http://www.healthlit.org/scienceInside/eb_asthmaandallergies.htm
With funding from the National Institutes of Health and the American Association for the Advancement of Science (AAAS), the Healthy People Library Project was created "to empower libraries to play an active role in increasing the quality and years of healthy life and eliminating health disparities for all Americans." Part of their work includes the electronic book series "The Science Inside". These books are intended to be used by health educators and members of the general public, and they cover topics like diabetes, obesity, high blood pressure, and HIV and AIDS. Visitors to the site can click on any book that sounds interesting, and a number of the booklets are also available in Spanish. The site is rounded out by the "Profiles of Healthy Living" section, which offers profiles of people who are making choices that encourage healthy living. [KMG]
Friday, February 27, 2009
Thursday, February 26, 2009
Energy density and weight loss: Feel full on fewer calories
Date updated: January 20, 2009
Content provided by MayoClinic.com
Feel full on fewer calories. It sounds like a diet gimmick. But in reality, the concept of energy density can indeed help you feel satisfied with fewer calories. By consuming fewer calories, you can lose weight over time and keep it off long term.
Energy density: Volume versus calories
All foods have a certain number of calories within a given amount (volume). Some foods, such as desserts, candies and processed foods, are high in energy density. This means that a small volume of that food has a large number of calories.
Alternatively, some foods - such as vegetables and fruits - have low energy density. These foods provide a larger portion size with a fewer number of calories.
Two factors play an important role in what makes food less calorie packed and more filling:
Water. Many fruits and vegetables are high in water, which provides volume but not calories. Grapefruit, for example, is about 90 percent water and has just 38 calories in a half-fruit serving. Carrots are about 88 percent water and have only 52 calories in 1 cup.
Fiber. High-fiber foods - such as vegetables, fruits and whole grains - not only provide volume, but also take longer to digest, making you feel full longer.
Pictures comparing high-energy-dense foods with low-energy-dense foods. Each of these high-energy-dense plates holds about the same amount of calories as its low-energy-dense counterpart. But the high-energy-dense plates provide just a small portion for those calories. The low-energy-dense plates provide large volume - focusing on fruits, vegetables and whole grains - in relation to their calorie content.
Your best food choices
Changing lifestyle habits is never easy, and creating an eating plan using this concept is no exception. The first step is knowing which foods are best.
Vegetables. Most vegetables - salad greens, asparagus, green beans, broccoli and zucchini, for example - are low in calories but high in volume.
Fruits. Practically all types of fruit fit into a healthy diet. But some fruits are better choices than others are. Whole fresh, frozen and canned fruits without added sugar are better options than fruit juices and dried fruits, which are concentrated sources of natural sugar and therefore have a higher calorie content.
Carbohydrates. Most carbohydrates are either grains or made from grains, such as cereal, rice, bread and pasta. The best type is whole grains because they're higher in fiber and other important nutrients. Examples include whole-wheat bread, whole-wheat pasta, oatmeal, brown rice and whole-grain cereal.
Protein and dairy. These include food from both plant and animal sources. The best choices are foods that are high in protein but low in fat and calories, such as legumes (beans, peas and lentils, which are also good sources of fiber), fish, skinned white-meat poultry, fat-free dairy products and egg whites.
Eat sweets and high-fat foods in moderation since many of these foods are high in calories but low in volume.
Make it work for you
Starting a healthy diet that emphasizes fresh fruits and vegetables and whole grains makes room in your diet for some of your favorite foods in small quantities: a piece of chocolate cake or a small scoop of ice cream, for example. When you're not feeling desperately hungry and deprived, as you might on some diets, you can enjoy a small portion of dessert without guilt.
Here are ideas to make this eating plan work for you:
Increase the ratio of fruits and vegetables in your meals. For example, add blueberries to your cereal in the morning. Or top your pasta with sauteed vegetables and tomato sauce. Decrease the meat portion on your plate and increase the serving size of vegetables.
Experiment with new foods and combinations. Try mango or peach slices on whole-wheat toast with a little peanut butter and honey. Toss some mandarin orange and peach slices into a salad. You may find some new tastes you love that fit within your eating plan.
Start with soup or salad. Begin lunch or dinner with a broth-based, vegetable-filled soup or a large salad with a small amount of low-fat or fat-free dressing. These foods take longer to eat and curb your hunger. Next, serve whole grains, an extra portion or two of vegetables and a small serving of lean protein for your main course.
By eating larger portions of foods less packed with calories, you squelch those hunger pangs, take in fewer calories and feel better about your meal, which contributes to how satisfied you feel overall.
©1998-2008 Mayo Foundation for Medical Education and Research (MFMER)
Content provided by MayoClinic.com
Feel full on fewer calories. It sounds like a diet gimmick. But in reality, the concept of energy density can indeed help you feel satisfied with fewer calories. By consuming fewer calories, you can lose weight over time and keep it off long term.
Energy density: Volume versus calories
All foods have a certain number of calories within a given amount (volume). Some foods, such as desserts, candies and processed foods, are high in energy density. This means that a small volume of that food has a large number of calories.
Alternatively, some foods - such as vegetables and fruits - have low energy density. These foods provide a larger portion size with a fewer number of calories.
Two factors play an important role in what makes food less calorie packed and more filling:
Water. Many fruits and vegetables are high in water, which provides volume but not calories. Grapefruit, for example, is about 90 percent water and has just 38 calories in a half-fruit serving. Carrots are about 88 percent water and have only 52 calories in 1 cup.
