To your health: Tips to Wage The War of Nutrition

How To Gain Bone Mass | LIVESTRONG.COM

2011-01-10T17:07:00.000-08:00

Overview

Until your 30s, your bones take in more calcium than they use, resulting in increased bone mass. Sometime in your 30s, the balance shifts, and your body begins to leach calcium from your bones without replacing it, leading to decreased bone density. Low bone density means your bones are more fragile and break more easily. As you age, maintaining or gaining bone mass becomes an important part of your health care regimen.

Step 1

Increase your calcium intake to at least 1,000mg per day by eating calcium-rich foods, such as dairy products or leafy green vegetables, or by taking calcium supplements. If you're a postmenopausal woman, you need more calcium, so plan your diet to include 1,200 to 1,500mg of calcium, says Betsy Felser, a physician and assistant professor of clinical medicine at the University of California's Keck School of Medicine, in "USC Health" magazine.

Step 2

Take a vitamin D supplement to ensure that you get between 400 and 800mg of vitamin D every day, recommends Robert K. Rude, professor of medicine at the Keck School of Medicine and osteoporosis specialist, in "USC Health" magazine. Vitamin D helps your bones absorb calcium.

Step 3

Stop smoking. If you're a smoker, your chances of developing osteoporosis--low bone density--are significantly higher, according to Cedars-Sinai Medical Center. Quitting can help you improve your bone mass.

Step 4

Exercise for at least 30 minutes on most days of the week. According to Cedars-Sinai, a sedentary lifestyle increases your osteoporosis risk while regular exercise boosts your bone health.

Step 5

Do weight-bearing exercises like running, walking, weight training, tennis or dancing regularly. Weight-bearing exercises improve your bone strength by forcing bones to work against gravity, explains the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

References

Photo Credit

girl running in jog bra image by jimcox40 fromFotolia.com

About this Author

Holly Roberts is an award-winning health and fitness writer whose work has appeared in health, lifestyle and fitness magazines. Roberts has also worked as an editor for health association publications and medical journals. She has been a professional writer for more than 10 years and holds a B.A. in English and an M.A. in literature.

Article reviewed by Elizabeth Ahders

Last updated on: 08/04/10

More Evidence that Artificial Sweeteners Cause Weight Gain - Wellsphere

2011-01-10T16:26:00.000-08:00

More Evidence that Artificial Sweeteners Cause Weight Gain - Wellsphere

More Evidence that Artificial Sweeteners Cause Weight Gain

Posted Jul 03 2008 4:12pm

I recently told you about some research showing a nasty little correlation between the use of artificial sweeteners and compromised health, specifically where diet soda consumption was found to be associated with increased risk for both cardiovascular disease and metabolic syndrome, not to mention obesity.

(Two years ago, a study at the University of Texas found there was a 41% increase in the risk of being overweight for every single can of diet soda a person consumed, as I reported inDiet Soda No Bargainon September 26 2007.)

Now, in a new study from published in the February issue of Behavioral Neuroscience, rats that were fed artificially sweetened yogurt in addition to their regular rat chow wound up eating more and gaining more weight than rats that ate yogurt with real sugar. Psychiatrist Guido Frank at the University of Colorado in Denver says about this, "There is good evidence that the brain responds differently to artificial sweeteners and you should take this into account when designing weight-loss programs".

So why would you eat more calories when you're consuming artificial sweeteners?

We don't know for sure but three possible reasons have been suggested.

I've speculated before that artificial sweeteners might cause a blood sugar or insulin response simply via the mechanism of classical conditioning- much like Pavlov's dogs salivating at the sound of a bell simply because the bell had been associated with a steak. A second reason might be that exposure to artificial sweeteners in some way undermines the brain's ability to track calories and to determine when to stop eating.

Finally there's the possibility that diet soda drinkers do an eating version of what economists call "risk compensation"- theythinkthey're significantly cutting back on calories so they subconsciously "allow" themselves to eat more, usually way more than the number of calories they've "saved" by drinking diet soda!

Anyway you look at it, and whatever the reason turns out to be, most chemical artificial sweeteners aren't doing you any good.

And if you want further reason not to believe everything you read about nutrition in the popular press, a recent publication which shall remain nameless, "reported" on the recent artificial sweetener study, concluding that since artificial sweeteners were clearly bad, "you're better off eating real sugar".

Excuse me, how about a reality check young yeoman journalist: You're better off eatingneither! Just because Marlboro lights have less nicotine than Marlboro's doesn't mean Marlboro's are a good thing!

Calcium Alone Won't do a Thing for Reducing Hip Fractures

Short Burst "Interval" Training As Effective As Long Slow Aerobics

Artificial Sweeteners and Bladder Cancer: No Credible Link Thus far.

