Could your child’s birthday be to blame for his ADHD diagnosis?  Maybe, especially if he’s one of the youngest students in the class.

In soon-to-be published research in the Journal of Health Economics, health economist Todd Elder, PhD, of Michigan State University, East Lansing, says as many as 1 million children in the U.S. may have been misdiagnosed with ADHD, simply because of their age and maturity level. That ought to be terrifying news, when you consider that the "cure" for ADHD is one of the most commonly overprescribed drugs in America — Methylphenidate, the generic name for a group of drugs that includes Ritalin, Concerta, Metadate CD and others. About 29 million prescriptions were written last year in the United States for Ritalin and similar drugs to treat attention deficit disorder and hyperactivity, 23 million of them for children.

While kids around the country are popping them like candy, few parents know the very real risks associated with these psychotropic medications such as:

• A 2005 study showed that Ritalin and other stimulant drugs given to children might increase their risk of cancer later in life.
• In a 70-week study, preschoolers on Ritalin, grew about half an inch less and gained about 2 pounds less than expected.
• A University of Buffalo study proved that Ritalin has the potential for causing long-lasting changes in brain cell structure and function.
• Hostility, aggression, anxiety, depression, and paranoia and suicide are potential side effects of Ritalin.

Matthew Smith’s parents wish they had known more about Ritalin before agreeing to give it to their son. Fourteen year old Matthew suddenly died on March 21, 2000. The cause of death was determined to be from the long-term (age 7-14) use of Ritalin. According to the Chief Pathologist of Oakland County, Michigan, upon autopsy, Matthew’s heart showed clear signs of small vessel damage caused from the use of Methylphenidate (Ritalin). In fact, according to his father, the certificate of death reads: "Death caused from Long Term Use of Methylphenidate, Ritalin."

And the reason Matthew was originally placed on Ritalin?  In first grade, Matthew was an active child who wasn’t as mature as some of his peers.  That immaturity cost him his life.

Elder’s study found that the youngest children in kindergarten were 60% more likely to be diagnosed with ADHD than their oldest classmates and were more likely to be on ADHD medications than the older kids. In gambling circles, those would be known as bankable odds. One in 100 preschoolers is already on Ritalin.  That works out to 70,000+ children between the ages of 3 and 4 on a daily dose of psychotropic drugs. I’ll leave it to science fiction writers to imagine what the long term consequences might be.

What are we doing to our children?

We punish our kids for being active, playful, and sociable — all of the things we should want our kids to be.  Maybe the problem isn’t our kids.  Maybe the problem is that too many schools are demanding that we drug our kids into uniform, passive submission.

All I can say is, "Thank goodness Ritalin wasn’t in use during the 30’s, or we’d never have the Little Rascals to enjoy today. Every single one of them would have been considered ADHD and drugged into boring conformity."

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Worried that your infant isn’t getting enough products high in sugar, artificial flavoring and colors?  Then Mead Johnson (part of Nestle, the multi-million-dollar-Swiss conglomerate) has got just the product for you.  Chocolate-flavored formula.  Don’t worry, if your little one isn’t hooked on chocolate yet, they’ve got vanilla, too. 

What’s the best way to set up our children for chronic illnesses, obesity and poor health? 

Get them addicted to toxic foods before they can walk or talk.  So if you expose a child to junk foods as infants, then their brains will become hardwired so that they are more likely to eat junk food themselves, with a particular fondness for treats high in fat, sugar and salt.  While we’d all agree that chocolate-flavored formula is bad for our children, even traditional formula still pales in comparison to the benefits of breast milk.
One of the best reasons to breastfeed is that breast milk aids in the development of baby’s immune system, providing protection against multiple diseases. The beneficial effects of breastfeeding children are well-documented and include a lower risk for ear and respiratory infections, atopic dermatitis, gastroenteritis, necrotizing enterocolitis, and sudden infant death syndrome (SIDS). But is also helps prevent Type 1 and Type 2 diabetes in children.

In one research study, children in New South Wales, Australia who had developed Type 1 diabetes were matched with healthy children (ratio 1:2) of the same sex and age for comparison. The results were statistically significant.  Those who were exclusively breastfed during their first three months of life had a 34% lower risk of developing diabetes than those who were not breastfed.  Children given cow’s milk-based formula in their first three months were 52% more likely to develop Type 1 diabetes than those not given cow’s milk formula.

There is growing evidence that breastfeeding may also reduce a child’s risk of developing Type 2 diabetes as an adult.  Less obesity, and lower insulin concentrations in later life are thought to be key benefits.

But enough about the child, what about the mother? Are there any benefits to breastfeeding for the mother?

As it turns out, there are many! Breastfeeding isn’t just good for babies’ short and long-term health, it’s good for mom, too. A new study shows that moms who breastfeed for at least two months are less likely to develop Type 2 diabetes later in life compared to those who do not breast-feed. Researchers from the University of Pittsburgh studied more than 2,200 women aged 40 to 78. They found that 27 percent of mothers who didn’t breast-feed developed Type 2 diabetes, almost double the rate among women who breast-fed or never gave birth.

And if a reduced risk of diabetes is not enough, for women with a family history of breast cancer, breastfeeding may offer as much as a 59% reduction in their odds of getting breast cancer themselves — a result that stunned the researchers who conducted the study.

