Fat Kids don't Think They are fat!

In a recent survey, researchers discovered that about 75% of obese children felt they were not overweight when asked the question - "Do you consider yourself now to be fat or overweight, too thin, or about the right weight?" 

This kind of self image misconception will make it more difficult to help our children lose weight.

Brain - Blood Connections Stress and Heart Disease

We have known that increased stress can lead to premature death, but there has never been a direct connection. Now in a study using both mice, and ironically, medical residents in ICU rotations, researchers discovered that high stress situations leads to increased levels of inflammatory white blood cells, and actually led to destabilization of ateriosclerotic plaques (or blockages). This made them more susceptible to creating complete blockages and causing heart attacks.

So maybe we should all listen to Bobby McFerrin - "Don't Worry - Be Happy" and live longer!

High Fat - Low Calorie Diets Prevent Gallstones!

When people go on a severe low calorie diet, including Nutrisystem and Jenny Craig, there is a tendency to form gallstones. There are many theories, including excess excretion of cholesterol, decreased bileproduction, etc; but it is a well known fact.

Researchers examined a high fat low calorie diet (such as is found in Atkins diet) and discovered that these patients actually had less gallstones than control dieters. This can be a consideration in a weight loss diet; but should not be a lifestyle change since, in the long run, it will lead to more issues such as heart disease and cancer.

The best way to lose weight is a sensible diet (not extreme low calorie) and exercise

Caffeine Powder - Potentially Fatal

Caffeine Powder - A Dangerous Additive

Recently some vitamin shops have begun to market pure caffeine powder as a supplement to perk you up. 

However, unlike coffee or Red Bull, it is much easier to take potentially fatal overdoses. You can buy one pound bags; one teaspoon contains as much caffeine as 25 cups of coffee. There has already been one death of a teenager form powdered caffeine.

There is no reason for this product to be on the market.

Your Diet Red Meat - Breast Cancer; Organic Foods are better!

In a recent study reviewing many thousand nurses over twenty years, it was found that there was a significantly increased risk of breast cancer in women who had 1 serving of red meat daily versus one serving a week. They also found that eating chicken after menopause was associated with a lower risk!

In other review, organic food was found to have to have significantly higher levels of anti-oxidants than non-organic. Antioxidants are associated with lower risks of cancer and heart disease. As well non-organic foods had higher levels of pesticides and toxic metals such as cadmium.

Although this does not prove that organic foods are healthier, I prefer that my family eat organic. Furthermore, limiting red meat and eating more fish and chicken seems the way to go.

Eat better to live well.

Please check out the recent NYT article

http://www.nytimes.com/2014/07/12/science/earth/study-of-organic-crops-finds-fewer-pesticides-and-more-antioxidants-.html?_r=2

Are Digital Screens the new Babysitters?

Recently the American Pediatric Association recommended that parents restrict children's "screen" time to two hours a day (not including school). This includes TV, computers, tablets, etc. This is based on rates of obesity and physical health. Unfortunately, in a recent study only 27% of kids have accomplished this. We need to do better.

In a related story, there is a report of an allergic reaction to the nickel in an ipad. The child continued to break out until an appropriate case was placed on it. Maybe we should add more irritating chemicals to children's tablets!

Stronger is Younger!

It makes sense that increased muscle mass in older individuals is associated with better health - seniors will be less likely to fall and injure themselves.

In a recent study this was confirmed by looking at muscle mass in seniors and following them for over 13 years. Those with the highest muscle mass had a significantly lower death rate.

So continue to exercise and lift weights. You will live longer and feel better!

Sunshine on my Shoulders...

Did John Denver know something when he wrote this song? It does seem that many people are addicted to tanning; in spite iof the increased risks of skin cancer.

Researchers discovered that, in mice at least, sun exposure can cause increase in endorphins, which are our body's morphine like substances. As well, there was an increased pain threshold and more addictive behavior in general. They also discovered that mice who had been made addicted to substances preferred increased sun exposure.

Another reason to avoid sun exposure and excess tanning aside from cancer!

New 3-D Mammograms

There has been some controversy about screening mammograms, and many are saying they should not even be done. However this is based on studies using older techniques, and relies heavily on cost-benefit analysis; not something you want to tell someone with cancer!