Fiber. High-fiber foods - such as vegetables, fruits and whole grains - not only provide volume, but also take longer to digest, making you feel full longer.
Pictures comparing high-energy-dense foods with low-energy-dense foods. Each of these high-energy-dense plates holds about the same amount of calories as its low-energy-dense counterpart. But the high-energy-dense plates provide just a small portion for those calories. The low-energy-dense plates provide large volume - focusing on fruits, vegetables and whole grains - in relation to their calorie content.
Your best food choices
Changing lifestyle habits is never easy, and creating an eating plan using this concept is no exception. The first step is knowing which foods are best.
Vegetables. Most vegetables - salad greens, asparagus, green beans, broccoli and zucchini, for example - are low in calories but high in volume.
Fruits. Practically all types of fruit fit into a healthy diet. But some fruits are better choices than others are. Whole fresh, frozen and canned fruits without added sugar are better options than fruit juices and dried fruits, which are concentrated sources of natural sugar and therefore have a higher calorie content.
Carbohydrates. Most carbohydrates are either grains or made from grains, such as cereal, rice, bread and pasta. The best type is whole grains because they're higher in fiber and other important nutrients. Examples include whole-wheat bread, whole-wheat pasta, oatmeal, brown rice and whole-grain cereal.
Protein and dairy. These include food from both plant and animal sources. The best choices are foods that are high in protein but low in fat and calories, such as legumes (beans, peas and lentils, which are also good sources of fiber), fish, skinned white-meat poultry, fat-free dairy products and egg whites.
Eat sweets and high-fat foods in moderation since many of these foods are high in calories but low in volume.
Make it work for you
Starting a healthy diet that emphasizes fresh fruits and vegetables and whole grains makes room in your diet for some of your favorite foods in small quantities: a piece of chocolate cake or a small scoop of ice cream, for example. When you're not feeling desperately hungry and deprived, as you might on some diets, you can enjoy a small portion of dessert without guilt.
Here are ideas to make this eating plan work for you:
Increase the ratio of fruits and vegetables in your meals. For example, add blueberries to your cereal in the morning. Or top your pasta with sauteed vegetables and tomato sauce. Decrease the meat portion on your plate and increase the serving size of vegetables.
Experiment with new foods and combinations. Try mango or peach slices on whole-wheat toast with a little peanut butter and honey. Toss some mandarin orange and peach slices into a salad. You may find some new tastes you love that fit within your eating plan.
Start with soup or salad. Begin lunch or dinner with a broth-based, vegetable-filled soup or a large salad with a small amount of low-fat or fat-free dressing. These foods take longer to eat and curb your hunger. Next, serve whole grains, an extra portion or two of vegetables and a small serving of lean protein for your main course.
By eating larger portions of foods less packed with calories, you squelch those hunger pangs, take in fewer calories and feel better about your meal, which contributes to how satisfied you feel overall.
©1998-2008 Mayo Foundation for Medical Education and Research (MFMER)
Wednesday, February 25, 2009
Drinking Raises Cancer Risk for Middle-Age Women
Even one drink a day poses danger, large study finds
TUESDAY, Feb. 24 (HealthDay News) - Research involving more than a million middle-age women finds that even moderate drinking raises risks for breast, liver and other cancers.
"Even relatively low levels of drinking -- on the order of one alcoholic drink per day -- increase a woman's risk of developing cancer," said lead researcher Naomi Allen, from the cancer epidemiology unit at the University of Oxford in the United Kingdom. "Because a high proportion of women drink low amounts of alcohol regularly and because most of the increased risk is for breast cancer, the risk among women associated with drinking alcohol is of particular importance."
In fact, the study found that moderate drinking accounts for 13 percent of breast, liver, rectum and upper respiratory/digestive tract cancers among women.
The association between moderate alcohol intake and breast cancer in women is well-known, the researchers point out. What's new here, they say, is the finding that even low levels of drinking can raise a woman's risk of developing cancer of the liver and rectum. For women who smoke, cancers of the mouth and throat were also linked to high alcohol consumption.
The report is published in the Feb. 24 online edition of the Journal of the National Cancer Institute.
For the study, Allen's team collected data on more than 1.2 million middle-age British women participating in the Million Women Study. The researchers used the National Health Service Central Registries to identify cancer cases among these women.
Most women in the study had about a drink a day, and a smaller percentage had three or more drinks a day, the researchers found. Over more than seven years of follow-up, 68,775 women developed cancer.
"These findings are robust, and alcohol consumption was assessed several times before women were diagnosed with cancer, making these estimates reliable," Allen said.
Overall, the risk of cancer increased as alcohol consumption increased. The type of alcohol consumed appeared to make no difference.
Women who drank and also smoked faced increased risk of cancers of the oral cavity and pharynx, esophagus, and larynx (voice box), the researchers found.
The study suggests "that in developed countries, where women typically consume low-moderate amounts of alcohol, we estimate that for every additional drink regularly consumed each day, there would be about 15 extra cases of cancers of the breast, liver, rectum and mouth and throat diagnosed for every 1,000 women up to the age of 75," Allen said. "Most of this excess risk is due to breast cancer."
Susan M. Gapstur, vice president of epidemiology at the American Cancer Society, said the findings confirm and expand on those from previous studies in men and in smaller cohorts of women.
