FOOD & HEALTH SKEPTIC ARCHIVE
Monitoring food and health news
-- with particular attention to fads, fallacies and the "obesity" war
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A major cause of increasing obesity is certainly the campaign against it -- as dieting usually makes people FATTER. If there were any sincerity to the obesity warriors, they would ban all diet advertising and otherwise shut up about it. Re-authorizing now-banned school playground activities and school outings would help too. But it is so much easier to blame obesity on the evil "multinationals" than it is to blame it on your own restrictions on the natural activities of kids
NOTE: "No trial has ever demonstrated benefits from reducing dietary saturated fat".
A brief summary of the last 50 years' of research into diet: Everything you can possibly eat or drink is both bad and good for you
30 November, 2008
BLACKS ARE FATTER AND MALE DROPOUTS ARE FATTER
The article below is a bit hard to follow and its political correctness does not help. IQ was of course not examined but I think that "Males with a disadvantaged background who experienced early transitions into the labor force" can be decoded in one word as "dropouts" -- and they were found to be fatter. And blacks were found to be fatter too, perhaps reflecting that many of them are dropouts. Why an early dropout from education is asssociated with being overweight one can only speculate but it would appear consistent with the usual finding that high IQ people have better biological functioning generally. So low IQ people may have worse functioning even in trivial ways
Obesity, Race/ethnicity and Life Course Socioeconomic Status across the Transition from Adolescence to Adulthood
By Melissa Scharoun-Lee et al.
Background: Differences in the association of socioeconomic status (SES) with obesity may underlie racial/ethnic disparities in obesity that increase dramatically across the transition to adulthood in the US.
Objective: To examine racial/ethnic differences in the influence of life course SES on longitudinal obesity patterns from adolescence to adulthood.
Methods: Latent class analysis was used on a nationally representative, diverse sample of 12,940 adolescents followed into young adulthood (mean age=21.7 years) to identify life course SES group profiles based on SES data in adolescence and young adulthood. Gender-stratified multinomial logistic regression models estimated the association of SES groups with obesity incidence and persistence versus staying non-obese.
Results: No significant interactions with race/ethnicity were observed, though racial/ethnic minorities had the highest obesity risk across SES groups. Racial/ethnic-pooled associations between disadvantaged SES exposure and higher obesity risk were strong but differed by gender. Males with a disadvantaged background who experienced early transitions into the labor force, marriage and residential independence had the highest risk of obesity incidence (RRR=1.64; 95%CI: 1.12, 2.40), while females exposed to persistent adversity were at highest risk (RRR=3.01, 95%CI: 1.95, 4.66). In general, SES group membership had a stronger relationship with obesity persistence than incidence.
Conclusions: The relationship between SES and obesity patterns is similar across race/ethnicity and differs by gender during the transition to adulthood. However, stronger associations with obesity persistence and enduring racial/ethnic disparities in obesity risk across SES groups suggest that these social factors play a larger role in disparities earlier in the life course.
J Epidemiol Community Health. Published Online First: 31 October 2008
The Catch-22 of Aging
It seems there's just no way to beat Father Time. As we age, our chromosomes fracture, and specialized proteins rush in to reverse the damage. But new research shows that in doing so, these proteins inadvertently switch on genes that can contribute to aging, allowing senescence to march ever onward.
The idea that a protein might patch up a rickety, aging chromosome is not new. About a decade ago, researchers identified a protein called Sir2 that zooms to the spot of broken DNA in yeast cells and repairs the breaks. But to do that, Sir2 has to abandon its job of inactivating a sterility gene elsewhere in the yeast genome. The result is yeast cells that have intact DNA but are sterile, a symptom of aging in the fungi. Since then, researchers have drawn more connections between Sir2 and its protein family, the sirtuins, to aging in yeast, insects, and mice (Science, 18 June 2004, p. 1731). But they didn't know if the mammalian equivalent of Sir2, a protein called SIRT1, caused the same genetic catch-22.
To find out, molecular biologist David Sinclair of Harvard Medical School in Boston and colleagues studied SIRT1 in mice. In mouse embryonic stem cells, the researchers saw that SIRT1 hangs out near strands of DNA that don't seem to produce proteins, suggesting that it plays a gene-silencing role like Sir2 plays in yeast.
Next, the researchers mimicked aging in mouse cells by exposing them to hydrogen peroxide. The chemical simulates oxidative stress, a buildup of reactive oxygen that often occurs in older cells; many researchers believe that oxidative stress damages cell structures, such as chromosomes, and causes the problems we associate with aging. After 1 hour in the peroxide solution, more than 90% of the SIRT1 proteins left their original locations on the chromosome and moved to the breaks, the researchers report today in the journal Cell.
What was the effect of SIRT1 leaving its post? Further work in the brains of aging rodents suggested that many of the genes associated with SIRT1 turn on in older mice, possibly because SIRT1 has left the scene to repair a broken chromosome. The result could be a liver gene turning on in the brain, disrupting the brain's function, says Sinclair. Such faulty gene activity contributes to a multitude of age-related problems, such as diabetes and dementia.
Overall, the findings indicate that a mammalian cell's effort to stave off old age can actually promote the symptoms of aging. "This may be a very fundamental Achilles' heel of life," says Sinclair. Still, understanding how SIRT1 contributes to the process can help researchers develop better treatments for aging-related problems, Sinclair says. For example, in further experiments, his team showed that mice fed SIRT1 lived more than 25 days longer than did control mice after exposure to genome-altering radiation.
Leonard Guarente, a molecular biologist at the Massachusetts Institute of Technology in Cambridge who conducted some of the original sirtuin studies in yeast, says the work provides greater insight into aging in mammals, including humans. It also, he notes, shows that simple organisms like yeast still have something to teach us.
29 November, 2008
Holiday Meals Rife With (Safe) Carcinogens!
'Americans are still constantly bombarded with dire warnings.'
The widespread belief that organic and so-called "natural foods" are safer than conventional ones is simply not true. Scientists with the American Council on Science and Health (ACSH) point out that the foods that make up a traditional holiday dinner are loaded with "carcinogens": chemicals that in large doses cause cancer in laboratory animals.
None of these chemicals are man-made or added to the foods. These "carcinogens" occur naturally in foods. But ACSH scientists have good news: these natural carcinogens, like their synthetic counterparts, pose no hazard to human health -- because we are exposed to such low levels, and because we are not the same as lab animals.
Dr. Elizabeth Whelan, president of ACSH, notes, "Americans are still constantly bombarded with dire warnings that synthetic chemicals have untoward, if not downright deadly effects on our health." She continues, "We're also told that so-called natural or organic foods are better for us than those containing any synthetic ingredients or produced by conventional means."
ACSH's Holiday Dinner Menu highlights the chemicals -- and the carcinogens -- that Mother Nature herself has put in our food. These natural carcinogens, like synthetic chemicals, have been shown to cause cancer only in very high doses, given over a lifetime to lab animals. They are present in such small amounts in our foods that they do not endanger consumers.
This fact hasn't dampened the ardor of self-styled consumer activists, who "warn" consumers about the supposed dangers of acrylamide, for example, which is produced when foods high in carbohydrates are cooked at high temperatures. "Acrylamide, like the majority of the other rodent carcinogens listed in the menu, has never been shown to be a human carcinogen," observes ACSH nutrition director Dr. Ruth Kava. No component of the traditional holiday meal is devoid of animal carcinogens (defined here as substances that at high doses cause cancer in laboratory animals), including:
hydrazines (mushroom soup)
aniline, caffeic acid, benzaldehyde, hydrogen peroxide, quercetin glycosides, and psoralens (vegetable salad)
heterocyclic amines, acrylamide, benzo(a)pyrene, ethyl carbamate, dihydrazines, d-limonene, safrole, and quercetin glycosides (roast turkey with stuffing)
benzene and heterocyclic amines (prime rib of beef with parsley sauce)
furfural, ethyl alcohol, allyl isothiocyanate (broccoli, potatoes, sweet potatoes)
coumarin, methyl eugenol, acetaldehyde, estragole, and safrole (apple and pumpkin pies)
ethyl alcohol with ethyl carbamate (red and white wines)
Then sit back and relax with some benzofuran, caffeic acid, catechol, 1,2,5,6,-dibenz(a)anthracene with 4-methylcatechol (coffee). And those -- all produced courtesy of Mother Nature -- are only the carcinogens. Your 100% natural holiday meal is also replete with toxins. These include the solanine, arsenic, and chaconine in potatoes, the hydrogen cyanide in lima beans, and the hallucinogenic compound myristicin found in nutmeg, black pepper, and carrots.
Rest easy, though, because virtually none of the compounds on ACSH's list are established human carcinogens, and, as the Holiday Dinner Menu demonstrates, we would have to eat enormous amounts of these foods over long periods of time before we could ever expect them to cause cancer. The same is true of the majority of the food additives that are now considered to be "carcinogenic" based exclusively on animal experiments, notes ACSH.
Dr. Whelan has also explained the Menu -- and its lesson about common but harmless carcinogens -- in a short video message, with a normal-quality version for general viewers and a downloadable high-quality version for interested media to use.
MENTAL ILLNESS IS GREATEST AMONG THE POOR
I keep mentioning findings like this because social class is so regularly ignored in epidemiological interpretations. And as epidemiological associations go, the overall effect below was quite strong
What is the association between wealth and mental health?
By Kristie N Carter et al.
Objective: To investigate the association between asset wealth and mental health in New Zealand (NZ) and whether it is independent of other socioeconomic measures and baseline health status.
Methods: Data for this study was from the first three waves of the Survey of Families, Income and Employment (SoFIE) conducted in New Zealand (2002-2004/05) (N=15,340). The Kessler-10 was used as a measure of psychological distress. The association of quintiles of wealth with psychological distress was investigated using logistic regression, controlling for confounders, socioeconomic variables and prior health status.
Results: The odds of reporting high psychological distress were greater in the lowest wealth quintile compared to the highest (OR 3.06, 95% CI 2.68-3.50). Adjusting for age and sex did not alter the relationship, however adjusting for income and area deprivation attenuated the odds ratio to 1.73 (1.48 to 2.04). Further controlling for baseline health status reduced the odds ratio to 1.45 (1.23 to 1.71), although the confidence interval still excluded the null.
Conclusions: Inequalities in wealth are strongly associated with psychological distress, over and above other confounding demographic variables and baseline health status. Much, but not all, of that association is confounded by adult socioeconomic position. This suggests that policy measures to improve asset wealth, through savings and home ownership, may have positive health implications and help to reduce health inequalities.
J Epidemiol Community Health. Published Online First: 21 November 2008
28 November, 2008
Are maddies sicker?
Found: Sick leave for mental illness linked to early death. This is consistent with the view that there is a general syndrome of better biological functioning. "To him that hath, more will be given him; to him that hath not what little he hath not will be taken away". We also see it in the better health of high IQ people, for instance. A more straightforward explanation, however, is that mad people are more likely to harm themselves, whether accidentally or deliberately
People who need to take time off from work for a mental health problem may live shorter lives than those in better psychiatric health, a new study suggests. Researchers found that among nearly 20,000 French workers they followed, those who'd taken at least 1 week's sick leave for a mental health disorder had a higher death rate over 14 years.
At the outset, 41 percent of the workers -- all public utility employees -- had taken at least 1 week's sick leave over the past 3 years. Those who'd taken time off specifically for depression or other mental health disorders were one quarter to one third more likely to die over the study period than workers with no mental-health absences. "Basically the message is that workers with medically certified absences for mental diagnoses should be considered a population at a higher risk of fatal disease," lead researcher Dr. Jane E. Ferrie, of the University College London in the UK, told Reuters Health.
She stressed, however, that the findings point to a relatively higher death rate in this group as a whole -- and that does not mean that any one person with a mental health disorder has an unusually high risk of early death. When studies observe large populations over time to look for patterns, the results cannot be used to "infer risk at the level of the individual," Ferrie explained.
The findings, published in the Journal of Epidemiology and Community Health, are based on 19,235 public utility employees (5271 female) who were part of long-range health study. The researchers used employment records to verify any medically certified work absences the employees had between 1990 and 1992. (French law requires workers to get a medical certificate from their doctors for each day of sick leave.)
Between 1993 and 2007, there were 902 deaths among the study participants. Those who'd taken 7 days or more off from work for a mental health disorder had a higher risk of death, even when their age and type of job were taken into account.
With the exception of extreme cases, mental health problems do not, in themselves, kill people, Ferrie pointed out. Instead, she explained, poor mental health is often connected to poor physical health. On one hand, physical conditions may lead to depression or other mental health problems, Ferrie noted. On the other, psychiatric conditions may directly impair physical health, possibly by affecting the nervous and hormonal systems.
ANOTHER CONFIRMATION THAT THE POOR ARE SICKER
This too is consistent with a pattern of general biological fitness
Co-occurrence of risk factors for cardiovascular disease by social class: 1958 British birth cohort
By C Power et al.
Aim: To establish whether social differences in multiple risk factors for cardiovascular disease are due to a greater strength of association (higher correlation) between risk factors in less advantaged groups.
Methods: Co-occurrence of five risk factors (smoking, hypertension, low high-density lipoprotein cholesterol, obesity, diabetes) in 3614 British 45-year-old men and 3560 women in the manual and non-manual social groups.
Results: 4.0% of women in manual groups had 3 or more risk factors compared with 1.7% in non-manual groups: 6.2% and 3.4% respectively for men. There was a higher than expected percentage of the population, overall, with 3 or more risk factors assuming independence between risk factors; correspondingly, there was a slightly lower than expected proportion with one factor. However, patterns of observed to expected ratios were consistent in manual and non-manual groups and did not differ by the number of risk factors.
Conclusions: Higher prevalence of multiple risk factors in manual groups was due to the higher prevalence of individual factors rather than a greater tendency of those with an individual risk factor to have additional risks. Strategies to reduce multiple risk factors in less advantaged groups would help to lessen their health burden.
Journal of Epidemiology and Community Health 2008;62:1030-1035
27 November, 2008
Beer sends you blind (?)
Another stupid "correlation is causation" claim
Knocking back four beers a day doesn't just risk a serious beer gut - it could also be damaging your eyesight, a study of Australian men has found. Melbourne research shows men in their 60s who drink alcohol heavily are about six times more likely to develop the most debilitating form of age-related macular degeneration (AMD). About 15 per cent of Australians are affected by the disease - where sight fades in the centre of the visual field - and 1 per cent will have the advanced or end-stage form that eventually steals sight.
Smoking and genetics have been linked to the condition but Dr Elaine Chong from the Royal Victorian Eye and Ear Hospital decided to study the diet and eye health of almost 7000 people over a period of time to determine the contribution of alcohol. "We found that higher levels of alcohol, more than four standard drinks a day, was associated with a three-fold increase in end-stage AMD in men," Dr Chong said. Beer drinking, in particular, carried a six-fold increased risk. Quantities of wine and spirits drunk were too low to evaluate their risk. The same link was not see in women, possibly because they were less likely to drink heavily, she said.
Explaining the trigger, Dr Chong said it was possible alcohol could increase oxidative stress to the retina. "Alcohol is a neurotoxin so it is thought that high levels can actually cause retinal damage that might lead to the disease," she said. An earlier study found rats fed alcohol in the lab were more likely to develop signs of end-stage AMD.
While the new findings, presented at an ophthalmology conference in Melbourne today, suggest drinking habits could be contributing, it may not be that clear cut. "It might be that heavy drinkers were also more likely to smoke, which is a well-identified disease risk," Dr Chong said. "But regardless, heavy alcohol intake is harmful so cutting back will always do you good."
Do British women fear fat more than drunkenness?
Could be these days
Bottles of wine and beer could soon carry labels warning of their calorie content. Experts believe binge drinkers, not deterred by information about how much alcohol a drink contains, might think again if they knew how fattening it was. The message would be most likely to hit home with image-conscious young drinkers and women.
One option would see the calorie content equated to a fattening food - such as comparing the calories in a pint of lager to a sausage roll. The proposals, from the Government's Advisory Council on the Misuse of Drugs, was last night condemned by the drinks industry. It claimed it could simply push drinkers into deciding they may have to 'skip a meal' in order to drink.
The advisory council, an influential body usually listened to by Ministers, said all alcohol bottles should carry labels warning of the 'harm caused', similar to those on cigarette packets. In a paper sent to Ministers, it added: 'Labelling could include calorie content and possibly specific warnings e.g increased risk of accidents.' One example given in the document is: 'A pint of lager = 2.3 units = 170 calories = a sausage roll'. It adds: 'Other types of comparison could be worth exploring.'
The council's views were sent to the Department for Health as part of the 'Safe Sensible Social' drinking laws review. The results of the review, including a crackdown on happy hours and other promotions, will be published once they have been approved by Gordon Brown.
Other advisory council suggestions include increasing taxes on strong drinks. The stronger a drink, the more it would cost. At present, some of the most potent brands of lager and cider are also the cheapest. The ACMD said: 'One major reason for the increase in binge intoxication in the UK is the gradual increase in the alcohol content of alcohol in wines, beers and especially lagers. 'Reducing alcohol content would be a simple approach to reducing intoxication. `Differential taxing - according to alcohol content per unit - could be one such method employed to reduce the amount of alcohol consumed.'
Other controversial proposals include so-called town centre 'wet' or 'damp houses' where drunks could go to sleep off a night's heavy drinking in safety. The ACMD launched a blistering attack on supermarkets, which often sell alcohol as a loss leader to entice more customers. It said: 'Such cheap availability encourages bulk purchase and consumption. Of specific concern is that the pricing puts alcohol more within the budgets of young people.'
A spokesman for the Wine and Spirit Trade Association warned against the calorie labelling plan. 'It's good in principle for consumers to have the information to make an informed choice but you wouldn't want people choosing alcohol by calories or thinking they could have a drink and skip a meal. 'Alcohol with food is better and adults should decide based on alcohol content, not calories.'
Drivers under the age of 21 should have a zero-alcohol limit, the advisory council said. Just one small glass of wine raises the odds of a young driver crashing six-fold, it warned. Drivers under 21 are already banned from drinking in Europe, as well as in parts of the U.S., Canada and Australia.
26 November, 2008
Video games can help develop the user's mind
WITH a serious stack of cash to spend, young teenager Dylan Ford blew the lot on a huge house and proceeded to fill it with television sets. But as the cash ran out, he became depressed. The house looked like a bomb site and Dylan couldn't get a job because he felt so low. It was time to sell the TVs. "I didn't spread my assets and just bought the best of everything. "Then I realised I couldn't pay for all the rest of the stuff. I hadn't even bought a refrigerator," says the 13-year-old from Kenmore, in Brisbane's southwest.
One would hope that when Dylan gets old enough to move into his own place, he won't make the same mistakes he did with his character on The Sims video game. "Games are a fantastic way to see action and consequence," says Dylan's father, Matthew Ford, who has spent 15 years developing video games. "You make choices and you suffer the consequences - and remember, games are heartless."
Far from being a scourge on society - to blame for everything from obesity to aggression and violence - Ford believes that, used in the right way, games can be a positive influence. "Real issues do get brought up in games and you have to think about what constitutes a good act or an evil act. "I use these as a springboard to talk about issues with Dylan. "Some games can help you develop your mind in a way that's not unlike chess, where you have to think several steps ahead.
"In some strategy games there is some very deep thinking required. Parents shouldn't feel bad that their children are playing games. "I think games are largely misunderstood by parents. "The analogy is very much like rock 'n' roll, when people used to say it's just full of noise and suggestion. "Games are in a similar position. Even jazz went through that - and remember Shakespeare was once considered a bad moral influence."
Ford believes much of the research linking video games and violent behaviour has proved a correlative - rather than a causative - link."There's a correlative link between fights at school and how much a child plays violent games but that doesn't mean the games cause that behaviour. "If your child is obsessed with playing violent games then you should take a look not at the game but what's inside your child that attracts them to that game - that can be the canary in the coalmine."
