Can exercise keep you from gaining weight?

Yes, if you do more of it than most of us do, a Harvard Medical School study concludes.

Among normal-weight women, the likelihood of putting on weight decreased as physical activity level increased. Among women who were overweight or obese, there was no relationship between physical activity and weight gain.

Thus, for women who aren’t overweight or obese, exercise can keep off excess pounds, but it must add up to about seven hours per week of moderately intense activity such as brisk walking or casual bicycling — or 3.5 hours per week of vigorous activity such as jogging or aerobic dancing.

For women who are already overweight or obese, increased physical activity alone is not enough to prevent further weight gain. These women also need to reduce their calorie intake. But they should still get at least 30 minutes of moderately intense physical activity most days for the sake of the many health benefits, which include a reduced risk of chronic conditions such as heart disease and stroke.

The researchers analyzed data provided by 34,079 healthy women, average age 54, who were participating in the long-term Women’s Health Study. Between 1992 and 2007, the women reported their body weight and physical activities every three years. They also provided information on matters that could affect the link between physical activity and weight change, such as smoking, postmenopausal hormone use, alcohol intake, and diet.

Whither our public hospitals?

Do you depend on a public hospital for your health care? More than a fifth of the nation's 5,000 hospitals are owned by local governments.

These hospitals are in trouble, the Wall Street Journal reports.

Local governments have less tax revenue coming in because of hard economic times, and more patients lack health-insurance coverage. Meantime costs keep rising, and many hospitals have debt to service. And looking forward to the next several years, all hospitals will be prodded by health-care overhaul legislation to make investments in electronic medical records and other health IT systems, and to better coordinate increasingly complex care. That’s tough to do without economies of scale.

As a result, many governments are selling or forging partnerships with for-profit entities to offload their public hospitals. James Burgdorfer, a partner with investment banker Juniper Advisory, tells the Journal that most public systems won't be around in two decades because health-care is too complex for local politicians. “By the nature of their small size, their independence and their political entanglements, they are poorly equipped to survive.”

Ownership of hospitals in general is changing -- 25 purchases or mergers, involving 53 hospitals, totaling $3.1 billion in the first half of this year alone. Nonprofit hospitals are also takeover targets; private companies are betting on the industry, assuming that health-care overhaul will eventually yield more paying, insured customers.

News roundup: black rice, breastfeeding, fluoride and more

News from the world of medicine:

Inexpensive black rice contains health-promoting anthocyanin antioxidants, similar to those found in blackberries and blueberries, new research from Louisiana State University indicates. "Just a spoonful of black rice bran contains more health promoting anthocyanin antioxidants than are found in a spoonful or blueberries, but with less sugar and more fiber and vitamin E antioxidants," Zhimin Xu, PhD, of Louisiana State University Agricultural Center, says.

Breastfeeding for a month or longer appears to reduce a woman's risk of getting diabetes later in life, according to a new study.

The eight unexplained symptoms most closely linked to cancer have been highlighted by researchers at Keele University. They are blood in urine, anaemia, rectal blood, coughing up blood, breast lump or mass, difficulty swallowing, post-menopausal bleeding and abnormal prostate tests.

Children drinking water with added fluoride helps dental health in adulthood decades later, a new study finds. "Your fluoridation exposure at birth is affecting your tooth loss in your 40s and 50s, regardless of what your fluoridation exposure was like when you were 20 and 30 years old," said Neidell, a health policy professor at the Mailman School of Public Health at Columbia University.

Murine leukemia viruses (MLV), a family of retroviruses known to cause cancer in mice, may be linked to chronic fatigue syndrome (CFS), a study shows.

Naringenin, an antioxidant derived from the bitter flavor of grapefruits and other citrus fruits, may cause the liver to break down fat while increasing insulin sensitivity, a process that naturally occurs during long periods of fasting. If the results of this study extend to human patients, this dietary supplement could become a staple in the treatment of hyperlipidemia, type-2 diabetes, and perhaps metabolic syndrome.

A breakthrough in cancer treatment

Advances in genetic technologies have allowed scientists to study the genetic mutations that underlie cancer in much greater detail. The result has been a new approach to drug design. Unlike chemotherapy, which can affect both healthy and cancerous cells and often triggers serious side effects, genetically targeted drugs act selectively on cancer cells that carry the mutation.

Now comes news of an experimental drug designed to block the effects of a genetic mutation often found in patients with malignant melanoma, a deadly cancer with few existing treatments, Technology Review reports.

The drug significantly shrank tumors in about 80 percent of those who carried the mutation. The findings signal a major success for so-called targeted cancer therapies, which are designed to block the effects of genetic mutations that drive the growth of cancer cells.

"This study is a major breakthrough in cancer treatment, and for metastatic melanoma," says Matthew Meyerson, an oncologist and researcher at the Dana Farber Cancer Institute in Boston. "It's a spectacular example of how genome-targeted therapies are beginning to help cancer patients."

In this study, 37 of 48 patients with the mutation responded to the new experimental drug, with their tumors shrinking by more than 30 percent. Tumors completely disappeared in three of those patients. About 30 percent of patients who took the drug the longest developed a specific type of squamous cell carcinoma, a tumor that usually doesn't spread and typically resolves on its own. 