But several questions remain unanswered, she said. "For example, researchers remain concerned about the pattern of consumption," Gapstur said. "It is unclear, for example, whether someone who drinks several glasses of wine on one day during the week has the same risk as someone who drinks one glass of wine per day with a meal. In addition, the effects of quitting or reducing drinking on cancer risk are also unclear."
The American Cancer Society currently recommends limiting intake to one drink a day for women and two drinks a day for men, Gapstur said.
On the other hand, numerous studies have suggested that alcohol, especially red wine, might help deter heart disease -- complicating decisions around drinking and health.
"If you do not drink, there is no reason to start drinking," Gapstur reasoned. "However, in light of the findings from the Million Women Study, women who are concerned about their cancer risk versus their risk of cardiovascular disease might want to discuss the potential risks and benefits of even low alcohol intake with their health-care providers."
In an accompanying journal editorial, Dr. Michael Lauer, director of the Division of Prevention and Population Sciences at the U.S. National Heart, Lung and Blood Institute, said he believes the risk for cancer might outweigh any perceived benefit in terms of heart disease.
"People who are not drinkers should not start drinking to prevent heart disease, and even people who are drinking should discuss this with their physicians," he said. "And as part of that conversation, they should consider other conditions than heart disease. We cannot just focus on heart disease."
TUESDAY, Feb. 24 (HealthDay News) - Research involving more than a million middle-age women finds that even moderate drinking raises risks for breast, liver and other cancers.
"Even relatively low levels of drinking -- on the order of one alcoholic drink per day -- increase a woman's risk of developing cancer," said lead researcher Naomi Allen, from the cancer epidemiology unit at the University of Oxford in the United Kingdom. "Because a high proportion of women drink low amounts of alcohol regularly and because most of the increased risk is for breast cancer, the risk among women associated with drinking alcohol is of particular importance."
In fact, the study found that moderate drinking accounts for 13 percent of breast, liver, rectum and upper respiratory/digestive tract cancers among women.
The association between moderate alcohol intake and breast cancer in women is well-known, the researchers point out. What's new here, they say, is the finding that even low levels of drinking can raise a woman's risk of developing cancer of the liver and rectum. For women who smoke, cancers of the mouth and throat were also linked to high alcohol consumption.
The report is published in the Feb. 24 online edition of the Journal of the National Cancer Institute.
For the study, Allen's team collected data on more than 1.2 million middle-age British women participating in the Million Women Study. The researchers used the National Health Service Central Registries to identify cancer cases among these women.
Most women in the study had about a drink a day, and a smaller percentage had three or more drinks a day, the researchers found. Over more than seven years of follow-up, 68,775 women developed cancer.
"These findings are robust, and alcohol consumption was assessed several times before women were diagnosed with cancer, making these estimates reliable," Allen said.
Overall, the risk of cancer increased as alcohol consumption increased. The type of alcohol consumed appeared to make no difference.
Women who drank and also smoked faced increased risk of cancers of the oral cavity and pharynx, esophagus, and larynx (voice box), the researchers found.
The study suggests "that in developed countries, where women typically consume low-moderate amounts of alcohol, we estimate that for every additional drink regularly consumed each day, there would be about 15 extra cases of cancers of the breast, liver, rectum and mouth and throat diagnosed for every 1,000 women up to the age of 75," Allen said. "Most of this excess risk is due to breast cancer."
Susan M. Gapstur, vice president of epidemiology at the American Cancer Society, said the findings confirm and expand on those from previous studies in men and in smaller cohorts of women.
But several questions remain unanswered, she said. "For example, researchers remain concerned about the pattern of consumption," Gapstur said. "It is unclear, for example, whether someone who drinks several glasses of wine on one day during the week has the same risk as someone who drinks one glass of wine per day with a meal. In addition, the effects of quitting or reducing drinking on cancer risk are also unclear."
The American Cancer Society currently recommends limiting intake to one drink a day for women and two drinks a day for men, Gapstur said.
On the other hand, numerous studies have suggested that alcohol, especially red wine, might help deter heart disease -- complicating decisions around drinking and health.
"If you do not drink, there is no reason to start drinking," Gapstur reasoned. "However, in light of the findings from the Million Women Study, women who are concerned about their cancer risk versus their risk of cardiovascular disease might want to discuss the potential risks and benefits of even low alcohol intake with their health-care providers."
In an accompanying journal editorial, Dr. Michael Lauer, director of the Division of Prevention and Population Sciences at the U.S. National Heart, Lung and Blood Institute, said he believes the risk for cancer might outweigh any perceived benefit in terms of heart disease.
"People who are not drinkers should not start drinking to prevent heart disease, and even people who are drinking should discuss this with their physicians," he said. "And as part of that conversation, they should consider other conditions than heart disease. We cannot just focus on heart disease."
Diabetes Linked to Depression During and After Pregnancy
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Study was based on more than 11,000 low-income mothers
TUESDAY, Feb. 24 (HealthDay News) -- Low-income women with diabetes who are pregnant or recently gave birth face almost twice the risk of depression compared to women without the blood sugar disorder, a new study found.
And, it didn't matter whether the women developed diabetes before or during pregnancy, or if they were taking insulin or oral medications. The risk of depression was still much stronger for women with diabetes, the study found.
"Those with diabetes have nearly twice the risk of depression during pregnancy and post-partum," said the study's lead author, Katy Backes Kozhimannil, a research fellow in the department of ambulatory care and prevention at Harvard Medical School in Boston.