Jeff Brand, a director of the Centre for New Media Research at Bond University, has spent 10 years exploring the cognitive and behavioural effects of electronic media on young audiences. His work is part of a growing body of evidence that has looked for the positive benefits, rather than the unsavoury disadvantages, of games. He says his own research shows how older generations who have never held a controller or jiggled a joystick "tend to be fearful of games". "It's the Pied Piper syndrome where people see the game as leading children away from those who should be leading them," he says. Brand, also a parent with an 11-year-old boy, agrees with Ford that games only become a problem if parents fail to engage with the issues that games throw up.
Both Brand and Ford employ a "screen time" rule restricting their child's access to any screen-based media to a certain number of minutes a day. Brand has just released research commissioned by the Interactive Entertainment Association of Australia that looks at who plays games and the attitude of the population towards them. The research revealed the average age of the Australian video game player is now 30. Many games are now geared towards that market.
"Take a game like Grand Theft Auto: San Andreas," Brand said. It's a violent game and it's intended for adults. But the game is satire - but it does teach us about follow-through and moral choices, and morality is a tough thing to teach." "Most of us understand that after we have stepped out of the movie theatre or played a game, that we have come back to the real world. "But the vast majority of games offer something other than violence in their storytelling."
Brand says the genre of games now topping the charts target families and party groups. "It is the one genre that has suddenly rocketed," he said. "These are the games with a social and learning value."
Pain relief from marijuana derivative in sight
It makes you cold and immobile but what the heck!
SCIENTISTS have discovered a method to release the pain-relieving potential of one of the same proteins in the body which is activated by marijuana. According to a study released today, in experiments on mice, researchers found a chemical that prevents a naturally occurring enzyme from blocking the cannabinoid receptor, called 2-arachidonoylgylcerol, or 2-AG. Once the enzyme, known as MAGL, is deactivated, the protein is more effective in dampening pain, said the team, led by Benjamin Cravatt of the Scripps Research Institute in La Jolla, California.
The complex human cannabinoid system is thought to hold great potential for the control of chronic pain, and could also prove useful in the treatment of anxiety, depression and even obesity.
In earlier research, Mr Cravatt and colleagues decoded the chain of chemical reactions that acted on another cannabinoid receptor, AEA, paving the way for the development of pain-relieving medications. But finding the key for unlocking 2-AG proved more difficult. The tools - selective and efficacious MAGL inhibitors - just weren't there, said Jonathan Long, a graduate student at Scripps and lead author of the study. The breakthrough came thanks to a new technique for rapidly testing large numbers of chemical compounds - all potential inhibitors - called Activity-Based Protein Profiling.
One of the 200 compounds researchers created was particularly effective in blocking MAGL, and did not appear to interfere with any of several dozen other brain enzymes. Tests on mice showed the new molecule - JLZ184 - increased the concentration of 2-AG in the brain, significantly reducing pain in the lab animals.
The molecule did, however, have at least two drawbacks, highlighted by the complex web of reactions in neurochemical pathways: JLZ184 caused hypothermia, a lowering of the body temperature and reduced movement. These side-effects would have to be managed in any treatments developed for humans, the researchers said.
25 November, 2008
The Downturn's Upside
Your retirement savings are swirling through the drain of the market meltdown, your home isn't worth what a Chihuahua's doghouse was a year ago, and the United States may be facing the most severe recession since the Great Depression. But cheer up, for this is a happy column! The economic misery is numbingly real, but it's also true that a downturn isn't uniformly bad and might even be good for you in several ways:
A recession could save your life. Christopher Ruhm, an economist at the University of North Carolina, Greensboro, argues that death rates go down during economic slowdowns. Professor Ruhm's research indicates that suicides rise but total mortality rates drop, as do deaths from heart attacks, car accidents, pneumonia and most other causes. For example, each one-percentage-point drop in unemployment in the United States is associated with an extra 3,900 deaths from heart attacks.
Some experts are skeptical. But in downturns we drive less and so car accidents decline, while less business activity means fewer job accidents and less pollution. Moreover, in recessions people have more leisure time and seem to smoke less, exercise more and eat more healthily.
A bear market might benefit you, if you are in your working years and won't have to sell your stocks soon. That's because you're probably accumulating stocks now in your retirement account, and you'll accumulate more when share prices are low. Americans are twice as likely to own a retirement account, like a 401(k) or an I.R.A., as to own a stock portfolio outright. For anyone a decade or more from retirement, a bear market is a chance to pick up bargains. For such people, today's bear market probably won't affect share prices when you have to sell. I hit age 70 in 2029, and I doubt that the market level then will be affected by today's turmoil.
(This is the view of the "revert to the mean" school of financial economists, who see share prices eventually returning to long-term trends. Conversely, some economists in the "random walk" school think prices won't necessarily ever catch up. In the absence of firm evidence about who is right, you may as well side with the former; you'll feel better as you survey the wreckage of your 401(k).)
Falling housing prices harm landlords and speculators but benefit renters and first-time buyers (if they can still get mortgages). These beneficiaries tend to be low-income families, thus in this respect the poor may benefit. Likewise, a recession lowers prices of gas, oil and food, which disproportionately affect the poor. More broadly, there's some evidence that falling home and stock prices will raise savings rates in the United States. That is necessary for the long-term health of the economy.
Income doesn't have much to do with happiness. Americans haven't become any happier as they have prospered in the last half-century. And winning the lottery doesn't make people happier in the long term. This is called the Easterlin Paradox: Once they have met their basic needs, people don't become happier as they become richer. In recent years, new research has undermined the Easterlin Paradox, yet it's still true that happiness has less to do with money than with friendships and finding meaning in a cause larger than oneself. "There's pretty good evidence that money doesn't matter much for how you feel moment to moment," said Alan Krueger, a Princeton University economist who is conducting extensive research on happiness. "What seems to matter much more is having good friends and family, and time to spend on social activities."
The big exception to all this is people who lose their jobs or homes, and the new president should act immediately to help them. Professor Krueger argues that for these people, the losses are greater than we have generally realized, for their losses are not only monetary but also the erosion of self-esteem and friendships as they are wrenched out of social networks that enrich their lives (and help them find new jobs). And for those who lose health insurance, a medical or dental problem is enormously stressful, even life-threatening. One lesson is that the government should try particularly hard to keep people in their homes. We should, for example, allow courts to ease the terms of mortgages to prevent foreclosures, while also boosting assistance to help the unemployed find jobs.
Obviously, a meltdown isn't good. Divorce rates spike in recessions. Credit evaporates, lives are upended, and for retirees counting on selling stocks to survive, a bear market is a catastrophe. Yet that's not the whole picture, and we shouldn't overdo the gloom the way we overdid the giddiness during the boom. For most Americans, those who keep their homes and jobs and are years from retirement, even the most bearish cloud might have a silver lining.
Skinny models a turn-off in TV commercials
A QUEENSLAND study has found that skinny models in TV commercials and other advertising are a turn-off to consumers. University of Queensland psychologist Phillippa Diedrichs found images of super-thin models carried no advantage in encouraging young women to buy products. For most adult women, advertisements showing skinny girls discouraged sales, whereas plus-size models encouraged women to buy, the study found.
Ms Diedrichs created a series of mock ads for underwear, shampoo and party dresses using a skinny size 8 model and another featuring a size 14 woman. When the ads were shown to 300 young men and women aged between 18 and 25, they felt better - and more likely to buy - after viewing images of larger models.
"For anything to change, research has to be convincing, not just to government and health researchers but also to people in advertising who actually make the decisions," Ms Diedrichs said.
Recent fashion shows in Madrid and Milan banned "size 0" models deemed unhealthy by a body mass index measure.
24 November, 2008
Teenagers 'learn social skills online'
This will be a nasty surprise for the do-gooders who are sure that computers are bad for kids
A study of 800 people, conducted over three years -- including 5000 hours of observation - has concluded that teens can learn social skills online. While this may seem fairly obvious to some, it is a valuable tool in the battle between generations. "It might surprise parents to learn that it is not a waste of time for their teens to hang out online," said Mizuko Ito, lead author of the study by the private, grant-making MacArthur Foundation.
"There are myths about kids spending time online - that it is dangerous or making them lazy," said Ms Ito, a researcher at the University of California. "But we found that spending time online is essential for young people to pick up the social and technical skills they need to be competent citizens in the digital age," she said.
For the study, described as the most extensive ever conducted in the US on teens and their use of digital media, researchers from the University of Southern California and the University of California, Berkeley, interviewed more than 800 young people and their parents over three years. They also spent more than 5000 hours observing teens on sites such as MySpace, Facebook and YouTube.
"There is a generation gap in how youth and adults view the value of online activity. "Adults tend to be in the dark about what youth are doing online, and often view online activity as risky or an unproductive distraction," it said, while "youth understand the social value of online activity," the study found.
The results could also help combat the stereotype of antisocial geeks. "Kids learn on the internet in a self-directed way, by looking around for information they are interested in, or connecting with others who can help them," it said. "This is a big departure from how they are asked to learn in most schools, where the teacher is the expert and there is a fixed set of content to master."
The study also found that while many young people are gaining new literacy and technical skills, "they are also facing new challenges in how to manage their visibility and social relationships online". "Online media, messages, and profiles that young people post can travel beyond expected audiences and are often difficult to eradicate after the fact," the study said.
Motorbike riders risk impotence, say Japanese doctors
Japs must be pretty fragile. I was a biker for years without any problems. Falling off was not so good though
Men who ride motorcycles are at risk of impotence and urinary problems because the vibration of the engine damages nerves in their penises, a study has found. A survey of more than 230 motorcyclists who rode their bikes for about three hours every weekend found almost 70 per cent had problems gaining an erection or emptying their bladders.
Doctors in Japan, who published two studies on the dangers in the International Journal Of Impotence Research, said seats on most motorcycles put undue pressure on the perineum, the area between the anus and the scrotum, and restricted blood flow to the penis. Vibrations from the engine also caused a decrease in two growth hormones in the bladder and prostate related to bladder relaxation.
Impotence affects most males during their lives and can be caused by emotional issues, high cholesterol, heart disease, diabetes, high blood pressure, smoking or alcohol. But all men should avoid sitting on hard bicycle or motorcycle seats, particularly seats with thin, pointed ends, for long periods to prevent compression of pelvic floor muscles, Impotence Australia chief executive officer Brett McCann said yesterday. All men in the study had been sexually active in the past six months and none had any illnesses.
About 76 per cent of riders aged 40 to 49, and 93 per cent of those aged 50 to 59, reported severe erectile dysfunction, compared with 37 per cent and 42 per cent respectively among those who did not ride motorcycles.
John Sbrocchi, of Wamberal, has been riding a scooter to work for 2½ years. His sex life had not suffered. Scooters normally have wider, softer seats than motorcycles, but vibrations can still affect the genitals. "I do have urinary flow issues, but I'm not putting it down to the scooter," Mr Sbrocchi said. "I'm a man of 62 and when you get to that age you get prostate problems. I think scooters are one of life's greatest innovations so it would take more than that to put me off."
23 November, 2008
Dangerous nonsense: Vitamin 'better than sunscreen'
Don't give up your sunscreen yet. Vitamin B3 has been around for ages and people do normally get it in their food. But lots of people still get skin cancer
A vitamin found in meats, nuts, grains and cereals might be more effective than sunscreen in preventing skin cancer, new research has found. Nicotinamide, or vitamin B3, prevents damage from both UVA and UVB radiation by protecting the immune system, and could be taken in tablet form or added to sunscreen, Associate Professor Diona Damian of the University of Sydney says.
Sunscreens provide good protection against UVB rays, which cause sunburn and skin cancer, but the products are less effective in protecting against UVA, which can also cause skin cancer. "UV radiation in sunlight suppresses the skin's immune system and makes it more susceptible to skin cancer," she said. "Our research found that nicotinamide [vitamin B3] can prevent the immunosuppressive effects of UV by energising cells so they maintain their immunity."
Tests using the water-soluble vitamin offered equally strong protection against both UVA and UVB in both lotion and tablet form, according to tests on volunteers, Professor Damian said. "Nicotinamide is well tolerated, so could also be taken orally as a supplement, particularly by people who have a higher susceptibility to skin cancer," she said. It is also relatively cheap to produce so it could potentially be incorporated into sunscreen to boost its effectiveness against UVA, she added.
The research was also looking to determine whether the vitamin could be used to treat sunspots, common lesions that sometimes progress to skin cancer.
Britain: Alternative medicine professions 'need statutory regulation'
If regular medicine does, the freaky stuff sure does. Some herbal products, for instance, are among the most toxic substances known -- e.g. ricin
Acupuncturists, Chinese medicine practitioners and medical herbalists should be formally regulated to ensure they are "fit to practise", the Health Professions Council (HPC) told the Government today. The professions are not currently subject to statutory regulation but the HPC formally recommended a system was introduced to make it easier to ensure people were "meeting standards".
HPC chief executive Marc Seale said: "The HPC has made a recommendation to the Secretary of State for Health advocating the regulation of acupuncturists, medical herbalists and traditional Chinese medicine practitioners. "The HPC was set up in order to protect the public and we strongly believe that statutory regulation can more effectively assure that practitioners are meeting standards and are fit to practise."
A Department of Health steering group report in June said regulation was "in the public interest". It said it was important people had confidence that practitioners from these fields were "properly trained, understand the limits of their competence and know when and to whom to refer". The report added: "There has also been widespread concern about the safety, in particular, of traditional Chinese medicines when inappropriately administered."
The HPC already regulates 13 health professions, including chiropodists and podiatrists, dieticians, paramedics, physiotherapists, radiographers and speech therapists. Each profession has a professional title which can only be used by those who meet the requirements to join the HPC's register. Using the title without being on the register is a criminal offence.
The steering group said the HPC had already demonstrated effective, safe and cost-effective statutory regulation and it was "convinced" this could be extended to cover practitioners of acupuncture, herbal medicine, traditional Chinese medicine and other traditional-medicine systems practised within the UK.
However it recognised the workload associated with regulating acupuncture, herbal medicine and traditional Chinese medicine might be greater than that previously experienced in regulating well-established health professional sectors.
The HPC said earlier this year it would welcome the opportunity to regulate the professions although the final decision about regulation and how it was achieved rested with the Government.
22 November, 2008
Eggs: Here we go again
Eggs were bad for cholesterol in the '90s. Now people with type 2 diabetes are warned off eggs. Just the usual epidemiological crap, of course. The old scare became unstuck as early as 1979, when it was found that serum cholesterol showed only a very shaky correlation with egg consumption but I see below that we still have some believers in the old religion.
The journal abstract is here. All effects were very weak. As eggs are a very common dietary component in Western populations, one must suspect cultural differences in many of those who ate few eggs. And it could be anything associated with those cultural differences that gave rise to the small observed differences in diabetic morbidity. As the authors themselves note, previous studies have shown inconclusive effects of egg consumption on blood sugar. So the relationship suggested below is also unlikely from that perspective
EATING more than a couple of eggs a week increases the risk of developing diabetes, a major study has found. It can also make the condition worse in those who already have diabetes. Australian specialists are urging type 2 diabetics and people at risk of developing the blood glucose condition to limit their egg intake after a US study found them to be detrimental to their health.
Specialists at Harvard Medical School in Boston found eating an egg every day may increase the risk of type 2 diabetes by about 60 per cent. Women were most susceptible, with females consuming seven eggs or more a week increasing their risk by 77 per cent. Eating just one egg a week carried no increased risk, Dr Michael Dr Gaziano wrote in the journal Diabetes Care. The study, the first of its kind, made the conclusions after tracking the egg-eating habits of almost 57,000 men and women over two decades.
Dr Alan Barclay, manager of human nutrition at Diabetes Australia-NSW, said the results were consistent with the advice it has provided for some years that people with diabetes should have moderate egg consumption.
Eggs are a good source of vitamins, proteins and other nutrients, but they are also rich in cholesterol, which in high amounts can clog arteries and raise the risk of heart attack, stroke
Is your Omega-3 fish oil supplement any good - or a load of old codswallop?
Good to see SOME skepticism below: A sort of falling out among thieves
We have been told to take more of it, and there's strong evidence that Omega 3 really is crucial for our brains, hearts and immune systems. We don't need any more convincing, it seems - keen to improve our brainpower, we now spend 60million pounds a year on Omega 3 pills. But according to an expert, many people may be wasting their money, because they end up with supplements providing little or no benefit.
Dr Alex Richardson, of the charity Food & Behaviour Research, and one of the world's leading researchers into Omega 3, says the poor quality of many supplements is a concern. 'There are different kinds of Omega 3 - not all of which have the same health benefits,' she says. One of the main problems, she explains, is that supplements often contain little, if any, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) - the most important forms of Omega 3. 'What's more, at the moment there is no official recommended daily allowance of Omega 3.'
So taking a pill to boost your brainpower and health is far from straightforward. Dr Richardson believes this confusion is 'disastrous - because consuming more of the vital Omega 3 fats found in fish and seafood is probably the single most important dietary change that most people could make to improve their health'. 'It's well-known that Omega 3s are important for staving off heart attacks and strokes, and are good for eyesight and inflammatory conditions such as arthritis. But it's less well-known that EPA and DHA are crucial for brain function and mental well-being. 'However, surveys show that nine out of ten Britons don't get the minimum they need to maintain a healthy heart (around 500mg/day), let alone to support optimal brain and immune system functioning (1000mg/day).'
The best way to get nutrients is from food; for Omega 3s, this means everyone should eat two to four portions of fish a week, one of them oily. But if this isn't possible, taking a supplement is the next best option, says Dr Richardson.
So if you do resort to an Omega-3 pill, how can you make sure you find ones that make a difference? 'In the absence of an official recommended daily amount, start by choosing products that contain EPA and DHA,' says Dr Richardson. 'This usually means fish oils. Vegetarian Omega 3 supplements usually contain none at all: instead, they are made with linseed or flax oil, which provide a different form of Omega 3.' They're not a complete waste of money, she adds, but vegetarians would be better off taking ones containing DHA from algae. Next, ignore any doses suggested on the packet, and focus on the small print to find out how much EPA and DHA combined the product provides. 'A good target for mental well-being and performance is 1000mg per day,' she says. And to get this amount, you may well need to take more than the manufacturer's suggested dose.
And don't bother splashing out on the more expensive combination supplements containing Omega 3, 6 and 9. Our bodies produce our own Omega 9 - and it is also found in nuts, seeds, avocados and olive oil. And as for Omega 6, found in vegetable oils, meat, eggs and dairy, we should be trying to reduce rather than boost it - a diet low in Omega 3 and high in Omega 6 is linked to a range of conditions, including heart disease, depression, allergies and cancer.
Lower speed limit to tackle obesity crisis, say "experts"
A good way for a government to lose power, particularly since there is no crisis
SPEED limits in suburban streets should be slashed to 30km/h to encourage pedestrians and cyclists and tackle the obesity epidemic, experts say. Griffith University transport planning researcher Matthew Burke said cutting speeds from 50km/h on local streets would not only reduce road trauma, it would also curb obesity rates by encouraging more people to walk and cycle. "A car can stop in 3m travelling at 30km/h," Dr Burke said. "It would make walking safe for everyone, it would make cycling safe enough for grandmas. It would be a very easy thing to do ... for next to no money."
Queensland chief health officer Jeannette Young has identified obesity as the biggest health issue facing the state. Her recently released report, The Health of Queenslanders: Prevention of Chronic Disease, says almost 57 per cent of the state's population is overweight or obese, including 21 per cent of children.
Dr Burke said cutting neighbourhood speed limits to 30km/h would make walking or cycling to school safer for children. "By reducing road speeds, you limit traffic danger," he said. "I think it's a joke that we think we're doing kids a favour with a 40km/h safety zone around schools when best practice globally is for all local streets to be down at 30km/h."
Lowering the speed limit indirectly addresses parents' fear of stranger danger, Dr Burke said. Encouraging more people to take up walking or cycling, increases the number of "eyes" that can look out for children as they make their way to school, he said. Mental health may also benefit. "A convivial street environment where walking and cycling are possible are streets where neighbours meet each other, where there are greater social networks," Dr Burke said. "We've seen much research about the importance of those networks for the importance of people's mental health."