2011-01-10T16:18:00.000-08:00

Artificial Sweeteners and Bladder Cancer: A Link, Not according to Science? | 3FC

Artificial Sweeteners and Bladder Cancer: A Link?
January 29, 2010

For years now, many dieters and health-concise people have consumed beverages that contained artificial sweeteners. Rather found in tea or diet soda, the product has been popular among the masses. There is now scientific information regarding a potential link between the artificial sweeteners and bladder cancer.
The Definition of Artificial Sweeteners

This product can also be refered to as sugar substitutes. They are substances used in place of sucrose, commonly known as table sugar, to sweeten foods and beverages. There are six main kinds of sweetener in America. They are saccharin, aspartame, sucralose, neotame, acesulfame potassium and stevia.
Artificial sweeteners require smaller amounts to sweeten to the small level as sucrose. Artificial sweeteners are regulated by the FDA. However, since the Artificial Sweeteners are considered generally recognized as a safe product, it can be marketed before approval by the FDA. Popular brands sold are Equal and NutraSweet.
What Started the Frenzy

Back in the 1970s, a different sweetener, saccharin, linked bladder cancer to lab rats. This discovery started the worries about sugar substitutes. This discovery linked the cancer to rats only, the sweetener did not have the same affect on people. But, the concern had already been set in many American’s minds.
Studies Pertaining to the Link

During 1995 and 1996, a new study consisted of more than half a million Americans. 340,045 Men and 226,945 women were participants in a research project regarding artificial sweeteners. The study was done by reputable, independent researchers. The participants were between the ages of 50 to 69. Participants filled out surveys with specific food and drink intake. From there, researches would figure out the amount of aspartame each participant consumed. Soda and sweetener added to coffee and tea were given high preference.
The results showed no increased risks among the participants who drank large quantities of sweetened drinks daily. This study was run by scientists at the National Cancer Institute.
What It Means to the Diet Soda Drinker

While the rumor of cancer from sweeteners has been cleared based on this study, there will always be skeptics. People may base their opinions on previous generation family members rather than scientific fact. While significant artificial sweeteners can cause weight gain, there is no proof that it can cause cancer.
The Future of the Artificial Sweetener

While sales of the Artificial Sweetener may decrease from time to time, the product is not going anywhere. Products that contain these sweeteners are such items as bubble gum, diet sodas, creams for coffee, sweeteners for tea and coffee. These products will continue to be available, as they have been found safe for consumption.

Thirteen Pros and Cons of Artificial Sweeteners | 3FC

2011-01-10T16:12:00.000-08:00

So other that the last one re: bowl loosening (which is a definite side effect IMHO) all others are related to the 'Italian studies' (which are not credible IMHO/have not been replicated-- a big red flag in any experiment) and as it relates to how you can use them/like them.

Thirteen Pros and Cons of Artificial Sweeteners | 3FC

Thirteen Pros and Cons of Artificial Sweeteners

February 5, 2010

With so many options it may be hard to choose artificial sweeteners that are right for you. Most artificial sweeteners have both pros and cons, leaving it hard to decide which one to choose. Each substitute has its own individual set of pros and cons.

Pros

All sugar substitutes have known pros other than just that most of them have no calories. Some of the more common pros include:

Leaving no effect on your body’s blood-sugar levels.
A better, sweeter flavor than sugar.
Helping the body loose weight.
No adverse changes on taste when heated.
The ability to use less product to achieve the same level of sweetness.
Most artificial sweeteners appear to be safe for pregnant women.
Some artificial sweeteners have been proven to not increase cancer risks.
Combining certain artificial sweeteners can produce a customized, unique flavor.
Some products, such as Stevia, have been used before in other countries with no adverse effects on the populace.
Helping you control diabetes.
Replacements for less suitable sweeteners such as high fructose corn syrup.
Allowing the common dieter the ability to eat foods they normally wouldn’t be allowed because of high sugar content.

Cons

The bad side effects are the most notorious part of sugar substitutes, some of which are harmful enough to cause death. Some of the more common cons include;

Unlisted calories.
Changing the texture of baked goods.
Adding an ‘artificial’ taste to food or drinks.
Claims of organ damage in animal testing.
Certain artificial sweeteners are listed as “anticipated human carcinogens.”
Possible bodily harm to children who consume it.
Certain sweeteners contain phenylalanine which some people can’t metabolize.
Some sweeteners cannot be used for baking.
Some people are allergic to artificial sweeteners.
When used alone as a sweetener some artificial sweeteners have a bitter taste.
Many tests concerning artificial sweeteners have been proven to be poorly conducted.
Some artificial sweeteners have not been approved by the FDA.
Possible laxative effect when more than recommended is consumed.

There are also reports of side effects such as:

Headaches and dizziness
Mood changes
Weight gain
Vision and hearing problems
Muscle spasms
Fatigue
Anxiety attacks
Depression
Memory loss
Heart palpitations
Lupus
Epilepsy
Nausea
Insomnia
Joint pain

Unfortunately, most new artificial sweeteners are too new to have been tested fully, so many of them may prove to be more harmful in the long run than they appear to be right now. If you happen to have many allergies it may be best to consult your physician before trying any artificial sweeteners.

Related posts:

Artificial Sweetener Are Bad

2011-01-10T16:05:00.000-08:00

I've included the comments to show how funny some people are after reading a few blogs they are 'scientists' or something...

Artificial Sweetener Are Bad

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By Hilium

For years, artificial sweeteners have been hailed as the dieter's dream come true. Great taste. No calories. What could be better?

Problem: The sweeteners have not lived up to their publicity. Most don't really taste all that good. And the more tests we conduct, the more bad news we get about their adverse effects on our health.

The truth about: Saccharin. Widely available as Sweet-'nLow. The first noncaloric artificial sweetener, saccharin was discovered in 1879, when it was accidentally produced by a student at Johns Hopkins University.

Saccharin is used in canned fruits and chewing gums and in unexpected places, including toothpaste. Its use has declined somewhat since the advent of newer sweeteners (see below).

Pros: 350 times sweeter than sugar.

Cons: Produces a bitter aftertaste. Saccharin creates a slightly increased risk of bladder cancer in humans. Products containing saccharin are required to carry a warning label regarding the cancer risk.

Acesulfame K. Widely available as Sunette and Sweet-One.

