your kids come home from school.

9. Apples
If an apple a day really does keep the doctor away, it might be because of its high concentration of quercetin, a flavanoid also present in onions and tea.

In a 2008 University of Michigan study of more than 8,000 American adults, researchers found a link between apples, flavanoids and quercetin and decreased inflammation. Diet fix: Toss diced apples into chicken salad or warm your family with a baked apple and a pinch of cinnamon.

10. Broccoli
This nutritional powerhouse contains many disease fighters, including beta-carotene, vitamin C and the B vitamin folate. It also has kaempferol, another flavanoid linked to decreased inflammation.

Diet fix:
Toss steamed broccoli with whole-wheat pasta and pine nuts. For even more kaempferol, pick up some kale, green beans, leeks and tea.
A Daily Anti-Inflammation Eating Plan
Can’t figure out to get all these anti-inflammatory foods into your meals? Try the menu below:

Breakfast:

Oatmeal sprinkled with dried cranberries and cinnamon

Snack:

Grapes

Lunch:

Green salad loaded with fresh veggies, including broccoli, onions, a sprinkling of walnuts or almonds and fresh-cracked pepper and an olive or canola oil dressing

Top your salad with grilled chicken

Whole-grain bread or crackers

Unsweetened tea
Snack:

Cherries, walnuts

Dinner:

Sliced fresh tomato drizzled with olive oil

Grilled salmon with rosemary

Sauteed spinach with leeks and ginger

Brown rice

Unsweetened tea

Dessert:

Apple, sliced and sprinkled with cinnamon, cooked in the microwave or baked in the oven.
What’s Your Food Cures IQ?
In her groundbreaking book Food Cures, Joy Bauer reveals the foods that manage, treat and even cure common health concerns such as arthritis, heart disease, diabetes and more. Do you have the prescription for better health?

Exercise As Chronic Pain Treatment - Breaking a Sweat Can Bring Relief, Say Experts

2012-02-15T01:11:00.000-08:00

No one wants to be physically active when they’re hurting. For the 116 million Americans suffering with chronic pain, it’s often more tempting to lie down than move. But the right exercise program can provide effective chronic pain treatment, pain experts say. The trick is to find a workout that makes you feel better rather than worse. Here’s how...

Chronic pain isn’t an equal-opportunity affliction. It strikes women more frequently than men, and leaves them hurting with low back, neck and hip aches from arthritis; severe headaches; fibromyalgia; and irritable bowel syndrome (IBS).

It's enough to make you head to bed.

“My patients are reluctant to exercise because they’re afraid it will increase their pain,” says Jennifer Kelly, Ph.D., a clinical psychologist and director of the Atlanta Center for Behavioral Medicine.

“The less you do, the more difficult it is to do anything,” says Kelly, who has specialized in treating women with chronic pain for 24 years.

That's why movement – especially exercise – is an "excellent way to suppress pain,” says rheumatologist David Borenstein, M.D., a clinical professor at George Washington University School of Medicine and author of Heal Your Back: Your Complete Prescription for Preventing, Treating, and Eliminating Back Pain (M. Evans & Company).

That's because active women generate endorphins, natural chemicals that inhibit pain signals to the brain, he explains.

“If you’re breaking into perspiration, you’re making your own opioids,” or natural painkillers, Borenstein adds.
But no one – and especially chronic pain patients – should just go from being a horizontal spud on the couch to running a triathlon.

First, check with your doctor before starting aprogram to ensure that the type and intensity of exercise you’re planning to do won't worsen your condition.

Don't stop exercising if you have slight discomfort at the beginning – a little soreness is to be expected if you haven’t been active for a while, says Marie Hoeger Bement, Ph.D., an assistant professor of physical therapy at Marquette University.

“You also can expect mild fatigue and a light brush of perspiration,” adds Elaine Larson, a physical therapist at University of Utah Chronic Pain Center.

“You want to build slowly and use the activity for your benefit,” she says.

Read on for 10 chronic pain treatment exercises for top complaints.

1. Chronic Pain Treatment: Walking, Hiking and Treadmills
Walking helps nearly everyone with chronic pain. Walks can even ease stress-triggered headaches.

By stimulating fluid and blood flow to joints, walking promotes joint repair and eases pain, says Larson.
Start with a few minutes on flat surfaces every other day, building gradually.

Special considerations: Women with osteoarthritis or rheumatoid arthritis should avoid walking on concrete, cautions physical therapist Shannon Wilson of Peace Health Southwest Medical Center in Vancouver, Wash. Hard surfaces stress joints.

Hiking sharp hills or on uneven terrain in the wilderness can also worsen knee pain, she adds.

Women with fibromyalgia should use Nordic walking poles, which provide balance and prevent falls, says Kim Dupree Jones, Ph.D., of Oregon Health & Science University.

2. Chronic Pain Treatment: Running
Running can relieve stress, which may ease headaches, says Seymour Diamond, M.D., executive chairman of the National Headache Foundation.

It also may lessen discomfort for women suffering from IBS, suggests a preliminary study of IBS patients published in 2011 in the American Journal of Gastroenterology.

Special considerations: Avoid running if you have arthritis in your legs or hips because it pounds lower joints, exacerbating pain in those regions.

It also aggravates lower back disc pain, says Dana Dailey, a physical therapist at Genesis Medical Center in Moline, Ill.

To avoid knee injuries – a problem common to dedicated runners – wear knee braces, suggests Wilson.

3. Chronic Pain Treatment: Outdoor Bicycling
Biking increases blood supply to muscles and joints. It also can spur the release of endorphins which lift mood and reduce pain, says Dailey.

Special considerations: Adjust the seat and handlebars so that you’re not hunching over or extending your legs uncomfortably far while pedaling. Low handlebars can worsen neck or back pain, cautions Bement.

Heavy resistance or steep hills strain knees, an issue for women with joint pain.

Biking in colder weather can increase pain for women with fibromyalgia or arthritis, says Wilson.

4. Chronic Pain Treatment: Water Sports
Water sports are the safest physical activity for chronic pain patients, and water aerobics benefit those with fibromyalgia, says Jones.

Both swimming and pool aerobics ease overweight, deconditioned women into an exercise program.

Plus, the water’s buoyancy can help swimmers with arthritis or even serious spinal and range-of-motion pain to get back in shape, says Wilson.

Flotation devices may make exercising easier at the start, she advises.
Special considerations: Overhead arm strokes, such as those used in the front crawl or back stroke, may increase pain for women with shoulder or arm stiffness. Try the breast stroke instead.

Warm water is better for those with arthritis because cold temperatures can increase pain, notes Wilson.

Start slowly, because the ease of moving in water can prompt women to overdo exercises at first, Larson advises.

“Your body isn’t giving you the instant feedback of soreness you get on land,” she says.

5. Chronic Pain Treatment: Pilates
Pilates, a system of exercises that stretches muscles, strengthens a woman’s back and abdominals, which helps to support aching joints, says Wilson.

Women with IBS, as well as neck, shoulder, back and knee pain, have reported the exercise helps reduce their discomfort, says Risa Sheppard, a Pilates teacher for 36 years in Los Angeles.

Special considerations: Women with back and shoulder pain may need to skip or modify Pilates positions that extend the arms overhead or far out in front of the body, says Jones.

Also, avoid large classes that can't accommodate modifications for your condition, Dailey says.

6. Chronic Pain Treatment: Yoga
Yoga postures and breathing exercises relieve stress, a big pain culprit. Typically, as her chronic pain patients ease into an exercise program, pain decreases along with depression and anxiety, Kelly says.

Regular practice can help those with headaches, backaches and fibromyalgia, says Kelly McGonigal, Ph.D., who teaches yoga in a Stanford University School of Medicine class and wrote the book, Yoga for Pain Relief: Simple Practices to Calm Your Mind and Heal Your Pain (New Harbinger Publications).

Restorative yoga, which uses props to support poses, is tailored to chronic pain patients, modifying positions that otherwise may be too difficult or dangerous.

Special considerations: Be careful with deep squats and extreme forward or backward stretches, which could worsen joint pain and create new injuries, says Wilson.

As with Pilates, stay away from large classes that don’t allow a routine that accommodates your condition, experts say.

Also, don’t pressure yourself to keep up with others in a class if it’s not comfortable. If you're holding your breath or straining to breathe, you’re pushing beyond the safety point, McGonigal cautions.

7. Chronic Pain Treatment: Zumba
This Latin-inspired, fast-moving dance and movement activity is fun, and women are more motivated to stick with it. Zumba can strengthen muscles and unleash a surge of endorphins that blunt pain, Wilson says.

Special considerations: Zumba's twisting movements and lunges can sharpen neck, back or knee pain for women with arthritis.

Be careful if you have fibromyalgia, which can impair balance. It’s easy to fall when you’re doing fast foot movements, Jones warns.

Plus, Larson adds, because time flies when you’re enjoying an activity, watch that you don't overtax your body.

“Fifteen minutes at your own pace could be fun,” he says. “An hour of too much could be a disaster.”

8. Chronic Pain Treatment: Tennis
Tennis can take the sting out of headaches by lowering stress, especially for women who are long-time players and enjoy the sport, says Diamond.

Special considerations: Twists, sudden direction changes and sharp arm movements can hurt women with shoulder, elbow and knee pain, as well as back injuries.

A wider grip and larger racket can prevent pain for women with arthritis in their hands.

Also, briefer, more frequent sessions are best, suggests Larson.

9. Chronic Pain Treatment: Gym Machines (Ellipticals, Steppers, Recumbent Bikes)
Ex-runners with chronic pain like elliptical machines because they produce the same “endorphin high” as running, without endangering joints.

Ellipticals also are a good choice for women with joint injuries because they can control the intensity and direction of the pulleys, says Bement.

Steppers can strengthen leg muscles.

Recumbent bikes, which have seats with backs and sit low to the ground, take pressure off lower backs and necks.

Special considerations: Ellipticals adjusted into a deep incline can place tremendous pressure on the knees, worsening arthritis or knee injuries. So can the repetitive motions of a stepper. For women with limited range of motion, recumbent bikes may be difficult to mount and dismount says Wilson.

10. Chronic Pain Treatment: Weight-lifting
With careful supervision of form, weight-training can bring relief for women with fibromyalgia and other types of chronic pain.

Start slowly: Using light weights with few repetitions is safest, experts say. And programs should be balanced, so all parts of the body gain strength at the same time, Jones adds.
Special considerations: Lifting heavy weights above the waist can aggravate back pain, Dailey warns.

Also, holding weights over the head or doing bicep curls fully extended can create more shoulder and arm discomfort, she says.

Women with arthritis should never lift weights on days with active inflammation of joints (redness, warmth and swelling) or they risk greater injury, she adds.

What’s Your Fitness Style?
Some people find it easy to wake up at 4:30 a.m. and go for a five-mile run, while others simply hit the snooze button. Aspects of your personality determine the kind of exerciser you are, so if you're in a fitness rut, it's time to put your unique interests back into the workout equation.

THOUGHT FOR THE DAY...

2012-02-14T01:30:00.001-08:00

Of all the things you wear, your expression is the most important.

FUN FACTS - AND A GREAT WAY TO MAKE EXTRA INCOME AND LOTS OF IT WITH MJ TLC - AND - CHECK OUT " WWW.MELODY'SHAPPYWORLD.COM " FOR A FREE WAY TO BRING HAPPINESS, LOVE AND HOPE TO THE WORLD WE LIVE IN!!

2012-02-14T01:28:00.000-08:00

* When you are looking at someone you love, your pupils dilate, they do the same when you are looking at someone you hate. *

* Bullet proof vests, fire escapes, windshield wipers, and laser printers were all invented by women. *

* Donkeys kill more people annually than plane crashes. *

* The most children born to any one woman was 69, she was a peasant who lived a 40 year life, in which she had 16 twins, 7 triplets, and 4 quadruplets. *

* Your fingernails grow faster in winter. *

* Tae Kwon Do is only around 60 years old. *
___________________________________________________________________________

WWW.MELODYSHAPPYWORLD.COM - "True happiness is not looking back with regret, but looking forward to the future and creating your own exciting, magnificent destiny and masterpiece, YOUR LIFE!"

MELODY JENSEN IS THE MOST WONDERFUL PERSON AND THE GREATEST HUMANITARIAN I KNOW. CHECK OUT MELODY'S HAPPY WORLD, IT'S FREE!!

ASSOCIATIONS:
WWW.MELODYSSECRET.COM

Fight Brain Decline Every Day

2012-02-14T00:56:00.001-08:00

A recent study of 7,000 British government workers found that decline in brain function can occur as early as age 45. While the findings have some scientists calling for more research in the hope of treating decline when it first begins, one expert says the brain can be improved at any age. And this is particularly important considering that brain function peaks around age 30.

“At any age the brain is subject to improvement,” Dr. Michael Merzenich, professor emeritus from the University of California, San Francisco, and a longtime researcher of brain plasticity, tells Newsmax Health. “It’s plastic and you can improve your faculties at any age. But it’s more and more important that you do that to maintain yourself in the middle and toward the end of life.”

Once brain function peaks, it begins its decline as we continue to age, he says. Decline for women is a bit slower than it is for men because of hormonal differences, experts believe. But once women have gone through menopause, their cognitive decline begins catching up with that of men, and by age 65 it is about equal, Merzenich says.

Researchers previously regarded the brain as rather static, that its functionality and structure were capable of little more than deteriorating as we aged, he explains.

“But we now know that that’s completely incorrect,” he says. “We now know from research over the last 20 or 30 years that each time you acquire a new skill or a new ability, you’re actually changing the physical machinery of your brain. And that’s its plasticity.”

Merzenich, founding chief executive officer of the Scientific Learning Corporation and co-founder of Posit Science, has studied brain plasticity and learning for years. His companies have developed software programs that test and strengthen the brain and its visual, auditory, and cognitive functions — tools that create a sort of “brain gym” that he likens to a workout for the body.

“You can actually train the brain systematically to refine and strengthen its abilities, to speed up its processes, to make it operate more reliably by specific forms of intensive exercises,” he says.

The software programs, which have been clinically studied, work on distinct areas of memory and processing speed, and are designed to improve focus, thinking, and remembering.

In addition to these programs, the following everyday habits and activities — when done at a more conscious level — can help improve brain function including memory, processing, and perception, according to Merzenich.

Reading

Reading is important because it helps us acquire information, he says. “Having a strong and active mature life is to continue to grow with the information you have at hand. You need to load your reference library continuously.”

Taking a walk and looking around

Absorb your environment as you stroll — leave the headphones and cellphone at home and take in all the details of your surroundings, he says. When you return home, reconstruct in detail the route and scenery in your head. Merzenich says he does this forward and backwards on a daily basis. “That form of (mental) exercise is incredibly important because it keeps alive brain machinery that we know specifically deteriorates in older age to contribute to the onset of Alzheimer’s disease.”

Learning something new

What you choose to do, whether it’s taking up pottery or ping-pong, should be physically and cognitively challenging and really matter to you. “The brain is a learning machine and basically it needs new learning,” he says.

Becoming fully engaged

No matter what you are doing, be present and look for the surprises, he says. Practice what the meditators call mindfulness. Doing this exercises the way the brain takes in information in detail, a function that deteriorates with age. “People now are sleepwalking across the landscape,” he observes. “People are to a large extent drinking in every detail they see on their high-definition TV.”

Being regularly social

Daily social activity is important not only to stave off loneliness but to exercise the “very substantial part of the brain dedicated to social cognition,” he says. And being involved in a social activity that’s meaningful is particularly valuable. “It’s been demonstrated over and over again to be good for your brain health.”

Eczema Linked to Mens' Sex Woes

2012-02-14T00:54:00.001-08:00

Men who have the allergic skin condition eczema may have a higher risk of erectile dysfunction than other men, according to a Taiwanese study.

Though the study of several thousand men with erectile dysfunction (ED), which appeared in the Journal of Sexual Medicine, addressed a link, researchers said more study is needed and it is still too soon to confirm that eczema alone can cause impotence.

"There was an association between ED and prior atopic dermatitis," wrote lead researcher Shiu-Dong Chung and colleagues at Taipei Medical University. Atopic dermatitis is the medical term for eczema.

"Future studies are recommended, both to replicate the results seen here and to clarify the mechanisms behind them."

It's well known that some chronic illnesses, such as heart disease and diabetes, are connected to a higher risk of erectile dysfunction, perhaps due to dysfunction in the blood vessels and nerves.

Some past studies have also found that men with certain inflammatory skin conditions, such as psoriasis, have a higher rate of erectile dysfunction than other men.

Chung and colleagues looked through insurance claims data on 3,997 men with newly diagnosed erectile dysfunction, and compared them with nearly 20,000 men the same age with no known history of erectile dysfunction.

Almost 11 percent of men with erectile dysfunction had eczema before the impotence diagnosis. By comparison, just under seven percent of men without erectile dysfunction had a history of eczema.

After the researchers weighed other factors, including health problems such as diabetes and heart disease, they found that men with erectile dysfunction were 60 percent more likely to have a history of eczema than men without ED.

What the findings mean is unclear.

One question is why skin diseases like eczema or psoriasis would be linked to erectile dysfunction. Chung's team said it's possible that the underlying inflammation of the diseases, which may affect blood vessels as well as the skin, is to blame.

Allergy expert Donald Leung, an allergist and immunologist at National Jewish Health in Denver, Colorado, said the results were "interesting" but the study had limitations.

One is that it relied on administrative claims, which may not be accurate. It was also not clear whether the men had eczema at the time of the erectile dysfunction diagnosis or at some point years earlier, said Leung, who did not take part in the study.

"More studies are needed to confirm that atopic dermatitis alone may be a cause of ED," Leung told Reuters Health in an email, noting that any chronic health condition potentially creates emotional stress for a couple.

Chung and his team agreed, acknowledging that they had no information on the men's lifestyle habits or family history, and some of those factors could help account for the connection between eczema and impotence.

Still, they suggested that doctors ask men with eczema about their sexual function, as part of "routine holistic care."

1 in 20 Over 50 Have Knee Replacements

2012-02-14T00:40:00.000-08:00

Nearly 1 in 20 Americans older than 50 have artificial knees, or more than 4 million people, according to the first national estimate showing how common these replacement joints have become in an aging population.

Doctors know the number of knee replacement operations has surged in the past decade, especially in baby boomers. But until now, there was no good fix on the total number of people living with them.

The estimate is important because it shows that a big segment of the population might need future knee-related care, said Dr. Daniel Berry, president of the American Academy of Orthopedic Surgeons and chairman of orthopedic surgery at the Mayo Clinic in Rochester, Minn. He was not involved in the research.

People with knee replacements sometimes develop knee infections or scar tissue that require additional treatment. But also, even artificial knees wear out, so as the operations are increasingly done on younger people, many will live long enough to almost certainly need a second or even third knee replacement.

The new estimate comes in an analysis being presented Friday at the academy's annual meeting in San Francisco.

"These data are sobering because we didn't know what an army of people we've created over the last decade," said Elena Losina, lead author of the analysis and co-director of the Orthopedics and Arthritis Center for Outcomes Research at Harvard's Brigham and Women's Hospital. "The numbers will only increase, based on current trends."

Replacement joints can greatly improve quality of life for people with worn-out knees, but they're not risk-free and it's a major operation that people should not take lightly, she said.

Modern knee replacements in the United States date back to the 1970s. Since then, advances in materials and techniques, including imaging scans to create better-fitting joints, have made the implants more durable and lifelike, surgeons say.

Losina and colleagues came up with their estimate by analyzing national data on the number of knee replacements done from 1998 to 2009, U.S. census data, death statistics, and national health surveys.

For example, in 2009, more than 600,000 knee replacement operations were done nationwide. The study estimate includes people who had knee replacement operations that year and in previous years who are still living.

Overall, 4.5 million Americans are living with artificial knees. That includes an estimated 500,000 who have had at least two replacement operations on the same knee.

Knee replacements are most common in people older than 80 — 1 in 10 people in this age range have them, the study found. Though they're less prevalent in people younger than that, there are still more than half a million Americans in their 50s with the artificial joints, and based on current trends, operations in that age group are expected to increase.

According to the federal Agency for Healthcare Research and Quality, knee replacements tripled in people ages 45 to 64 between 1997 and 2009.

Doctors think two trends have contributed to that increase: the nation's obesity epidemic and amateur athletes who don't adjust workouts to spare aging or even injured joints. Both can lead to or worsen arthritis, the main reason for replacing knees.

Donna Brent, 63, is in the latter category. The Deerfield, Ill., administrative assistant says decades of racket ball, tennis, softball, and other sports took a toll on her knees, but she got used to living with the pain, even when she became bowlegged and developed a limp. When pain "started getting in the way of some of my sports," she gave in to her doctor's advice and had the operation last June on her right knee. She said she feels better than ever, is back to exercising, and plans to resume tennis and softball when the weather warms up.

During knee replacement operations, surgeons slice off a small portion of the worn-out surface on the ends of both leg bones that meet at the knee, then implant an artificial joint usually made of plastic or metal. Typical operations last about two hours, require a few days in the hospital, and cost roughly $40,000.

Artificial knees generally last 15 to 20 years. While some are promoted as lasting 30 years, these estimates are generally based on use among older people more sedentary than baby boomers who expect new knees to let them be as active as they were before surgery. Sometimes that's possible, though doctors often discourage knee replacement patients from engaging in high-impact sports including jogging.

The National Institute of Arthritis, Musculoskeletal and Skin Diseases paid for the study.

Aspirin Doesn't Cause Stomach Bleeding — It's Bacteria!

2012-02-14T00:37:00.001-08:00

A study is underway in the United Kingdom that could revolutionize the treatment of heart disease. Even though a small daily tablet of aspirin has been shown to lower the risk of cardiovascular disease, millions don't take it because of aspirin's long-term association with an increased risk of gastrointestinal bleeding. Instead of taking the cheap, over-the-counter pill, they're often prescribed expensive treatments that are frequently less effective.

But some scientists believe that aspirin, which was thought to irritate the stomach and cause ulcers, has been unfairly blamed for the bleeding. They believe the real cause is a common stomach bug — helicobacter pylori bacterium (H. pylori) — the same bacteria that causes stomach ulcers. The aspirin, they contend, only aggravates the problems caused by H. pylori.

Statistics show that one in four people are infected with H. pylori at some time during their lives, even though it often causes no symptoms. However, about three in 20 people who are infected with the bacteria will eventually develop a peptic ulcer.

Researchers from Nottingham University believe that by treating people who have the bacteria with antibiotics, more people would be able to take aspirin, which studies show lowers the risk of many medical problems including cancer.

One study at Nottingham found that 60 percent of people who took low-dose aspirin (81 mg) and were diagnosed with internal bleeding tested positive for H. pylori. The researchers theorize that the ulcer is caused by H. pylori and aspirin, which thins the blood and makes the ulcer bleed. If the bacteria is eliminated, the patient won't get an ulcer, and aspirin won't increase the risk of bleeding, the researchers theorize.

Currently, a new study called the Helicobacter Eradication Aspirin Trial is getting underway at five British universities. The randomized, double-blind, placebo-controlled trial will begin in March and will include 40,000 Brits more than 60 years old.

Patients who take less than 325 mg of aspirin daily (325 mg is a regular-sized aspirin) will first be tested for H. pylori. Those who test positive will be given an intensive one-week course of antibiotics authorized for H. pylori eradication (treatment will include 30 mg of lansoprazole, 500 mg of clarithromycin, and 400 mg of metronidazoleor — all given twice a day) or placebo tablets that look identical to the antibiotics.

Studies have shown that aspirin is an effective medicine for many conditions. They include:

• Heart attack. The National Heart Foundation reported a study stating that a daily low-dose aspirin lowered the risk of a nonfatal heart attack by 26 percent. Studies have shown that regular use of aspirin by those who have already suffered a heart attack lowers the risk of having a second heart attack, and may even lower the risk of a first heart attack in those patients at high risk. Most experts recommend a baby or low-dose aspirin (81 mg) daily. During an acute heart attack, chewing two full-strength (325 mg) tablets can help you survive long enough to get to the emergency room.

• Tension headaches. Aspirin eases pain in up to 75 percent of people with tension headaches. Patient.co.uk states that some trials suggest that full-dose aspirin is the most effective drug for relieving tension headaches.

• Migraine headaches. One British study of high-dose aspirin found it was effective in relieving both pain and nausea in more than half of those suffering an acute migraine. "Aspirin 900 mg or 1,000 mg is an effective treatment for acute migraine headaches, with participants in these studies experiencing reduction in both pain and associated symptoms, such as nausea and photophobia," Henry J. McQuay, DM, of the University of Oxford in England, and co-authors said in a statement. Some studies have shown aspirin is as effective as the prescription painkiller Imitrex, which is prescribed to treat migraines.

• Arthritis. For many years aspirin was the "gold standard" for relieving the symptoms of arthritis, and according to the University of Iowa Health Care, it's still the standard by which all other pain relievers are measured. Aspirin in high doses is often used round-the-clock to reduce the redness, swelling, and pain of arthritis. Aspirin in lower doses (one or two 325 mg tablets) combats muscle pulls and other minor ailments.

• Alzheimer's disease. Studies have found that a daily low-dose aspirin can slow and even prevent the onset of dementia, including Alzheimer's. A study of more than 3,000 people in Utah found that people who took aspirin, Advil, or Ibuprofen four times a week for longer than two years, reduced their risk of developing Alzheimer's by 45 percent. Experts theorize that Alzheimer's is caused by inflammation, which aspirin fights. The other theory is that aspirin's anti-inflammatory characteristics keep memory-destroying amyloid plaques from forming.

• Stroke. A study reported by the National Heart Foundation found those who took aspirin had a 25 percent reduction in risk of stroke and a 13 percent reduction in the risk of death compared to patients who didn't take aspirin. Aspirin may prevent ischemic (clot-related) strokes by slightly thinning blood. It interferes with the production of prothrombin, which is necessary for blood clots to form.

• Colon cancer. An article published in the Journal of the American Medical Association found that patients who used aspirin after being diagnosed with colon cancer had a 29 percent lower risk of dying than those who didn't use aspirin. In addition, those who began taking aspirin after a diagnosis of colon cancer reduced their risk from death by colorectal cancer 47 percent. A British study found that aspirin reduced the risk of colon cancer by 24 percent and the risk of dying from the disease by 35 percent. A new study found that people with Lynch syndrome, a genetic disorder that raises the risk of colon and uterine cancers, cut their risk in half. Researchers believe aspirin may control cancer cells by fighting inflammation.

• Prostate cancer. Aspirin may stop a recurrence of prostate cancer. A study from the University of Chicago found that anti-clotting medication, such as aspirin, lowered the chances of prostate cancer returning by 46 percent, and the anti-cancer benefit was more pronounced in those men who took aspirin.

• Breast cancer. Researchers found that women who took aspirin lowered their risk of dying from breast cancer by 50 percent and also cut their risk of recurrence by half. "Taking aspirin may become another simple, low-cost and relatively safe tool to help women with breast cancer live longer, healthier lives," said study leader Dr. Michelle Holmes of Harvard Medical School.

• Prostate cancer. Patients suffering from prostate cancer who had been treated with either surgery or radiation and who took anticoagulant drugs such as aspirin, dramatically lowered their risk of dying from their disease. After 10 years, those men who took anticoagulants had a 4 percent risk of dying compared to 10 percent for men who didn't take the drugs.

• Age-Related Macular Degeneration. Harvard researchers found that women who took low-dose aspirin to safeguard their hearts, also reduced their risk of age-related macular degeneration (AMD), an eye disease that destroys the central vision, by 18 percent.

Risk Factors for COPD Patients - An Expert Reveals Who Gets The Disease

2012-02-14T00:35:00.000-08:00

What is COPD? Are all COPD patients either smokers or former smokers? The answer, primarily, is yes. But there are other ways to get chronic obstructive pulmonary disease. Lighting up is the most common trigger, but read on for other possible causes and treatments. Plus, how much do you know about COPD?

Chronic obstructive pulmonary disease (COPD) isn’t just for smokers. Although smoking increases your risk drastically, there are other ways to get the disease, which is actually a combination of disorders.

“There are a lot of terms we use loosely in COPD,” says Mark Millard, M.D., medical director of the Martha Foster Lung Care Center at Baylor University Medical Center in Dallas, Tex.

“Emphysema is one [and] chronic obstructive bronchitis is another,” he says. “But all of these are characterized by airflow obstruction that’s not fully reversible.”

Identifying the cause is important because it affects your treatment.

In this Lifescript exclusive interview, Millard discusses risks factors for COPD, as well as how the disease is diagnosed and treated.
What is COPD?
COPD is an acronym.

C stands for chronic – in other words, this doesn’t go away. It’s always there.

O stands for obstruction, which defines the problem. When you blow out, you can’t get enough air out of the airways. You can get air in, but getting air out is the problem.

P stands for pulmonary, which is a lung problem.

And D means it’s a disease.

How do patients get a COPD diagnosis?
The only way to make a definitive COPD diagnosis is through a breathing test with a [device called a] spirometer.

It measures airflow obstruction, and the time to do it is when [the patient is] sick with bronchitis.

That’s when you find out if this is somebody with just a cold – in which case the breathing test may be normal – or if this is someone with COPD.
Exhaling issues are a symptom of asthma. What’s the difference between COPD and asthma?
In asthma, it may be fully reversible. An asthmatic [patient] may have a problem getting air out because the airway is narrowed by a bronchospasm [an abnormal contraction of muscles in the bronchi, large air tubes in the lungs].

However, when you take your quick-relief medicine or a daily controller drug, suddenly airways are open and normal.

Asthma is characterized by significant improvement, if not normalization, after treatment.

And COPD doesn’t normalize after treatment?
COPD is characterized by airflow obstruction that’s not fully reversible. It may get a little better with medication, but if it doesn’t get [significantly] better, that’s COPD.

Are COPD patients more likely to be smokers?
If you look in the U.S., 95% of COPD patients have smoked at least a pack a day for 10 years.

If you never smoked and have a COPD diagnosis and you live in this country, it’s one of three things:

The most common is the doctor made the wrong diagnosis. We’re not supposed to admit mistakes, but, frankly, we make mistakes in medicine.
The second is a [genetic] alpha-1-antitrypsin deficiency that predisposes some people to emphysema. People can develop emphysema at an early age if they smoke, and in older years even if they never smoked.

A very heavily polluted environment is the third way people can get chronic obstructive pulmonary disease.

The most common cause in the Third World is tobacco smoke, but there are also women who live in one-room huts and have open-source heating and cooking.

They heat and cook on a stove that’s not ventilated. It dumps pollution into the enclosed environment in high concentrations.

They become COPD patients without ever having smoked a cigarette because they’re in that smoke all the time.

So those environmental causes are mostly in Third World nations?
The majority of them are. That doesn’t mean air pollution and secondhand tobacco smoke can’t exacerbate lung disease, but it’s usually not a primary cause of COPD.

Is alpha-1-antitrypsin a missing component to the genetic makeup of some COPD patients?
It’s kind of like blue eyes, a recessive gene. You have to have two alpha-1-antitrypsin deficient genes to get emphysema.

Or, if you smoke crazily and have maybe one gene, you’re predisposed [to COPD].

But the classic alpha-1-antritrypsin person is younger when [they] develop emphysema without smoking or just with trivial smoking.
Is there a group of people who are predisposed to the alpha-1-antitrypsin deficiency?
It happens more in Scandinavians or northern Europeans. So areas of the U.S. that have more northern Europeans are more likely to get it than [areas with more] Latinos, African-Americans or Native Americans.

Is there a treatment for COPD patients that addresses the alpha-1-antitrypsin deficiency?
Treatment includes replacing the enzyme. You can blunt the decline of disease by monthly infusions.

The alpha-1-antitrypsin enzyme is very important to reduce stress on the airways and prevent inflammation from damaging air sacks.

When you don’t have it, the bad enzymes act like Pac-Men and chew up your lungs as opposed to being squelched by the good enzymes.

If enzyme therapy is effective in people with the genetic deficiency, why can’t it be used in COPD patients who have smoked?
It doesn’t work. We don’t understand all the genetic factors that go into why people get COPD.

We understand that it runs in families [and] it’s clearly triggered by tobacco and usually heavy smoking.