Dr Burke was backed by international expert Rodney Tolley, an honorary research fellow at Staffordshire University in Britain and director of Walk 21 - an organisation attempting to make communities more "walkable". Dr Tolley, who addressed Queensland Health staff this week, said the city of Graz in Austria had set 30km/h limits 20 years ago. "Motorists will often say we can't possibly travel that slow, it will disrupt our day," he said. "But the time losses involved in travelling at those speeds are very, very small."
21 November, 2008
Vitamins E and C don't prevent cancer, landmark study finds
This is just the latest study to show that "antioxidants" do no good but do do some harm but the believers in the antioxidant religion will sail on regardless, as they have done before
Nearly 10 years of testing on thousands of doctors show two hugely popular vitamins don't prevent cancer. In the latest antioxidant letdown, researchers who followed nearly 15,000 male physicians found no evidence vitamin E or vitamin C supplements protect against cancer. "We're kind of rocking the foundation of what we were always brought to believe," Ottawa Hospital urologist Dr. John Mahoney said after learning the results. "We all think that we should be taking vitamins because it makes us more healthy, and yet we can't prove that."
The new research involves preliminary findings from the U.S. Physicians' Health Study II. Researchers tracked 14,641 doctors, aged 50 and older. Each was given either 400 IU (international units) of vitamin E every other day, 500 milligrams of vitamin C daily, or their placebos. After an average eight years of treatment and followup, about 2,000 men had been diagnosed with cancer, including about half with prostate cancer. Neither vitamin E nor vitamin C supplements reduced the risk of prostate cancer, "total cancer" or other cancers such as colorectal or lung.
There were 490 cases of prostate cancer in men who took vitamin E, versus 523 in the placebo group. For total cancer, there were 978 cases in men randomized to vitamin E, compared to 951 who got placebo. It was a similar story for vitamin C: 964 cancers in the vitamin C group, versus 965 in placebo.
Millions of Canadians - an estimated 10 to 15 per cent of adults - take the supplements, even though evidence of any clear benefit for cancer prevention has been "shaky at best," says Howard Sesso, an assistant professor of medicine at Brigham and Women's Hospital in Boston. "Until you do these much larger-scale, randomized clinical trials, you don't really know what the actual answer is." Based on their trial, as well as others, "we feel that there are no compelling reasons for people to take either vitamin E or C for the prevention of cancer at this time," Sesso says.
The findings will be presented Monday at a meeting of the American Association for Cancer Research in Washington, D.C. Sesso says the results held after they took age, smoking status, personal history of cancer and other factors into account. Last week, the same team found vitamin E and C supplements had no effect on the risk of heart attacks, stroke, cardiovascular death, congestive heart failure, angina or heart bypass surgery in the same group of middle-aged and older doctors. They did find an increase in hemorrhagic stroke with vitamin E use. [In other words, antioxidants could kill you]
Last month, 35,000 men from the U.S., Puerto Rico and Canada enrolled in a study testing whether 400 IU daily of vitamin E daily, or 200 micrograms of selenium, can prevent prostate cancer. They were told to stop taking their supplements after a data and safety committee found vitamin E may slightly increase the chance of getting prostate cancer, and that selenium may increase the chance of getting diabetes. The findings aren't proven.
With annual vitamin supplement sales in the billions of U.S. dollars, the latest run of disappointing news could have broad public health implications, researchers say. The doctor's study involved men exclusively, but researchers believe the results could be extrapolated to women as well. A study published three years ago involving nearly 40,000 mostly middle-aged women found those who swallowed 600 IU of vitamin E every other day were no less likely to develop breast, lung, colon or other cancers than women taking a placebo.
Vitamins E, C and other antioxidants are thought to prevent damage to the body's cells by mopping up free radicals - toxic molecules the body produces when it burns sugar and fat. Some studies had found that people who reported eating diets rich in vitamins E and C had less cancer. They suggested taking the vitamins as supplements might offer protection, particularly vitamin E for prostate cancer.
Sesso says critics could argue that the doses they tested were too low. People who prescribe to the vitamin C theory that Linus Pauling and others pushed for decades "would argue 500 mg may not be enough" to show an effect. "But the doses we utilized are very common doses that are still far exceeding what you can get from diet alone," Sesso says. The supplements didn't cause any harm.
Other vitamins, especially vitamin D, are showing promise, and the final piece of the doctors' health study involves testing daily multivitamin supplements. "Until you do the trials, you really can't close the door on all antioxidants," Sesso says.
But Mahoney says he could never understand, biologically, how vitamin supplements might prevent cancer later in life. "Often the cancer 'hits' have happened when you or I are 20 and 30. You just take a guy who's 50 and you give him some vitamins and he's supposed to reduce his cancer? That doesn't seem to go along with the biology of cancer formation. It doesn't seem to make that much sense."
Doctors recommend a healthy diet, exercise, weight management and not smoking to reduce cancer risk. [And most of that is guesswork too]
Vaccine hope in MS link to virus
THE debilitating disease multiple sclerosis, which affects more than 18,000 Australians, could be prevented with a vaccine being trialled in Europe. Researchers from the University of Queensland yesterday confirmed a link between the Epstein-Barr virus, which causes glandular fever and is carried by more than 90 per cent of the world's population, and multiple sclerosis, saying the vaccine, developed to combat glandular fever, could save thousands of lives.
But some doctors are cautious, warning that the vaccine has not been fully tested as a preventive for multiple sclerosis and does not take into account the influence of genetic and environmental factors which can also trigger the disease. Previous studies have shown that people with a parent, child or sibling with multiple sclerosis are at a greater risk of contracting the disease themselves, and the further someone lives from the equator, the higher their risk, indicating that exposure to sunlight and vitamin D play a significant role. [Really? I don't suppose there could be racial and cultural differences among people living near the equator]
In people with multiple sclerosis, the body's immune system attacks the nervous system, causing bladder and bowel dysfunction, memory loss, tremors, vision problems, hearing loss, anxiety, depression, dizziness and difficulty in walking. There is no cure and medications can only ease symptoms.
More than 99 per cent of people with multiple sclerosis have been infected with Epstein-Barr virus during their lifetime but those who contract the virus in the first few years of life, such as children in developing countries where the virus is endemic, show no symptoms. Those who contract the virus in their teens or early 20s, as in most Western countries, usually develop glandular fever, or infectious mononucleosis, and suffer from extreme fatigue, muscle aches, headaches, throat inflammation and weight loss. Research has shown those people are more likely to go on to develop multiple sclerosis later in life.
The study's lead researcher and a neurologist at Royal Brisbane and Women's Hospital, Michael Pender, said yesterday the glandular fever vaccine, once fully tested, could be included in Australia's childhood vaccine program for people who had a diagnosed relative. "It may only help some people, but it is a step in the right direction," he said.
But Robert Booy, a professor in pediatrics with the National Centre for Immunisation Research at the Children's Hospital at Westmead, said yesterday it was still too early to label the Epstein-Barr virus as the main driver behind the disease, and until scientists could establish the exact cause, it was impossible to ensure a vaccine did not contain proteins which could trigger multiple sclerosis.
The scientific chairman of MS Research Australia, Bill Carroll, agreed, saying he was excited that the link between Epstein-Barr and multiple sclerosis had been further confirmed, but remained cautious about the efficacy of a vaccine. "EBV is an important prerequisite in multiple sclerosis but it is not the only factor which causes the disease. There is also often a 20-year time lag between contracting EBV and MS, so it is impossible to say that other factors, influenced by genetics and the environment, do not come into play during that time and can still result in a person developing the disease," Dr Carroll said.
20 November, 2008
Goji berry may stop skin cancer (?)
A tiny red berry celebrated for its antioxidant qualities may also help protect against skin damage that leads to cancer, researchers believe. Scientists at the University of Sydney fed diluted juice from the goji berry to mice in the laboratory and found it protected them against the same sun damage as other mice when exposed to harsh UV rays. Another experiment showed skin cancer advanced slower in mice that had drunk goji juice.
Cancer specialists have cautioned that while the berry, strong in antioxidant properties, appears to act like a sunscreen in mice, it is untested on humans. Goji juice has been the subject of bad press in recent years after tests by the Australian Consumer Association showed it was no more beneficial to health than standard fruit juices.
Dr Vivienne Reeve, from the university's Faculty of Veterinary Science, told a medical research conference in Brisbane on Monday that she fed mice either water or diluted juice and then exposed them to UV radiation to give them sunburn. "The goji berry-drinking mice had significantly less inflammation of the skin," said Dr Reeve, who is a scientific adviser to a company that distributes the juice. "And the juice seemed to protect the immune system because they didn't get immuno-suppression which is a major risk factor for skin cancer development in chronically over-exposed skin."
It also appeared to have protective properties against skin cancer growth, she said, with another experiment showing skin cancer-induced mice had significantly slower growing tumours.
"We haven't tested it on humans but this gives us every indication that we should if we want to help protect people from sun damage and disease," she said.
Cancer Council Australia chief executive Professor Ian Olver said the research was interesting but should be viewed with caution. "Just because it works like sunscreen in mice does not mean it will do the same in humans as the two types of skin are very different," Prof Olver said.
Bake Sales Fall Victim to Push for "Healthier" Foods
The do-gooders are determined to do you good whether you want that or not. Too bad if you disagree with them about what is good. They have the certainty of the ignorant on their side
Tommy Cornelius and the other members of the Piedmont High School boys water polo team never expected to find themselves running through school in their Speedos to promote a bake sale across the street. But times have been tough since the school banned homemade brownies and cupcakes.
The old-fashioned school bake sale, once as American as apple pie, is fast becoming obsolete in California, a result of strict new state nutrition standards for public schools that regulate the types of food that can be sold to students. The guidelines were passed by lawmakers in 2005 and took effect in July 2007. They require that snacks sold during the school day contain no more than 35 percent sugar by weight and derive no more than 35 percent of their calories from fat and no more than 10 percent of their calories from saturated fat.
The Piedmont High water polo team falls woefully short of these standards, selling cupcakes, caramel apples and lemon bars off campus in a flagrant act of nutritional disobedience.
“I know obesity is a big problem, and it’s good the school cares,” said Sam Cardoza, a senior who briefly became a successful entrepreneur last year when chocolate chip cookies were banned from the cafeteria. “At the same time, you shouldn’t stop a kid from buying a cookie.”
California is a hatchery of food trends, but its regulations are not the country’s strongest. A study of 500 to 600 school districts nationwide found that many now have policies that limit the amount of fat, trans fats, sodium and sugars in food sold or served at school, with the strictest rules directed at elementary schools, said Jamie Chriqui, a senior research scientist with the Institute for Health Research and Policy at the University of Illinois at Chicago. The idea is that policy interventions to reduce consumption “will do for junk food what smoking bans and taxes did for tobacco,” Ms. Chriqui said.
In California, sports drinks, which can contain almost as much sugar as soda, are still allowed in middle and high schools, but sodas, including diet sodas, will be banned from all schools next year. According to the Center for Science in the Public Interest, Kentucky has the strictest regulations on school nutrition, with sugar and sodium limits on beverages that eliminate most standard sports drinks. “Before, it was the chips, the Hostess cupcakes, the Little Debbie doughnut sticks,” said Ginger Gray, the director of school nutrition for the Kenton County School District in northern Kentucky. Now, only pure fruit juice and low-fat or skim milk are allowed. The district’s most popular dish is whole-wheat stromboli made from scratch, Ms. Gray said, adding that she leans toward foods that families can cook at home. “You’re teaching them habits for life,” she said.
The regulatory focus on school nutrition has been gaining ground nationwide in recent years, amid concerns over childhood obesity and a lack of access to healthful food. Sixteen states have set standards for so-called competitive foods that compete with meals, like à la carte cookies, cinnamon buns and soft drinks. And, yes, this even affects bake sales.
In Chula Vista, Calif., near San Diego, sales plummeted at Hilltop High School’s multicultural food fair, an annual fund-raising event for the foreign language and global studies departments that has traditionally featured bratwurst, breadsticks with marinara sauce, apple pie and root beer floats. “This year was really hard,” said Jade Wagner, a senior, referring to the half-bratwursts and nondairy diet root beers.
If bake sales are out, “healthy” fund-raisers, like carwashes and balloon-o-grams, are in. In Oakland, Calif., new traditions are replacing old ones: a “Healthy Halloween” vegetable platter for kindergartners at Montclair Elementary; power bars and apple slices at the after-school homework club at Crocker Highlands Elementary; a Caesar salad-making class, a weekly organic produce stand and “nutrition breaks” replacing snack breaks at Peralta Elementary.
In Berkeley, birthplace of California cuisine, food served at school is free of bovine growth hormones, irradiation, hydrogenated oils and known genetic modification.
Birthday celebrations are not immune from nutrition watchdogs: around the country, there is growing pressure to forgo cupcakes in favor of nonfood treats. “I don’t think all celebrations need to be around food,” said Ann Cooper, the director of nutrition services for the Berkeley school district. “We need to get past the mentality of food used for punishment or praise.”
In Guilford, Conn., the school district’s health advisory committee has decided that birthday parties belong at home. At A. W. Cox Elementary, birthdays are celebrated with an extra 15 minutes of recess, special pencils or a “birthday book club” with commemorative inserts. “The children have totally refocused,” said the principal, Merry Leventhal. “They’re happy to celebrate in these other ways.”
A recent study by the Rudd Center for Food Policy and Obesity at Yale found that, contrary to parental fears, children were not compensating for the absence of sugar or fat at school by raiding the refrigerator at home. “Some people think that kids have this internal potato chip monitor, but there’s no evidence of that,” said Marlene B. Schwartz, the center’s deputy director. “People really do eat what’s in front of them.”
In California, bake sales are waning because ingredients cannot be regulated. Sales are banned during school hours but may be held a half-hour before or after school. The ban on bake sales has not been met with universal enthusiasm. The Piedmont Highlander, the school newspaper, editorialized about “birthday cakes turned into contraband” and homemade goodies snatched from students “by the long arm and hungry mouth of the law.”
Even some nutritionists question whether banishing bake sales is the best approach. “It concerns me we’re not teaching moderation,” said Stephanie Bruce, the president of the California School Nutrition Association, who works in the Ontario-Montclair School District in Ontario, Calif.
Melissa Luna, considered the ueber-mom of Crocker Highlands Elementary in Oakland, said that sometimes calories mattered less than the importance of a cause — like the bake sale organized to raise money for Christopher Rodriguez, a student who was shot and paralyzed last March by a stray bullet from a gas station robbery while he was taking piano lessons across the street. The sale, attended by members of the Oakland Raiders and Oakland Athletics, raised $30,000.
In Berkeley, Anna X. L. Wong, a kindergarten teacher at Jefferson Elementary, incorporates “good foods” versus “bad foods” into the curriculum and offers her students healthy snacks, including edamame — her version of preventive medicine. “We talk about the word ‘courage,’ ” Ms. Wong said of her young students. “That means being brave enough to try new things.”
19 November, 2008
Diabetes link to germ-free environment
This theory became well-known in connection with asthma -- where it has not worked very well subsequently -- so much caution is advised. There could, for instance, be no group that disconfirms the "dirty environment" hypothesis more strikingly than Australian Aborigines. They commonly live in appallingly dirty environments that shock outsiders.
So what is their incidence of asthma and other autoimmune diseases? Is it low? Far from it. We read, for instance: "Contrary to popular belief, Indigenous Australians are more likely to have asthma than non-Indigenous Australians. This difference exists across all age groups but it is most pronounced in older adults, especially women aged over 35 in whom the prevalence for Indigenous Australians is double that for non-Indigenous Australians". Beat that! Another great theory stubs its toe on pesky facts. Aborigines also have very high rates of diabetes but I could not find a breakdown into Type 1 and Type 2
Amy-Lee Nakhl was the picture of health - but, in fact, she was at death's door. She ate healthily and drank lots and lots of water, just as the health experts advise. However, it was her never-ending water guzzling that prompted a relative to suggest that perhaps something was wrong. Amy-Lee's mother, Belinda, took her to the doctor where alarms bells rang. A quick blood-sugar test showed the then five-year-old's levels were at 38.5 - far above the safe 4 to 6 range. Suddenly, Amy-Lee was in hospital battling type 1 diabetes, a life-threatening condition that affects about 140,000 Australians.
Unlike type 2, type 1 diabetes is not preventable because it is not linked with lifestyle factors, such as diet and exercise.
Work funded by the Juvenile Diabetes Research Foundation in the US backs the theory that the Western world's germ-free environment is leading to increased rates of some diseases. Mike Wilson, chief executive of the foundation in Australia, said scientists had found that mice kept completely free of bacteria had alarmingly high rates of type 1 diabetes. "Type 1 diabetes is caused by a combination of genes and environmental triggers," Mr Wilson said. "This research helps build our understanding of the increasing numbers of new cases of type 1 diabetes. It suggests there is a certain level of exposure to bacteria that is, in fact, healthy."
Mrs Nakhl said Amy-Lee, now 11, had been hospitalised many times since her diagnosis and even though she receives her insulin though a pump, rather than injections, the disease was a constant worry. "Every day is full of fear and it's a horrible life to live," she said.
Chicken-Haters Grilled By California Attorney General
Leave it to the PETA-worshiping Physicians Committee for Responsible Medicine (PCRM) to take all the fun out of eating. In October 2006, the deceptive animal rights group sued seven restaurant chains under California’s “Proposition 65” law, claiming that the eateries needed to warn consumers that grilled chicken contained a cancer-causing ingredient. Cancer? Don’t worry. Like most statements emanating from PCRM’s office, this tall tale was all fuss and feathers. You don’t have to take our word for it. The office of California’s Attorney General just put it in writing.
On Monday PCRM will go to court to argue for a settlement of its lawsuit, which would require some California restaurants to post cancer warnings about a chemical (called “PhIP”) that can form when chicken is grilled. But California Supervising Deputy Attorney General Edward Weil is urging a judge to reject that settlement, writing in his formal Objections that such a warning “would not be in the public interest.”
Why? It’s pretty obvious, really—unless you’re PCRM’s legal director, a self-described vegetarian who wouldn’t know much about cooking birds in the first place.
PhIP forms in tiny, trace amounts when you grill chicken. But if you don’t cook it, of course, there’s a risk of bacterial contamination. (Memo to vegans everywhere: This is why the rest of us don’t eat our poultry “medium rare.”) So, as the Attorney General concludes, a health warning would make no sense “where the chemical in question is created by a process [cooking] that actually has the net effect of making the food safer to eat, i.e., killing bacteria.”
It must really drive PCRM nuts that the cancer-causing properties of PhIP have only been established in laboratory tests performed on animals. While pondering that irony, we recommend this lime-marinated grilled chicken recipe from the “Cooking for Engineers” website. We’ve tried it. It’s juicy, flavorful, and guaranteed to annoy a vegan activist near you.
18 November, 2008
Child obesity checks should start from birth, say Australian "experts"
Which means that it is mostly inborn behaviour that they will be trying to change! When will people start to rebel against this ever-growing intrusion into their personal lives?
Children should be weighed and monitored for obesity from birth to stop them becoming unhealthy, fat adults, according to researchers. The experts argue the Federal Government's Healthy Kids Check plan to weigh all children from the age of four from next year is leaving it too late, given one in five children are already overweight by the age of three.
Their advice comes as a senior Adelaide heart specialist predicted the nation would fail to cut obesity levels over the next 20 years unless it developed new strategies to tackle the "complex" epidemic. Dr Anthea Magarey, a dietician with the Childhood Obesity Research Group at Flinders University, and colleague Rebecca Perry want the Federal Government to consider an ongoing monitoring system - starting from birth - of children's weight, diet and activity.
While sometimes early weight gain may be "puppy fat" which disappears with a growth spurt, they say it can often instead be the start of an ongoing weight problem linked to poor eating habits. "If you're monitoring a child you can identify where their weight is increasing disproportionate to their height," Dr Magarey said. "They may not be overweight or obese yet, but it can ring a few bells and then we can say ok, maybe we should be looking at what this child is eating and what their activity levels are." Parents whose children were putting on excessive weight for their age and height could then receive advice about how to properly feed them.