The newest substance to be approved for use as a tabletop sweetener. It has not yet been approved for any additional uses.

Pros: 200 times sweeter than sugar.

Cons: Although it has not been thoroughly tested, long-term rat studies produced lung, breast and other tumors. It may slightly increase the risk of cancer and should not have been approved.

Aspartame. Widely available as Equal and NutraSweet. Used in soft drinks and in countless types of diet foods. It breaks down at high temperatures, however, and can't be used in baked or cooked foods.

Pros: 150 to 200 times sweeter than sugar.

Cons: Early tests showed that aspartame may have caused an increased incidence of brain tumors in rats. (Other animals tested showed no tumors.)

A board of public inquiry revoked the Food and Drug Administration's (FDA) 1974 approval of aspartame on the grounds that the research did not conclusively show that aspartame does not cause brain tumors. Three of five members of an FDA panel selected to review the board's decision agreed with it. But the FDA commissioner overturned the board's decision and reapproved aspartame anyway.

The rat study has not been repeated, so the question of brain-tumor risk remains unresolved. Also, the medical literature is peppered with reports of headaches and other reactions associated with aspartame.

Recommended: People who seem to be sensitive to aspartame should avoid it. Products containing aspartame also must carry a warning label for people with phenylketonuria (PKU), a genetic problem that afflicts one in 20,000 people. People with PKU can't metabolize a component of aspartame.

Warning for travelers:

Cyclamate, a popular sweetener in the 1950s and 1960s, was banned in the US in 1970. It was linked to bladder cancer, shrinking testes and other health risks in laboratory animals.

But US manufacturers still market cyclamate to many other countries, where it is used alone, or combined with saccharin. When you travel, read labels very carefully to avoid products that contain cyclamate.

Do we really need them?

More and more evidence shows that artificial sweeteners are not all they're cracked up to be.

Reasons:

Each presents some health risk.
Despite the popularity of artificial sweeteners, people are consuming more sugar than ever.

Theory: Sugar substitutes may be stimulating our appetite for sugar.

Although artificial sweeteners have no calories, they have no nutritive value either. Bottom line: Most people probably would be better off using moderate amounts of sugar.

One teaspoon of sugar contains fewer than 25 calories. Used in moderation, its only adverse effect (except in people with diabetes and some other medical conditions) is to promote tooth decay, which is easily preventable and treatable.

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Comments

J. Ross 20 months ago

OTHER STUDIES SEEN ON THE INTERNET CONTRADICT YOUR FINDINGS !

me 19 months ago

I strongly believe that sweeteners are making our bodies worse. Sweetener is a chemical, and while it may have less calories than sugar, it is far worse. It is really bad for you, even worse than sugar. Uh, so how does that work? It doesn't!

K.S 19 months ago

Even though sweeteners are supposed to be better, they don't taste nicer and are worse for you than sugar. I agree, with the research I've done I know that sugar is better than artificial chemicals.

Julie W 19 months ago

Though I have researched a lot about artificial sweeteners and have found many different opinions, I have finally come to a conclusion. While sweeteners contain no sugar, they are a chemical, and 100% FAKE. Thay have no calories, but many are a health risk and are dangerous to animals and us. If you're smart, you would keep your body healthy.

D.C 19 months ago

I don't know much about artificial sweeteners, but now I do! There are lot's of different opinons of course, but I learnt a lot just from your page. Thank you!

M.Hughes 19 months ago

I'm not really sure what to believe. Some people don't really think it matters, but some do. I now realise that sweeteners are fake and are a chemical, and I don't have diet cokes or sprite zeros anymore.

J. Sabz 19 months ago

Thanks, now I'll be more careful when drinking coffe!!

flobberface 18 months ago

duuuude, sweeteners are BAD (:

M 15 months ago

Thanks for this i.m.o. well-balanced article. The long and short of it is that neither sugar nor artificial sweeteners are harmful when used in moderation. Trouble is, some of us have problems with moderation.

IP 15 months ago

Why does everybody think that just because something is a 'chemical' it is automatically bad for you? Just because its not Natural? Sugar is a chemical too - 12 atoms of carbon, 22 of hydrogen, and 11 of oxygen.

FDA=devil 13 months ago

Aspartame contains methanol which breaks down in the system to produce many metabolites, one of which is formeldahyde. To defend harmful artificial sweeteners with the argument that they are made up of a different arrangement of the same atoms is as ignorant as saying "the FDA approved it so it must be safe.

Jake 13 months ago

Artificial sweeteners are WORSE than sugar! Sugar is only bad for you when over consumed. Your body uses sugar for energy fist because it is easily metabollized. Think about it why is sugar in pretty much any natural food? Why do you want to eat something that tastes like a cats pooper? Just stop eating so much junk food if your a fat whale and stop being lazy. Oh and has anyone ever wondered why the only people that drink diet soda are fat? Maybe cause if you cut out all the sugar in your diet you body stores ever little bit it does get as fat for a rainy day

josh 9 months ago

the better i can limit my 6 year old son from artifical sweetners, the less his allergies act up

Chem Major 2 months ago

As a chemistry major at a prestigious American university (currently ranked in the top thirty according to newsweek), I can safely say that there is little to no risk of using the artifical sweetener saccharin specifically. I have been working for months and doing research on this sweetener, and the negative health effects were specific to rats because of a unique metabolistic chemical in their bodies that will cause cancer in the presence of saccharin. This is NOT present in humans. Also, for those who do not understand the word chemical, sugar (glucose) is also a chemical (to be accurate, everything is a chemical or made up of chemicals). Finally, 10 years ago the warning labels were removed because the FDA found CONCLUSIVELY that it does not cause cancer in humans.