There are advances in mammography, the most recent being 3-D mammograms or tomosynthesis. This uses thin slices (like a CAT scan) and a computer to create a 3-D image for the radiologist to review.

Preliminary reports show that this seems to have less false positives (or unnecessary biopsies), and is slightly more accurate. If this is the case in larger studies I predict it will replace current mammography.

Vaccine Prices - Profit at expense of Health?

Vaccines are extremely important to prevent death and disease among children. In a recent very large review, researchers found that vaccines have few if any serious side effects, and their benefits far outweigh their risks.

However costs to physicians have increased dramatically. With reimbursement from insurance companies slow and often difficult this has led many physicians to stop stocking vaccines. I recall many years ago when I was dispensing flu vaccine that the cost of the vaccination increased to almost $20 (my cost). At that time Medicare was only paying us $12, so we stopped carrying it. At the same time Walgreens and other pharmacies starting providing it (coincidence??). In the next year reimbursements came back up (to $24), but many physicians had stopped.

Is this a trend? Again, the lack of any regulation of pharmaceutical companies has many consequences. See the NYT article below.

http://www.nytimes.com/2014/07/03/health/Vaccine-Costs-Soaring-Paying-Till-It-Hurts.html?_r=2

Fat Kids Die Young!

As America gets more obese, in spite of more health awareness, more research has been done concerning long term effects.

It has been previously shown that obesity in adolescence results in with an increased risk for death in the middle-aged and elderly. But what about younger ages?

In a recent study in Israel, where men and women had been conscripted into the army as adolescents, researchers compared medical death rates (not counting injury or accidents) based on weight. They found a linear correlation between weight and premature death; the highest weight group having twice the death rate before age 50.

This will most likely apply to American youth and is a serious concern.

Changing Your Genes - A new Future?

Scientists have developed methods to modify individual genes through specific enzymes. In monkeys they have been able to disrupt a potentially harmful gene in an embryo so the result is an unaffected baby. As well, in preliminary experiments they have managed to modify a defective or mutant gene.

This is very early in the modification of genes, but the concerns are of designer genes and modifications once this technique gets perfected. On the other hand it could become a boon to parents with genetic defects concerned about passing them on to their children.

Pour on the EVOO - Extra Virgin Olive Oil!

There have been many studies showing the benefit of the Mediterranean diet on preventing heart disease. Now a new report shows that supplementing this diet with EVOO results in a 40% decrease in the incidence of an irregular heart beat called Atrial Fibrillation (AF). AF can lead to strokes, and causes a 30% decrease in your heart's capacity.

So pour it on!

Are PAP smears still recommended? If you answered no read on:

There has been a lot of publicity today about the new recommendation of the American College of Physicians that pelvic exams are probably unnecessary in healthy females.

Does that mean you don't need to get a PAP smear?

NO! The study actually stated that the INTERNAL EXAM was probably unnecessary; BUT THE PAP SMEAR YEARLY WAS IMPORTANT TO PREVENT CERVICAL CANCER!

Most people I spoke to did not separate these two procedures. Sexually active females should get examined yearly for cervical cancer, and generally for sexually transmitted diseases. There is a lot of controversy generated about internal bimanual exams, but NOT the PAP smear!

The New Heroin Addict

Twenty or more years ago, heroin addicts were typically living on the streets and involved in crime and prostitution. After the death of actor Philip Seymour Hoffman it has become clear that this drug has migrated to the more affluent.

However the introduction of Oxycontin and other similar narcotics has led to a dramatic increase in addiction to pain medications. Unfortunately this has become a lucrative source of revenue for many unscrupulous physicians, resulting in more addictions.

With the street cost of oxycontin going as high as $70, many addicts are migrating to the even more dangerous heroin; where the equivalent high can cost $10.

In a recent study researchers looked at almost 3,000 heroin addicts and compared their demographics with previous statistics from the 60's and 70's.

Of the participants who began using heroin in the 1960s, most were men (<80%) who began heroin use at around age 16; about half were white. Starting in 2010, narcotic use typically began with a prescription opioid at age 23; about half of these addicted individuals were women, and 90% were white. Most of these began with narcotic pain pills and switched for practical reasons.