The plan comes as advertising companies have rejected a proposal to ban junk food advertising to children, arguing the term "junk food" is "derogatory" and that all food is healthy. The Australian Association of National Advertisers has also tried to downplay the obesity epidemic, citing a Commonwealth study this year that showed "no appreciable change in childhood obesity levels since 1995". "The claimed 'epidemic' has been exposed as a deliberate attempt at misinformation of the Australian public and its politicians," it says in comments made to the Australian Communications and Media Authority.
The association argued that it would be "unreasonable and unjust" to place impositions on television advertising. "There is overwhelming evidence that food and beverages advertising to children is neither the primary nor a significant contributor to childhood obesity."
Black dog danger for coronary patients
Not exactly surprising that a heart attack would make you depressed but the much poorer outcome among depressed patients is interesting. Gordon Parker is a very old hand at depression research and I think he may be onto something here
HEART attack patients should be screened for depression in the months after they leave hospital, a ground-breaking Australian study suggests. Low mood that develops following a cardiac event significantly increases the risk of death or readmission, research by the Black Dog Institute found. But the increased risk only applies to coronary patients who are experiencing a depressive episode for the first time, and not to those who had a history of depression before, or at the time of, their heart attack.
The discovery challenges the long-held view that a lifetime of depression or being depressed at the time of the heart attack increases the risk of subsequent cardiac death or readmission to hospital. "The study suggests that the time to screen people is once they've left hospital and in the months afterwards," said Professor Gordon Parker, executive director for the institute. "There is no need to screen people when they are admitted and prescribe antidepressants as a public policy, yet that has been the [standard] wisdom."
The study evaluated 500 patients from the cardiac ward at Sydney's Prince of Wales Hospital for lifetime and current depression. Their progress was tracked for 12 months and even after taking into account cardiac risk factors such as age, gender and smoking status, depression that developed in the month after the heart attack increased the patient's odds of cardiac readmission - or death - up to seven times.
Professor Parker said the discovery suggests depression which occurs soon after a heart attack may be a different, more physical type than that experienced by lifetime sufferers - which may explain the increased effect on the heart.
He said: "We know there are a number of biological changes that occur in depressed patients that may be related to their poorer cardiac outcome, such as increased blood clotting, sympathetic nervous system activity and inflammation."
17 November, 2008
Australia: Schools to ban candy
Talk about the ultimate killjoys! What would childhood be without candy? Zero evidence that the ban will do any good, of course. It could well make candy more attractive
The Victorian Goverment will ban lollies from school canteens and vending machines from next year to boost student health and stamina. The sweets will be replaced with fruit, salads and fresh wraps.
"With alarming statistics showing almost one-quarter of children aged two to 16 years are overweight or obese, it is vital that we work together to reinforce the healthy living message," Education Minister Bronwyn Pike said on Sunday in a statement. About 100 schools will be audited in 2009 to ensure they comply with the confectionery ban.
Skin cancer vaccine?
Looks like it is only a minor cause of skin cancer that is affected
The pioneering Australian scientist who discovered the cure for cervical cancer is on the verge of creating the world's first vaccine for skin cancer. Professor Ian Frazer, former Australian of the Year, has revealed the vaccine could be ready within the next five to 10 years.
As with the jab now given to millions of young girls each year to prevent cervical cancer, children aged between 10 and 12 would be given the vaccine to prevent skin cancer later in life, Professor Frazer envisages. Testing on animals has shown the vaccine to be successful and human trials will start next year. Australia has the world's highest rate of skin cancer with more than 380,000 people diagnosed with the disease and 1600 dying from it each year.
Professor Frazer will reveal this ground-breaking skin work at the Australian Health and Medical Research Congress to be held in Brisbane tomorrow. He said it would be rewarding to develop a vaccine for a cancer that was so prevalent in Australia with its hot climate. "It's an important challenge with a very major health benefit if it works," Professor Frazer told The Sunday Telegraph. "If we get encouraging results we will try and push it on as fast as we can. It's really a given that we try to focus on health problems which are significant ones. "When you're looking at treatments, your focus needs to be on diseases that are most common."
The new skin-cancer vaccine works by targeting papillomavirus, a common skin infection that affects most people and can linger in the body, turning abnormal cells into cancer. Prof Frazer and his team from the Diamantina Institute at the University of Queensland are focusing on preventing squamous-cell skin cancer, which is strongly linked to papillomavirus. Squamous cell is the second most common skin cancer, affecting 137,600 people in Australia this year and killing 400.
It's not yet known if melanomas which are the most deadly form of skin cancer, are also caused by papillomavirus. "My entire career has been focused on understanding the interaction between papillomavirus and the cancers they affect," Prof Frazer said. "We know it causes at least five per cent of all cancers globally so one in 20 of the cancers that people get is caused by papillomavirus. It's a huge issue."
The new vaccine is part of a two-pronged approach to tackle skin cancer. The other approach involves "switching off" one of the skin's controls to allow killer cells to destroy potentially cancerous cells. "Getting the vaccine is the easy part," Prof Frazer said. "We need to introduce this other component to change the setting in the local environment. "The skin has a number of defences against the body's own immune system. "What we're learning is the nature of those controls and how to turn them off. "We can turn them off in animals and if we turn them off, the vaccine does its job."
16 November, 2008
Pregnant Women Shouldn't Swallow Mercury Scares
Food fads in conflict here: Omega 3 versus mercury. On all the evidence neither is any cause for concern but mercury is probably the biggest beat-up. So I endorse the conclusion without endorsing the reasoning
Washington Post writer Moira McLaughlin is six months pregnant and responsibly trying to navigate the tricky world of prenatal nutrition. That is no easy task, since even the Food and Drug Administration's (FDA) dietary advice for pregnant women can be dangerously misleading. But a look at the science of seafood and pregnancy can do wonders for McLaughlin's menu planning -- and prevent the columnist from making a costly mistake. In her latest column, she talked about how extensive the "no no" list is for moms-to-be:No deli meats, no sushi, no blue cheese, no soft cheese (unless pasteurized). No homemade ice cream, no cookie dough, no sprouts, no pepperoni. No massages in the first trimester, no saunas, no hot tubs and no heart rate over 140.McLaughlin isn't exaggerating the seriousness of her dietary dilemma: As we documented in our recent "Tuna Meltdown" report, more than a quarter-million children in low-income households were deprived of intelligence-boosting omega-3 fatty acids as a result of overblown mercury warnings. ButMcLaughlin must not know that the FDA builds a tenfold cushion into its recommendations when it comes to mercury in tuna. That means she could eat five times as much tuna as the FDA says she can and still be protected by a 200 percent buffer between her baby and any risk of negative health impacts.
And fish? That proved way too challenging for my pregnant mind to muddle through. Because they contain fatty acids crucial for fetal brain development, the Food and Drug Administration says pregnant women should eat two meals a week of shrimp, salmon, pollock or catfish. But because of their toxic mercury content, the FDA says pregnant women should avoid shark, swordfish, king mackerel and tilefish. A little canned tuna is okay, but not albacore. Locally caught fish might be okay; just check the Environmental Protection Agency's fish advisory Web site. Ocean fish is better than lake fish. Crab is low in mercury but not totally free of it and, according to some Web sites, pregnant women should avoid it.
So . . . eating the right fish will get my kid into Harvard? Eat the wrong fish and we should give up on the idea of college altogether.
Canned tuna is consistently the cheapest source of omega-3 fatty acids - the nutrient she cites as "crucial for fetal brain development." However, because of overblown warnings by the federal government and fishy scare tactics by environmental and animal-rights groups that don't want anyone chowing down on seafood, most pregnant women don't get enough in their diet.
And speaking of Harvard, earlier this year the prestigious university published a study that showed moms who ate canned tuna twice a week had children who scored higher on intelligence tests than kids whose moms avoided it altogether.
So when McLaughlin's cravings kick in for a late night tunafish sandwich, she shouldn't question whether she should give in. In 21 years, her baby can thank her for it in his valedictory address. Even if he graduates from Yale instead.
Source (See the original for links etc.)
Empty out your bathroom cabinet... this $8 cream does EVERYTHING
I am inclined to regard cosmetics and such things as all a lot of nonsense but if the British goo below sidetracks people from wasting their money on more expensive stuff I am all for it
They say that for the credit crunch, it's the cream of the crop. The packaging isn't swish - but neither is the price tag. And for $8, it'll do almost everything you need. Boots's Aqueous Cream has become a top seller as shoppers tighten the purse strings during the economic downturn, according to the store. It has been billed as a one-stop bathroom essential for the budget conscious.
The cream can be used as a moisturiser, cleanser, shaving cream, shower gel, and an aid for chapped lips. 'This product is really versatile, effective and doesn't cost the earth,' said Angela Chalmers, a pharmacist at the high-street chemist. 'It's a phenomenal seller. Some stores are ordering 10-20 tubes a day just to keep it on the shelves.'
The main ingredient for the fragrance-free product is paraffin wax - used in some of the most expensive face creams. Miss Chalmers said consumers have been attracted by the 'simple formula and versatility' of the 500g tubs. 'The whole family can use it. When you think about the winter, it really is a wonderful product. 'When you rub it on to dry skin, it acts as a moisturiser. But mix it with water in the shower and it acts as a great emollient that just washes off. 'A lot of people use it instead of shower gel. It is also a good shaving cream and leaves your skin feeling soft and moisturised and not irritated. 'It's also great for chapped lips, it's good for massaging into fingers and cuticles and it's also fantastic for those suffering from chilblains. You can even use it as a cleanser.
'That's what's quite unique about this product. It really is the cream for the credit crunch. 'There are other branded moisturisers that come in 500g quantities but they tend to be very expensive, you're talking about $20 to $24. You can also get it in 100g tubes so it's easy to carry around with you.' The recent bad weather is also thought to have provoked a rise in demand for the cream, Miss Chalmers added.
Last year, a Boots anti-ageing cream became a sell-out after tests established that it really worked. Scientists discovered that No 7 Protect & Perfect Beauty Serum can rejuvenate skin, beating wrinkles. The product quickly flew off shelves after it was shown to work on BBC2's Horizon and then featured in the Daily Mail. Its appeal was boosted by the cost of $35 for a 30ml jar, a fraction of the price of other products.
15 November, 2008
GROWTH HORMONE REVIVED?
The use of human growth hormone as an "elixir of youth" still has a substantial body of followers despite its sometimes severe side-effects and dubious benefits. So is there a way getting a better deal out of it? The study below has a brief look at that. It looks at stimulating the body to produce more of its own growth hormone. The results after two years seem good -- a more youthful body and only minor side-effects. As the authors note, however, longer-term side-effects are the big question. Also note that it did not reduce fat overall
Effects of an Oral Ghrelin Mimetic on Body Composition and Clinical Outcomes in Healthy Older Adults. A Randomized Trial
Background: Growth hormone secretion and muscle mass decline from midpuberty throughout life, culminating in sarcopenia, frailty, decreased function, and loss of independence. The decline of growth hormone in the development of sarcopenia is one of many factors, and its etiologic role needs to be demonstrated.
Objective: To determine whether MK-677, an oral ghrelin mimetic, increases growth hormone secretion into the young-adult range without serious adverse effects, prevents the decline of fat-free mass, and decreases abdominal visceral fat in healthy older adults.
Design: 2-year, double-blind, randomized, placebo-controlled, modified-crossover clinical trial.
Setting: General clinical research center study performed at a university hospital.
Participants: 65 healthy adults (men, women receiving hormone replacement therapy, and women not receiving hormone replacement therapy) ranging from 60 to 81 years of age.
Intervention: Oral administration of MK-677, 25 mg, or placebo once daily.
Measurements: Growth hormone and insulin-like growth factor I levels. Fat-free mass and abdominal visceral fat were the primary end points after 1 year of treatment. Other end points were body weight, fat mass, insulin sensitivity, lipid and cortisol levels, bone mineral density, limb lean and fat mass, isokinetic strength, function, and quality of life. All end points were assessed at baseline and every 6 months.
Results: Daily administration of MK-677 significantly increased growth hormone and insulin-like growth factor I levels to those of healthy young adults without serious adverse effects. Mean fat-free mass decreased in the placebo group but increased in the MK-677 group (change, -0.5 kg [95% CI, -1.1 to 0.2 kg] vs. 1.1 kg [CI, 0.7 to 1.5 kg], respectively; P < 0.001), as did body cell mass, as reflected by intracellular water (change, -1.0 kg [CI, -2.1 to 0.2 kg] vs. 0.8 kg [CI, -0.1 to 1.6 kg], respectively; P = 0.021). No significant differences were observed in abdominal visceral fat or total fat mass; however, the average increase in limb fat was greater in the MK-677 group than the placebo group (1.1 kg vs. 0.24 kg; P = 0.001). Body weight increased 0.8 kg (CI, -0.3 to 1.8 kg) in the placebo group and 2.7 kg (CI, 2.0 to 3.5 kg) in the MK-677 group (P = 0.003). Fasting blood glucose level increased an average of 0.3 mmol/L (5 mg/dL) in the MK-677 group (P = 0.015), and insulin sensitivity decreased.
The most frequent side effects were an increase in appetite that subsided in a few months and transient, mild lower-extremity edema and muscle pain. Low-density lipoprotein cholesterol levels decreased in the MK-677 group relative to baseline values (change, -0.14 mmol/L [CI, -0.27 to -0.01 mmol/L]; -5.4 mg/dL [CI, -10.4 to -0.4 mg/dL]; P = 0.026); no differences between groups were observed in total or high-density lipoprotein cholesterol levels. Cortisol levels increased 47 nmol/L (CI, 28 to 71 nmol/L (1.7 æg/dL [CI, 1.0 to 2.6 æg/dL]) in MK-677 recipients (P = 0.020). Changes in bone mineral density consistent with increased bone remodeling occurred in MK-677 recipients. Increased fat-free mass did not result in changes in strength or function. Two-year exploratory analyses confirmed the 1-year results.
Limitation: Study power (duration and participant number) was insufficient to evaluate functional end points in healthy elderly persons.
Conclusion: Over 12 months, the ghrelin mimetic MK-677 enhanced pulsatile growth hormone secretion, significantly increased fat-free mass, and was generally well tolerated. Long-term functional and, ultimately, pharmacoeconomic, studies in elderly persons are indicated.
Annals of Internal Medicine, 4 November 2008 | Volume 149 Issue 9 | Pages 601-611
Forgotten but not gone: leprosy lives on in America
Long seen as a disease of biblical times, leprosy still appears and may be spreading in the United States, researchers say. But it's often misdiagnosed, they warn, with disastrous results.
Also known as Hansen's disease, leprosy is a slow, chronic illness that often leads to disability and disfigurement by attacking the peripheral nervous system and by degrading motor skills. Scientists don't clearly understand how it's transmitted. "We believe there are more cases of leprosy not identified due to the lack of awareness about the disease among physicians in the U.S.," said James Krahenbuhl, director of the Health Resources Service Administration's National Hansen's Disease Program in Baton Rouge, La. This leads to "misdiagnosis and wrong treatments," he added. About 150 leprosy cases are diagnosed yearly; 3,000 people in the United States are being treated, he said.
Leprosy, whose patients have historically been quarantined in isolated "leper colonies" throughout many countries and time periods, is caused by a rodshaped bacterium, Mycobacterium leprae. Infection and symptoms can take three to 10 years to set in, making it hard for researchers to pinpoint where or how people catch the illness, according to the Hansen's Disease program.
Patients gradually lose feeling in their fingers and toes, leaving them open to repeated burns and cuts which get infected. The repeated damage leads to bone absorption and motor nerve deterioration causing fingers to shorten and curve, resulting in a clawlike appearance. Leprosy is fully treatable with medicine in early stages. But nerve damage that occurs in later stages can't be reversed.
Because many U.S. leprosy patients are poor immigrants who turn to free clinics or emergency rooms, many of the doctors involved aren't familiar with the disease, according to the program. They often mistake the skin lesions for a fungus or ringworm and prescribe a topical cream. Because leprosy progresses slowly, it can take months or longer before it becomes clear the treatment is failing -- giving the disease a sizeable head start.
Leprosy prevails most in the tropics and poor countries. Due to changes in immigrant relocation, leprosy is now being diagnosed throughout the United States, Krahenbuhl said. The program sees about 30 cases each year among residents in southern Louisiana and the Gulf Coast of Texas who were born in the U.S. and who have never visited an endemic country.
"As we see leprosy move toward internal regions of the States, it becomes more urgent to reach those physicians to let them know about the symptoms of this disease," said Krahenbuhl. To raise awareness among physicians, he plans to lead a symposium on the topic at the American Society of Tropical Medicine and Hygiene meeting Dec. 7 to 11 in New Orleans.
14 November, 2008
Lack of Sleep Linked to Heart Risk
So people who are unwell tend to have disturbed sleep? Sounds reasonable. But that is not the inference drawn below
Sleeping less than seven and a half hours per day may be associated with future risk of heart disease, according to a report in the November 10 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In addition, a combination of little sleep and overnight elevated blood pressure appears to be associated with an increased risk of the disease.
"Reflecting changing lifestyles, people are sleeping less in modern societies," according to background information in the article. Getting adequate sleep is essential to preventing health conditions such as obesity and diabetes as well as several risk factors for cardiovascular disease including sleep-disordered breathing and night-time hypertension (high blood pressure).
Kazuo Eguchi, M.D., Ph.D., at Jichi Medical University, Tochigi, Japan, and colleagues monitored the sleep of 1,255 individuals with hypertension (average age 70.4) and followed them for an average of 50 months. Researchers noted patients' sleep duration, daytime and nighttime blood pressure and cardiovascular disease events such as stroke, heart attack and sudden cardiac death.
During follow-up, 99 cardiovascular disease events occurred. Sleep duration of less than 7.5 hours was associated with incident cardiovascular disease. "The incidence of cardiovascular disease was 2.4 per 100 person-years in subjects with less than 7.5 hours of sleep and 1.8 per 100 person-years in subjects with longer sleep duration," the authors write.
Patients with shorter sleep duration plus an overnight increase in blood pressure had a higher incidence of heart disease than those with normal sleep duration plus no overnight increase in blood pressure, but the occurrence of cardiovascular disease in those with a longer sleep duration vs. those with a shorter sleep duration was similar in those who did not experience an overnight elevation in blood pressure.
"In conclusion, shorter duration of sleep is a predictor of incident cardiovascular disease in elderly individuals with hypertension," particularly when it occurs with elevated nighttime blood pressure, the authors note. "Physicians should inquire about sleep duration in the risk assessment of patients with hypertension."
Early exposure to peanuts may prevent allergy
Note that most epidemiological reports make a great thing over the incidence of something being, say, 30% higher. In this case, the incidence is 1,000% higher. Time to think we are onto something real, I would say
Contrary to widespread recommendations, the consumption of peanuts in infancy is associated with a low prevalence of peanut allergy, the results of a new study suggest. "Our study findings raise the question of whether early introduction rather than avoidance of peanut in infancy is the better strategy for the prevention of peanut allergy," write researchers in the Journal of Allergy and Clinical Immunology.
In the UK, Australia and, until recently, the United States, guidelines have recommended that women avoid peanuts during pregnancy and breastfeeding, and should not introduce peanuts into their children's diets during infancy, note Dr. George Du Toit of King's College London and colleagues.
The researchers analyzed the prevalence of peanut allergy and diet histories for 5,171 Jewish children from the UK and 5,615 Jewish children from Israel. They found that children from the UK had a prevalence of peanut allergy that was 10-fold higher than that of children from Israel - 1.85 percent versus 0.17 percent.
"This difference is not accounted for by differences in atopy," the investigators write. Atopy is the inherited tendency to develop common allergic diseases such as eczema, hay fever or asthma.
They also found no differences between the two groups in environmental exposure to common causes of allergy, such as house dust mite and grass pollen, social class or genetic background.
"The most obvious difference in the diet of infants in both populations occurs in the introduction of peanut," they note. Approximately 69 percent of infants in Israel consume peanuts by 9 months of age, compared with just 10 percent of those in the UK.