Brett 7 weeks ago

As a food scientist, the more articles written by laymen and the more comments posted by the public I read (concerning foods,additives,nutrition etc) the more I realise that the majority of people, including the author of this article, are dim-witted, uneducated conspiracy theorists.

Aspartame Safety Concerns on MedicineNet.com

2011-01-10T16:00:00.000-08:00

Aspartame Safety Concerns on MedicineNet.com

Aspartame Safety Concerns

Food Frauds Slideshow Pictures

Take the Quiz: Diet & Nutrition

Take the Quiz: Sugar and Sweeteners

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

In response to research published by Italian scientists that suggests that the artificial sweetener aspartame can cause cancer, the U.S. consumer organization Center for Science in the Public Interest requested an urgent Food and Drug Administration (FDA) review of the product's safety in June 2007.

Aspartame, which has been on the U.S. market since 1981, is composed primarily of two common amino acids, aspartic acid and phenylalanine. Each of these is also a building block for conventional foods such as protein and natural flavor molecules. Before its FDA approval, the safety of aspartame was tested in over 100 scientific studies. These studies were carried out in both humans and laboratory animals and included studies of rats that were fed aspartame in doses greater than 100 times the amount that humans would normally consume.

The data that sparked the controversy were from a report by researchers at the European Ramazzini Foundation (ERF) in Bologna, Italy, published in 2005. The scientists carried out tests of over 4,000 rats that regularly consumed high doses of aspartame and were allowed to live until they died naturally. Scientists from ERF concluded from their study that aspartame causes cancer and that current uses and consumption of the sweetener should be reevaluated.

The controversy prompted a review of the data by the European Food Safety Authority (EFSA) in May 2006. At that time, an EFSA press release stated that EFSA's review of ERF's study concluded, among other things, that on the basis of all evidence currently available to EFSA, ERF's conclusion that aspartame is a carcinogen is not supported by the data and the EFSA sees no need to further review its earlier scientific opinion on thesafety of aspartame or to revise the Acceptable Daily Intake.

Upon learning of the ERF study results, the U.S. FDA also requested the study data from ERF to evaluate the findings. On Feb. 28, 2006, the agency received a portion of the data requested. The FDA issued a statement in May 2006 which stated:

In summary, the FDA currently supports its previous position regarding the safety of aspartame. However, because of its phenylalanine component, aspartame does carry a risk for people with the rare genetic disorder phenylketonuria. People who have this disorder should avoid or restrict aspartame use because of their body's difficulty in metabolizing phenylalanine.

Last Editorial Review: 7/10/2007

When the Diagnosis Is 'Dead Butt Syndrome' - NYTimes.com

2010-12-25T09:12:00.000-08:00

When the Diagnosis Is 'Dead Butt Syndrome' - NYTimes.com

December 21, 2010, 11:42 AM

When the Diagnosis Is ‘Dead Butt Syndrome’

By JEN A. MILLER

Jen Miller at the finish of the Ocean Drive 10 Miler in Wildwood, N.J.

My butt, unfortunately, is dead.

“Dead butt syndrome,” the sports medicine doctor said to me after making me go through a series of circus-act contortions that involved swiveling my hip in all directions. His voice was very serious, his tone stern. I wondered if I should start making funeral arrangements for my rear, maybe a New Orleans-style blowout parade?

Hold the tuba. My butt’s not really dead. It can’t be revived with defibrillator paddles, but it can be fixed.

The technical name of the condition I have is gluteus medius tendinosis — an inflammation of the tendons in the gluteus medius, one of three large muscles that make up the butt. It’s a very isolated and painful injury that knocked me out of marathon training in January with stabbing pains in my hip. It’s a symptom related to what running experts hammer at: the need for cross-training and strength training. I was running so much that I told myself I didn’t have time for the exercise machines or weights, so I have no one to blame but myself.

I’ve been running for five years, but I’d never heard of the problem. I ran it by a friend, a former track coach at the University of Pennsylvania, and he was baffled too. I haven’t seen any coverage, though the doctor said it’s fairly common with runners who train for half marathons and beyond. It took him five minutes to figure out the problem.

“A new thought in running medicine is that almost all lower extremity injuries, whether they involve your calf, your plantar fascia or your iliotibial band, are linked to the gluteus medius,” said Dr. Darrin Bright, a sports medicine physician with Riverside Methodist Hospital in Columbus, Ohio, and medical director of that city’s marathon. “In the last five to 10 years, we’ve just realized how much of an important role the gluteus medius plays in stabilizing the hips and the pelvis in running.”

If you think of the pelvis as a cup, the muscles that attach to it, including the three gluteal muscles and the lower abdominals, interact in an intricate choreography to keep the cup upright when you run or walk. If these muscles are strong, the cup stays in place with no pain. If one or more of those muscles is weak, the smaller muscles around the hip take on pressure they weren’t designed to bear.

The cup still stays up, but at a price. First come muscle tears and inflammation, followed by scar tissue in the muscle. If left untreated, this process becomes a cycle that keeps feeding into itself.

“For people who have persistent pain, it’s healing gone wrong,” Dr. Bright said. “That gluteus medius isn’t firing the way it’s supposed to. You’re getting an inhibition of the muscle fibers. It’s kind of dead.”