But so far, this is all about health. And as we learned from Billy Crystal on Saturday Night Live, “It’s better to look good than to feel good.”  And as it turns out, breastfeeding can help you do just that. The same study that found that breastfeeding reduced the risk of moms developing diabetes also found that breastfeeding helps reduce belly fat — and what new mom doesn’t want that? In fact, the two results are likely connected, since the indications are that it is the losing of the belly fat that is responsible for the reduced risk of diabetes. Why it’s enough for men with Dunlop disease (my belly dun lopped over my belt) to want to get pregnant, give birth, and breastfeed themselves.

Bottom line: studies now show that breastfeeding helps prevent Type 1 diabetes in babies, Type 2 diabetes in moms, and even helps new moms trim down and tone up. Add that to all the other benefits associated with breastfeeding, and you’ve got a can’t lose proposition.

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A new study recently reported in WebMD showed that treatment of osteoarthritis-related knee pain with acupuncture produced about the same results as treatment with "sham acupuncture." In this study, one group of patients received authentic acupuncture treatments, but in the other group, the physicians inserted the needles outside of the correct meridian points and too shallowly to make a difference.

The researchers compared the real and bogus acupuncture treatments in 455 sufferers of knee arthritis. Subjects’ symptoms included pain, swelling of the knee, and stiffness in the knee joints. But the study wasn’t simply about the effectiveness of acupuncture. It was also about the impact of the interaction with the physician on patient outcomes. The accupuncturists were trained to deliver the treatment in two styles: "high expectation" and "neutral expectation." High expectation involved telling patients that the physician has had a high degree of success reducing pain using the treatment. Neutral expectation involved telling patients that the treatment may or may not work.

In the end, the recipients of both the real and fake acupuncture reported greater improvement in their symptoms than those who received no treatment. But among  patients who saw a high-expectation physician,  41.2 percent report a 50 percent improvement in symptoms, as compared to only 33.6 percent of those who saw a neutral expectation doctor. In a news release, study leader Dr. Maria Suarez-Almazor, a rheumatologist at the University of Texas Anderson Cancer Center in Houston, said, "We found a small but significant effect on pain and satisfaction with treatment, demonstrating a placebo effect related to the clinician’s communications style. The improvement in pain and satisfaction suggests that the benefits of acupuncture may be partially mediated through placebo effects related to the behavior of the acupuncturist."

As the witch said in Monty Python and the Holy Grail, after being exposed in a scientific study, "It’s a fair cop." I know most practitioners of acupuncture will be indignant, but let’s be honest for a moment. Doesn’t a patient’s mental state have a great deal to do with the effectiveness of any treatment?

And that would apply to medical doctors and their cuttings and dosings too, would it not?

In other words, the old "bedside manner" may be as much of a healing tool as the pocket full of pills. When the physician helps the patient feel hope, the results are better than when the physician frightens the patient with stories of scary outcomes or leaves the patient’s expectations in neutral. The study also underlines the fact that so much of healing occurs in the mind. According to WebMD, "Optimism is a resource for healing. Optimists are more likely to overcome pain and adversity in their efforts to improve their medical treatment outcomes. For example, optimistic coronary bypass patients generally recover more quickly and have fewer complications after surgery than do patients who are less hopeful." 

And then there’s the American Psychological Association list of facts demonstrating the mind/body connection in positive health outcomes. The list notes that higher levels of hostility are a better predictor of heart disease than cholesterol levels, cigarette smoking, or obesity; and that employees using mental health counseling reduced their use of medical insurance by 31 percent.

Clearly, positive health outcomes require, among other things, a positive attitude on the part of both patient and physician, appropriate treatment regimens, and good patient-physician communication. If any of these elements are off the mark, they can have a profound impact on the results.

In the meantime, don’t give up on acupuncture. Remember, in the study, the treatment helped even those who believed it might not. Confidence in the physician merely improved the results. In addition, there have been numerous medical studies that have acupuncture’s as effective as medical treatments for a number of conditions. For example, there’s the 2008 study that shows that acupuncture works as well as myofascial pain therapy in treating chronic musculoskeletal pain. And of course, for all those people who used acupuncture as their analgesic of choice during major surgery, it would be a huge surprise to find out that the effect was all placebo.

In the end, there’s no denying the influence of the mind when it comes to reducing pain…and even mortality. This is true regardless of the type of therapy used, alternative or medical. It is not for nothing that one of the most important chapters in Lessons from the Miracle Doctors is titled, "The Thought that Kills."

:hc

As a nod to greenness, many people avoid taking receipts when they make purchases at a store.  Now there’s another reason not to take your store receipts: avoiding contact with the bisphenol-A (BPA) that is often used as a color developer on thermal sensitive cash register paper.

Can you believe it? Even receipts you get for buying supplements at the health food store can cause cancer. As I’ve written several times before, BPA is bad stuff with a rap sheet as long as the Gambino family’s. And despite the FDA’s blessing, the list of charges keeps growing.  Used in making plastics–most notably water bottles and food containers, BPA mimics the effects of estrogen and has, in the past, been linked to breast and prostate cancers, diabetes, birth defects, and heart disease, among other things. A study last year connected BPA exposure with erectile dysfunction in men.  And just a few months ago, I reported on a British study that showed that those with high concentrations of BPA in their urine were twice as likely to have coronary heart disease.

