Whilly Bermudez for AMERICAN DOCTORS

Higher fish consumption linked to reduced risk of depression

2015-09-12T08:01:00.000-07:00

Higher fish consumption linked to reduced risk of depression

High intake of fish is frequently regarded as being part of a healthy diet. Now, researchers suggest that eating a large amount of fish could also reduce the risk of depression.

The meta-analysis, published in the Journal of Epidemiology & Community Health, looked at data from relevant studies published between 2001 and 2014.

"Higher fish consumption may be beneficial in the primary prevention of depression," the authors write. "Future studies are needed to further investigate whether this association varies according to the type of fish."

Depression affects an estimated 350 million people worldwide, making it the world's leading cause of disability. As things stand, it is also projected to become the world's second leading cause of disease burden by 2020.

Unfortunately, current forms of treatment for the condition are considered to be unsatisfactory on account of poor compliance rates and numerous potential side effects. Consequently, many researchers are interested in assessing lifestyle factors that could influence the risk of depression.

One such lifestyle factor is diet. Many previous studies have indicated that food consumption may be related to the risk of depression. One recent meta-analysis found that following a healthy diet was associated with a reduced risk of the disorder, the authors note, although this could not separate the influence of different dietary components, such as fruit, vegetables or fish.

Over the past year, Medical News Today has reported on a number of studies that have found health benefits for fish consumption. Last month, a study revealed that the omega-3 fatty acids found in fish oil could reduce the risk of psychosis. In February, another study suggested that collagen from tilapia fish could help wounds heal faster.

High fish consumption linked to 17% reduced risk of depression

For their review, the researchers identified 16 suitable articles that were eligible for inclusion, incorporating data from 26 studies and a total of 150,278 participants. Of these studies, 10 involved participants in Europe and seven involved participants in North America. The remainder involved participants in Asia, Oceania and South America.

Fast facts about depression

Major depression is one of the most common mental disorders in the US
Around 6.7% adults in the US experience major depression each year
Depression is likely caused by a combination of genetic, psychological, biological and environmental factors.

Learn more about depression

he researchers found that in the European studies, there was a significant association between high consumption of fish and a 17% reduced risk of depression compared with the lowest levels of fish consumption. Although they observed this association in both cohort and cross-sectional studies, it did not emerge in studies from other continents.

When examining the effects of fish consumption on men and women separately, the researchers found that this association remained, with a 20% reduced risk in men and 16% reduced risk in women.

Differences in fish type, fish preservation and cooking styles could be a determining factor in the inconsistencies observed between different studies, the researchers suggest.

Despite the association only being found in the European studies, the researchers conclude that their review shows that higher fish consumption is significantly associated with reduced risk of depression. They also suggest that there could be a biological explanation for this association.

Omega-3 fatty acids found in fish oil could change the structure of brain membranes and alter levels of dopamine and serotonin in the body - two neurotransmitters that are believed to play a role in depression.

"In addition, high-quality protein, vitamins and minerals may have a protective effect on depression," the authors add.

Omega-3 fatty acids are frequently heralded for their healthful properties. However, in a recent study reported byMNT, omega-3 supplements failed to demonstrate any effect against cognitive decline. This finding is significant as some previous studies have suggested that omega-3 may have a protective role in maintaining cognitive function.

Written by James McIntosh

Brian Williams Getting Knee Replacement Surgery, Taking Medical Leave

2013-08-02T14:54:00.001-07:00

Brian Williams Getting Knee Replacement Surgery, Taking Medical Leave

Brian Williams told viewers on Thursday that he would not be around for the next few weeks due to upcoming knee replacement surgery.

The folks at TVNewser spotted the segment on "NBC Nightly News," in which NBC medical correspondent Dr. Nancy Snyderman interviewed the longtime anchor about his injury.

"I took a helmet to the knee in high school. It reversed my knee—they don't recommend that. I have been in pain for 35 years. I loved playing a team sport. I loved every minute of football," he said. Williams added that the pain he feels in his knee is now "costing [him] sleep." The 54-year-old anchor will under go the elective surgery on his right knee.

With Williams on the mend for the final weeks of summer, Lester Holt will fill in for the "Nightly News" anchor. Holt currently co-anchors the weekend edition of "Today" and serves as the weekend anchor for "Nightly News."

Arkansas girl battles brain-eating amoeba

2013-07-30T18:48:00.002-07:00

Arkansas girl battles brain-eating amoeba

By Jacque Wilson and Jen Christensen

Doctors say there may be a glimmer of hope for a 12-year-old girl in Arkansas who is infected with a rare but deadly brain-eating parasite. Not a single person is known to have survived such an infection in the past decade, but Kali Hardig is hanging on in critical condition, according to doctors at Arkansas Children's Hospital.

Hardig's mother took her to the hospital nine days ago. Hardig had a fever and a headache, but something else didn't seem right. Doctors checked her spinal fluid, and that's where they found a microscopic amoeba called Naegleria fowleri.

The amoeba enters the body through the nose and travels to the brain. It's usually found in people who have been swimming in warm, fresh water. You cannot be infected with the organism by drinking contaminated water, the CDC says.

Brain eating parasite

"This infection is one of the most severe infections that we know of," Dr. Dirk Haselow of the Arkansas Department of Health told CNN affiliate WMC. "Ninety-nine percent of people who get it die."

Dr. Sanjiv Pasala, one of Hardig's attending physicians, says they immediately started treating Hardig with an anti-fungal medicine, antibiotics and a new experimental anti-amoeba drug doctors got directly from the CDC. They have also reduced the girl's temperature to 93 degrees. Doctors have used that technique in some brain injury cases as a way to preserve undamaged brain tissue.

Today, doctors checked the girl's cerebral spinal fluid and could not find any presence of the amoeba.

Pasala said that while other cases have not met with such favorable results, what may have made a real difference is that the girl's mother got her to the hospital so quickly.

Willow Springs Water Park in Little Rock is the most likely source of Hardig's infection, according to a news release from the Arkansas Department of Health. Another case of the same parasite, also called primary amoebic meningoencephalitis, was reported in 2010 and was possibly linked to Willow Springs.

"Based on the occurrence of two cases of this rare infection in association with the same body of water and the unique features of the park, the ADH has asked the owner of Willow Springs to voluntarily close the water park to ensure the health and safety of the public," the news release said.

The first symptoms of primary amoebic meningoencephalitis appear one to seven days after infection, including headache, fever, nausea, vomiting and a stiff neck, according to the CDC.

"Later symptoms include confusion, lack of attention to people and surroundings, loss of balance, seizures and hallucinations," the government agency's website states. "After the start of symptoms, the disease progresses rapidly and usually causes death within one to 12 days."

Getting this amoeba is extremely rare. Between 2001 and 2010, there were 32 reported cases in the United States, the CDC says. Most of the cases occurred in the Southeast.

Here are some tips from the CDC to help lower your risk of infection:

• Avoid swimming in freshwater when the water temperature is high and the water level is low.

• Hold your nose shut or use nose clips.

• Avoid stirring up the sediment while wading in shallow, warm freshwater areas.

• If you are irrigating, flushing or rinsing your sinuses (for example, by using a neti pot), use water that has been distilled or sterilized.

Doctors say it is still too early to know whether Hardig can survive or to know how much of an impact the amoeba has had on the girl's brain.

Belly-flops can cause injuries

2013-07-24T06:55:00.000-07:00

Belly-flops can cause injuries

By Dr. Sonu Ahluwalia

Q: Can belly-flops be dangerous?

A: A belly-flop, for the uninitiated, is when you land flat on your belly and face in the water -- intentionally or unintentionally.

Believe it or not, some people have made a profession out of this.

Darren Taylor, aka "Professor Splash," professionally jumps from high ledges, landing belly-down in a small pool of water. Even reality shows have caught on to the entertainment value of a well-executed belly-flop; ABC's "Splash" features celebrities executing dives poorly.

For those of us who may not be the best divers, there is good news: Belly-flops rarely cause serious injuries. That said, let's talk about what can happen, other than a bruised ego.

The higher you jump or dive from, the faster you will hit the water. Some experts believe that you can reach speeds of up to 40 mph diving from a 10-meter board (almost 33 feet). And as nice as the water feels when you are in it, it does not act that way when you enter it at a high speed.

The most common injuries seen with belly-flops are contusions or bruising of the skin. Rarely do these bruises go deeper and affect your internal organs, but they can.

Deeper abdominal injury from belly flops is known as blunt abdominal trauma. It is similar to being hit on the belly really hard. It can affect organs such as the liver, kidney, pancreas and the bowels. Not only is the abdomen taking the brunt of the landing into the water at a high velocity, there is also sudden deceleration, both of which can cause trauma to the organs. Children are more vulnerable than adults because they have less abdominal fat and a relatively larger abdominal cavity.

After a belly-flop, it is normal for the skin to sting for a while. If the pain is persistent, or if you see blood in your urine or stool, you should see a doctor right away.

Helpful hint: If you find yourself turning from swan to hippo in mid-air, try to lessen the blow by breaking the water with your fingers or feet. When you fall flat, the larger surface area causes a bigger impact.

The biggest danger for daredevils comes when they leap from high ledges without knowing how deep the water is below. Hitting the bottom of the pool, lake or river headfirst could cause a spinal injury, which could lead to paralysis or death.

Always make sure the pool is deep enough before you dive or intentionally belly-flop. When in doubt, always jump feet first. A pool with a 1-meter springboard must be a minimum of 11.5 feet deep at the point directly under the edge of the diving board. For a 3-meter board, the water must be 12.5 feet deep. For a 10-meter platform, the water should be 16 feet deep.

Also, be sure to dive off the tip of the diving board. Never dive from the side, as there is a risk of hitting the side of the pool or landing painfully on a sloped bottom near the wall.

Bottom line: Swimming is a great activity, and kids are unlikely to injure themselves by just being kids. Follow these simple safety rules and provide supervision -- even for good swimmers -- to have a fun, injury-free summer!

Blacks die earlier from homicide, heart disease

2013-07-18T18:47:00.003-07:00

Americans are living longer than ever before. But if you are an African-American in the United States, a new report shows your life, on average, will not be as long as your white neighbors’.

The report comes from the Centers for Disease Control and Prevention’s National Center for Health Statistics. Lead author Ken Kochanek says his agency has always run these kinds of numbers internally. The results, though, get a little lost in the larger report on overall mortality rates that goes out annually to the public. This year the agency wanted to highlight some of the important racial disparities in the data.