Some of us run through the pain, which is what I did. And many compensate by adjusting their strides in a way that impedes the gait and can lead to problems in the quads, hamstrings, Achilles tendons, heels, knees, calves, ankles, feet or toes.

“Whether they’re recreational weekend runners up to the elite marathoners, the majority of runners I see have weak gluteus medius and gluteus maximus muscles,” said Dr. David Webner, a sports medicine doctor at Crozer-Keystone Health System in Springfield, Pa.

For about 70 percent of his patients, physical therapy that stretches the muscles in the hip and leg and strengthens the gluteus muscles, along with a temporary reduction in the mileage and intensity of running, resolves the problem. Deep tissue massage, which sends more blood to the area to break up scar tissue, along with strength training may also help to break the cycle of inflammation and scarring.

More advanced approaches include ultrasound guided tenotomy, which uses ultrasound to identify the affected muscles and then “poke little holes in the area of the scar tissue,” Dr. Webner said, or platelet-rich plasma therapy, which involves injections of centrifuged blood products and is what Tiger Woods underwent after knee surgery last year.

Fortunately, I didn’t need to take it that far. I’m lucky — the pain has ebbed with physical therapy and changing one of my weekly runs to a cross-training workout.

“Those runners who do multiple types of exercising are less prone to have weakness than runners who do just running,” said Dr. Webner. “Triathletes who come into my office don’t have as much weakness as just solo runners.”

So I’m biking. I row. I sweat through elliptical workouts at the gym.

And I no longer have the feeling that a pin is stabbing my hip every time I drive. I can sit for more than a half hour without pain. And last month I ran the Amish Bird-in-Hand half marathon, and felt no more discomfort than you’d expect to endure running 13.1 miles through the hills of Pennsylvania Dutch country.

To keep my rear alive, I must be vigilant about continuing to strengthen my lower abdominal and gluteal muscles. Last week, I slacked off and the pain came creeping back.

Is it annoying to have to focus so much on these muscles to run? Absolutely. But if it’ll revive my butt, it’s worth every leg lift and crunch.

Jen A. Miller is the author of “The Jersey Shore: Atlantic City to Cape May.”

A Doctor's Disdain for Medical 'Googlers' - NYTimes.com

2010-12-25T09:11:00.000-08:00

A Doctor's Disdain for Medical 'Googlers' - NYTimes.com

November 19, 2007, 11:06 AM

A Doctor’s Disdain for Medical ‘Googlers’

By TARA PARKER-POPE

(Jason Lee/Reuters)

Can a patient ever show up at the doctor’s office with too much information?

A doctor’s essay about medical “Googlers” — patients who research their symptoms, illness and doctors on the Web before seeking treatment — suggests they can. The report, which appeared in Time magazine, was written by Dr. Scott Haig, an assistant clinical professor of orthopedic surgery at Columbia University College of Physicians and Surgeons. He begins with a description of a patient he calls Susan, who seems to be clicking on a keyboard as she speaks to him on the phone. “I knew she was Googling me,” he writes.

Dr. Haig’s disdain for her information-seeking ways becomes quickly evident. He describes the woman’s child, whom she brings to the office, as “a little monster” and notes that the woman soon “launched into me with a barrage of excruciatingly well-informed questions.” Every doctor knows patients like this, he writes, calling them “brainsuckers.”

Susan had chosen me because she had researched my education, read a paper I had written, determined my university affiliation and knew where I lived. It was a little too much — as if she knew how stinky and snorey I was last Sunday morning. Yes, she was simply researching important aspects of her own health care. Yes, who your surgeon is certainly affects what your surgeon does. But I was unnerved by how she brandished her information, too personal and just too rude on our first meeting.

The problem, Dr. Haig notes, is that patients can have too much information and often don’t have the expertise to make sense of it. “There’s so much information (as well as misinformation) in medicine — and, yes, a lot of it can be Googled — that one major responsibility of an expert is to know what to ignore,” Dr. Haig writes.

Dr. Haig’s essay, however, has riled patient advocates, who believe patients need to arm themselves with information and take charge of their own medical care. Mary Shomon, who runs a popular thyroid disease blog on About.com, recently highlighted the essay on her site, generating angry responses from readers. Ms. Shomon said she thinks many physicians like Dr. Haig are threatened by patients who use Google and other Internet resources to research their own health questions.

“By condemning Googlers, he made it clear that he’s threatened by empowered, educated and assertive patients who do their own research,” said Ms. Shomon. “He can’t handle a patient who talks and doesn’t just listen. Good patients…are seen and not heard, right?”

Dr. Haig concludes his essay by confessing that he decided not to treat the woman, whom he described as “the queen of all Googlers.”

I couldn’t even get a word in edgewise. So, I cut her off. I punted. I told her there was nothing I could do differently than her last three orthopedists, but I could refer her to another who might be able to help.

Doctors and Patients, Doctors, google, Internet

When the Diagnosis Is 'Dead Butt Syndrome' - NYTimes.com

2010-12-24T20:44:00.000-08:00

When the Diagnosis Is 'Dead Butt Syndrome' - NYTimes.com

When the Diagnosis Is ‘Dead Butt Syndrome’
By JEN A. MILLER

Jen Miller at the finish of the Ocean Drive 10 Miler in Wildwood, N.J.
My butt, unfortunately, is dead.

“Dead butt syndrome,” the sports medicine doctor said to me after making me go through a series of circus-act contortions that involved swiveling my hip in all directions. His voice was very serious, his tone stern. I wondered if I should start making funeral arrangements for my rear, maybe a New Orleans-style blowout parade?