And, Kozhimannil added, women who'd never been depressed before appeared to be at risk, too. "One in 10 women who had no indication of prior depression received a diagnosis of depression within a year following delivery," she said.
Results of the study were published in the Feb. 25 issue of the Journal of the American Medical Association.
Although the study didn't look at potential reasons for this association, Kozhimannil said there are biological changes that occur with diabetes that might increase the risk of depression. She also said the stress of managing a chronic illness might contribute to the risk of depression.
Post-partum depression affects about 10 percent of new mothers, usually between two and six months after birth, according to background information in the study. If left untreated, post-partum depression can affect the mother-child relationship as well as the child's development.
Risk factors for post-partum depression include a history of depression, troubled relationships, domestic violence, stressful life events, financial problems, lack of social or emotional support, a difficult pregnancy or delivery, and health problems with the baby. Previous studies have linked diabetes to an increased risk of depression in general, according to the study authors.
To assess whether or not diabetes is a factor in pre- and post-partum depression, Kozhimannil and her colleagues reviewed data on more than 11,000 women who gave birth between 2004 and 2006. All of the women were continuously enrolled in Medicaid during the study period.
From this low-income population, the researchers found that 15.2 percent of women with diabetes developed depression during or after their pregnancy. In women without diabetes, that number was 8.5 percent. In women who'd never been depressed before, 9.6 percent of those with diabetes developed depression, compared to 5.9 percent of those without the blood sugar condition.
"Health-care facilities need to pay particular attention for depression in women with diabetes during the post-partum period," said Kozhimannil. "Both diabetes and depression in the post-partum period are treatable."
Dr. Robert Welch, chairman of obstetrics and gynecology at Providence Hospital in Southfield, Mich., called the new research an interesting study, but said it left some important questions unanswered. For example, he wondered how many of these pregnancies were planned, and exactly how many of the women with diabetes were newly diagnosed?
"A new diagnosis may be overwhelming for a lot of women," he said.
Also, in a Medicaid population, it can be more difficult to get diabetes well monitored, which could add to the stress these women are already feeling, Welch said. "Diabetes is an expensive disease, and this study calls out the need for additional mid-level providers who have more time to assist in making [a depression] diagnosis," he said.
Both Welch and Kozhimannil said that while this study was done with low-income women, the findings may be similar for higher-income women, though the stressors may be different.
Welch recommended that no matter what your income, if you're expecting, you should try to set up a support system before the baby arrives. Try to set up extra help so you're not alone with the baby day after day, he said.
"Years ago, when you brought a baby home, grandma and other family members were there. Now, grandmothers are working. And, if you have diabetes, too, it's an overwhelming situation. You're fatigued from the new baby and have the stress of managing diabetes," he said.
HealthDay
Copyright (c) 2009 ScoutNews, LLC. All rights reserved.
Search Terms
Study was based on more than 11,000 low-income mothers
TUESDAY, Feb. 24 (HealthDay News) -- Low-income women with diabetes who are pregnant or recently gave birth face almost twice the risk of depression compared to women without the blood sugar disorder, a new study found.
And, it didn't matter whether the women developed diabetes before or during pregnancy, or if they were taking insulin or oral medications. The risk of depression was still much stronger for women with diabetes, the study found.
"Those with diabetes have nearly twice the risk of depression during pregnancy and post-partum," said the study's lead author, Katy Backes Kozhimannil, a research fellow in the department of ambulatory care and prevention at Harvard Medical School in Boston.
And, Kozhimannil added, women who'd never been depressed before appeared to be at risk, too. "One in 10 women who had no indication of prior depression received a diagnosis of depression within a year following delivery," she said.
Results of the study were published in the Feb. 25 issue of the Journal of the American Medical Association.
Although the study didn't look at potential reasons for this association, Kozhimannil said there are biological changes that occur with diabetes that might increase the risk of depression. She also said the stress of managing a chronic illness might contribute to the risk of depression.
Post-partum depression affects about 10 percent of new mothers, usually between two and six months after birth, according to background information in the study. If left untreated, post-partum depression can affect the mother-child relationship as well as the child's development.
Risk factors for post-partum depression include a history of depression, troubled relationships, domestic violence, stressful life events, financial problems, lack of social or emotional support, a difficult pregnancy or delivery, and health problems with the baby. Previous studies have linked diabetes to an increased risk of depression in general, according to the study authors.
To assess whether or not diabetes is a factor in pre- and post-partum depression, Kozhimannil and her colleagues reviewed data on more than 11,000 women who gave birth between 2004 and 2006. All of the women were continuously enrolled in Medicaid during the study period.
From this low-income population, the researchers found that 15.2 percent of women with diabetes developed depression during or after their pregnancy. In women without diabetes, that number was 8.5 percent. In women who'd never been depressed before, 9.6 percent of those with diabetes developed depression, compared to 5.9 percent of those without the blood sugar condition.
"Health-care facilities need to pay particular attention for depression in women with diabetes during the post-partum period," said Kozhimannil. "Both diabetes and depression in the post-partum period are treatable."
Dr. Robert Welch, chairman of obstetrics and gynecology at Providence Hospital in Southfield, Mich., called the new research an interesting study, but said it left some important questions unanswered. For example, he wondered how many of these pregnancies were planned, and exactly how many of the women with diabetes were newly diagnosed?