Image: A PET scan of one melanoma patient shows a significant decrease in the size and number of tumors (shown in black) 15 days after treatment with an experimental drug.

Walk and think at the same time

More good news for plain old-fashioned walking.

A group of "professional couch potatoes," as one researcher described them, has proven that even moderate exercise -- in this case walking at one's own pace for 40 minutes three times a week -- can enhance the connectivity of important brain circuits, combat declines in brain function associated with aging and increase performance on cognitive tasks.

Rather than focusing on specific brain structures, the study looked at activity in brain regions that function together as networks.

"Almost nothing in the brain gets done by one area -- it's more of a circuit," said University of Illinois psychology professor and Beckman Institute Director Art Kramer, who led the study with kinesiology and community health professor Edward McAuley and doctoral student Michelle Voss. "These networks can become more or less connected. In general, as we get older, they become less connected, so we were interested in the effects of fitness on connectivity of brain networks that show the most dysfunction with age."

Neuroscientists have identified several distinct brain circuits. Perhaps the most intriguing is the default mode network (DMN), which dominates brain activity when a person is least engaged with the outside world -- either passively observing something or simply daydreaming. Previous studies found that a loss of coordination in the DMN is a common symptom of aging and in extreme cases can be a marker of disease, Voss said.

At the end of the year, DMN connectivity was significantly improved in the brains of the older walkers, but not in the stretching and toning group, the researchers report. The walkers also had increased connectivity in parts of another brain circuit (the fronto-executive network, which aids in the performance of complex tasks) and they did significantly better on cognitive tests than their toning and stretching peers.

"The higher the connectivity, the better the performance on some of these cognitive tasks, especially the ones we call executive control tasks -- things like planning, scheduling, dealing with ambiguity, working memory and multitasking," Kramer said. These are the very skills that tend to decline with aging, he said.

You don't even need a gym membership.

Graphs of the dynamic development of correlations between brain networks. (A) In children the regions are largely local and are organized by their physical location; the frontal regions are highlighted in light blue. (B) In adults the networks become highly correlated despite their physical distance; the default network is highlighted in light red.

What you eat: broccoli, tea, cranberries, grapes

Bottled tea may be all the rage among health-conscious people, but it may not have as many health benefits as you think. Bottled tea is billed as being healthful because it contains polyphenols, antioxidants that may help ward off a range of diseases, including cancer. But scientists say they’ve found that many of the popular bottled tea drinks contain fewer polyphenols than a single cup of home-brewed green or black tea. And some contain such small amounts that a person would have to drink 20 bottles to get the same polyphenol benefit in a single cup of tea.

Scientists report that within eight hours of drinking cranberry juice, the juice could help prevent bacteria from developing into an infection in the urinary tract.

Fibers from broccoli and plantain plants may block a key stage in the development of Crohn’s disease, a new study finds.

Crohn’s is an inflammatory bowel disorder that affects about seven of every 100,000 people in North America.

The plant extract resveratrol, found in the skin of red grapes, appears to suppress inflammation and may fight aging in humans, according to a new study. Common food sources of resveratrol include grapes, wine, peanuts, blueberries, and cranberries.

Low-carbohydrate weight loss diets have an edge over low-fat diets for improving HDL cholesterol levels long term, according to a study funded by the National Institutes of Health. 

Listen to me, Doc

I know my doctor, Anthony "The Probe" Armageddon, doesn't listen to half of what I say. Heck, I don't listen to half of what the voices in my head say when I'm in his office.

Danielle Ofri, an internist at New York City’s Bellevue Hospital and author of Medicine in Translation: Journeys with my Patients, gives us some insight into doctor hearing.

Doctors have always filtered patients’ words. Some of this is the result of the historical difference in lay versus medical language. A patient may say that she had trouble breathing, though did not cough up any blood. The doctor would then write that “the patient admitted to dyspnea, but denied hemoptysis.”


Doctors often prioritize patients’ symptoms differently from the way patients do. A patient may be most concerned about a painful ingrown toenail, but the doctor may focus on the anginal symptoms of chest pain instead.

And then doctors may—diplomatically or not—casually toss some patients’ concerns aside entirely. I have been guilty of this myself. I have some patients who seem to stockpile hordes of complaints for me, unloading them in heaps during our 15-minute visit. I listen and nod, but choose not to enter into the medical record the ones that seem clinically insignificant.  This stems from both the reality of the time crunch, and my clinical experience that most of these minor aches and pains are self-resolving.

Maybe she's doing a disservice to her patients by acting as a filter, she says.

A growing body of evidence suggests that the gap between what patients say and what doctors document can be ample. Patients often report symptoms much earlier than did doctors. Several studies have shown that patients’ report of symptoms correlate more accurately to actual health status than did the doctors’ reports.


for regular medical visits, perhaps there could be a section of the computerized medical record for the patients to access directly to list all concerns. This would be a legitimate part of the record, and then I would have my part in which I’d place my clinical impressions of these symptoms.


Seems like a good idea to me. I bet that we’d uncover many more side effects sooner. It would also remind us, that doctors need to view patients’ words as primary data, and that we should be careful about filtering the patient’s voice too much.

Maybe, just maybe the patient knows something about his or her body ... nah.