There are a lot of intriguing theories as to why [COPD happens to smokers]. The lungs may actually be sensitized.

The tobacco smoke may in some way cause the body to think the lung is a foreign substance and go after it, in the same way [your body] would reject a transplanted kidney or liver.

Is a COPD diagnosis more prevalent in women than men?
The Virginia Slims revolution really turned nasty because women may be more susceptible to the effects of tobacco smoke than men.

Why?
We don’t know why – but we do know that more women die of lung cancer now than men.
Lung cancer is the leading cause of death from cancer in men and women. Lung cancer surpasses breast cancer in women in terms of its lethality.

Women seem to be more susceptible to the effects of tobacco smoke, and we’re seeing many [more] women COPD patients than men.

What treatments are available for those who don’t respond to enzyme replacement therapy?
The most important treatment for COPD patients is to stop smoking. Your lung function may not improve that much when you stop smoking, but it doesn’t get worse – and the disease certainly won’t progress any faster in a nonsmoker than a patient who is still lighting up.

Do the lungs still decline in function?
COPD is a two-sided coin. The first part is shortness of breath, but the second is exacerbation, which is essentially an acute episode of bronchitis.

If you have COPD and continue to have repeated episodes of bronchitis – where you need antibiotics and prednisone, and you seem to be sick forever several times a year – you may have continued decline of lung function even if you stop smoking.

How does that affect treatment?
COPD [treatments] are almost all inhaled medications that reduce shortness of breath.

We have two classes of bronchodilators [which open the bronchi] and combinations of bronchodilators and cortisone derivatives that are somewhat like the ones used to treat asthma.

They’re usually at a higher strength, however, to reduce shortness of breath in COPD patients.
Can exercise help COPD patients?
It can be a struggle. COPD patients have to keep moving.

The problem is that if they move too fast or breathe so they’re panting, their lungs will hyperinflate (fill up with too much air that cannot be exhaled) and they stop.

Then, they get depressed because they’re afraid to do any more. But they get out of shape, so when they try to do something it takes even more air because their muscles are very inefficient and they’re breathing faster.

Pretty soon they can’t get out of the chair without panting, much less go to the bathroom.

What can COPD patients do to avoid that vicious cycle?
[They can get] pulmonary rehabilitation – and that’s why it’s now a covered Medicare benefit.

A little less than half of COPD patients have Medicare, and slightly more than 50% are below the age of Medicare. The younger ones usually have a milder form of the disease.

In a six-week rehab program tailored to people who get short of breath with activity, they teach strategies for getting from here to there without feeling like you’re going to die.
What does that rehab entail?
Pacing yourself. Don’t do a sprint. Take it easy and practice a breathing technique called “pursed-lip breathing.” Breathe in through your nose and then out through your mouth with your lips pursed as though you’re whistling.

That creates enough backpressure in your airways to keep them from collapsing or narrowing as you exhale.

Do COPD patients get stronger as they exercise?
You’ll be able to get much farther down the road before you have to stop. Then you can start to train yourself as you increase activity.

If you train your muscles, it takes less air for the same amount of activity so you can recapture some of that territory you’ve lost because of de-conditioning and muscle inactivity.

What lifestyle changes and home remedies are available?
Don’t smoke. If you don’t smoke there are a whole host of diseases you can cross off your list.

Lightning can strike, but it’s rare. If you don’t smoke, your likelihood of getting COPD is the same as winning the Texas lottery.

For more information, visit our COPD Health Center.
How Much Do You Know About COPD?
Chronic obstructive pulmonary disease (COPD) is on the rise, according to the National Institutes of Health. More than 12 million people in the U.S. are currently diagnosed with it, and another 12 million may have it but don’t know.

THOUGHT FOR THE DAY...

2012-02-13T02:06:00.003-08:00

May the world be kind to you, and may your own thoughts be gentle upon yourself.

FUN FACTS - AND A GREAT WAY TO MAKE EXTRA INCOME AND LOTS OF IT WITH MJ TLC - AND - CHECK OUT " WWW.MELODY'SHAPPYWORLD.COM " FOR A FREE WAY TO BRING HAPPINESS, LOVE AND HOPE TO THE WORLD WE LIVE IN!!

2012-02-13T01:44:00.000-08:00

* Most liquid laundry detergents are alive with living organisms that help to break down stains! *

* Most dust particles in your house are made from dead skin! *

* Liquid TIDE laundry detergent glows under a blacklight. *

* Iron weighs more after it rusts. *

* If you are locked in a completely sealed room, you will die of carbon dioxide poisoning first before you will die of oxygen deprivation. *

If the chemical sodium is dropped into water it will immediately and violently explode. *
___________________________________________________________________________

WWW.MELODYSHAPPYWORLD.COM - "True happiness is not looking back with regret, but looking forward to the future and creating your own exciting, magnificent destiny and masterpiece, YOUR LIFE!"

MELODY JENSEN IS THE MOST WONDERFUL PERSON AND THE GREATEST HUMANITARIAN I KNOW. CHECK OUT MELODY'S HAPPY WORLD, IT'S FREE!!

ASSOCIATIONS:
WWW.MELODYSSECRET.COM

The Exercise That Helps Parkinson's Patients Walk

2012-02-13T01:36:00.001-08:00

The slow, controlled motions of tai chi can help the impaired balance of people with mild or moderate Parkinson's disease, and the improvements persist for at least three months, according to a small study out Wednesday.

Compared with people who received stretching exercises, tai chi practitioners had fewer falls, longer strides and better balance, researchers found.

"Tai chi fits very well to address the problem Parkinson's disease patients face," said Fuzhong Li of the Oregon Research Institute in Eugene, whose findings appear in the New England Journal of Medicine.

Difficulty walking and remaining standing are hallmarks of Parkinson's, which results from the death of brain cells that generate the chemical dopamine.

"We're not going to get rid of the symptoms. It's not a drug. It can't cure the disease. But, in my view, it can slow down the progression of the disease," Li told Reuters Health.

Although not all studies agree, other research has shown that because it is a balance-based exercise, tai chi may help improve strength and reduce falls in older adults. But there are few large studies in Parkinson's patients.

Li and his colleagues sent 195 seniors, all from Oregon, to one of three classes that met twice weekly for an hour. All could stand unaided, but some needed a device to help them walk.

The tai chi exercises were designed to improve balance with a controlled displacement of the center of mass. Resistance training with ankle weights and weighted vests was used in a second group to strengthen muscles important to posture, balance and gait. A third group had classes that involved gentle stretching.

People in all three groups started off with similar 64-point scores on a 100-point scale that measured how far they could lean or shift their center of gravity without falling.

But after 24 weeks of classes, those in the stretching group saw their average score drop by two points, indicating some deterioration in their condition.

The typical score rose by four points in the resistance group and by 10 points among the tai chi practitioners.

All of the volunteers were tested when their medication was working and their symptoms were controlled.

The improvement with tai chi was even more significant on a test to see how far the person could move toward a target without extraneous movement.

Stride length, walking velocity, knee movement and other measurements also showed more improvement. And people who did tai chi reported only 62 total falls during the training -- less than half of what the other groups reported.

Three months after the classes stopped, some of the benefits persisted. For instance, tai chi practitioners had 60 percent fewer falls than the resistance-training group and 69 percent fewer than the stretching group.

"This is the first time to my knowledge that a study was able to show some durability as a treatment for balance," Li said. "This was a big gap in a research field that didn't have any follow-up data with an exercise regimen."

There was, however, some slippage. The average score for leaning and shifting gravity, which had improved by 10 points in the tai chi practitioners, appeared to drop slightly.

The nice thing about tai chi, he said, is that "this is not equipment-dependent. It can be practiced at any place, at any time."

Parkinson's affects at least 500,000 Americans, most of them elderly, according to the National Institute of Neurological Disorders and Stroke, which funded the new study.

The cost of tai chi classes varies, but prices are typically similar to those of other types of exercise classes.

Cancer Drug Reverses Alzheimer's in Mice

2012-02-13T01:26:00.001-08:00

A widely available cancer drug has shown remarkable success in reversing Alzheimer's disease in mice, raising hope of a breakthrough against incurable dementia in humans, US researchers said Thursday.

Mice treated with the drug, known as bexarotene, became rapidly smarter and the plaque in their brains that was causing Alzheimer's started to disappear within hours, said the research in the US journal Science.

"We were shocked and amazed," lead author Gary Landreth, a professor in the Department of Neurosciences at Case Western Reserve University School of Medicine in Ohio, told AFP.

"Things like this had never, ever been seen before," he said.

The drug works by boosting levels of a protein, Apolipoprotein E (ApoE), that helps clear amyloid plaque buildup in the brain, a key hallmark of Alzheimer's disease.

"Think of this as a garbage disposal," Landreth said.

"When we are young and healthy, all of us can basically get rid of this (amyloid) and degrade it and grind it into small bits and it gets cleared.

"Many of us will be unable to do this as efficiently as we age. And this is associated with mental decline or cognitive impairment."

Six hours after mice got the drug, which works through the liver to boost retinoid X receptors (RXR), stimulating production of ApoE in the brain, soluble amyloid levels fell 25 percent, ultimately reaching a 75 percent drop.

The effect lasted up to three days, said the study.

Soon after taking the drug, mice began performing better in tests, showing that they were able to remember things again, were more social and were able to smell again, a sense that is commonly lost in Alzheimer's.

Also, unlike normal mice, Alzheimer's mice will not usually build nests if given tissue paper in their cage, as if they have forgotten to associate paper with the opportunity to nest.

But 72 hours after treatment, the Alzheimer's mice began to build nests again.

"They are not great nests but they are nests nonetheless," added Landreth, suggesting that if the drug can be shown to work in humans it might be best targeted at people in the early stages of the disease.

Clinical trials for humans are being designed and should produce early results in the coming year, researchers said.

Bexarotene was initially made by US-based Ligand Pharmaceuticals under the brand name Targretin.

It gained orphan drug status in the United States — approval by the US Food and Drug Administration — in 1999 as a treatment for cutaneous T-cell lymphoma, a rare cancer of the immune system that manifests in the skin and liver.

The Japanese pharmaceutical giant Eisai bought the worldwide rights for it in 2006. Bexarotene is now available in 26 countries in Europe, North America and South America.

Scott Turner, director of the Georgetown University Medical Center's Memory Disorders Program, who was not involved in the research, welcomed the findings.

"This looks very exciting," he said. "This is a brand new way to move forward in human trials of Alzheimer's disease and it works great with mice."

Turner, a neurologist and leading expert in Alzheimer's disease, however cautioned that more study was needed to see if the same results can be seen in humans.

"One obstacle is that the mice may not be a good model of Alzheimer's disease. We have so many things that work in mice and we try them in humans and they just completely fail," he said.

Bexarotene has a good safety profile, though women who are pregnant or may become pregnant are warned to stay away from it because it risks causing fetal defects.

Typical side effects include diarrhea, dizziness, nausea, dry skin and trouble sleeping.

Since the drug is typically given to cancer patients, Landreth said there have been no anecdotal reports of improved memory in humans, since most do not live long enough to reach the stage of Alzheimer's.

"We have clinical consultants or dermatologists who use this all the time but they hadn't thought to look at this so there is very little anecdotal data around."

Trials should begin in the next month or so, Landreth said.

"Perhaps the most important thing is to ask the question: Does this drug work in human beings as it does in mice? Does it get into the brain? And does it have an effect on amyloid levels and increase ApoE levels?

Coffee Fights Type 2 Diabetes Risk

2012-02-13T01:14:00.001-08:00

If you need one more excuse to pour another piping-hot cup o' joe, one study provides it.

According to research published in the journal Diabetes Care, regular coffee drinkers benefit from a substantially reduced risk of developing type 2 diabetes than their coffee-abstaining peers.

The study, conducted by researchers at the University of California, San Diego, was based on data from more than 900 adults.

Monitoring the subjects over the course of eight years, researchers noted that those adults who consumed coffee daily – even decaf blends – were a surprising 60% less likely to be diagnosed with type 2 diabetes.

The reduced risk held constant even when other dietary and lifestyle factors were taken into account.

Recovering Alcoholic Shares Her Struggle - Suburban Mom Tale of Getting and Staying Sober

2012-02-13T01:05:00.000-08:00

Giving up alcohol can be like losing a best friend: The bottle is a constant companion – to offer solace when you’re down and a good time when you want to party. In a revealing exclusive, recovering alcoholic Brenda Wilhelmson explains how she got sober...

The suburban mother of two, Brenda Wilhelmson helped her kids with their homework, worked hard as a journalist and shared an active social life with her husband.

She also drank with abandon: Martinis before dinner, a shared bottle of wine with the evening meal and a post-dinner to top it off.

Wilhelmson partied hard on weekends too. Her “nighttime” friends – fellow drinkers outside her sober, daytime social sphere – shared her passion for alcohol and didn’t flinch when she blacked out or drove home drunk.

Then, 8-1/2 years ago – following a sickening two-day bender – she decided she couldn’t take another sip.

"Every day I was with the same people, attended the same dinner parties, did the same drinking over and over,” Wilhelmson says. “I didn’t want that life anymore."

So she quit drinking, joined Alcoholics Anonymous’ 12-step program and chronicled her difficult journey toward getting and staying sober
in a journal and book, Diary of an Alcoholic Housewife (Hazelden).

In this exclusive interview, Wilhelmson, now 47, talks about her life as a hidden, alcoholic mom, and offers tips to recognize whether you – or a friend or loved one – has a drinking problem.

How did you know that you were an alcoholic?
About 16 years ago, when my son Max was 2, I thought of myself as a “problem drinker.” I could never drink just a glass or two of alcohol. Any time I drank, I got drunk. But [still] I didn’t think I was an alcoholic.

It’s difficult to know when you’ve crossed the line – that you’ve had enough and must put the liquor away.

My drinking escalated over the years. By the time I quit, I had blacked out [several times], and the next day I’d say, “I won’t drink today.” Then at dinner I’d be shaking a martini.

I realized I was an alcoholic two years before getting sober.

Did you intentionally choose friends who drank as you did?
Definitely! I wanted to hang out with people who drank like me. My dad
and grandfather were alcoholics. That kind of drinking seemed normal to me.

My daytime friends didn’t drink, and that was OK. I socialized with my drinking friends at night, because they didn’t make me feel guilty. If I went to dinner with friends who were light drinkers, I felt uncomfortable.

Did your husband have an impact on your alcohol consumption?
I [thought] my husband drank as much as I did, [that] we were on an even playing field. [But] we weren’t.

I already had consumed one or two martinis when he came home from work. Then he’d have one and I’d join him. We’d have wine with dinner. Afterward, I’d open a bottle of wine and pour myself [more].

I thought he was keeping up, but it was clear later that he wasn’t drinking as much as me.

When I quit, he drew way back. He rarely drank at home. He’s not an alcoholic.

What prompted you to stop drinking and become a recovering alcoholic?
About 9 years ago, I attended two drinking parties back to back and drank until I blacked out. When I awoke the next day, I realized I’d fallen and cracked my head. It was pounding.

I was supposed to go out that night and drink again. When I was getting
ready to go, I realized I couldn’t do it anymore. I was disgusted with my drinking and how I was living.

[Afterward] I stayed sober for about two weeks.

I drank again on Christmas Eve and the day after that. Then, on Dec. 27, 2002, I stopped and haven’t had a drink since.

Did you decide to get sober because you weren’t taking proper care of your kids?
Not at first. I was able to do everything I was supposed to do as a parent.

My daytime friends – my book club group and parents of my kids’ friends – had no idea [I was an alcoholic].

I was a very active, involved mother.

I helped with homework and cooked good meals. I did most of those duties hung over, though. Then I’d start drinking at 5 p.m. when cooking dinner.

I did worry, when Max was 10 years old, that I was setting a bad example. He got anti-drinking messages at school and made comments to me that alcohol is bad. He was noticing my drinking.

To get sober, you turned to a 12-step program. Is support vital for recovering alcoholics?
I definitely recommend it. At first, it was hard for a high-functioning
[recovering alcoholic] like me to sit in meetings and hear the awful stories about people who ended up in jail and homeless.

Over time, [however] I started recognizing that some of the bad things I heard about could’ve happened to me. One person smashed her car into a vehicle with teenage boys in it, and went to jail because of it.

That was a huge wake-up call to me [because] I had driven home in a blacked-out state.

What helps you stay sober?
For me, going to meetings and working the 12 steps are most important. Without them, I wouldn’t have stayed sober. I still go to meetings at least once and sometimes twice a week.

The 12 steps teach us not to glamorize what we used to do and not to pick up that first drink again. For years now I’ve imagined what would happen if I drank again.

Early on, I had to talk myself out of taking a drink. Now, having worked through that urge, I don’t think about drinking. I know I can’t have just one.

What was the hardest part about being a recovering alcoholic?
During the first year, learning how to live my life and get through [big] events without drinking. I faced every holiday and wedding [or] people
getting sick, without being able to drink. It was very hard.

Would you advise a recovering alcoholic to stay away from hard-drinking friends and family?
It’s wise to question your motives if you go to an event where there’s drinking.

If a family member is getting married, that’s a good reason to be there. If not, don’t put yourself in those situations.

Early in my recovery, I foolishly put myself in such situations. Then I saw alcoholic behavior from sober eyes and it was ugly.

Also, I quickly realized I couldn’t be around alcohol. One whiff of booze and it would be over for me. I didn’t want to live like that.

Do you still struggle every day with the urge to have a drink?
I work hard to remind myself that recovery is never done.

One good thing about attending meetings is that periodically I hear someone talk about drinking again after 25 years. That’s tough.

It’s fortunate they’re back now, because many people get taken down the old road fast and don’t get a second chance.

At first you didn’t tell most people that you were recovering alcoholic – why?
Beyond family and close friends, it wasn’t anyone’s business. [I lived] in a
tight-knit community Chicago suburb [and] I didn’t want my children’s friends’ parents gossiping about me.

Also – and important at the time – I didn’t want people judging me if I decided to drink again one day [and saying] that a recovering alcoholic was drinking again.

Given your alcoholism, would you go back to the past if you could and forgo that first drink?
I don’t regret my past. I am who I am today because of what I’ve been through and what it taught me. I don’t want my children to go down the road I did, though – or anyone else.

What did you learn as a recovering alcoholic?
That life is a lot better without drinking. If you’re a problem drinker and disgusted with how you’re living, you have a choice.

Life is hard, and getting and staying sober isn’t easy. But my life is so much more interesting and adventurous without drinking.

I felt for years that I was anesthetized. Today, I’m living in the moment. I feel my emotions, and it’s a roller coaster ride. It’s not boring – which is
what you think when you’re an alcoholic. It’s exciting.

What are red flags of alcoholism?
It’s a bad sign if whenever you drink you can’t stop or wind up drunk. Also, if you’re blacking out – it doesn’t have to be every time – that’s a warning sign. If controlled drinking isn’t fun for you, beware.

What’s your advice for helping a girlfriend who’s drinking heavily?
If you want to have a conversation about it, don’t do it if the friend is drunk. She won’t listen or remember.

Catch her when she’s sober, but not feeling great. Ask her how she feels or if she’s thinking about quitting.

If she doesn’t want to stop drinking, there’s nothing you can do. The only way a person quits drinking is if they want to stop.

Al-Anon gives great advice about how to handle an addicted loved one. We
can only control our behavior [and] how we react to them and make decisions based on what’s healthy for us.

What advice do you have for women struggling with alcoholism?
Be honest. Admit to yourself what you already know, and if you need help, get it.

Do You Drink Too Much?
The one or two glasses of wine you drink at the occasional meal when you dine out are no big deal, but what about the standard two glasses of wine you have with every dinner? Could this love of Chardonnay mean that you drink too much? Many people wonder the same thing – whether or not their drinking habits are over the top.

9 Proven Treatments for Overactive Bladder - Lifestyle Changes, Medications to Combat OAB Symptoms

2012-02-13T01:00:00.000-08:00

Do you have an urge to pee – constantly? It might not be your coffee habit; you could have an overactive bladder. But not to worry. These latest treatments and helpful tips can take the urgency out of your day…

A coffee refill, another glass of wine – they’re sure to send you to the ladies’ room. But are you taking far more bathroom breaks than you used to without knowing why? And what’s considered normal anyway?

Generally, eight bathroom visits a day is typical.

More breaks than that – especially if they disrupt your day or wake you at night – could mean you have an overactive bladder (OAB), according to D.C. urologist Arnold J. Willis, M.D., a faculty member at George Washington University Medical School.

“The real issue is urgency and whether the frequency [of bathroom breaks] interferes with the quality of your life,” Willis says.

About 17 million people suffer from OAB, the often sudden and compelling urge to urinate – and an occasional inability to hold back until you reach the toilet.

Although it’s more common as we age, women in their 30s and 40s are at particular risk, says Willis.

That’s because pregnancy and childbirth can weaken pelvic floor muscles, which support the bladder and relax every time you urinate. And the estrogen loss that comes with menopause dries vaginal tissues, shortening and weakening the muscle pressure around the urethra (the tube that carries urine from the bladder), leading to leaks.

Why the waterworks? Essentially, something’s wrong with how your bladder lets the brain know it’s time to pee.
Normally, when the bladder’s three quarters full of urine, the sacral nerves that control the bladder tell your brain that you have to go. As you pee, bladder muscles contract, forcing urine to flow.

If you have an overactive bladder, the sacral nerves start signaling an urgency to urinate too early – when the bladder is only half full – and the bladder muscles contract more often and more urgently. It all leads to more frequent bathroom trips and occasional leaks.

It’s not curable, but is it possible to manage OAB and get back your life? Yes!

Here are doctor-recommended tips and medical breakthroughs to bring you relief:

Lifestyle Changes to Lessen the Urge
Upping your tolerance of OAB symptoms can help you avoid accidents and discomfort. Here are 6 key ways to get through your day:

1. Limit your liquids.
The less you drink, the fewer times you’ll have to go.

While doctors generally recommend sipping 8-9 cups of water a day, according to the Mayo Clinic, how much to drink when you have OAB depends on the person, so ask your doctor for guidelines, Willis says. It could be one of the causes of frequent urination.

What you’re drinking also affects your urge to pee.

“Caffeine and alcohol are diuretics,” says Judd Boczko, M.D., a urologist in private practice in White Plains, N.Y. “So they cause you to make more urine.”

They’ll also stimulate the bladder, he adds, as will decaffeinated coffee – it’s not totally caffeine-free – and green tea. This causes extra irritation that the nerves sense, which makes you think you have to pee when you don’t.

Switching to decaf teas and other liquids will help.

2. Put the squeeze on.
If you’ve had children, you’re probably familiar with Kegel exercises, the repeated squeezing of pelvic muscles that helps women push during childbirth. Those same muscles control the flow of urine.

“Kegels strengthen the pelvic floor muscles that affect bladder control,” says Boczko, who recommends doing at least ten 10-second squeezes three times a day to keep from leaking.

Willis recommends even longer Kegels workouts: 15-20 minutes twice a day.

“You may say, ‘I don’t have time,’” he says. “But you can do them while you’re listening to music or at a stoplight.”

3. Lose the excess weight.
“The heavier you are, the more weight you place on your pelvic floor muscles,” Willis says. Pressure on these muscles weakens them, meaning more little leaks.

Excess weight also increases pressure on the bladder, he adds, making you feel an urge to pee.

4. Focus on fiber.
Because the bladder and bowel are next to each other, constipation can be one of the causes of frequent urination.

“You can stretch the pelvic floor muscles by straining [to move your bowels],” Willis says.

To stay regular, add more fiber to your diet with foods like brown rice, whole wheat bread, fruits and vegetables. Willis also recommends taking a fiber supplement, like Metamucil, twice a day.

5. Keep your cool.
Spicy foods like chili, taco sauces and wasabi can irritate the bladder lining, increasing your urge to go, according to Willis.

Choose milder spices like cilantro, mint and oregano to flavor dishes.

6. Take time to unwind.
Mortgage payments, deadlines, crowded commutes – all that stress affects your bladder, making you have to go even more, although doctors are unclear why, says Boczko.

So keep stress levels low – with relaxation techniques such as meditation, deep breathing exercises or progressive muscle relaxation, says Willis.

His tips: When you’re starting to stress, breathe in slowly to the count of 10, then release your breath, again counting to 10. Repeat several times throughout the day.
To relax muscles, lie on the floor, tensing and releasing various muscle groups one by one, starting at your head and moving down to toes.

If you’re frequently stressed, see a psychotherapist, who can prescribe an antidepressant like amitriptyline (Elavil) to lessen anxiety, Boczko advises.

Medical Options to Manage OAB
Lifestyle changes can help, but only in conjuction with medical treatment, says Willis. Here’s what your doctor may recommend:

1. Medication
Lifestyle changes are the first line of OAB defense, but if you don’t get relief, your doctor may prescribe an antimuscarinic. This category of drugs blocks nerve endings to the bladder, making it contract less often and less urgently so you don’t feel the urge to pee.

But too high a dosage can shut you down altogether – stopping bladder contractions and keeping you from urinating, says Willis. “So we start low and work up to a dosage that’s effective.”

Patients are asked to keep a diary for a month or two, logging each time they use the bathroom so a doctor can monitor the drug’s effects.

Side effects include dry mouth and eyes, constipation and, in rare cases, blurred vision. “In those cases, you might have to cut back on dosage or switch drugs,” Willis says.

If you have narrow-angle glaucoma, a progressive eye disease, check with your eye doctor before taking these drugs, because they can increase pressure within the eye, aggravating symptoms.
2. Non-surgical treatments

Urgent PC: Doctors may also treat OAB with a non-surgical procedure, such as the office-based treatment Urgent PC.

In this technique, approved by the Food and Drug Administration (FDA) in 2005, the doctor inserts a small needle near your ankle that’s hooked up to an electrical stimulator and sends impulses up your leg to the sacral nerves, disrupting the nerve signals that normally make you have to pee.

The result: more bladder control.

“It’s like acupuncture,” Boczko says. “A patient comes in once a week for 12 weeks for a half-hour. Then I taper [off] the treatments.”

Most patients need repeat treatments every six months, although some can stop after one round.

How well does it work? A 2010 multi-center trial found that 60% of patients improved after treatment, compared with only 22% of the control group – a similar result to studies on OAB medicines, says Boczko.
Renessa: This non-surgical option is used for women who pee before reaching the bathroom, says Willis.

“It’s very innovative and gets women out of diapers,” he says.

In this treatment, a doctor inserts a small tube into the bladder through the urethra and applies a low-temperature heat that mildly damages tissue. When the treated tissue heals, it’s firmer, tightening the urinary tract opening so it won’t leak.

The procedure requires nine in-office treatments that take 60 seconds each.

Is it effective? A 12-month multi-center U.S. clinical trial involving 250 women found that 76% were incontinent less often and 58% no longer had to wear pads.

Botox: While still only in experimental stages and not FDA-approved for this purpose, some doctors inject Botox directly into the bladder wall, according to Willis.

Patients undergo multiple injections and treatments, and it has been shown to help with relaxing bladder muscles and the OAB urge to go.
3. Surgery
For patients who don’t respond to lifestyle changes, medication or non-surgical options, a doctor may recommend sacral nerve stimulation. A small device is permanently and surgically implanted in a patient’s bottom that automatically sends impulses to the sacral nerves, delaying signals to the brain telling it you have to go.

“By sending direct electrical impulses to those nerves, you moderate the bladder’s threshold,” Boczko says.

For example, if you feel the need to urinate when your bladder is holding only 2 ounces of urine, the implant may delay the nerve signal so you get an urge only when the bladder is 8 ounces full. (A healthy bladder can usually hold up to 16 ounces of urine for 2-5 hours, according to the National Institute of Diabetes and Digestive and Kidney Diseases.)

This surgery has drawbacks, says Boczko: The battery has to be changed every 5-8 years. And the lead wires may get dislodged and have to be reinserted.

But it's effective: According to a 2007 review of a multicenter trial involving 163 patients with incontinence and overactive bladder, 65% were helped by sacral nerve stimulation.

Health writer Dorothy Foltz-Gray is a frequent contributor.
Are You Having Bladder Problems?
Leak when you laugh? Have a constant urge to pee? Incontinence is a problem that can be managed. Knowing the causes and common triggers can help you stay dry and out of the bathroom.

THOUGHT FOR THE DAY...

2012-02-12T01:01:00.001-08:00

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2012-02-12T00:58:00.000-08:00

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Hormone Replacement Therapy Can Cause Breast Cancer, Says Doc

2012-02-12T00:24:00.001-08:00

Does hormone replacement therapy (HRT) cause breast cancer? The "Million Women Study" (MWS) concluded in 2003 that HRT used to treat the symptoms of menopause raised the risk of breast cancer. Millions of women refused to take the hormones, which included estrogen and/or progesterone, and either lived with hot flashes and other symptoms of menopause, or with the fear of an increased risk for breast cancer.

Periodically, updates of the study have clarified the danger, saying estrogen-only treatments increase the risk of breast cancer by 30 percent, while treatments containing a combination of estrogen and progesterone raises risk twofold when compared to women who do not take hormones.

But last week, a new study said the MWS study was flawed, and a solid conclusion about the safety of HRT couldn't be drawn. So, are hormone replacement therapies safe? "That depends," says Dr. David Brownstein, editor of The Natural Way to Health newsletter and board-certified family physician.

"There is an increased risk of breast cancer with synthetic progesterone or Provera," Dr. Brownstein tells Newsmax Health. "This synthetic hormone is associated with a host of serious adverse effects including invasive breast cancer, heart disease, stroke, and irreversible osteoporosis.

"However, studies haven't positively shown an increase in breast cancer with estrogen," he said.

"The studies are confusing because some menopausal studies are done with women who are only taking estrogen, while other studies include women who take only progesterone," says Dr. Brownstein. "Progesterone alone does definitely cause breast cancer, and there is no reason it should be on the market."

"Some studies of estrogen or Primarin, have shown an increase in breast cancer, and some show none," he said. "It's about half and half."

Although the safety of synthetic HRT is questionable, bioidentical hormones are safe and effective, says Dr. Brownstein. "Bioidentical progesterone is made from plant products and has the same chemical structure as the progesterone that is produced in the body," he said.

"Not a single study has ever been shown to increase the risk of breast cancer," he said."In fact, there have been numerous studies that show natural bioidentical hormones reduce the risk of breast cancer, and other studies that show women who are markedly deficient in progesterone have a higher incidence of several cancers, including breast cancer.

"It's a crime that synthetic progesterone is still allowed in the marketplace," he said. "It's a toxic substance, and it should have been pulled from the market years ago.

"Natural bioidentical progesterone is available, and it does not cause the negative effects associated with synthetic progesterone," he said. "There's no reason to use the synthetic."

Fasting Weakens Tumors, Boosts Chemo

2012-02-12T00:22:00.001-08:00

Early research on mice with cancer shows that fasting may weaken tumors and help chemotherapy work better, scientists said on Wednesday.

While it remains unknown if the same approach could work in humans, or if it would even be safe, researchers said the findings suggest a promising new route of study for improving response to cancer treatment.

In the mice experiments, "the combination of fasting cycles plus chemotherapy was either more or much more effective than chemo alone," said senior author Valter Longo, professor of gerontology and biological sciences at the University of Southern California (USC).

Longo and colleagues previously published findings in 2008 that showed how fasting protected normal cells against chemotherapy in a study that focused on one type of cancer and a single chemo drug.

The latest study expands on that research to show that fasting makes cancer cells more vulnerable, and spanned several different types of cancer in mice.

Types of cancers studied included breast cancer, melanoma, glioma, and human neuroblastoma.

All cancers studied showed that fasting combined with chemotherapy improved survival, slowed the growth of tumors and/or limited their spread.

The study appears in the journal Science Translational Medicine.

"We don't know whether in humans it's effective," Longo said, adding that for now fasting should be "off-limits" to cancer patients, although they should feel they can ask their doctors about the possibility.

In 2010, a small study of 10 human cancer patients who tried fasting cycles with their drug treatment showed that they perceived fewer side effects from chemo, according to self-reported data. The study was published in the journal Aging.

The results of a phase 1 trial assessing the safety of fasting two days before and one day after chemotherapy in patients with breast, urinary tract, and ovarian cancer, conducted at the USC, have been submitted for presentation at the annual meeting of the American Society of Cancer Oncologists later this year.