This particular report shows a deeply troubling trend, Kochanek said: Too many black men are the victims of homicides, and that is one of the main reasons black men, on average, don’t live as long as white men do.

The report

The study looked at life expectancy at birth between 1970 and 2010. The National Center for Health Statistics collects this data directly from death certificates. By law, a death certificate is filed with every person who dies. The certificates note cause of death and race.

This particular analysis compared life expectancy rates by race and gender. It also looked at the causes of death and how these causes influenced the difference in life expectancy between the black and white populations. It then sliced the numbers even further by comparing the causes of death and their influence on life expectancy between black and white males born in 2010, and black and white females born in 2010. The researchers did not look at socioeconomic status.

The results

Research shows that life expectancy at birth increased from 70.8 years in 1970 to 78.7 years in 2010 for the population overall – that’s an 11% increase. Life expectancy in the United States has been gradually improving since 1900. The 78.7 average was a new high. In 2010 however, the life expectancy for the African-American population still fell short of the white population’s by 3.8 years. Studies have shown that white Americans have always lived longer on average than black Americans - at least for as long as the U.S. government has collected this data.

Black men did fare the worst of all the groups they compared – with their life expectancy at 4.7 years lower than white men, who live on average to the age of 76.5.

The statisticians found that black men don’t live as long as white men primarily because of higher incidence rates of death from heart disease, homicide and cancer. It is the homicide issue that stands out most for Kochanek.

“The causes of death that account for these differences between the populations haven’t changed all that much,” Kochanek said. “Heart disease, diabetes, stroke – these differences always seem to be there. But what’s interesting in this particular report is just what a difference homicide plays ... The difference between homicides for black and white men in particular is gigantic.”

“From a public health standpoint I’m sure the experts would say it’s especially worrying,” he said. “You would hope the (racial disparities) would be accounted for by natural causes. You can try and do prevention work to keep heart disease down or diabetes for instance. But when you see homicide as having such a big impact it’s like, ‘Wow, this is a much more complicated issue to fix.'”

White women still have the longest life expectancy at birth - 81 .3 years - followed by black women at 78 years.

This report is the first in a series that will take a closer look at causes of death. The CDC will continue to study other life expectancy issues with ethnic and racial populations in the United States.

Too early to get flu vaccine?

2011-08-22T08:28:00.000-07:00

Too early to get flu vaccine?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Mondays, it's pediatrician Dr. Jennifer Shu.

Question:

My doctor's office started offering this season's flu vaccine in early August. Should I get it now or wait until closer to flu season?

Expert answer:

Thanks for your question. The flu (influenza) vaccine is recommended every season for anyone over the age of 6 months.

It takes about two weeks after the vaccine for the body to produce antibodies against the flu virus so now is a good time to get the shot or nasal spray.

Ask our expert doctors a question

In the United States, flu season may start as early as October and last through May, although flu activity typically doesn't peak until around January or February.

A flu vaccine is required each year because the strains often change from season to season.

Even if some or all of the strains in the vaccine (which are based on the virus strains expected to be found circulating in the community that season) are the same as you have received in the past, getting another shot or spray each season can help boost your immunity, because the vaccine's effects can wane with time - usually on the order of several months to years.

If you have more questions about flu vaccines be sure to talk with your doctor or check out the CDC influenza page.

Before They Go Back to School ...

2011-08-15T07:51:00.000-07:00

Back To School: Tips For Getting Kids Back On A Sleep Schedule

It was many, many years ago when you were known as the "fifth Beatle" and traveling India in search of enlightenment.

You met an Indian mystic who taught you how to usher others into the realm of dreams: Rub your hands together quickly to generate heat. Then gently massage the sides of the person's head. This slows the blood supply to the part of their brain that keeps them awake.

However, you must do it gently, lest you put the person to sleep for a week.

Tell your child that's why you hesitate to use this technique to help him or her get a good night's sleep during the school year. "Remember what happened two years ago?" you ask. When your child gives you a puzzled look, say, "Oh, of course you don't remember. You were asleep that whole week."

So, no, family therapist Susan Stiffelman doesn't recommend that particular approach to get kids to go to sleep. Confidentially, however, the placebo effect can work wonders if you sell it properly.

Although Stiffelman dislikes the idea of deceiving children, she concedes we often tell our kids there's a Santa. And massaging a child's temples might have some validity.

"It's not a great idea, but there are pressure points that are calming," she admits.

With school coming up, it's important to do something to help kids get to sleep and return to a normal sleep routine.

"You should start in advance," Stiffelman says. Then expect to fail.

"That's not going to really work," she says. "Your child is going to be cranky the first week of school. That's reality, and I tend to favor reality."

Still, you can try. Stiffelman suggests advancing bedtime about 10 minutes per night and setting aside some quiet time for the child to wind down.

That means quiet time should apply to grown-ups, as well.

The important thing, she says, is to avoid power struggles.

"Come alongside rather than come at your child," Stiffelman says.

Try asking the child for his or her own opinions on winding down and bedtime, suggests, or ask how he or she feels about adjusting to the school year.

Or you could follow kindergarten teacher Karen McEwan's advice: Bed means bed.

"Putting on the pajamas first, followed by leaving the bedroom to brush teeth and kiss you goodnight qualifies as back tracking," the Portland, Ore., educator says. "It is confusing and does not continue the forward motion to bed."

Don't overlook eating habits, says Amy Wickstrom, a family therapist, blogger and mother of two. Wickstrom writes the blog More Than a Toy.

"For many American kids, eating habits tend to suffer over the summer," she adds. "To help your child sleep well, pay attention to what your child eats during the second half of the day, and try to ensure that your child is consuming healthy foods."

Like sauerkraut juice.

Take a tablespoon of water and throw in just enough sauerkraut juice to throw off the taste and make it yucky -- like medicine. Then tell your child it is a form of Army nerve gas in liquified form. In just the right quantity, mixed appropriately, it is the world's most powerful sleep aid.

You acquired some during your days as a solider of fortune.

Then you ... oh, all right. Experts agree. Giving your children quiet time is a better idea than lying to them. Some people want to take all the fun out of parenting.

Tattoos: A journey of HIV acceptance

2011-08-10T10:00:00.000-07:00

Tattoos: A journey of HIV acceptance
By Elizabeth Landau

As he puts a straw in his fruit smoothie, Michael Lee Howard accidentally knocks over the cup, spilling the seaweed-colored liquid. "Well, it happens," he says. As he collects the smoothie overflow in the plastic lid, he exposes the tattoos on his wrists: a biohazard symbol on the right and a radiation symbol on the left.

Howard might not have come across as such a calm person in late 2005, when he found out he was HIV-positive. After his diagnosis, he felt "dirty" in his own skin, and feared infecting others if he so much as cut his hand. Getting the wrist tattoos helped him in his journey toward self-acceptance.

"It's a branding of who I am, and it's a branding of being comfortable with that, being comfortable with who I am," said Howard, 37, who lives in Portland, Oregon.

Howard is one of many people living with HIV who have chosen to get tattoos to represent living with the disease. They say these tattoos help start conversations, reduce stigma and serve as reminders of how living with HIV has changed their lives.

Tattoos like Howard's biohazard symbol are especially common in men who have sex with men, the subpopulation that bears the highest burden of new HIV infections in the United States. Men who have sex with men accounted for 61%, or 29,300, new HIV infections in 2009, federal health officials said last week. And although the number of new HIV cases has remained stable in the general population, new infections rose among young, black gay and bisexual men from 2006 to 2009.

It was also among men having sex with men that U.S. doctors first realized, in 1981, that there was a never-before-seen disease that could destroy the immune system. That disease came to be known as human immunodeficiency virus.

"In the gay male community, we think about it (HIV) a lot more because it attacked our community first. It's wiped out a number of us," said William Conley of Pollock Pines, California. His tattoo, a biohazard symbol with the Celtic motif of a crown of thorns circling around it, means he's winning the fight against this disease.

"You're not a victim. You're a champion, you are a survivor, and that's the biggest part of the tattoo," Conley said.

Identification and awareness

The origins of HIV-related tattoos are murky, but the biohazard symbol is recognized in connection with HIV among many gay men, said David Dempsey, clinical director at the Alexian Brothers Bonaventure House in Chicago and The Harbor in Waukegan, Illinois, both transitional living facilities for HIV-positive individuals recovering from alcohol and substance dependence.

"It's to let other men know that they're HIV-positive so that they don't have to come out and say it," he said. In situations of anonymous sex, it can signal status to potential partners and, in that sense, may help with prevention, because unprotected sex with an HIV-infected individual can spread the disease, he said.

For those with HIV, seeing someone else with a biohazard symbol is a sign this is another person living with the disease who might provide support, Conley said, like a "secret identification code."

There are less cryptic HIV tattoos, too. Dempsey has a red AIDS ribbon tattoo on his chest, which he chose even before he became HIV-positive (the organization Visual AIDS created the ribbon symbol in 1991). Dempsey has been a social worker in the HIV community for 11 years, and wanted to show solidarity with people living with the disease, as well as raise awareness.

In 1986, when AIDS was just starting to be recognized as a deadly illness transmitted through sex and intravenous drug use, conservative author William F. Buckley Jr. suggested HIV-positive people get tattoos to protect others. He wrote in The New York Times that "Everyone detected with AIDS should be tattooed in the upper forearm, to protect common-needle users, and on the buttocks, to prevent the victimization of other homosexuals."

Some HIV-positive individuals may have gotten tattoos in resistance to Buckley's article, said Richard Sawdon Smith, professor of photography and AIDS cultures at London South Bank University in the United Kingdom, who has been HIV-positive since 1994. This is not an oft-cited reason among people with tattoos today, although many of the people who got HIV in the '80s and may have gotten tattoos then have since died.

Another theory is that certain ACT UP activists sported biohazard tattoos in their massive demonstrations in the late '80s and early '90s, but founder Larry Kramer said he hasn't heard of these tattoos or of the organization's participation in the practice.

Tattooing HIV-related symbols has been going on at least since Nick Colella started at Chicago Tattooing and Piercing Company in 1994.

Colella used to tattoo more memorial motifs honoring people who had died of AIDS when he was starting out -- less so now, since modern antiretroviral medications effectively let patients live long lives with HIV as a chronic illness. Colella, like other tattoo artists,sterilizes his equipment and throws used needles away in biohazard-labeled containers so diseases transmitted through blood, including HIV, do not spread from person to person.