Health news roundup: berries, narcotics, Parkinson's, vitamin D

Scientists have reported the first evidence that eating blueberries, strawberries, and acai berries may help the aging brain stay healthy in a crucial but previously unrecognized way. Berries, and possibly walnuts, activate the brain's natural "housekeeper" mechanism, which cleans up and recycles toxic proteins linked to age-related memory loss and other mental decline.

A virus called XMRC may be linked to chronic fatigue syndrome (CFS), a study shows. The new study shows that 86.5% of 37 people with CFS had evidence of this virus in their blood, as did 6.8% healthy blood donors. "There is a dramatic association with CFS, [but] we have not determined causality for this agent," said Harvey Alter, MD,  at the National Institutes of Health (NIH) Clinical Center.

There is now biologic evidence to back up the belief that vitamin D may protect against autoimmune diseases and certain cancers. A new genetic analysis lends support to the idea that the vitamin interacts with genes specific for colorectal cancer, multiple sclerosis, type 1 diabetes, and other diseases, says Oxford University genetic researcher Sreeram Ramagopalan.

A government study found that the share of substance abuse treatment admissions involving prescription narcotics increased more than fourfold between 1998 and 2008, from 2.2 to 9.8 percent.  A second study found that emergency room visits involving nonmedical use of these drugs jumped 111 percent over the same period, to 305,885. Nearly everyone, it seems, is at equal risk.

Researchers has discovered new evidence that Parkinson's disease may have an infectious or autoimmune origin. Researchers detected a new association with the HLA (human leukocyte antigen) region, which contains a large number of genes related to immune system function in humans. Researchers will now be encouraged to take a fresh look at the possible role of infections, inflammation and autoimmunity in Parkinson's disease.

A study suggests that a water soluble extract of cinnamon, which contains antioxidative compounds, could help reduce risk factors associated with diabetes and heart disease.

Yoga and your mood

Researchers at Boston University School of Medicine have found that yoga may be superior to other forms of exercise in its positive effect on mood and anxiety. The findings are the first to demonstrate an association between yoga postures, increased GABA levels and decreased anxiety.

Low gamma-aminobutyric levels are associated with depression and other widespread anxiety disorders.

GABA is the chief inhibitory neurotransmitter in the mammalian central nervous system. It plays a role in regulating neuronal excitability throughout the nervous system. In humans, GABA is also directly responsible for the regulation of muscle tone.

The government's new role in your health

Remember the group that touched off a firestorm last year when it recommended that women start getting routine mammograms at age 50 instead of 40?

Sure enough, it will play an even bigger role in the future.

It's the U.S. Preventive Services Task Force, a volunteer group made up of primary care and public health experts. The Washington Post reports:

For years, an obscure federal task force sifted through medical literature on colonoscopies, prostate-cancer screening and fluoride treatments, ferreting out the best evidence for doctors to use in caring for their patients. But now its recommendations have financial implications, raising the stakes for patients, doctors and others in the health-care industry.

Here's the important point:

Under the new law, the task force could become a political lightning rod. If it doesn't recommend a service, insurers might not pay for it, and advocates might argue the decision is a barrier to care. If the panel does back a service, it might increase patients' access, as well as create new business opportunities. 

This isn't the only group in the new game.

In addition to the task force, other scientific bodies and government groups will also help determine the services that must be covered. For instance, plans must also cover a set of standard vaccines recommended by the Advisory Committee on Immunization Practices, as well as screening practices for children that have been developed by the Health Resources and Services Administration in conjunction the American Academy of Pediatrics.

 You and your doctor and some faceless bureaucrat at your insurance company? Those were the days.

Tai chi is found to relieve chronic pain

A posture from the Yang style tai chi chuan 

I took a brief course in tai chi this year. What I sudied is called Tai Chi Easy, because it has only five moves drawn from the many tai chi disciplines. It is a relaxing experience.

Now some researchers have found it to be a good treatment for fibromyalgia, a somewhat mysterious chronic pain condition. The New York Times reports:

A clinical trial at Tufts Medical Center found that after 12 weeks of tai chi, patients with fibromyalgia, a chronic pain condition, did significantly better in measurements of pain, fatigue, physical functioning, sleeplessness and depression than a comparable group given stretching exercises and wellness education. Tai chi patients were also more likely to sustain improvement three months later.

Fibromyalgia is a complex and often-confusing condition, affecting five million Americans, mostly women. Since its symptoms can be wide-ranging and can mimic other disorders, and its diagnosis depends largely on patients’ descriptions, not blood tests or biopsies, its cause and treatment have been the subject of debate.

“It’s an impressive finding,” said Dr. Daniel Solomon, chief of clinical research in rheumatology at Brigham and Women’s Hospital in Boston, who was not involved in the research. “This was a well-done study. It was kind of amazing that the effects seem to carry over.” 

More on the study:

The fibromyalgia study involved the yang style of tai chi, taught by a Boston tai chi master, Ramel Rones. Dr. Solomon and other experts cautioned that bigger studies with other masters and approaches were necessary.

Still, patients, who received twice-weekly tai chi classes and a DVD to practice with 20 minutes daily, showed weekly improvement on an established measurement, the Fibromyalgia Impact Questionnaire, improving more than the stretching-and-education group in physicians’ assessments, sleep, walking and mental health. One-third stopped using medication, compared with one-sixth in the stretching group.