Comment from the Volokhs:
What the article describing the study doesn't say is that most Israeli infants are introduced to a peanut snack called "Bamba" as one of their first foods. We started giving Natalie Bamba at around eight months, contrary to our doctors' recommendations. My wife said at the time, "I don't care what the doctors here say. Where is the evidence that peanut allergies are caused by early exposure to peanuts? [There is none, just a theory.] We all ate Bamba as babies in Israel growing up, and I never even heard of peanut allergies until I moved to the U.S."
13 November, 2008
No link between IVF and breast cancer
Fears that IVF might raise women's risk of developing breast cancer have been dispelled by a nationwide study in the Netherlands, which has found that the fertility treatment has no effect on the disease.
While no link between IVF and breast cancer has been firmly established, some scientists have worried about the potential effects of fertility drugs used to stimulate the ovaries so that eggs can be collected and fertilised. These expose the body to high levels of oestrogen, a female hormone to which some breast tumours are sensitive. Some women who have had IVF and then gone on to develop breast tumours have blamed their condition on it. Sarah Parkinson, the late wife of the comedian Paul Merton, wrote before her death in 2003 of her belief that IVF had caused her cancer.
The new research, led by Alexandra van den Belt-Dusebout, of the Netherlands Cancer Institute, should reassure women considering fertility treatment that it does not pose a breast cancer risk. In the study, which was presented at the American Society for Reproductive Medicine conference in San Francisco, the Dutch team used a national registry to investigate more than 25,000 women who received IVF or other fertility treatments between 1980 and 1995. Almost 19,000 of the women had had IVF, while the other sub-fertile women had had different treatments or none.
There was no statistically significant difference in breast cancer incidence between either group as a whole and the general population. There was a slight increase in breast cancer risk among the infertility patients who had been followed up for the longest periods - 15 years - but this was accounted for by the size of their families. Women who seek fertility treatment tend to have fewer children than average, and to start having them later in life. Breast cancer studies must always correct for family size and childbearing patterns, because women who have more children at younger ages are known to be less likely to develop the disease. "After 15 years, the risk was a bit higher than in the general population, but this could be through a difference in the number of children compared to the general population," Dr van den Belt-Dusebout said. "When the hazard ratios are adjusted for parity [number of children] they are not significantly different."
The study also compared women who had had different numbers of IVF cycles, and found no relationship between extra cycles and breast cancer risk. This is important because women who have more cycles are exposed to higher amounts of drugs, and the lack of a dose-response relationship suggests there is no effect. "Our preliminary analysis indicates that for 15 years after IVF there is no increased risk of breast cancer compared to the female general Dutch population," Dr van den Belt-Dusebout said."
The study also revealed no significant differences in breast cancer risk between the infertile patients who had IVF and those who did not.
The findings support the outcome of a major review of the evidence published in 2004, which also found no causative link between IVF and breast cancer. The study even found that IVF may actually decrease breast cancer risk when it is successful, by allowing women to give birth and thus to gain the protective effect of having children.
A Doctor, a Mutation and a Potential Cure for AIDS
A Bone Marrow Transplant to Treat a Leukemia Patient Also Gives Him Virus-Resistant Cells; Many Thanks, Sample 61
The startling case of an AIDS patient who underwent a bone marrow transplant to treat leukemia is stirring new hope that gene-therapy strategies on the far edges of AIDS research might someday cure the disease. The patient, a 42-year-old American living in Berlin, is still recovering from his leukemia therapy, but he appears to have won his battle with AIDS. Doctors have not been able to detect the virus in his blood for more than 600 days, despite his having ceased all conventional AIDS medication. Normally when a patient stops taking AIDS drugs, the virus stampedes through the body within weeks, or days. "I was very surprised," said the doctor, Gero Huetter.
The breakthrough appears to be that Dr. Huetter, a soft-spoken hematologist who isn't an AIDS specialist, deliberately replaced the patient's bone marrow cells with those from a donor who has a naturally occurring genetic mutation that renders his cells immune to almost all strains of HIV, the virus that causes AIDS.
The development suggests a potential new therapeutic avenue and comes as the search for a cure has adopted new urgency. Many fear that current AIDS drugs aren't sustainable. Known as antiretrovirals, the medications prevent the virus from replicating but must be taken every day for life and are expensive for poor countries where the disease runs rampant. Last year, AIDS killed two million people; 2.7 million more contracted the virus, so treatment costs will keep ballooning.
While cautioning that the Berlin case could be a fluke, David Baltimore, who won a Nobel prize for his research on tumor viruses, deemed it "a very good sign" and a virtual "proof of principle" for gene-therapy approaches. Dr. Baltimore and his colleague, University of California at Los Angeles researcher Irvin Chen, have developed a gene therapy strategy against HIV that works in a similar way to the Berlin case. Drs. Baltimore and Chen have formed a private company to develop the therapy.
Back in 1996, when "cocktails" of antiretroviral drugs were proved effective, some researchers proposed that all cells harboring HIV might eventually die off, leading to eradication of HIV from the body -- in short, a cure. Those hopes foundered on the discovery that HIV, which integrates itself into a patient's own DNA, hides in so-called "sanctuary cells," where it lies dormant yet remains capable of reigniting an infection.
But that same year, researchers discovered that some gay men astonishingly remained uninfected despite engaging in very risky sex with as many as hundreds of partners. These men had inherited a mutation from both their parents that made them virtually immune to HIV.
The mutation prevents a molecule called CCR5 from appearing on the surface of cells. CCR5 acts as a kind of door for the virus. Since most HIV strains must bind to CCR5 to enter cells, the mutation bars the virus from entering. A new AIDS drug, Selzentry, made by Pfizer Inc., doesn't attack HIV itself but works by blocking CCR5.
About 1% of Europeans, and even more in northern Europe, inherit the CCR5 mutation from both parents. People of African, Asian and South American descent almost never carry it.
Dr. Huetter, 39, remembered this research when his American leukemia patient failed first-line chemotherapy in 2006. He was treating the patient at Berlin's Charite Medical University, the same institution where German physician Robert Koch performed some of his groundbreaking research on infectious diseases in the 19th century. Dr. Huetter scoured research on CCR5 and consulted with his superiors.
Finally, he recommended standard second-line treatment: a bone marrow transplant -- but from a donor who had inherited the CCR5 mutation from both parents. Bone marrow is where immune-system cells are generated, so transplanting mutant bone-marrow cells would render the patient immune to HIV into perpetuity, at least in theory.
There were a total of 80 compatible blood donors living in Germany. Luckily, on the 61st sample he tested, Dr. Huetter's colleague Daniel Nowak found one with the mutation from both parents.
To prepare for the transplant, Dr. Huetter first administered a standard regimen of powerful drugs and radiation to kill the patient's own bone marrow cells and many immune-system cells. This procedure, lethal to many cells that harbor HIV, may have helped the treatment succeed.
The transplant specialists ordered the patient to stop taking his AIDS drugs when they transfused the donor cells, because they feared the powerful drugs might undermine the cells' ability to survive in their new host. They planned to resume the drugs once HIV re-emerged in the blood. But it never did. Nearly two years later, standard tests haven't detected virus in his blood, or in the brain and rectal tissues where it often hides....
Blocking CCR5 might have side effects: A study suggests that people with the mutation are more likely to die from West Nile virus. Most worrisome: The transplant treatment itself, given only to late-stage cancer patients, kills up to 30% of patients. While scientists are drawing up research protocols to try this approach on other leukemia and lymphoma patients, they know it will never be widely used to treat AIDS because of the mortality risk.
There is a potentially safer alternative: Re-engineering a patient's own cells through gene therapy. Due to some disastrous failures, gene therapy now "has a bad name," says Dr. Baltimore. In 1999, an 18-year-old patient died in a gene therapy trial. Even one of gene therapy's greatest successes -- curing children of the inherited "bubble boy" disease -- came at the high price of causing some patients to develop leukemia.
12 November, 2008
Frozen IVF embryos produce healthier children
That does NOT mean that the method is safer. It's just natural selection at work: Only the most robust survive freezing
IVF produces healthier children when embryos are frozen and thawed before being transferred to the womb, according to new research. Babies born from frozen IVF embryos are less likely to be born prematurely or underweight than are those conceived during fresh treatment cycles, three independent teams of scientists have found. One of the studies also recorded lower rates of stillbirth and early death among frozen-embryo babies. The results, from researchers based in the United States, Australia and Finland, suggest that far from being riskier than conventional IVF, as is generally thought, cycles using frozen embryos may actually be safer.
The research is particularly significant because separate teams from three countries have reached the same conclusion, each using large samples including thousands of IVF cycles. A fourth team, from Denmark, also reported similar findings earlier in the year.
Scientists said the work would be important because women are increasingly encouraged to use just one fresh embryo during IVF, to guard against damaging twin and triplet births, and to freeze any that are left over for later use. It will dispel doubts about whether this policy trades the risks of multiple births for hazards associated with frozen embryos. Allan Pacey, secretary of the British Fertility Society, said: “This all works to the advantage of single embryo transfer. It suggests it might be better from the point of view of a healthy child to go for frozen embryos, which is an integral part of the strategy. People shouldn’t be scared of frozen embryos.”
The studies, presented at the American Society for Reproductive Medicine conference in San Francisco, do not explain why babies born from frozen embryos seem to do better, but there are several hypotheses. When fresh embryos are used in treatment, women may still be under the influence of powerful hormonal drugs used to stimulate their ovaries into producing extra eggs, or the anaesthetics used during egg collection. Either of these may interfere with the endometrial lining of the womb, and thus with the formation of the placenta.
Another possibility is that as some frozen embryos generally fail to survive thawing, this effectively “weeds out” those that are of poor quality. A third possibility is that women who produce lots of good quality embryos are more likely to have frozen cycles, and also have a lower risk of complicated pregnancies.
“These findings are really quite interesting,” Dr Pacey said. “It kind of defies logic to a certain extent. It seems to be an issue with the formation of the placenta, but how it has an effect isn’t known. “This may be a bit of biology that has escaped most people. The assumption has always been that if the endometrium [the womb lining] is thick, it’s functional. In an IVF cycle, the endometrium looks normal on ultrasound, but perhaps there is something subtle going on.”
Despite their apparent health benefits, however, frozen IVF cycles are unlikely to supplant fresh ones as the routine option because they have a lower success rate. In Britain, 24.4 per cent of fresh cycles lead to a live birth, compared to 17.4 per cent of frozen cycles. There were 33,916 fresh cycles performed in 2006, and 7,911 frozen cycles.
Embryo `quality check' could double IVF success rate
Infertile couples could double their chances of starting a family by IVF, with an embryo quality test developed by British and American scientists. The first trial of the procedure, which identifies embryos with the best chances of developing into healthy babies, delivered remarkable results that suggest it could transform IVF success rates, while helping to prevent damaging multiple pregnancies. Of 23 women to have their embryos genetically screened with the technology, two have given birth while another 16 are currently pregnant and have passed the point at which miscarriages typically occur. Another two became pregnant but miscarried. The 78 per cent success rate is particularly outstanding because all the patients had a poor prognosis, with an average age of 37® and a history of failed attempts at IVF or miscarriage.
Dagan Wells, of the University of Oxford, who leads the research team, has applied for permission from the Human Fertilisation and Embryology Authority (HFEA) to offer the test at the Oxford Fertility Unit, and a British trial is expected to begin next year. The test will eventually cost about 2,000 pounds.
It could raise success rates when only a single embryo is used. The HFEA has launched a strategy to promote single embryo transfer, to guard against twin and triplet pregnancies - the biggest health risk of IVF. Dr Wells said: "The pregnancy rates we've got so far are absolutely phenomenal." The probability that one embryo leads to a pregnancy is doubled, he said. "That means that you've got a much better chance of a pregnancy if you do a single embryo transfer."
The new procedure to detect chromosomal defects called aneuploidies was developed by Dr Wells with colleagues from the Colorado Centre for Reproductive Medicine near Denver. More than half of all embryos are aneuploid, which means they have too many chromosomes or too few. Most of these fail to implant in the womb or miscarry, while the few that survive have chromosomal disorders such as Down's syndrome. While a preimplantation genetic test for aneuploidy is already available, it is controversial as there is little evidence that it helps women to conceive. Some studies have even suggested it is harmful, and the British Fertility Society recommends that it should be offered only in clinical trials.
The new approach improves on this by testing IVF embryos when they reach the blastocyst stage of 100 to 150 cells. This allows extra cells to be removed for genetic analysis, giving increased accuracy. It also employs a more advanced profiling system called comparative genomic hybridisation, which can screen all 23 pairs of chromosomes, against only ten with existing techniques.
In the trial, which will be presented today at the American Society for Reproductive Medicine conference in San Francisco, patients had IVF at the Colorado centre, and cells were then removed and DNA sent to Oxford for analysis. Once the normal embryos had been identified, these were then implanted. The 78 per cent success rate recorded so far is significantly better than the 60 per cent that the clinic usually achieves for this patient group. For each individual embryo, the implantation rate is 62 per cent, against a normal rate of 28 per cent.
Mandy Katz-Jaffe, of the Colorado centre, said: "This is still a trial, and we don't offer it yet as a clinical procedure. But this is very promising." Allan Pacey, of the British Fertility Society, said the results were interesting, but that it would need to see larger studies with a control group before the society changed its policy on preimplantation screening.
11 November, 2008
Crestor (rosuvastatin) gets new credit for preventing heart disease
And also shows the irrelevance of cholesterol. Note however that we are as usual still looking at a quite small minority of people who benefit. As it says here: "Dr. Tonkin, however, says, "The importance of intervention for individuals being treated and for public health policy depends on the absolute risk reduction, not the relative risk reduction." According to Dr. Tonkin, for example, the 20% relative risk reduction seen with rosuvastatin treatment in individuals with elevated hsCRP alone translates to a 0.055% [tiny] absolute risk reduction. "We would need to treat 190 people over the course of the study to prevent one death," he says."
A new statin drug dramatically cuts the number of heart attacks and strokes, even for people without high cholesterol. In a major trial, daily treatment with Crestor slashed the rate of heart problems and deaths by 44 per cent. Crucially, the U.S. study involved those who would not normally be considered at risk of heart problems. Their cholesterol was at 'healthy' levels that would not qualify them for statin treatment in the UK and many other countries. But they all had high levels of a protein linked to heart disease. Now the U.S. researchers want this factor to be considered when deciding who will receive statins. British experts say the study could open a new era in assessing people's risk of heart attacks and strokes.
The trial, called Jupiter, involved almost 18,000 people - one in seven of them from the UK. They all had high levels of a protein called hsCRP - high sensitivity C-reactive protein - which is linked to inflammation in the arteries. Crestor, which is already available on the NHS, cut these levels and also halved levels of the 'bad' cholesterol known as LDL. Heart attacks were cut by 54 per cent, strokes by 48 per cent and the need for angioplasty or bypass by 46 per cent among the group on Crestor compared to those taking a placebo or dummy pill.
Those taking Crestor, also known as rosuvastatin, were actually 20 per cent less likely to die from any cause. The results were so dramatic that the trial was stopped in March, halfway through its planned four-year run, because it was considered unethical to keep giving placebos to half the patients. The results of the study will be released today at a meeting of the American Heart Association in Chicago.
More than four million Britons regularly take statins to control cholesterol. Eight out of ten use the cheapest generic drug, simvastatin, which costs just 1.42 pounds a month. Crestor, which is made by AstraZeneca, costs 26 pounds a month for a 20mg dose.
Experts warned against trying to replicate the effects of Crestor - the newest and most effective statin - by using other statins at higher doses. Professor Martin Cowie, professor of cardiology at the National Heart and Lung Institute, Imperial College, London, said it was apparent that some statins worked differently from others. He said simply giving patients massive doses of other statins would not necessarily work and could push upside effects to unacceptable levels. Professor Cowie pointed out that GPs and cardiologists are under increasing pressure to cut the drugs bill by putting patients on the cheapest statins. He said: 'I sympathise with the need to consider costs but you have to balance risks and benefits amid this push to switch patients to generic drugs.'
Dr Sarah Jarvis, women's health spokesman for the Royal College of General Practitioners, said the Jupiter findings were 'extremely exciting' and meant hsCRP levels were becoming an important measure of heart health. She said: 'The study shows a 50 per cent reduction in LDL for all patients, and we've never had a big enough study to demonstrate this in women before. 'This high-intensity statin saves lives with safety and tolerability levels that other statins can't match. 'To get this kind of effect from simvastatin, for example, would mean increasing the dose so high that you get horrendous side effects, as other research has now proved.'
Professor Jim Shepherd, professor of Vascular Biochemistry at the University of Glasgow-Royal Infirmary, said last night: 'The study has significant implications for the future of cardiovascular risk management.' The benefits to men and women in the trial were nearly twice what doctors expect from statins among patients with high cholesterol.
The lead researcher on the Jupiter study was Dr Paul Ridker, director of the Centre for Cardiovascular Disease Prevention at Brigham & Women's Hospital in Boston, Massachusetts. He said: 'Half of all heart attacks and strokes occur in men and women with normal cholesterol. 'We've been searching for ways to improve detection of risk in those patients. 'We can no longer assume that a patient with low cholesterol is a safe patient.'
A Danish study released last month appeared to rule out Creactive protein as a cause of heart attacks. But the Jupiter team said high hsCRP levels could indicate a greater chance that fatty plaques in the arteries could break off and cause stroke or heart attack.
Volunteers in the Jupiter trial were middle-aged men and women with hsCRP levels averaging more than four times the preferred level. Professor Peter Weissberg, medical director at the British Heart Foundation, said last night: 'The Jupiter study is the first to show that rosuvastatin reduces heart attacks and saves lives, even in people whose cholesterol is not raised. It strongly supports the "lower is better" approach to cholesterol management. 'However, further studies are required to determine if measuring C-Reactive Protein is the right way to identify people likely to gain most from treatment.'
Soccer causes motor neurone disease?
Hard to see why. Sounds like hysteria over a random correlation
A senior doctor urged the Football Association last week to investigate whether the sport contributes to motor neurone disease (MND). "I shall be in touch with the FA about carrying out this research," said Ammar Al-Chalabi, a neurologist at King's College London. "The FA does not seem hostile to the idea."
Andrin Cooper, a spokesman for the FA, said it had no plans to conduct a "specific MND study" at present. However, he added that the organisation was involved in a 10-year study on how "heading the ball affects the brain" and that its medical committee would be meeting next year to assess the preliminary results.
Five thousand people in Britain suffer from MND, which claimed the life of David Niven, the actor, and has also felled several prominent footballers. They include Jimmy "Jinky" Johnstone, the Celtic forward, who died in 2006, aged 61, and Don Revie, the England and Leeds United manager, also 61 when he died in 1989; and Rob Hindmarch, the former Derby County and Sunderland player, who died in 2002 at the age of 41.
Al-Chalabi was a member of a research team that discovered an apparent "cluster" of three MND sufferers who played for the same amateur football club in Kent. They had another potential risk factor in common, however: all had suffered a big electric shock once in their life. "They all got the disease at the same time and two died in the same weekend," he said. "Since then it has emerged that another of their friends has got it."
Del Deamus, 34, from Welwyn Garden City in Hertfordshire, is convinced there is a link between sport and the disease. Diagnosed with MND in February, he had played football for England as a schoolboy and later as an apprentice for Tottenham Hotspur. "I heard that head injuries might be a factor and thought, that's me - I had lots of head injuries," he said last week. "But boxers don't seem to suffer from it. So maybe it's something in the grass. We just don't know."
10 November, 2008
Inept people don't know it
The findings below are reasonable but the explanations offered seem unduly complex. The highly generalizable nature of IQ would seem a sufficient explanation. I think the findings show that substantial intelligence is required for accurate self-awareness
There are many incompetent people in the world. Dr. David A. Dunning is haunted by the fear he might be one of them. Dr. Dunning, a professor of psychology at Cornell, worries about this because, according to his research, most incompetent people do not know that they are incompetent. On the contrary. People who do things badly, Dr. Dunning has found in studies conducted with a graduate student, Justin Kruger, are usually supremely confident of their abilities -- more confident, in fact, than people who do things well. ''I began to think that there were probably lots of things that I was bad at and I didn't know it,'' Dr. Dunning said.