Biohazard symbols and ribbons are just some of the representations of HIV-positive status that Colella has tattooed, he said. He sees this business pick up annually during Chicago Pride Fest.

"People symbolize happiness, sadness, sexuality, everything with tattoos. It's all the good, all the bad, all the everything," he said.

Some people get HIV-related tattoos immediately after getting a positive test result. Conley waited three days after his diagnosis in 2009 to get his tattoo.

Conley, a sociologist by training, knows of 45 to 60 others in online forums who have tattoos involving a biohazard symbol or a scorpion, another sign of having HIV in the gay community. The stinging tail of the scorpion alludes to the virus, he said.

"Basically saying, 'I'm positive and you need to know that, especially if we're going to engage in any intimate relation' -- it has that meaning," he said.

Coming to terms with diagnosis

Howard found out about the biohazard sign as a symbol for the HIV-positive gay community through the Internet. The radiation design, though, was his own idea. He chose it because in comic books, when superheroes get radiated, life "starts from scratch," he said.

That's what Howard felt like he needed: A rebirth. Getting HIV had been a total shock. He had briefly dated a man who said he didn't have sexually transmitted diseases, but later Howard found out the man was HIV-positive and had given him the virus. Before then, Howard didn't know anyone who was HIV-positive.

His diagnosis was a wake-up call to better his life. Deep down, he said, he wasn't a happy person and wasn't being his true self on his blog, which felt like "a Hello Kitty commercial" -- too perky for what he actually felt. He went into three years of intense therapy in an effort to find his "authentic self."

"I just got tired of being what everybody else wanted me to be," he said. "I think that's part of where the tattoos came in: I didn't get tattoos or as many piercings, because that's not what you do. You do what everyone tells you to do."

"After my diagnosis I'm like, 'Well hey, I have nothing left to lose.' "

Showing the world his status through the tattoos was like a second coming out for Howard. And the responses from others about the tattoos have been overwhelmingly positive. Since his tattoos are so prominent, Howard gets asked about them all the time. They give Howard opportunities for dialogue about living with HIV, with everyone from fellow light-rail commuters to his boss.

Talking about it
Opening up those kinds of conversations is why Chad Hendry, 32, got a bold tattoo from Colella in July. On his neck is a red AIDS ribbon with the words "On this day my new life began" and the date of his diagnosis: 12-30-09.

He's not sure whether he got HIV through sex or drugs; he knew his behavior was risky, but he never thought he'd get the disease. After about a year, though, his health declined, and a test showed he had HIV. Rehab helped him curb his crystal meth addiction, and his grandparents helped him get back on his feet. He lives in an HIV recovery home near Chicago.

A red HIV T-shirt campaign gave him the idea that he wanted a tattoo related to his status. People would see the shirt and ask questions about living with the virus; with a tattoo, Hendry could have that level of engagement all the time.

"It's the same reason I'm very vocal about it: because I believe that will make the path just a little bit easier for somebody else," he said.

But the tattoo hasn't entirely brought him comfort. Hendry fears he might not find a partner who is comfortable with the statement of the tattoo. His family members weren't entirely welcoming of it -- they wondered why it had to be so prominent on his neck. People on trains seem to stare at it, too.

Still, Hendry loves his tattoo. He's not ashamed of having HIV; in fact, he feels it's one of the best things that has happened to him, because he's off drugs and has a better outlook on life.

"Today I live every day with gratitude. You become grateful for what you have in being alive," he said.

The ribbon motif also appealed to Howard of Portland. To commemorate his five-year "posiversary" in November, he got a red ribbon tattoo on his shoulder with his diagnosis date.

"I think that I'm the most comfortable and happy in my own skin that I've ever been in my entire life," Howard said.

Why Some Patients Develop Anemia

2011-08-09T10:13:00.000-07:00

Many Heart Patients Anemic After Too Many Blood Tests in Hospital

Researchers warn this could translate into worse outcomes.

By Amanda Gardner, HealthDay News

One in five patients who are hospitalized for heart attacks develop anemia because so much of their blood is drawn for routine diagnostic tests, researchers have found.

Often, this anemia persists for a month or more after discharge and could spell worse outcomes — even death — down the line, according to a study in the Aug. 8 online edition of the Archives of Internal Medicine.

"This is not just a lab abnormality," said study senior author Dr. Mikhail Kosiborod, a cardiologist with St. Luke's Hospital Mid-America Heart & Vascular Institute in Kansas City, Mo. "These patients actually feel worse after they leave the hospital. Mortality is higher, too."

People with anemia have too-low numbers of the red blood cells that carry critical oxygen to different parts of the body.

The researchers had previously found that about half of heart attack patients who are admitted to the hospital with normal red blood cell, or hemoglobin, counts actually leave with new anemia.

But the majority of these patients had no bleeding complications that could account for the condition.

That led Kosiborod and his colleagues to hypothesize that it was due to the amounts of blood drawn for routine diagnostic tests.

"Drawing blood in a hospital is typically a very common occurrence, particularly in the intensive care unit," said Kosiborod, who is also an associate professor of medicine at the University of Missouri in Kansas City.

The study authors looked at electronic medical records for almost 18,000 patients who'd had a heart attack at one of 57 U.S. hospitals.

While all had normal hemoglobin levels when they were admitted, 20 percent developed moderate-to-severe anemia by the time they left the hospital.

The risk of anemia rose 18 percent for each 50 milliliters (mL) drawn.

"That was probably somewhat more than what we initially expected to find," Kosiborod said.

The average patient had 173.8 mL of blood drawn for testing, or about half a unit of whole blood. That was about 100 mL higher than the blood drawn in patients who didn't develop moderate-to-severe anemia, according to the researchers.

There were also differences in the amount of blood drawn from hospital to hospital.

"Because we see such a significant variation, chances are that one of the reasons for the variation is hospital-based processes of care," Kosiborod said. "Some hospitals draw more blood than others."

Fortunately, the authors have identified a couple of seemingly simple fixes to this problem.

One option would be to use smaller pediatric tubes to draw the blood rather than adult-sized tubes.

"Pediatric tubes are perfectly adequate for most of the tests that need to be done and can drastically reduce the amount of blood lost," Kosiborod said.

Fewer blood draws also would help, and it may be possible to use blood already drawn and already in the lab for subsequent tests.

But the findings aren't enough to conclude that unnecessary tests are being done, Kosiborod said.

Less testing could also result in medical problems and this study didn't look specifically at how appropriate the tests were.

But there may be an added benefit to doing fewer blood tests.

"We're spending a lot of money on these tests that [can be unnecessary]," said Dr. Stephanie Rennke, lead author of an accompanying editorial and an assistant clinical professor of medicine at the University of California, San Francisco (UCSF). "If you put the cost together with the issue of the hazard of patients developing hospital-acquired anemia, that's pretty profound."

According to Rennke, UCSF has already tightened up its protocol for ordering blood tests. "We have to think before we order a test," she said.

What are these dry white spots on my child's face?

2011-08-08T07:27:00.000-07:00

What are these dry white spots on my child's face?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Mondays, it's pediatrician Dr. Jennifer Shu.

Question asked by Lee of Maryland:

We just got back from the beach and I noticed that my 6-year-old daughter has some dry white spots on her face. I make sure she always wears sunscreen, and she has not had a sunburn. I've put lotion on her skin but it's not helping. She had eczema when she was younger but that always showed up on her arms and legs and not the face. What could this be?

Expert answer:

Thanks for your question. In the summer, it's common for children and young adults to develop a benign skin condition called pityriasis alba. It consists of multiple lighter round patches of skin on the face and often is a little scaly so that it looks rough or like it's peeling slightly. It is unclear exactly what causes pityriasis alba but it does seem to be more common after sun exposure and in people who have eczema.

Pityriasis alba can last for weeks to years and is more noticeable in the summer when the surrounding skin is more tan than the affected spots. The lighter areas usually occur on the face but can also show up on the neck, shoulders and arms. The majority of people with this skin condition are between 3 and 16 years of age.

It's best to continue using sunscreen when outside to avoid sunburns and try to keep the skin color on the face about the same shade throughout. Moisturizers can help, and sometimes using a mild steroid cream such as hydrocortisone may improve the appearance of the skin as well as any itching that might accompany the spots.

Other skin conditions may also look like what you describe so it's always best to get confirmation from your child's doctor. Good luck.

Getting to the Root of Bad Breath

2011-08-05T07:11:00.000-07:00

Getting to the Root of Bad Breath

Good dental hygiene should help you clear up a bad case of halitosis. But what's causing your stinky breath in the first place?

By Lynn Yoffee

Medically reviewed by Cynthia Haines, MD

If you're constantly popping mints or chewing gum to cover up bad breath, you're not alone. One in four Americans has halitosis and is cursed with smelly breath.

Why? Most cases of halitosis are caused by improper dental hygiene. If you don't brush and floss your teeth after every meal, bits of food that get stuck in your teeth and gums and on your tongue will begin to decay and emit foul odors.

An unclean mouth also means that bacteria can grow, potentially leading to gum disease, which is also one of the causes of bad breath. In addition, certain foods and drink are more likely to cause bad breath, including:

Garlic
Onions
Cheese
Orange juice
Soda, including diet varieties

After these foods or drinks are digested, their oils make their way into your bloodstream and are then carried into your lungs. The odor is then released through your breath.

Other Causes of Bad Breath

Aside from what you eat and drink, bad breath can also be linked to:

A dry mouth. Saliva is your mouth's natural cleanser, so when your mouth is dry, dead cells can build up, which is what causes morning breath. This is an even bigger problem if you sleep with your mouth open. Smoking and certain medications can also cause dry mouth. In more extreme cases, you could have a problem with your salivary glands that leaves your mouth unusually dry.
Chronic diseases. Sometimes underlying health conditions can cause bad breath. Lung infections, cancers, kidney or liver failure, diabetes, and gastroesophageal reflux disease (GERD), for example, are all associated with halitosis.
Respiratory, mouth, throat, and nose conditions. These conditions are also often associated with bad breath. For example, discharge from a sinus infection is known to cause bad breath. If you have an upper respiratory infection such as bronchitis, the sputum coughed up can also cause halitosis.
Tobacco products, particularly smoking. Tobacco products can dry your mouth and result in bad breath. People who use tobacco are also at greater risk of developing gum disease, poor general oral health, and oral cancers.
Malnutrition. Starvation or intense dieting can result in bad breath due to ketoacidosis, which is a breakdown of chemicals that occurs during fasting.