You can begin exploring tai chi here.

From the Duh Department

Eat your vegetables and exercise -- are you tired of hearing it? Well, here's more proof of it.

First the green stuff:

Eating more green leafy vegetables can significantly reduce the risk of developing type 2 diabetes, according to research published online in the British Medical Journal.

The authors believe that fruit and vegetables can prevent chronic diseases because of their antioxidant content. Green leafy vegetables such as spinach may also act to reduce type 2 diabetes risk due to their high magnesium content.

The authors argue that "our results support the evidence that 'foods' rather than isolated components such as antioxidants are beneficial for health … results from several supplement trials have produced disappointing results for prevention of disease."

And the get moving stuff:

Researchers analyzed city- and state-level data from the United States and international data from 15 countries to study the relationship between "active travel" -- bicycling or walking rather than driving -- and physical activity, obesity and diabetes.

The results showed that more than half of the differences in obesity rates among countries is linked to walking and cycling rates. In addition, about 30 percent of the difference in obesity rates among states and cities is linked to walking and cycling rates.

So, ride your bike to the green grocer.

Body shop of the future

Regenerative medicine’s once-wild ideas are fast becoming reality, Smithsonian reports.

Late last year, Organovo, a biotech company in San Diego, began distributing the first commercially available body-part printer. Yes, you read correctly: a printer for body parts. Using the same idea as an ink-jet printer, it jets laser-guided droplets of cells and scaffold material onto a movable platform. With each pass of the printer head, the platform sinks, and the deposited material gradually builds up a 3-D piece of tissue. Regenerative medicine laboratories around the world have relied on the printer to generate pieces of skin, muscle and blood vessels.

Anthony Atala, director of the Wake Forest Institute for Regenerative Medicine, and colleagues use human cells to grow muscles, blood vessels, skin and even a complete urinary bladder. Atala’s lab has used the technology to construct a two-chambered mouse-size heart in about 40 minutes.

They have also managed to fashion lab-built kidneys that produce urine when implanted into experimental animals. And within a few years, he says, human skin could be coaxed into growing in a lab and be given to burn victims and other patients who today must undergo painful skin grafts.

Organs grown outside the body will transform medicine, Atala predicts, but spurring repair and regrowth within the body will be just as important. He and other scientists foresee injecting healthy cells and growth-inducing molecules into diseased or injured lungs, livers and hearts, prompting them to regenerate. Then there’s the ultimate challenge: Could a patient someday regrow an entire limb?

“It is not outside the realm of possibility,” Atala says. “If a salamander can do it, why can’t a human?”

Which is worse: seeking a mate or finding one?

A couple of items in the news point to the effects of love relationships on our health.

At Harvard, they've decided that competing for mates can shorten a man's life.

A new study by Harvard researchers shows that ratios between males and females affect human longevity.  Men who reach sexual maturity in a context in which they far outnumber women live, on average, three months less than men whosecompetition for a mate isn’t as stiff.  The steeper the gender ratio (alsoknown as the operational sex ratio), the sharper the decline in lifespan.

“At first blush, a quarter of a year may not seem like much, but it is comparable to the effects of, say, taking a daily aspirin, or engaging in moderate exercise,” says Nicholas Christakis, senior author on the study and professor of medicine and medical sociology at Harvard Medical School.

And maybe finding a mate isn't so good after all, as numerous studies showing better health among the married show. There's this:

But while it’s clear that marriage is profoundly connected to health and well-being, new research is increasingly presenting a more nuanced view of the so-called marriage advantage. Several new studies, for instance, show that the marriage advantage doesn’t extend to those in troubled relationships, which can leave a person far less healthy than if he or she had never married at all. One recent study suggests that a stressful marriage can be as bad for the heart as a regular smoking habit. And despite years of research suggesting that single people have poorer health than those who marry, a major study released last year concluded that single people who have never married have better health than those who married and then divorced. 

You just can't win.

Your heart: chocolate good, meat bad

Two new heart studies tell us more about nutrition and the heart.

First, the bad news.

Cutting back on red and processed meats may significantly reduce heart disease risk in women, a new study says. Scientists examined data on 84,136 women between the ages of 30 and 55 over a 26-year period ending in 2006. The study found that women who had two servings per day of red meat had a 30% greater risk of developing heart disease compared to women who had half a serving daily.

Now the good news.

Researchers in Boston examined data from a nine-year study of 31,823  women in Sweden to determine the effect of eating chocolate on heart disease and found that eating some of the sweet stuff may reduce the risk of heart failure.

• Women who ate an average of one to two servings of high-quality chocolate per week had a 32% lower risk of developing heart failure.
• Women who had one to three servings per month had a 26% reduced risk.
• Women who ate at least one serving daily did not appear to benefit from a protective effect, probably due to the additional calories.

Darn.

Chill out, save your heart

A red face and strained neck is having the effect you might imagine. Research shows that angry people are more likely to have heart disease or suffer a stroke.

Researchers from the National Institute on Aging (NIA) in Baltimore, a division of the National Institutes of Health, found that people who are angry and aggressive showed a greater thickness of the carotid arteries in the neck, a key risk factor for heart attack or stroke, compared with people who were more easygoing.