We need to police the pain clinics better. The recent approval by the FDA of another pain medication containing hydrocodone which can easily be injected was, in my opinion, unnecessary and a step in the wrong direction.

Dangers to Our Children in Breakfast Cereals and Acne Products

I have frequently mentioned the abuse of vitamins and supplements, but now a new study looking at breakfast cereals puts it into even better perspective.

According to a report from the Environmental Working Group children who eat fortified cereals and snack bars are at risk for consuming potentially dangerous levels of niacin, vitamin A, and zinc.

They found many children's cereals fortified with 30-50% more than the adult recommended daily requirements of these vitamins! Such products include General Mills Total Raisin Bran, Kellogg's Cocoa Krispies, and Balance Bars.

Among potential side effects are skin reactions, immune suppression and liver damage. Please read their report:

http://static.ewg.org/reports/2014/children_at_risk/pdf/too_much_of_a_good_thing.pdf

In a second study, researchers found that over the counter ACNE products were associated with frequent adverse effects.

The FDA is warning that "rare but serious and potentially life-threatening" allergic reactions may occur with some over-the-counter topical acne products containing benzoyl peroxide or salicylic acid. Symptoms — including dyspnea and swelling of the eyes, face, lips, or tongue — may appear within minutes to longer than a day after application.

The products in question include those marketed as Proactiv, Neutrogena, MaxClarity, Oxy, Ambi, Aveeno, Clean & Clear, and store brands.

Although rare, you and your adolescent children should be aware of these potential reactions. 

Is Marijuana Safe? Maybe

It seems that Marijuana (weed, pot, etc) is becoming more and more accepted and legal. It is also becoming much more potent (through selective botany) than the weed of my (and Bill Clinton's) generation - estimated to have 3-4 times the concentration of THC, the active ingredient.

Although is is a relatively safe drug (and probably less toxic than alcohol) it is still a drug, and we should be aware of the side effects and dangers.

1. Addiction. Although the risk is low, it is real, and about 9% of regular users become addicted to it.

2. Memory, Co-ordination and Judgement. Like alcohol and other drugs, using pot will result in impaired driving with increased risk of accidents, poor judgement and memory lapses. When someone is "high" they should be treated as if they were drunk when it comes to responsible action.

3. Neurological Changes. Heavy use in adolescents has been shown to adversely and permanently affect brain development. Use should be strongly discouraged in teens.

4. Gateway to More Potent Drugs. Like Alcohol and Pills, marijuana creates a pleasant experience which often leads to use of more potent drugs. It is not worse than any other drug or alcohol.

5. Psychosis. High dose Marijuana can lead to acute psychotic or paranoid reactions.

6. Cancer. Smoking marijuana is less toxic than tobacco, but chronic use may lead to increase risk of cancer. It definitely is associated, in heavy use, with chronic bronchitis.

As usual, using common sense can make this drug safe to use. Since that usually develops well after adolescence, and combined with permanent neurological changes its use must be avoided in teens. Use in adults appropriately (similar to alcohol recommendations) is probably safe.

Causes of Autism

Autism, or Autistic Spectrum Disorder seems to be on the increase. There is some controversy as to whether this is due to better diagnosis or a real increase.

There have been many studies that point to ASD being a combined genetic and environmental disorder that shows its sign even before a baby is born. Now people are looking at exposures to see what could be leading to the disease.

Researchers studied 970 children (aged 2 to 5 years) in California with autism spectrum disorders, developmental delay, or typical development. Data on the use of commercial pesticides (in places such as farms, golf courses, parks) were linked to the mothers' addresses during pregnancy.

Compared to controls, children with autism were 60% more likely to have been exposed to organophosphate insecticides. Furthermore, children with developmental delay were almost 150% more likely to have had carbamate pesticides (most industrial but some, like Sevin, available to homeowners) applied near their homes.

 Looking at stored samples of amniotic fluid of autistic children Danish researchers found significantly higher levels of several hormones. Possible reasons for this include exposure to environmental endocrine disrupters, which are highly prevalent in food, cosmetics, and other materials. For example, phthalates, known endocrine disrupters, are associated with ASD, and are found in hundreds of plastic products (http://toxtown.nlm.nih.gov/text_version/chemicals.php?id=24). Also see http://www.niehs.nih.gov/health/topics/agents/endocrine/.