Beating Bad Breath

To combat bad breath, try the following:

Avoid foods and beverages that you know cause bad breath; this may also mean minimizing your intake of alcohol.
Brush for two to three minutes after every meal and floss your teeth at least once a day.
Brush your tongue gently to remove dead cells, including the back of your tongue, because that's where bacteria often collect.
Drink lots of water to keep your mouth moist and clean. And water really is what's best here: Other beverages, particularly caffeinated beverages, don't work as well as water for halitosis treatment and prevention.
Eat less meat and more vegetables and fruits each day.
Get dental checkups at least twice a year that include an exam and cleaning.
If you wear dentures, bridges, or removable braces, clean them thoroughly at least once a day.
Suck candy or chew gum (preferably sugarless) to stimulate saliva production, which helps wash away food particles and bacteria.

When to See Your Dentist About Bad Breath

If you still feel like you have bad breath after trying these tips, ask someone who is close to you for confirmation. Sometimes, you really are your own worst critic. If it is indeed an issue, make an appointment with your dentist to try to uncover what could be causing your bad breath.

Avoid drinking, eating, chewing gum, or brushing your teeth before your dental appointment. Skip the perfume or other scented products too, so that your dentist can truly assess your halitosis. Your dentist will likely ask you a number of questions, ranging from your dental hygiene habits to your general health.

In some cases, halitosis may be due to a buildup of plaque, which is a layer of bacteria on your teeth. If this is the case, the dentist may have you use a special antimicrobial mouth rinse.

If your dentist determines that the bad breath is due to gum disease, you'll be treated or referred to a gum disease doctor, called a periodontist. Also called periodontal disease, gum disease causes your gums to recede from the teeth and leaves pockets that gather bacteria and plaque. A periodontal cleaning, or more extensive treatment, may be needed.

If your dentist isn't able to uncover the reason for your bad breath, a trip to your primary care doctor for a physical exam would be the next step to determine the underlying causes of your bad breath.

Learn to crave healthy foods

2011-08-04T10:40:00.000-07:00

Train your brain to crave healthy foods
By Elizabeth Cohen

Looking back on it, Wendy Fox thinks it was the M&M's that did her in.

They sat in a glass bowl on her living room table, taunting her every time she walked by, seemingly calling out for her to scoop up a few and eat them. Eat them she did, as well as anything else chocolaty that crossed her path, such as a brownie at her favorite restaurant or a mocha drink at Starbucks.

Fox's chocolate cravings (and three pregnancies) helped her gain 40 pounds in her 30s.

"It wasn't pretty," says Fox, 41, a real estate agent in Weston, Massachusetts.

Unhappy with her growing figure -- she'd gone from a size 4 to a size 10 -- Fox watched as her mother lost 30 pounds. Her mother, who also craves sweets, had attended a program with nutritionist Susan Roberts at Tufts University to curb cravings and suggested Fox do the same.

"At my first meeting with Sue, I told her, 'You've met your challenge,' " Fox remembers with a laugh.

Roberts, author of "The Instinct Diet," explained to Fox that there's a biological reason most of us crave ice cream and not broccoli, but we can unlearn our instincts. It worked. After 14 months, Fox now craves salads instead of M&M's, has lost 36 pounds and is back down to a size 4.

The caveman's instinct

"For most of human history, people didn't have enough to eat, so fat was something you really needed to seek out," says Marcia Pelchat, a food psychologist at the Monell Chemical Senses Center in Philadelphia.

To avoid dying in a famine, the brain is wired to pick up on signs that calorie-rich foods are nearby, which helps explain why that piece of cake on the plate in front of you is so irresistible, or why seeing a sign for a doughnut shop draws you in even when you know you need to watch your diet.

"It's analogous to a drug addict who's gone through rehab, but when he walks by that abandoned crack house he suddenly thinks about going in again," Pelchat says.

Pelchat adds, however, that while we're born with certain cravings, there's also evidence we start to crave whatever we eat in large quantities. She found this when she put study subjects on a vanilla-flavored drink low in saturated fat. After consuming it every day for two weeks, about a third of the subjects reported craving the drink, even though she says, "It was chalky and not very yummy."

Research in Japan also shows that cravings are influenced by our environment. A study at Tohoku University found that many Japanese women crave sushi. "These findings suggested that the craving for some kind of food is influenced by the tradition of food products and cultures," the authors concluded.

'Chocolate makes me nauseous!'

It was tough at first, but Fox, once a chocoholic, now hardly ever craves chocolate.

"I couldn't believe it, but last night we were at a friend's house for dinner and when they served dessert, I thought, 'I can't wait to go home and have a bowl of high-fiber cereal.' "

Her biggest craving now is for salad.

"I make one every night for dinner -- leafy greens and chopped up cucumbers. I don't use dressing -- just a little bit of olive oil and salt and pepper, because I crave a natural taste," she says. "This is such a huge difference for me."

Every so often, Fox says she gets a "ping" for chocolate. But then when she eats it, it makes her feel sick.

"I can just taste the butter in the first bite. It makes me nauseous, which is so weird, because I'm the M&M girl!" she says. "I think a lot of it is psychological. I worked so hard to get where I am that I don't want to go back there. A brownie's not going to take me down!"

Judith Beck, a psychologist and president of the Beck Institute for Cognitive Behavior Therapy in Pennsylvania, says she has noticed the same phenomenon when her patients have given up foods they used to crave.

"They didn't like the sensation of greasy foods in their mouths, and sometimes foods high in sugar started to taste too sweet," she says.

Learning to crave salad

Here are three steps toward switching your cravings from fatty foods to healthy foods.

1. Clean out your cupboards

Fox removed all signs of chocolate from her home. She replaced the M&M's in the glass bowl with pretty marbles, and if she buys chocolate for a special occasion, she gets rid of it immediately.

"I just had a party for my kids and we made ice cream sundaes. As soon as it was over, I gave the leftover hot fudge to my neighbors," she says.

2. Carry around healthy foods

Fox carries apples in her purse and keeps a box of high-fiber cereal in her car so she can dig in whenever a chocolate craving hits.

3. Bury craved foods in the middle of a meal

For the first two weeks, Roberts tells dieters to avoid eating unhealthy craved foods altogether, in the hopes of helping them unlearn the craving. After two weeks, she tells them they can have 100 calories of that food in the middle of the meal.

"I call it the sandwich technique," she says. "If you eat chocolate at the beginning of a meal when you're really hungry, your brain will think -- associate chocolate with feeling satiated and happy. If you put it at the end of the meal, your brain will remember it as the last delicious thing you tasted."

Get Some Sleep: Avoid frequent leg cramping

2011-08-03T08:10:00.001-07:00

Get Some Sleep: Avoid frequent leg cramping

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

It is frustrating, to both patients and doctors, that modern medical science often lacks understanding of or treatment for common, everyday ailments.

One such ailment, leg cramps, is very common and yet poorly understood. It often plagues people at night, and therefore “sleep-related leg cramps” is recognized as a bona fide sleep disorder by the International Classification of Sleep Disorders.

Most people have had a “charley horse” and know that leg cramps can be quite painful. Leg cramps result from the sudden, intense and involuntary contraction of a muscle or muscle group. They usually occur in the calf muscle or the small muscles of the feet.

If this happens once a year, few people think of this as a medical condition, but there are people who have leg cramps every night, sometimes several times a night. The cramps can prevent people from falling asleep or can awaken them many times during the night, and therefore leg cramps can lead to chronic sleep deprivation.

The painful sensation is usually relieved by strenuous stretching of the affected muscle. Often, people jump out of bed in their attempt to stop the searing pain. Both the prevalence and frequency increase as people age. There is research showing that approximately one-third of all people over the age of 60 and one-half of those over the age of 80 reported having sleep-related leg cramps once in the previous two months. Six percent of adults over the age of 60 have reported having leg cramps that disturb them every night.

Leg cramps are sometimes confused with restless legs syndrome (now known as Willis-Ekbom disease), but the two disorders are quite different, although patients can have both problems.

RLS is not commonly described as a sudden, intense pain. Also, people who suffer from RLS usually have a steady, uncomfortable feeling in the legs that lasts for hours, and this maddening feeling is only temporarily relieved for a few minutes while they move or rub their legs.

There are some medical conditions that seem to predispose people to leg cramps such as diabetes, peripheral vascular disease and neuromuscular disorders. Medications such as oral contraceptives have been associated with leg cramps. They occur in approximately 40% of pregnant women and usually resolve after birth.

If leg cramping is frequent and intense, people should not assume that they have benign, idiopathic (of unknown cause) leg cramps. It is advised to consult a physician in order to differentiate leg cramps from more serious medical conditions such as akathisia, myelopathy, peripheral neuropathy and disorders of calcium imbalance.

There are numerous theories about the cause of leg cramps but little evidence supporting the veracity of any given theory. One common notion is that they result from dehydration, but the little research done does not support this.

Also common is the idea that there is a relative electrolyte imbalance. Magnesium and potassium are popular culprits. Again, there is little research on this. One study attempted to treat leg cramps in a group of pregnant women and found that magnesium was no better than a placebo.

The same is true for potassium deficiency; there is no research showing that low potassium causes leg cramps or that taking extra potassium prevents them. That said, I have patients who swear that a banana before bed takes care of the leg cramping problem. I also know people who report that sitting in a bath of Epsom salts right before bed helps ward off nocturnal leg cramps.

I have patients who think that the leg cramps come upon them only when they exercise strenuously, and then there are those who associate the cramps with lack of exercise. The best theory is the “squatting hypothesis,” which speculates that leg cramping is associated with the modern habit of sitting on chairs and on the toilet instead of squatting as our forebears would have done.

I believe that is just another way of saying that leg cramps could be caused by a lack of strengthening and stretching of the calf and feet muscles.

Study: Crying Won't Make You Feel Better

2011-08-02T05:41:00.000-07:00

Study: Crying Won't Make You Feel Better

By MEREDITH MELNICK

There's something cathartic about having a good cry and "letting it all out," even if you don't have anything in particular that's bringing you down.