Personality matters.

People considered the least agreeable and the most antagonistic had a 40% increased risk for arterial wall thickening.

The researchers write that “when the Type A behavioral pattern was dissected into its constituent parts, hostility emerged as the dominant predictor of coronary artery disease.” Their latest findings uphold the connection between aggressive behavior and heart health.

It applies to men and women, young and old.

The stress of being a care giver

I know from watching my Mom care for my Dad, who had Parkinson's, how stressful it can be. So I took notice when I came across a study documenting the effects of this stress. It was conducted at Ohio State University.

The chronic stress that spouses and children develop while caring for Alzheimer's disease patients may shorten the caregivers' lives by as much as four to eight years, the study found.

The researchers focused on telomeres, areas of genetic material on the ends of a cell's chromosomes. Over time, as a cell divides, those telomeres shorten, losing genetic instructions. An enzyme – telomerase – normally works to repair that damage to the chromosome, said Ronald Glaser, a professor of molecular virology, immunology and medical genetics.

“Telomeres are like caps on the chromosome,” said Glaser, head of Ohio State 's Institute for Behavioral Medicine Research. “Think of it as a frayed rope – if the caps weren't there, the rope would unravel. The telomeres insulate and protect the ends of the chromosomes.

“As we get older, the telomeres shorten and the activity of the telomerase enzyme lessens,” he said. “It's part of the aging process.”

The care givers were more depressed than a control group.

“Symptoms of depression in caregivers were twice as severe as those apparent among the control group,” Jan Kiecolt-Glaser, a professor of psychology and psychiatry, said.

“Caregivers also had fewer lymphocytes,” Glaser said, “a very important component of the immune system. They also showed a higher level of cytokines, molecules key to the inflammation response, than did the control group.” 

Other experiments showed that the actual telomeres in blood cells of caregivers were shorter than those of the controls, and that the level of the telomerase repair enzyme among caregivers was also lower.  

Much of the Ohio State work is now shifting to studies on how to intervene with that stress in hopes of slowing the weakening of the immune system in highly stressed people.

You don't need heavy weights to build muscle

Current gym dogma holds that to build muscle size you need to lift heavy weights. However, a new study conducted at McMaster University has shown that a similar degree of muscle building can be achieved by using lighter weights. The secret is to pump iron until you reach muscle fatigue.
 
"Rather than grunting and straining to lift heavy weights, you can grab something much lighter but you have to lift it until you can't lift it anymore," says Stuart Phillips, associate professor of kinesiology at McMaster University. "We're convinced that growing muscle means stimulating your muscle to make new muscle proteins, a process in the body that over time accumulates into bigger muscles.

The project that showed it's really not the weight that you lift but the fact that you get muscular fatigue that's the critical point in building muscle. The study used light weights that represented a percentage of what the subjects could lift. The heavier weights were set to 90% of a person's best lift and the light weights at a mere 30% of what people could lift. "It's a very light weight," says Phillips noting that the 90-80% range is usually something people can lift from 5-10 times before fatigue sets in. At 30%, Burd reported that subjects could lift that weight at least 24 times before they felt fatigue.

These new data have practical significance for gym enthusiasts but more importantly for people with compromised skeletal muscle mass, such as the elderly, patients with cancer, or those who are recovering from trauma, surgery or even stroke.

The flu vaccine is in

Here comes the flu vaccine.

For the first time, the seasonal flu vaccine is recommended for all men, women -- including pregnant women -- and children over age 6 months. Exceptions include only those allergic to eggs or those with other health issues that make vaccination unwise, WebMD reports.

There will be plenty of vaccine. Manufacturers tell the CDC they'll have 170 million doses on hand. They've already begun shipping the vaccine across the nation.

This isn't about the H1N1 swine flu. That U.S. emergency ended in June, and the World Health Organization this week called off its pandemic alert. This time it's about seasonal flu, joined but no longer dominated by the 2009 H1N1 swine flu. The CDC warned that the H3N2 flu bug has begun popping up in states across the U.S.

Yikes!

Don't peek in the kitchen

If you're dining out you might not want to know what's going on back there.

Researchers at North Carolina State University set up cameras in commercial kitchens that followed the best industry practices for training their staffs. They found

approximately one cross-contamination event per food handler per hour. In other words, the average kitchen worker committed eight cross-contamination errors, which have the potential to lead to illnesses, in the course of the typical eight-hour shift.

Cross-contamination occurs when pathogens, such as Salmonella, are transferred from a raw or contaminated source to food that is ready to eat. For example, using a knife to cut raw chicken and then using the same knife to slice a sandwich in half. Cross-contamination can also result from direct contact, such as raw meat dripping onto vegetables that are to be used in a salad.

"Each of these errors would have been deemed a violation under U.S. Food and Drug Administration Food Code inspection guidelines. But more importantly, cross-contamination has the potential to lead to foodborne illnesses and has in recent outbreaks," said Dr. Ben Chapman, assistant professor and food safety specialist in the department of family and consumer sciences.

Cross-contamination increased and hand-washing decreased at peak hours, the researchers found. So if you plan to eat out, try to do it at, say, 3 a.m.