What’s BPA doing in cash register paper? To make thermal paper, manufacturers sprinkle the surface of one side with a powdery coating that contains BPA, dye, and solvent. When the paper is heated or subjected to pressure, the coating ingredients combine and release the ink’s color. 

Three recent studies have assayed the amount of BPA that is found in cash register receipts and its transferability to the skin.   Researchers at the Warner Babcock for Green Chemistry in Wilmington, MA looked at 10 receipts and found BPA in six of them, in quantities ranging from 1.09 to 1.7 percent by mass, and in two more, in quantities of .30 to .83 percent BPA

Separately, a Swiss study looked at 13 European receipts and found that in eleven, 0.8 to 1.7 percent of the paper’s mass was BPA. According to the co-author of this study, analytical Chemist Koni Grall, a substantial amount of BPA rubbed off the paper from contact with dry fingers. Wet fingers picked up ten times more. But even with dry skin, two hours after contact, around 30 percent of the BPA that rubbed off the paper and onto the skin "was no longer extractable — could not be washed off." Grall theorizes that the BPA probably was absorbed into fatty or waxy elements of the skin. He goes on to say, "The shocking thing is what happened when I applied a bit of BPA onto my fingers with ethanol [alcohol]. After two hours it had disappeared. Totally." In other words, the alcohol significantly enhanced the absorption of BPA into the skin.

In the Washington, DC area, the Environmental Working Group (EWG) assayed 36 receipts that they collected from DC area retailers, as well as stores in seven other states and several in a city in Japan. Says study leader Frederick vom Saal of the University of Missouri in Columbia, "I won’t touch receipts now."  His study not only confirmed the wet-versus-dry transfer rate reported by Grall, but it also showed that the longer you hold the receipt, the more BPA gets transferred to your skin.

According to Grall, the exposure from touching one receipt is miniscule — 2.5 percent of the tolerable daily intake (assuming you believe that the assessment of what’s tolerable is valid). But for someone who is working in a retail store, handling receipts all the time and using skin cream, the intake could reach what European and US health authorities define as the tolerable limit — 50 micrograms of BPA per kilogram of body weight. The concentrations of pure BPA found in a surface coating on register paper can be as high as 10%.

Again, the bottom line is that longer contact and contact accompanied by moisture significantly increases the exposure. This means that drooling babies who play with store receipts, people with sweaty hands, those who use skin creams and oils, and those who have frequent contact with cash register receipts are likely candidates for higher levels of absorption of BPA.

The EWG notes, "Retail workers carry an average of 30 percent more BPA in their bodies than other adults. It is unclear how much BPA-coated receipts contribute to people’s total exposure to the ubiquitous plastics chemical. What is certain, however, is that since many retail outlets already use BPA-free paper for their receipts, this is one source of contamination that could easily be eliminated completely." And the EWG mentions a hopeful statistic: 60 percent of the receipts collected did not have significant levels of BPA.  Indeed, according to the EWG, "The leading U.S. thermal paper maker, Wisconsin-based Appleton Papers Inc., no longer incorporates BPA in any of its thermal papers."  They take these facts as evidence that retailers are using alternatives.

It’s not possible to distinguish the BPA containing receipts by looking at them, although you can tell if the receipt is thermally treated if it discolors when you rub it with a coin.   The study by the Environmental Working Group gives some hints about what to avoid.  According to its online summary, "The receipt for a McDonald’s Happy Meal™ purchased in Clinton, Conn., on April 21, 2010, had an estimated 13 milligrams of BPA. That equals the amount of BPA in 126 cans of Chef Boyardee Overstuffed Beef Ravioli in Hearty Tomato & Meat Sauce —  one of the products with the highest concentrations of BPA in EWG’s 2007 tests of canned foods." In fairness, the EWG did point out that receipts from a MacDonald’s in Japan had undetectable levels of BPA. It also noted that Safeway had the highest levels of BPA in its receipts by several measures.

There are specific steps you can take to minimize exposure to BPA from store receipts.  The EWG advises that you go paperless whenever possible, stash receipts in a separate wallet or envelope and handle them as little as possible, avoid the use of alcohol-based hand cleaners after handling receipts, and wash your hands immediately after handling receipts. Don’t give receipts to toddlers and babies to play with. And finally, don’t recycle BPA laden receipts. Remember, just because you’re paranoid, doesn’t mean your receipts aren’t trying to kill you!

:hc

Here’s a new twist on the old Drunken Shrimp recipe. According to a new study just published in the journal Aquatic Toxology, a lot of shrimp may be getting stoned on Prozac. That’s because they swim in waters polluted by pharmaceutical drugs, including antidepressants, which get flushed into the world’s waterways after they go through our bodies. The study, undertaken by researchers at U.K.’s University of Portsmouth, demonstrates that antidepressants now present in seawater may be altering the behavior of shrimp in ways that make them more vulnerable to predators. 

As reported in the National Geographic News, scientists exposed shrimp to fluoxetine, which is the generic name for the active ingredient in Prozac and Sarafem.  The exposure mimicked the average levels of fluoxetine found in water coming from sewage-treatment plants. And the shrimp, which normally hide in dark, safe corners, merrily headed for bright spots like drunken sailors drawn by neon lights. These shrimp were not happy drunks either, at least not according to the rather sensationalistic journalists who reported that the Prozac-intoxicated shrimp were committing "suicide." What they meant, according to study co-author Alex Ford, is that, "This behavior makes them much more likely to be eaten by a predator, such as a fish or bird."

