Sips of alcohol in Children has adverse effects!

Most people think it is harmless to allow your underage children to have a sip of alcohol.

But is a recent study, researchers found that, even after correcting for parental drinking habits, these children (average age 7.5)had, by 6th grade, over 5 times the risk of having a full drink or getting drunk, and almost three times the risk of trying a cigarette or marijuana. Drinking sips for religious purposes was excluded.

It seems we should be keeping alcohol out of the hands of our kids!

Do antibiotics cause obesity?

The trend lately has been not to treat children with antibiotics unless absolutely necessary. Although this seems obvious, in the past pediatricians and family doctors often prescribed medication at the first sign of a fever or ear infection. Now we wait and find a majority of kids do get better without antibiotics.

One of the reasons has been to prevent resistance. Recently there has been much research on the microbiotome or bacteria that naturally grow in our intestines. These may contribute to obesity as well as some auto-immune diseases when disturbed.

In a study of 12,000 children in Finland, where all medical records are available for these types of research, use of antibiotics was significantly related to obesity after the age of two. The worst antibiotic was macrolides (erythromycin and zithromax), and the association was higher if the child was given antibiotics before 6 months of age.

So listen to your doctor, and don't use antibiotics unless absolutely necessary!

Does Vitamin D help the skin?

Maybe. We know a form of Vitamin D cream is useful in psoriasis, and researchers were wondering if Vitamin D supplement would help psoriasis and atopic dermatitis (like eczema).

Using a group of children with eczema, they first looked at Vitamin D levels, which were "normal" in only about 15%. I say normal in quotes because when they looked at control children they also were "normal" in only 15%; this makes one question the concept of what is normal.

However, supplement of 1000 units of Vitamin D significantly decreased the eczema as compared to placebo; it also had some effect on psoriasis.

The dose for adults would be 2000U.

This study is very preliminary, but since there are virtually no side effects to 2000 units a day in adults it may be worth a try if you suffer from these skin disorders.

Too Much Testing in Medicine

I have mentioned on may occasions that many doctors tend to order unnecessary tests or drugs - such as for osteoperosis or even cholesterol.

In our medical system there is a financial incentive for physicians to order more tests or procedures. You might ask "what could it hurt to do more tests?"  Well actually it can be quite dangerous.

I met a 79 year old man the other day here in Las Vegas who had just found an new doctor. He said the physician must be good since he ordered a carotid ultrasound - a test to look at the arteries in the neck. Well this man had never had a stroke. What if the test had found a blockage? Current studies it is much more dangerous to fix a blocked artery in the neck in someone like him than to just be sure his cholesterol is well controlled. The risk of a stroke from surgery is about ten times the normal risk!

So what was the test done? No doubt there was a financial consideration for the doctor.

Other (expensive) tests that are overused because the results should not change your management and can only lead to more complications include:

 Osteoperosis (DEXA) scans in younger women or healthy men
Total body CAT scans
Heart Calcium scores

Now, a recent study points out the excess colonoscopies being done. Current guidelines for repeat testing are very scientifically sound and offer the best chance for cancer prevention, especially considering the risk of the procedure (about 1 in 3000 perforations needing surgery, and 1 in 10,000 deaths). Yet in a review of over a 1000 patients followed for 10 years, about 40% were rechecked early. Extrapolating to the general population means there are many unnecessary surgeries or deaths.

Don't be afraid to ask you doctor about scientific evidence, and, in this case, go to the CDC website and do your own research!

Evolution is working!

Sometimes a report shows up that makes me smile and seems evidence that there is some intelligence in evolution.

In a recent study on sperm counts in men, researchers found that, in 18-22 year olds, active men had counts that were 75% higher than sedentary ones. Even better, they found that watching TV could result in an additional 45% drop. Maybe there is some hope after all!

In a related report, it was found that men who ate food with higher levels of pesticides had 50% lower sperm counts. These were foods readily available and compared with organic low chemical foods.

So it seems that those men who watch TV, don't exercise, and don't watch what they eat may, hopefully, be headed towards extinction!

Tylenol - Not Effective?

Tylenol is usually recommended as a first line treatment for back or joint pain, but authors of a recent study noticed that there have been no studies comparing it with placebo.

That said they looked at over 3000 patients with knee and back pain. Although there was a minimal trend for pain relief this was not statistically significant. And there were more cases of liver problems in the tylenol group (tylenol is high doses is toxic to the liver).

That's all well and good in younger patients who can try aleve or advil; but as we age drugs like these can cause kidney damage and are second line. And I would not use a narcotic first line.

So continue exercise and stretching, and I would still use tylenol, or perhaps low dose aleve for back pain. But this certainly is thought provoking!

Shingle Vaccine - Booster Needed?

Shingles is a very painful reactivation of dormant chicken pox virus that can affect 10% or more of the population. If not immediately treated it can lead to chronic severe pain in up to half affected individuals. It is VERY often missed by physicians early on!

Since most of us have had chicken pox we are all at risk. we do not know if the vaccine that is currently given children will prevent this.