More on how to buy vitamins

Since my previous post, I've come across more information from the Dietary Supplement Quality Initiative, which seems to be independent. It offers this guidance:

Here are some strategies for learning about the quality of any dietary supplement.
1. If it carries the ConsumerLab.com quality seal or appears on the list of brands on their www.ConsumerLab.com website that passed their random independent testing program, you can be assured the supplement is high quality and should perform as expected.

2. If it carries the USP or NF seal, the producer is claiming that it meets the US Pharmacopoeia or National Formulary standards for that product. Among other things, these standards cover potency, minimum dosage, and purity from contamination.

3. If it carries the NNFA's "GMP" seal, the manufacturer has passed a comprehensive, independent inspection of its manufacturing process. (This gives solid assurance of a well made product, but says nothing about the manufacturer's choices of which ingredients and potency levels to use.)

4. If it carries the BioFIT trademark, the product has passed "biological assay" testing, which means that it displays biochemical activity that is consistent with having the corresponding effect in the human body.

5. SupplementWatch.com uses a subjective, 100-point system for rating brands. Up to twenty points are awarded for each of five categories: health claims, scientific theory, scientific research, safety and side effects, and value (relative cost).

6. Call the supplement's producer and ask for the head of their quality control or assurance program. (Be prepared to ask a few questions!) This will tell you if they actually have a quality control program. If they don't (they might be a reseller or rebrander), ask how they deal with quality control issues.

Avoid dementia: eat an apple, read a book

British and French researchers studied 1,433 healthy people aged over 65 living in the south of France, who underwent cognitive tests at the start of the study in 1999-2001 and again two, four and seven years later. Here's what they found:

"Reduction in the incidence of dementia over the next seven years would be maximised by the elimination of diabetes and possibly depression. Increasing crystallised intelligence and consumption of fruit and vegetables also seem to have a potentially high impact."

Achieving those results could mean that almost 40% of those who are expected to be affected by the condition in the future avoid it.

Some specifics:

• Increasing the involvement of people of all ages in education, especially literacy, would on its own bring about an 18% drop in the number of expected new cases of the disease over the next seven years.
• Eliminating depression and diabetes, and improving the general intake of fruit and vegetables, would lead to a further 21% fewer people succumbing to the condition.

And this matters because:

A Medical Research Council (MRC) study found that patients in their sixties whose condition is diagnosed by a GP typically live for an extra 6.7 years, while those whose dementia is detected as part of screening during a research study tended to have a life expectancy of 10.7 more years. And yet up to two-thirds of people with dementia never receive a diagnosis and, as this research implies, many of those who do only do so in the later stages.

I can't remember where I put my apple, so I'm depressed and I think I'll just have me a jelly doughnut.

How to buy vitamins

You don't always get what you expect in vitamins and supplements, and you have to be careful. So how do you know which brand is best? I've been frustrated in trying to answer that question. I have found one answer at Consumer Reports. Here's what it has to say:

With all the choices, it's no wonder half of multivitamin users in a new, nationally representative Consumer Reports telephone survey expressed some doubt that they were taking the right product for their needs. Our survey, which included 2,002 adults and took place in April 2010, uncovered some other concerns, too: Fifty-six percent of respondents who took a multivitamin worried that it contained harmful ingredients, for example, and 47 percent expressed concern that their multivitamin didn't contain the levels of nutrients listed on the bottle. 

Here's one solution.

USP verified indicates that a product has been verified for purity, strength, safety, dissolvability, and manufacturing quality by the USP, an independent standards-setting authority for the drug and dietary supplement industries. USP claim indicates that the manufacturer claims the product was made to one or more of the USP's quality standards or specifications, but the claim is not vetted by the USP. The verification seal holds more weight than a USP claim on the label, which several of the other products we tested had. 

USP is, no, not the post office, but rather U.S. Pharmacopeia. Here's a database it recommends, and you can check their approved list here. Here's one of its symbols:

I've also read about ConsumerLab, which charges a fee to read its reports. I haven't tried it. And the FDA has information here. And the National Institutes of Health here.

By the way, Consumer Reports checked out 21 multivitamins. All but one of the products we tested met their label claims for key essential vitamins and minerals, and none contained worrisome levels of contaminants such as arsenic or heavy metals. Most of the pills we tested also passed the U.S. Pharmacopeia's dissolution test, which involves immersing them in a simulated stomach-acid solution to determine whether they'll dissolve properly in your body.

Their research shows that the best of the bunch can save you money: Kirkland, the Costco brand, topped the list of multivitamins.

Mellowing out as we get older

From Johns Hopkins University Health Publishing:

Although memory function may decline with age, emotional stability increases, according to a study reported in the Journal of Neuroscience. Forget the myth that older people are crankier than younger ones. In fact, the reverse is true: Age brings increased emotional equanimity.

Australian researchers evaluated 142 people between the ages of 12 and 79. All were in good physical health and had no current or past history of mental illness. The study participants were asked to complete a questionnaire that assesses emotional stability, with higher scores suggesting more positive emotions.

In addition, the individuals' brain activity was assessed by functional magnetic resonance imaging (fMRI) while they viewed images of various facial expressions. Scores on the questionnaire kept in step with age, rising along with seniority. The brain fMRI images revealed that the older adults' emotional reactions were primarily influenced by the medial prefrontal cortex, an area of the brain needed for conscious thought.