One reason that the ignorant also tend to be the blissfully self-assured, the researchers believe, is that the skills required for competence often are the same skills necessary to recognize competence. The incompetent, therefore, suffer doubly, they suggested in a paper appearing in the December issue of the Journal of Personality and Social Psychology. ''Not only do they reach erroneous conclusions and make unfortunate choices, but their incompetence robs them of the ability to realize it,'' wrote Dr. Kruger, now an assistant professor at the University of Illinois, and Dr. Dunning.
This deficiency in ''self-monitoring skills,'' the researchers said, helps explain the tendency of the humor-impaired to persist in telling jokes that are not funny, of day traders to repeatedly jump into the market -- and repeatedly lose out -- and of the politically clueless to continue holding forth at dinner parties on the fine points of campaign strategy.
In a series of studies, Dr. Kruger and Dr. Dunning tested their theory of incompetence. They found that subjects who scored in the lowest quartile on tests of logic, English grammar and humor were also the most likely to ''grossly overestimate'' how well they had performed.
In all three tests, subjects' ratings of their ability were positively linked to their actual scores. But the lowest-ranked participants showed much greater distortions in their self-estimates. Asked to evaluate their performance on the test of logical reasoning, for example, subjects who scored only in the 12th percentile guessed that they had scored in the 62nd percentile, and deemed their overall skill at logical reasoning to be at the 68th percentile. Similarly, subjects who scored at the 10th percentile on the grammar test ranked themselves at the 67th percentile in the ability to ''identify grammatically correct standard English,'' and estimated their test scores to be at the 61st percentile.
Unlike their unskilled counterparts, the most able subjects in the study, Dr. Kruger and Dr. Dunning found, were likely to underestimate their own competence. The researchers attributed this to the fact that, in the absence of information about how others were doing, highly competent subjects assumed that others were performing as well as they were -- a phenomenon psychologists term the ''false consensus effect.'' When high scoring subjects were asked to ''grade'' the grammar tests of their peers, however, they quickly revised their evaluations of their own performance.
And the research meshes neatly with other work indicating that overconfidence is a common; studies have found, for example, that the vast majority of people rate themselves as ''above average'' on a wide array of abilities -- though such an abundance of talent would be impossible in statistical terms. And this overestimation, studies indicate, is more likely for tasks that are difficult than for those that are easy.
But Dr. Dunning said his current research and past studies indicated that there were many reasons why people would tend to overestimate their competency, and not be aware of it. In some cases, Dr. Dunning pointed out, an awareness of one's own inability is inevitable: ''In a golf game, when your ball is heading into the woods, you know you're incompetent,'' he said. But in other situations, feedback is absent, or at least more ambiguous; even a humorless joke, for example, is likely to be met with polite laughter.
Australian obesity inquiry told extreme health programs too risky
A rare burst of realism
Some dieting and exercise programs may do more harm than good, a parliamentary inquiry into obesity has been told. A submission by the Telethon Institute for Child Health Research, co-written by Professor Fiona Stanley, warned that "toughening up" exercise and diet programs wasn't the answer to the obesity epidemic. The submission was presented to the inquiry on Friday.
"We fear that there is a risk, if exercise and diet strategies are taken to extremes, that they could cause harm to some people," the experts wrote. "Extreme diets may have unwanted side effects. ''While high levels of LDL (low-density lipoprotein) cholesterol have been linked with heart disease, low levels have been linked with depression and attempted self-harm." [Both links are likely to be epidemiological nonsense but it is nice to have one cancelling the other out]
The institute's submission criticised other arguments presented to the Inquiry into Obesity in Australia. It said some recommended diet and exercise programs "had never been properly tested and (were) based on some measure of faith or belief". "Where evidence is weakest is regarding the question of what works to reduce obesity. Some trials of increased exercise and/or various diets show limited benefits, if any."
The submission questioned experts' calls for "toughening up" strategies that had not shown any impact on the rate of obesity. Increasing the "dose" of strategies - such as mandating exercise through schools or further reducing fat content in fast foods - could be futile if the strategies were flawed. "There may be some element missing, or some flaw in the strategies or the ideas underlining them, that prevent them being successful or lead them to be ineffective," it said.
The report recommended new policies should be trialled first. [What a revolutionary idea for the food Fascists!]
The House of Representatives Health Committee is holding national hearings and will make recommendations to the Government next year. Committee chair Steve Georganas said there had not been enough monitoring and tracking research in recent years, but there were successful programs that could be rolled out across the country. "No one advocates over-strict diets,'' he said. ''It's about a healthy lifestyle, not flogging people to death. ''There is evidence of many programs working. [What sort of evidence? Not double-blind, I'll warrant] ''But there's no easy solution. ''We need people to eat less and exercise more, but getting the whole society to change their habits is very difficult." [And improper]
9 November, 2008
MIGRAINES CUT BREAST CANCER?
I thought at first that this would be just a chance result of data dredging but the work, as presented, does seem a little better than that. A reasonable hypothesis was generated and epidemiological data was sought to examine it. One understands the absence of an in vivo test but that absence does leave the evidence shaky. So MUCH more epidemiological data is needed before the association can be taken seriously. Even in the highly selective "sample" used, however, the association of migraine with cancer was not strong (lots of migraine sufferers DID get cancer) -- so there may not be a lot of point in further work. Popular summary plus journal abstract below:
In a puzzling twist, women who have a history of migraine headaches are far less likely to develop breast cancer than other women, U.S. researchers said on Thursday. The study is the first to look at the relationship between breast cancer and migraines and its findings may point to new ways of reducing a woman's breast cancer risk, they said.
"We found that, overall, women who had a history of migraines had a 30 percent lower risk of breast cancer compared to women who did not have a history of such headaches," said Dr. Christopher Li of the Fred Hutchinson Cancer Research Center in Seattle, whose findings appear in the journal Cancer Epidemiology, Biomarkers and Prevention. Li said the reduction in risk was for the most common types of breast cancers -- those driven by hormones, such as estrogen-receptor positive breast cancer, which is fueled by estrogen, and progesterone-receptor positive breast cancer, which is fueled by progesterone.
Hormones also play a role in migraines, a brutal type of headache often accompanied by nausea, vomiting and heightened sensitivity to light and sound. Women are two to three times more likely than men to get migraines.
While it is not exactly clear why women with a history of migraines had a lower risk for breast cancer, Li and colleagues suspect hormones are playing a role. "Women who have higher levels of estrogen in their blood have higher levels of breast cancer," Li said in a telephone interview. And he said migraines are often triggered by low levels of the hormone estrogen, such as when estrogen levels fall during a woman's menstrual cycle. Women who get migraines "may have a chronically lower baseline estrogen. That difference could be what is protective against breast cancer," Li said.
For the study, Li and colleagues analyzed data from two studies of 3,412 post-menopausal women in the Seattle area, 1,938 of whom had been diagnosed with breast cancer and 1,474 of whom had no history of breast cancer. Women in the study provided information on their migraine history. They found women who had reported a clinical diagnosis of migraine had a 30 percent reduced risk of developing hormonally sensitive breast cancers.
"Migraines are typically most severe among pre-menopausal women," Li said. "This study was all post-menopausal women." He said that suggests the protective effect seen in women who get migraines may have a lasting effect at reducing breast cancer risk. "While these results need to be interpreted with caution, they point to a possible new factor that may be related to breast-cancer risk," Li said in a statement.
Migraine in Postmenopausal Women and the Risk of Invasive Breast Cancer
By Robert W. Mathes et al.
Background: The frequency of migraine headache changes at various times of a woman's reproductive cycle. Menarche, menses, pregnancy, and perimenopause may carry a different migraine risk conceivably because of fluctuating estrogen levels, and in general, migraine frequency is associated with falling estrogen levels. Given the strong relationship between endogenous estrogen levels and breast cancer risk, migraine sufferers may experience a reduced risk of breast cancer.
Methods: We combined data from two population-based case-control studies to examine the relationship between migraine and risk of postmenopausal invasive breast cancer among 1,199 ductal carcinoma cases, 739 lobular carcinoma cases, and 1,474 controls 55 to 79 years of age. Polytomous logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI).
Results: Women who reported a clinical diagnosis of migraine had reduced risks of ductal carcinoma (OR, 0.67; 95% CI, 0.54-0.82) and lobular carcinoma (OR, 0.68; 95% CI, 0.52-0.90). These associations were primarily limited to hormone receptor–positive tumors as migraine was associated with a 0.65-fold (95% CI, 0.51-0.83) reduced risk of estrogen receptor–positive (ER+)/progesterone receptor–positive (PR+) ductal carcinoma. The reductions in risk observed were seen among migraine sufferers who did and did not use prescription medications for their migraines.
Conclusions: These data suggest that a history of migraine is associated with a decreased risk of breast cancer, particularly among ER+/PR+ ductal and lobular carcinomas. Because this is the first study to address an association between migraine history and breast cancer risk, additional studies are needed to confirm this finding.
Cancer Epidemiology Biomarkers & Prevention 17, 3116-3122, November 1, 2008
Vaccine to halt progress of Alzheimer's disease?
A revolutionary jab that scientists believe could stop Alzheimer's disease in its tracks is being tested on patients. Initial results indicate it could stop sufferers from reaching the devastating final stages of the disease, which can destroy the ability to walk, talk and even swallow. Scientists are said to be excited after a year-long trial on sufferers. However the drug, effectively a vaccine, is not expected to repair the damage already done to patients, so would not be a cure.
Current Alzheimer's drugs - some of which have not been approved for use on the NHS - can halt the progression of the disease for some patients but effects wear off over time. In contrast, it is hoped the new jab will hold the disease - the most common form of dementia - at bay indefinitely. The vaccine generates antibodies that seek out and destroy the sticky protein that clogs the brain in Alzheimer's sufferers. When the jab was given to mice suffering an Alzheimer's-like disease, 80 per cent of the amyloid protein patches or plaques were broken up.
Now it has been given to people for the first time, with promising results. In a year-long trial, researchers from the Karolinska Institute in Sweden gave 31 men and women with mild or moderate Alzheimer's regular injections of the vaccine. Tests showed the drug, which is known as CAD106, triggered the production of anti-amyloid antibodies in two-thirds of cases and was safe to use. However, most patients did suffer side-effects, including headaches and nasal problems.
British experts called the results 'encouraging' but cautioned that other promising jabs had failed to come to fruition. Professor Clive Ballard, of the Alzheimer's Society, said the vaccine might be of most benefit to those in the very early stages of the disease. He said: 'The current treatments are better than nothing and probably buy people between six and 12 months of improved function. 'But what they don't do is change the underlying disease. 'If you could target people really early on, presumably you could really slow down the progression of the disease and give people a much longer period of quality function.'
Scientists hope the vaccine could be used to immunise those with a family history of the disease. A mass vaccination of people in late middle-age could even be possible. It is believed half of the 434 billion spent on Alzheimer's in Britain each year could be saved if patients developed the disease five years later than they do now.
Rebecca Wood, of the Alzheimer's Research Trust, called the idea of breaking-up amyloid 'really attractive' but warned it was unclear whether this would improve health. The drug, developed by Swiss biotechnology firm Cytos, has been sold to Swiss pharmaceutical giant Novartis. During its trial, four suffered serious reactions but they were not believed to be caused by the jab. Two more studies are already under way. However, experts warn it could be a decade before the jab hits the market.
8 November, 2008
Can living in rainy areas really cause one-third of autism cases?
An excerpt from Sandy Szwarc below. I wholeheartedly endorse her comments
At first, this study sounded like it might have been published in the Journal of Spurious Correlations or an entry for the Spurious Correlations Contest and would provide a note of levity.
A few years ago, three economists had self-published a paper reporting a correlation between rising rates of cable television subscriptions and autism in Northwest coastal areas since the 1970s. That was funny because, of course, anything that has increased since the 1970s could be said to spuriously correlate with autism; nor had they made any effort to see if the autistic children had even watched more television.
One section of that original paper has just been republished in Archives of Pediatric and Adolescent Medicine, a journal of the American Medical Association. For real. It reported a correlation between higher amounts of rain and snowfall during 1987-2001 in Northwest coastal areas and autism rates among school-aged children in 2005.
Yet, the authors concluded that this association supports their hypothesis of an environmental trigger for autism and went on to speculate on "a number of possibilities of what such an environmental trigger might be." The first was television and video viewing because "it seems plausible" that it's associated with precipitation and could possibly be associated with "more serious health problems such as autism." They went on to put forth even more fanciful and worrying possibilities of unseen environmental exposures, as we'll look at in a minute, and concluded that this paper proved further research into this link was warranted.
This isn't funny anymore. If this is what now constitutes medical research in a peer-reviewed journal and is actually being taken seriously by the medical community and major universities, we are in serious trouble.
Much more here
More on exercise and breast cancer
I looked at a study claiming a link between exercise and breast cancer on 2nd. After looking no further than the abstract, I concluded that the claims by the authors that exercise prevents cancer were "rather ludicrous, really".
In her usual way, however, Sandy Szwarc did a much more careful examination of the study on 3rd and found that it was not so much ludicrous as an outright fraud. What the study in fact clearly showed was that there was NO CONNECTION between exercise and breast cancer. The authors reported a negative result as a positive one. But the goodness of exercise is conventional wisdom so the crap slipped through all the barriers that should have stopped it. It is sad that it takes outsiders such as myself and Sandy to blow the whistle on such nonsense.
I look at a lot more studies than Sandy does because one fatal flaw causes me to read no further. But when Sandy goes to town she slaughters the stuff so thoroughly that there are not even any bones left. I don't suppose she will change but I would like her to apply her fine mind to more studies, more briefly. Once something is dead, there is not much point killing it over and over again.
7 November, 2008
Folic Acid and Antioxidants Won't Prevent Cancer
The report below is based on a very limited sample -- women with heart disease symptoms -- so is of uncertain generalizability -- but it is reminiscent of an earlier Norwegian study of older heart disease sufferers which found "This trial did not find an effect of treatment with folic acid/vitamin B12 or vitamin B6 on total mortality or cardiovascular events". So far, then, the case for positive benefits of pill-popping would seem to be more faith-based than fact-based.
The report below is, however, disingenuous in saying that only one previous study showed an INCREASED risk of cancer from supplements. Note this recent expert comment about folates and bowel cancer:"Other reasonable hypotheses about one-carbon metabolism and colorectal carcinogenesis, based on our current understanding of the biochemistry and underlying mechanisms, have also not been proven correct. In a recently published placebo-controlled randomized clinical trial among 1021 men and women with a recent history of colorectal adenoma, supplemental folic acid at 1 mg/d for up to 6 years did not reduce the incidence of subsequent colorectal adenomas and might have increased it."WHOA! The folate that Americans get compulsorily added to their bread did no good and seems to have done harm?? And do we see a double blind controlled study contradicting epidemiological inferences?? Who would have believed it! They go on to admit that two animal studies have shown that folate INCREASES cancer. Aren't you glad that your government is dosing you up with the stuff and giving you no say in the matter?
The addition of folate to our bread is more and more looking like an iatrogenic disaster to come. I think I should note once again that a folate expert has reported that the addition of folate to bread seems to have caused an upsurge in bowel cancer among Americans --JR.Taking folic acid or other B vitamin supplements won't lower your risk of cancer, new research shows. However, the good news is that it won't increase your risk either, according to the study, which was published in the Nov. 5 issue of the Journal of the American Medical Association. "In women at risk of cardiovascular disease, we found that folic acid, vitamin B6 and vitamin B12 had no beneficial or harmful effects on the risk of invasive cancer or breast cancer," said study author Dr. Shumin Zhang, an associate professor of medicine at Brigham and Women's Hospital and Harvard Medical School, in Boston.
Because adequate levels of folic acid in women have been proven to prevent serious birth defects, the government has mandated that folic acid be added to cereals and breads since January 1998, according to the U.S. Centers for Disease Control and Prevention. Additionally, about one-third of U.S. adults take a daily multi-vitamin that contains folic acid, B6 and B12, according to the study. Some studies have suggested that supplements of these nutrients might be protective against cancer, though results have been inconsistent, according to background information in the study.
One study even suggested that such supplements might raise the risk of cancer.
To address these concerns, Zhang and colleagues reviewed data on 5,442 women who participated in the Women's Antioxidant and Folic Acid Cardiovascular Study. All of the women were over 42 years old, and had either preexisting cardiac disease or three or more risk factors for heart disease. The study participants were randomly assigned to receive either a supplement containing 2.5 milligrams (mg) of folic acid, 50 mg of vitamin B6 and 1 mg of vitamin B12, or a placebo. The study lasted 7.3 years, from April 1998 through July 2005.
During that time, 379 women developed invasive cancer -- 187 in the active treatment group and 192 in the placebo group. Of the women who developed cancer, 154 developed breast cancer -- 70 in the active treatment group and 84 in the placebo group. None of these differences were statistically significant.
However, when the researchers broke the data down by age, they did note what appeared to be a protective effect from the supplement treatment in women over 65. Zhang said this might be because older women generally have a higher need for these nutrients. But she also said these results should be "interpreted with caution," because the study wasn't designed to look at age differences. "It's something that needs further study," she added.
Victoria Stevens, strategic director of laboratory services for the American Cancer Society, agreed. "There was a suggestion of a protective effect in older women that I think is worth following-up," Stevens said.
The bottom line, according to Stevens, is that "supplements aren't a magic bullet" for cancer prevention. "There are really good reasons for women to take folic acid, especially if they're planning on having a baby, because there's really conclusive evidence that it can reduce birth defects. But, for the average woman in terms of cancer risk, folic acid and B vitamins don't seem to increase or reduce risk," Zhang said.
THE LIMITATIONS OF PEER REVIEW
Having myself often been peer-reviwed and been a reviewer, the finding below does not surprise me at all. One sometimes wonders if the reviewer has read the paper at all. My impression is that the main achievement of such reviews is to keep boat-rocking papers out of the journals and expectation-confirming papers in. Abstract follows:
What errors do peer reviewers detect, and does training improve their ability to detect them?
By Sara Schroter et al
Objective: To analyse data from a trial and report the frequencies with which major and minor errors are detected at a general medical journal, the types of errors missed and the impact of training on error detection.
Design: 607 peer reviewers at the BMJ were randomized to two intervention groups receiving different types of training (face-to-face training or a self-taught package) and a control group. Each reviewer was sent the same three test papers over the study period, each of which had nine major and five minor methodological errors inserted.
Main outcome measures: The quality of review, assessed using a validated instrument, and the number and type of errors detected before and after training.
Results: The number of major errors detected varied over the three papers. The interventions had small effects. At baseline (Paper 1) reviewers found an average of 2.58 of the nine major errors, with no notable difference between the groups. The mean number of errors reported was similar for the second and third papers, 2.71 and 3.0, respectively. Biased randomization was the error detected most frequently in all three papers, with over 60% of reviewers rejecting the papers identifying this error. Reviewers who did not reject the papers found fewer errors and the proportion finding biased randomization was less than 40% for each paper.
Conclusions: Editors should not assume that reviewers will detect most major errors, particularly those concerned with the context of study. Short training packages have only a slight impact on improving error detection.
6 November, 2008
"The red wine weight loss wonder drug that lets you eat junk food"
Anything that "mimics" resveratrol or red wine is ipso facto suspect as a therapeutic agent. The red-wine/resveratrol theory is a great fad but resveratrol does NOT do many of the things claimed for it when properly tested -- such as prolong life
For dedicated couch potatoes, it sounds almost too good to be true. A drug inspired by red wine could allow them to eat as much junk food as they like without putting on a pound. It could also provide the benefits of exercise without moving a muscle. And if that were not enough, the pill - which mimics the action of resveratrol, the 'wonder ingredient' in red wine - may also prevent diabetes.