"A new diagnosis may be overwhelming for a lot of women," he said.
Also, in a Medicaid population, it can be more difficult to get diabetes well monitored, which could add to the stress these women are already feeling, Welch said. "Diabetes is an expensive disease, and this study calls out the need for additional mid-level providers who have more time to assist in making [a depression] diagnosis," he said.
Both Welch and Kozhimannil said that while this study was done with low-income women, the findings may be similar for higher-income women, though the stressors may be different.
Welch recommended that no matter what your income, if you're expecting, you should try to set up a support system before the baby arrives. Try to set up extra help so you're not alone with the baby day after day, he said.
"Years ago, when you brought a baby home, grandma and other family members were there. Now, grandmothers are working. And, if you have diabetes, too, it's an overwhelming situation. You're fatigued from the new baby and have the stress of managing diabetes," he said.
HealthDay
Copyright (c) 2009 ScoutNews, LLC. All rights reserved.
Diabetes Linked to Depression During and After Pregnancy
Study was based on more than 11,000 low-income mothers
TUESDAY, Feb. 24 (HealthDay News) -- Low-income women with diabetes who are pregnant or recently gave birth face almost twice the risk of depression compared to women without the blood sugar disorder, a new study found.
And, it didn't matter whether the women developed diabetes before or during pregnancy, or if they were taking insulin or oral medications. The risk of depression was still much stronger for women with diabetes, the study found.
"Those with diabetes have nearly twice the risk of depression during pregnancy and post-partum," said the study's lead author, Katy Backes Kozhimannil, a research fellow in the department of ambulatory care and prevention at Harvard Medical School in Boston.
And, Kozhimannil added, women who'd never been depressed before appeared to be at risk, too. "One in 10 women who had no indication of prior depression received a diagnosis of depression within a year following delivery," she said.
Results of the study were published in the Feb. 25 issue of the Journal of the American Medical Association.
Although the study didn't look at potential reasons for this association, Kozhimannil said there are biological changes that occur with diabetes that might increase the risk of depression. She also said the stress of managing a chronic illness might contribute to the risk of depression.
Post-partum depression affects about 10 percent of new mothers, usually between two and six months after birth, according to background information in the study. If left untreated, post-partum depression can affect the mother-child relationship as well as the child's development.
Risk factors for post-partum depression include a history of depression, troubled relationships, domestic violence, stressful life events, financial problems, lack of social or emotional support, a difficult pregnancy or delivery, and health problems with the baby. Previous studies have linked diabetes to an increased risk of depression in general, according to the study authors.
To assess whether or not diabetes is a factor in pre- and post-partum depression, Kozhimannil and her colleagues reviewed data on more than 11,000 women who gave birth between 2004 and 2006. All of the women were continuously enrolled in Medicaid during the study period.
From this low-income population, the researchers found that 15.2 percent of women with diabetes developed depression during or after their pregnancy. In women without diabetes, that number was 8.5 percent. In women who'd never been depressed before, 9.6 percent of those with diabetes developed depression, compared to 5.9 percent of those without the blood sugar condition.
"Health-care facilities need to pay particular attention for depression in women with diabetes during the post-partum period," said Kozhimannil. "Both diabetes and depression in the post-partum period are treatable."
Dr. Robert Welch, chairman of obstetrics and gynecology at Providence Hospital in Southfield, Mich., called the new research an interesting study, but said it left some important questions unanswered. For example, he wondered how many of these pregnancies were planned, and exactly how many of the women with diabetes were newly diagnosed?
"A new diagnosis may be overwhelming for a lot of women," he said.
Also, in a Medicaid population, it can be more difficult to get diabetes well monitored, which could add to the stress these women are already feeling, Welch said. "Diabetes is an expensive disease, and this study calls out the need for additional mid-level providers who have more time to assist in making [a depression] diagnosis," he said.
Both Welch and Kozhimannil said that while this study was done with low-income women, the findings may be similar for higher-income women, though the stressors may be different.
Welch recommended that no matter what your income, if you're expecting, you should try to set up a support system before the baby arrives. Try to set up extra help so you're not alone with the baby day after day, he said.
"Years ago, when you brought a baby home, grandma and other family members were there. Now, grandmothers are working. And, if you have diabetes, too, it's an overwhelming situation. You're fatigued from the new baby and have the stress of managing diabetes," he said.
HealthDay
Copyright (c) 2009 ScoutNews, LLC. All rights reserved.
TUESDAY, Feb. 24 (HealthDay News) -- Low-income women with diabetes who are pregnant or recently gave birth face almost twice the risk of depression compared to women without the blood sugar disorder, a new study found.
And, it didn't matter whether the women developed diabetes before or during pregnancy, or if they were taking insulin or oral medications. The risk of depression was still much stronger for women with diabetes, the study found.
"Those with diabetes have nearly twice the risk of depression during pregnancy and post-partum," said the study's lead author, Katy Backes Kozhimannil, a research fellow in the department of ambulatory care and prevention at Harvard Medical School in Boston.
And, Kozhimannil added, women who'd never been depressed before appeared to be at risk, too. "One in 10 women who had no indication of prior depression received a diagnosis of depression within a year following delivery," she said.
Results of the study were published in the Feb. 25 issue of the Journal of the American Medical Association.
Although the study didn't look at potential reasons for this association, Kozhimannil said there are biological changes that occur with diabetes that might increase the risk of depression. She also said the stress of managing a chronic illness might contribute to the risk of depression.