What happens is that fluoxetine makes the animal’s brain more sensitive to seratonin. This alters mood and sleep patterns, which in turn affects the animal’s behavior. The researchers noted that with the rising use of antidepressants — 2005 usage levels were recently calculated at 10 percent of the U.S. population, or 27 million people, and climbing — it is very likely that the drugs are affecting other animals as well.

But antidepressants are just the tip of the pharmaceutical iceberg. Sea animals are regularly exposed to a range of drugs including antidepressants, painkillers, and anti-inflammatory drugs. Dr. Ford points out that the impact of these substances can be reduced through more public education about responsible disposal of prescriptions and the installation of improved technology at sewage treatment plants for breaking down excreted and flushed pharmaceuticals.

And again, if only the problem stopped with pharmaceutical pollution in the waterways, it wouldn’t seem so overwhelming. But the waters teem with plenty of other toxins that affect sea life. For instance, some years back, government researchers studying the Potomac River discovered "smallmouth bass with intersex, a condition where male fish develop premature egg cells."  Interestingly, while large numbers of male fish with intersex were turned up in the study, no cases of female fish with imposex — a corresponding condition in which female fish have malformed ovaries or produce sperm — were found. By studying the composition of the water, the researchers were able to determine that the fish were affected by chemicals that are known to trigger sex changes in animals.  Specifically, they found "chemicals from pesticides and flame retardants as well as fragrances commonly found in products such as soaps, antiperspirants, and deodorants."  All of the fish studied had at least one of these pollutants in their systems. If these chemicals trigger sex changes in animals en masse, we can only shudder to think what direct contact with these things does to us. Early puberty for girls and smaller penises for boys may be just a hint of things to come.

Of course, it’s not exactly hot off the presses that chemical residues are having a profound impact on aquatic life. A 2008 study by Environment Canada determined that about 400 of the 30,000 or so chemicals used commercially in the U.S. and Canada don’t break down in the environment.  One result is that increasing amounts of these substances can accumulate in fish and wildlife. As you might suspect, fewer than 25 percent of these chemicals are regularly analyzed.  Over 75 percent have not been studied at all.

Then there is the earlier work by John Incardona and Nathaniel Scholz at National Oceanic and Atmospheric Administration’s Northwest Fisheries Science Center and the West Coast Center for Oceans and Human Health on the impact of the Exxon Valdez spill in the Pacific.  They found that the polycyclic aromatic hydrocarbons (PAHs) left floating through the waters caused heart defects in herring and pink salmon embryos.  And let’s not forget that PAHs flow into coastal waters not only from oils spills, but from urban runoff and other sources. 

Dr. Incardona has studied the impact of PAHs over the last six years.  PAHs come from burning fossil fuels and carbon-based fuels from wood, incense, cigarettes, and so on. Dr. Incardona says they slow the heartbeat in fish embryos to such an extent that they lead to heart deformities and fluid buildup around the heart.  In zebrafish, whose systems are remarkably like humans, the absorption of PAHs through the skin leads to severe heart deformities.

If it‘s not good for the shrimp, herring, salmon, and zebrafish, the odds are it’s not good for us.  Incardona says that when it comes to PAHs, in urban environments, "we are breathing an aerosolized oil spill." PAH’s should be considered "prime suspects for cardiovascular impacts related to air pollution."

You can’t run and you can’t hide. Both the water and the air are being made into toxic stews that can have disastrous impacts on life on the planet.  The ultimate solution is to reduce reliance on toxic chemicals and to increase the filtering and removal of these chemicals from wastewater BEFORE it is discharged into the environment. Right!! In these days of budget deficits and economic woes, that may be unrealistic. On the other hand, if the environment is made continually inhospitable for human, animal and plant life, the economic issues will eventually cease to matter. But by now, you know what to do to protect yourself to the extent possible — clean up your drinking water, grow your own food and sprouts when possible, choose food sources wisely when growing your own is not an option, and detox every three months.

Oh, and grab onto something quickly if you ever find yourself slowly drifting towards a bright light.

:hc

While it isn’t news that women often sacrifice comfort for fashion, science is beginning to tally the cost of doing so. I’ve written before about the painful consequences women suffer from wearing high heels. Now, several studies show that short-term pain is but a prelude in terms of long-term damage. Just last month, for example, a study led by Professor Marco Narici, from Manchester Metropolitan University in the U.K., showed that wearing high heels really does a number on the wearer’s tendons.

According to Professor Narici, when women wear two-inch or higher heels frequently, they shorten the fibers in their calf muscles by an average of 13 percent. This exerts pressure on the Achilles tendon, making it thicker and stiffer.  The result is often calf pain and difficulty stretching the foot up and down, which can make it more difficult to walk on flat surfaces and to run. And although I can hear chiropractors, massage therapists, and other body workers saying, "I told you so," it is worth at least passing notice that scientific research has finally confirmed the findings of non-traditional practitioners.

Indeed, another recent study conducted by researchers at Iowa State University demonstrated that high heel wearers face increased risk of joint degeneration and the eventual development of osteoarthritis due to the extra pressure exerted on the knees.  Led by Dr. Danielle Barkema, the researchers looked at the impact on women between the ages of 18 and 40 of wearing flats, two-inch heels, and 3.5-inch heels.  They used sensors and cameras to measure the forces and shock waves in the legs of the women as they walked in the three types of shoes.