"A way to beat cancer cells may not be to try to find drugs that kill them specifically but to confuse them by generating extreme environments, such as fasting that only normal cells can quickly respond to," Longo said.

Kids skip sunscreen

2012-02-12T00:21:00.001-08:00

It's hard to think of sunburn when you're battling sub-zero February temperatures every day -- but summer will be here soon enough.

And when it arrives, you can bet that two things will happen: You'll hear a lot of mainstream noise about the supposed importance of wearing sunblock... and kids will get sunburned anyway.

Now, that same mainstream is in a tizzy over a small survey that shows kids aren't interested in wearing sunscreen -- and that as they grow up, they simply stop putting it on.

Take that, mom!

The survey of 360 kids found that half of them used the stuff regularly when they were in fifth grade -- and half of them got sunburned at least once during the summer.

Three years later, the number of kids using sunscreen fell dramatically: By the time the kids reached eighth grade, only 25 percent of them reported using sunscreen regularly -- despite reporting even more time out in the sun.

More time in the sun, less sunscreen -- the mainstream coverage of this ends pretty much there. And naturally, they're all screaming for these kids to put on their sunscreen.

But here's the "rest of the story" -- the part you couldn't hear over those screams: In eighth grade, the number of kids reporting at least one sunburn didn't change. It was still 50 percent.

Maybe sunscreen isn't all it's cracked up to be after all.

And it's not just that these chemical goos don't work nearly as well as their backers claim. In fact, many of them are actually far more dangerous than a summer full of sunburns.

Common sunscreens contain well-known hormone-disrupting chemicals such as oxybenzone. Until recently, many sunscreens -- including some of the best-selling brands -- contained a form of vitamin A that could actually speed the growth of skin tumors.

In other words, the very chemicals that were supposed to protect people from sunburn and, eventually, skin cancers can actually cause the disease and speed its progression.

That's why the best defense against sunburn isn't a layer of dangerous chemicals. It's common sense: Get some sun at every age, because it's the best (and cheapest) way to get your vitamin D.

And when you've had enough, cover up -- or at least seek shade or head inside before you get burned.

Some kids will of course get burned anyway. So be it -- at least they're outside, where they belong, and not parked on the sofa.

On a mission for your health,
Ed Martin
Editor, House Calls

Get the ADHD Facts You Need to Help Your Child - Top 11 ADHD Myths and Facts

2012-02-12T00:20:00.000-08:00

Sometimes you envy your child’s energy. Other times you wonder if your Energizer Bunny will ever wind down. If that’s often the case, it’s possible your kid has attention deficit hyperactivity disorder (ADHD). Before you worry, get the truth behind 11 common ADHD myths...

If you've spent any time around schools, parks or other places children play, you've probably heard about ADHD – attention deficit hyperactivity disorder. “That boy is so hyper; he must have ADHD,” parents and teachers say, flinging around the label as casually as kids do with a ball.

But what is ADHD really?

According to the Centers for Disease Control and Prevention (CDC), five million children age 3-17 have this chronic brain disorder, which shows up as inattention, hyperactivity and impulsive behavior, worse than the norm for kids. Undiagnosed and untreated, the condition can affect your child’s self-esteem, schoolwork and friendships.

But every wiggle worm doesn’t have ADHD. Before you start wondering whether your child has ADHD, read on for the truth behind common myths.

1. Myth or Fact? ADHD is just a problem with organization.
Myth. While children with ADHD have difficulties organizing their time and activities, it's not the cause of the disorder, says Ben Vitiello, M.D., a psychiatrist and chief of Child and Adolescent Treatment and Preventive Intervention Research at the National Institute of Mental Health (NIMH).

A 2010 Michigan State University study found that a neurological problem contributes to ADHD symptoms by causing an imbalance in brain chemistry.
ADHD is due in part to a deficiency of the neurotransmitter serotonin (which helps with relaxation) and a child's tendency to get distressed over social situations, the research showed.

But that's not all: The brains of children with ADHD have thinner tissue and are less developed than those of children without the disorder, according to NIMH research.

Also, there’s often a 3-year delay in the development of an ADHD brain. This delay affects the front of the brain's outer mantle, or cortex, which controls thoughts, attention and planning.

In addition, a 2010 study by Harvard University researchers showed that kids exposed to certain pesticides, called organophosphates, seem to be at increased risk of ADHD.

2. Myth or Fact? ADHD is a result of poor parenting.
Myth. Stow your suitcase – you're not going on a guilt trip.

ADHD is a neurological problem that has nothing to do with discipline, says Vitiello. When a child with ADHD shouts in the library, it's not because his parents didn't teach him better – it's because he can't control his impulses.

In fact, strict parenting can make ADHD symptoms worse.

The best approach for children with ADHD is to seek professional guidance, which can include drug therapy, psychotherapy and behavioral treatment, Vitiello says.

3. Myth or Fact? ADHD doesn't affect girls.
Myth. In fact, this harmful myth may explain why NIMH statistics show that boys are diagnosed four times more often than girls.

Adults may ignore ADHD symptoms in girls because hyperactivity shows up “more often as hyper-talkativeness and hyper-reactivity" rather than rowdy behavior, says Kathleen Nadeau, a psychologist and director of Maryland's Chesapeake ADHD Center.

Hyper-reactivity is characterized by the tendency to be highly emotional and oversensitive, Nadeau says. As a result, girls with ADHD often have difficulty controlling their emotions in relationships, taking offense easily and escalating confrontations by making impulsive remarks.

Like their male counterparts, however, girls with ADHD are often inattentive, meaning they’re unable to stay focused and tend to lose important items, says Nadeau, who is also co-founder of the nonprofit National Center for Gender Issues in ADHD, a group that educates the public on the prevalence of ADHD in girls.

In girls, inattentiveness causes their self-esteem to suffer, putting them at risk for teen pregnancy, sexually transmitted diseases, anxiety and depression, Nadeau says.

4. Myth or Fact? ADHD is not the same thing as a learning problem.
Fact. Kids with ADHD have attention problems, which may lead to troubles with schoolwork, but a learning disability is a different diagnosis, says Alice Medalia, Ph.D., psychologist and professor at Columbia University Medical Center's Department of Psychiatry.
According to the CDC, 5% of children in this country have ADHD without a learning disability, 5% have a learning disability without ADHD, and 4% have both.

However, even children with ADHD who don’t have a learning disability can have learning problems, usually related to listening and oral expression.

In fact, half of children with ADHD have trouble with listening comprehension (understanding what people tell them), according to ADHD: Handbook for Diagnosis and Treatment by Russell A. Barkley, a research professor in the Department of Psychiatry at SUNY Upstate Medical University.

Barkley also directed a 2002 study showing that ADHD kids have speech problems as well as difficulty processing what they hear in class and in social situations.

5. Myth or Fact? There are more symptoms than hyperactivity.
Fact. It's the most in-your-face symptom, but there are actually three ADHD subtypes, with varying degrees of hyperactivity, according to NIMH researchers:

Predominantly hyperactive-impulsive: Children are mostly overactive and have trouble controlling their behavior.

Predominantly inattentive: Children aren't overactive but have trouble paying attention and remaining focused.

Combined hyperactive-impulsive and inattentive: A combination of the two.
So why do many people associate ADHD just with extreme restlessness?

Because "hyperactivity is so easily observed and so potentially disruptive, while inattention requires more thought and observation [to detect]," Nadeau says.

6. Myth or Fact? ADHD can be cured.
Myth. If it seems that ADHD symptoms have vanished, you're doing something right.

Some medications and behavioral treatments can quiet ADHD symptoms or sharpen children's focus and memory, helping students complete schoolwork and get along with kids who don't have the disorder, according to Medalia.

But miracle cures for ADHD?

"If you mean completely taking it away, [they don't exist]," Medalia says.

7. Myth or Fact? Eating too much sugar causes ADHD.
Myth. Many parents have watched their kids gobble down candy and moments later have ADHD-like behavior – bouncing off walls, shouting like maniacs and unable to focus. But sugary foods don’t cause ADHD, according to Medalia.

A 1995 report published in the Journal of the American Medical Association concurs: Scientists analyzed 23 separate studies of sugar on the behavior or cognition of children and found that it doesn't significantly affect how they act or think.
So what does Medalia tell concerned parents?

“People often ask [whether too much sugar can cause ADHD], and the answer is always that healthy habits are the best way to go."

8. Myth or Fact? ADHD can't be treated without drugs.
Myth. Some children with ADHD can improve with behavioral treatment alone, Vitiello says. This includes making schedules, lists and charts to help kids stay organized and prioritize tasks like homework and household chores. To lessen the anxiety that often goes along with ADHD, doctors may also teach kids relaxation techniques.

But some kids need medication.

“You don't use it in every case, of course – you have to evaluate each person individually," he says.

One of the most comprehensive studies ever done on the disorder – NIMH's $11 million Multimodal Treatment Study of Children with ADHD (called the MTA study) – reports that overall, children's ADHD symptoms improved more with medication or with a combination of behavioral treatment and medication than with behavioral treatment alone.

9. Myth or Fact? Brain scans can diagnose ADHD.
Myth. MRIs alone can't tell whether a child has ADHD, because a diagnosis requires monitoring kids’ behavior, says NIMH's Vitiello.
Doctors must detect a list of symptoms identified by the American Psychiatric Association, including restlessness and inability to focus, that are present for more than six months.

Brain scans also aren't precise enough to detect ADHD, says David Rabiner, Ph.D., a psychologist and professor at Duke University. The brains of children with ADHD appear too much like the brains of children with other mental disorders, he says.

There are technologies, however, that can assist in making an ADHD diagnosis, he says.

He’s a proponent of electroencephalographs (EEG), or neurofeedback, a non-invasive tool used to take images of the brain while a child performs various tasks that shows how the brain changes during these tasks.

10. Myth or Fact? Children with ADHD aren’t smart.
Myth. Though children with ADHD often do poorly in school, the disorder has nothing to do with IQ, scientists say. And a high IQ alone doesn't prevent a child with ADHD from experiencing the cognitive impairment associated with the disorder.

In a 2009 Yale University study, 75% of kids with ADHD and a high IQ (scores of 120 and higher) still suffered from significant impairment in memory and cognitive tests, unlike people with similar IQs who didn’t have the disorder.

However, other factors, particularly family relationships, can affect kids’ success over ADHD.
"The highly intelligent person with a more severe form of the disorder and a less supportive family may not do as well as one who doesn't have such a high IQ but does have a supportive family,” Vitiello says.

11. Myth or Fact? Kids can't outgrow ADHD.
Fact. Symptoms of the disorder may fade, but it never goes away.

Research has shown that ADHD often carries over from childhood into adolescence and adulthood, and some symptoms – inability to pay attention or focus, or uncontrolled behavior – can worsen with age.

In fact, while NIMH statistics show that the disorder affects 3%-5% of preschool and school-age children, it impacts 4.4% of adults age 18-44.

If untreated in adults, ADHD can lead to depression, anxiety and substance abuse, as well as work, legal, financial and personal problems.

But the news isn't all doom and gloom; children with ADHD can go on to live happy, successful lives.

"The key is to learn how to manage the illness,” Medalia says.

"When people get good at managing symptoms of the illness – with medication, behavioral strategies and a good support system – they’re able to work toward and achieve the personal goals that are really meaningful to them," she says.
For more information, visit our ADHD Health Center.

How Much Do You Know About ADHD?
Do you battle inattention and restlessness? You could have attention deficit hyperactivity disorder (ADHD). About 8-9 million adults have ADHD. Many adults are unaware of their disorder, as it was never diagnosed in childhood.

Gene Testing: Does It Help or Hurt? - What Your Genetic History Reveals About Your Future Health

2012-02-12T00:14:00.000-08:00

Worried about what medical conditions are lurking in your family tree? Breast or ovarian cancer? Huntington's disease? Gene testing, or genetic testing, may offer knowledge but not always comfort. So when is gene testing helpful and when should you steer clear? Read on for the answers...

Seven years ago, when she considered marriage and children, Anna Gorman decided to be tested for the BRCA1 and 2 gene mutations because ovarian cancer killed her grandmother and aunt.

She tested positive for BRCA1, which raises the risk of breast cancer up to 85% by age 70 and ovarian cancer by 55%.

“I wasn’t surprised, but I was upset and overwhelmed,” says Gorman, now a 35-year-old Los Angeles journalist.

So she then married her longtime boyfriend, gave birth to two daughters and had her ovaries removed by age 32.

Three years later, she had a double mastectomy.

The surgeries were hard. Still, she was relieved when it was over.

“It’s a dramatic step to take, but … lots of people get cancer and die,” she says. “I could do something about it.”

Like Gorman, many women worry about diseases that lurk in their family trees. In fact, they lead the pack when seeking genetic information.

“Women are drivers of the acquisition of medical care, period,” says Ora Gordon, M.D., M.S., director of the GenRISK Adult Genetics program at Los Angeles’ Cedars-Sinai Medical Center.

In fact, women make up 80% of her practice, she says.
Genetic testing is common for pregnant women and those considering pregnancy, but others anxious about hereditary illnesses — sickle-cell disease (a disorder that affects red blood cells), heart disease and diabetes — are also seeking genetic information in far greater numbers.

Screening for cystic fibrosis numbered in the thousands a decade ago; today millions undergo the testing, says Steve Keiles, M.S., president of the National Society of Genetic Counselors and director of Genetic Counseling at Ambry Genetics in Aliso Viejo, Calif.

In 1999, only 415 labs tested for 704 diseases.

Today, more than 600 laboratories worldwide are equipped to test for 1,794 diseases; 1,185 clinics provide counseling, according to GeneTests at NCBI, a medical genetics information resource at the University of Washington in Seattle.

What gene testing reveals
Why do so many women go for testing? Besides diagnosing and predicting diseases, genetic tests also:

Determine if a patient carries gene mutations for disorders that might be passed to children

Assess the health of a fetus (if it is at risk for inheriting a condition)

Screen fertilized eggs before implantation

Screen newborns at risk for genetic disorders that should be treated immediately
Home-testing kits
If you won’t see a physician because of privacy concerns or live in a remote area far from genetic-counseling centers, online companies offer home testing kits for common diseases, such as some breast and colon cancers, autoimmune disorders, macular degeneration and cardiovascular disease.

With the kits, you take a blood test or mouth swab and then send it to a laboratory. (Prices for online kits and mainstream clinical tests vary widely, depending on the services and tests ordered. At-home genetic tests can be pricey, from $295-$1,200.)

But beware: Some online companies offer a look at your genetic background for entertainment, not medical, purposes. And some don’t look for gene mutations, an often vital component when looking for diseases.

Also, home tests may not be accurate for some conditions, such as diabetes.

There’s “no reliable screening for type 2 diabetes,” Keiles says. “You can tell a lot just from your family history."

How online tests work
But there’s more to DNA testing than just getting results. Some tests are tough to interpret because of the procedure’s complexity and multilayered findings. And not all labs have trained genetics counselors to read them.

Navigenics, a San Francisco Bay Area-based online company, offers genetic counseling along with test kits and advises customers to seek tests the company doesn’t offer when appropriate, says Elissa Levin, director of genetics counseling. Counselors also follow up with phone calls after results are sent, she says.

But women with family histories of diseases such as breast and uterine cancer, Huntington’s disease and muscular dystrophy should seek genetic counseling first to make sure they’re proper candidates for testing, genetic counselors say.

For example, during counseling for Alzheimer’s – which you may not get even if you test positive – counselors sometimes find that you’re at higher risk for a more preventable health problem, such as heart disease. So they may recommend relatively inexpensive diagnostic blood tests along with lifestyle and diet changes.
Getting Tested
If you want counseling or testing, the National Society of Genetic Counselors can provide names of counselors by location, as well as guidelines for choosing a professional and getting the most out of the sessions.

Counseling alone costs about $400 and the cost of genetic tests range from $700-$4,000, Gordon says. It typically takes 2-6 weeks to get results, but some are available in days.

You also can ask your doctor for a referral; it may be covered by your health insurance plan.

The results won’t affect your rates because information the tests glean is private: In 2008, Congress passed the Genetic Nondiscrimination Information Act, which protects patients against discrimination by an insurer or employer based on genetic information. For many insurance plans, the law went into effect in May.

Who should be tested?
But genetic tests aren’t for everyone. For one thing, many of the disorders they detect are rare, Keiles says.

“Most testing is targeted to ethnic groups,” for example, Tay-Sachs for people of Jewish descent and sickle-cell disease for African Americans, he says.

And gene testing for most cancers is unnecessary because about 90% of them aren’t inherited, he says.

With some diseases, such as amyotrophic lateral sclerosis — commonly known as Lou Gehrig’s disease — a positive result won’t lead to better treatment or prevention.

“I don’t want to put patients through that if all I’m doing is giving them anxiety,” GenRISK’s Gordon says.

“Sometimes, too much information can be bad,” said Peter Weiss, M.D., a Beverly Hills, Calif. obstetrician and gynecologist. “Patients need to weigh the risks and rewards of the information they get from testing and be ready to deal with [it].”

But that may change with scientific advances. The future of genetic testing centers around whole-genome sequencing, said David Stillman, a pathology professor at the University of Utah.

That process — which may be routine in 10-15 years — will allow scientists to sequence not just for one gene, such as the BRCA mutation or cystic fibrosis carriers, but all of a person’s DNA to get a better picture of the medical problem he or she may face. (The expensive process has been done on only four or five people so far.)
Common Genetic Tests
Here's a guide to the most common genetic tests and those who should consider having them:

1. Down Syndrome
This genetic disorder occurs in one out of every 700-800 infants and causes lifelong mental retardation, developmental delays and other problems.

Screening for Down syndrome is a routine part of prenatal care. Your obstetrician will typically do an ultrasound and blood test in the first trimester, then a “quad screen” blood test at 15-20 weeks.

If tests are positive, the next step is chorionic villus sampling (CVS), in which cells are taken from the mother’s placenta at nine to 14 weeks, or amniocentesis after 15 weeks, in which a sample of amniotic fluid surrounding the fetus is withdrawn with a needle inserted into the woman’s uterus.

Who should have the test? Older pregnant women because the risk of conceiving a Down syndrome baby at age 35 is one in 400. By age 45, it’s one in 35. Also at higher risk are those with a Down syndrome child and men couples who are carriers. The screening is common among pregnant women of all ages.

Pros: Both amniocentesis and CVS are 98%-99% accurate.

Cons: There's a 1-in-200 risk of miscarriage from amniocentesis and a 1-in-100 risk from CVS.

Cost: Both procedures average about $1,500, which many insurance plans cover.

2. Neural tube defects
Neural tube defects — including spina bifada, anencephaly and encephalocele — are openings in the spinal cord or brain and are among the most common birth defects.

They’re detected during pregnancy by one of three tests:

Amniocentesis

A maternal serum alpha fetoprotein (MSAFP) blood test administered at weeks 16-18

A high-resolution ultrasound after 18 weeks
Who should have the test? Women who have had a fetus or baby with neural tube defects. Those with folic acid deficiencies have a higher risk for the defects. Many pregnant women have one of the tests for routine prenatal care.

Pros: Parents can prepare for the special medical care that babies with the defects will need.

Cons: Amniocentesis raises miscarriage risks.

Cost: The MSAFP blood test is about $162 in California; costs may vary in other states. The high-resolution ultrasound costs from $300-$500. Amniocentesis and CVS each costs about $1,500.

3. BRCA1 and BRCA2 genes
The letters stand for breast cancer susceptibility genes 1 and 2, respectively. They are tumor suppressors and mutations have been linked to hereditary breast and ovarian cancer.

The procedure is a simple blood test, which can be done in a doctor’s office.

Who should have the tests: The gene mutations are most common in Jews of Ashkenazi, or Eastern European, descent. Those with a first-degree relative (mother, daughter or sister) or two second-degree relatives (aunt, grandmother) diagnosed with breast or ovarian cancer should consider testing.

Other women with two first-degree relatives diagnosed with breast or ovarian cancer before age 50 should also consider it.

Pros: Learning that you don’t have the mutation can relieve you of worry and avoid costly preventive procedures.

Cons: If the test is positive, you may become anxious and depressed. A counselor can help you consider preventive measures, such as having your breasts and ovaries removed.

Cost: From several hundred dollars to $3,200, depending on the extent of the testing.

4. Cystic Fibrosis
An inherited chronic disease, cystic fibrosis affects the lungs and digestive systems of about 30,000 children and adults in the U.S.

A sweat test is the gold standard for diagnosis; People with CF have a higher level of chloride (salt) in their perspiration. A chemical to induce sweating is applied to an arm or leg. The liquid is then collected and analyzed in a lab.

A blood test can determine if you carry one or more CF gene mutations and how many copies of each.

With a positive test result, the next step is genetic testing to see which mutation you have. Screening newborns for CF is routine in most states.

Who should have the tests? More than 10 million Americans with no symptoms are carriers of the defective cystic fibrosis gene. The blood test helps detect carriers who may pass CF to their children.

To get the disease, a child must inherit one copy of the defective CF gene from each parent. The American College of Obstetrics and Gynecologists recommends that all couples considering having a child — and pregnant women — have the genetic-carrier testing done.

Pros: Carriers can make an informed decision about family planning, with the help of genetic counseling.

By testing their child, they can find out early if he or she has the disease and from which mutations. Early treatment and preventive measures help because symptoms often don’t show up until degeneration has begun.

Cons: Getting a positive CF diagnosis often is stressful and upsetting to parents.

Cost: Sweat tests usually cost about $300 at CF-accredited centers.

A limited mutation panel (23-97 mutations) to see if you’re a carrier typically runs about $400-$500; a comprehensive sequence analysis (more than 1,500 mutations) costs about $2,500.

Mutation testing for those already diagnosed with CF sometimes can be done with the carrier panel, but if that doesn’t find the mutations, a sequence test will cost $2,500-$3,200 for more results.

5. Sickle Cell Anemia
This inherited condition causes a deficiency in healthy red blood cells to carry enough oxygen throughout the body.

A blood test can detect the defective form of hemoglobin that causes the disease. Newborns are routinely screened for it.

In pregnant women, amniocentesis or chorionic villus (CVS) sampling will detect the disease.

Who should have the test? The gene is common among people of African, Mediterranean, Middle Eastern and East Indian ancestry. In the U.S., African Americans and Latinos are more commonly affected.

Both parents must carry a sickle cell gene for their baby to be born with the disease. Carriers — those with no symptoms — may pass it on to their children. Those with a sister or brother with the disease are at higher risk.

Pros: Couples who know they're carriers can seek genetic counseling for prevention information and treatment options.

Cons: If the screening is positive, more tests are needed to determine the number of sickle cells present. There are risks of miscarriage associated with amniocentesis and CVS screenings.

Cost: The hemoglobin test runs about $75; DNA tests are about $300.

THOUGHT FOR THE DAY...

2012-02-11T01:19:00.001-08:00

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2012-02-11T01:16:00.000-08:00

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Shocking the Brain Improves Memory

2012-02-11T00:47:00.001-08:00

Stimulating the brain with an electrical current can improve memory, according to a study that suggests a novel approach to treating Alzheimer’s disease and dementia.

Researchers at the University of California, Los Angeles, studied seven volunteers with epilepsy who already had electrodes implanted in their brains to detect seizures, and found that memory improved when the electrodes were turned on during tasks. The study, published Wednesday in the New England Journal of Medicine, was designed to test a theory shown in animal studies that stimulation deep in the brain improves recall.

“What we found here was a particular golden gate, a small area in the entorhinal cortex, where stimulation has a striking effect on memory,” said lead researcher Itzhak Fried, a professor of neurosurgery at UCLA, in a telephone interview. “This is an area of the brain which is critical in transformation of experience into lasting memories.”

The findings have implications for patients with Alzheimer’s disease and dementia. The volunteers had varying memory strength and all improved when the electrical stimulation was turned on, Fried said. The tasks depended on spatial memory, a key component of everyday living such as finding your car in a parking lot and remembering where you stashed the keys, he said.

Study volunteers played a video game in which they acted as a taxi cab driver shuttling passengers across a virtual city. The electrodes received electrical stimulation while patients learned to get to three stores, and were turned off for another three. In a subsequent test, volunteers were able to find shortcuts and get to the stores they visited while the stimulation was on more quickly. That showed improved spatial memory, said lead researcher Fried.

Memory Circuits

The study also shows it’s possible to reach circuits in the brain involved with processing memory and that electrical stimulation can enhance their function, said Andres Lozano, chair of neurosurgery at the University of Toronto. The approach may have treatment implications for patients with memory disturbances, said Lozano, who wasn’t involved in the study.

The location of the electrodes was key, Fried said. Stimulation of the hippocampus, a key component of the brain that converts short-term experience into long-term memory, didn’t help. The hippocampus is one of the first areas where destruction from Alzheimer’s disease occurs. However, the stimulation was beneficial when it occurred at the entorhinal cortex, which leads to the hippocampus.

Tiny electrodes, measuring less than 2 millimeters in size, were placed a little less than two inches into the brain. None of the patients felt the stimulation.

“Alzheimer’s disease is the big target here because it’s such a huge problem with people getting older,” said Matt Stead, a neurologist at the Mayo Clinic in Rochester, Minn., who wasn’t involved in the study. “This is probably one of the most hopeful things I’ve seen regarding Alzheimer’s disease in a long time, because none of the medicines seem to do much.”

Prostate Cancer and The Pill

2012-02-11T00:33:00.000-08:00

Question: Do birth control pills somehow play a role in prostate cancer?

Dr. Brownstein's Answer:

Researchers recently studied the link between prostate cancer incidence and mortality and the use of birth control pills. The authors of the study, published in 2011 in the British Medical Journal, hypothesized that birth control pills may lead to environmental estrogen contamination, causing increased rates of prostate illness in men.

The researchers correlated prostate cancer statistics with contraception use and found that oral contraceptive use was significantly associated with prostate cancer incidence and mortality in individual nations worldwide.

Other forms of contraception (IUDs, condoms, or vaginal barriers) were not correlated with prostate cancer incidence or mortality. The scientists concluded: “A significant association between oral contraceptives and prostate cancer has been shown.”

In the United States many of us know someone who has prostate cancer. Autopsy reports have shown that one in three men had prostate cancer at the time of their death.

Figuring out the causes of prostate cancer should be a national priority. Unfortunately, that’s not the case. In fact, there is currently little research into the underlying causes of prostate cancer.

This study showed a correlation with birth control pill use and prostate cancer mortality and incidence. We will not beat prostate cancer (nor other cancers) with chemotherapy, surgery, and radiation. We will beat cancer by cleaning up our environment and supplying the body with the optimal nutrition it needs.

Furthermore, we need to stop manufacturing and using synthetic hormones, which are toxic to us and the environment. Only bioidentical, natural hormones should be used for hormone therapy.

Birth control pills should be avoided as they utilize synthetic hormones and have been shown to increase the risk of breast cancer. New evidence suggests that they increase the risk of prostate cancer as well. Using a synthetic hormone reminds me of Forrest Gump’s motto: “Stupid is as stupid does.”

Expert Advice on How to Avoid Dental Problems - Keep Your Teeth Clean and You’ll Keep Them Longer

2012-02-11T00:25:00.000-08:00

How does tooth decay start and what does it say about your overall health? What are the most effective treatments? To mark National Dental Health Month, an expert in the field answers your most common questions about this condition...

What causes teeth to rot? Believe it or not, that answer remained elusive until the 1970s.

Now, we know, of course, that plaque – tough, filmy bacteria that adhere to teeth – is the culprit. This knowledge and better oral hygiene means that most of us, thankfully, are keeping our teeth longer, according to the National Institute of Dental and Craniofacial Research.

Still, there's plenty to clear up when it comes to dental health.

“People don’t always believe it when they’re told they have a dental problem,” says Marjorie Jeffcoat, D.M.D., professor of dentistry and dean emeritus at the University of Pennsylvania School of Dental Medicine.

“But it’s important to know what’s going on with your mouth. If damage is happening to the teeth, damage is being done to rest of the body.”

How much do you know about your mouth? Lifescript spoke with Jeffcoat for tips to keep teeth in top shape and dental problems at bay.
Why are so many people in denial about dental problems?
Often, the issue is silent and doesn’t hurt until it’s serious – when a tooth breaks, for example.

Yet, cavities and gum disease are chronic infections, which can worsen many systemic diseases, such as diabetes and HIV.

In pregnancy, they can even contribute to preterm delivery.

So our teeth are linked to our general health?
That’s right. Like other body parts, oral tissue can even get cancer.

That’s why your dentist needs to do an exam, even if you have full dentures.

Do dentists automatically check for oral cancer?
They should, but patients should also ask to be sure.

I always tell my patients, “I’m taking a moment to look for lumps or bumps that shouldn’t be there that are more important than a cavity."

If your dentist doesn’t mention anything like this, ask for an oral cancer check.
Do you recommend brushing twice a day and flossing at night to prevent dental problems?
You should brush at least twice a day – or after meals and sugary snacks. But I make recommendations based on the individual patient’s problem areas — where [in the mouth he or she] isn’t brushing, what he or she is currently doing and how often he or she is doing it.

We have lots of devices – different types of toothbrushes, flosses, little brushes, things with rubber tips and more.

So, for example, if you have a big bridge, I may suggest using a small brush to get under the bridge and clean the plaque.

Do you have a toothbrush preference?
Some patients do well with a manual brush, but most do better with a rotary electric brush. That’s what’s sitting on my bathroom counter. Some high-end electric brushes even control if you’re brushing too hard, a problem if your gums are thin.

A dentist or hygienist can help you select a proper brush. If a patient has a grip problem, for example, the dentist may recommend a brush with big, soft handles.

What are the most common brushing mistakes?
Brushing too hard with a hard brush is No. 1. Use a soft brush so bristles can go between teeth and so you don’t brush away your gums.

Also, patients tend to miss the same spots over and over again. If you’re right-handed, you tend to brush better on the left.

So, often I’ll tell the patient to spend a little more time thinking about the right side if she’s right-handed.

Brushing long enough is also sometimes difficult. Electric toothbrushes often have a timer.

If patients use a manual brush, I recommend a timer [for] 3 minutes.
And flossing is essential to preventing dental problems, right?
Well, you absolutely need something that cleans between your teeth. But many patients don’t floss or do it incorrectly. It’s hard for a lot of people to maneuver. Some patients sort of use it like a cheese slicer – they go straight up and cut their gums.

So if you don’t have the dexterity to floss correctly, ask your dentist or hygienist about other options.

And if you are going to use floss, first train yourself in front of a mirror. Once you know your teeth and where the spaces are, you can do it while you watch the news before bed. If you have something to watch while you floss, you tend to do it more regularly.

People who have big spaces between their teeth can use little brushes or rubber tips. Some patients like Stim-u-dents, which are little triangles that come in a box that fits in a pocket. Men seem to like these, but women usually don’t.

What makes getting between teeth so important?
Gum disease often starts between the teeth. So if you aren’t doing something to get at that surface, you’ll have problems.

If done correctly, flossing can also get under the gum line. Ask your dentist or hygienist to give you a quick lesson on how to do it.

Your toothbrush also helps get the between-teeth surfaces. Remember, soft brushes are the ticket. Hard brushes can’t mold easily and get in there.
What’s the story behind mouthwashes? Do they help avoid dental problems or are they purely for masking odor?
It depends on the rinse. Many – probably most – are purely cosmetic, but certainly not all are.

In fact, a recent study showed that use of a certain over-the-counter mouth rinse – Crest Pro-Health, which contains a controlled-release antimicrobial called cetylpyridinium chloride, or CPC – among pregnant women with periodontal disease cut the number of preemie births by more than half.

Many women develop periodontal disease in pregnancy. The rinse also helped stabilize or decrease gum inflammation, bleeding and swelling.

It is easy to use and inexpensive. You don’t need a prescription, and it contains no alcohol.

Do you have to be careful about alcohol in mouth rinse?
From 9%-14% of mouth rinse is ingested. Some goes through the cheek and some is swallowed.

We don’t recommend anything with alcohol to a pregnant woman. Other people may not like to have alcohol, either; recovering alcoholics, for example, or just people who don’t like the bite of alcohol in a mouth rinse.