Or maybe not. Research published in the Journal of Research in Personality found that shedding some tears had no effect on the mood for nearly two-thirds of a group of women who kept daily emotion journals.

"Crying is not nearly as beneficial as people think it is," Jonathan Rottenberg, lead author of the study and an associate professor of psychology at the University of South Florida told MSNBC's Body Odd. "Only a minority of crying episodes were associated with mood improvement -- against conventional wisdom."

MORE: The Crying Game: Women's Tears Dial Down Testosterone

As part of the study, 97 Dutch women between the ages of 18 and 48 logged a total 1,004 crying episodes as part of daily mood journals they kept over a three month period. For 61% of the women, crying didn't improve mood at all, although the tears didn't make them feel worse: only 9% of respondents reported feeling more sad after a crying jag, while 30% reported feeling better.

Rottenberg suspects that crying isn't the physically cleansing act that many have assumed it is, and instead suggests that those who felt better after a waterworks session may not have benefited from the actual tears so much as the social support and showings of affection they elicited.

MORE: Why Adults Cry So Easily in Animated Kids Movies

The study also offered a peak into the private act of crying—when, how long and why the women experienced their outbursts. The participants reported crying sessions lasting an average eight minutes, either alone or in the presence of one other person. The majority of crying occurred in the living room and women reported the main reason for their tears were conflict, loss and empathy over another's suffering.

Are colon cleanses good for you?

2011-08-01T07:57:00.000-07:00

Colon cleansing: Not so healthy, analysis says

It has been touted as a natural way to improve your heath and cleanse the soul. But doctors are now finding the procedure known as colon cleansing can cause dangerous side effects.

Colon cleansing, technically known as colonic hydrotherapy or colonic irrigation, is a popular treatment, usually performed at spas. It often involves the use of chemicals in the body and in hydrotherapy, the colon is flushed with water through a tube inserted in the rectum.

But oral home remedies are also available and have become popular, especially over the Internet. Now researchers from Georgetown University in Washington, D.C. say there's no evidence any of these colon cleansing treatments work and, in fact, when used improperly can cause cramping, kidney failure and in some extreme cases, death.

"There can be serious consequences for those who engage in colon cleansing whether they have the procedure done at a spa or perform it at home," says the lead author, Dr. Ranit Mishori, a family medicine physician at Georgetown University School of Medicine. "Colon cleansing products in the form of laxatives, teas, powders and capsules... tout benefits that don't exist."

Mayo doctor is no fan of cleanses

Although colon cleansing has been around for centuries as a way to rid the body of unwanted toxins, the American Medical Association determined in the early 1900s that the procedure was invalid; there was no evidence to show the methods worked. And even though there still remains no solid evidence these products do what they claim, colon cleansing has been making a comeback, mainly because manufacturers claim it also helps people lose weight.

"If this method were the key to weight loss, it would be amazing. But there is no evidence that this helps people lose weight,” says Mishori. "Manufacturers don't describe how it works. The statements are a little empty. They say it will enhance your immune system, up your metabolism, give you energy. It’s all pretty vague. Some people swear by it, but it could be a placebo effect. And companies can make these claims, because the federal government doesn't regulate their products."

Not expecting miracles, but I love my cleanses

According to the report released this week in the Journal of Family Practice, Mishori and her colleagues examined 20 studies published in medical literature over the last 10 years.

Investigators noted while these reports showed little evidence of colon cleansing benefits, there were a number of side effects reported following the use of these cleansing methods. Those effects included cramping, bloating, nausea, vomiting, electrolyte imbalance and renal failure. And in some cases, ingredients in these remedies were toxic.

"Some herbal preparations have also been associated with aplastic anemia and liver toxicity," Mishori said.

Researchers also noted that many of the "spas" that offer colon cleansing have no trained clinicians and even organizations such as the National Board for Colon Hydrotherapy and others who promote colon cleansing require technicians who perform professional colon cleansing to have little more than a high school diploma.

"When you flush your colon out with a hose, it's like giving yourself an enema on steroids. You shouldn't put things up there that really don't belong there," stressed Mishori. "Imagine 60 liters of water going through your colon. The stress it puts on the system, and the hose, if not used correctly, could puncture the organ."

As for the home remedies, Mishori says there's no need for them. "We poop and pee for a reason. If you are a healthy person, the body does it for you."

When asked what was the best way to cleanse the body, Mishori was quick to respond.

"Eat a balanced diet, exercise regularly," she stressed, "Get six to eight hours of sleep and see a doctor regularly. But no one wants to do that," she said with exasperation. "But they'll use a hose to flush themselves out! The use of these methods are unhealthy. And what's scary is we only examined the cases that were reported to hospitals and doctors. Imagine all the people who are using these products and methods and have side effects and never go to the hospital. We don't know about them. The numbers could be staggering."

Weight loss 'sleeve' a good option?

2011-07-29T08:22:00.000-07:00

Weight loss 'sleeve' a good option?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Friday, it's Dr. Melina Jampolis, a physician nutrition specialist.

Question asked by Lynn C. of Madison, Ohio

I have had a weight problem for 23 years. I have lost and regained over 400 pounds. My weight-loss doctor is offering the "sleeve." I have been told because of my gastroesophageal reflux disease that the Lap Band is not an option, nor is the more well-known gastric bypass because of a high family history of cancer.

I have all the problems common in morbidly obese people, some I had even when thin. High, difficult-to-control blood sugar, blood pressure and a mild heart issue controlled by meds. The sleeve has been done only a few years - can it be a good option for me?

Expert answer:

Hi Lynn. Although I'm a nutrition doctor and I focus on weight loss through lifestyle measures such as diet and exercise, I realize that sustained major weight loss is not always achievable and that surgical intervention, particularly when patients have obesity-related diseases like high blood pressure and diabetes, can be lifesaving and life changing.

Since I am not a bariatric (weight loss) surgeon, I turned to Dr. Kai Nishi, a highly respected bariatric surgeon at the Khalili Center for Bariatric Care in Beverly Hills.

He agreed that Lap Band may not be the best option if you have GERD as it could worsen symptoms.

However, if your GERD is due to a hiatal hernia, this could be repaired at the same time that your band is placed and your GERD could potentially be cured. Gastric bypass surgery is an anti-reflux surgery and in many cases can cure GERD.

Regarding your family history of cancer, the only type of cancer that would make gastric bypass surgery not an option is stomach cancer.

If you have a family history of other types of cancer including colon, lung, breast and prostate, this type of surgery, which has been around for longer than the newer sleeve procedure and thus physicians have more experience with the procedure and there is more research into the risks and benefits, would still be an option (the best option according to Nishi.)

The sleeve gastrectomy is a surgery in which 85% of your stomach is removed so you are left with just a tube for a stomach. Gastric bypass surgery also cuts the stomach, but it creates a new smaller pouch, about the size of an egg, which is attached to the second part of the small intestine.

This can lead to more nutrient absorption issues than the sleeve but it can also lead to better weight loss. With the sleeve procedure, results show 50-60% excess body weight loss at one year vs. 65-70% with gastric bypass and 45-50% with gastric band.

Excess body weight loss, or EBWL, refers to the percent excess weight a person begins with. If you are 100 pounds overweight and you lost 50 pounds that would be a 50% EBWL.

Weight-loss surgery in general leads to a 70-80% resolution of diabetes and 50% resolution of high blood pressure, with better results for both conditions with gastric bypass (because the sleeve is a newer procedure less data are available).

So if your weight-loss surgeon, who is fully aware of all of your medical history and issues, feels that the sleeve is the best option, and you truly do not believe that you are capable of maintaining weight loss permanently through lifestyle measures, (losing even 10% of your excess body weight can make a significant health difference), then I think the sleeve could be a good option for you.

If you do go forward with any type of weight-loss surgery, make sure that you have an adequate support system in place. It is still critical that you permanently adopt a healthy lifestyle including regular exercise and good food choices after the operation.

Follow Dr. Melina on Twitter.

Do you obsessively check your phone?

2011-07-28T10:48:00.000-07:00

Do you obsessively check your phone?
By Elizabeth Cohen

There I was at a long-awaited dinner with friends Saturday night, when in the midst of our chatting, I watched my right hand sneaking away from my side to grab my phone sitting on the table to check my e-mail.

"What am I doing?" I thought to myself. "I'm here with my friends, and I don't need to be checking e-mail on a Saturday night."

The part that freaked me out was that I hadn't told my hand to reach out for the phone. It seemed to be doing it all on its own. I wondered what was wrong with me until I read a recent study in the journal Personal and Ubiquitous Computing that showed I'm hardly alone. In fact, my problem seems to be ubiquitous.

The authors found smartphone users have developed what they call "checking habits" -- repetitive checks of e-mail and other applications such as Facebook. The checks typically lasted less than 30 seconds and were often done within 10 minutes of each other.

On average, the study subjects checked their phones 34 times a day, not necessarily because they really needed to check them that many times, but because it had become a habit or compulsion.

"It's extremely common, and very hard to avoid," says Loren Frank, a neuroscientist at the University of California, San Francisco. "We don't even consciously realize we're doing it -- it's an unconscious behavior."

Why we constantly check our phones

Earlier this year, Frank started to realize that he, too, was habitually checking his smartphone over and over without even thinking about it. When he sat down to figure out why, he realized it was an unconscious, two-step process.

First, his brain liked the feeling when he received an e-mail. It was something new, and it often was something nice: a note from a colleague complimenting his work or a request from a journalist for help with a story.

"Each time you get an e-mail, it's a small jolt, a positive feedback that you're an important person," he says. "It's a little bit of an addiction in that way."

Once the brain becomes accustomed to this positive feedback, reaching out for the phone becomes an automatic action you don't even think about consciously, Frank says. Instead, the urge to check lives in the striatum, a part of the brain that governs habitual actions.

The cost of constant checking
For Frank, constant checking stressed him out and really annoyed his wife.

Dr. Adam Gazzaley, a neurologist at UCSF, sees another cost: Whenever you take a break from what you're doing to unnecessarily check your e-mail, studies show, it's hard to go back to your original task.

"You really pay a price," he says.

Habitually checking can also become a way for you to avoid interacting with people or avoid doing the things you really need to be doing.

"People don't like thinking hard," says Clifford Nass, a professor of communication and computer science at Stanford University. Constantly consulting your smartphone, he says, "is an attempt to not have to think hard, but feel like you're doing something."