Hold the tuba. My butt’s not really dead. It can’t be revived with defibrillator paddles, but it can be fixed.

The technical name of the condition I have is gluteus medius tendinosis — an inflammation of the tendons in the gluteus medius, one of three large muscles that make up the butt. It’s a very isolated and painful injury that knocked me out of marathon training in January with stabbing pains in my hip. It’s a symptom related to what running experts hammer at: the need for cross-training and strength training. I was running so much that I told myself I didn’t have time for the exercise machines or weights, so I have no one to blame but myself.

I’ve been running for five years, but I’d never heard of the problem. I ran it by a friend, a former track coach at the University of Pennsylvania, and he was baffled too. I haven’t seen any coverage, though the doctor said it’s fairly common with runners who train for half marathons and beyond. It took him five minutes to figure out the problem.

“A new thought in running medicine is that almost all lower extremity injuries, whether they involve your calf, your plantar fascia or your iliotibial band, are linked to the gluteus medius,” said Dr. Darrin Bright, a sports medicine physician with Riverside Methodist Hospital in Columbus, Ohio, and medical director of that city’s marathon. “In the last five to 10 years, we’ve just realized how much of an important role the gluteus medius plays in stabilizing the hips and the pelvis in running.”

If you think of the pelvis as a cup, the muscles that attach to it, including the three gluteal muscles and the lower abdominals, interact in an intricate choreography to keep the cup upright when you run or walk. If these muscles are strong, the cup stays in place with no pain. If one or more of those muscles is weak, the smaller muscles around the hip take on pressure they weren’t designed to bear.

The cup still stays up, but at a price. First come muscle tears and inflammation, followed by scar tissue in the muscle. If left untreated, this process becomes a cycle that keeps feeding into itself.

“For people who have persistent pain, it’s healing gone wrong,” Dr. Bright said. “That gluteus medius isn’t firing the way it’s supposed to. You’re getting an inhibition of the muscle fibers. It’s kind of dead.”

Some of us run through the pain, which is what I did. And many compensate by adjusting their strides in a way that impedes the gait and can lead to problems in the quads, hamstrings, Achilles tendons, heels, knees, calves, ankles, feet or toes.

“Whether they’re recreational weekend runners up to the elite marathoners, the majority of runners I see have weak gluteus medius and gluteus maximus muscles,” said Dr. David Webner, a sports medicine doctor at Crozer-Keystone Health System in Springfield, Pa.

For about 70 percent of his patients, physical therapy that stretches the muscles in the hip and leg and strengthens the gluteus muscles, along with a temporary reduction in the mileage and intensity of running, resolves the problem. Deep tissue massage, which sends more blood to the area to break up scar tissue, along with strength training may also help to break the cycle of inflammation and scarring.

More advanced approaches include ultrasound guided tenotomy, which uses ultrasound to identify the affected muscles and then “poke little holes in the area of the scar tissue,” Dr. Webner said, or platelet-rich plasma therapy, which involves injections of centrifuged blood products and is what Tiger Woods underwent after knee surgery last year.

Fortunately, I didn’t need to take it that far. I’m lucky — the pain has ebbed with physical therapy and changing one of my weekly runs to a cross-training workout.

“Those runners who do multiple types of exercising are less prone to have weakness than runners who do just running,” said Dr. Webner. “Triathletes who come into my office don’t have as much weakness as just solo runners.”

So I’m biking. I row. I sweat through elliptical workouts at the gym.

And I no longer have the feeling that a pin is stabbing my hip every time I drive. I can sit for more than a half hour without pain. And last month I ran the Amish Bird-in-Hand half marathon, and felt no more discomfort than you’d expect to endure running 13.1 miles through the hills of Pennsylvania Dutch country.

To keep my rear alive, I must be vigilant about continuing to strengthen my lower abdominal and gluteal muscles. Last week, I slacked off and the pain came creeping back.

Is it annoying to have to focus so much on these muscles to run? Absolutely. But if it’ll revive my butt, it’s worth every leg lift and crunch.

Jen A. Miller is the author of “The Jersey Shore: Atlantic City to Cape May.”
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Can Humming Ease Sinus Problems? - NYTimes.com

2010-12-24T20:43:00.000-08:00

Can Humming Ease Sinus Problems? - NYTimes.com

REALLY?
The Claim: Humming Can Ease Sinus Problems
By ANAHAD O’CONNOR
Published: December 20, 2010
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Dealing with a cold is bad enough, but when it leads to a sinus infection, the misery can double. Some researchers have proposed a surprising remedy: channeling your inner Sinatra.

Sinus infections — which afflict more than 37 million Americans every year — generally occur when the lining of the sinuses becomes inflamed, trapping air and pus and other secretions, and leading to pain, headaches and congestion. Because the inflammation is often caused by upper-respiratory infections, people with asthma and allergies are more vulnerable than others to chronic sinusitis.

Keeping the sinuses healthy and infection-free requires ventilation — keeping air flowing smoothly between the sinus and nasal cavities. And what better way to keep air moving through the sinuses and nasal cavity than by humming a tune?

In a study in The American Journal of Respiratory and Critical Care Medicine, researchers examined this by comparing airflow in people when they hummed and when they quietly exhaled. Specifically, they looked to see if humming led to greater levels of exhaled nitric oxide, a gas produced in the sinuses. Ultimately, nitric oxides during humming rose 15-fold.