What should we look for in a mouth rinse if we want something other than a cosmetic freshener?
If cavities are your big problem, look for an over-the-counter fluoride rinse. If periodontal disease is your current problem or biggest risk, I might prescribe a mouth rinse with the antiseptic chlorhexidine.

Or I’d recommend something over the counter with an antimicrobial ingredient such as CPC.
There have been reports that alcohol in mouth rinses may contribute to oral cancer risk. Do you worry about alcohol in mouth rinse for this reason?
No. I don’t think those studies were well designed. So I wouldn’t tell my patients that rinses with alcohol are dangerous.

However, we know that if you smoke and/or drink alcohol, your risk for certain cancers escalates. So, frankly, I’d rather avoid mouth rinses with alcohol for my patients.

To prevent dental problems, is it necessary to get your teeth professionally cleaned or can super-vigilant people do a good enough job at home?
A professional hygienist or dentist cleans plaque off of your teeth. Plaque calcifies because your saliva is saturated with calcium.

Because of this, you get stuff – sort of like hard rocks – on your teeth, which you just can’t remove at home.

If you have a lot of plaque, you end up with periodontal disease. So, yes, professional cleaning is truly needed.

And the rule of getting your teeth cleaned every six months is valid?
Your dentist should make the call how often you need it.

Six months is a good average, but if you do an impeccable job cleaning your teeth, if you don’t have any periodontal disease, and you have few or no "caries" [tooth decay], maybe he or she will recommend you come back in nine months.

On the other hand, I have some patients who need to come back much sooner than six months. I try to see some of my pregnant patients every six weeks because pregnancy hormones contribute to gum disease.

It really depends on the patient.
Does diet influence oral health?
Diet directly affects your oral health. Sugar or sucrose is the No. 1 thing that bacteria feed on to make cavities. So it’s important not to have a lot of sugar or, if you do, clean your teeth afterward.

Teach kids to brush their teeth after they eat lollipops, for example.

Calcium is also very important, especially for women. Osteoporosis, a bone loss disease, also affects the bone around teeth.

Calcium is especially important for kids. The most important bone-building years happen by the time someone is 20. If you decide to start taking calcium supplements when you’re 50, you’re not getting the same major benefit you would have gotten before age 20.

Also, vitamin D inadequacy is rampant in this country. If you don’t have vitamin D, you can’t build bone. You get vitamin D from sunshine, but most of us use sunblock.

Ask your doctor to check your vitamin D levels and see if you could benefit from a supplement.

Are discolored teeth inevitable?
As we age, our teeth naturally become a darker shade of whatever they were. If your teeth had a yellow tinge when you were 15, they will be more so when you’re 70.

It happens because we inflict tiny amounts of trauma on our teeth over time — little things, like hitting them with a fork. As these little traumas occur, the tooth lays down more tooth to protect the nerve.

As more and more good tooth is laid down, you see the color more. So a progression of color intensity is normal and natural.

But that’s different from extrinsic staining. Things like coffee or red wine tend to stain teeth, so you just have to do a very good job cleaning your teeth after you eat or drink these things.

If you do, you won’t get a lot of staining. I drink a lot of coffee and have very little staining. Unfortunately, for many people the stains build up, and it gets much harder to get them off.
That’s where bleaching comes in, right?
Yes, you can do it at home or in the dental office. Bleaching in the dental office is fast and effective. You can get maximum bleaching in very little time.

But there are usually temporary side effects such as some tooth sensitivity.

At home, you can use strips or other agents that you put on your teeth for various lengths of time. They don’t work as quickly, but they offer some advantages.

If a patient experiences sensitivity, they can just take them off and stop. I like patients to be able to be in control.

But I recommend a dental exam before doing any home whitening to make sure there are no signs of dental problems that would give them difficulty.

Can bleaching products be harmful to teeth?
If you use fluoride toothpaste afterward, there’s no evidence that they negatively influence the health of the teeth.

If too much bleach comes in contact with the gums and you have thin gums or certain special problems, though, you can make them sore or do injury to them.

Any last words of teeth wisdom?
If you want your teeth to look as white as a sheet, think twice. Teeth aren’t supposed to be this color. Also, ask your dentist for advice on taking care of your teeth. And listen to this advice!

You will never get another set of teeth. You want them to stick around.

For more information and expert advice, visit our Dental Health Center.
What's Your Dental Health IQ?
Thanks to more knowledge and better oral hygiene, we’re keeping our teeth much longer these days. Yet, how much do you really know about preventing cavities and gum disease?

Diabetes Complications From Head to Toe

2012-02-11T00:16:00.001-08:00

If you have diabetes, you face serious dangers all over your body, ranging from eye, mouth and foot problems to kidney damage and heart disease. But can you prevent complications once you have the disease?

Read on for expert advice on avoiding serious diabetes troubles. Plus, how much do you really know about diabetes? Find out with our quiz...

Diabetes is a complex disease that can affect your entire body, from top to bottom. Unchecked, it could leave you needing a seeing-eye dog, kidney transplant or foot amputation.

“Having chronic high blood sugar damages blood vessels throughout the body, so you can have [problems] anywhere,” says Judith Fradkin, M.D., director of the diabetes division at the National Institute of Diabetes and Digestive and Kidney Diseases.

It also harms the nervous system, which further impairs blood flow.

“Controlling blood sugar, blood pressure and lipids can prevent those complications,” she adds.

Learn how to prevent or halt diabetes complications for each precious body part by following this expert advice.

Eyes
Diabetes is the leading cause of blindness in adults aged 20-74, according to the American Diabetes Association (ADA).

The culprit is diabetic retinopathy, a condition that damages blood vessels in the retinas. This may cause leaking blood or abnormal blood-vessel growth in the inner eye.

Strictly controlling blood-sugar levels can help prevent diabetic retinopathy from progressing, according to a 2010 National Institutes of Health study published in the New England Journal of Medicine.

Most people with diabetes have only minor eye disorders – and regular check-ups can help keep them from getting worse, according to the ADA.

The best way to prevent eye problems? By tightly controlling blood sugar and blood pressure, and getting annual exams with an optometrist or ophthalmologist (not an optician, who doesn’t perform medical tests), the ADA says.

And if you smoke, stop. Smoking increases your risk for eye problems, according to the Centers for Disease Control and Prevention (CDC).For sudden sight disturbances – including floaters that block part of your field of vision, or worsening peripheral vision (so you can’t see things at the side) – see an ophthalmologist right away.

Also, seek immediate treatment if your vision becomes blurry, you start seeing double, your eyes hurt or are persistently red, if you feel pressure, or if straight lines appear wavy.

Blood-vessel damage in the eyes can’t be cured, but you can stop it from progressing, so it's important to seek help.

“Laser therapy can prevent people from going blind,” Fradkin says. “And there are drugs that inhibit blood-vessel growth in the eye.”

Mouth
Gum infections and severe gum disease (periodontitis) are common diabetes complications, especially if blood glucose levels are poorly controlled, because the body is more susceptible to bacterial infections.

“It can be a vicious cycle,” Fradkin says. “Diabetes makes gum disease worse, and gum disease makes diabetes worse.”

Good oral care is especially important for people with diabetes, so keep those twice-yearly (or even more often, if necessary) appointments with your dentist and/or periodontist

Gum disease has been linked to cardiovascular disease – another diabetes complication – so better oral hygiene may lead to better health.

Skin
When you have diabetes, you’re more prone to fungal or bacterial skin infections anywhere on the body.

“Blood sugar coats the infection-fighting white blood cells, so they're not able to [get rid of] bacteria as well,” says podiatrist Lee C. Rogers, DPM, associate medical director at the Amputation Prevention Center at Valley Presbyterian Hospital in Van Nuys, Calif.

See a dermatologist or your diabetes specialist for prompt treatment if you notice rashes or itchy areas on your skin – they could be signs of bacteria or fungus.

“Fungal toenail and foot infections are common in diabetes,” Rogers says. “You need to have them treated before you get cracks in your skin and bacterial infection.”

Heart
Diabetes and heart disease are closely linked: You’re 2-4 times more likely to have a heart attack or stroke if you have diabetes.

“Having diabetes is considered a coronary equivalent, meaning it’s like having had a previous heart attack – which raises future heart attack risk,” Rogers says.

But diabetes patients don't always have typical symptoms, such as chest pain, chest pressure or pain in the shoulder or jaw.

“That’s because the nerves going to the heart or chest are damaged,” Rogers says. “Patients often have shortness of breath, but not the signs they’re taught to look for, so they may seek treatment too late.”

The best way to lower your risk for heart disease and stroke is to manage your blood glucose. (On the A1C test, which measures your average blood sugar over time, strive for less than 7% – or about 150 mg/dL – according to American College of Physicians guidelines.)

Once again, this means you need to get regular check-ups, and monitor and control your blood pressure and cholesterol carefully. Your doctor may also prescribe medications such as daily aspirin or statin drugs to help reduce heart attack risk.

Patients with high blood pressure who saw their doctors frequently were able to get blood-pressure levels back to normal sooner (1.5 months versus 12.2 months), lowering their risk of heart disease or stroke, according to a 2010 Harvard Medical School study published in the medical journal Hypertension.

Bones
Osteoporosis, a condition that makes your bones less dense and more likely to break as you age, is linked to type 1 diabetes complications. That may be because people who develop diabetes at a young age don’t gain as much bone density as healthy people, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

But type 2 diabetes can increase fracture risk too. Typically, osteoporosis and breaks are more common in thin or frail people, because they have less padding to protect their weakened bones when they fall.

But people with type 2 diabetes tend to trip and fall more often, often due to vision problems and nerve damage in the feet. They’re also more likely to be sedentary, a risk factor for osteoporosis.

The U.S. Preventive Services Task Force, a panel of health-care experts, recommends routine osteoporosis screenings for women aged 65 and older. But your endocrinologist or diabetes specialist may recommend earlier screenings based on your risk factors. Osteoporosis has “silent” symptoms, so testing may reduce your risk of fractures.

You should also ask your doctor if exercising more is a good idea.

“People should be cautious of doing too much exercise when they have diabetes and nerve damage, because the more walking you do, the more you risk injury [from falls] and foot ulcers,” Rogers says.

But exercise can be beneficial if your doctor gives you the go-ahead. “Even walking 10 minutes a day [can help] if you can’t walk half an hour,” Fradkin says.

Kidneys
Diabetes is the leading cause of kidney failure, with nearly half of all cases attributed to the disease, according to the ADA.

Kidney disease often develops silently over a decade or more, but you can help prevent it by controlling blood sugar and blood pressure.

“Your doctor will monitor your urine to see if you’re developing protein in [it], a sign of kidney damage,” Fradkin says. “With proper diagnosis and blood-sugar and blood-pressure control, we have evidence that we can reduce rates of kidney disease by 50%-60%.”

Bladder
Up to two-thirds of women develop bladder-control diabetes complications. If you experience incontinence, a urologist or diabetes specialist can recommend exercises or medication.

“Many bladder problems are related to nerve damage, because nerves control bladder function,” Fradkin says. “Controlling blood sugar can [reduce] nerve damage.”

If you’re overweight, dropping a few pounds can also help.
“Weight loss has been shown to make substantial improvement in reducing incontinence,” Fradkin says.

Those with nerve damage can improve bladder control with “timed voiding,” or urinating on a set schedule. You can also be taught how to recognize that your bladder is full, even if you don’t feel the urge to go. If leakage is the problem, strengthening muscles with Kegel exercises may help, but medication or surgery may be necessary.

Vaginal Tissue
After having diabetes for a number of years, you may develop sexual problems: vaginal dryness, pain during intercourse or a decrease in libido. Some women may have trouble getting aroused or reaching orgasm due to nerve damage and reduced blood flow.

Many women may not realize that these diabetes complications could be related to the disease, and assume that sexual problems come with aging or menopause.

“But people with diabetes develop these problems at higher rates,” Fradkin says.

That’s because hormonal changes can affect your blood glucose level, thus worsening mood swings, fatigue and hot flashes.

Besides watching your blood glucose, physical aids such as vaginal lubricants, as well as relationship counseling, can help.

Your doctor may also recommend weight loss.

“In our diabetes prevention clinical trial, losing about 15 pounds resulted in fewer problems with sexual function,” Fradkin says.

Legs and Feet
Up to 70% of people with diabetes have nervous-system damage. When the feet are affected, the resulting numbness can lead to injury, foot ulcers and even amputations.

“Foot problems are twofold,” Fradkin says. “Blood vessel damage can cause poor circulation to the feet, so wounds don’t heal.”

Meanwhile, people who have numbness or a loss of sensation in their feet (and legs, if the feet have been affected for a while) can’t tell that they’ve injured themselves.

“If you’re not able to feel things, you’re not warned about having an injury, like stepping on a tack,” Rogers says. “When healthy people get the smallest pebble in their shoe, they stop because it’s so bothersome. But diabetes patients don't feel it and get a blister, which develops into an ulcer that they can’t feel.”

About half of foot ulcers become infected, and 15% of those require amputations, according to Rogers.

Although nerve damage can’t be reversed, it’s possible to keep the damage from worsening (or affecting the legs as well as the feet) by controlling blood sugar and blood pressure.Regularly seeing a podiatrist, who’s specially trained to detect potential foot problems, may be the best way to prevent them.

A study presented at an American Podiatric Medical Association meeting in 2010 found that diabetes patients who saw podiatrists before they were diagnosed with foot ulcers had a lower risk of hospitalization or amputation.

For more information, visit our Diabetes Health Center.
How Much Do You Know About Diabetes?
In the United States alone, 23.6 million people have diabetes. And 5.6 million of them don’t even know it. Unfortunately, misinformation about the disease is rampant – and mixing up the facts can create dire diabetes complications.

How to Feel Beautiful With Psoriasis - Expert Tips on Treating Psoriasis and How to Feel Pretty

2012-02-11T00:13:00.000-08:00

Psoriasis is a non-contagious skin condition that causes scaly, red patches to appear anywhere on the body. It can make you self-conscious about your appearance. Read on for advice from experts and patients on treating psoriasis and how to cope with the disorder...

What is psoriasis? And what causes it to flare?

Psoriasis isn’t fatal like cancer, but it has no cure. About 7.5 million Americans are affected by the disfiguring skin condition, which causes red welts on skin. It usually first appears between 15-35 years old and may be hereditary.

Psoriasis symptoms may be confined to small areas of the body – an elbow, for example. They can also cover the entire torso or, even worse, your face. Because of the lesions, many sufferers feel like lepers, untouchable and alone.

But you don’t have to lock yourself in your bedroom. Read on as doctors, patients and experts explain what triggers the disorder and share how to feel beautiful when your skin is acting up.

When the Immune System Turns Against Itself
Experts believe psoriasis is an autoimmune disease. A popular theory is that the immune system triggers skin cells to grow faster than your body can shed them.
Skin cells normally take 28-30 days to mature and fall off the body. With psoriasis, they grow in 3-4 days. And instead of shedding, they gather and form red, rough or silver-hued lesions.

Certain people may have a genetic predisposition toward the disorder, experts say. It’s usually triggered by stress, trauma or injury to the skin, or medications such as lithium, antimalarials and indomethacin, an anti-inflammatory drug for arthritis.

In some people, the inflammatory process also attacks the joints, causing psoriatic arthritis.

Coping with Emotional Scars
As distressing as the lesions are, the emotional pain of psoriasis is often more upsetting than the disease itself.

Many women with psoriasis symptoms experience embarrassment and unkind reactions from people around them.

It’s like grief, says Jonathan Weiss, M.D., a dermatologist in Atlanta and an assistant clinical professor of dermatology at Emory University.

Many psoriasis sufferers go through the same emotions as someone who has lost a loved one, he says: Denial, depression, anger and acceptance.
They’re mourning the loss of control over their health and well-being, often in the prime of their lives.

“There’s a lot of stigma around skin that doesn’t look healthy,” agrees Portland, Ore., psychologist Julie Nelligan, who works with the National Psoriasis Foundation. “People wrongly assume that it’s contagious.”

The social shunning can be excruciatingly hurtful, as it was for Allyson DeLorenzo, 29, a graduate student in New York City. She was 18 and in college when diagnosed with psoriasis.

DeLorenzo remembers several painful encounters. Once at a pool during spring break, a mom asked what disease she had because she worried her child would get it.

Another time, a manicurist insisted on wearing rubber gloves during a pedicure.

“On one hand, I could understand completely,” she says. “On the other, it made me feel crappy that someone didn’t want to touch me.”

Keeping Emotions in Check
It’s important to manage your sadness, frustration and embarrassment because stress and anxiety can trigger and make psoriasis symptoms worse, says Ted Grossbart, Ph.D., a psychologist in Boston and author of Skin Deep: A Mind/Body Program for Healthy Skin (Health Press).
Here’s how to cope with the condition:

1. Learn about the disease.
The more you know about psoriasis, the quicker you’ll become comfortable with it, Weiss says.

“You’ll come to a level of understanding that you don’t always have control over it and will learn to control what you can,” he adds.

To learn more about psoriasis, check out the National Institutes of Health, American Academy of Family Physicians and National Psoriasis Foundation.

2. Educate others.
When people ask questions about your “skin problem,” turn it into an opportunity to teach them about psoriasis. Explain that it’s a medical condition you can’t control and that it isn’t contagious.

The more comfortable you feel about your disease, the more capable you’ll be about discussing it.

“I realized it didn’t have to define who I am,” DeLorenzo says. “I was able to incorporate it and say, ‘I’m Allyson, and I have psoriasis.’”

3. Tackle stress head-on.
Having psoriasis is like having a built-in stress meter. When your anxiety level goes up, psoriasis spreads.

So it’s important to know what triggers anxiety or anger – whether it’s your mother-in-law or the morning commute – and find ways to lessen it, Grossbart says.

Consider engaging in yoga, meditation and regular exercise, all activities that can reduce your stress level.

Or spend time gardening and hiking or vegging on the beach. That’s what finally helped Dawn Swidorski, a San Francisco outreach specialist with the condition.

Those activities relaxed her and, for the first time since she was diagnosed, she let go of her anxiety over psoriasis symptoms.

“I didn’t care about it as much,” she says. “As soon as I wasn’t obsessing about it, it went away.”

4. Develop social support.
Connect with others who have psoriasis, so you don’t feel like the lone “leper.”

“I find that if people feel supported, their depression and anxiety lessens,” says Nelligan, the Portland psychologist. Not only will that ease flare-ups, but sharing information about the disease will also help erase the stigma, she adds.

Which is what happened to DeLorenzo. She got over her feelings of shame when she was able to diagnose a friend and met another woman with psoriasis.

“By that point, I realized I wasn’t alone,” she says. “I started wearing short sleeves and shorts and I became more comfortable discussing it.”
DeLorenzo also joined the board of the National Psoriasis Foundation and took part in a fund-raising walk.

“Not only was I doing something to help myself and others with psoriasis, I also was able to connect with others who have it,” she says.

5. Dress appropriately.
Living with red lesions all over your body can shake the self-esteem of even the most confident person.

If you’re embarrassed by your psoriasis, dress in ways that conceal the lesions. Wear 3/4-length or long sleeve shirts and slacks instead of dresses or shorts.

Dress in light-colored clothes, so flakes are less visible. And choose items you really like, so you’ll feel better about your appearance.

The color and texture of the fabrics you wear make a difference in how you look and feel too, says Chad Hayduk, a makeup artist who has psoriasis and co-founder of Three Custom Color Specialists in New York City.

“Psoriasis can be irritated by rough, scratchy fabrics so avoid wools,” he says. “Wear softer, more free-flowing fabrics to let the skin breathe and prevent abrasion.”
Sometimes a simple change in clothing can help lessen the frequency of outbreaks. Swidorski’s psoriasis improved when she moved from Michigan to California in 1990 and was forced to dress in lighter clothing because of the state’s year-round warmer climate.

Because psoriasis’ lesions can be red or pinkish, “you should avoid wearing fabrics and makeup in those shades,” Hayduk says. They’ll make flaky patches stand out.

6. Cover up.
Certain cosmetics can help conceal patches. But be careful, because some can exacerbate the condition. Ask your dermatologist to find out which products might work best for you.

Wear fragrance-free makeup because perfumes can irritate the skin.

Also look for moisturizing foundations, “which will help hydrate, condition and calm the flaking,” Hayduk says. “A liquid or oil-based product will be easier to apply.”

But it isn’t just dry skin, so don’t try treating psoriasis or get rid of the flakes with moisturizer. Again, consult a dermatologist for recommendations.

Avoid matte, oil-fighting and oil-free formulations too – and “anything that’s too waxy because they can be irritating,” he says.

For a more natural finish, apply concealer and foundation with a clean, synthetic brush.
“You can control the amount of coverage on flaky areas and it will look less heavy-handed than application with fingers,” Hayduk says. “A brush can also feather out the edges, giving you a seamless appearance.”

If you’re using concealer on the body - where heavier application might be necessary - look for water-resistant makeup or one that won’t stick to clothing and will last longer.

For color, Hayduk suggests trying to match the skin tone as closely as possible. Also buy products with a touch of yellow to help minimize redness.

7. Consider therapy.
After she was diagnosed, DeLorenzo became so depressed, she said, that she’d cry every day. She told no one about her psoriasis except her closest friends.

If anyone asked about her disease, she would dodge the question.

“At that point, I was so uncomfortable with it,” she says. “And maybe part of it was denial too. I didn’t want to accept that I had a lifelong sentence of psoriasis.”

Mild cases of depression and anxiety often can be managed with a balanced lifestyle. But if the blues don’t let up, see a mental health professional, who can provide proper treatment and counseling.

Or find a doctor who will help you not only with medical treatment, but also counsel you through the emotional havoc that psoriasis symptoms can cause, Weiss says.
The best way to find a good doctor and support groups? Check out the National Psoriasis Foundation website, Weiss advises.

For more expert advice and information, visit our Psoriasis Health Center.

Are You Skin-Care Savvy?
If your skin-care knowledge could barely fill a pillbox, you need a refresher course. Do you know how to put your best face forward?

THOUGHT FOR THE DAY...

2012-02-10T00:33:00.001-08:00

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2012-02-10T00:26:00.000-08:00

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Healthy Weight Loss with Rheumatoid Arthritis - Rheumatoid Arthritis Diet and Exercise Tips

2012-02-10T00:17:00.000-08:00

When joints ache, it’s hard to find comfort in a plate of celery sticks. But slimming down doesn’t have to mean tasteless foods, and it’s crucial for women with rheumatoid arthritis. Start losing weight with these 16 rheumatoid-arthritis diet and exercise tips...

With rheumatoid arthritis (RA), the last thing you need is extra weight on your throbbing joints. It adds pain and could eventually cause worse damage.

“Weight directly affects bone structure with grinding pressure that can also lead to osteoarthritis,” says Peter Vash, M.D., M.Ph., executive medical director of the Lindora Clinic in Costa Mesa, Calif.

On top of that, fat cells secrete inflammatory hormones and other chemicals that hasten RA’s destruction of bone and cartilage.

But regular exercise is difficult if you’re in pain, and some RA medications, such as corticosteroids, can increase the likelihood you’ll pack on pounds. Plus, many of us turn to food for comfort, says Vash, a weight-loss expert who treats RA patients.

So how do you maintain a healthy weight with rheumatoid arthritis?

Whether you’re heavy, or even one of the few RA patients who’ve lost weight due to pain and fever from inflammation, it’s important to build up your body and get better nutrition, notes Nathan Wei, M.D., director of the Arthritis Treatment Center in Frederick, Md.

Do both with these 16 RA expert tips:

1. Get daily exercise.
While strenuous activity may be too painful at times, the old mantra that exercise harms people with RA no longer stands.

In fact, you should do some form of exercise every day, Wei says.

For best results, combine stretching and strengthening exercises with low-impact cardiovascular exercise like walking or swimming.

Swimming is particularly good, Vash adds. “It’s easy to move in water, and it takes the weight off joints like hips and knees.”

2. Build lean muscle.
Strengthening exercises are particularly important for women with rheumatoid arthritis, helping them hold on to – or increase – lean muscle mass, says Maura Daly Iversen, S.D., D.P.T., chair of the Department of Physical Therapy at Northeastern University in Boston.

And the more muscle you have, the more calories you burn.

To maintain muscle mass, lift light weights or use resistance bands for 15 minutes twice a day, Iversen suggests.

Cuff weights are easier on joints if you have hand or wrist pain.

3. Eat like a Greek.
A Mediterranean diet is the best way to lose weight if you’re concerned about health, says chef-turned-weight-expert Timothy S. Harlan, M.D., medical director at Tulane University Medical Group and author of Just Tell Me What to Eat (Da Capo Lifelong Books).

That means eating veggies, fruits, whole grains, fish and lean meats, legumes (such as beans), yogurt and unsaturated fats like olive oil.

“You lose weight eating these foods because they’re less calorie-dense – you can eat more and still be satisfied,” he says.

4. Seek help to stay motivated.
Work with a nutritionist or ask your doctor to recommend a weight-loss program.

Either one can provide structure, support and motivation, says Vash.

“People with RA tend to feel discouraged because pain wears them down,” he says. “So it helps to get support from a dietitian or program that can encourage them to eat good food, stay away from alcohol [which is calorically dense] and take their medications.”

Some insurance plans cover weight-loss treatments if they’re tied to the treatment of a chronic disease like RA, Vash says.

5. Keep a food diary.
Write down everything on your plate.

You may be surprised by how much more you’re eating than you thought.

“It’s a good method of tracking what you eat,” Harlan says. “It keeps you honest.”

It also makes it easier for a dietitian to create a meal plan that lets you eat the foods you like while including a wider range of nutrients.

6. Drink more water.
Drinking six to eight 8-ounce glasses of water a day is a simple weight-loss technique, Iversen says.

You feel fuller, so you eat fewer calories.

"People tend to eat when, in reality, they’re only thirsty,” Vash adds.

Make it easy by toting a water bottle, and keep a pitcher of cold water in your fridge. (Add fresh cucumber or fruit slices to make it more appealing.)

7. Eat breakfast.
People who regularly eat a morning meal are more likely to keep pounds off, according to the National Weight Control Registry, which tracks people who’ve maintained their goal weight for years.

In fact, skipping breakfast is the worst way to save on calories, Harlan says.

“By noon, you’ve been 18 hours without food,” he says. “Your metabolism is lower and your body works to store calories as fat. And, now, you’re starving, so you scarf Krispy Kremes and then eat lunch.”

But don’t go overboard: Eating a large breakfast didn’t lower calories people ate at lunch and dinner, according to a 2011 study at the Technical University of Munich in Germany.

Instead, focus on protein and quality carbs, like a piece of whole-grain toast, Harlan recommends.

8. Map out your meals.
Eat three balanced meals a day to avoid random grazing, Vash says.

And if you always get hungry in the afternoon, keep a healthful snack on hand to avoid the lure of the office vending machine.

“Plan what you’re going to eat, along with when and where,” Harlan adds. “That’s half the battle.”

9. Pack your lunch.
Even some relatively healthful takeout options are loaded with calories and sodium, Harlan says. Bringing your own meal to work helps you control food intake. Plus, you’ll save a few bucks.

10. Eat protein at every meal.
Protein builds strength and muscle mass, and can help weight-loss efforts by giving you a sense of fullness.

“And it keeps your blood sugar up, which boosts energy and mood,” Vash says.

So slip skinless chicken into brown rice, add tofu to a veggie stir-fry and sprinkle toasted walnuts on your salad.

11. Give your fridge and pantry a makeover.
Buying good-for-you food in advance can keep your diet on track. “If you have healthy things in your cupboard, you’ll eat them,” Harlan says.

Toss the cheese curls, chips and other diet-derailing snacks. Replace them with canned and dried beans, jars of tomatoes or tomato sauce, brown rice, whole-wheat pasta, nuts and high-quality olive oil.

Fill your freezer with frozen vegetables and the fridge with fresh fruits and vegetables that keep, such as leeks, onions, apples and pears.

“Everything in your cupboard should be fresh and real,” Harlan says. “If you need to know Latin to understand an ingredient list, something’s wrong with the food.”

12. Nix nighttime noshing.
Pain and depression can get the best of you in the evenings, tempting you to turn to high-calorie comfort foods. One reason: Cortisol, a stress hormone that’s also an anti-inflammatory, sinks low after the sun goes down.

“That’s why everything appears worse at night,” Vash says. “Worries and concerns are magnified, and friends aren’t around to help.”

When night-time aches or the blues hit, don’t reach for cookies. Instead, pour yourself a cup of warm broth or green tea – it doubles as a soothing hand warmer.

13. Brighten your plate.
White flour, pasta and rice are nutritional wimps. Fiber and nutrients such as potassium and magnesium have been stripped away to give them that light color.

Fiber is particularly important for women with rheumatoid arthritis, Harlan says, because it slows digestion and adds bulk so you stay full longer.

But to get the full range of nutrients, eat a rainbow of vegetables and fruits, he says.

14. Watch your meds.
Corticosteroid medications like prednisone, commonly given to patients with rheumatoid arthritis, can cause weight gain by increasing fluid retention and body fat, says Iversen. They can also increase appetite.

If you have these side effects, talk to your doctor, Vash suggests. “There are good alternative medications that can be used for RA.”

15. Skip shortcuts.
Fad diets that promise fast results don’t work over the long term.

“Let your physician recommend a reputable plan,” Vash says. “It will be high quality and safer than wasting your money and hopes on [sketchy] cures.”

16. See a specialist.
When struggling with RA-related issues, including weight gain or excessive weight loss, see a rheumatologist, a doctor who specializes in inflammatory conditions (such as RA).

“It helps to work with a caring physician who will be positive and up on the latest treatments and advances,” Vash says.

Ask your doctor for a recommendation.

To learn more, visit our Rheumatoid Arthritis Health Center.
How Much Do You Know About the Types of Arthritis?
About 46 million American adults – nearly one in five – suffer from some type of arthritis. It’s estimated that number will rise to 67 million by 2030. Do you or someone close to you have arthritis?

Bread: The Biggest Salt Culprit

2012-02-10T00:11:00.001-08:00

Nine out of 10 American adults consume too much salt and the leading culprit is not potato chips or popcorn but slices of bread and dinner rolls, the Centers for Disease Control and Prevention said on Tuesday.

Forty-four percent of salt consumed can be linked to 10 types of foods, CDC said. Bread and rolls lead the list followed by cold cuts and cured meat, pizza, poultry, soups, sandwiches, cheese, pasta dishes, meat dishes, and snacks such as pretzels and potato chips.

Bread may not have much salt in a single serving, but when eaten several times a day can raise daily salt intake. A single slice of white bread could contain as many as 230 milligrams of salt, according to the CDC.

High salt intake can raise blood pressure, which can lead to heart disease and stroke, the CDC said.

The average American consumes 3,266 milligrams of salt daily, not counting salt added at the table, which is far above the recommended 2,300 milligrams, the CDC said.

For six out of 10 Americans, including those who are over age 51 or have high blood pressure or diabetes, 1,500 milligrams is the recommended daily salt limit.

Even foods that seem healthy such as cottage cheese may be high in salt, the agency reported. Even raw chicken and pork is often injected with salt.

The CDC recommended eating more fruits and vegetables and carefully reading the labels on food products to find those with the lowest salt content.

"Heart disease and stroke are leading causes of death in the United States and are largely dependent on the high rate of high blood pressure," CDC Director Dr. Thomas R. Frieden told reporters in a telephone news conference Tuesday.

One in three American adults has high blood pressure, he added.

"One of the things that is driving blood pressure up is that most adults in this country eat or drink about twice the amount of sodium as is recommended," Frieden said. "Most of that extra sodium comes from common grocery store and restaurant items and a very small proportion from the salt shaker at the table."

Nearly two-thirds of the salt consumed by Americans is found in store products, 24.8 percent from restaurants, and the remainder from other sources such as vending machines and the home salt shaker, the study found.

Salt per calorie of food consumed was much higher at restaurants than from store-bought food, the CDC said.

Frieden recommended that food producers and restaurants voluntarily reduce the amount of salt in their food. A 25 percent drop in the salt content of the top 10 sodium sources would save 28,000 lives a year, he added. It would also give consumers more choice, he said.

The Grocery Manufacturer's Association said that the food industry has been trying to reduce the salt content of thousands of products while keeping it tasty for consumers.