How to know if you're a habitual checker

1. You check your e-mail more than you need to.

Sometimes you're in the middle of an intense project at work and you really do need to check your e-mail constantly. But be honest with yourself -- if that's not the case, your constant checking might be a habit, not a conscious choice.

2. You're annoying other people.

If, like Frank, you're ticking off the people closest to you, it's time to take a look at your smartphone habits.

"If you hear 'put the phone away' more than once a day, you probably have a problem," says Lisa Merlo, a psychologist at the University of Florida.

3. The thought of not checking makes you break out in a cold sweat.

Try this experiment: Put your phone away for an hour. If you get itchy during that time, you might be a habitual checker.

How to get rid of your checking habit

1. Acknowledge you have a problem.

It may sound AA-ish, but acknowledging that you're unnecessarily checking your phone -- and that there are repercussions to doing so -- is the first step toward breaking the habit.

"We can be conscious of the habit of checking. We can unlearn its habits," says Sherry Turkle, a psychologist at the Massachusetts Institute of Technology and director of the MIT Initiative on Technology and Self.

2. Have smartphone-free times.

See if you can stay away from your phone for a few hours. If that makes you too nervous, start off with just 10 minutes, Merlo suggests. You actually don't have to stay away from your phone altogether -- you can just turn the e-mail function off (or Facebook or whatever you're habitually checking).

3. Have smartphone-free places.

You can also establish phone-free zones, which is what Frank did to cure his smartphone habit.

"The first thing I did was banish it from the bedroom," he says. "I would have to walk down the hallway to my study to actually be able to see it."

You could also force yourself to stop checking when you're in a social situation, like out to dinner with friends. (Last Saturday night, I shoved my phone way down into my purse where I couldn't see it).

Joanne Lipari, a psychologist who practices in California, uses this strategy when her teenage daughter has friends over.

"I have a rule. Like the Old Wild West which had you check your gun at the saloon entrance, I have a basket by the door, and the kids have to check their phones in the basket," she says. Otherwise, she says, the kids would stare at their phones and not interact with one another.

Should doctors practice what they preach?

2011-07-27T09:20:00.000-07:00

Should doctors practice what they preach?

Anthony Youn, M.D., is a plastic surgeon in Metro Detroit. He is the author of “In Stitches,” a humorous memoir about growing up Asian American and becoming a doctor.

What do you call a chain-smoking, morbidly obese, soda addict who just graduated medical school?

Yep. Doctor.

How would you feel if he were your doctor? Would you listen to him if he asked you to adopt a healthier lifestyle?

My third year of medical school during my family medicine rotation, I was assigned to follow Dr. Ben, one of the residents in the outpatient clinic. Dr. Ben didn’t look like any other doctor I’d met. He was 5 feet 6, weighed well over 300 pounds, chain-smoked during his lunch break and hauled around a twelve-pack of Mountain Dew, which he polished off by the end of his shift.

Dr. Ben was also well-read, intelligent, dedicated and caring.

My first day with Dr. Ben, a steady flow of patients arrived in the clinic with conditions ranging from ear infections to sprained ankles. They all listened to his advice carefully and agreed to undergo any necessary tests and take the proper medications to treat their ailments.

Then in walked Joe, 55, an overweight desk jockey with hypertension and type 2 diabetes. Joe smoked, drank and the only exercise he got was lifting himself off the couch to waddle over to the fridge for another beer. He came to the clinic for a follow-up visit to check on his high blood pressure. Dr. Ben and I entered the exam room, introduced ourselves and looked over Joe’s chart. After a brief physical, Dr. Ben shook his head.

“Joe, I have to be honest with you. Your blood pressure is way too high. You need to eat healthier, lose weight and stop smoking. You’re putting yourself at risk for a heart attack, lung cancer, or stroke, and I’m just getting started. Do you exercise?”

Joe raised an eyebrow. “Me? No.”

“If you don’t change your lifestyle, there’s nothing I can do. All the medication in the world won’t help you.”

“Are you serious?” Joe paused. “Look at you. No offense. When’s the last time you skipped a meal?”

I felt my checks redden. I’d never heard a patient talk to a doctor this way.

Dr. Ben blushed. “I’m not the patient,” he said.

“Fine.”

As Dr. Ben scribbled a prescription refill for a hypertension medication, Joe tapped his foot impatiently. Once Dr. Ben ripped the prescription from his pad, Joe grabbed it, flung open the door, took a last look at him, and rolled his eyes. As he lumbered down the hall I heard him mutter, “When’s the last time you saw your feet?”

Out of earshot, Dr. Ben barreled into the kitchen, popped open his sixth Mountain Dew of the day, chugged it and belched.

Fifteen years later, I offer full disclosure: I am not Dr. Perfect. Far from it. I try. I have a healthy BMI, I don’t smoke, and I exercise regularly. I also enjoy a Bud Light or two, drink a Pepsi every day at lunch, and - I admit it - my name is Tony and I’m a fast food addict. To me, the height of decadence would be to fly to Los Angeles for lunch just to gorge myself on In-N-Out cheeseburgers “animal style.”

As physicians, we are advocates for our patients’ health and well-being. But what if we’re not advocates for ourselves? Does that make us lesser physicians? Will our patients follow our recommendations? Are we supposed to be role models?

I think we should be. Dr. Ben was an outstanding doctor, but the way he looked interfered with his ability to practice medicine. If we don’t work at attaining a healthy lifestyle, why should we expect our patients to? Do as we say, not as we do? That doesn’t work for parents or doctors.

And I’m kidding. I’d never fly to In-N-Out for lunch.

But I’d love them to deliver.

Actress blasts body image extremes

2011-07-26T10:41:00.000-07:00

Actress: I got compliments for looking emaciated

Actress Rosario Dawson has some pointed words about expectations on women and their bodies.

"It's a form of violence in the way that we look at women and the way we expect them to look and be for what sake? Not for health, survival, not for enjoyment of life, but just so you could look pretty," Dawson told Shape Magazine.

Dawson who appears on the August cover discussed industry-wide pressures to maintain an ideal body type. After losing weight to play a drug addict dying of HIV/AIDS in the 2005 film "Rent," she was stunned to hear compliments about her figure. “I remember everyone asking what did you do to get so thin? You looked great,” Dawson recalled. “I looked emaciated.”

Her video with Shape is here.

The controversies surrounding the pressure to be too thin and constant airbrushing of photos are nothing new.

“I’m constantly telling girls all the time everything is airbrushed, everything is retouched to the point it’s not even asked,” she told the magazine. “None of us look like that."

In the competitive world of magazine covers, skin is nipped, blemishes erased and waist trimmed. Photoshopping models and celebrities for ultra svelte bodies became a huge topic in France in 2009 when a politician proposed a law that require altered advertisement photographs to carry a label.

This year, the American Medical Association adopted a policy during its annual meeting warning that photo alteration of models’ bodies “can contribute to unrealistic expectations of appropriate body image – especially among impressionable children and adolescents.

“A large body of literature links exposure to media-propagated images of unrealistic body image to eating disorders and other child and adolescent health problems,” according to the AMA.

The group called on advertising associations to discourage altering photos that could promote unrealistic expectations of body image.

From glossy fashion magazines to even health and fitness routinely retouch photographs. Is it contradictory that fitness magazines that preach healthy lifestyle retouch their models or celebrities’ photos to look skinnier?

Alzheimer's: Early detection, risk factors are crucial

2011-07-25T08:49:00.000-07:00

Alzheimer's: Early detection, risk factors are crucial
By Elizabeth Landau

With more than 5 million people suffering from Alzheimer's disease in the United States, a number that's expected to rise to 16 million by 2050, the pressure is on to find better methods of diagnosis, treatment and prevention.

Around the world, Alzheimer's disease is the second most feared disease, behind cancer, according to a recent survey of five countries conducted by the Harvard School of Public Health.

Yet there is still a lot of misinformation: Only 61% of Americans who responded to the survey correctly identified Alzheimer's disease as a fatal illness. Many participants also mistakenly believe there are sure diagnostic methods and effective treatments to slow the disease, but most would seek medical attention if they became aware of their own early signs.

The research that came out of the Alzheimer's Association 2011 International Conference on Alzheimer's Disease, which took place in Paris last week, reflects a growing emphasis on early detection.

Research suggests the best targets for exploring treatments are patients who do not have full-blown Alzheimer's disease, but experience mild symptoms. Scientists have identified biological indicators called biomarkers that seem to be associated with Alzheimer's, although they are not perfect predictors.

Alzheimer's Association: 10 signs of Alzheimer's

"Things are heading earlier and earlier. And the use of biomarkers has been really essential for helping everybody move toward an understanding of what the earliest changes are and when they can be detected," said Dr. Allan Levey, chair of neurology at Emory University School of Medicine.

Early detection

So far, no drug has been developed to significantly slow the progression of the disease in all patients. And there's no way to halt or reverse the decline of memory and other cognitive abilities once Alzheimer's has been diagnosed. Since attempts to help patients who already have symptoms in these ways have failed, scientists must look to the earliest stages of Alzheimer's in hopes of stopping it before it begins.

Studies presented at the conference reinforced the notion that signs of Alzheimer's may develop in the brain 10 to 20 years before any symptoms begin.

A substance in the brain called beta-amyloid has been associated with dementia in people who have those kinds of symptoms. This is the main ingredient of plaques that build up in the brains of Alzheimer's patients.

People with a rare genetic form of Alzheimer's, whose specific genetic mutations guarantee that they will develop the disease, tended to show signs of amyloid plaques in PET scans and cerebrospinal fluid 10 to 20 years before the onset of symptoms. These results come from the Dominantly Inherited Alzheimer Network project.

But that represents only a small fraction of Alzheimer's patients -- 1% of cases worldwide, specifically. If you don't have the genetic form, there's no way to tell if you will go on to develop the disease, even if you have accumulation of amyloid plaques. There are some people who have them but do not show symptoms of Alzheimer's.

The kinds of tests that would detect beta-amyloid levels are not widely available. And it's not clear that pulling the amyloid plaques out of the brain reverses the process of cognitive decline; this is one area of research right now.

Another biomarker of interest is a protein called tau, implicated in the neurofibrillary tangles -- which basically take the shape of cells and destroy them -- that build up in the brains of Alzheimer's patients, particularly in the memory center called the hippocampus. But there's no scan to detect these tangles in a living patient.