The research showed that wearing heels changed the women’s posture and caused their ankles to tilt inward, destabilizing their ankle joints.  In addition, there was a significant increase in the loading on the inner knee — a type of pressure known as ‘medial loading’ that increases the risk of joint degeneration and osteoarthritis.

Interestingly, the leaders of both studies stopped short of recommending that women stop wearing high heels. (They must be fans of ZZ Top’s Legs.) Professor Narici advised women to limit the amount of time spent in stilettos and add a regimen of stretching exercises. Looked at from a certain perspective, that’s the equivalent of advising women to periodically stab themselves but keep a good supply of bandaids around. In a similar spirit, Dr. Barkema said that her study didn’t mean that every woman who wore high heels would develop arthritis in her knees. Still, she did allow that high heels are "just not very good for the body."

Rheumatologist Naija Shakoor of Rush University Medical Center in Chicago, who is investigating what makes for the perfect shoe, echoes the sentiments of Narici and Barkema. "It’s just common sense that high heels are bad for women. I would save them for social occasions and going out. For every day, light, flexible and flat is the way to go," she said in an article on the DiscoveryNews website.

Perhaps these researchers are just being practical, given the conviction with which women wear high heels. WebMD cites a survey conducted by the American Podiatric Medical Association that showed "some 42% of women admitted they’d wear a shoe they liked even if it gave them discomfort; 73% admitted already having a shoe-related foot issue." But then again, how many potato chip fans refuse to indulge even though they know the negative impact on health? In any event, the article makes clear that "many women refuse to give up their high heels."

Still, many women in their 40s and 50s admit that it is harder for them to wear heels now then it was when they were in their 20s and 30s. That correlates directly to anatomical changes in the legs and feet of women as they age. For example, loss of fat on the bottom of the foot commonly occurs with aging. This means less protection on the bony ends of the feet, which then grind into the sole of the shoe from all the weight that bears down when a woman slips into her stilettos. The result can be foot pain and increased risk of stress fractures and osteoarthritis. Plus, if a woman has bunions, corns, or calluses, high heels can make them worse.

So if you can’t feel your womanly best without significant time strapped into your Manolos, WebMD lists five tips for protecting your feet in high heels. First, get heels that fit correctly, so your foot doesn’t slide forward to create more pressure and pain on the toes. Second, use cushioned silicone inserts to replace the lost fat on the bottom of your foot. Third, increase stability by wearing a thicker heel and vary heel heights to reduce Achilles’ problems. Fourth, wear a heel with a more gradual slope to the "flatbed" part of the shoe. It will place less stress on the arch. And fifth, to relieve pressure on corns and calluses, wear open-toed shoes.

On the other hand, if you’re inclined to see stilettos as a modern-day version of Chinese foot-binding (and the parallels can’t be ignored, considering the disabilities caused by heels), just say "no" and wear something that allows your feet and legs to do what they were designed to do.

:hc

Just like Britney Spears, whose career died and then came roaring back, Bordetella pertussis (B. pertussis, or whooping cough) is back with a vengeance. It’s one of those illnesses that everyone thinks was wiped out because kids have been getting vaccinated against it since the 1940s.

But despite the continued high level of vaccinations, Pennsylvania’s Department of Health just issued a health warning of unusually high levels of pertussis, and California has reported an epidemic, with 2,774 cases confirmed in 2010 alone. According to the New York Department of Health, "Since the 1980s, the number of reported pertussis cases has gradually increased in the United States. In 2005, over 25,000 cases of pertussis cases were reported in the United States, the highest number of reported cases since 1959. Approximately 60 percent of the cases were in adolescents and adults."

For some people, their first thought might be, "Serves those parents right who refused to vaccinate their children." But they’d be wrong.

So whence the comeback of pertussis? According to the U.S. Centers for Disease Control, a 2009 study of the pertussis virus in the Netherlands showed that variations in the virus have produced a higher level of pertussis toxin (Ptx), and that this has led to the resurgence of the disease. What this means is that the virus strains have become more infectious, compromising the efficacy of the vaccine and making the disease more contagious.  Plus, the effects of the vaccine diminish over time, so adults may have lost their protections. Says Dr. Tom Clark, an epidemiologist with the CDC, "Immunity wears off, especially for adults who are decades past their most recent vaccination."

Pertussis spreads from person to person by direct contact with mucous droplets. In other words, you get it from infected people who cough or sneeze in your presence, and it’s highly contagious. Early symptoms resemble a mild cold — runny nose, sneezing, low-grade fever, mild coughing — but then it blossoms into a severe cough within several weeks, causing severe inflammation of the lungs. The cough may be accompanied by whooping or gasping for breath, vomiting, seizures, and pneumonia. Standard medical treatment is with antibiotics, typically azithromycin (Zithromax), erythromycin, and clarithromycin (Biaxin).

Once the disease develops, it can take a long time to recover, even after treatment with antibiotics. According to Dr. Stephen Ostroff, Pennsylvania’s acting physician general, "Think of it like a tornado going through your neighborhood. The tornado may go through relatively quickly, but it takes a long time to clean up the damage. That’s true of this infection as well."