Post-partum depression affects about 10 percent of new mothers, usually between two and six months after birth, according to background information in the study. If left untreated, post-partum depression can affect the mother-child relationship as well as the child's development.
Risk factors for post-partum depression include a history of depression, troubled relationships, domestic violence, stressful life events, financial problems, lack of social or emotional support, a difficult pregnancy or delivery, and health problems with the baby. Previous studies have linked diabetes to an increased risk of depression in general, according to the study authors.
To assess whether or not diabetes is a factor in pre- and post-partum depression, Kozhimannil and her colleagues reviewed data on more than 11,000 women who gave birth between 2004 and 2006. All of the women were continuously enrolled in Medicaid during the study period.
From this low-income population, the researchers found that 15.2 percent of women with diabetes developed depression during or after their pregnancy. In women without diabetes, that number was 8.5 percent. In women who'd never been depressed before, 9.6 percent of those with diabetes developed depression, compared to 5.9 percent of those without the blood sugar condition.
"Health-care facilities need to pay particular attention for depression in women with diabetes during the post-partum period," said Kozhimannil. "Both diabetes and depression in the post-partum period are treatable."
Dr. Robert Welch, chairman of obstetrics and gynecology at Providence Hospital in Southfield, Mich., called the new research an interesting study, but said it left some important questions unanswered. For example, he wondered how many of these pregnancies were planned, and exactly how many of the women with diabetes were newly diagnosed?
"A new diagnosis may be overwhelming for a lot of women," he said.
Also, in a Medicaid population, it can be more difficult to get diabetes well monitored, which could add to the stress these women are already feeling, Welch said. "Diabetes is an expensive disease, and this study calls out the need for additional mid-level providers who have more time to assist in making [a depression] diagnosis," he said.
Both Welch and Kozhimannil said that while this study was done with low-income women, the findings may be similar for higher-income women, though the stressors may be different.
Welch recommended that no matter what your income, if you're expecting, you should try to set up a support system before the baby arrives. Try to set up extra help so you're not alone with the baby day after day, he said.
"Years ago, when you brought a baby home, grandma and other family members were there. Now, grandmothers are working. And, if you have diabetes, too, it's an overwhelming situation. You're fatigued from the new baby and have the stress of managing diabetes," he said.
HealthDay
Copyright (c) 2009 ScoutNews, LLC. All rights reserved.
Tuesday, February 24, 2009
Calcium Helps Ward Off Colon Cancer
Effect is strongest for women, study finds, doesn't extend to other malignancies
HealthDay
Monday, February 23, 2009
MONDAY, Feb. 23 (HealthDay News) -- High dietary intake of calcium may reduce the incidence of colorectal cancer, especially for women, but has no apparent effect in reducing other malignancies, a U.S. National Cancer Institute study finds.
Why calcium should influence cancer risk differently in women versus men isn't clear, said Yikyung Park, a staff scientist at NCI who led the study. "One can speculate that hormonal or metabolic factors contribute to this difference," she said.
Park and her colleagues relied on data for nearly 500,000 men and women who participated in the U.S. National Institutes of Health-AARP Diet and Health Study. Participants filled out a food questionnaire when they enrolled and then were followed for an average of seven years.
"In both men and women, dairy food and calcium intakes were inversely associated with cancers of the digestive system," the researchers reported in the Feb. 23 issue of the Archives of Internal Medicine.
The top one-fifth of women with the highest intake averaged 1,881 milligrams of calcium per day. This group experienced a 23 percent lower risk of colon cancer than those women in the lowest fifth of intake, who averaged 494 milligrams daily. The comparable reduction for men was 16 percent.
The U.S. Institute of Medicine recommends a daily calcium intake of 1,200 milligrams for adults 50 and older, roughly the amount found in three cups a day of the dairy products that are the main sources of calcium. Other sources of calcium include sardines and green, leafy vegetables.
Calcium has been shown to reduce abnormal growths and induce normal turnover of cells in the gastrointestinal system, the report noted.
The study was done because "calcium has been hypothesized to play different roles in different cancer sites, but testing has been incomplete, inconsistent and limited," Park said.
One expert said the study is an important one. "This is the first paper looking at calcium, dairy products and all cancers combined," said Marji McCullough, strategic director of nutritional epidemiology at the American Cancer Society. The findings, she said, "were consistent with the previous literature."
For example, a controlled trial reported last year found no protective effect of calcium intake against breast cancer. The new report confirms that finding, and also finds that the nutrient offers no protective effect against prostate cancer.
The NCI study results "are consistent with guidelines for a healthy diet," McCullough said. "But it is important for people to understand that they shouldn't go overboard on calcium."
No additional protective effect was found for calcium intakes greater than 1,300 milligrams a day, according to the NCI study.
Current calcium recommendations are best met by dietary sources rather than supplements, McCullough added, in part because diet offers more than just calcium. "Calcium and vitamin D and are highly correlated in the diet, and it is difficult to isolate a single component," she said. "It may be that a combination of nutrients is important."
The combination of calcium of vitamin D is important, since vitamin D facilitates calcium's absorption by the digestive system. The skin makes vitamin D naturally through exposure to sunlight.
Another report in the same issue of the journal finds that that a combination of vitamins B6, B12 and folic acid appears to reduce the risk among women of age-related macular degeneration, a major cause of vision loss for older Americans.