The man-made drug, which is known only as SRT1720, fools the body into thinking food is scarce and it has to burn off fat to survive. The brainchild of scientists at US firm Sirtris, the drug exploits the healthy qualities of resveratrol, a chemical found in grape skins. Previous studies have endowed resveratrol with the ability to ward off a host of ills, from old age to heart disease, cancer, obesity and Alzheimer's disease.
Sirtris has already developed a concentrated form of resveratrol in a pill. However, the new drug could be even more powerful and have fewer side-effects. David Sinclair, co-founder of Sirtris, which is now owned by Glaxo-SmithKline, said recently: 'The excitement here is that we are not talking about red wine any more. We are talking about real drugs.'
In experiments, mice given SRT1720 didn't gain an ounce, despite being fed fatty foods. Blood tests suggested they were also protected against diabetes. The treated animals also had more stamina and were able to run twice as far. However, they had to be forced to exercise. Left to their own devices, they would move around less than normal, the journal Cell Metabolism reports. [A very discouraging side-effect, one would think]
The drug is made up of chemicals that affect the body in a similar way to resveratrol. Both resveratrol and the new drug trigger a protein called SIRT1 that plays a key role in regulating the body's supply of energy. The result is that the body burns off its fat stores, even when food is plentiful.
Researcher Professor Johan Auwerx, of the Ecole Polytechnique Federale de Lausanne in Switzerland, said: 'These results show that new synthetic SIRT1 activators can reproduce the positive metabolic effects that were previously demonstrated using resveratrol. 'But unlike resveratrol, these new chemical entities target only the SIRT1 pathway, making them more selective and potent for achieving these metabolic benefits.' He added that the drug, which is around seven years from the market, is likely to be used to treat obesity and diabetes.
Prof Ian Broom, an obesity expert from Robert Gordon University in Aberdeen, said any drug that burnt off fat while protecting against diabetes would be welcomed. But he cautioned that much more research - including studies into side-effects - would be needed before SRT1720 became accepted as a treatment for obesity.
PhD student unlocks diabetes insulin mystery
AUSTRALIAN scientists have uncovered a key clue in the mystery of how insulin works, bringing them closer to a cure for diabetes. A Sydney PhD student Freddy Yip has solved a problem plaguing researchers worldwide for more than half a century - how insulin prompts fat and muscle cells to absorb glucose. This process is defective in the growing number of people with type 2 diabetes so understanding it opens the way for new therapies to correct it.
"While we're certainly not saying we've found a way to cure diabetes, we are saying we've found a pretty significant clue," said David James, head of the diabetes program at the Garvan Institute for Medical Research. "Since the 1920s, when Banting and Best discovered insulin, scientists have been battling to discover how it actually works," Professor James said. "Then along comes Freddy Yip, doing his PhD, who unveils a completely novel action of insulin, one which we believe plays a fundamental role in glucose uptake."
The findings, published in the journal Cell Metabolism, focus on two intersecting problematic processes affecting diabetics, insufficient production of insulin in the pancreas after a meal and so-called insulin resistance, and the faulty uptake and storage of glucose in fat and muscle cells. "In the cell we have series of motor proteins that have the ability to move other molecules from one place to another along intracellular railroad tracks," Mr Yip said. "I have discovered that insulin activates a specific kind of motor protein known as Myo1c, which in turn performs a critical role in glucose uptake." The motor protein helps move glucose transporter proteins from inside the cell to the surface membrane so that they can pump glucose into the cell.
The findings offer up a new target for diabetes treatment. "We think there may be blockages in the signal between insulin and myo1c in people who develop insulin resistance," he said. "If we're correct, it should be possible to target that pathway for development of new therapies." Statistics show about 700,000 Australians suffered diabetes in 2005, a figure which has doubled since 1981.
5 November, 2008
Why heart pumps could kill off the transplant
There are no rejection problems, and they cost a lot less than transplants. The new, smaller heart pumps could save thousands of lives. So why are they still treated as the poor relation?
When the South African surgeon Christiaan Barnard carried out the first heart transplant in December 1967, the world held its breath. His patient, 53-year-old Lewis Washkansky, lived for only another 18 days. The drugs he needed to stop his body rejecting the new organ compromised his immune system to such an extent he couldn't fight off other illnesses, and he died of pneumonia. But the precedent had been set: the most powerful and emotionally iconic of human organs could be taken from the body of a dead person to give the chance of an extended life to another. It was a transforming, era-defining moment that reinforced our faith in medical science and ensured Barnard's place in history. But how successful would heart transplantation be in the long term?
Just over 40 years later, the very same question is still being asked. The procedure, and the drugs needed to maintain a newly donated heart, may be much more sophisticated, and heart transplants may be regarded by the public as one of the most glamorous of surgical career paths, but surgeons themselves are carrying out significantly fewer of the operations. This is partly because a range of other treatments is available to patients, and partly because of the low number of suitable donor hearts.
When surgeons do operate, the outcome is often poor. Of the 100-plus people who receive a new heart each year, 10 are likely to die within 12 months as a result of donor-organ rejection and other complications; and of the remainder, a significant proportion will develop cancer within five years from the toxic anti-rejection drugs they must take for the rest of their lives. Specialists argue that the number of long-term survivors has increased, with some living for decades; but they admit that most transplant patients die within 10 years of receiving a new organ.
In the past year and a half, the deaths of 11 patients who had just received new hearts has raised more serious questions about our cardiac-transplant programme. In that time, both Papworth hospital in Cambridgeshire and Harefield, on the outskirts of London - the most prestigious centres in the UK for heart transplants - have had to suspend these operations because of a run of unexplained deaths: seven patients at Papworth from January to September 2007, and four at Harefield who died one after the other between July and October this year. None of the victims survived to leave hospital, each one dying within a month of their operation. An inquiry at Papworth, where the deaths represented more than one-third of the 20 transplants carried out there last year, was inconclusive. At Harefield, an inquiry is ongoing.
Meanwhile, the number of organ donations has plummeted to an all-time low: only 135 patients received new hearts in the year to April 2008; more than 500 hearts were offered for transplant, but many were not considered a suitable match or of sufficient quality for their intended recipients. At the procedure's peak, in 1989/90, there were over 400 heart transplants. Today there are simply fewer good hearts to choose from, because seat-belt legislation has dramatically cut the number of deaths in road accidents, and thus the number of hearts available for transplantation, and because families are often unwilling to offer up their newly deceased loved ones for organ harvesting. There are now so few heart-transplant surgeons in the country - 50 at most - that it's easy to imagine a time when they outnumber the available donors; not a state of affairs Barnard could have imagined all those years ago.
Against this background, some heart surgeons are arguing that we need to think again and turn our attention to electric heart pumps, an apparently riskier medical solution, but one that offers a cheaper, off-the-shelf opportunity to save a life without someone having to die first; and one that has been proved to have therapeutic potential for those who merely need to rest their heart, not replace it.
Paul Maidment, an army chef, is a case in point. At the time that the unlucky patients at Papworth and Harefield were preparing themselves for transplant surgery last year, Maidment was larking about with his mates in the catering corps in Iraq, fronting a band called the Basra City Rollers. By May this year he was fighting for his life, his heart stopping every few minutes even as doctors struggled to keep it going. It was not a stray bullet that had caused the lethal damage, but a rare adrenalin-secreting tumour that was pouring toxic quantities of the fight-or-flight hormone into his bloodstream, sending his blood pressure soaring and putting a fatal strain on his heart. At the age of 28, Maidment appeared to have metamorphosed from a muscle-bound model for army recruitment into a near-corpse, wracked by repeated heart attacks.
Nobody at the Royal Devon and Exeter hospital knew what to do. David Smith, the cardiologist treating Maidment, was aware of implantable electric heart pumps that could take the strain off exhausted hearts like his, giving the muscle vital time to recover. Smith had read a paper produced by a team in Oxford - one of a small number of groups lobbying for the use of such devices - which had achieved remarkable results with the handful of patients who had received charitable funding for the devices (each unit costs between 40,000 and 60,000 pounds).
The problem in this case wasn't funding but logistics: how to get Maidment to Oxford's John Radcliffe hospital, where a pump could be fitted while he was still attached to the roomful of equipment that might or might not keep him going for the journey. A Sea King helicopter was scrambled by the army for the 40-minute trip. His parents, Steve and Sandy, followed by car. "We'd been told he would probably die on the journey," says his mother. "He was cold and sweaty, and his skin was like candle wax, the most awful colour I have ever seen." By the time the couple reached the hospital, the pump was already in. Stephen Westaby, a cardiac surgeon turned professor of biomedical sciences, who has led the world in the use of the technology, assured them their son would live.
Four days later Maidment's heart was sufficiently rested from its trauma for the pump to be removed. Two weeks after that, he was off the drugs that had kept him unconscious while he recovered. Coincidentally, a letter announcing his promotion from corporal to sergeant had arrived at his home during his suspension from existence. Life, for him, goes on.
For many sufferers of heart problems, that is not the case. Britain has one of the highest heart-disease rates in the developed world: 700 people a day have a heart attack, which usually leaves the muscle damaged and weakened. Every year 100,000 people die of heart failure, either as a result of this damage or as a consequence of infection, high blood pressure or inherited heart weakness. At the moment only 105 of these patients have made it onto the heart-transplant waiting list because the number of available organs is so small. But could many more benefit from a pump?
The doctors crusading for their greater use are convinced that the life-saving possibilities of the new battery-operated devices have been under-researched to keep a lid on spiralling healthcare costs, and to ensure that talking up the pumps does not deal a potentially fatal blow to Britain's struggling heart-transplant industry. They are keen that patients should have a range of treatments available and want to widen the debate, not narrow it.
There are also uncomfortable ethical issues that the campaigners would rather not address. The advent of electric heart pumps raises the possibility of thousands of wealthy old people demanding access to a new lease of battery-powered life. In the United States, Westaby's innovation is proving popular with a growing number of over-75s. There are an estimated 1,000 battery-operated elderly Americans going about their business in the US. The record for the oldest patient to be fitted with one has just been set by an 87-year-old from San Diego. Because the research isn't available, nobody knows how long these patients may live.
Back in the more prosaic world of the British NHS, the deaths at Papworth and Harefield have raised inevitable questions. Is the stock of good hearts decreasing? Are surgeons doing enough operations to maintain their skill levels? "There was no common factor to explain the deaths which occurred here," said a Papworth spokesman.
While awaiting the full results of their inquiry, Harefield say they see no obvious pattern emerging: their four deaths involved hearts from three different unidentified retrieval centres, with three different surgeons operating. In addition to Harefield and Papworth, specialist units in Newcastle, Manchester and Birmingham also receive heart-transplant patients. A handful more are occasionally carried out in Glasgow (three in the year to April 2008) and at Great Ormond Street children's hospital in London, which did nine in the same year. Each centre employs up to five highly skilled transplant surgeons to give the requisite 24-hour cover. That means most of them are doing no more than four to six transplants a year - considerably fewer than, for example, liver- or kidney-transplant surgeons. The UK performs between 600 and 700 liver transplants a year and more than 1,300 kidney transplants.
Children currently have better survival rates than adults for heart transplants, and as yet there is no immediate possibility of a paediatric pump being made available to them. For around 30 youngsters a year, transplantation is their best chance of a span of extra life. Mike Burch, a senior cardiologist who is lead transplant consultant at Great Ormond Street, says he has used 16 heart pumps in children to keep them alive while they wait for a donor organ, but in none of these cases did the child's heart stage the miraculous recovery seen in adult hearts relieved of the burden of pumping. He thinks donor- organ transplants will for some time remain the only option for children.
Losing weight with a food diary
Simply writing down your daily food intake can double your weight loss -- for some people anyway
When Bridget Jones slavishly recorded her lists - "Food consumed today: 2 pkts emmenthal cheese slices, 14 cold new potatoes, 2 bloody marys, 12 Milk Tray" - it turns out she was way ahead of medical science. According to the American Journal of Preventive Medicine, dieters who keep a food diary can double their weight loss. The study followed 1,700 overweight people over six months, and revealed that those who wrote down everything they ate lost an average of 13lb.
"Recording what you eat can really help you lose weight, because a lot of the time, you're not conscious of your behaviour," says Azmina Govindji, a consultant nutritionist and author of The Hot Body Plan. "Some eating habits are situational - for example, having tea and a chocolate biscuit while watching your favourite television programme. We do it on autopilot. If you know that you actually have to record every item you eat, it gives a split-second pause for thought. You think, `Do I really want to write this down?' "
It's a trend that is sweeping America, with a plethora of websites, such as thedailyplate.com, that allow users to log their food sins into a digital confessional that even calculates the calories for you. Julia Cameron, author of the creativity bible The Artist's Way, has gone a step further with The Writing Diet, a self-help book that explores the link between eating mindfully and living a happy life.
"Through the use of a food journal, we often become aware of patterns that are self-destructive," Govindji says. "We become more authentically honest with ourselves, and we start asking the question `What's eating me?' instead of `What can I eat?' " Even people who believe that they are resolutely healthy can get a shock when they see everything written down in black and white. "Mothers who eat the last few chips on a child's plate, or the single woman who reaches for the H„agen-Dazs when she's feeling lonely in front of the TV, start to see where their diets are going wrong," she says.
These emotional triggers can often come as the biggest surprise. To this end, Govindji gets clients to keep a "food and mood" diary, so they write down not only every mouthful they eat, but the time of day and how they were feeling at that moment. "Once someone spots a pattern, then they can do something to change it," she says. The most common patterns she uncovers are in those who eat naughty foods because they are bored, hormonal or depressed.
Which brings us to an obvious flaw in the food diary. Surely mere mortals are tempted to cheat? "Well, yes, we're all human. If someone is going to see an expert, they are obviously going to be concerned to be seen in a good light," she concedes. "But if you're just doing this at home for yourself, what would be the point of lying? You're setting up a dialogue with yourself, so there's no point. It can just be for your eyes only."
In any case, new research from the University of Wisconsin-Madison has revealed a way around the tendency to fib - the photo diary. Taking a digital snap of every meal was shown to be an even more powerful and accurate weight-loss tool. One volunteer told the researchers: "I had to think more carefully about what I was going to eat because I had to take a picture of it. I was less likely to have a jumbo bag of M&M's. It curbed my choices. It didn't alter them completely, but who wants to take a photo of a jumbo bag of M&M's?"
Who, indeed. But the good news, according to Govindji, is that you don't have to keep this up for very long. "Two or three days is enough to get a real understanding of how and why we eat what we do."
4 November, 2008
Women told to limit caffeine during pregnancy
Now that a few glasses of wine are off the hook, they have to have something else that they can bear down on. But once again all they have is epidemiological evidence. Big coffee drinkers have smaller babies but why? A direct causal link is only an assumption. Maybe (for instance) anxious mothers drink more coffee and it is the anxiety that affects the baby, not the coffee. You wonder how these guys got past Statistics 101 -- if they did
Pregnant women will be warned this week to limit their caffeine consumption to two cups of coffee a day or risk giving birth to underweight babies. The government's food standards watchdog will issue guidance to coincide with a study linking caffeine to low birth weight. Scientists have previously linked it to miscarriages. The advice from the Food Standards Agency (FSA) comes a week after scientists found that a weekly glass of wine during pregnancy could help boost a baby's behaviour and vocabulary.
The FSA is lowering the current recommended caffeine limit of 300mg a day to 200mg, the equivalent of two average-sized mugs of instant or two cups of brewed coffee a day. It has also identified other products containing caffeine that count towards the 200mg total. The limit is equivalent to four cups of tea, five cans of cola, three energy drinks or five bars of chocolate. Andrew Wadge, chief scientist at the FSA, said: "This is new advice but these are not new risks. I want to reassure women that if you're pregnant and have been following the previous advice, the risk is likely to be tiny."
Coffee shops have higher levels of caffeine in their drinks than assumed in the FSA guide-lines, which state that an average mug of coffee contains 100mg. A small cafe latte in Starbucks contains 240mg of caffeine, meaning a pregnant woman would exceed the recommended daily caffeine intake in one drink. A new generation of energy drinks, including Spike Shooter, contain up to 300mg of caffeine in a single can. The mass market drink, Red Bull, typically contains 80mg.
The FSA is changing its guide-lines following advice from the independent committee on toxicity, which after assessing the new research and previous studies decided that caffeine could be harmful to the unborn child at lower levels.
Researchers from Leicester and Leeds universities monitored the daily caffeine intake of 2,500 pregnant women using questionnaires. They compared this with the birth weight of the baby, taking into account the weight and ethnic background of the mother. The research, to be published in the British Medical Journal on Wednesday, found that women with a caffeine intake of more than 200mg a day were more likely to give birth to smaller babies.
One committee member said: "The [body of] research shows we get an adverse effect at a slightly lower caffeine intake than we previously thought, in terms of both reduced birth weight and increased instance of spontaneous abortion. "The final decision mainly went on the birth weight with babies born at a weight appropriate for a baby a few weeks younger. If you're small for gestational age, you're more likely to have intellectual impairment and hyperactivity in later life."
Research in the US published this year in the American Journal of Obstetrics & Gynaecology found that drinking more than 200mg of coffee a day doubled the risk of miscarriage.
Pat O'Brien, consultant obstetrician and spokesman for the Royal College of Obstetricians and Gynaecologists, said he recommended women should abstain from caffeine in the first 12 weeks of pregnancy. He said: "This is a very vulnerable time for the baby, and it's when most miscarriages occur."
Fight dementia with a keen social life
New research suggests that there is hope for people with dementia, the key is to keep up their social life. Amusing that demented people are mostly happy. That rather confirms my take on the happiness literature
For many of us, there's little more bleak than the prospect of Alzheimer's disease - it's that idea of the loss of self that is so frightening. Yet a new study turns on its head the assumption that a good quality of life ends once Alzheimer's and other forms of dementia take hold. Not only does it indicate that those affected can lead fulfilling lives, but that there's something that will make happiness almost guaranteed: keep up the social life.
The study, from University College London published in the Journal of Neurology, Neurosurgery & Psychiatry, is one of the first to ask people with dementia directly about their feelings over time, to try and gauge their quality of life.
Dementia is the accelerated loss of brain cells, usually due to a disease such as Alzheimer's. It affects 750,000 people in the UK. This new study comes at a time when news stories about the need for treatments, and the decline of high-profile figures such as Iris Murdoch have consistently painted a picture of loss. Baroness Warnock, an expert in medical ethics, has controversially proposed euthanasia for dementia sufferers because of the strain they put on their families and public services.
But Cornelius Katona, a leading expert in old-age psychiatry from University College London's medical school, believes we should pay more attention to the factors that can make a difference to the lives of people affected by this potentially terrifying condition. And his research suggests that if we make sure the right activities and environments are available, we can give people with dementia a good quality of life without searching for elusive, expensive drugs.
"If you work clinically with people with dementia, you aren't usually struck by how distressed and miserable they are," Professor Katona says. "People with dementia generally rate their quality of life highly. That was a starting point for our research. We also suspected that the traditional ideas of what it meant to age `successfully' - avoiding ill-health, poverty and other adversity - were flawed. Actually, avoiding adversity isn't necessarily the key to being satisfied with life as you get older."
The new study focused around interviews with 224 people with mild, moderate and severe Alzheimer's, but its results apply to all forms of dementia. The interviewees were assessed to ensure that they could give meaningful answers and asked questions using standard health status, cognitive impairment and quality of life questionnaires. These indicated how happy they were with their life, and also how well they were mentally and physically functioning.
The researchers went back after 18 months, and asked the same questions. The resulting analysis looked at who had declined most physically and mentally, and who had stayed happiest. It came up with some fascinating results. Generally, those affected by dementia - whether it be severe or mild - didn't experience any decline in their sense of wellbeing over the 18 months, even though an objective assessment might have noted one.
And those with the highest sense of wellbeing were also those who scored highest on "social relationships" measures - how many people they regarded as close, how often they saw them, and what the relationships were like. People who had the best relationships were the most happy, and stayed happy longer. The results also showed that the happiest people were those who hadn't any indication of mental health problems such as anxiety and depression at the onset of Alzheimer's. This, says Katona, indicated that they were ageing "successfully" - despite their decline in cognitive function. It means we should be careful not to judge a decline by our own standards, rather than their own. "When you compare how a carer rates the quality of life of someone with dementia with how the person with dementia themselves rates it, then you find the carer always rates it lower. This is all probably related to the carer's own susceptibility to anxiety and depression, because their lives are so stressed."