Another study a year later in The European Respiratory Journal found a similar effect: humming resulted in a large increase in nasal nitric oxide, “caused by a rapid gas exchange in the paranasal sinuses.” Since reduced airflow plays a major role in sinus infections, the researchers suggested that daily periods of humming might help people lower their risk of chronic problems. But further study is needed, they said.

THE BOTTOM LINE

Studies show that humming helps increase airflow between the sinus and nasal cavities, which could potentially help protect against sinus infections.

ANAHAD O’CONNOR scitimes@nytimes.com

A version of this article appeared in print on December 21, 2010, on page D6 of the New York edition.
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The Benefits of Exercising Before Breakfast - NYTimes.com

2010-12-24T20:42:00.001-08:00

The Benefits of Exercising Before Breakfast - NYTimes.com

December 15, 2010, 12:01 AM
Phys Ed: The Benefits of Exercising Before Breakfast
By GRETCHEN REYNOLDS

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The holiday season brings many joys and, unfortunately, many countervailing dietary pitfalls. Even the fittest and most disciplined of us can succumb, indulging in more fat and calories than at any other time of the year. The health consequences, if the behavior is unchecked, can be swift and worrying. A recent study by scientists in Australia found that after only three days, an extremely high-fat, high-calorie diet can lead to increased blood sugar and insulin resistance, potentially increasing the risk for Type 2 diabetes. Waistlines also can expand at this time of year, prompting self-recrimination and unrealistic New Year’s resolutions.

But a new study published in The Journal of Physiology suggests a more reliable and far simpler response. Run or bicycle before breakfast. Exercising in the morning, before eating, the study results show, seems to significantly lessen the ill effects of holiday Bacchanalias.

For the study, researchers in Belgium recruited 28 healthy, active young men and began stuffing them with a truly lousy diet, composed of 50 percent fat and 30 percent more calories, overall, than the men had been consuming. Some of the men agreed not to exercise during the experiment. The rest were assigned to one of two exercise groups. The groups’ regimens were identical and exhausting. The men worked out four times a week in the mornings, running and cycling at a strenuous intensity. Two of the sessions lasted 90 minutes, the others, an hour. All of the workouts were supervised, so the energy expenditure of the two groups was identical.

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Their early-morning routines, however, were not. One of the groups ate a hefty, carbohydrate-rich breakfast before exercising and continued to ingest carbohydrates, in the form of something like a sports drink, throughout their workouts. The second group worked out without eating first and drank only water during the training. They made up for their abstinence with breakfast later that morning, comparable in calories to the other group’s trencherman portions.

The experiment lasted for six weeks. At the end, the nonexercising group was, to no one’s surprise, super-sized, having packed on an average of more than six pounds. They had also developed insulin resistance — their muscles were no longer responding well to insulin and weren’t pulling sugar (or, more technically, glucose) out of the bloodstream efficiently — and they had begun storing extra fat within and between their muscle cells. Both insulin resistance and fat-marbled muscles are metabolically unhealthy conditions that can be precursors of diabetes.

The men who ate breakfast before exercising gained weight, too, although only about half as much as the control group. Like those sedentary big eaters, however, they had become more insulin-resistant and were storing a greater amount of fat in their muscles.

Only the group that exercised before breakfast gained almost no weight and showed no signs of insulin resistance. They also burned the fat they were taking in more efficiently. “Our current data,” the study’s authors wrote, “indicate that exercise training in the fasted state is more effective than exercise in the carbohydrate-fed state to stimulate glucose tolerance despite a hypercaloric high-fat diet.”

Just how exercising before breakfast blunts the deleterious effects of overindulging is not completely understood, although this study points toward several intriguing explanations. For one, as has been known for some time, exercising in a fasted state (usually possible only before breakfast), coaxes the body to burn a greater percentage of fat for fuel during vigorous exercise, instead of relying primarily on carbohydrates. When you burn fat, you obviously don’t store it in your muscles. In “our study, only the fasted group demonstrated beneficial metabolic adaptations, which eventually may enhance oxidative fatty acid turnover,” said Peter Hespel, Ph.D., a professor in the Research Center for Exercise and Health at Catholic University Leuven in Belgium and senior author of the study.

At the same time, the fasting group showed increased levels of a muscle protein that “is responsible for insulin-stimulated glucose transport in muscle and thus plays a pivotal role in regulation of insulin sensitivity,” Dr Hespel said.

In other words, working out before breakfast directly combated the two most detrimental effects of eating a high-fat, high-calorie diet. It also helped the men avoid gaining weight.

There are caveats, of course. Exercising on an empty stomach is unlikely to improve your performance during that workout. Carbohydrates are easier for working muscles to access and burn for energy than fat, which is why athletes typically eat a high-carbohydrate diet. The researchers also don’t know whether the same benefits will accrue if you exercise at a more leisurely pace and for less time than in this study, although, according to Leonie Heilbronn, Ph.D., a professor at the University of Adelaide in Australia, who has extensively studied the effects of high-fat diets and wrote a commentary about the Belgian study, “I would predict low intensity is better than nothing.”

So, unpleasant as the prospect may be, set your alarm after the next Christmas party to wake you early enough that you can run before sitting down to breakfast. “I would recommend this,” Dr. Heilbronn concluded, “as a way of combating Christmas” and those insidiously delectable cookies.
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Skipping Eye Exams Is Common Despite Fear of Losing Vision - NYTimes.com

2010-12-24T20:42:00.000-08:00

Skipping Eye Exams Is Common Despite Fear of Losing Vision - NYTimes.com

PERSONAL HEALTH
What We’re Not Looking After: Our Eyes
By JANE E. BRODY
Published: December 20, 2010
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Joe Lovett was scared, really scared. Being able to see was critical to his work as a documentary filmmaker and, he thought, to his ability to live independently. But longstanding glaucoma threatened to rob him of this most important sense — the sense that more than 80 percent of Americans worry most about losing, according to a recent survey.
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Partly to assuage his fears, partly to learn how to cope if he becomes blind, and partly to alert Americans to the importance of regular eye care, Mr. Lovett, 65, decided to do what he does best. He produced a documentary called “Going Blind,” with the telling subtitle “Coming Out of the Dark About Vision Loss.”