In contrast, the emotional reactions of younger people were centered in the amygdala, a part of the brain implicated in automatic fear responses. This reorganization of the brain's emotion system may happen as older people integrate their accumulated life experience and find meaning and patterns in that experience.

Can you keep your health insurance plan?

We were promised repeatedly that we would be able to keep our current health insurance plan if we like it. Is that the case?

Mary Katharine Ham of the Weekly Standard and Townhall’s political editor Guy Benson report:

Over and over again, the president and his ideological allies assured Americans satisfied with their current plan/doctor/coverage that nothing would change if the bill became law.

He told the AMA: “If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.”

A former Medicare/Medicaid official wrote that insurers and doctors are already shifting business models in anticipation of dramatic changes. CBS News featured a small business in Pennsylvania to demonstrate how provisions within Obamacare incentivize employers to drop their employee’s health coverage, and how other elements of the law discourage hiring—thus undermining the nation’s employment recovery. Companies with 25-49 workers are relatively unscathed by the new law, whereas businesses with 50 or more employees face stringent new mandates. Under this system, employers with, say 48 workers, would have compelling reasons to avoid hiring any more full-time workers.
Critics of the bill predicted this pledge would expire almost immediately. They were right. As government mandates for plans— “important consumer protections” as Obama called them— pile up, premiums will rise and the composition of even allegedly “grandfathered” plans will change.

Even more devastating, draft regulation guidelines issued by the federal government itself predict that between half and two-thirds of Americans’ current private plans will lose grandfathered (i.e., “protected”) status by 2013. As the Daily Caller reports, “for plans that do not fall under the grandfathered status, employers would have to find a plan that complies with the health care bill.” More than one million part-time and lower-wage workers are already feeling the squeeze, as popular “mini-med” affordable limited-benefit plans will be banned by the feds starting this fall.

Bottom line: Despite what the president told us repeatedly, it’s quite possible you will not be permitted to keep your health care plan– no matter how much you may like it. Supporters of health care reform argue that government mandates for certain kinds of coverage will only change health care plans for the better, making them more comprehensive, so no one will be negatively impacted. This argument ignores the loss of both choice and money inflicted by government mandates, but even if it were true, that wasn’t the promise, was it?

Will we regrow limbs some day?

Animals like newts and zebra fish can regenerate limbs, fins, even part of the heart. A human can renew his liver to some extent, and regrow a fingertip while very young, but not much more. But humans have very little regenerative capacity, probably because of an evolutionary trade-off: suppressing cell growth reduced the risk of cancer, enabling humans to live longer.

Two studies reported in The New York Times suggest that we may be able to have this ability after all.

By inactivating two genes that work to suppress tumors, researchers at Stanford University got mouse muscle cells to revert to a younger state, start dividing and help repair tissue. 

“We have shown we can recapitulate in mammalian cells behavior of lower vertebrate cells that is required for regeneration,” Dr. Jason H. Pomerantz said. “We would propose using it in amputations of a limb or part of a limb or in cardiac muscle.” Interfering with tumor suppressor genes is a dangerous game, but Dr. Pomerantz said the genes could be inhibited for just a short period by applying the right dose of drug. When the drug has dissipated, the antitumor function of the gene would be restored.

In the second study, at the University of California at San Francisco, researchers have developed a way of reprogramming the ordinary tissue cells of a mouse heart into heart muscle cells, the type that is irretrievably lost in a heart attack. To make clinical use of the discovery, they would need to duplicate the process with human cells, and then develop three drugs that could substitute for the three proteins used in the conversion process. The drugs could be loaded into a stent, a small tube used in coronary bypass operations. With the stent inserted into a heart artery, the drugs would convert some of the heart’s tissue cells into heart muscle cells.

Predicting Alzheimer's before the symptoms appear

Some day we may know years before the mind starts to go that we're at risk for Alzheimer's, much as we know today that cholesterol is a marker for later heart disease.

The National Institute on Aging and the Alzheimer’s Association announced new proposed guidelines in July, The New York Times reports. There was some muttering over this by people who felt it might give the pharmaceutical industry reason to produce drugs people might nor really need -- something the organization's denied.

Today a diagnosis — based on declining memory and reasoning abilities — requires severe symptoms. But researchers agree that Alzheimer’s smolders in the brain a decade or more before memory loss or diminished ability to reason. With new criteria for early diagnosis, the stage is set for testing drugs that might prevent the disease from running its course, investigators say.

Already, some doctors are using biomarkers, like spinal fluid tests that are commercially available, against the advice of researchers. Scientists are still working on standardizing the tests — making sure that, like a test for cholesterol or prostate cancer, an Alzheimer’s biomarker test done in one lab will give the same results as one done elsewhere. The spinal fluid tests can show levels of amyloid and another Alzheimer’s protein, tau. But it is not yet known what levels of amyloid or tau in spinal fluid are abnormal. And measurements of amyloid and tau can vary as much as 30 percent from one research lab to another.

It might be a decade or more before any drugs are found to work and approved for marketing. So there is not much people can do if they go to a private doctor, have a spinal fluid test and are told they might be in the early stages of Alzheimer’s.

Do you know what's in those supplements?