A controlled trial including more than 5,400 women 40 and older found a 34 percent lower incidence of the eye disorder in women taking the vitamins compared to those taking an inactive placebo, said the report by researchers at Harvard Medical School and Brigham and Women's Hospital, Boston.
HealthDay
Monday, February 23, 2009
MONDAY, Feb. 23 (HealthDay News) -- High dietary intake of calcium may reduce the incidence of colorectal cancer, especially for women, but has no apparent effect in reducing other malignancies, a U.S. National Cancer Institute study finds.
Why calcium should influence cancer risk differently in women versus men isn't clear, said Yikyung Park, a staff scientist at NCI who led the study. "One can speculate that hormonal or metabolic factors contribute to this difference," she said.
Park and her colleagues relied on data for nearly 500,000 men and women who participated in the U.S. National Institutes of Health-AARP Diet and Health Study. Participants filled out a food questionnaire when they enrolled and then were followed for an average of seven years.
"In both men and women, dairy food and calcium intakes were inversely associated with cancers of the digestive system," the researchers reported in the Feb. 23 issue of the Archives of Internal Medicine.
The top one-fifth of women with the highest intake averaged 1,881 milligrams of calcium per day. This group experienced a 23 percent lower risk of colon cancer than those women in the lowest fifth of intake, who averaged 494 milligrams daily. The comparable reduction for men was 16 percent.
The U.S. Institute of Medicine recommends a daily calcium intake of 1,200 milligrams for adults 50 and older, roughly the amount found in three cups a day of the dairy products that are the main sources of calcium. Other sources of calcium include sardines and green, leafy vegetables.
Calcium has been shown to reduce abnormal growths and induce normal turnover of cells in the gastrointestinal system, the report noted.
The study was done because "calcium has been hypothesized to play different roles in different cancer sites, but testing has been incomplete, inconsistent and limited," Park said.
One expert said the study is an important one. "This is the first paper looking at calcium, dairy products and all cancers combined," said Marji McCullough, strategic director of nutritional epidemiology at the American Cancer Society. The findings, she said, "were consistent with the previous literature."
For example, a controlled trial reported last year found no protective effect of calcium intake against breast cancer. The new report confirms that finding, and also finds that the nutrient offers no protective effect against prostate cancer.
The NCI study results "are consistent with guidelines for a healthy diet," McCullough said. "But it is important for people to understand that they shouldn't go overboard on calcium."
No additional protective effect was found for calcium intakes greater than 1,300 milligrams a day, according to the NCI study.
Current calcium recommendations are best met by dietary sources rather than supplements, McCullough added, in part because diet offers more than just calcium. "Calcium and vitamin D and are highly correlated in the diet, and it is difficult to isolate a single component," she said. "It may be that a combination of nutrients is important."
The combination of calcium of vitamin D is important, since vitamin D facilitates calcium's absorption by the digestive system. The skin makes vitamin D naturally through exposure to sunlight.
Another report in the same issue of the journal finds that that a combination of vitamins B6, B12 and folic acid appears to reduce the risk among women of age-related macular degeneration, a major cause of vision loss for older Americans.
A controlled trial including more than 5,400 women 40 and older found a 34 percent lower incidence of the eye disorder in women taking the vitamins compared to those taking an inactive placebo, said the report by researchers at Harvard Medical School and Brigham and Women's Hospital, Boston.
Reminding Patients and Docs May Improve Colorectal Screening Rates
By Kristina Fiore, Staff Writer, MedPage Today
Published: February 24, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.
BOSTON, Feb. 23 -- Reminding both patients and physicians to schedule colonoscopies may improve colorectal cancer screening rates, researchers here said.
Explain that patients who receive mailed reminders for colorectal cancer screening have significantly higher rates of screening. Electronic reminders sent to their physicians tend to increase colonoscopy rates as well.
Patients who received mailed reminders had significantly higher rates of screening. Electronic reminders to their physicians tended to increase colonoscopy rates for some patients as well, Thomas D. Sequist, M.D., of Brigham and Women's Hospital and colleagues reported in the Feb. 23 Archives of Internal Medicine.
"These complementary approaches have the potential to promote the overarching goal of widespread screening to reduce the incidence, morbidity, and mortality of colorectal cancer," the researchers said.
Preventive screening reduces colorectal cancer mortality rates, but only 60% of eligible patients reported that they were up-to-date with screening, the researchers said. Also, physicians may not have enough time during office visits to discuss the growing number of recommended preventive services.
Previous screening studies have focused on either patients or physicians, the researchers said, so they decided to investigate the joint impact of patient mailings and electronic reminders to primary care physicians.
They conducted a randomized controlled trial of patient and physician reminders in 11 ambulatory healthcare centers from April 2006 to June 2007. The study covered 21,860 patients ages 50 to 80 who were overdue for colorectal cancer screening, along with 110 primary care physicians.
The overdue patients received either no written communication at all or a mailing with an educational pamphlet, a fecal occult blood test kit, and instructions for scheduling a flexible sigmoidoscopy or colonoscopy.
Physicians were randomly assigned to receive electronic reminders during office visits with overdue patients, while others got no reminder.
The researchers found that screening rates were higher for patients who received mailings compared with those who did not (44% versus 38.1%, P<0.001).
They also found that the effectiveness of the mailings increased as patients got older: +3.7% for ages 50 to 59, compared to +7.3% for ages 60 to 69 and +10.1% for ages 70 to 80 (P=0.01 for trend).