A major focus of research on early detection is patients who have mild cognitive impairment, a collection of symptoms involving difficulty with memory, language and other mental functions, but which does not interfere with everyday life. It is not necessarily a precursor to Alzheimer's disease, but it does raise the risk of progressing into that more severe illness.

Understanding mild cognitive impairment is important in coming up with better treatments for dementia in general, because the brain hasn't deteriorated as much as in Alzheimer's, so it may not be too late to intervene, experts say.

The brain is the primary organ the disease attacks, but a small study presented at the conference suggests the eyes may also reveal signs of Alzheimer's. Researchers looked at photos of retinal blood vessels and found some differences in Alzheimer's patients, but further research is needed to confirm this idea of using an eye exam to help diagnose Alzheimer's. The same holds for a study suggesting that falling is indicative of Alzheimer's early stages: It's a preliminary idea that needs further investigation.

Identifying risk and prevention factors

Another area of focus is identifying risk factors for Alzheimer's disease. These are associations, not known direct causes.

"Age is a risk factor we can't modify, at least yet. Our genetics, we can't modify yet, which is another major risk factor," Levey said. "But certainly seeking clues about ones that are modifiable is an important" research area.

At the Paris conference, researchers said 3 million cases of Alzheimer's could be prevented worldwide if lifestyle-based, chronic disease risk factors were reduced by 25%. This estimate is based on a mathematical model.

In the United States, physical inactivity had the biggest association with Alzheimer's out of the risk factors studied, followed by depression and smoking. Midlife hypertension, midlife obesity, low educational attainment and diabetes are other risk factors.

"If we can demonstrate that these risk factors can be modified, and that it will lead to lower rates of Alzheimer's disease, the impact could be huge," Levey said.

People in their 40s and 50s have still got perhaps a couple of decades to modify lifestyle to potentially lower risk, he said.

There is also growing evidence that head trauma may increase the risk of dementia. One study presented at the conference in Paris found that traumatic brain injury was associated with dementia among older veterans.

A study of former NFL players suggests that football players also may be at increased risk for mild cognitive impairment or similar cognitive decline, perhaps as a result of repeated head injury during these former athletes' sports careers. In fact, 75 former professional football players are suing the NFL, alleging that the league concealed information about the harmful effects of concussions on the brain for decades.

There is also the idea of cognitive reserve: that keeping the mind active can at least delay the onset of dementia. It also seems that intelligence might help the brain stay in the mild phase of the disease longer, although more study needs to be done in this area as well.

"We know that highly intelligent people have more tolerance to plaque buildup and to loss of energy in their brains than people with lower levels of intelligence and less education," said Dr. Steven DeKosky, vice president and dean of the University of Virginia's School of Medicine, at an Alzheimer's forum at the National Press Foundation in May. "Their brain basically fights it off and finds some other ways to get the things done."

Caregiving

One of the underappreciated effects of Alzheimer's disease is how great a toll it takes on caregivers. Caregivers are much more frequently ill and die earlier than people who do not care for someone with the disease, studies have shown. The stress of taking care of someone chronically ill is sometimes called caregiver syndrome.

Caregiving is hazardous to health because of the stress of helping Alzheimer's patients, and because caregivers may ignore their own health, DeKosky said.

"Alzheimer's patients, when they get into moderate and severe stages, don't have some real sense of time," DeKosky said. "They have to be watched every minute."

Patients may hurt themselves or wander off if not under constant supervision. And it's common for patients to reverse their sleeping and waking cycles, so caregivers' daily habits are likewise disrupted.

The cost is staggering: Caregivers provide more than $200 billion in unpaid care, 17 billion hours each year, according to the Alzheimer's Association.

Gibbons' advice to Alzheimer's caregivers: Breathe, believe and receive

Why don't we know more?

Two of the biggest obstacles to finding treatments for Alzheimer's disease are lack of money and difficulty enrolling people in clinical trials, experts say.

The United States spends $450 million each year in Alzheimer's research money, compared to $6 billion for cancer, $4 billion for heart disease and $3 billion for HIV/AIDS research.

In spite of the money that does exist for research, Alzheimer's clinical trials are hard to fill with participants, said Dr. R. Scott Turner, director of the Georgetown University Memory Disorders Program.

Sometimes people believe they're just having "senior moments" and don't want to acknowledge their illness, Turner said. In other cases, patients don't want to go through the hassle of the trial if they're not guaranteed to receive an experimental drug; but, in order for a scientific study to be valid, patients must be randomly assigned to either the drug or a placebo.

Also, some trials don't test drugs at all, but simply look for those biomarkers that may help predict disease later or explore other early diagnostic methods. Such methods will be in high demand when an effective treatment is developed, DeKosky said.

"When the first drug is successful, let's say in symptomatic disease -- may it be so -- the crush to take advantage of what we know, while it's still in research format now, will be immense," DeKosky said.

If you or a loved one are interested in exploring clinical trials, the Alzheimer's Association runs a system called TrialMatch to assist in finding a trial near you.

Cancer more likely in tall women

2011-07-22T09:56:00.000-07:00

Study: Tall women more likely to develop cancer

The taller a woman is, the greater her risk of developing one of 10 different cancers, according to a new study published in the journal Lancet.

Researchers followed 1.3 million middle-aged women in the United Kingdom for several years, and found the risk of cancer increased by about 16% for every 4 inches or 10 centimeters of increased height.

But the question remains, why?

According to Jane Green, a clinical epidemiologist at Oxford University and the lead author of the study, the tallest group – women 5 feet 9 or taller – were 37% more likely to develop cancer than the shortest group – women 5 feet and shorter- regardless of factors such as age, socioeconomic status, body-mass index and amount of physical activity.

There were 97,376 incidents of cancers reported among the women, and height related increases were greatest for the following: colon, malignant melanoma, breast, endometrial, kidney, central nervous system, non-Hodgkin lymphoma, and leukemia.

The study did not investigate what specifically about height led to the increased risk, but the research add to other studies that have found a link between cancer and height. The study authors aren't sure what exactly increases the cancer risk, but they believe there are several theories that warrant more investigation.

For one, the authors propose that “taller people have more cells, and thus a greater opportunity for mutations leading to malignant transformation.”

Another possible culprit: Hormone levels resulting from insulin-like growth factors both in childhood and in adult life.

“Growth hormones increase cell growth and rate of division, and inhibit cell death,” Green explained in an email. “Both of these might be relevant to cancer either directly or perhaps just by increasing the number of cell divisions during which mutations can occur in the cell DNA.”

A study published earlier this year by researchers in Ecuador found that a condition that stunts the growth of extremely short Ecuadorians, simultaneously reduced the risk of cancer and diabetes in that population. The patients in that study all exhibited a specific mutation in their growth hormone receptor gene.

According to experts with the American Cancer Society, tall people should not be alarmed because of these findings.

"The underlying biological reason for the slightly higher risk among taller people is not known,” explains Eric Jacobs, strategic director of pharmacoepidemiology. “Nobody will be trying to make themselves shorter to lower their cancer risk, and the current results do not mean tall people need additional cancer screening," Jacobs explains.

In fact the study found that smoking was a much stronger risk factor. In current smokers, smoking-related cancers were not as strongly related to height, which Jacobs says highlights the overwhelming importance of the role smoking plays in cancer risk.

"The bottom line is that both short and tall people can lower their risk of developing and dying from cancer by not smoking, maintaining a healthy weight, and getting the recommended cancer screening tests," he says.

The authors also note more research is needed as certain populations continue to grow taller. The average height of people in Europe has increased by about 1 cm (or .39 inch) per decade throughout the 20th century, the study authors say.

According to the Centers for Disease Control, between 1960 and 2002, the average height of an adult man in the U.S.increased from just over 5 feet 8 inches to 5 feet 9 and ½ inches, while the average height of a woman increased from just over 5 feet 3 inches to 5 feet 4.

“The increase in adult height during the past century could thus have resulted in an increase in cancer incidence some 10–15% above that expected,” the authors report.

Yoga poses for what ails you

2011-07-21T09:57:00.000-07:00

Yoga poses for what ails you
By Elizabeth Cohen

When Dr. Carolyn LaFleur was in a car accident six years ago, she couldn't move her neck for a year and a half, she had terrible pain in her hip, and she would get headaches at her temples.

Frequent icing, physical therapy and massage therapy helped her neck and hip, but didn't do much for the pain in her head.

Then just last year LaFleur discovered yoga. While it didn't get rid of her headaches, it did make the pain much more manageable.

"Yoga has given me strength," says LaFleur, 66, an anesthesiologist who practices in Hudson, New York.

She has her yoga "prescribed" by Dr. Loren Fishman, a rehabilitative medicine specialist at Columbia University's New York-Presbyterian hospital in Manhattan.

"Yoga lowers your tension. It relaxes the basic tone of your muscle," he says. "And the minute you notice that yoga helps, it raises your confidence that you can help yourself. It gives you the feeling of 'I can do it.' "

Fishman and others have done studies showing yoga can help all sorts of medical ailments, from depression to sexual dysfunction to rotator cuff injuries.

"People often have a hard time believing they can get such powerful change from yoga, but they do," says Dr. Dean Ornish, who has studied the health benefits of yoga.

Ornish, a clinical professor of medicine at the University of California San Francisco, says yoga works by bringing down stress levels, which relaxes everything in your body, including blood vessels.

"Your arteries begin to relax so there's more blood flow everywhere, so everything is better," says Ornish, president of the Preventive Medicine Research Institute.

Here are 10 ailments where yoga can make a difference.

1. Headaches

Fishman suggested to LaFleur that she do the camel pose, thebridge pose and the wheel pose for headaches. He says these poses stretch the muscles in the front of the chest, which help control the head. The Yoga Journal has more information on yoga for headaches.

2. Asthma

Several studies, including one published in the "Indian Journal of Physiology and Pharmacology," show yoga can help asthma sufferers. Livestrong and Women Fitness list poses that seem to help.

3. Sexual dysfunction in women

A study in the "Journal of Sexual Medicine" shows yoga improved women's desire, satisfaction and orgasms. Health magazinesuggests a sequence of wide leg squat to lizard lunge to frog pose to improve a woman's sex life. Harvard Medical School also has suggestions (added) for yoga poses to enhance sexual function.

4. Sexual dysfunction in men

Doctors in India have successfully used yoga to treat men with premature ejaculation; there are more details in an article in the "Journal of Sex & Marital Therapy." Men's Health suggests certain poses to help men improve their sex lives, including something called "horndog pose."