In addition to Mr. Lovett, the film features six people whose vision was destroyed or severely impaired by disease or injury:

¶Jessica Jones, an artist who lost her sight to diabetic retinopathy at age 32, but now teaches art to blind and disabled children.

¶Emmet Teran, a schoolboy whose vision is limited by albinism, a condition he inherited from his father, and who uses comedy to help him cope with bullies.

¶Peter D’Elia, an architect in his 80s who has continued working despite vision lost to age-related macular degeneration.

¶Ray Korman, blinded at age 40 by an incurable eye disease called retinitis pigmentosa, whose life was turned around by a guide dog and who now promotes this aid to others.

¶Patricia Williams, a fiercely independent woman legally blind because of glaucoma and a traumatic injury, who continues to work as a program support assistant for the Veterans Administration.

¶Steve Baskis, a soldier blinded at age 22 by a roadside bomb in Iraq, who now lives independently and offers encouragement to others injured at war.

Sadly, the nationwide survey (conducted Sept. 8 through 12 by Harris Interactive) showed that only a small minority of those most at risk get the yearly eye exams that could detect a vision problem and prevent, delay or even reverse its progression. Fully 86 percent of those who already have an eye disease do not get routine exams, the telephone survey of 1,004 adults revealed.

The survey was commissioned by Lighthouse International, the world-renowned nonprofit organization in New York that seeks to prevent vision loss and treats those affected. In an interview, Lighthouse’s president, Mark G. Ackermann, emphasized that our rapidly aging population predicts a rising prevalence of sight-robbing diseases like age-related macular degeneration and diabetic retinopathy that will leave “some 61 million Americans at high risk of serious vision loss.”

The Benefits of a Checkup

Low vision and blindness are costly problems in more ways than you might think. In addition to the occupational and social consequences of vision loss, there are serious medical costs, not the least of them from injuries due to falls. Poor vision accounts for 18 percent of broken hips, Mr. Ackermann said.

So, why, I asked, don’t more of us get regular eye exams? For one thing, they are not covered by Medicare and many health insurers. Even the new health care law has yet to include basic eye exams and rehabilitation services for vision loss, though advocates like Mr. Ackermann are pushing hard for this coverage in regulations now being prepared.

Lighthouse International is one of five regional low-vision centers participating in a Medicare demonstration project in which trained therapists teach patients how to use optical devices, how to make changes in their homes to facilitate independence and how to maintain mobility outside the home. Thus far, an interim analysis showed, the costs of providing these services are well below what had been anticipated.

I can think of no good reason for excluding this coverage in the nation’s health care overhaul, any more than there are good excuses for Medicare’s failure to pay for hearing aids. A lack of coverage for such services will inevitably carry its own heavy costs in the long run.

But even those who have insurance or can pay out of pocket are often reluctant to go for regular eye exams. Fear and depression are common impediments for those at risk of vision loss, said Dr. Bruce Rosenthal, low-vision specialist at Lighthouse. Patients worry that they could become totally blind and unable to work, read or drive a car, he said.

Yet many people fail to realize that early detection can result in vision-preserving therapy. Those at risk include people with diabetes, high blood pressure, high cholesterol or cardiovascular disease, as well as anyone who has been a smoker or has a family history of an eye disorder like macular degeneration, diabetic retinopathy or glaucoma.

Smoking raises the risk of macular degeneration two to six times, Dr. Rosenthal said.

Furthermore, he said, the eyes are truly a window to the body, and a proper eye exam can often alert physicians to a serious underlying disease like diabetes, multiple sclerosis or even a brain tumor.

Reasons Not to Wait

He recommends that all children have “a basic professional eye exam” before they start elementary school. “Being able to read the eye chart, which tests distance vision, is not enough, since most learning occurs close up,” he said. “One in three New York City schoolchildren has a vision deficit. Learning and behavior problems can result if a child does not receive adequate vision correction.”

Annual checkups are best done from age 20 on, and certainly by age 40, Dr. Rosenthal said. Waiting until you have symptoms is hardly ideal. For example, glaucoma in its early stages is a silent thief of sight. It could take 10 years to cause a noticeable problem, by which time the changes are irreversible.

For those who already have serious vision loss, the range of visual aids now available is extraordinary — and increasing almost daily. There are large-picture closed-circuit televisions, devices like the Kindle that can read books aloud, computers and readers that scan documents and read them out loud, Braille and large-print music, as well as the more familiar long canes and guide dogs.

On Oct. 13, President Obama signed legislation requiring that every new technological advance be made accessible to people who are blind, visually impaired or deaf.

Producing “Going Blind” helped to reassure Mr. Lovett that he will be able to cope, whatever the future holds. Meanwhile, the regular checkups and treatments he has received have slowed progression of his glaucoma, allowing him to continue his professional work and ride his bicycle along the many new bike paths in New York City.

This is the first of two columns on vision loss.

A version of this article appeared in print on December 21, 2010, on page D2 of the New York edition.
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