"While progress is being made, reducing sodium in products without affecting the taste or consumer acceptance of products is no easy task," the industry group said in a statement emailed to Reuters.

The group said that challenges of reducing salt include finding substitutes for it that maintain the taste, and making sure that food safety standards are met because salt is a major preservative in many foods.

Fitness and Fatness Both Impact Heart

2012-02-10T00:09:00.001-08:00

Losing fitness or packing on fat with age each can be bad for the heart — but avoiding either one of those fates may protect the ticker, a study published Monday suggests.

U.S. researchers found that of more than 3,100 healthy adults they followed, those who improved — or simply maintained — their fitness levels were less likely to develop high blood pressure, high cholesterol or other well-established heart disease risk factors.

Similarly, people who maintained their weight had fewer of those red flags than people who became heavier over time.

That may sound logical, but part of what's new in the findings, researchers say, is that changes in fitness and "fatness" each appeared important on their own.

In general, people who kept their fitness levels over time seemed to counter some of the ill effects of weight gain. And dips in fitness levels weren't as bad if a person lost some excess body fat.

The results suggest that protecting heart health is not as hard as some people think, according to lead researcher Duck-chul Lee, of the University of South Carolina in Columbia.

That is, just maintaining your weight and fitness levels as you age may be enough to see benefits.

"If you're overweight, losing weight and improving your fitness may be the best combination," Lee told Reuters Health. "But that's very challenging."

For many people, "maintenance" may be more achievable, Lee said.

The study, published in the Journal of the American College of Cardiology, included 3,148 men and women in the Dallas area who were in their early 40s, on average, at the outset.

Over six years, they developed high blood pressure at a rate of four percent each year, high cholesterol at a rate of three percent per year and so-called metabolic syndrome at a rate of two percent per year. (Metabolic syndrome refers to a collection of risk factors for heart disease -- including high blood pressure, unhealthy cholesterol levels, abdominal obesity and high blood sugar.)

But people who kept up or improved their fitness levels — as measured during treadmill tests — had lower odds of developing those heart risk factors.

Their risks of high blood pressure or high cholesterol were 26 percent to 30 percent lower, versus people whose fitness levels declined. And their risk of metabolic syndrome was 42 percent to 52 percent lower.

Similarly, when people increased their percentage of body fat over time, they were more likely to develop heart risk factors.

For each one percent increase in body fat, the odds of those risk factors climbed anywhere from three percent to eight percent.

But in general, people who gained weight stayed healthier if they kept up their fitness levels. And if overweight people shed some fat, they countered some of the negative effects of waning fitness.

The bottom line, according to Lee, is that people who are active should stay active. Even if you don't see a benefit on your bathroom scale, you'll stay fit.

"If you're already exercising, keep it up, and maybe increase the intensity if you can," Lee said.

If you're sedentary but healthy, he said, you can safely take up moderate exercise like brisk walking. Lee added, though, that people who are obese or have chronic health conditions should talk to their doctors first.

"It's the sedentary people who will get the most benefit from exercise in a short time," Lee said.

He was, however, referring to the benefit of improved fitness. Overweight people often fail to see the pounds fly off when they first start exercising -- possibly because they are hungrier and start eating more.

Don't get discouraged by that, Lee said. You can improve your cardiovascular fitness even without shedding the extra body fat. One way to tell if your fitness is improving, Lee said, is to simply notice how you feel when you go about your normal exercise routine; if it's getting easier, you're getting fitter.

To actually lose weight, diet changes are needed as well.

"Most people will lose weight with exercise," Lee said

Older Women More Likely To Die of Breast Cancer

2012-02-10T00:08:00.000-08:00

Breast cancer is often considered more deadly among younger women, but a new study shows older women are actually more likely to die of the disease.

Researchers found that among women who had been diagnosed with a certain type of breast cancer, those over 75 years old were 63 percent more likely to die of the cancer than women younger than 65.

"I suspect it's undertreatment," said Dr. Stephen Jones, one of the authors of the study and the medical director at US Oncology Research in Texas. "We did show the rates of chemotherapy and radiation therapy are less in the older group."

Jones and his colleagues tracked nearly 10,000 women who had already gone through menopause and who had been diagnosed with hormone receptor-positive breast cancer.

That is the most common type of the disease, and it is considered less dangerous than the hormone receptor-negative types because it is often slower growing and might respond to hormone treatments.

Younger women are more likely than older women to have the receptor-negative cancer and they also tend to get diagnosed at a later stage, leading to the idea that breast cancer is more deadly for them.

In this study, the researchers found that five out of every 100 women who were diagnosed under age 65 and six out of every 100 women diagnosed between 65 and 74 years old died from breast cancer within five years.

Among women over age 75 at the time of their diagnosis, eight out of every 100 died from the cancer.

The team isn't sure how to account for the gap, but Dr. Hyman Muss of the University of North Carolina School of Medicine, agreed with Jones.

"What's different in older women is they tend to get lesser and poorer treatment," said Muss, who was not involved in the new study.

About one in eight American women will get breast cancer at some point in their life, but less than a fourth of them will die from it.

Breast cancer can be treated with a combination of surgery, radiation, chemotherapy, and hormonal medications.

Nearly all the women in the study went through surgery, but just half of the women over age 75 had radiation, and just five percent had chemotherapy.

In comparison, 75 percent of women under age 65 received radiation and 51 percent had chemotherapy.

"There are beliefs that older women do not benefit from chemotherapy as much as younger women, and that the side effects are worse," said Dr. Gerrit-Jan Liefers, a researcher at Leiden University Medical Centre in The Netherlands who also worked on the study.

He added that the patients themselves may also be more hesitant to treat their cancer aggressively.

A recent study found that, while the rates of breast cancer deaths have been slowing, older women have had smaller gains than younger women.

Those authors also attribute the differences in part to less aggressive treatment in older women.

"You don't want to treat older women so aggressively that you actually cause more problems from the treatment than from the disease," Dr. Benjamin Smith from the University of Texas MD Anderson Cancer Center in Houston, who worked on that study, told Reuters Health in November.

Muss said it's possible to overtreat elderly patients, but otherwise healthy women in their 70s would likely benefit from chemotherapy.

"We need to teach doctors not to think of a person's chronologic age, but think of their functional age," Muss said.

Liefers said clinicians badly need a tool that can help them better calculate the optimal treatment for older women.

His findings, published in the Journal of the American Medical Association, also showed that as women got older, the chances of dying from something other than their breast cancer increased dramatically.

The encouraging finding for women of all age groups is that the vast majority will survive their cancer, Jones pointed out.

"The overall death rates are pretty low," he told Reuters Health. "I think that's a good message."

Shocking the Brain Improves Memory

2012-02-10T00:02:00.000-08:00

THOUGHT FOR THE DAY...

2012-02-09T07:45:00.000-08:00

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2012-02-09T07:40:00.000-08:00

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* The sun is 330,330 times larger than the earth. *
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Alzheimer's Research Gets Funding Boost

2012-02-09T00:38:00.001-08:00

The Obama administration is boosting funding for Alzheimer’s research by $50 million this year to further investigate the genetic underpinnings of the disease and test drugs that may arrest its development.

About 5.1 million Americans suffer from the condition and caseloads are expected to double by 2050, according to the Department of Health and Human Services. The cause of the degenerative condition is unknown and there is no cure.

Patient advocacy groups have intensified lobbying efforts in the last two years, arguing that federal research efforts are underfunded and the disease poses a long-term economic threat, said George Vradenburg, chairman of UsAgainstAlzheimers, a Washington nonprofit.

“If you look at it over the next 10 years, the aggregate cost is about $2 trillion — which in fact is about the amount we’re supposed to be trying to reduce our operating deficit by,” Vradenburg said. “It is of that kind of scale.”

Medicare and Medicaid, the government health programs for the elderly and the poor, spend about $130 billion combined each year treating Alzheimer’s patients, Vradenburg said.

The National Institutes of Health, the largest source of biomedical research funding in the world, expected to spend about $450 million on Alzheimer’s research this year before Wednesday’s announcement. The agency will spend about $3.1 billion on HIV/AIDS research this year and $5.8 billion on cancer.

Critical Challenge

Alzheimer’s “has quickly become one of our nation’s most critical health challenges,” Health and Human Services Secretary Kathleen Sebelius said at an event in Washington Wednesday announcing the new funding.

About half of the $50 million will be used to sequence the genomes of people with Alzheimer’s to try to identify genes and gene changes connected to the disease, said Richard Hodes, director of the National Institute of Aging in Bethesda, Maryland, the arm of NIH that directs Alzheimer’s research. The rest will be dedicated to the “most meritorious” Alzheimer’s projects at NIH’s 32 institutes, Hodes said by phone.

Vradenburg, whose wife’s mother died of Alzheimer’s, founded his organization in the fall of 2010 and has since joined with Eric Hall, president and CEO of another advocacy group, Alzheimer’s Foundation of America, to create Leaders Engaged in Alzheimer’s Disease, an umbrella organization.

The groups produced a report last May that criticized funding for the National Institute of Aging as “miniscule and declining” and called for an increase of $300 million per year, to $1.4 billion, for the office.

National Plan

President Barack Obama signed a law in January 2011 that creates a national plan to address Alzheimer’s. Vrandenburg and Hall sit on a board advising Sebelius’ department on the plan, which will be completed in May, Vrandenburg said.

Advocacy efforts for Alzheimer’s patients haven’t previously been as robust as those for cancer and AIDS patients because people with dementia often aren’t able to speak for themselves, Hall said.

Cancer, for example, “has survivors — the people with the disease are able to raise their voice and engage,” he said. “Alzheimer’s disease is rather unique in that yes, some folks with Alzheimer’s in the early stage are able to speak. But generally they lose that ability; they’re not able to rally, if you will.”

Research breakthroughs are also driving the increased funding, Vradenburg said.

Suspect Protein

Scientists sponsored by NIH reported on Feb. 2 that for the first time they were able to track a protein associated with Alzheimer’s, called tau, as it spread through the brains of mice, destroying neurons. That and other recent developments have inspired confidence that new treatments may be found, said Francis Collins, director of the NIH.

Much of the new research may examine ways to prevent or slow the onset of Alzheimer’s, rather than treatments once it is established, Hodes said.

“The strong sense is that failure to make important inroads to date is at least in part due to the fact treatment has been directed at established disease,” Hodes said.

Obama plans to ask for an extra $80 million for Alzheimer’s research in his fiscal 2013 budget, to be released next week, Sebelius said. Sebelius’ department also plans to spend $26 million this year for Alzheimer’s efforts unrelated to research, such as support for patient families.

Copyright Bloomberg News

Flu Shot Dangers – What You Need to Know

2012-02-09T00:35:00.000-08:00

Government health authorities made a big push this fall and winter to get Americans to get the flu shot. But does is really work? Dr. Erika Schwartz, a leading national expert on disease prevention and the author of four best-selling books, says not everyone needs a flu shot, and questions remain about its possible side effects.

“Some people need the flu shot — if they are older, they’re chronically ill, if their immune system is at risk,” she says. “But in general, most people do not need the flu shot.”

Flu Shot Dangers – What You Need to Know

Wednesday, February 8, 2012 8:00 AM

Government health authorities made a big push this fall and winter to get Americans to get the flu shot. But does is really work? Dr. Erika Schwartz, a leading national expert on disease prevention and the author of four best-selling books, says not everyone needs a flu shot, and questions remain about its possible side effects.

“Some people need the flu shot — if they are older, they’re chronically ill, if their immune system is at risk,” she says. “But in general, most people do not need the flu shot.”

Reports so far this winter show the flu season has been a mild one, with the Centers for Disease Control and Prevention saying flu activity is “relatively low.” Even if that changes and many more cases are reported, Dr. Schwartz advises people who are healthy not to panic and get a flu shot, especially because it takes six to 12 weeks for it to become fully effective, she says.

“If you’re going to run out the moment you hear somebody next door got the flu, then you’re actually not doing yourself a service,” she says. “You’re better off washing your hands, sleeping well, exercising, eating right, not drinking a lot of alcohol, not drinking a lot of caffeine, and really taking care of yourself because that’s more likely to prevent the flu than the flu shot.”

What’s more, people should know that there are questions about possible ill effects from the flu shot. About .35 percent of the flu vaccines made in the United States contain the preservative thimerosal, a stabilizer that has mercury in it. While other flu vaccines may not contain mercury, a potential neurotoxin, they do contain other stabilizers and not enough is known about their safety either, she says.

Some people may confuse colds with flu, but the flu is much more severe. A cold lasts about three to five days and causes coughing, sneezing, runny nose, and sometimes a low fever. Flu, on the other hand, is like a severe cold, she says, plus it causes terrible muscle aches, intense fatigue, and sometimes gastrointestinal symptoms like vomiting, nausea, and diarrhea. It usually lasts about five to seven days.

“It really affects your entire body and also it’s always associated with high fever,” she says. “But the treatment (for colds and flu) is all the same because it’s all caused by a virus, which is usually self-contained. So you want fluids, vitamin C, (the milk protein supplement) lactoferrin, and rest.”

Taking the flu remedy Tamiflu is not the answer, she says, because there is no scientific data proving it shortens flu duration. Also, studies have raised questions about whether Tamiflu results in more severe flu later in people who take it.

And while many of us would love a simple prescription for antibiotics to fight the flu, they do not treat the flu because it is caused by a virus. Antibiotics fight bacteria, parasites, and fungi, Dr. Schwartz notes, not viruses.

“We want to go get an antibiotic, but it’s actually going to make us sicker over the long run because antibiotics decrease our immune system’s reaction and response to any kind of viral infection.”

Symptoms of Endometriosis Myths Debunked - Is Endometrial Tissue Cancer? Plus 9 More Questions Answered

2012-02-09T00:28:00.000-08:00

When a disease remains an enigma to doctors, it’s no wonder women are confused. While the condition can be incredibly painful, some women experience no symptoms of endometriosis at all. Does it make you infertile? Is there a cure? Here’s what you need to know...

More than 5 million women in the U.S. have it – yet for many, endometriosis remains shrouded in mystery. Although thought of as a serious condition, it’s largely misunderstood, even by the medical profession.

“One reason endometriosis is mysterious is that many women with minimal disease have very severe pain, whereas many women with advanced disease have very little pain,” says Charla M. Blacker, M.D., an ob-gyn and reproductive endocrinologist at Henry Ford Health System in Troy, Mich.

Endometriosis is a physiological disease. The uterus is lined with endometrial tissue. In most women, this tissue is found only in the uterus.

However, in women with endometriosis, endometrial tissue grows in places where it’s not supposed – for example, on the outside of the uterus, ovaries, bowels, bladder, fallopian tubes, rectum, lining
of the pelvic cavity and elsewhere. In rare cases, it can grow in the brain or lungs.

When this happens, the growth can produce cysts, scar tissue, nodules, bumps or adhesions – all of which can interfere with the organ's function and trigger severe pain.

Highly variable symptoms of endometriosis and no known cause can make the disease ripe for misinformation. Here's the truth behind 10 commonly held beliefs.

1. Endometriosis is just another name for heavy periods that young women eventually outgrow.
False. Heavy periods is one of the symptoms of endometriosis, but sometimes they're also a sign of another problem (usually a hormonal imbalance). Conversely, endometriosis can cause heavy periods, but not always.

Endometrial tissue within the uterus responds to your body’s reproductive hormones and goes through a monthly cycle. It builds up in preparation for an egg implantation and pregnancy. If that doesn't occur, blood and tissue inside the uterus break down and are shed as menstrual flow.

However, because blood from displaced endometrial tissue can't flow out of the body as menstruation, it remains and instead irritates the surrounding organs.

2. Heavy, painful periods always signal endometriosis.
False. “Heavy, painful periods don’t necessarily mean endometriosis,” says Carlos Rotman, M.D., chief of gynecology at Weiss Memorial Hospital and associate professor of obstetrics and gynecology at Rush Medical College in Chicago.

Menstrual and pelvic pain can have other causes, such as uterine fibroids and infections, although about 25%-35% of women with severe menstrual
pain have endometriosis.

If a teen or woman has painful periods fewer than 27 days apart, with bleeding that lasts for more than seven days, she should talk with her doctor about the possibility of endometriosis, especially if there’s a family history.

Women can develop endometriosis at any point in their reproductive years, from puberty to menopause. After menopause, hormone levels decrease and menstruation ceases, so endometrial tissue no longer sheds in the uterus.

The disease is most commonly discovered between 25 and 30 years old in asymptomatic women, when they have trouble getting pregnant.

3. The only symptom of endometriosis is menstrual pain.
False. “Symptoms of endometriosis are extremely variable and may range from no symptoms to debilitating pain during the menstrual period, with intercourse or throughout the month,” Blacker says.

Endometriosis can also be associated with chronic pelvic and low-back pain, intestinal pain, premenstrual spotting and painful bowel movements or urination. But these symptoms can have many other causes too.

In rare cases, endometriosis can cause pain in unusual locations with very odd symptoms, according to the U.S. Department of Health and Human Services Office on Women’s Health. For example, endometriosis in the lung can cause a collapsed lung. Or in the brain, it can trigger a seizure.

Painful symptoms of endometriosis can be erratic. Typically, it begins just before the menstrual period and goes away or gets lighter once bleeding begins. But that’s often not the case.

“Pain from endometriosis can also be constant and ongoing,” throughout
the menstrual cycle, says R. Mark Ellerkmann, M.D., chief of the Division of Urogynecology and Reconstructive Pelvic Surgery at the Greater Baltimore Medical Center.

4. Endometriosis isn't easily diagnosed.
True.When endometriosis causes typical symptoms – premenstrual pain and heavy periods, for example – a skilled gynecologist should be able to diagnose it based on your symptoms, family history and a pelvic exam.

When symptoms are erratic, however, diagnosis is more difficult. One challenge doctors face: There are no simple blood tests or X-rays that show endometriosis.

“We really can only accurately diagnose the condition by looking into the pelvis” with a minor surgery called laparoscopy, Rotman says.

With the procedure, you'll receive general anesthesia and your abdomen will be filled with gas to expand it and make it easier for your doctor to see the organs. Through a tiny cut in your abdomen, the doctor will slide in a thin tube with a light that allows visual inspection.

Sometimes endometrial tissue is clearly visible. Other times, it's identified through tissue samples that your doctor removes during the procedure and later examines under a microscope.

Advanced endometriosis may be visible on ultrasound imaging, but earlier, less prominent tissue growth and scarring is not.

5. Endometriosis interferes with fertility.
True. Endometriosis can interfere with fertility, but 60%-70% of women with endometriosis have no trouble getting pregnant.

However, even if a woman has no pain, her doctor should consider
endometriosis if she’s having trouble conceiving. About one-third of infertile women have endometriosis, making it one of the top three causes of female infertility.

“Endometriosis causes infertility in a couple ways,” Blacker says:

It causes inflammatory changes in the pelvis that result in scarring, which can interfere with the function of the fallopian tubes and prevent proper fertilization from eggs and sperm.

Even when scarring isn’t present, small amounts of endometriosis result in a decrease in pregnancy rate because of chemicals released by endometrial implants. Called cytokines, these are toxic to sperm and may contribute to early miscarriage.

Having endometrial tissue laparoscopically removed can help some women with endometriosis to conceive and have a successful pregnancy. Another option is assisted reproductive techniques, such as in vitro fertilization.

“By moving the fertilization process from the pelvis to the lab and replacing the embryo into the uterus without going through the affected
area, sperm and embryo aren’t exposed to these cytokines,” Blacker explains.

6. Endometriosis is a sexually transmitted disease.
False. Researchers know that endometriosis isn't caused by sexual activity, yet they don’t know what triggers it.

Because endometriosis seems to run in families, there may be a genetic component to the disease.

If your mother or sister has endometriosis, you have a 7% chance of developing it too, says Ellerkmann.

7. Pregnancy and menopause cure endometriosis.
False. Because of the hormonal changes of pregnancy, it can offer temporary relief for endometriosis. But it's no cure, and the signs of endometriosis can return after pregnancy.

In addition, having endometriosis during pregnancy is a major risk factor for premature birth and a C-section delivery, according to a 2009 study done at the Department of Woman and Child Health in Stockholm, Sweden.

Because menopause comes with a drop in estrogen, and estrogen feeds the endometrial growth, mild or moderate symptoms of endometriosis may
completely subside. But this isn’t always the case, according to the National Institutes of Health (NIH).

8. There are no good treatments for endometriosis.
False. Although endometriosis has no cure, treatments can successfully reduce symptoms.

One option is to have endometrial tissue growing outside the uterus removed through laparoscopic surgery. This is often the preferred treatment, although symptoms of endometriosis may return within a year for about 50% of women because the tissue grows back.

Several kinds of medications can also alleviate symptoms of endometriosis. They don’t work for every woman, but they may make the condition more bearable for many sufferers. Treatment options are individualized, depending on the extent and location of the disease, desire for pregnancy, patient’s age and the severity of the symptoms of endometriosis.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to relieve pain.

Oral contraceptives: Estrogen and progesterone, the hormones found in most birth control pills, work well if the pain or symptoms are mild, according to the NIH. Hormones can slow the growth of endometrial tissue and reduce the chances of new scarring and adhesions from developing. For some women, they help reduce or stop heavy menstrual flow, pain and other symptoms.

Natural or synthetic progesterone: Supplements of this hormone can
reduce menstrual flow, slow endometrial tissue growth and reduce pain and other symptoms.

“Approximately 80% of patients treated with progesterone therapy experience a partial or complete relief of their pain,” Ellerkmann says.

Danazol, a synthetic steroid, interrupts the release of hormones that are involved in the menstrual cycle. It can help reduce symptoms, but because it can be dangerous to an unborn baby, you should avoid pregnancy while taking it.

Gonadatropin-releasing hormone (GnRH) agonists: These drugs block the production of certain hormones, putting the body into a temporary menopausal state and slowing the growth of endometrial tissue.

Endometriosis treatments, which are administered via pills, injections, implants, or nasal sprays, can have side effects, such as hot flushes, headaches, vaginal dryness, mood changes, weight changes, insomnia, and decrease in bone density.

9. A hysterectomy will cure endometriosis.
False. Hysterectomy, the surgical removal of the uterus, fallopian tubes and ovaries, isn't a cure, but in most women it will end symptoms of endometriosis.

That's because endometriosis is most common on the reproductive organs
and the ovaries produce the hormones on which endometrial tissue thrives.

However, hysterectomy is usually a last resort because it takes away a woman’s ability to conceive.

10. Endometriosis is a kind of cancer.
False. Cysts formed by endometriosis are sometimes referred to as benign non-cancerous tumors, but you can have a tumor without having cancer.

While “endometrial cancer is a type of cancer that affects the lining of the inside of the uterus,” the NIH states, “endometriosis in itself is not a form of cancer.”

For more information, visit our Women's Health Center.

Do You Have Endometriosis?
Has your period always been troublesome? Can’t figure out your female problems? You may have endometriosis, a common gynecological condition in women that occurs during their reproductive years. Understanding the symptoms and how they impact you could take you one step closer to the answers and treatments you may need.

Top Mistakes People Make with Antidepressant Medication - What to Know When Taking Medication for Depression

2012-02-09T00:23:00.000-08:00

Americans prefer medication for depression, with 80% popping a pill for the condition, according to a Consumer Reports poll. But using antidepressants correctly will help your recovery, according to one Harvard-trained psychiatrist. Read on for his expert advice on the top mistakes people make with antidepressant medication…

Antidepressants are among the most commonly prescribed drugs in the U.S., with up 118 million prescriptions are written each year. Of these, more than 10% of women older than 18 take them, according to the Centers for Disease Control and Prevention (CDC).

But treating depression is more complicated than just swallowing a little pill every day.

Mistakes and misuse of antidepressants can hamper recovery for people with depression.

To find out the top blunders to avoid, we spoke with mood-disorder expert Michael Banov, M.D., a triple-board-certified, Harvard-educated psychiatrist and author of Taking Antidepressants: Your Comprehensive Guide to Starting, Staying On, and Safely Quitting (Sunrise River Press). Banov is also director of Northwest Behavioral Medicine and Northwest Behavioral Research Center in Atlanta, Ga, which tests new drugs to treat psychiatric disorders, including depression.

In this exclusive Lifescript interview, Banov discusses how to make the
most of your antidepressant. Read on for his advice.

What’s the biggest mistake people make with antidepressants?
Taking medicine too early – before you’ve tried to pull yourself out of depression with other methods, such as counseling and lifestyle changes.

Exercise, for example, boosts serotonin and endorphins, which have an antidepressant effect.

It has been shown to work well for mild to moderate depression, but it’s best when done with sufficient intensity. One 2005 study showed improvement with 35 minutes of fast walking five times a week, or 60 minutes three times a week.

You can make changes to your diet too. Fast food, refined sugars, soft drinks, white bread and unrefined carbohydrates have been associated with higher rates of mood disorders. So have deficiencies in vitamin B, magnesium and omega-3 (as found in fish).

The herbal supplement St. John’s Wort can improve mood, although it can also interfere with other medications. Talk with a doctor before trying it.

Yoga has been shown to increase GABA (gamma-aminobutyric acid), a brain neurotransmitter that improves mood and anxiety.

Other nontraditional healing practices, such as meditation and
acupuncture, may work for some.

For example, women may find hormonal supplements useful during menopause. For Seasonal Affective Disorder (SAD), light therapy may be helpful.

And let’s not forget psychotherapy. In moderate depressions, medication and therapy can be equally effective.

Can you wait too long to get on antidepressants?
The earlier you treat depression, with medicine or not, the better. But some people get angry, confused or concerned when antidepressants are recommended.

Women tend to be resistant because they fear weight gain or loss of sexual appetite. But not all antidepressants have these side effects.

Some types of depression may not get better without drugs. You need to stop the chemical changes in the brain. Situations such as not doing well at work, a broken relationship or loss of a family member will worsen depression.

How can delaying antidepressant treatment harm us?
A potential consequence of not seeking treatment is that it can get so bad that you may end up in the hospital or hurting yourself.

Untreated depression can cause physical changes that can impact physical
and mental health – including depleting brain neurotransmitters, such as serotonin, norepinephine and dopamine.

People with certain types of depressions absolutely need antidepressants immediately. For example, postpartum depression that turns into psychosis (hearing and seeing things that aren’t there) is a psychiatric emergency.

With other types of depression, it’s not as clear. People with melancholic depression – where you can’t sleep, aren't eating and lose weight – tend to need drugs more than people with other forms.

Obviously, you want to make sure the medication is safe, effective and the best for you. Your doctor should be able to answer questions and explain what you need and why.

Do other illnesses mimic depression?
Yes, another mistake people make is not checking for other medical reasons [for their blues].

Anyone diagnosed with depression should have a thorough physical examination to rule out viruses, thyroid disorders, diabetes, infections, autoimmune diseases, stroke, even some cancers. All can have depression-like symptoms.

Your doctor also should review prescription medicines you’re taking, as
well as over-the-counter drugs and herbal products, because some can [mimic] depression.

Should I worry about side effects?
When starting an antidepressant medication, educate yourself and be open-minded. Understand what to expect. There may be mild, short-term side effects in the first few weeks.

Some people say the antidepressant makes them too drowsy or unable to sleep, that they feel agitated or nauseous, or have headaches.

If you’re concerned about side effects, call your doctor. A lowered dose or taking the drug at a different time of day may make the experience a lot better.

Also, understand that antidepressants don’t work immediately. Some people expect them to work within days, but it can take 4-6 weeks to feel their full effect.

And if one drug doesn’t work, consider taking another. There are 30 commonly used antidepressants on the market, and none has been shown conclusively to work better than another.

Patients often ask, ‘What’s the best medication to treat my depression?’ The answer is, ‘Whatever works best for you.’

What happens if I miss doses?
If you don’t take your antidepressant medication consistently from the beginning, you won’t get a good result. Over time, your depression will get
worse. People who miss doses may experience withdrawal symptoms.

If you’re not going to take your medicine or choose to stop shortly after starting, tell your doctor. He or she will address concerns and offer alternatives.

What if I continue having good and bad days?
You may be having a partial response to the drug. If you have residual symptoms, your depression is more likely to return.

Many people feel so much better with medication that they dismiss such symptoms as just having a ‘little’ trouble sleeping or a ‘slight’ energy problem.

But ignoring these symptoms is a mistake. You need to be open with your doctor about any problem.

I advise patients to keep a mood chart or diary to track feelings. There’s also a free iPhone application called “Mood Reporter.”

Write down whether you’re having a good or bad day, rates of depression and sleep [patterns]. This will help you and your doctor monitor where you are [in the recovery process].

If the first antidepressant isn’t showing the desired improvement, there may be other options. Research funded by the National Institute for Mental Health (NIMH) has shown that those who didn’t do well with their
first drug often did better when they switched to a second one.

Do I need to see a therapist if I’m taking an antidepressant?
Not all people need therapy, but everyone should do more than just take a pill. Most often, people do best with a combination of medication and non-drug treatment, such as lifestyle changes and therapy.

If you’re in therapy, continue it. If you’re not, take care of yourself with a good diet, exercise and stress reduction.

Don’t depend on medicine alone. You may feel so much better on the drug that you feel like you’ve found the answer. But you may find the depression eventually returns and even worsens if you don’t include other forms of treatment.

I’m feeling better. Can I stop taking the antidepressant?
Don’t make that mistake. The decision to stop taking medication must be made with your doctor and under their supervision.

Even if you feel better after a few months, the rate of depression returning is very high if you stop your antidepressant before 9-12 months.

Are antidepressants addictive?
No, but you can have withdrawal symptoms. Some antidepressants need
to be gradually stopped so your body can adjust. For most people, 4-6 weeks is needed to slowly and gradually wean off an antidepressant.

How do I know if I’m ready to stop my antidepressant?
The length of time someone needs to stay on antidepressants varies widely by person. The generally recommended time for antidepressant treatment for a single depression episode is 9-12 months.

Getting on antidepressants isn’t a life sentence, but if you have chronic depression – repeated episodes – you may need to stay on maintenance medication indefinitely, often at lowered doses.

Three good reasons to discontinue medication are:

You no longer need antidepressants to stay well.

The side effects outweigh the benefits.

The drug never really helped you get better.

For more information, visit our new Depression Health Center.
How Much Do You Know About Depression?
Despite all the progress in diagnosing and treating this disease, many people still are in the dark when it comes to understanding depression. How much do you really know?

The Right Diet During Pregnancy - The Best Pregnancy Foods for a Healthy Baby

2012-02-09T00:19:00.000-08:00

You may be eating for two, but that doesn’t mean supersizing your meals. Instead of piling another scoop of ice cream on your sundae, learn all about the healthful pregnancy foods you’ll need to help ensure the best outcome for you and your baby...

When you’re carrying a growing baby, good nutrition is more important than ever. After all, everything you eat is passed on to your little one.

But knowing exactly what to eat – and how much of each nutrient you need – can be as nerve-wracking as choosing a name.

Fortunately, the main goal is simple: Increase the amounts of healthful nutrients in your diet during pregnancy, says Kelly O’Connor, R.D., L.D., a registered dietitian at Mercy Medical Center in Baltimore.

“[The extra nutrition] will ensure that the mother remains healthy and that she promotes the normal growth and development of her baby,” O’Connor says.

Eating nutrient-dense foods also helps prevent too much weight gain, which can affect labor and the outcome of the birth, says Sean Daneshmand, M.D., ob-gyn, a maternal fetal medicine specialist with Sharp Hospital in San Diego.

"Obese women run an increased risk of gestational diabetes, congenital malformations (i.e. spine deformities), and 4-5 times the risk of having a stillbirth," he says.

For the recommended weight gain of 25-30 pounds, the average woman’s diet during pregnancy should include about 300 extra calories a day, says O’Connor.

And you need to make them count, she says. While sweets or junk food on occasion are fine, focus on wholesome foods that are rich in essential nutrients.
Most doctors also recommend taking prenatal vitamins to ensure consistent intake throughout the pregnancy, O’Connor adds.

So which nutrients are most important for your diet during pregnancy – and how do you get enough? Here’s what you should know about the top 10.

1. Folate
Why it’s important: This crucial B vitamin is involved in the development of the fetus’ neural tube – the beginnings of the brain and spinal cord.