A study published in the Journal of International Psychogeriatrics last month found that one in four spouses of people with dementia was suffering from clinical depression.
Since conducting the study into Alzheimer's, with UCL's Professor of Mental Health Sciences, Gill Livingstone, Katona has conducted a larger study into what predicts good quality of life as we age generally. Again the factors are your previous state of mental health, and how socially engaged you are. "The real point of this is that there's something you can do," Katona says. "If we're going to prepare for an ageing population, with a higher proportion of people with dementia, we need to tackle anxiety and depression better whatever age it strikes. And we need to facilitate social networks in middle and late life, before people start becoming more dependent."
For those of us worried about ageing, the lesson is to make sure you don't become socially isolated in mid to late life. And address any problems you have with anxiety or depression - talking to your doctor is a good start.
For those caring for people with dementia, the message is more complex: you can't change someone's history of mental health, and dementia is, by its very nature, an isolating condition. When people no longer behave in a socially acceptable manner, getting out and meeting people - or even having visitors - can be problematic. But local groups, such as those run by the Alzheimer's Society, can provide a continuing opportunity for a social life and for people to talk about their illness by phone or in person.
Professor June Andrews, Director of the esteemed Dementia Services Development Centre at the University of Stirling, says the new research is a welcome recognition that dementia is not the sentence to distress and misery that it's made out to be - and that much can be done now to improve the experience of people affected, without wonder drugs. "What people need, if they're to cope, is not a pill but to get out," she says.
James McKillop, aged 68, from Glasgow, agrees. In fact, a diagnosis of dementia in November 1999 changed his life for the better. For years before that, he'd been depressed. Things kept on going wrong in his personal and work life, and he didn't understand why. In 1995, he'd had to give up his Civil Service job because he was forgetting how to do routine procedures - things that he'd done week-in, week-out for the past 25 years.
"In the end, I couldn't cope. I became a hermit, staring at a blank TV screen all day. I'd become more and more frustrated, unable to make head or tail of what was happening, and I gave my wife and family a really miserable time. But receiving a diagnosis of dementia changed everything because I realised I was at fault and they realised I was ill." McKillop believes that he has a better quality of life now than before the diagnosis. "I have met so many wonderful people who have enriched my life. I wish I had developed dementia many years ago."
And so what is the advice for people with dementia, and their families? It's essential to identify the first signs of the disease early, so family members can discuss how to keep social activities and ties going. Another area to consider is starting a life story book (see box left) - a detailed record of a person's past life which they keep with them, so that even when they're in an environment (like a home) where they're not well known, there are prompts to start conversations and possibly a relationship.
And does Katona have any specific suggestions for activities that might stand people in good stead if they develop dementia? Something, even, that the Government might prescribe in the absence of wonder drugs? "It's all about keeping active socially as well as physically. Something like ballroom dancing seems to be especially beneficial, because as well as giving people a good cardiovascular workout, it provides a social network. So, if you're in your fifties or sixties, I'd recommend people should start that."
3 November, 2008
The faddist hatred of salt has had a worrisome side-effect
Iodine deficiency was long ago thought to be dealt with adequately by putting iodine in table salt. Your salt container probably says "iodized" somewhere on it. There is iodine in sea salt naturally as well. But the report below reveals that iodine deficiency is now showing up. Obviously the totally unwarranted hatred of dietary salt has had the intended effect of reducing consumption of it and the unintended effect of reducing iodine intake
AUSTRALIA'S top food regulator Food Standards Australia New Zealand has ruled that iodine must be added to all bread by September 2009. Food Standards Australia New Zealand is responding to its Australian Total Diet Study, which found that about 43 per cent of Australians have an inadequate iodine intake. It estimates this will drop to no more than 5 per cent after iodine-fortification of bread.
The ATDS is conducted about every two years to ensure the Australian food supply is safe and nutritious. "Insufficient iodine intake, particularly in groups such as pregnant women, babies and young children, is of great concern," Parliamentary Secretary for Health and Ageing Senator Jan McLucas said. "Mild to moderate iodine deficiency can result in children having learning difficulties and can affect the development of motor skills and hearing. "In extreme cases it can result in severe intellectual disability."
Women aged 19 to 49 need between 100 and 200 micrograms of iodine a day but the study found 70 per cent were not getting enough. Ten per cent of children aged two to three years are also not getting enough iodine.
Ninety-six types of food were tested in a "table-ready" state for the trace elements selenium, chromium, molybdenum, nickel and iodine. The survey found that selenium intake also needed further investigation. FSANZ chief scientist Dr Paul Brent said that the agency had taken a new approach to producing a world-leading total diet study focused exclusively on nutrients.
Green space better for kids' waistlines, health?
The brain-dead leaping to desired conclusions never stops. Could it be that people who live in "greener" areas are more economically successful? Greener areas ARE more desirable. And since we know that economically successful people have better health, does not the study below simply confirm that for yet another population?
In an era of rampant obesity that has raised concerns over youth health in particular, researchers have found that for poor children, living in "greener" neighborhoods is linked to slower weight gain. The findings come from a study billed as the first to examine the effect of neighborhood parks and other leafy areas on inner city children's weight over time.
Past studies have offered "snapshots in time" showing effects similar to this one, said Gilbert Liu, senior author of the new research in the December issue of the American Journal of Preventive Medicine. "Our new study of over 3,800 inner city children revealed that living in areas with green space has a long term positive impact on children's weight and thus health," added Liu, of the Indiana University School of Medicine.
The study followed children ages 3 to 18 over two years. Higher neighborhood greenness was associated with slower increases in body mass indexa standard measure of weight excess or deficiencyregardless of age, race, sex or residential density, scientists said. The children in the study were mainly African-American and publicly insured.
The researchers used satellite images to measure greenness, which wasn't simply defined as parks. "Our research team adapted methods, originally developed for agricultur and forestry research, to estimate greenness," said research group member Jeffrey S. Wilson of Indiana UniversityPurdue University Indianapolis. "These measures are affected by all forms of vegetation that are visible to the satellite and take into consideration not only how much vegetation is present, but how healthy that vegetation is." Trees and other urban vegetation improve aesthetics, reduce pollution and keep things cooler, making the outside a more attractive place to play, walk or run, scientists noted.
Childhood obesity is associated with a variety of health problems including type 2 diabetes, asthma, hypertension, sleep apnea and emotional distress. Over the past 30 years, obesity has doubled in children age 2 to 5 and age 12 to 19 years and has tripled in children between 6 and 11 years of age, according to the U.S. Institute of Medicine.
Obese child are likely to be obese as adults increasing risk for cardiovascular disease, high blood pressure, stroke and higher health care costs. "Obesity is a national epidemic," said Liu, a pediatrician. "Our lifestyle makes us sedentary and less healthy. For children, physical activity is active play and that usually take place outdoors. We need to encourage them to go outside and play."
2 November, 2008
Mothers who drink moderately have smarter kids (?)
It's nice to see the official wisdom getting a kick in the pants but this analysis says that the report below is misleading. I noted particularly: "Compared with abstainers they also found that ‘light’ drinkers were more likely to be better educated, from higher income households and were less likely to have smoked during pregnancy". So if there were any real effects they were likely to be socio-economic rather than due to alcohol. I would likely to look more closely at the study but I could not find it online where it is said to be. The full citation of the study appears to be: Kelly Y, Sacker A, Gray R, Kelly J, Wolke D, Quigley MA. "Light drinking in pregnancy, a risk for behavioural problems and cognitive deficits at 3 years of age?"
Women who drink alcohol occasionally during pregnancy do not harm their unborn babies – in fact their children may even benefit, a large study suggests. Research involving more than 12,000 children showed that mothers who drank lightly during pregnancy – defined as one to two units, or a single drink a week – did not increase the risk of having babies with mental impairment or behavioural problems. Rather, children born to light drinkers were found to be less likely to have problems and peformed better in some tests compared with offspring of mothers who did not drink at all.
The findings run counter to government guidance, which advises pregnant women and those trying to conceive to cut out alcohol altogether. The latest study is the most comprehensive examination so far of the effects of light drinking by expectant mothers. However, doctors reiterated warnings last night of the risks of heavy drinking during pregnancy, and expressed concern that women should not be “lulled into a false sense of security”.
Researchers at University College London examined data on the behaviour and mental skills of 12,495 three-year-olds. The data, taken from the UK Millennium Cohort Study, showed that boys born to mothers who drank lightly were 40 per cent less likely to have conduct problems than those whose mothers abstained, and were 30 per cent less likely to be hyperactive. They also had higher scores on tests of vocabulary and whether they could identify colours, shapes, letters and numbers compared with those born to mothers who did not drink.
Girls born to light drinkers were 30 per cent less likely to have emotional symptoms and peer problems compared with those born to abstainers, although these differences could partially be explained by family and social backgrounds, the researchers said. The National Institute for Health and Clinical Excellence (NICE), the medical watchdog, said last year that there was no consistent evidence to show whether a small amount of alcohol damaged unborn children. In guidance issued in March, however, NICE advised that women should not drink when trying to conceive or during the first three months of pregnancy.
The Department of Health, the Royal College of Obstetricians and Gynaecologists and the British Medical Association have emphasised that the safest option was not to drink alcohol at all while pregnant.
Doctors have long suspected an association between foetal abnormality and alcohol consumption during pregnancy. Research showing a link with stillbirths first appeared in 1899. Foetal alcohol syndrome is diagnosed in about 6,000 children a year. The children, born to women who drink excessively, are short, hyperactive and have small eyes and no indentation between their nose and thin upper lip.
Yvonne Kelly, who led the UCL study, published today in the International Journal of Epidemiology, said that “very few studies have considered whether light drinking is a risk”. She said that the research highlighted “an inconsistency in policy around the issue”.
Sir Liam Donaldson, the Chief Medical Officer for England, said that official advice was clear. “If they do choose to drink, to protect the baby they should not drink more than one to two units of alcohol once or twice a week and should not get drunk,” he added. Siobhan Freegard, the co-founder of Netmums.com, a mothering advice forum, said: “While the advice and guidance on alcohol does seem to keep changing, none of it is conclusive. And so most of us seem to feel that the ‘occasional glass doesn’t hurt’ approach works for us.”
Does strenuous excercise cut breast cancer risk in over-60s?
Less than 5% of the sample got cancer so we are looking only at degrees of rarity here and the intergroup difference is not large. In other words, many of those who got cancer DID do strenuous excercise. Coupled with earlier findings that contradict it, I think we have to suspect that this is just a data dredging report. The journal abstract is here. Note that this is another extreme quintile finding. In other words, the researchers had to discard 3/5 of their data to produce their findings! Rather ludicrous, really
Getting stuck into the housework or doing salsa dancing late in life could significantly cut a woman's risk of breast cancer, research shows. Women who regularly carry out strenuous exercise in their 60s are 30 per cent less likely to develop the disease. The finding adds to mounting evidence about the power of exercise to stave off the disease which, as Britain's most common cancer, kills more than 1,000 women a month.
The U.S. government researchers made the link after tracking the health of more than 32,000 women for 11 years. At the start of the study, the women, who had an average age of 61, were asked to list how much gentle and strenuous exercise they did. Gentle exercise included light housework, such as hoovering, washing clothes and mowing the lawn, as well as walking and hiking, bowling, golf and cycling. Examples of vigorous activity included heavy housework such as scrubbing floors, digging the garden and chopping wood. Heavy exercise, such as running, fast jogging, competitive tennis and fast dancing also fitted the bill.
Eleven years later, 1,506 of the women had developed breast cancer, the journal Breast Cancer Research reports. Analysis showed that vigorous, but not gentle, exercise cut the risk of the disease - though only in women who weren't overweight. The researchers, from the National Cancer Institute in Maryland, said this showed that gentle exercise was not enough to keep the disease at bay. They added that the large number of women involved and the length of the study increased the reliability of the results.
However, other studies have found that gentle exercise can be valuable in warding off breast cancer. A six-year study of more than 20,000 European women concluded that hoovering, dusting and other light domestic chores cut the risk of the disease by almost 30 per cent. Those researchers concluded that regular gentle exercise may be better for health than occasional heavy exercise.
Maggie Alexander, of Breakthrough Breast Cancer, said: 'There is still much to be learned about what type of activity you should do and how often in order to lower your breast cancer risk. 'However, we do know that regular exercise can help prevent weight gain and obesity, both of which are known to increase breast cancer risk. [Rubbish. Fat women get LESS breast cancer] 'We encourage all women to lead a healthy lifestyle by maintaining a healthy weight, eating a balanced diet, taking regular exercise and limiting alcohol intake.'
Henry Scowcroft, of Cancer Research UK, said: 'Clearly, we need to do more work to find out exactly how exercise affects breast cancer risk, so that women can make informed decisions about their lifestyle.'
1 November, 2008
HRT increases the chance of needing joint replacement, researchers claim
How delightful! Alternative explanations for an epidemiological finding are explored for once below
Women taking HRT are more likely to need joint surgery, claim researchers. They had a 58 per cent extra risk of requiring a new knee than those who had never used the therapy. And their chances of needing a hip replacement were 38 per cent higher if they were taking hormone replacement therapy, which is used to treat symptoms of the menopause
The findings may surprise users as the therapy is well-known as a preventative for osteoporosis, or thinning of the bones. Researchers at Oxford University admit they are baffled by the findings. They said they may be due to the effect of the oestrogen in HRT on the joints. Other experts challenged the verdict, however, pointing out that separate research on HRT shows it improves the elasticity of joints. They believe the likeliest explanation is that HRT enables women to stay fitter for longer, which results in greater demand for joint replacements compared with more sedentary counterparts.
The latest findings, published today in the journal Annals of the Rheumatic Diseases, come from a survey of 1.3million middle-aged British women. Researchers asked women how old they were when they had their first and last periods, how many children they had given birth to, and whether they had used oral contraceptives and HRT. On average, they were monitored for six years, to see whether they were admitted to hospital for a knee or hip replacement for the joint disease osteoarthritis. During this period, more than 12,000 needed a hip replacement and just under 10,000 a knee replacement.
Mothers with a lot of children and women who went through puberty early also had a higher chance of needing a knee or hip replacement. Starting menstruation at or before the age of 11 boosted the probability of both types of surgery by between 9 per cent and 15 per cent. Every birth also increased the risk of a hip replacement by 2 per cent and that of a knee replacement by 8 per cent. Previous-use of oral contraceptivesdid not affect the risk of joint surgery, even though it supplies extra oestrogen.
Researcher Dr Bette Liu said: 'These findings, along with other evidence, strongly suggest that the female sex hormone oestrogen plays a role in the development of osteoarthritis of the hip and knee and the subsequent need for joint replacement.' However, as women taking HRT are better off and better educated they could be getting joint replacements because they make more use of health services. Dr Liu added: 'There is not enough evidence to recommend women change their use of HRT because they may be worried about developing osteoarthritis or having a joint replacement.'
Dr John Stevenson, chairman of the charity Women's Health Concern, said previous studies using MRI scans found HRT users had more cartilage in knee joints than non-users, which would help prevent osteoarthritis. 'There is no plausible biological reason for this finding when we know oestrogen protects bones,' he said. 'If it's correct then it may demonstrate that women on HRT who tend to be more active may eventually need a replacement as a result of more wear and tear, especially as they tend to live longer than women not taking HRT.'
Genes that make some people homosexual make their brothers and sisters fecund
I don't find the argument below intuitively persuasive but the evidence used is certainly of high quality. I am inclined to think however that a more parsimonious explanation of the findings would be that homosexuals come from parents with a high sex drive and a high sex drive is more likely to "go wrong" than a more moderate one.
THE evidence suggests that homosexual behaviour is partly genetic. Studies of identical twins, for example, show that if one of a pair (regardless of sex) is homosexual, the other has a 50% chance of being so, too. That observation, though, raises a worrying evolutionary question: how could a trait so at odds with reproductive success survive the ruthless imperatives of natural selection?
Various answers have been suggested. However, they all boil down to the idea that the relatives of those who are gay gain some advantage that allows genes predisposing people to homosexual behaviour to be passed on collaterally.
One proposal is that the help provided by maiden aunts and bachelor uncles in caring and providing for the children of their brothers and sisters might suffice. That seems unlikely to be the whole story (the amount of help needed to compensate would be huge), though it might be a contributory factor. The other idea, since there is evidence that male homosexuals, at least, are more likely than average to come from large families, is that the genes for gayness bring reproductive advantage to those who have them but are not actually gay themselves. Originally, the thought was that whichever genes make men gay might make women more fecund, and possibly vice versa.
Brendan Zietsch of the Queensland Institute of Medical Research in Brisbane, Australia, and his colleagues have, however, come up with a twist on this idea. In a paper to be published soon in Evolution and Human Behavior, they suggest the advantage accrues not to relatives of the opposite sex, but to those of the same one. They think that genes which cause men to be more feminine in appearance, outlook and behaviour and those that make women more masculine in those attributes, confer reproductive advantages as long as they do not push the individual possessing them all the way to homosexuality.
The straight truth
Other evidence does indeed show that homosexuals tend to be "gender atypical" in areas beside their choice of sexual partner. Gay men often see themselves as being more feminine than straight men do, and, mutatis mutandis, the same is true for lesbians. To a lesser extent, homosexuals tend to have gender-atypical careers, hobbies and other interests.
Personality tests also show differences, with gay men ranking higher than straight men in standardised tests for agreeableness, expressiveness, conscientiousness, openness to experience and neuroticism. Lesbians tend to be more assertive and less neurotic than straight women.
There are also data which suggest that having a more feminine personality might indeed give a heterosexual male an advantage. Though women prefer traditionally macho men at the time in their menstrual cycles when they are most fertile, at other times they are more attracted to those with feminine traits such as tenderness, considerateness and kindness, as well as those with feminised faces. The explanation usually advanced for this is that macho men will provide the sperm needed to make sexy sons, but the more feminised phenotype makes a better carer and provider-in other words an ideal husband. And, despite all the adultery and cuckoldry that goes on in the world, it is the husband who fathers most of the children.
As far as masculinised women are concerned, less research has been done on the advantages that their appearance and behaviour might bring. What data there are, however, suggest they tend to have more sexual partners than highly feminised women do. That may, Dr Zietsch speculates, reflect increased competitiveness or a willingness to engage in unrestrained sexual relations (ie, to behave in a male-like way) that other women do not share.
Dr Zietsch and his colleagues tested their idea by doing a twin study of their own. They asked 4,904 individual twins, not all of them identical, to fill out anonymous questionnaires about their sexual orientation, their gender self-identification and the number of opposite-sex partners they had had during the course of their lives. (They used this figure as a proxy for reproductive fitness, since modern birth-control techniques mask actual reproductive fitness.)
The rules of attraction
Their first observation was that the number of sexual partners an individual claimed did correlate with that individual's "gender identity". The more feminine a man, the more masculine a woman, the higher the hit rate with the opposite sex-though women of all gender identities reported fewer partners than men did. (This paradox is normal in such studies. It probably reflects either male boasting or female bashfulness, but though it affects totals it does not seem to affect trends.)
When the relationships between twins were included in the statistical analysis (all genes in common for identical twins; a 50% overlap for the non-identical) the team was able to show that both atypical gender identity and its influence on the number of people of the opposite sex an individual claimed to have seduced were under a significant amount of genetic control. More directly, the study showed that heterosexuals with a homosexual twin tend to have more sexual partners than heterosexuals with a heterosexual twin.
According to the final crunching of the numbers, genes explain 27% of an individual's gender identity and 59% of the variation in the number of sexual partners that people have. The team also measured the genetic component of sexual orientation and came up with a figure of 47%-more or less the same, therefore, as that from previous studies. The idea that it is having fecund relatives that sustains homosexuality thus looks quite plausible.