Being more common and severe in older people (as one of those I avoid the word elderly now!) the CDC (and I) recommend getting the shingles vaccine which lowers (but does not entirely remove) the risk.

Now a new study asks how long does this effect last? Unfortunately by 10 years the vaccine had lost most of its efficacy; and the incidence of shingles in vaccinated individuals was about the same as non-vaccinated.

I often get asked if having shingles once means that the vaccine is not needed. The disease itself does result in better antibody levels that the vaccine, but these also will likely wane after 7-10 years. So my advice would be yes, get the vaccine, but in about 5-7 years after the outbreak.

Expect a recommendation for a booster in about 7 years if these findings are confirmed. The drug company will be very happy!

Air Pollution and Stroke

Air pollution has been linked to permanent decreased lung function in children as well as cancer and general poor health.

Now a new analysis shows that there is a direct link with strokes. This is a linear relationship, with increasing pollution closely related to increased risk of stroke.

Air pollution has been previously linked with an increased risk for heart attacks. Potential mechanisms include effects on the arteries, lower levels of oxygen in the blood, and increased risk for blood clots.

Given the substantial burden of stroke, especially in low- and middle-income countries, public health officials should maximize efforts to improve air quality to potentially reduce the global burden of stroke.

FDA ignores amphetamine like additive

In a recent expose by the New York Times, it was revealed that certain supplements, advertised for energy and weight loss contained a synthetic amphetamine stimulant.

This product  can lead to heart attacks and high blood pressure, and has addiction potential.

Researchers purchased 21 brands of Acacia rigidula supplements online from January through April 2014 and found over 50% contained this substance, which should be closely controlled.

And the FDA - they knew about this 2 years ago, but failed to do anything about it. Read the article. Can we really trust the FDA or is it being controlled by businesses now?

New York Times Article

Which Diet is Best?

In a study sure to get publicity (especially from Jenny Craig) researchers compared the long term success of several diet plan.

They compared the results of 11 programs: Weight Watchers, Jenny Craig, Nutrisystem, Health Management Resources (HMR), Medifast, OPTIFAST, Atkins, The Biggest Loser Club, eDiets, Lose It!, and SlimFast. These programs were compared with controls, which generally provided traditional counseling and education.

Although all diets resulted in short term loss, only Jenny Craig and Weight Watchers maintained some of the weight loss after a year. They were able to show only modest weight loss compared with controls: 4.9% greater weight loss with Jenny Craig, 2.6% greater with Weight Watchers.

They only way to maintain weight loss is through a lifestyle change. A diet is just that - a temporary aid that will not help without a permanent commitment! Weight Watchers recommends a change in your eating habits. That is what is needed!

In the wind - Germs and Antibiotics!

Antibiotics have been used in agriculture as a way to make livestock larger and healthier; even though modern science has shown that simply providing a cleaner environment achieves the same thing.

Although the trends are towards hormone and antibiotic free meats, their use is still widespread.

Now, some researchers have sampled air downwind from large-scale beef cattle feed yards. They not only found detectable levels of antibiotics, but also bacteria with medicine resistant genes!

With all the evidence pointing towards the lack of necessity of these methods it is sad that we cannot stop this practice. As consumers we need to only purchase antibiotic free meats and force the issue in that way!

Boiling Bubbles in the Brain for Alzheimers

Using the theory that the border between the blood circulation and the brain (called the blood brain barrier) may prevent removal of toxic amyloid proteins which may cause Alzheimer's, researchers have tried an innovative technique.

In mice bred to develop this, the injected micro-bubbles then use ultrasound to heat them up and "loosen" this barrier.

They found that treated mice had decreased levels of amyloid and improved memory.

Although still a long way from human trials, I found this fascinating and wonder

how they ever even thought of it!

TV watching can cause diabetes!

Diabetes is associated with obesity which is epidemic in our society. Sedentary activities, such as TV watching also leads to weight gain.

In a study of over 3000 adults, researchers discovered that the more TV watched was significantly associated with a higher risk of diabetes (and weight gain). In addition, using counseling and lifestyle intervention they were able to decrease this risk as well as the amount of TV watched. This effect on weight and diabetes was even better than adding a medication (metformin) which is currently the first line treatment.

So get away from that poison screen and get out and exercise! You will live longer, and enjoy life more!

Sleep - why and how important it is - non-drug treatments for insomnia

Researchers are getting closer to establishing why we need to sleep and its overall importance in health.

Getting proper sleep is associated with improved learning and memory. Researchers have found that during sleep the brain is able to remove waste products much more efficiently than while awake; this may be a vital purpose.

In addition these products can cause inflammation, the excess of which is associated with Alzheimer's disease and heart attacks. In a recent study looking a aiding sleep without drugs, it was found that use of the relaxation and sleep techniques was associated with significant decreases in inflammation and improvement in health.

They used Cognitive Behavior Therapy (which has become very useful in many psychological disturbances) and Tai Chi Chih.

They recommended that older — and probably all — patients with insomnia should be offered one of these evidence-based treatments and should probably be monitored for depression and medical consequences of inflammation.

So if you can't sleep maybe its time you looked into these methods!