Taking folic acid (the synthetic supplement form of folate) may reduce the risk of spinal cord birth defects, especially spina bifida. It also helps prevent anemia, “which can become a serious complication of pregnancy,” O’Connor says.

Because birth defects can occur at the beginning of a pregnancy, many doctors recommend you start taking folic acid if you’re even trying to have a baby.

If possible, “folic acid should be taken at least a month prior to conception,” Daneshmand says.

Get it in your pregnancy foods: The National Institutes of Health (NIH) recommends 600 micrograms (mcg) of folic acid for pregnant women – which is the amount often included in prenatal vitamins.

But food sources are preferable to supplement forms, says O’Connor. So get more folic acid during pregnancy with oranges and orange juice, whole grains, leafy green vegetables, beans, bananas, broccoli and fortified cereals.

“Continue including those food sources in the diet along with a supplement to keep the intake consistent and adequate day after day,” O’Connor says.

2. Vitamin B12
Why it’s important: This vitamin plays a role in the development of the nervous system, and along with folic acid, it may be involved in neural tube development, according to the NIH.

Get it in your pregnancy foods: Pregnant women should get 2.6 mcg of B12, the NIH says.

Most women absorb enough through their diet during pregnancy, says pediatrician Erika Landau, M.D., author of The Essential Guide to Baby’s First Year (Penguin). “If you have a healthy diet and are taking prenatal vitamins you should be OK.”

Because the main food sources are animal products, the American Dietetic Association recommends B12 supplements for strict vegetarians during both pregnancy and lactation. This ensures that enough of the vitamin is transferred to the fetus and infant.

B12 can be found in milk and milk products, lean meats, poultry, fish, eggs and nuts, as well as fortified cereals.

3. Iron
Why it’s important: Iron is part of hemoglobin, a substance in red blood cells that carries oxygen throughout the body.

When you’re pregnant, your body makes 30% more blood, so you have enough to share with your baby. A lack of iron could hurt your ability to make additional red blood cells, putting you at risk for iron-deficiency anemia (and increasing your baby’s risk of anemia in infancy).

Doctors often give pregnant women iron to supplement their diet during pregnancy, especially if they’re anemic or at risk of developing anemia, says O’Connor.

Get it in your pregnancy foods: The recommended daily allowance for iron is 30 milligrams (mg) for pregnant and lactating women, up from 18 mg per day for non-pregnant women under 50. This amount is often included in prenatal vitamins, but can also be met by three daily servings of iron-rich foods a day.
This boost can cause constipation in pregnant women, so it’s important to drink adequate fluids (at least 8 cups of water per day, according to the Cleveland Clinic) and get plenty of fiber from whole grains, fruits and vegetables.

Highly fortified breakfast cereals are a good source of iron, containing as much as 18 mg per serving.

Other good sources include whole grains, breads, lean beef, chicken, clams, crab, fish, egg yolks, oysters, pork, shrimp and turkey – as well as fruits such as berries, apricots, dried fruit, grapes, oranges, plums, prune juice and vegetables.

Lean beef is one of the best sources, says Keith-Thomas Ayoob, Ed.D., R.D., associate clinical professor of pediatrics at Albert Einstein College of Medicine in New York.

“Strive for lean beef three times a week,” he says.

4. Vitamin C
Why it’s important: A vitamin C deficiency is associated with a low-birth-weight baby, pre-eclampsia (pregnancy-induced high blood pressure) and anemia (because it helps the body absorb iron), says Landau. It’s best to get it from foods rather than supplements, because “moms should focus on eating as many fresh fruits and vegetables as they can,” she says.

Get it in your pregnancy foods: Pregnant women should get 120 mg of vitamin C per day, according to the NIH.

Good natural sources include red bell peppers, broccoli, collard greens and vegetable juices, along with mangos, papayas, cantaloupe, strawberries, oranges and orange juice.

5. Zinc
Why it’s important: A zinc deficiency may also contribute to pre-eclampsia (high blood pressure). The condition is associated with swelling of the body’s tissues and excess protein in the urine, and zinc helps the body absorb protein rather than excrete it.

Get it in your pregnancy foods: The RDA of zinc is 11 mg for pregnant women and 12 mg for lactating women, says O’Connor.
Additional zinc supplements aren’t usually needed if a woman is already taking prenatal vitamins and eating a good variety of foods, she says.

High-protein foods such as meat, chicken and fish are good sources of zinc. Dark meat chicken contains more than light meat.

6. Calcium
Why it’s important: Calcium builds bones – not just yours, but your baby’s too.

If you don’t get enough to support your child’s bone growth, your body will take calcium away from your bones. This decreases your bone mass and puts you at risk for osteoporosis later in life.

“The baby will have good bones whether you drink [enough] milk or not,” Ayoob says.

Get it in your pregnancy foods: The recommended daily allowance for calcium is 1,200 mg for pregnant and lactating women over the age of 24; women under 24 may need up to 1,500 mg per day.

Low-fat dairy products contain the highest amounts of calcium; spinach, beans and almonds also rank high.

Four daily servings of dairy and calcium-rich foods in your diet during pregnancy will help ensure you’re meeting calcium requirements.

7. Vitamin D
Why it’s important: The “sunshine vitamin” works along with calcium to build baby’s bones; it also helps your body absorb calcium.

“A baby’s bones start forming early [in the first trimester], so it’s important to have enough vitamin D from the very beginning of your diet during pregnancy,” Landau says.
“I usually recommend 800 IU [“international units” – one IU is equal to 40 mcg], unless the mother is deficient in vitamin D, in which case she may need more,” Landau advises.

Routine screening of pregnant women for vitamin D levels isn’t necessary, and you probably get enough if you’re taking prenatal vitamins, according to a June 2011 statement issued by the American College of Obstetricians and Gynecologists.

But if your doctor suspects you’re deficient, he or she can do a blood test to find out.

Get it in your pregnancy foods: Your body creates vitamin D through a reaction of sunlight on the skin. But sun exposure without protection is linked to skin cancer and isn’t recommended, says Landau.

“You can get vitamin D from food, but not enough to fulfill your requirements without adding too many calories,” she adds. Salmon and fortified foods such as milk, soy milk or orange juice are some of the sources.

If you take additional vitamin D supplements, try capsules for best absorption, says Landau.

8. DHA (docosahexaenoic acid)
Why it’s important: An omega-3 fatty acid, DHA plays a role in the development of the fetal brain, eyes and heart, says dietitian Elizabeth Somer, R.D., author of Nutrition for a Healthy Pregnancy (Henry Holt and Co.).

Infants whose mothers took DHA during the last half of pregnancy had a lower ponderal index (the infant equivalent to body mass index), which is associated with a lower risk of obesity later in life, according to an April 2011 study published in the British Journal of Nutrition.

Get it in your pregnancy foods: A diet during pregnancy should provide at least 300 mg of DHA per day, according to Somer.

“Most women get only 60-80 mg of DHA a day, so it’s important to consider supplementation,” Somer says.
DHA is found in some cold-water fatty fish, but “many pregnant and nursing women don’t like to eat fish because of contaminants,” she adds.

You can eat up to 12 ounces a week, or two servings, of lower-mercury fish and shellfish, such as shrimp, or canned light tuna, salmon, pollock and catfish.

Albacore tuna contains more mercury than light tuna, so limit yourself to no more than 6 ounces of albacore per week.

Avoid shark, swordfish, king mackerel and tilefish, which have the highest levels of mercury.

Many fish-oil supplements have been distilled to remove toxins – a 2008 test of more than 40 brands by ConsumerLab.com found no mercury contamination.

9. Protein
Why it’s important: Protein helps support the growth of the baby, especially during size increases in the second and third trimesters, according to O’Connor.

“[A woman’s] protein needs increase by about 15 grams (g) a day in a diet during pregnancy,” she says.

Get it in your pregnancy foods: Your diet during pregnancy should include approximately 70 g of protein a day. An average portion of a protein-rich food, such as 3-1/2 ounces of fish or chicken, contains about 22 g.

Protein intake should primarily take the form of lean meats, chicken or other poultry, fish (especially those with omega-3 fatty acids), nuts, legumes, low-fat dairy products and soy products.

Cheese is a source of both protein and calcium, but some women may find it constipating.

If you’re a vegetarian, there’s no need to start eating meat – “you can still get plenty of protein,” Landau says.

But because vegans don’t eat dairy or eggs, they should see a nutritionist to ensure they get enough protein during pregnancy.

10. Carbohydrates
Why they’re important: Pregnancy is not a good time to drastically cut carbs, according to a study published in the April 2011 issue of Diabetes, a journal of the American Diabetes Association.

It showed that moms who limit their carbohydrate intake during the first trimester were more likely to have children who become obese.

Carbohydrates should comprise approximately 50% of a diet during pregnancy.

Get them in your pregnancy foods: Choose healthy carbs – including whole grains and brown rice – instead of over-processed and refined flours and sugars.

Limit carbs that are high on the glycemic index, which are likely to cause a more rapid rise in blood sugar, says Daneshmand. These include white bread, pretzels and doughnuts.

High-glycemic fruits include bananas and pineapple. Instead, choose lower-glycemic fruits such as cherries, apricots, grapefruit, apples, plums and peaches.

For more information, visit our Pregnancy Healthy Eating Guide
Are You Ready for Your New Baby?
Your belly is bulging and your due date is fast approaching. Your bag is packed, the baby’s room is done, and you have a name picked out. But are you ready for your new baby?

THOUGHT FOR THE DAY...

2012-02-08T01:06:00.001-08:00

We can judge the heart of a man by his treatment of animals.

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2012-02-08T01:03:00.000-08:00

* Sound travels about 4 times faster in water than in air. *

* Oxygen, carbon, hydrogen and nitrogen make up 90% of the human body. *

* 0.3% of solar energy from the Sahara is enough to power the whole of Europe. *

* Oak trees produce 2,200 acorns in a season, but each acorn only has a 1 in 10,000 chance of becoming an oak tree. *

* Scientists aren't sure what color dinosaurs were. *

* The only letter not appearing on the Periodic Table is the letter "J". *
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Anxiety Therapy Less Effective in Elderly

2012-02-08T00:49:00.000-08:00

A form of talk therapy called cognitive behavioral therapy appears to help older adults battle anxiety disorders slightly better than other approaches, but not as well as in younger adults, according to a new study.

"Cognitive behavioral therapy is the mainstay for treating anxiety disorders in younger adults. Its lower effect in older adults in this study is concerning," said Dr. Eric Lenze, a professor at Washington University School of Medicine who was not involved in this study.

Anxiety disorders, which include panic disorder, phobias, post-traumatic stress, and generalized anxiety disorder, are common in adults over age 55.

The authors write in the Journal of the American Geriatrics Society that three to 14 out of every 100 older adults has an anxiety disorder.

While earlier studies have shown that cognitive behavioral therapy works well for younger and middle-aged adults, there has not been as much research into the treatment for seniors.

"The prevailing assumption tends to be that what works with working-age people will work with older people, but this might not actually be the case," said Rebecca Gould, the lead author of the study and a researcher at King's College London.

Gould's team gathered up the results from 12 previous studies on people over age 55 with an anxiety disorder.

Half of the studies compared cognitive behavioral therapy to other treatments, such as medications or group discussions, while the other half compared the therapy to no treatment.

Cognitive behavioral therapy (CBT) often involves one-on-one meetings with a therapist, with the ultimate goal of solving the defective thinking process that's causing the disorder.

On average in the studies, people went through 12 sessions of therapy.

Compared to doing nothing, cognitive behavioral therapy had a "moderate" effect on helping people's anxiety.

Compared to medications or group discussions, the therapy relieved the disorder slightly better.

Gould's team noted that the improvement over other treatments was small.

"What this might mean clinically is that the client in the CBT condition might be a little less severely or moderately anxious relative to the client in the active control condition," Gould wrote in an email to Reuters Health.

Addressing Root Causes

Gould says therapy might work better than drugs because it seeks to fix the causes of anxiety rather than the symptoms.

"If we can address the causes of symptoms of anxiety (e.g. by changing how we think about or interpret things) then we can stop them coming back in the future. If we only address the symptoms of anxiety then we can't," she said.

Though Gould's analysis and those of studies in younger adults agree that cognitive behavioral therapy helps treat anxiety, the effect in older adults is small while the effect seen in younger adults is moderate or large, the authors wrote.

Gould said she doesn't know why the therapy seems less effective in older adults, but it's possible that talk therapy might take longer to work for them.

Lenze said that cognitive behavioral therapy is still worthwhile in older adults.

"Until better treatments are developed there are somewhat limited options," he told Reuters Health.

He added that anxiety can take a toll on the mental and physical health of adults if it's not treated.

Gould said more studies that compare cognitive behavioral therapy to other treatments are needed in older adults, and her group is planning a study that explores the benefit of "mindfulness-based" cognitive therapy, which includes practices such as meditation.

Lenze said he and his colleagues are also exploring this approach, as well as combining cognitive behavioral therapy with medications.

Green-Tea Drinkers Stay Agile in Old Age

2012-02-08T00:47:00.001-08:00

Elderly adults who regularly drink green tea may stay more agile and independent than their peers over time, according to a Japanese study that covered thousands of people.

Green tea contains antioxidant chemicals that may help ward off the cell damage that can lead to disease. Researchers have been studying green tea's effect on everything from cholesterol to the risk of certain cancers, with mixed results so far.

For the new study, published in the American Journal of Clinical Nutrition, researchers decided to examine the question of whether green tea drinkers have a lower risk of frailty and disability as they grow older.

Yasutake Tomata of the Tohoku University Graduate School of Medicine and his colleagues followed nearly 14,000 adults aged 65 or older for three years.

They found those who drank the most green tea were the least likely to develop "functional disability," or problems with daily activities or basic needs, such as dressing or bathing.

Specifically, almost 13 percent of adults who drank less than a cup of green tea per day became functionally disabled, compared with just over 7 percent of people who drank at least five cups a day.

"Green tea consumption is significantly associated with a lower risk of incident functional disability, even after adjustment for possible confounding factors," Tomata and his colleagues wrote.

The study did not prove that green tea alone kept people spry as they grew older.

Green-tea lovers generally had healthier diets, including more fish, vegetables, and fruit, as well as more education, lower smoking rates, fewer heart attacks and strokes, and greater mental sharpness.

They also tended to be more socially active and have more friends and family to rely on.

But even with those factors accounted for, green tea itself was tied to a lower disability risk, the researchers said.

People who drank at least five cups a day were one-third less likely to develop disabilities than those who had less than a cup per day. Those people who averaged three or four cups a day had a 25 percent lower risk.

Although it's not clear how green tea might offer a buffer against disability, Tomata's team did note that one recent study found green tea extracts seem to boost leg muscle strength in older women.

While green tea and its extracts are considered safe in small amounts, they do contain caffeine and small amounts of vitamin K, which means it could interfere with drugs that prevent blood clotting.

Cardio Fitness: How to Get Started

2012-02-08T00:46:00.000-08:00

Want an exercise that boosts your mood, improves heart function and cuts your cancer risk? The miracle workout is cardio, in whatever heart-pumping form you prefer. Read on to learn how it can help you…

Cardiovascular exercise is essential to any exercise program, says the American Council on Exercise (ACE). That’s true whether you want to get fit, stay healthy, lose weight, lower cholesterol, or prevent a variety of other diseases and disorders.

How does it work? When you move your body vigorously, you increase your heart rate. Over time, that improves your body’s ability to use oxygen. It also burns calories, builds muscle tone and transports more oxygen to your brain.

Why Do Cardio?
Here’s how cardio benefits your health.

Weight loss: People who did two hours of cardio a week along with resistance training decreased their diastolic blood pressure and lost an average of 4 pounds, a 2011 Duke University study found.

Reduced heart risks: Older adults who did cardio more than once a week were 40% less likely to have a silent stroke, according to a joint study from Columbia University and the University of Miami.

And elderly exercisers who did cardio six to seven times a week throughout their adulthood had more healthy heart muscle than young, sedentary people, according to a 2011 presentation to the American College of Cardiology.

Reduced cancer risk: Men who exercised an hour a day, six days a week, for a year, decreased the amount of cellular proliferation in the areas of the colon most vulnerable to cancer, according to a 2006 study by the Fred Hutchinson Cancer Research Center in Seattle.

Migraine relief: Aerobic exercise on a stationary bike for 40 minutes, three times a week, worked as well as relaxation therapy or the anti-epileptic drug topiramate in preventing migraines, according to a 2011 Swedish study. The bike workout reduced attacks by 75%.

Mental well-being: Middle-aged women who ran on a treadmill at moderate intensity for 30 minutes reported having more energy and greater feelings of psychological well-being, a 2011 Penn State University study found.

Chronic pain relief: Women who exercised at least two hours a week were 8% less likely to develop lower back pain than women who didn’t, and 9% less likely to develop neck and shoulder pain, according to a
2011 Norwegian study.

Get Equipped
Before you start your cardio workout, these basic tools will help you perform at your best.

Shoes: The type of exercise dictates the shoes you’ll need. Runners need knobby-soled shoes for forward-motion stability. For cross-training and most sports in which you move from side to side, such as tennis, you need a flat-soled shoe with good lateral support.

Sports bra: Bouncing breasts are a major exercise deterrent: One in two women complains of breast pain during exercise, according to a 2007 study by the University of Portsmouth, England.

Encapsulation bras hold each breast separately, rather than pressing them to your chest, as compression bras do. Even better? A bra that encapsulates and compresses.

Heart rate monitor: Enter your information into the device – height, weight, age – then strap on the chest transmitter. The display will show how many calories you’re burning.

“It’s an essential training tool that helps measure your intensity through your heart rate’s response to exercise,” says Robin Rutherford, an ACE-certified personal trainer with Whole Body Fitness in Newport Beach, Calif.

Use our target heart rate calculator to find out what heart rate is most beneficial to you during exercise.

Pedometer: An inexpensive, basic-model pedometer can record your steps.

“Aim for 10,000 steps a day,” says Lifescript fitness expert Joel Marion, author of The Cheat to Lose Diet (Three Rivers Press). “That’s the equivalent of walking 5 miles.”

Phone Apps:

RunKeeper: This free app uses your smart phone's global positioning system (GPS) to track your running route on a map and monitor activity. It tracks distance, time, pace and speed, as well as calories burned. Available for iPhone and Android.

Endomondo: Similar to other running apps, the free Endomondo Sports Tracker uses your phone's GPS to monitor activity in your favorite sport, whether running, biking, hiking, skiing, kayaking or walking. It plays music and lets you plan routes in Google Maps. You can get audio feedback on your performance, and friends can instant-message real-time pep talks to keep you moving. It also
keeps a history of runs and lets you compete with others. Available on iPhone.

Get Started
Choose a cardio workout that you enjoy – that way you’ll be more likely to stick with it, experts say. Here are some tips from the American Council on Exercise (ACE) on beginning a cardio program.

Increase exercise level gradually.
If you haven't exercised in a while, get your doctor's OK and find out what to avoid, especially if you have a chronic condition, such as heart disease, diabetes or arthritis.

At the very least, complete the Physical Activity Readiness Questionnaire (PAR-Q), an easy way to determine your physical readiness for exercise.

Go easy in the beginning. Do what you can and steadily increase time, frequency and intensity – in that order – increasing total weekly time by no more than 10% per week. As your fitness level improves, aim for 30 minutes, 5 days a week.

Be patient – regular exercise pays off, but too much too soon can lead to exhaustion or injury.

Warm up before your workout.
“Nobody would walk out the door and start sprinting,” says Marilyn Moffat, P.T., Ph.D., professor of physical therapy at New York University and co-author of The American Physical Therapy Association's Book of Body Maintenance (Henry Holt and Co.). “You walk, then jog, then run.”

It helps to transition from rest to movement by gradually increasing body temperature, heart rate and blood pressure to support the physical challenges of the workout. A proper warm-up also helps reduce post-exercise muscle stiffness and improves exercise performance.

Five to 10 minutes is usually plenty for a cardio warm-up, Moffat says.

Pace yourself.
Do the talk test: If you can talk comfortably – or slightly uncomfortably – you’re exercising at the right intensity.

You should be able to sing during a low-intensity workout (such as walking).

You should be able to talk comfortably during a moderate-intensity workout (such as jogging).

During a high-intensity workout (such as running), you should barely be able to talk.

Cool down gradually.
After a workout, keep your feet moving for 5-10 minutes.

“[Cooling down] prevents pooling of blood in the lower extremities,” Moffat says. That can cause your blood pressure to drop and even affect normal heart rhythm.

Do cardio regularly throughout the week.
Consistent exercise makes a difference in preventing serious health issues, according to an 18-year study of nearly 70,000 women. Compared with inactive subjects, those who exercised two hours a week had reduced risk of exercise-related sudden cardiac death, and those who exercised 4 or more hours a week had a 59% decreased risk of
sudden cardiac death.

Cardio Equipment
ACE recommends the following popular cardio equipment:

Treadmill: A 1996 study cited the treadmill as an optimal cardio choice when measuring energy use at various intensity levels.

Stationary bike: Exercise bikes, both recumbent and upright, are less stressful on the joints than other cardio equipment options. Recumbent bikes provide added back support for those with low back pain, as well as those new to cycling.

Elliptical trainer: These can serve as low-impact alternatives to treadmills for those with previous knee or leg injuries, as well as those new to exercise. If possible, choose an elliptical with an upper-body component to work the arms and increase the number of calories burned.

Stair climber: Though stair climbers and step mills can provide a great workout, they may take time to build up your endurance, so focus on gradually increasing the duration of your sessions. If you have knee pain or a previous knee or leg injury – or if your knees
start to hurt when you exercise – choose a lower-impact option.

Play It Safe
Before starting any cardio program, consult your doctor – especially if you have a chronic disease or history of stroke, cancer or other conditions.

Here are cardio workout tips for people with the following medical problems:

Heart disease: Cardio workouts are a great way to improve heart function. But too-rigorous exercise can trigger irregular heart rhythms, chest pain, dizziness and shortness of breath. Plus, many cardiac patients are out of shape, putting them at further risk for injuries. Before you start an exercise program, consult with a cardiologist to assess your heart’s health.

Fibromyalgia: When you start to exercise, symptoms may worsen before they get better, says Jacob Teitelbaum, M.D., a fibromyalgia expert who has the disorder.

"The pain from tight muscles, along with the fatigue, may initially make you hesitant to exercise,” he says.

Begin with a walking program (start with as few as 3 minutes). Work up to 45 to 60 minutes of daily walking. Then add an easy weight-lifting program, Teitelbaum advises.

Increase repetition in short cycles of 2-3 sets, 5-10 reps, and slowly increase weights (heaviness depends on your fitness level) as you grow stronger.

Asthma: Exercise will improve lung function and strengthen your breathing muscles.

But it can also trigger “symptoms of wheezing, a feeling of tightness in the chest and shortness of breath,” says Marjorie Slankard, M.D., clinical professor of medicine at Columbia University College of Physicians & Surgeons and director of the Allergy Clinic at Columbia Doctors Eastside.

Do stop-and-go exercises, including sports such as tennis or swimming, which trigger fewer asthma symptoms than long-endurance exercises, she advises.

You may also want to use a bronchodilator 15 minutes before working
out to open airways and ease or prevent symptoms, Slankard says.

Avoid Injuries
Take these steps to reduce risk of cardio-related sports injuries:

Get in shape for sports – don’t do a sport just to get in shape: “Athletes condition themselves specifically for the sport,” Moffat says.

By contrast, weekend warriors challenge their bodies with little preparation, “which can lead to injuries, aches and pains,” she says.

Hydrate: You can lose 1 to 2 liters of sweat per hour in high-temperature conditions. And cold temperatures trigger your body to increase urine output, which can also cause dehydration. Drink plenty of water or a sports drink with electrolytes, such as Gatorade, if you’re going to be exercising or exposed to high temperatures for more than 90 minutes.

Specific Injuries
Your cardio workout may cause the following common injuries. Here’s how to treat them:

Ankle sprain: Immediately practice P.R.I.C.E. -- Protection, Rest, Ice, Compression, Elevation. Use a bandage, brace or crutches when necessary, but don’t use any of them as an excuse to keep playing on an injury. This will only increase the time it takes to heal.

Runner’s knee: Patellofemoral pain syndrome, or runner’s knee, is often caused by repetitive stress to the knee joint, muscle weakness or tightness or dropped arches (flat feet). It can be caused by other exercises, not just running. For treatment, rest or decrease the intensity of your runs or workouts. Wear shoes with proper arch support and consider being professionally fitted at your local running store. You’ll aggravate runner’s knee by sitting with knees bent for long periods, running downhill or walking down stairs.

IT Band Syndrome (ITBS): The IT (iliotibial) band of connective tissue and muscle runs along the outer upper thigh down to the knee. When it’s too tight, it pulls painfully on its insertion point near the knee. Sometimes you’ll even feel pain at the band’s attachment point on the upper thigh. A too-tight IT band is a common cause of runner’s knees. It's common in athletes who jump a lot or do repetitive squatting. Because it’s a repetitive-use injury, it’ll heal only with rest.

Shin splints: To soothe the inflammation and pain along the inner part of the lower leg (tibia), try an ice cup. Fill a small paper cup with water and freeze it. Once frozen, peel back a couple inches of paper from the rim. Holding the base, rub the ice up and down your shin for 20 minutes. As it melts, the ice will conform to your shin and provide spot-on relief. Keep off your legs until the pain disappears. To prevent further injury, don’t run too hard, too fast. When you’re ready to go out again, choose a soft running surface, such as a track or grass − no bone-jarring concrete or pavement.

Knee pain or ACL sprain: The ACL (anterior cruciate ligament) is a main supportive connective tissue in the knee. Sudden pivots cause the knee joint to twist and yank on the ligament. An ACL
injury is always serious. See a doctor right away.

Pick Up the Pace
Here are some tips to safely increase the intensity of your cardio workouts:

Try mini-workouts: Exercising for 10 minutes, three times a day, is just as effective as a continuous 30-minute workout, according to ACE. You do need to work harder, however. Rev your heart rate with intervals, plyometrics (explosive movements such as jumping) and a variety of exercises, says Kelli Calabrese, an ACE-certified personal trainer and exercise specialist near Dallas.

Add random intervals: Interval training – alternating strenuous exercise with moderate rest periods – burns more fat, builds more muscle and boosts metabolism more than other types of exercise.

You may get even better results with a method called fartlek training (fartlek is Swedish for “speed play”), in which you randomly vary your walking, running or cycling routine.

For example, “If you’re walking by yourself or with a partner, pick out an object like a mailbox and jog or run to it, then return to your regular pace,” suggests Pete McCall, an exercise physiologist with the San Diego-based American Council on Exercise (ACE).

Run on sand: Your body has to work harder to run on sand than on a hard, flat surface. Every time you take a step and then push off the
shifting sand, your foot slips back.

Spice Things Up
Variety is the key to success in any cardio program, says Cory Bank, Ph.D., a peak-performance coach and professor of psychology at Philadelphia College of Osteopathic Medicine.

The burnout can be psychological too, he says. Not only will you get bored with the same old moves, you’ll also experience less of a boost from the brain’s natural “feel-good” chemicals, such as serotonin and endorphins, that exercise provides.

To stay motivated, change your workout routine, when and where you exercise – any variables you can control, Bank suggests.

Here are some variations to try:

Smartphone options: Download energizing music to your iPod or iPhone or add new toys: a pedometer, calorie counter or GPS movement tracker. All can jump-start your motivation, says San Diego fitness instructor Jessica Matthews, ACE’s certification director.

Schoolyard games: Try hula hoop, hopscotch, jump rope or dodgeball.

Team sports: Having structured practices and games (adult leagues in many sports are plentiful) will keep your exercise schedule busy and consistent. Because your fitness and skill levels contribute to a team’s success, you might push yourself harder.

Belly dancing: Performing hip rolls, figure eights and snake arms will firm up your whole body; synchronized arm and hip movements require steady concentration.

Boot camps: Outdoor obstacle courses with personal trainers offer a fun and challenging way for large groups of people to exercise together and improve their fitness. Most cost about $10 to $20 a session. Marathons and triathlons: Training for a 5K (3.1-mile) run can be a great goal and challenge. Work up to a 10K (6.1
miles), half-marathon (13.1 miles) or triathlon.

Also to consider: a sprint triathlon (0.5-mile swim, 12-mile bike ride and 3.1-mile run), which is roughly half the distance of a full triathlon.

Group running: You might get more benefits from running in a crowd. One animal study showed that rats that run in isolation didn’t produce as many new brain neurons and exhibited higher levels of stress than those that run in groups:

Backwards running: This works different muscles than forward-running, and it can also strengthen hips, legs, core and abs. Of course, you shouldn’t do this where you could run into anything.

Barefoot running: Some runners now choose to run barefoot, claiming it strengthens the foot and body mechanics and prevents common running injuries. Plus, by compensating for the lack of cushioning provided by shoes, barefoot runners tend to land on the pavement more softly. Several manufacturers now make shoes that protect your feet while replicating the experience of running barefoot.

Is Your Workout Routine Working For You?
While a workout may be perfect for one person, it may not be good for another.

How to Treat Arthritis Joint Pain - Learning the Symptoms and Finding Relief

2012-02-08T00:40:00.000-08:00

Your knees ache and hips creak. Did you do too much over the weekend? Or is it age? If you’re a woman in your 40s, you may have osteoarthritis, the most common form of arthritis. Find out what causes this painful joint disease and how to ease the aches and stiffness. Plus, how much do you know about osteoarthritis?

You feel great after that six-mile hike, those rousing sets of tennis, that morning jog. But lately, there’s an ache in your step. Some days walking feels more like hobbling.

You may be paying for living a longer, more active life than Mom or Grandma. Hobbies like hiking, tennis and gardening keep us fit and youthful into our senior years, but they also conspire against us.

The result of the wear and tear?

Osteoarthritis, a degenerative joint disease that causes pain and stiffness.

Arthritis has many forms, but osteoarthritis is the most common: More than 27 million Americans suffer from it, and women over age 45 are 10 times more likely to have osteoarthritis than men. Researchers don't know why, but it could be blamed on women's bone structure, or even the high heels women sometimes wear.

Former competitive athletes – from runners to divers to gymnasts – are particularly vulnerable.

Aging, excess weight and having a joint injury also increase risk. The disease usually targets weight-bearing joints, such as the hips, knees and lower back, but also the neck, fingers and big toe.
Osteoarthritis’ most common symptoms include:

Joint soreness after overuse or inactivity

Morning stiffness that improves with activity

Changes in posture or walking because of stiffness

What Causes the Pain?
Osteoarthritis breaks down cartilage, the primary shock absorber covering the joint ends. The subsequent damage occurs in several stages:

First, the cartilage cushion loses elasticity and is more easily damaged from injury or use.

As the cartilage wears down, the underlying bone thickens and develops growths or spurs. At this stage, bits of bone and cartilage float in the joint.

The joint lining then becomes inflamed and releases irritants that damage cartilage even more. The normal lubricant also deteriorates, further exposing the joint surfaces to injury.

Eventually, the joint becomes so painful and stiff that replacement may be the only option. The procedures are hugely successful: A study published in the journal Arthritis and Rheumatism showed that 77% of 112 knee replacement patients were satisfied or very satisfied with the results; 80% said they would have the surgery again.
Where You Feel It Most
Hips: If you have osteoarthritis of the hips, you may feel pain in the groin, inner thigh or buttocks.

The discomfort may radiate to the thigh or knee and force you to limp when walking.

Knees: Osteoarthritis of the knees usually causes pain, grating or catching at the joint as you move, especially on stairs.

Women tend to wear out their knees differently than men. First, women are more likely to tear one of their key knee ligaments, the anterior cruciate ligament, or ACL. (Female college basketball players, for example, are up to eight times more likely to sustain an ACL injury than their male counterparts.)

The resulting knee instability increases the risk for developing arthritis.

Women also are more likely to wear down the outer knees. Our broader pelvis force the legs to angle inward at the knee instead of straight down.

Researchers have developed gender-specific joint replacements for a more comfortable fit.