Part of the problem is that adolescents and adults, in whom pertussis is most prevalent, tend to wait for weeks before seeking medical care for a cough. When they finally do go to their doctor, the physician may not think of pertussis as the cause. According to Dr, Clark, "You only begin to think about pertussis when it’s been going on for weeks and weeks and then treatment is much less likely to make a difference, and you’ve spread it to other people." Plus, testing to confirm pertussis is not that reliable. It may take several weeks to get results from a culture of nasal secretions. And while there’s a quicker genetic test based on a cheek swab, not all labs perform it. The kicker is that both tests are only reliable in earliest stages of the disease — much earlier than most people seek care.

So what can you do to avoid falling prey to the disease? Many in the medical establishment suggest getting a booster (Tdap) of the DTP vaccine if you’re between the ages of 19 and 64 and haven’t previously received it. This vaccine ostensibly protects against diptheria, tetanus, and whooping cough. On the other hand, it’s not going to be that effective against the newer strains of the virus with the higher levels of pertussis toxin. It’s also worth noting that the vaccine has been controversial given the serious side effects it may trigger, including permanent neurological damage, brain injury, seizures, allergic reactions, and death. Most physicians feel the risk of whooping cough far outweighs the purportedly slim risk of vaccine side effects, so you may indeed have a physician recommend the booster to you if the current trend of increased disease incidence continues. Plus, there is a new, less dangerous iteration of the vaccine now out, called the acellular version, as opposed to the whole cell vaccine. If you do get talked into a vaccine, at least insist that it be the acellular variety. It appears, though, that some emerging strains of bacteria have already become resistant to the acellular vaccine.

If you don’t want the vaccine, how can you avoid whooping cough? Steer clear of anyone coughing, sneezing, wheezing, wiping his nose or displaying cold symptoms. If you must mingle with the potentially sick masses, the usual advice applies. Wash you hands well after being out in public and look to natural immune boosters and pathogen destroyers — to which no bacteria can become resistant.

hc:

A lot of sick people nationwide are wishing that Humpty Dumpty hadn’t landed in their sunny-side ups when he fell. Public health departments report that in the last few days, over 1000 people have been sickened by salmonella after eating tainted eggs. Over half a billion eggs have been recalled in response, with Wright County Egg of Galt, Iowa, recalling 380 million of those eggs, and a second Iowa-based farm recalling the rest of them. If you don’t live in Iowa but you’ve been enjoying omelets, you aren’t necessarily safe, because the eggs were distributed throughout the Midwest and California. And since salmonella has a two to three-week incubation period, the number of new cases will most likely increase substantially as the days pass. 

According to experts, delays in implementing new egg safety rules are to blame. I gave you a heads up on the new rules, which theoretically would have prevented this outbreak, a year ago, July. As I wrote then, the regulations gave large farms one year to comply with the new rules; small farms had three years. But in the same way that your car always seems to break down the day the warranty expires, the new egg regulations were only in the "phase-in" stage, and weren’t fully implemented yet just as the outbreak occurred. Said Sherri McGarry of the Food and Drug Administration, "The outbreak could have been prevented. The egg safety rule is in a phase-in approach, but there are measures that would have been in place that could have prevented this if it [had] been placed earlier than in July."  Shoulda, woulda, coulda…. The bottom line is that regulations, such as they are, do no good if they aren’t implemented.

And the thing is, salmonella is a miserable disease. Symptoms include diarrhea, fever, and abdominal cramps, chills, muscle pain, and vomiting that can last between four and seven days. The infection can spread beyond the intestines and cause life-threatening illness, paralysis, and a wide range of serious conditions. Children, the elderly, and those with immune deficiencies particularly are at risk of these more serious iterations of the disease.

As I’ve written before, salmonella bacteria live in the intestinal tracts of mammals, in their feces, and in the soil. Chickens mostly get exposed to the bacteria through feed containing animal parts and rat feces. And when large numbers of chickens live in close quarters like in factory farms, they can spread it among themselves through their feces.

The bacteria are transmitted to the egg in two ways. First, chickens deliver their eggs through the same passageway through which they deliver their poop (something to think about before letting your kids decorate Easter eggs without washing the shells), so it’s a simple matter for bacteria to be passed onto the eggshell. Also, chickens can harbor the bacteria in their ovaries, which means the bacteria can enter the yolk before the shell is formed. To make matters worse, a chicken infected with salmonella looks perfectly normal. The only way to confirm the presence of the bacteria is to test the chickens or eggs (or wait for people to get sick). Apparently, up to this point, major producers have been reluctant to conduct widespread testing, waiting for disaster to strike rather than taking preventative measures.

In any case, you can get salmonella by even brief contact with tainted shells or by eating eggs with runny yolks or consuming raw eggs in dishes like mousse or "real" Caesar salad dressing.  You can also get it simply by contact with contaminated utensils and surfaces, so washing your hands and anything that came into contact with the egg is a must. 

Large, factory egg producers (those that raise more than 50,000 hens) are required by the federal government to have the new rule in place by now.  These companies account for about 80 percent of the egg market.  The new rule requires them to:

• Buy chicks and young hens only from suppliers who monitor for Salmonella bacteria.
• Establish rodent, pest control, and biosecurity measures to prevent the spread of bacteria throughout the farm by people and equipment.
• Conduct testing in the poultry house for Salmonella enteritidis. If the tests find the bacterium, a representative sample of the eggs must be tested over an eight-week time period (four tests at two-week intervals); if any of the four egg tests is positive, the producer must further process the eggs to destroy the bacteria, or divert the eggs to a non-food use.
• Clean and disinfect poultry houses that have tested positive for Salmonella enteritidis.
• Refrigerate eggs at 45 degrees F during storage and transportation no later than 36 hours after the eggs are laid (this requirement also applies to egg producers whose eggs receive a treatment, such as pasteurization).