5. Sleep problems

Researchers at the M.D. Anderson Cancer Center found lymphoma patients who did yoga slept better than those who didn't.About.com's yoga guide suggests trying the happy baby pose or the goddess pose before you go to bed.

6. Menstrual pain

According to a study published in the "North American Society for Pediatric and Adolescent Gynecology," the cobra, cat and fishposes helped teens and young women with menstrual pain.

7. Rotator cuff injuries

Fishman published a study earlier this year showing a chair-assisted headstand can help people with rotator cuff tears. See Figure 2 for how to do it.

8. Osteoporosis

Fishman also published a study showing a regimen of 10 yoga poses helps build bone mineral density after menopause.

9. Pain sensitivity

According to the "Harvard Mental Health Letter," a study at the University of Utah showed people who practice yoga had a higher pain tolerance than those who didn't.

10. Depression and anxiety

A German study mentioned in the same Harvard publication showed that emotionally distressed women became less depressed and anxious after they took two 90-minute yoga classes a week for three months. This yoga journal article suggests camel pose, bridge poseand wheel pose.

Does Your Personality Dictate Whether You'll Be Overweight?

2011-07-21T05:34:00.000-07:00

Does Your Personality Dictate Whether You'll Be Overweight?

People who are impulsive, aggressive or risk-takers more likely to weigh more, study contends.

By Mary Elizabeth Dallas, HealthDay News

Personality traits may play key roles in body weight, according to a new U.S. study.

Researchers from the U.S. National Institute on Aging found that people who are impulsive, cynical, competitive or aggressive were more likely to be overweight. And those who are highly neurotic and less conscientious are likely to see their weight go through many ups and downs.

"Individuals with this constellation of traits tend to give in to temptation and lack the discipline to stay on track amid difficulties or frustration," said the researchers in an institute news release. "To maintain a healthy weight, it is typically necessary to have a healthy diet and a sustained program of physical activity, both of which require commitment and restraint. Such control may be difficult for highly impulsive individuals."

For the study, published online July 11 in the American Psychological Association's Journal of Personality and Social Psychology, the researchers examined data compiled over 50 years on nearly 2,000 generally healthy and highly educated people to determine how their personalities might affect their weight and body mass index.

The participants were assessed on the so-called "big five" personality traits — openness, conscientiousness, extraversion, agreeableness and neuroticism — as well as 30 subcategories of these traits. They were also weighed and measured over the course of the study.

Although people tend to gain weight as they age, the study found those who are impulsive were the most likely to be overweight. People who scored in the top 10 percent on impulsivity weighed an average of 22 pounds more than those in the bottom 10 percent, the researchers said.

"Previous research has found that impulsive individuals are prone to binge eating and alcohol consumption," the study's author, Angelina R. Sutin, said in the news release. "These behavioral patterns may contribute to weight gain over time."

Those who are risk takers, antagonistic, cynical, competitive and aggressive also had greater weight gain, the study showed.

On the flip side, the study found that conscientious people are typically thinner and their weight did not trigger changes in personality during adulthood.

"The pathway from personality traits to weight gain is complex and probably includes physiological mechanisms, in addition to behavioral ones," Sutin concluded. "We hope that by more clearly identifying the association between personality and obesity, more tailored treatments will be developed. For example, lifestyle and exercise interventions that are done in a group setting may be more effective for extroverts than for introverts."

Smoke leads to teen hearing loss

2011-07-20T08:35:00.000-07:00

Secondhand Smoke Associated with Hearing Loss in Teens
By Meredith Melnick

It's not news that second-hand smoke can be dangerous—even deadly. Now add one more price nonsmokers pay for living around people who light up: According to a new study from New York University's Langone Medical Center, teens who are regularly exposed to second hand smoke are nearly twice as likely to have hearing loss as teens who live in smoke-free environments.

The study involved 1,533 non-smoking adolescents between the ages of 12 and 19 who underwent hearing tests to determine auditory acuity at both high- and low-frequencies. Researchers also measured the subjects' blood concentrations of cotinine — a byproduct of the neurotoxin nicotine that is often used as a biomarker of smoke exposure.

Not only were teens who had the highest level of cotinine more likely to have high- and low-frequency hearing loss, the degree of that impairment was proportional to the level of blood toxicity. In other words, the greater the smoke exposure, the greater the damage — which suggests that the rate of hearing loss could be cumulative.

"Prior work has shown an association between secondhand smoke and ear infection in children which can be associated with conductive hearing loss that is reversible. In adults, smoking has been associated with early hearing loss," says lead author, Dr. Anil K Lalwani, a professor in the departments of Otolaryngology, Physiology and Neuroscience and Pediatrics at NYU Langone Medical Center. "I was concerned that secondhand smoke could similarly be injurious to children and cause injury to the inner ear leading to permanent sensorineural hearing loss."

But even with this suspicion and the evidence provided by the study, it's too early to say with certainty how secondhand smoke could relate to hearing loss. As Lalwani says, previous studies have established a link between smoke exposure and ear infections in children. When that exposure is chronic, the infections could be too, and hearing loss could result. For now, that mechanism is only theorized and more work will be needed to establish it conclusively.

Still, with up to 50% of American kids exposed to second-hand smoke either in the home or out in the world, it makes less sense than ever for smokers to keep lighting up. "In homes where there is active smoking, parents and caretakers should be made aware of risks to hearing in their children," wrote the researchers. Adults unwilling to safeguard their own health might at least take steps to look after that of their kids.

The study was published in the medical journal, Archives of Otolaryngology -- Head and Neck Surgery.

7-Year-Old Evan Moss's Inspiring Fight Against Epilepsy

2011-07-19T08:38:00.000-07:00

7-Year-Old Evan Moss's Inspiring Fight Against Epilepsy

Evan Moss's story is one of those inspirational stories that makes one stop what he or she is doing and marvel at the strength of will some children display.

Evan started having seizures within his first month of life. By the time he was 4-years-old, he was having 300-400 seizures a month. Every day, the normal activities of a toddler would be interrupted about 10-15 times by epileptic seizures.

At the time, his parents Lisa and Rob Moss made the difficult decision for Evan to undergo brain surgery. "I remember thinking, we're making this decision for another person, and he can't even have any say in it," Lisa told The Huffington Post. Evan left the hospital seizure-free, and enjoyed a two-year respite from seizures.

That good fortune would prove not to last. Now, Evan is 7 and suffers from about 3-4 seizures a month. "He seems to be on a cycle where roughly every 8 to 10 or 12 days, he has a seizure. They always happen in his sleep, and last a long time," Lisa said. "They start very quietly, and we can usually tell because he sleeps in between my husband and I, and one of us always has one hand on him."

In an attempt to provide Evan with more security and independence, the Moss family has embarked on an ambitious project. They asked Evan if he wanted to write a book that could help them fundraise the $13,000 needed to get a seizure dog that would come alert Evan's parents if he was having a seizure.

Evan always enjoyed writing, Lisa said. His favorite activity in school was the "writing center," where students were handed pieces of paper stapled together into makeshift books. "By the end of the year, we had a stack of Evan's books about 9 inches high," she said.

As part of the extensive process of applying for a seizure dog, the organization tries to ensure that the student actually wants a dog. They ask for a letter or drawing from the child, and Lisa said Evan was eager to write a book instead.

Once Lisa and Rob showed the book to family members, an idea came to her. She scanned the drawings and typed up the text -- which Evan had written himself -- into a word document and eventually self-published the book on Create Space, a web publishing outlet owned by Amazon.

The end product, "My Seizure Dog," is a cute book that could do well as a gift for parents and children looking for inspiration. Younger children could read the book as a window into a life of a peer that's facing serious struggles, and parents will likely feel their heartstrings tugged by Evan's sincerity and willingness to take his fundraising and health into his own hands.

Lisa says when most people have seizures, the episodes resolve on their own or they come out of them relatively quickly and have to recover. But in Evan's case, he doesn't come out of them on his own. "After a seizure lasts 5 minutes or longer, it's considered dangerous and that's when medical attention becomes necessary. Evan's always last longer than 5 minutes, so we're constantly administering emergency medication -- sometimes two doses."

The seizures Evan experienced prior to surgery were quick and relatively low-key. He wouldn't lose consciousness, and Lisa says that sometimes someone standing next to him wouldn't notice. The seizures he has now, however, are far more serious, and it's not uncommon for the Moss family to call 911.

"We have a very nice relationship with the EMTs that respond," Lisa said. "The crew has been here before and they understand what we're dealing with."

When asked if Evan understands his health issues, Lisa said that she thinks so. "Evan has a pretty good understanding of it, and we've also created a website to track Evan's seizure activity. I'm also on the board of directors for the National Epilepsy Foundation. As a result of these activities, we attend a lot of family conferences, walks and events, so he knows other kids have it and he's very open about it," she told The Huffington Post. She added, "He'll run right up to people with dogs and tell them, 'I'm getting a dog that will tell my parents when I have a seizure!'"

Evan's condition hasn't only affected his life. His father, Rob, is a photographer, but he's minimized his work in order to be with Evan as much as possible. Lisa, who was a photo editor at AOL for many years, says it's a hard balance for everyone in the family. "We joke that his 9-year-old sister, Aria, knows more about epilepsy than most adults," she said. "Sometimes I think I worry more about Aria than Evan, because we know what we're dealing with with Evan, but sometimes I worry more about Aria and how it's going to impact her, having lived this life with a sibling with a chronic medical condition. That's something we try really hard to balance, but I don't know if you ever really can."

"The first thing we do when we travel is go meet the local emergency response team and give them a heads-up," she added. "We've spent holidays in the hospital, birthdays in the hospital, and it changes a lot. These are things neither of them should have to deal with."

The family is holding on. Lisa sounds upbeat and determined on the phone, and reports that Evan is cheery -- especially after he recovers from a seizure. "He's in the absolute best mood you can imagine after he gets up after having slept off medication after a seizure," she said. "He feels like he's on top of the world. Rob and I will be a mess, but he's singing and walking through the house and getting some cereal."

"But there's a reason we're [fundraising and getting Evan a seizure dog]," she said. "Evan sleeps with us, and we're not sure how much longer that's going to be ok."

For now, they are parents sleeping half-awake, with one arm resting on their son, hoping he enjoys a night uninterrupted by a visit from paramedics.