High-heel shoes also increase osteoarthritis risk. Shoes with three-inch heels, whether stilettos or platform, put at least 22% more pressure on knee joints than low-heeled shoes because they strain muscles and tendons.
Hands: It’s common in the fingers too, causing joints to ache and swell. They may develop boney outgrowths and your hand may lose its grip strength or fine motor skills that help you pick up small items or hold a pencil.

Back: Repetitive stress on the spinal discs that cushion the vertebrae can cause them to break down. Again, boney spurs may develop, placing pressure on the nerves exiting the spinal canal.

Osteoarthritis of the back can lead to stiffness and pain in the neck, shoulder, arm, lower back and legs. It can also cause pinched nerves, which leads to weakness in arms and legs.

Treating Joint Pain
So how do you get rid of the pain?

Step 1: See a physician for tests, such as a blood count, joint X-rays and possibly a joint MRI.

Sometimes the doctor will remove some joint fluid to look for deterioration and to rule out other forms of arthritis, which are treated differently than osteoarthritis.
Early diagnosis and treatment are key to managing the disease. You can’t reverse the clock, but you can minimize joint damage and maintain range of motion.

You can also control pain and swelling, improve function and slow osteoarthritis' progression. Often treatment includes weight management (the less weight, the less stress on the joint), exercise, physical therapy and medication.

Traditional medications include:

Non-steroidal anti-inflammatories (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve)

Pain relievers such as acetaminophen (Tylenol)

Topical pain relievers, such as creams and rubs containing wintergreen oil or camphor

Steroids and viscosupplements, such as Synvisc, that a doctor can inject into the knee to supplement its normal lubricating fluid.

Fitted braces can also relieve some stress and reduce damage over time. Arthroscopic surgery may be necessary to clean up the joint, trim worn or torn cartilage and remove debris.

For advanced osteoarthritis, you may need a total joint replacement. Partial replacements (often called joint resurfacing) repair only the damaged area, allowing you to retain more of the original joint.

Relief, Naturally
Alternative treatments like glucosamine with chondroitin sulfate and methylsulfonylmethane (MSM) can help, often in combination with conventional methods.

Among the most popular:

Glucosamine: This sugar seems to play a role in cartilage formation and repair. One study showed that 50% of osteoarthritis patients had less pain when taking glucosamine supplements, particularly among those with mild to moderate symptoms.

But watch out: Glucosamine may upset your stomach and raise blood sugar levels. Also, don’t take it if you are allergic to shellfish.
Chondroitin sulfate: This protein part gives cartilage its elasticity. It may improve its shock-absorbing properties and help it retain water. Like glucosamine, chondroitin can upset your stomach.

Glucosamine and chondroitin: They've been used in combination for years in Europe to manage joint pain.

A study published in the New England Journal of Medicine in 2006 showed that the supplements were more effective together. They had little effect on mild pain, but showed a significant benefit in people with moderate to severe pain.

Methylsulfonylmethane or MSM: This naturally occurring sulfur compound found in fruits, vegetables and grains may also reduce pain and inflammation.

A pilot study of 50 men and women with osteoarthritis showed that MSM reduced pain and improved physical function without major side effects, but no controlled trials substantiate the claim.

Before you add a nutritional supplement to your treatment regimen, check with your doctor.
Exercise for Osteoarthritis
Doctors are increasingly recommending physical activity as a means for improving joint health.

As tempting as it may be to rest aching joints, structured mobility programs, combined with muscle-strengthening exercise and weight loss, seem to be the best treatments..

Besides weight control, a range of exercises are prescribed by doctors to help manage osteoarthritis. Each pound of weight loss reduces pressure on the knee by four pounds. So even modest amounts of weight loss can reduce the risk of osteoarthritis or improve symptoms.

Exercises that improve flexibility can help decrease joint stiffness and improve range of motion. These include hamstring and calf stretches, knee-to-chest flexing and neck and back stretches.

Activities that strengthen muscles are also important, as long as they don’t put undue stress on affected joints. Ideal exercises include cycling, elliptical trainers, Pilates, yoga, swimming and Tai Chi.

For more information and expert advice, visit our Arthritis Health Center .
Are You Bad to the Bone?
For years, you’ve been the first one on the tennis courts, the weekend hiker, the intrepid gardener on your knees for hours. While all those activities are great for you, they can also be hard on your joints.

How to Control Childhood Asthma Triggers

2012-02-08T00:36:00.000-08:00

Is your child wheezing, coughing and gasping for breath too often? Recognizing asthma triggers can help ward off attacks. Here’s how to help kids breathe easier…

A smoggy day, second-hand smoke or Chinese food – these can be a parent’s worst nightmare if your child has asthma.

That’s because they all can trigger life-threatening asthma symptoms. In fact, about 30% of such attacks result from environmental factors, according to 2002 study published in the journal Environmental Health Perspectives.

A parent’s best defense against asthma is recognizing and reducing triggers. That includes keeping you and your kids calm and avoiding food additives, according to the latest research.

“It effectively reduces asthma symptoms,” says Cherie L. Hyssong, a certified asthma educator and coordinator of the pulmonary lab at Frederick Memorial Healthcare System in Maryland.

Read on for 8 triggers, some surprising, and the steps to take to ward off attacks.

1. Extreme emotions
You love to hear your child laugh, but watch out: Hysterical laughter can set off an asthma attack. So can stress and anxiety. That’s because the lungs and brain are connected by the vagus nerve, one of the longest in the body, and stimulating it can cause asthma attacks.
Anti-asthma approach: No parent can control a child’s emotions. But you can keep home life calm by helping with homework, relaxing together or even doing art projects.

In fact, according to a 2010 study in the Journal of Allergy Clinical Immunology, National Jewish Health Hospital researchers found that art therapy decreased the frequency of asthma symptoms.

Control your own stress levels too. Moms who often express anxiety, anger or irritation can worsen children’s asthma symptoms, especially when they’re young, according to a 2010 study published in the journal BioPsychoSocial Medicine.

There’s no question that parenting a child with asthma can increase stress and make you doubt yourself, says Taiha Wagner, L.P.N., a pediatric asthma specialist in Eden Prairie, Minn.

“But taking time to recharge your mental and emotional batteries will help you feel more at ease and lessen the chances your stress will become an asthma trigger for your child,” she says.

2. Food allergies
According to the National Center for Health Statistics, children with food allergies are 2-4 times more likely to have asthma and other respiratory allergies.

“And the more food sensitivities a child has, the greater their asthma-related inflammation,” Wagner says. Some food can trigger an asthma attack within minutes.
Anti-asthma approach: Keep a record of foods that set off your child’s symptoms and try to avoid them. Common triggers include gluten, yeast and sugar - all increase respiratory inflammation.

Dairy foods are another potential problem; they increase mucous production in the lungs. Give children other calcium-rich foods, such as fortified milk alternatives and breakfast cereals, leafy vegetables, broccoli and almonds.

3. Food additives
Manufacturers often add ingredients to products to enhance flavor, color or appearance. But these additives can worsen asthma symptoms.

One to watch for is monosodium glutamate (MSG), which improves flavor in many foods, including Chinese cuisine, lunch meat, and sausage patties and links, according to a Johns Hopkins study published in the American Journal of Respiratory and Critical Care Medicine in 2010.

“MSG stimulates nerve cells in the mouth, lungs and other areas involved in asthma attacks,” explains William J. Calhoun, M.D., vice chair for research, Department of Internal Medicine at the University of Texas Medical Branch in Galveston.

Another potentially troublesome additive is tartrazine, also known as FD&C yellow #5, according to a ground-breaking 1985 University of Toronto study. It’s commonly found in breakfast cereals, cake mixes, chocolate and butterscotch chips, packaged frostings, many candies and other foods.

Tartrazine can cause inflammation in the stomach lining and elsewhere in the body, including airways, Calhoun says.
Anti-asthma approach: Unfortunately, consumers have no easy way to detect MSG, a form of glutamic acid. The federal government requires the crystalline amino acid to be labeled when it’s directly added to a product, but not in other forms.

For example, “autolyzed yeast," "maltodextrin," "sodium caseinate," and "soy sauce" are the common names of ingredients with MSG, according to Truth in Labeling, an anti-MSG advocacy group.

When ordering Chinese takeout, look for the phrases, “No MSG” or “MSG-free,” on the menu. Ask your server if you’re not sure.

Avoiding tartrazine is easier. Stay away from “fake” yellow foods and “stick to naturally yellow foods like beans, squash and corn,” Calhoun says.

4. Air quality
If your child has asthma, pay close attention to weather and air quality reports. Cold air, smog, ozone, pollen, second-hand smoke and even some perfumes and air fresheners can settle in lungs, causing irritation and inflammation.

Anti-asthma approach: You can’t control outdoor triggers, but you can avoid them.

Keep children indoors and use air conditioners when the pollen count is above 4.9 or air quality is worse than moderate (above 101) from ground-level ozone or smog. The Environmental Protection Agency (EPA) monitors air quality daily and posts results at Air Now.
Other steps:

Avoid smokers’ hangouts in public places like the mall, store and restaurant entrances.

Before heading outdoors on a chilly day, remind your child to breathe through his nose, not mouth, to prevent cold air from irritating the lungs. And have him breathe through a scarf.

Don’t use air fresheners and scented candles.

Change heating and air-conditioning systems filters at least every three months.

Ban smoking in your home and prevent your child from visiting homes filled with second-hand smoke.

5. Exercise
Does your child wheeze, cough or have trouble breathing after exercise? The cause may be exercise-induced bronchospasm, triggered after exertion and exacerbated in frigid weather.

When air passes through the nostrils, it’s warmed and dampened before it reaches airways and lungs. But exercising kids often breathe through the mouth instead. That means cold, dry air travels directly into their airways, triggering asthma attacks.
Anti-asthma approach: Don’t keep your child sitting in front of the TV to avoid exercise altogether. Instead, have her take up less-strenuous sports, such as horseback riding, gymnastics or swimming. Avoid endurance sports like long-distance running and cycling, Hyssong advises.

Talk to your pediatrician and the school nurse and teacher about low-impact exercises that your child can do when she can’t participate in strenuous physical education classes.

Plus, file an Asthma Action Plan with the nurse and others who care for your children. It should detail treatments and steps to take in an emergency or if symptoms flare up.

6. Respiratory infections
Respiratory viruses are one of the most common causes of an asthma attack in children. Unfortunately, there’s no way to completely prevent your child from getting a cold or flu, which are often spread at schools, daycare centers and playgroups. But you can reduce their exposure to germs.

Anti-asthma approach: Teach children to cover their mouths with a tissue or arm – not hands – when they cough or sneeze, and to wash hands frequently.

There’s a good chance your child won’t get sick as often as he nears the tween and teen years, says Michael Welch, M.D., co-director of the Allergy and Asthma Medical Group and Research Center, and clinical professor at the University of California School of Medicine, both in San Diego.

“They have better hygiene habits,” he explains.

7. Control household insects and dust
Dust mites, tiny microscopic spider-like creatures, feed on dead skin and infest beds, stuffed animals, pillows and carpets by the tens of millions. When inhaled, their feces and bodies set off asthma symptoms.

Cockroaches, commonly found in crowded inner cities and the South, also worsen asthma through their saliva, droppings or body parts, according to a 2005 National Institutes of Health study.

Anti-asthma approach: Thorough, routine cleaning is your best bet.

To kill mites, wash your child’s sheets at least once a week in hot water.

Put hypoallergenic covers on pillows and mattresses to reduce mite populations.

Limit the number of stuffed animals on your child’s bed or in the bedroom, Welch says.

Vacuum carpets at least once a week and remove throw rugs from bedrooms or play areas to cut down on dust, mites and cockroach remains.

Store food in air-tight containers, take out garbage daily and clean all crumbs immediately to reduce the odds cockroaches will feed on leftovers.

8. Animals
About 20%-30% of people with asthma are also allergic to animals, according to the American College of Allergy, Asthma and Immunology. But it’s not the animal’s fur that your child is allergic to: It's the dander - tiny particles of skin and hair, saliva and urine of any warm-blooded pet. Dogs, cats, hamsters, birds, guinea pigs, and even mice have dander.

For kids with severe animal allergies, just being in contact with someone with their pet’s fur on their clothing sets off an attack.

Anti-asthma strategy: Going pet-free is best. If that’s not an option, try a furless species, such as fish. Talk to your child’s doctor about species and breeds your child may be able to live with.

If you have already furry friends, reduce your child’s exposure:

Keep pets out of your child’s bedroom.

Try to prevent children from kissing or hugging pets.

Use a HEPA (High Efficiency Particulate Arresting) filter to clean air of dander.

Vacuum carpets often.

Also, beware of pets outside your home. Before a play date, ask ahead about animals living at the friend’s home. You may need to move the play date to your house.
Consult your doctor about how you can best manage your child’s asthma or if you suspect your child may have asthma.

How Much Do You Know About Asthma?
According to the Centers for Disease Control and Prevention, 17.5 million of all American adults and 7.5 million children have asthma, the disease that makes it hard to breathe from inflammation in the lungs and airways. Doctors say understanding how to manage and treat the disease, as well as spot the symptoms, can help a person with asthma enjoy a “normal” life.

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2012-02-07T00:58:00.001-08:00

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2012-02-07T00:43:00.000-08:00

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Yo-yo Dieting Doesn't Raise Death Risk

2012-02-07T00:22:00.001-08:00

Despite earlier concerns, dieters who repeatedly lose weight and then gain it back aren't at higher risk of early death than people who don't "yo-yo diet," according to a new report.

About two-thirds of Americans are overweight or obese, and many are trying to shed the extra pounds. Over the long term, however, most people who lose weight through dieting regain it later.

The health effects of such weight cycling, also called yo-yo dieting, are a matter of controversy.

Several studies have found that people whose weight cycles up and down tend to die earlier. But the majority of that research failed to differentiate between intentional weight loss and weight loss due to disease such as cancer, researchers write in the new report.

In the current work, nearly 56,000 men and more than 66,000 women answered questions about how often they had intentionally lost 10 or more pounds and later regained the weight. The participants were between 50 and 74 years old when the study started in 1992.

During a 16-year follow-up period that ended in 2008, roughly 15,000 men and 10,000 women died.

A total of 42 percent of men and nearly 57 percent of women in the study reported intentionally losing and then regaining at least 10 pounds one or more times in their life.

Among women whose weight yo-yoed the most — 20 times or more — 16 percent died over the study, compared to 15 percent of those who said their weight never cycled due to dieting.

For men, the corresponding numbers were 29 percent and 26 percent.

But as it turned out, participants whose weight cycled the most were also more likely to be heavy 10 years prior to the start of the study, which could raise their risk of death.

When the researchers accounted for that, as well as health problems such as diabetes, high blood pressure and smoking, the gaps in death rates disappeared.

"Our study shows that the act of weight cycling itself does not increase your risk of premature death," Victoria Stevens of the American Cancer Society in Atlanta told Reuters Health.

Her findings are published in the American Journal of Epidemiology.

Still, experts don't recommend yo-yo dieting, but rather slow-paced, sustained weight loss.

"While weight cycling may not kill you any sooner, yo-yo dieting is still not good for a whole lot of other reasons," Judy Caplan, a dietician in private practice in Virginia, told Reuters Health.

"Yo-yo dieters are great at losing weight, but not at maintaining the weight loss, which can leave a person demoralized," said Caplan, who is also a spokesperson for the Academy of Nutrition and Dietetics and was not involved in the new research.

Previous research has suggested that yo-yo dieting can slow metabolism and may actually contribute to more weight gain in the long run.

But for those who find their weight yo-yoing after dieting, the new findings contain a hopeful message.

"I think the study is encouraging," said Simone French, a behavioral scientist who specializes in obesity prevention at the University of Minnesota and was not involved in the work.

"It shows that people shouldn't be afraid to keep trying to lose weight, because they think it will increase their health risks if they gain it back."

Suzanne Somers: How Stem Cells Can Help Women Everywhere

2012-02-07T00:21:00.000-08:00

Suzanne Somers’ decision to try an experimental stem-cell procedure to rebuild the breast she lost to cancer has made her “whole again,” she says.

But her story doesn’t end there.

In an exclusive video interview with Newsmax Health, the Hollywood star says she is now working to publicize her experiences to draw attention to the cutting-edge procedure so other women can take advantage of it and federal officials will approve its use more widely in this country.
Currently, she says doctors are signing up women who qualify to participate in the clinical trial of the procedure at Hollywood Presbyterian Hospital overseen by her doctor, Joel Aronowitz.

“Right now, [women] can get into my clinical trial at Hollywood Presbyterian Hospital,” she says. “They could either call Hollywood Presbyterian or they could call Dr. Joel Aronowitz. If they get into this clinical trial before they close it, they could get it done for free.”

Somers believes the trial will prove the success of the procedure and that it will eventually become standard in breast cancer treatment, in which case health insurance will cover it.

But she says the implications are significant, not only for breast cancer survivors.

“Stem cell science will live up to its promise if allowed to progress, and I know the doctors in this country are itching to use it,” she notes. “But everyone is afraid because they don’t want the authorities to come down on them. So that’s why my procedure is important.”

She also recognizes she has a unique perspective and, as a celebrity health advocate, can bring wider attention to the issue.

“I have a louder voice,” she says. “I am able to get out in the media and be on the Internet and talk about this. And when the masses want something they can make enough noise to get it to happen. And I think that’s what’s going to happen.”

Suzanne believes her positive experience is one of the first to prove the promise of stem cell treatments. The stem cell treatment she underwent six months ago has given her a natural-looking and normal-feeling breast that is made of her own tissue, she says.

“When I tell women about this, their jaws drop and they just can’t believe this is available,” she says. “This is beyond breast cancer … if you just want bigger breasts you could also do this protocol. And it probably will have a negative impact on implants in the future, because implants have a lot of problems.

“So it’s quite a remarkable thing, and I hope that stem cell protocols become the way of medicine. In the next 13 to 15 years, stem cell protocols and nanotechnology will be the way it’s done, and the present paradigm of medicine will change completely.”

Echoing the health messages of her books, however, Somers says people can’t simply rely on new medical technology for health.

“The catch is you have to get there healthy, you can’t limp in to it,” she notes. “And so all these steps that people are taking today for their health – the way they eat, the way they sleep, the way they manage their stress, the way they avoid chemicals and eat organic food, and avoid pharmaceuticals unless absolutely necessary…

“You do those things and you most likely will be able to access the great advancements that are coming, most likely in the next 13 to 15 years.”

Suzanne says she’s passionate about the cause of breast cancer because it strikes so many women.

“The devastating diagnosis is one thing, and then the double whammy of losing a body part can do a person in,” she says. “I am passionate about this because it can be so helpful on a psychological level, and if your emotions are positive you can heal better. But when you look down and you see nothing there and you don’t feel like a woman, it has a devastating psychological effect on you. And I think this will be very helpful.

“I just think we need to each rethink how we’re taking care of our bodies.”

For more information, check out “Suzanne Somers Breaking Through,” her Internet talk show at: suzannesomers.com.

Protect Your Brain Health, Decade by Decade - 16 Doctor-Recommended Tips to Ward Off Alzheimer’s Disease

2012-02-07T00:18:00.000-08:00

Misplace your glasses or occasionally forget a friend’s name? These common memory lapses are normal – not signs of Alzheimer’s, a form of dementia that robs one of cognitive skills and independence. However, we now know Alzheimer’s starts in the brain decades before behavioral symptoms appear. But there are many ways to protect brain health. Read on for their expert tips...

We think of Alzheimer’s disease as an older person’s illness, but experts say critical proteins begin to break down as early as middle age.

“Long before you really start to notice you’re more forgetful or having trouble learning new things, your brain is experiencing changes that lead to the plaques and tangles that typically occur in Alzheimer’s,” says Daniel G. Amen, M.D., a psychiatrist and author of Change Your Brain, Change Your Body (Three Rivers Press).

Plaques are clumpy deposits of proteins that develop between brain cells in Alzheimer’s patients. They can block the brain from sending important messages. When nerve fibers that nourish the brain become
twisted, they’re called tangles, another symptom of Alzheimer’s disease.

Because you’re not likely to get diagnosed early when this damage is just starting, adopt a healthy brain lifestyle now to stop symptoms before they start.

Some surprising strategies can ward off Alzheimer’s disease, such as losing weight, breaking up your workload – even brushing your teeth. Read on for brain health tips for nearly every phase of life.

In Your 30s
You’re busy starting a family, launching a career and establishing a home. If you’re like most women, you’re probably feeling frazzled. Still, habits you set now will boost brain health for decades to come.

Brain Health Tip #1: Get your heart pumping.
Aerobic exercise triggers the secretion of brain growth factor (BGF), a neuronal growth hormone, says Pierce J. Howard, Ph.D., author of The Owner’s Manual for the Brain (Bard Press) and director of research for
the Center for Applied Cognitive Studies in Charlotte, N.C.

Exercise is “like fertilizer for the brain,” he says.

That’s because it creates new connections “for learning and strengthening what you already know,” he adds.

Aim to do slightly strenuous exercise, such as brisk walking or bicycling, 30 minutes a day, five days a week.

“If you’re not a little winded at the end, [your activity] hasn’t been brisk enough,” Howard says.

Brain Health Tip #2: Cut back on saturated fats.
Found in animal products such as meat, butter and cheese, saturated fats are the artery-clogging culprits behind cardiovascular disease, high blood pressure and high cholesterol, which starve blood flow to your brain.

“Brain function is improved by having good circulation,” says William Thies, Ph.D., chief medical and scientific officer for the Alzheimer’s Association.

“What’s good for your heart is good for your brain,” he explains.

Brain Health Tip #3: Steer clear of cigarettes.
If you smoke, quit. Smoking nearly doubled the risk for Alzheimer’s disease, according to a 2010 study in the Journal of Alzheimer’s Disease.

That’s because nicotine disrupts oxygen flow to the brain, reducing its ability to use glucose, leading to memory loss and problem-solving difficulties, Howard says.

It also raises cortisol, the stress hormone that keeps your body in a constant fight-or-flight state, he says.

“Cortisol affects the [brain’s] hippocampus, which affects the formation and retention of memory,” Howard says. “[It] literally shrinks the

hippocampus over time.”

Brain Health Tip #4: Organize your priorities.
Many women try to do too much and end up stressed and exhausted, says Gary Small, M.D., director of the University of California – Los Angeles’ Center on Aging at the Semel Institute for Neuroscience & Human Behavior, and author of The Memory Prescription (Hyperion).

“The problem is that we take on too many [responsibilities]” and that affects the brain’s ability to focus and remember, he says.

So start by assessing your priorities, learn to say no to demands on your time and ask for help.

Brain Health Tip #5: Brush and floss.
Your dentist’s advice may do more than clean your teeth – it may also protect your brain.

Adults in their 60s with gum disease were more likely to do poorly on cognitive tests involving memory and calculations, according to a 2010 study at Columbia University.

So follow these tips from the American Dental Association: Brush at least twice a day and floss every day.

In Your 40s
No wonder they call this the sandwich generation. You’re working a full-time job, raising children and caring for aging parents.

At the same time, hormones are shifting as you enter perimenopause, the period before menopause, when menstrual cycles cease. All these changes
cause tremendous stress and rob you of time to eat well and exercise regularly.

Brain Health Tip #6: Eat fish.
Certain fish, such as salmon, tuna and mackerel, contain omega-3 fatty acids that keep the membranes supple, Amen says.

“The brain’s cell membranes need omega-3s, especially DHA [docosahexaenoic acid] to function properly, he explains. “It increases fluidity and function.”

Don’t like seafood? Take fish oil capsules instead: 1,000 milligrams (mg) daily. Make sure the supplement has both EPA (eicosapentaenoic acid) and DHA, the most beneficial of the fatty acids, he advises.

Brain Health Tip #7: Stop multitasking.
Feel more efficient when you’re trying to do more than one thing at a time? In fact, it takes a toll on your brain, causing stress and possibly long-term memory loss, Small says.

Interruptions are particularly damaging to memory in older adults, a 2010 study at the University of California in San Francisco suggests.

It’s also inefficient and time-consuming to constantly switch from one task to another.

“The key to ending multitasking is to know you’re doing it,” Small says. “When you catch yourself doing it, eliminate at least one task. Focus on just one thing.”

Brain Health Tip #8: Watch your weight.
Overweight, middle-aged adults are more vulnerable to dementia, according to a 2011 study in the journal Neurology.

Researchers found they were 80% more likely to develop dementia than
peers with a normal body mass index (BMI).

“Fat produces inflammatory chemicals that damage the brain,” Amen says. “As your weight goes up, the function of the prefrontal cortex [which controls decision making and social behavior] goes down.”

Brain Health Tip #9: Get a good night’s sleep.
Researchers have long known that sleep is essential for memory, and a 2011 study at Stanford University found that uninterrupted sleep is what counts.

It’s important for recharging the brain and forming memories, Howard says.

But sleep isn’t easy when hormones are shifting and you’re juggling multiple responsibilities. To boost odds for sound sleep, Howard recommends these tips:

Limit caffeine intake, especially in the six hours before bedtime.

If you wake to go to the bathroom, try restricting fluids after dinner.

If necessary, try taking melatonin, a naturally occurring hormone that causes sleepiness.

Brain Health Tip #10: Try meditation.
Daily meditation reduces stress and amounts of the brain-sabotaging
hormone cortisol, Small says.

People who did mindfulness-based stress reduction meditation increased gray matter in areas of the brain involved in learning and memory, according to 2010 Harvard University study.

Meditation also induces feelings of relaxation and greater mental clarity. Whether you focus on your breath, a mantra or prayer, the key is to do it consistently, Small says.

“Any healthy brain strategy works best when practiced over time,” Small says. “One five-minute meditation session once a month is unlikely to do that.”

In Your 50s and Beyond
With kids out of the house, you may be breathing easier. Now you have time to focus on your own health.

Brain Health Tip #11: Learn something new.
New knowledge and skills can protect you from dementia by creating synapses and connections in the brain, Howard says.

“You may have tangles in the brain, but when you form connections, they bypass those.”

But what you learn should be different from what you already know. For example, “if you know French and decide to [learn] Italian, it’s not going
to be as effective [on your brain health] as Chinese,” Howard says.

At the same time, keep doing things you enjoy, he advises.

Brain Health Tip #12: Eat 4-6 servings of fruits and vegetables a day.
Fresh produce contains antioxidants that “help reduce the oxidative stress of brain aging and memory loss,” says Michael Wald, M.D., C.C.N., director of nutritional services at Integrated Medicine & Nutrition in Mount Kisco, NY.

It’s especially important to include berries in your diet, Wald says. Berries have anthocyanins, antioxidants that shield the brain from cell-damaging free radicals.

Vegetables high in antioxidants include beans, artichokes and russet potatoes.

Brain Health Tip #13: Get support.
One key to a healthy brain is having a supportive network of people, whether relatives, coworkers or new acquaintances.

“The more quality relationships an individual maintains and nurtures, the better chance of staving off dementia,” Howard says. “Friendships reduce stress, which lowers cortisol.”

Brain Health Tip #14: Eat healthy proteins.
All proteins contain amino acids tyrosine and tryptophan, which help the brain produce neurotransmitters essential for proper brain function, Wald
says.

Good sources include raw nuts, pumpkin seeds and egg whites, he adds.

Brain Health Tip #15: Take up ping-pong or ballroom dancing.
These activities challenge mind and body simultaneously, requiring skills such as anticipating the next move and good coordination.

They “activate the cerebellum in the bottom of the brain, which helps with thinking, organization and impulse control,” Amen explains

Brain Health Tip #16: Get into nature.
Too much time in sealed homes and offices saps your brain of fresh oxygen, which is essential to clear thinking, Howard says.

So get outside for frequent breaks or at least open a window. Just spending time in nature and sunshine can boost brain health by improving mood and creating calm.

It also provides vitamin D, and people with low levels of the “sunshine vitamin” have a greater risk for cognitive decline, according to a 2010 study in the Archives of Internal Medicine.

For more expert advice and information, visit our Alzheimer’s Disease Health Center.

How Much Do You Know About Alzheimer’s Disease?
More than 5 million Americans have Alzheimer’s disease, and that number could climb to 16 million by 2050. Women face a higher risk of developing it than men, and are also more likely to become caregivers.

Protect Your Brain Health, Decade by Decade - 16 Doctor-Recommended Tips to Ward Off Alzheimer’s Disease

2012-02-07T00:13:00.000-08:00

Are You Sleep-Deprived?

2012-02-07T00:10:00.001-08:00

Getting the recommended 7-8 hours of nightly sleep can make us thinner, happier and live longer. So why don’t most of us get enough? Top researcher James Maas, Ph.D., explains how to spot – and stop – sleep deprivation…

We spend a third of our lives sleeping. But more than 70% of us are still sleep-deprived, says James Maas, Ph.D., one of the country’s leading sleep researchers.

He blames the demands of a 24-hour society, where overtime hours, late-night web-surfing and all-night gyms are the norm.

And that hurts us more than we think, from our ability to hold our liquor to how healthy we are as we age.

“Sleep is the best predictor of longevity,” says Maas, author of Sleep for Success: Everything You Must Know About Sleep But Are Too Tired To Ask (Author Solutions). “Nutrition and exercise are extremely important, but you need all three to be psychologically and physically healthy,” he says.

Lack of sleep doesn’t just leave us feeling drowsy, moody and unproductive – it raises our risk of hypertension, heart attack and stroke, type 2 diabetes, periodontal disease, weight gain, depression, skin problems, even cancer.

In this exclusive Lifescript interview, Maas shares tips on how to rest better and get healthier.
How does the number of hours we sleep affect longevity?
There’s some research that shows those who sleep less than seven or more than nine hours have a higher [death] rate than people getting about eight hours of sleep each night.

In general, people who get adequate sleep will live significantly longer than those getting less – 2-3 years longer at least.

How do we know if we’re getting enough sleep?
If you’re fully alert all day with no midday dip, you’re doing fine. But most people aren’t.

Aside from drowsiness, how can someone tell if she's sleep-deprived?
Other symptoms include mood swings, irritability, anxiety and difficulty concentrating and remembering.

In chronic cases, sleep deprivation causes frequent infections or illnesses, blurred vision, depression and changes in appetite.

Most of us think of sleep as a luxury. It’s actually a necessity.
Is it true that falling asleep quickly isn’t a good thing?
Some people brag, “I can sleep anytime and anywhere,” or “I fall asleep as soon as my head hits the pillow.”

That’s actually a potential sign of sleep deprivation.

The average person needs 15-20 minutes to get to sleep. It takes that long for us to relax and for melatonin [a hormone that aids sleep] to be secreted in the brain.

What are other sleep myths?
Most people overestimate the amount of sleep they get by nearly an hour. They say they went to bed at 11, but that doesn’t mean they fell asleep then.

If you ask people how much they sleep at night, the average adult will say about 7.1 hours. When we actually measure this with electronic devices, it’s closer to 6 hours. That’s because people assume they fall right asleep, which is usually not the case.

How can we increase shut-eye time?
Start adding 15 extra minutes each night for a week and see how you feel. If you aren’t fully alert all day, add another 15 minutes each night the next week.
Most adults need to add an hour of sleep to their regular schedule. They won’t believe how much better they’ll feel.

Just one extra hour of sleep every night can greatly improve a person’s mood, alertness, health and productivity.

In your book, you write about getting the right kind of sleep. What do you mean?
There are five different sleep stages, which are important because each does different things. You need to go through all of them to be wide awake during the day.

REM sleep is critical for cognitive processing – retention, consolidation of memories and recall of critical information, as well creative problem solving and athletic performance.

Are more women sleep-deprived?
Women have more insomnia. In fact, 56% of women say they can’t get a good night’s sleep.

And they generally need more sleep than men to be fully alert during the day, because of hormones, stress and infant care responsibilities.
At certain phases of a woman’s life – pre-menstrual, pregnancy and the beginning of menopause – hormones are raging, and that affects sleep.

How does having a bed partner affect sleep?
Women sleep better alone because they’re lighter sleepers than men.

One reason is men, especially obese men, tend to snore, which ruins their partner’s sleep.

Of course, obese women tend to snore too.

About 86% of women say their husbands snore, and more than half say it disrupts their sleep.

[About] 23% of American couples sleep apart.