A dozen ingredients commonly found in dietary supplements should be avoided, according to a new study by Consumer Reports, because they are linked to cancer, coma, kidney and liver damage, heart problems, and death.

The magazine singles out 12  ingredients it termed the ''dirty dozen." "The dozen we call out in this report are by no means the only dangerous ingredients," Nancy Metcalf, senior program editor at Consumer Reports, told WebMD. "They are the ones we chose to highlight."

Here's the list:

• Aconite, used for joint pain, wounds, gout, and inflammation, but linked with nausea, vomiting, heart rhythm disorders, respiratory system paralysis, and death.
• Bitter orange, used for weight loss, allergies, and nasal congestion, but linked with fainting, heart rhythm disorder, heart attack, stroke, and death.
• Chaparral, used for weight loss, colds, infections, inflammation, cancer, and detoxification, but linked to kidney and liver problems.
• Colloidal silver, used for fungal and other infections, Lyme disease, rosacea, psoriasis, food poisoning, chronic fatigue syndrome, and HIV/AIDS, but linked to bluish skin color, mucous membrane discoloration, neurological problems, and kidney damage.
• Coltsfoot, used for cough, sore throat, laryngitis, bronchitis, and asthma, but linked to cancer and liver damage.
• Comfrey, used for cough, heavy menstrual periods, chest pain, and cancer, but linked to liver damage and cancer.
• Country mallow, used for allergies, asthma, weight loss, bronchitis, and nasal congestion, but linked to heart attack and arrhythmia, stroke, and death.
• Germanium, used for pain, infections, glaucoma, liver problems, arthritis, osteoporosis, heart disease, HIV/AIDS, and cancer, but linked to kidney damage and death.
• Greater celandine, used for upset stomach, irritable bowel syndrome, liver disorders, detoxification, and cancer, but linked to liver damage.
• Kava, used for anxiety (and is possibly effective, according to Consumer Reports), but linked to liver damage.
• Lobelia, used for coughs, bronchitis, asthma, smoking cessation, but linked to toxicity, with overdose linked with fast heartbeat, very low blood pressure, coma, and possible death.
• Yohimbe, used as an aphrodisiac, for chest pain or diabetic complications, depression, and erectile dysfunction (and possibly effective, according to Consumer Reports), but linked to high blood pressure and rapid heart rate at usual doses and at high doses linked to severe low blood pressure, heart problems, and death.

Some things you can do, according the Metcalf:

• beware of products that have been linked with the most problems -- those for weight loss, sexual enhancement, and body building.
• buy products that have a "USP Verified" mark, which means the manufacturer has asked the U.S. Pharmacopeia, a nonprofit standards-setting authority, to verify the quality, purity, and potency of its raw ingredients or the finished product.
• check out alerts and advisories regarding dietary supplements on the web sites of the National Institutes of Health Office of Dietary Supplements and the FDA.

Don't let the ticks bite

Ticks are a real problem where I live, which is not all that far from Lyme, Connecticut, which gave Lyme Disease its name. Once farmland, it's now covered with second-growth trees, which attack the deer, which have no predators after them.

We have our property sprayed for ticks. When our kids were little, we'd strip them down and examine every square inch of flesh, looking for a little black dot no larger than a pencil point.

Now, it seems, disease-bearing ticks are spreading. The Wall Street Journal reports:

Reported cases of Lyme, the most prevalent of tick-borne diseases, have risen sharply over the last decade, with 35,198 cases in 2008 compared with 13,000 cases in 2000. The CDC says because of under-reporting, the actual number of cases may be three times as high. Though still largely a problem in the Northeast and upper Midwest, Lyme is turning up all over the U.S. If not correctly diagnosed and treated, Lyme can cause chronic joint inflammation, neurological symptoms such as facial palsy, impaired memory and heart-rhythm irregularities.

Other tick-borne illnesses, though less widespread, are also on the rise. In 2008, there were 2,563 reported cases of Rocky Mountain spotted fever , compared with 579 in 1999. The fever can be quickly fatal unless treated with a powerful antibiotic. Last May, Wisconsin and Minnesota warned about a new species of the tick-borne bacteria ehrlichia, not previously found in North America, which can cause flu-like illness. The disease is transmitted by lone star ticks, which have spread to more states in recent years and are also linked to a new illness, called STARI, for southern tick-associated rash illness. 

There are things you can do outside to lessen the risk, the Centers for Disease Control says.

Studies by Kirby Stafford, chief entomologist at the Connecticut Agricultural Experiment Station, show that 82% of ticks on a property are within three yards of the lawn perimeter, particularly along woodlands, stone walls, and ornamental plantings.Dr. Stafford's recommendations include making a barrier of wood chips made of cedar—a natural tick repellent—between wooded areas or stone walls and lawns heavily used by the family, keeping pets out of woods, and avoiding vegetation that attracts deer. 

More advice on making your home safe here. Oh, if you think we were nutty about checking the kids, here's what the CDC recommends:

Check your children for ticks, especially in the hair, when returning from potentially tick-infested areas. Check these parts of your body and your child's body for ticks:

• Under the arms
• In and around the ears
• Inside belly button
• Back of the knees
• Under the arms
• In and around the hair
• Between the legs
• Around the waist

Well, it's something to do.