Smaller producers (between 3,000 and 50,000 hens) will have until 2012 to implement the rule. As I’ve said before, we can be thankful that the government has focused on cleaning up egg producers’ facilities and procedures instead of recommending antibiotic-based prophylactic methods for every egg sold.

But you have to wonder about the industrial production of eggs in the first place. As recently described by Kurt Friese in the Huffington Post, "Across the US there are about 280 million hens in battery cages at any given time, cages that so severely restrict their movements that they cannot even spread their wings. They can’t nest, bathe in the dust, perch or forage, all instinctive chicken behaviors. Completely depleted of calcium in a few short weeks, their bones break and they are shipped off, dead and dying, to soup plants (how’s that chicken noodle soup tasting right about now) and pet food factories." Then there is the matter of the immense amount of fecal and biological waste from these operations that seems to inevitably leak into the environment, threatening the health and wellbeing of people in adjacent communities. 

According to Friese, the "industrial" methods for raising "cage free" hens are hair-raisingly cruel as well. Among other things, the chickens’ beaks are clipped and the birds are exposed to ammonia and hydrogen sulfide gasses. Even organic methods of egg production are not exempt from cruelty. For example, male chicks are regularly "discarded" because, as non-egg layers, they are of no use to the industry. 

So what’s an egg lover to do? Try to get your eggs from a small, local producer and be sure to ask how they raise their hens. Can you say farmers market? And if you’re buying a commercial brand of organic or cage free in your local health food store, be sure and ask there, too. In the meantime, no matter how your eggs are produced, be smart about egg safety. Don’t use raw or undercooked eggs in food and wash everything that comes into contact with them well. Keep eggs refrigerated and don’t let cooked eggs stand around at room temperature for more than two hours. You can find a complete list of egg safety tips here. And as holiday season approaches, make sure to add plenty of rum to your eggnog — so you won’t think too much about what else might be in there.

:hc

A 50-year study of moose (those antlered animals, not the Loyal Order guys in funny hats) on Isle Royal in Lake Superior indicates that osteoarthritis may have its origins in poor nutrition. According to an article in The New York Times, the study involved the examination of numerous moose carcasses that showed, among other things, that these leggy critters are subject to arthritis. After examining some 1,200 carcasses (be assured, Bullwinkle J. Moose was not one of them), scientists found that more than 50 percent had arthritis and that the disease looks much the same in moose as it does in people. Arthritis affects the hips and knees of wild moose, making them especially vulnerable to their main predator, the wolf. Among humans, osteoarthritis also affects knees and hips, causing pain and debilitation (and making sufferers vulnerable to pharmaceutical predators).

Scientists involved in the study said that the evidence indicated that poor early nutrition was the main cause of moose arthritis. According to Dr. Rolf Peterson of Michigan Technological University, arthritic moose tended to be small as measured by their metatarsal bones, and small metatarsals correlate to poor early nutrition.  The scientists were able to determine that the small moose were born during times of food scarcity, as a result of which their mothers had difficulty producing enough milk. They theorize that if the arthritis had been due to wear and tear, the moose would have had to walk further to find food when they were grown. But the evidence indicted that the moose had plentiful food as adults, leaving early nutrition as the most likely source of the problem.

There is significant evidence of a correlation between poor early nutrition and increased incidence of arthritis in human beings as well. For example, studies of the bones of 16th century Native Americans in the Southeast show an increase in the incidence of osteoarthritis after contact with the Spanish changed the Native American diet from fish and wild plants to one focused on corn. In fairness, the Spanish also vastly increased the workload for these people, which, it could be argued, may have contributed to arthritis. But the study showed that the Native Americans became smaller and more subject to anemia and malnutrition as a result of the dietary changes imposed on them and that this was a significant contributor to the increased incidence of osteoarthritis. The Times article also points to studies in Britain and in China that showed that low birth weight and poor in utero nutrition are linked to the later development of osteoarthritis (as well as other disabilities.)

The idea that carrying excess weight contributes to osteoarthritis is also being looked at anew as a result of the link between nutrition and the condition. No longer is obesity seen simply as creating extra wear and tear on joints and cartilages. Obesity is often fueled by a poor diet.  Says Dr. Peter Bales of the University of California of Davis Health System, and authority on arthritis, "Poor diet results in inflammatory changes and damage in cartilage cells, which in turn lead to cartilage breakdown and the development of osteoarthritis."

According to Dr. Bales, the proper diet can significantly reduce the pain and stiffness associated with the disease. And his diet of choice? The Mediterranean diet, of course.  Why?  It’s less acidic, reducing the release of free radicals that can damage joints and cartilage. Plus the diet’s emphasis on vegetables, whole grains, olive oil, fruits and fish can support cartilage growth and slow its deterioration.   Bales also recommends limiting one’s intake of sugary and processed foods because they result in AGEs (advanced glycosylation end products). AGEs bind to the collagen in joints and cartilage rendering them more brittle.  He says increased vitamin C intake is important (vitamin C is alkalizing and anti-inflammatory) as is supplementation with fish oil, glucosamine, chondroitin, MSM, and  SAMe (S-adenosylmethionine). In addition, to Dr. Bales recommendations, I would also add supplementation with a formula containing avocado soy unsaponifiables, undenatured chicken collagen, ginger, cetyl myristoleate, and boswellia extract.