Is it OK to drink coffee to stay awake in the afternoon?
No, avoid caffeine – including coffee and chocolate – after 2 p.m. And no alcohol within three hours of bedtime. They’re all stimulants.

Also, quitting smoking improves sleep, since nicotine is a stronger stimulant than caffeine.
Does the amount of sleep you get affect alcohol tolerance?
Absolutely. In terms of a person’s ability to drive a car, one drink on six hours of sleep is the same as six drinks on eight hours of sleep.

When should you exercise?
You should exercise between 5 and 7 p.m., or at noon.

But not first thing in the morning – you risk back injury then, and your reflexes are slow. The fluid building all night between the discs in your spinal cord needs some time to dissipate.

Also, early-morning exercise is too far removed from bedtime to affect sleep quality.

What other factors affect our ability to sleep?
Bedroom environment, temperature, light and sound, mattress and pillows are all important.

If you miss sleep, take a short power nap. Think of it as a sleep debt you need to make up.
You coined the phrase “power nap” 36 years ago. What is it?
I invented the term in response to working as a consultant for IBM, where they were taking “power” breakfasts and “power” lunches.

A [2007] study in Greece found that power naps three times a week reduce the risk of heart attacks by 37%.

It’s a wonderful stop-gap measure if you don’t get enough nocturnal sleep.

The best time to take one is usually eight hours after you wake up, during that midday dip in alertness.

What’s the latest in sleep research?
There are areas of current research aimed at the effects of deprivation and the link between lack of sleep and cancer.

Sleep deprivation worsens sleep apnea [characterized by heavy snoring and repetitive pauses in breathing in sleep].

Eighteen million Americans have sleep apnea, and 95% are undiagnosed.
What advice do you give to sleep-deprived women?
There’s no pat answer. It’s like going to the doctor and saying you have a tummy ache. There can be 30 reasons.

If insomnia persists for more than three weeks, see someone trained in sleep medicine, not just your regular doctor.

Cognitive-behavioral therapy [talk therapy that changes negative behavior and thought patterns] works too.

A 10- to 15-minute nap – not so long that you go into a deep sleep, which would make you groggy when you get up and give you nocturnal insomnia – actually reduces stress.

You learn the rules of sleep hygiene [behavioral guidelines that help you fall, and stay, asleep. These include a cool bedroom temperature and limited nighttime use of laptops, TVs and cell phones.].

For more information, visit our Sleep Health Center.
Are You Smart About Sleep?
Getting a good night's sleep affects every aspect of your day, including your mood and your ability to be productive. And if that doesn't get your attention, listen up: Your sleep habits can even affect the number on the scale. Find out if you're smart about sleep, or if you need to be schooled by the Sandman.

THOUGHT FOR THE DAY...

2012-02-06T01:58:00.001-08:00

With courage, you will dare to take risks,
have the strength to be compassionate,
and the wisdom to be humble.
Courage is the foundation of integrity.

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2012-02-06T01:52:00.000-08:00

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* A toaster uses almost half as much energy as a full-sized oven. *
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How to Lower High Cholesterol When You Have Diabetes

2012-02-06T01:39:00.000-08:00

Did your last doctor’s office visit reveal high cholesterol? What’s next? Is it time to start taking pills or can you lower your LDL levels the old-fashioned way – diet and exercise? Learn more about the stages of your condition, including the diagnosis, treatments and medication available. Plus, how well do you understand cholesterol?

Cholesterol often gets a bad rap, but did you know it’s essential for many bodily functions?

It repairs cell membranes, produces vitamin D on the skin, makes hormones such as estrogen and testosterone, and helps with cells related to memory and learning, says Tracy Stevens, M.D., a cardiologist and spokeswoman for the American Heart Association (AHA).

But too much cholesterol can have deadly consequences, especially if you have diabetes type II. This waxy substance in the blood contributes to 20% of all strokes, 50% of all heart attacks and affects 36 million U.S. adults, according to the AHA.

You could have high cholesterol levels for years and never know it until something goes wrong, says Lisa Reis, M.D., a cardiologist and assistant professor at Saint Louis University Hospital in Missouri.

Fortunately, high cholesterol is easy to tame, says Binoy Singh, M.D., an internist and cardiologist with ColumbiaDoctors of Somers, N.Y.
“Many women can dramatically lower their cholesterol by eating a healthier diet and starting an exercise program and will not need to take medication,” Singh says.

Some cholesterol is healthy (“good” cholesterol), but high levels of “bad cholesterol” can sabotage your health.

People with diabetes have a harder time controlling cholesterol levels because the disease tends to lower "good" cholesterol levels and increase "bad" cholesterol readings. It puts them at a higher risk of heart disease, according to the AHA.

Good cholesterol, or high-density lipoprotein cholesterol (HDL), can protect against heart disease and stroke.

Bad cholesterol, or low-density lipoprotein cholesterol (LDL), accumulates in arteries that feed the heart (coronary arteries) and brain (carotid artery in the neck). Together with other substances, bad cholesterol forms plaque, a thick, hard deposit that narrows arteries and makes them less flexible – a condition called atherosclerosis.

If a blood clot forms and blocks an artery that’s already narrowed by plaque, you could have a heart attack or stroke, depending on which artery is clogged.

Two other substances that affect arteries and contribute to cholesterol are triglycerides and Lp(a) cholesterol, Stevens says.

Triglycerides are a type of fat that’s made by the body. In low levels, they’re not harmful. But lifestyle factors – such as being overweight or obese, being a couch potato, eating a high-carb diet, smoking and drinking too much alcohol – can cause triglycerides to proliferate to dangerous levels, she says.

If you have high triglyceride levels, you’re more likely to have high total cholesterol, too little good (HDL) cholesterol and too much bad (LDL) cholesterol, and an increased risk of cardiovascular disease, Stevens says. High triglyceride levels also increase your risk for metabolic syndrome, which is a combination of obesity, abdominal fat, unhealthy cholesterol levels, high blood pressure and insulin resistance that increases your risk for diabetes, heart disease and even death.

Lp(a) is a variation of bad (LDL) cholesterol. Scientists don’t fully understand Lp(a) but believe it may accelerate the accumulation of fatty deposits, increasing an already high risk of heart disease and stroke, according to the AHA.

About 25% of cholesterol in the body comes from foods that contain cholesterol, namely animal products such as meat, eggs, full-fat dairy treats like milk, cheese, butter and ice cream, and some seafood, including shrimp, says Darlene Zimmerman, M.S., R.D., Heart Smart dietitian at Henry Ford Hospital Heart and Vascular Institute in Detroit.

“Plant foods don’t have cholesterol,” she says.

The liver manufactures the remaining 75% of cholesterol in the body, says Brian Kahn, M.D., a cardiologist with the Heart Center at Overlea in Baltimore.
Testing
A simple blood test can determine whether you have high cholesterol levels.

If you have a family history of high cholesterol, get tested at age 20 and then every five years, advises Cindy Haines, M.D., a family physician and author of The New Prescription, How to Get the Best Health-Care in a Broken System (Health Communications Inc.).

If you’re not at high risk, get your first test by your early 30s, she adds.

How to Read the Numbers
A cholesterol test delivers measurements in milligrams per deciliter of blood (mg/dL). Your total cholesterol level should be less than 200 mg/dL. If it’s 200-239, it’s considered borderline high. If it’s more than 240 mg/dl, your risk is twice as high as a woman with healthy cholesterol, Stevens says.

Your good (HDL) cholesterol should be at least 50 mg/dL. The higher your good (HDL) cholesterol, the lower your risk for heart disease.

Being overweight or obese, smoking, and being inactive can lower your HDL. Estrogen may raise HDL cholesterol levels, which may explain why high cholesterol is more common among postmenopausal women than younger women, says Peter Alagona Jr., a cardiologist and researcher with Penn State Hershey Heart and Vascular Institute.

Your bad (LDL) cholesterol should be less than 100 mg/dL. Unhealthy lifestyle habits raise bad cholesterol levels. But a 2011 study conducted at Texas A&M University found that women who exercised rigorously and gained the most muscle mass also had the highest levels of LDL – an unexpected result that scientists are still trying to figure out.

Your triglyceride levels should be less than 150 mg/dL.

If you have risk factors for high cholesterol but normal test results, your doctor can order a special blood test called NMR LipoProfile that measures regular cholesterol and the number of LDL cholesterol-carrying particles in your bloodstream for a more complete picture of your cardiovascular risk, says James Underberg, M.D., a lipidologist with New York University Center for the Prevention of Cardiovascular Disease.

Treatment
So how is high cholesterol treated?

“Diet and exercise form the cornerstone of high cholesterol treatment,” says Brian Kahn, M.D., a cardiologist with the Heart Center at Overlea in Baltimore. “You may be able to lower your levels in a few months with healthier lifestyle habits.”

Some steps you can take:

“Eat a heart-healthy Mediterranean diet that revolves around fresh fruits and vegetables, whole grain foods, foods that are high in fiber, lean meats and poultry. Try to eat fish at least once or twice a week,” Zimmerman says.

Cut the fat: Eat a low-fat diet that contains no more than 25%-30% calories from fat, says Julie Bolick, M.S., R.D., a clinical nutritionist and lipid specialist for University of Utah’s Cardiovascular Genetics division. “Limit saturated fat to 7% of your daily fat intake by eating lean meats, margarine instead of butter and switching to low-fat and fat-free dairy products. The rest should come from monounsaturated fats and polyunsaturated fats.”

Monounsaturated fats are found in olive, peanut and canola oils, nuts and fatty fish like salmon, mackerel and herring. Polyunsaturated fats are found in soybean, corn and safflower oils, fatty fish, walnuts and sunflower seeds, oils and butters.

Focus on omega-3 fatty acids: A 2002 study conducted at Penn State Hershey Heart and Vascular Institute found that the omega-3 fatty acids in fish oil lowered triglycerides by as much as 30% and raised HDL cholesterol by as much as 3%. Best sources of the fatty acids include Pacific herring, farm-raised Atlantic salmon, mackerel, sardines and fresh tuna, as well as canola, flaxseed, walnut, soybean and fish oils.

Lower dietary cholesterol: Limit cholesterol to 300 milligrams (mg) daily, or 200 mg if you have heart disease, Bolick says. Avoid concentrated sources of cholesterol such as organ meats, egg yolks and whole milk products and switch to lean meats, egg substitute or egg whites and skim milk.

Avoid trans fats: “These are the black sheep of fats because they raise bad cholesterol and lower good cholesterol,” says Dominique Fradin-Read, M.D., a physician, and assistant clinical professor at Loma Linda University School of Medicine in Los Angeles. Trans fats also raise triglycerides and Lp(a).

“Products can claim to be free of trans fats if they contain less than 0.5 grams of trans fat per serving, but small amounts can really add up,” he says. Check the food label. If it lists partially hydrogenated fat, the product contains trans fats.

Stop smoking: Smoking increases inflammation of arteries and destabilizes plaque, which can rupture and lead to heart attacks or even death, says Stevens.

Drink in moderation: “One drink a day, such as a glass of red wine or a beer, can help increase good cholesterol,” Zimmerman says.

Lower sodium: High cholesterol levels contribute to high blood pressure and a high sodium diet increases the risk. Reduce your intake to 2,300 mg or less and slash sodium by eating fresh, rather than canned or preserved, foods and avoiding salty items such as bacon, soups and stews.

For more information, check out the DASH diet (Dietary Approaches to Stop Hypertension).

Medications
If diet and exercise aren’t enough to lower your cholesterol or if you have very high cholesterol, your doctor may prescribe one of these medications, which can lower cholesterol in 4-6 weeks, Kahn says:

Statins (Lipitor, Lescol, Crestor): These medications inhibit an enzyme in the liver from producing cholesterol. Side effects are rare but include muscle aches and pains.

Bile-acid-binding resins (Welchol, Prevalite, Questran): The liver converts cholesterol to bile to aid in digestion.

Resins bind to this bile in the digestive tract and it’s then eliminated from the body. In response, the liver uses excess cholesterol to make more bile acids, which in turn are also cleared from the body.

Cholesterol absorption inhibitors (Zetia, Vytorin): These drugs inhibit absorption of dietary cholesterol and reduce blood cholesterol.

Fibrates (Lofibra, Tricor, Lopid): Fibrates decrease triglycerides by reducing the liver's production of very-low-density lipoprotein (VLDL) cholesterol and increasing the removal of triglycerides from your blood.

Niacin (Niaspan): Prescription-strength niacin inhibits the liver from producing bad (LDL and VLDL) cholesterol.

Omega-3 fatty acids (Lovaza, a prescription-strength omega-3 fatty acid): will help lower your triglycerides.

For more information, visit our Cholesterol Health Center .

How Well Do You Understand Cholesterol?
Cholesterol is much maligned, yet many people don’t understand this essential substance and how it works in our bodies. Do you know your HDL from your LDL? How about which lifestyle choices influence cholesterol levels?

Drinking Black Tea Cuts Blood Pressure

2012-02-06T01:34:00.001-08:00

People who enjoy drinking black tea throughout the day may get the added benefit of a slight reduction in their blood pressure, suggests a new Australian study.

Although the study cannot identify specific components of the tea that might lead to a drop in blood pressure, the researchers said past studies have shown flavonoids, compounds found in many plants such as tea, are good for heart health.

"The message really isn't for an individual to go out and drink a lot of tea," said Jonathan Hodgson, the study's lead author and a researcher from the University of Western Australia. He said, instead, the drop is like a bonus.

The study, published in the Archives of Internal Medicine, randomly assigned 95 Australians with normal blood pressure to two groups. One group drank black tea and another drank a beverage similar in taste and caffeine content.

Before the study started, the participants' blood pressure throughout the day was about 121/72 millimeters of mercury (mm Hg).

Blood pressure readings less than 120/80 mm Hg are considered normal. High blood pressure is defined as a reading of 140/90 or above. People with a reading between the two are said to have "pre-hypertension."

Each group drank their assigned beverages three times per day for six months.

After the six months the tea drinkers' systolic blood pressure — the top number — fell 2 mm Hg, and their diastolic blood pressure also fell about 2 mm Hg.

While a drop in blood pressure is generally good, a 2 mm Hg drop is not significant enough to bring a person with high blood pressure out of the danger zone.

"Those are small changes and are nothing like what you would see if you took a blood pressure lowering medication," said Dr. Joseph Vita, who has studied flavonoids at the Boston University School of Medicine and was not involved with the study.

However, the placebo group's systolic blood pressure went up about 1 mm Hg and their diastolic blood pressure also increased about 0.5 mm Hg.

To account for potential influences from other foods, researchers had the people in both groups cut back on flavonoid-rich foods such as apples, grapes, dark chocolate and wine four weeks before and all throughout the study.

Hodgson said making the placebo group go from a flavonoid-rich diet before the study to a lower one could have caused blood pressure to go up.

The research was funded through government grants and by Unilever Research and Development, which is an arm of the company that owns the Lipton brand.

According to the researchers, the findings might provide a bigger benefit if they are applied to a large group.

"You've got — in the population — large numbers of people with blood pressure around the hypertension range. So just shifting that population down can make a big difference," said Hodgson.

Robotic Prostate Surgery is Overhyped

2012-02-06T01:33:00.000-08:00

Robot-assisted surgery for prostate cancer has been heavily hyped, and a new study suggests that men's expectations of the surgery may be too high.

Researchers found that of 171 men facing prostate cancer surgery, those having robotic surgery expected a shorter hospital stay, and a quicker return to their usual physical activity and sex life.

But those hopes may not be realistic.

Prostate removal is one treatment option for prostate cancer, and in the United States, a majority of those surgeries are now done with the help of a "robot."

During the procedure, the surgeon sits at a console, operating robotic "arms" that extract the prostate gland through small cuts in the abdomen.

The robotic approach is expensive. And after hospitals invest the roughly $1.5 million for the machines, plus the cost of surgeon training and annual service contracts, they often aggressively market the approach — as do the companies behind the technology.

And that may include claims that robotic surgery is better than the old-fashioned way.

"Since about the mid-2000s, people were thinking that robotic surgery was the greatest thing since sliced bread," said Dr. Judd W. Moul, a prostate surgeon at Duke University Medical Center who led the new study.

There was reason to believe that the better visualization with robotic surgery could lead to some better outcomes, Moul told Reuters Health.

On the other hand, he said, when surgeons actually use their hands, they get "tactile feedback" that's missing with the robotic approach.

And studies have suggested that while robotic surgery may have some short-term advantages — like a somewhat shorter hospital stay — there may be no clear difference in the most important outcomes.

So far, there's no good evidence that robotic-surgery patients fare any better as far as cancer recurrence or long-term side effects like urine leakage and erectile dysfunction.

And in an earlier study, Moul and his colleagues found that men who had the robotic procedure were actually less satisfied in the long run than those who had traditional surgery.

They guessed that patients' expectations going into surgery might have something to do with it.

More Optimism

So for the new study, they surveyed 171 men about their expectations heading into prostate cancer surgery. The majority of patients — 97 — had opted for robotic surgery, while 74 were going with the traditional route.

Overall, 89 percent of men having the robotic surgery expected to stay just one night in the hospital, versus 37 percent of men having traditional surgery.

The robotic-surgery group also thought they would be back to exercising sooner — typically predicting a five-week wait, versus six weeks in the other group. And they expected to have recovered their erectile function within five months of surgery.

Men having traditional surgery were much less optimistic. They typically assumed it would take nine months to regain their sex life.

On average, Moul said, men having robotic surgery do seem to get out of the hospital eight to 12 hours quicker.

But a small percentage, he noted, end up staying in the hospital for a few days because their bowel function does not return quickly.

As far as physical activity and long-term erectile function, it's not clear if there's any advantage to robotic surgery. At Duke, Moul noted, men are advised to avoid any heavy lifting for six weeks after surgery — robotic or not.

Ask Tough Questions

Where are men getting their expectations? Ads, the Internet, and the general belief that high-tech must be better may all play a role, according to Moul.

"But I think that probably physician counseling has a lot to do with it," Moul said.

He noted that surgeons do have an incentive to push men toward the new technology in order to "work through their learning curve" — that is, hone their skills by doing more procedures.

Increasingly, experts are saying that men should put more stock in their surgeon's experience than on the type of prostate surgery.

Moul agreed. That experience, he said, "is what drives the long-term outcomes of urinary and sexual recovery of function."

"Ask your surgeon the tough questions," Moul said. That means asking how many procedures he or she has ever done, and how many per year.

There's no hard-and-fast number that defines a "good" surgeon. But Moul suggested that a doctor who performs at least 40 to 75 procedures a year (of one specific kind — robot or traditional) would be considered experienced.

Of course, that all assumes a man has decided on having surgery.

Many men with early-stage prostate cancer can decide to hold off on treatment altogether. That's because prostate tumors are often slow-growing and may never advance to the point of threatening a man's life.

One study found that more than 120,000 American men diagnosed with prostate cancer every year are ideal candidates for "watchful waiting" — which means doctors keep an eye on the cancer to see if it's progressing.

In reality, though, the majority of those men end up having surgery, radiation, or other treatment instead.

Exercises to Help Patients with COPD - Easy Workouts to Improve Dyspnea and Other Breathing Troubles

2012-02-06T01:30:00.000-08:00

Even though people with chronic obstructive pulmonary disease (COPD) suffer from shortness of breath, it’s important for them to keep moving, experts say. We asked a celebrity exercise trainer to design a workout especially for patients with COPD – one that gently maximizes lung capacity and builds muscle without causing breathing trouble...

For women with chronic obstructive pulmonary disease (COPD), walking up a flight of stairs, pushing a cart at the grocery store or even tinkering in the garden is difficult.

That’s because the disease causes airways and balloon-like air sacs in the lungs to lose elasticity. They can’t properly fill with air, leaving COPD patients gasping, coughing and wheezing.

Even though there’s no cure for the disease, COPD treatment, which includes inhaled medicine and smoking cessation, can make breathing more comfortable, doctors say.

One more thing eases breathing troubles for patients with COPD: exercise.

“Aerobic activity, such as walking or riding a stationary bike, improves lung power and capacity, and allows you to be active without getting winded,” says Stephen Mueller, M.D., a pulmonologist at Methodist Charlton Medical Center in Dallas, Texas. “It strengthens lungs, making it easier to breathe in and out. That, in turn, improves your
quality of life.”

One of the primary symptoms of COPD is shortness of breath, or dyspnea, Mueller says. Because it’s hard to breathe, patients with COPD believe it’s best to sit still or be inactive.

However, inactivity often results in deconditioning, which can actually result in further dyspnea, Mueller says.

“Your lungs need to be exercised to stay elastic and properly fill with air, so exercising is recommended for patients with COPD,” he says.

Regular exercise may also restore your quality of life too.

“Once COPD is controlled, probably with medicine or pulmonary rehabilitation, you should be able to do everyday things, like grocery shop, walk and play catch with grandkids,” says Byron Thomashow, M.D., medical director at Columbia University/New York Presbyterian Hospital.

To help patients with COPD get – and stay – moving, Lifescript consulted Natania Goldberg, a certified personal trainer and wellness coach at the Sports Club in Los Angeles who trains patients with COPD. Read on for
her exclusive tips and a simple exercise routine.

Why is it important for patients with COPD to exercise?
Doctors say not exercising can lead to a vicious cycle of fear and anxiety followed by inactivity for someone living with COPD.

But engaging in an exercise program helps a COPD patient understand they can live with breathing troubles and also help reduce it.

As a result of [regular workouts], patients with COPD have improvements in quality of life, sense of well-being, independence and overall enjoyment.

Do patients with COPD have to go to a gym to exercise?
No. Walking is a great way for people with COPD to be active. Done regularly, it can improve the body's ability to use oxygen because it’s an aerobic activity – it requires your heart and lungs to work harder than normal, so they get a good workout.

Walking is a low-impact exercise that places little, if any, stress on the joints, and is generally an easy exercise for patients with COPD to perform.

It also helps build endurance, reconditions and strengthens muscles and improves well-being.

As you build endurance, breathing at rest or during activity might become
easier. So trips to the grocery store won’t be as tiring or difficult.

How should a COPD patient start a walking regimen?
Start small and don’t get discouraged. Even if you walk down the driveway and back the first day, that’s an accomplishment – and a start.

Every day add just one or two more steps – more if possible.

What should patients with COPD work up to?
The goal is to walk at least 10,000 steps a day and wear a pedometer – even around the house or to the store – to track your progress. Keep a walking journal so you can quickly see your progress.

Other than walking, what forms of exercise can patients with COPD do?
The American College of Sports Medicine recommends forms of exercise that increase total body oxygen demands and require usage of the large muscle groups like legs, arms and mid-section.

Besides walking, some great forms of aerobic activity are riding a stationary bike or swimming. Stair stepping or rowing machines are alternatives, but only if they don’t cause excessive shortness of breath.

Besides improving respiratory function, what are other benefits to exercising if you’re a COPD patient?
Patients with COPD lose upper body strength because they think they can’t exercise. They also lose muscle because their diaphragm, which is a muscle, weakens as a result of not being able to breathe deeply. The diaphragm doesn’t get a good workout.

Resistance training for the upper body helps strengthen the diaphragm as
well as muscles in the arms, back and shoulders.

Here is a workout that can tone and help manage symptoms.

Seated or standing dumbbell curls

Equipment needed: 1-, 2- or 5-pound weights

Frequency: 2-3 times per week

Duration: 1 set of 8-15 repetitions (you can start at 8 and build up to 15).

How to do it:

1. Using a 1-, 2- or 5-pound weight, sit or stand with your feet shoulder-width apart.

2. Keep your back straight and let the dumbbells dangle at your sides with palms facing inward.

3. With your arms straight, slowly raise the dumbbells until they are parallel to the floor. Repeat the exercise 8 times.

Tips: Your arm should be perpendicular to your torso.
Push-ups on a wall

Equipment needed: none

Frequency: 2-3 times per week

Duration: 1 set, 8-15 repetitions. (You can start at 8 and build up to 15.)

How to do it:

1. Stand facing a wall approximately 2 feet away.

Keep your feet together, place your hands flat on the wall slightly more than shoulder-width apart. Your arms should be straight out in front of you.

2. Lean in toward the wall (tucking your elbows in) until your nose is almost touching the wall and hold this position for 5 seconds.

3. Return to standing position and repeat.

Leg Lifts

Frequency: 2-3 times per week

Duration: 1 set, 8-15 repetitions. (Start at 8 and build up to 15.)

How to do it:

1. Lie on the floor with toes pointed up, arms at sides and palms open.

2. Bend your right leg and put your foot flat on the floor.

3. Slowly raise your left leg as high as you can, hold it in the air for 5 seconds and then return it to the ground.

4. Repeat raising the left leg 8-15 times before switching to the other leg.

For more information and expert tips, visit our COPD Health Center.

How Much Do You Know About COPD?
Chronic obstructive pulmonary disease (COPD) is on the rise, according to the National Institutes of Health. More than 12 million people in the U.S. are currently diagnosed with it, and another 12 million may have it but don’t know.

Could You Have Ulcerative Colitis?

2012-02-06T01:25:00.000-08:00

Even one day of stomach cramping or diarrhea is too many. But diseases like ulcerative colitis inflame your bowels and make daily pain commonplace. Understanding the disease and its triggers can help. Here are answers to your top 10 questions about ulcerative colitis and suggestions for easing discomfort...

1. What is ulcerative colitis? I’ve heard it mentioned with irritable bowel syndrome and Crohn’s disease. Are they all the same thing?
No, but they do share some symptoms. Ulcerative colitis (UC) causes inflammation along the lining of the lower gastrointestinal (GI) tract: the colon and the rectum. The inflammation kills cells that line those parts, resulting in ulcers that may bleed and ooze pus.

The result is abdominal pain and cramping, diarrhea and even bloody, pus-laden stool.

It may affect only the last portion of the colon and rectum, known as ulcerative proctitis. If it affects only the lower colon, it’s called limited, or distal, colitis. Pancolitis affects the entire colon.

Crohn’s disease, like ulcerative colitis, also causes GI inflammation: both are inflammatory bowel diseases (IBD).

But Crohn’s disease can affect any part of the GI tract, from the mouth to the anus, although its target is most commonly the ileum, the last portion of the small intestine. (That’s why it’s sometimes called ileitis or enteritis.)
Crohn’s disease differs from ulcerative colitis in several ways:

It may inflame all the bowel’s layers, not just the top layer as UC does.

It may affect any area of the GI tract; UC most often affects the colon only.

Crohn’s disease may skip portions of the GI tract, interspersing healthy and diseased bowel; UC usually spreads
along the bowel without skipping sections.

Treatments for the two diseases differ too. So do some complications. The most common complication of Crohn’s, for example, is intestinal blockage, which isn’t common in UC.

Unlike UC and Crohn’s, irritable bowel syndrome (IBS) doesn’t involve GI inflammation. Instead, IBS results from abnormal contractions of the GI tract.

Although IBS causes some similar symptoms, such as diarrhea and abdominal cramping, it doesn’t damage the bowel or lead to serious illness such as cancer, which UC and Crohn’s do (see Question #10).
The confusion between IBS and the inflammatory bowel diseases UC and Crohn’s may also come from having such similar acronyms: IBS and IBD.

2. Are certain people more likely to get UC than others?
UC affects men and women equally. People who have a close relative – a parent or sibling – with UC or Crohn’s disease are also more likely to get UC. And UC occurs more frequently in Caucasians and in people of Eastern European Jewish descent (Ashkenazi Jews).

UC can affect all ages, but most commonly starts between the ages of 15 and 30. Nobody knows why, although it’s thought that genetics play a role. However, UC is not just hereditary: Many people get it without having a genetic predisposition, and not everyone with a predisposition gets it.

3. What causes it?
No one knows. Some studies link abnormalities in the body’s immune system with UC, but it’s unclear whether those are a cause or result of the disease. Other studies suggest that both Crohn’s and UC stem from an abnormal reaction of the body’s immune system to normal bacteria in the GI tract.

Specific genes are probably involved too, since the disease runs in families and certain population groups.

4. What symptoms should I look for?
UC symptoms include any or all of the following:

Profound fatigue

Scant appetite

Weight loss

Bloody diarrhea

Abdominal cramping

Nausea

Vomiting

Joint pain

Eye inflammation

Skin lesions

For severe UC, you may see recurrent bouts of fever along with abdominal symptoms, including rectal bleeding. Flare-ups may come and go but rarely disappear.
Acute GI infections, such as salmonella or giardia, can have many of the same abdominal symptoms but usually resolve on their own without recurring. Talk to your doctor if symptoms last longer than a week or if they are severe and accompanied by high fever.

5. Is it a stress-related disease?
UC isn’t initially caused by emotional stress, but distress – including the anxiety of having the disease – may worsen symptoms and trigger flare-ups.

Massage therapy, meditation, deep breathing, yoga and cognitive behavioral therapy (which allow patients to explore and rid themselves of negative thoughts and attitudes) may help manage stress.

6. Can medications trigger it?
Yes, some drugs can be tough on the UC gut. Nonsteroidal anti-inflammatories (NSAIDs), such as ibuprofen (Advil), have been linked to UC flare-ups.

Antibiotics may also worsen symptoms and should be taken only if absolutely necessary.

Stopping or skipping doses of UC medication may also lead to flare-ups.

7. Can diet, like spicy or high-fiber foods, aggravate it?
Yes, but no one food triggers a flare-up for every UC patient. High-fiber foods such as bran, beans, nuts, seeds and popcorn may increase diarrhea and gas in some people with UC, as can spicy and greasy foods.

You may have to go easy on caffeine and liquor too.

Some people with UC can’t eat any type of pepper – raw or as seasoning.

The trick is to find out which foods trigger your UC flare-ups and avoid them while trying to eat a well-balanced, nutritious diet.

Some doctors recommend “the specific carbohydrate diet,” which is free of grains, milk products and sugar. Instead, it’s loaded with fresh fruits and vegetables, meats, fish and natural cheeses and yogurt.

The theory is that carbohydrate sugars may fuel the growth of bacteria and yeast in the intestines, which interfere with digestion and produce toxins that could harm the small intestine.

Researchers are also exploring the benefits of probiotics – live beneficial bacteria available in some yogurts and as supplements – and anti-inflammatory omega-3 fatty acids found in fatty fish like tuna and salmon, as well as in walnuts, flaxseeds and soybeans.

8. Is UC curable? Or is it a life-long condition?
Ulcerative colitis is usually life-long, although some people may be cured by having their colon and rectum removed. Surgery isn’t commonly recommended for people with mild UC cases – infrequent flare-ups, perhaps even years apart – and flare-ups that are easily treated with medications.

But it may be recommended for some patients with frequent flare-ups and severe symptoms.

Even with surgery, some symptoms – especially those outside the GI tract like joint pain – may not go away. And the surgery can have long-term complications, such as blockage, stool leakage and even infertility.

If the lower colon is severely affected, a surgeon may have to close off the rectum, leaving the patient with a permanent ostomy - an opening in the abdomen through which feces empty (into a collection bag).

About 25%-40% of UC patients eventually have their colons removed because they rupture. Or they need this surgery because of massive bleeding from the rectum, the risk of colon cancer, or illness so severe that medications can no longer control it.

9. What are medication options?
The types of medication used to treat UC include:

Those that relieve symptoms, such as anti-diarrheal medications, pain relievers and anti-fever medications like acetaminophen (Tylenol)
Those that help control bowel damage by decreasing inflammation, such as aminosalicylates, which include aspirin and corticosteroids

Those that suppress the body’s immune system, such as azathioprine (Imuran) and cyclosporine (Sandimmune)

Your symptoms determine which drug or combination of drugs is recommended. Your doctor may also prescribe anti-anxiety meds or antidepressants to help lower your stress levels.

10. Can UC lead to cancer?
The risk of developing colon cancer increases with the severity and duration of the disease.

For example, in a patient whose UC involves the entire colon, the risk of developing colon cancer can be 32 times higher than normal. About 5% of UC patients develop colon cancer.

Because of the high risk, the American Cancer Society recommends a colonoscopy with biopsies every one to two years if you have had IBD throughout the colon for eight years or more, or for those who have had IBD for 12-15 years in their lower colon only.

THOUGHT FOR THE DAY...

2012-02-05T01:23:00.001-08:00

Life isn't about waiting for the storm to pass... It's about learning to Dance in the Rain.