Around 1863, the German philosopher Ludwig Feuerbach, wrote, "Man is what he eats," which has come down to us as "you are what you eat." And while Feuerbach had a spiritual meaning in mind, I can’t help but be struck by its literal relevance in the case of osteoarthritis. Both the type of nutrition one has as a child and the diet one eats as an adult have direct impact on the health or deterioration of the joints and cartilages in later life (as well as on the entire system). Whether moose or man, it seems, the effects of bodily wear and tear combined with genetic predisposition can be triggered or fended off by the dietary choices both we and our parents make.

:hc

During the healthcare debate in the United States, the Canadian healthcare system was continually singled out as an example of both what’s good and bad about government involvement in healthcare. As it turns out, timing is everything. Things are now looking mostly grim for the healthcare system north of the border, thanks to the ever-increasing surfeit of aging baby boomers. (I could swear I’ve been predicting for years this would be a problem.)  As the Canadian baby boomers enter their "golden years," they require more healthcare attention than they did when younger, and that means more expense. It’s the same situation as in the U.S., with the boomer generation eating up more and more of the system’s resources.

An article in the Economist points out that healthcare spending in Canada, which accounted for 35% of provincial budgets in 1999, now accounts for 46%. At this rate of growth, by 2030 it will eat up 80% of the provincial budget in Ontario, the most populous province. (Just in time for current Canadian 30-year-olds to require their first colonoscopies.)  In Canada, at least, the biggest reason for this increase is rising prescription drug costs, with boomers being primary consumers. The percentage of the public health budget spent on pharmaceuticals has tripled since 1980.

The Canadian system presents something of a pickle for those who would control drug costs. On the one hand, as large buyers, provinces can negotiate with manufacturers to lower the costs of branded drugs. But when in comes to generics, the provinces cap the amount they pay to a fixed percent of the cost of branded drugs. And the percentage is so high (50%) that it has made Canadian generics among the most expensive in the world. (Those "cheap" Canadian drugs you can order over the Internet are all branded.) Also, Canadian law allows manufacturers to pay an annual kickback to pharmacists in exchange for stocking branded drugs. In fact, pharmacists received about $712 million last year in compensation for stocking the brand-names. The kickback expenses don’t make a dent in the profits gained from brand-name sales, and so the drug companies win big time. 

Of course, the logical response would be for the provinces to slash the generic fee cap. And in fact, in March, Ontario announced that it would do just that, reducing the cap from 50 percent to 25 percent. But this set off considerable protest by the drug industry because pharmacists stand to lose a large amount of income as a result. The country’s biggest chain of pharmacies threatened layoffs and store closures. It also asked customers to sign protest cards and curtailed hours in seven stores in the district of the provincial health care minister. Talk about making a fight personal. However, Ontario stuck to its guns — sort of. It did slash the generic fee cap, but it also agreed to increase pharmacists’ dispensing fees and to allow them to charge for patient counseling to make up some of their lost income. Other provinces are now considering making the same "adjustment."

So again, you have the drug costs added to the financial strains caused by the health-care needs of the aging boomer generation, who will comprise 25 percent of the population by 2036. The Canadian census of 2006 showed that one out of every seven people was a senior citizen, compared to one out of 50 in 1966. The implications of this increase in the proportion of seniors for the healthcare system are obvious. Seniors see their doctors more often, take more prescription drugs, and are more subject to diseases and conditions requiring lengthy hospital stays compared to the hip-hop generation and their parents. Greater numbers of seniors translates to a greater financial burden on the healthcare budget (and greater amount of out-of-pocket health expenses for seniors.)…and a smaller percentage of young working people to pay for those expenses.

But in a sense, all these issues ignore what is perhaps the key driving factor.  Yes, it is true that in both Canada and the U.S. healthcare costs are skyrocketing. And indeed, drug costs are absorbing a disproportionate chunk of the healthcare budgets. And it is also true that the proportion of the population that is elderly is increasing and accounts for a greater and greater share of health care expenditures. But underlying all of these issues is the philosophical orientation of Western healthcare systems. If only mainstream medicine stopped focusing on fixing health problems after the fact instead of preventing them from happening in the first place, healthcare costs could be slashed across the board. And with more citizens than ever graduating into the "senior class," this need to stress wellness over treatment becomes even more critical. And this is not just an issue for the United States and Canada; it is an issue that must be faced sooner or later by every country in both the developed and developing worlds.

To decrease costs, we need to change the way medicine is practiced. It is great to have drugs and procedures that can address diseases after they have developed. But it is far better to deliver information, practices, and dietary and lifestyle changes that can prevent the diseases and conditions from developing in the first place. As Navi Radjou, Executive Director of the Centre for India & Global Business at the Judge Business School at the University of Cambridge, said in a blog in the Harvard Business Review, "By improving the holistic health and wellness of all American workers and citizens, both governments and corporations could save hundreds billions of dollars currently wasted in untargeted, inefficient therapies." Or as I keep saying over and over, the only way to save health care (in any and all countries) is for people to stop using it "patch up" self-inflicted illness.

:hc