"Our findings underscore that informed patients can play an active role in completing effective preventive services," the researchers said.
The researchers said that electronic reminders to physicians did not significantly increase overall screening rates.
Rates were similar among patients whose physicians received electronic reminders and the control group (41.9% versus 40.2%), "in part because over one-third of patients had no visits with their primary care physician during the 15-month study period," the researchers said.
However, electronic reminders tended to increase screening rates among patients who had at least three visits to their primary care doctor during the study period (59.5% versus 52.7% P=0.07).
The number of orders for colonoscopy did modestly increase for patients whose physicians were electronically reminded, but there was no corresponding increase in completed procedures. The researchers said that nearly half of patients for whom it was ordered did not complete the procedure.
"This finding underscores the need for more effective communication with patients to encourage them to complete colonoscopy procedures that are scheduled," they said.
Detection of adenomas tended to be greater among patients who received mailings (5.7% versus 5.2%; P=.10) and among patients whose physicians received electronic reminders, compared with controls (5.7% versus 5.2%; P=.10), researchers said.
"Mailed reminders to patients are an effective tool to promote colorectal cancer screening," they concluded, "and electronic reminders to physicians may increase screening among adults who have more frequent primary care visits."
They pointed out that "the generalizability of our study must also be considered. We implemented our intervention within a single group practice using an advanced electronic health record, so our findings may not apply to less structured settings."
The study was supported by a grant from the National Cancer Institute.
The researchers reported no conflicts of interest.
Primary source: Archives of Internal Medicine
Source reference:
Sequist TD, et al "Patient and physician reminders to promote colorectal cancer screening" Arch Intern Med 2009; 169(4): 364-71.
Published: February 24, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.
BOSTON, Feb. 23 -- Reminding both patients and physicians to schedule colonoscopies may improve colorectal cancer screening rates, researchers here said.
Explain that patients who receive mailed reminders for colorectal cancer screening have significantly higher rates of screening. Electronic reminders sent to their physicians tend to increase colonoscopy rates as well.
Patients who received mailed reminders had significantly higher rates of screening. Electronic reminders to their physicians tended to increase colonoscopy rates for some patients as well, Thomas D. Sequist, M.D., of Brigham and Women's Hospital and colleagues reported in the Feb. 23 Archives of Internal Medicine.
"These complementary approaches have the potential to promote the overarching goal of widespread screening to reduce the incidence, morbidity, and mortality of colorectal cancer," the researchers said.
Preventive screening reduces colorectal cancer mortality rates, but only 60% of eligible patients reported that they were up-to-date with screening, the researchers said. Also, physicians may not have enough time during office visits to discuss the growing number of recommended preventive services.
Previous screening studies have focused on either patients or physicians, the researchers said, so they decided to investigate the joint impact of patient mailings and electronic reminders to primary care physicians.
They conducted a randomized controlled trial of patient and physician reminders in 11 ambulatory healthcare centers from April 2006 to June 2007. The study covered 21,860 patients ages 50 to 80 who were overdue for colorectal cancer screening, along with 110 primary care physicians.
The overdue patients received either no written communication at all or a mailing with an educational pamphlet, a fecal occult blood test kit, and instructions for scheduling a flexible sigmoidoscopy or colonoscopy.
Physicians were randomly assigned to receive electronic reminders during office visits with overdue patients, while others got no reminder.
The researchers found that screening rates were higher for patients who received mailings compared with those who did not (44% versus 38.1%, P<0.001).
They also found that the effectiveness of the mailings increased as patients got older: +3.7% for ages 50 to 59, compared to +7.3% for ages 60 to 69 and +10.1% for ages 70 to 80 (P=0.01 for trend).
"Our findings underscore that informed patients can play an active role in completing effective preventive services," the researchers said.
The researchers said that electronic reminders to physicians did not significantly increase overall screening rates.
Rates were similar among patients whose physicians received electronic reminders and the control group (41.9% versus 40.2%), "in part because over one-third of patients had no visits with their primary care physician during the 15-month study period," the researchers said.
However, electronic reminders tended to increase screening rates among patients who had at least three visits to their primary care doctor during the study period (59.5% versus 52.7% P=0.07).
The number of orders for colonoscopy did modestly increase for patients whose physicians were electronically reminded, but there was no corresponding increase in completed procedures. The researchers said that nearly half of patients for whom it was ordered did not complete the procedure.
"This finding underscores the need for more effective communication with patients to encourage them to complete colonoscopy procedures that are scheduled," they said.
Detection of adenomas tended to be greater among patients who received mailings (5.7% versus 5.2%; P=.10) and among patients whose physicians received electronic reminders, compared with controls (5.7% versus 5.2%; P=.10), researchers said.
"Mailed reminders to patients are an effective tool to promote colorectal cancer screening," they concluded, "and electronic reminders to physicians may increase screening among adults who have more frequent primary care visits."
They pointed out that "the generalizability of our study must also be considered. We implemented our intervention within a single group practice using an advanced electronic health record, so our findings may not apply to less structured settings."
The study was supported by a grant from the National Cancer Institute.
The researchers reported no conflicts of interest.
Primary source: Archives of Internal Medicine
Source reference:
Sequist TD, et al "Patient and physician reminders to promote colorectal cancer screening" Arch Intern Med 2009; 169(4): 364-71.
Monday, February 23, 2009
Vitamins, Folic Acid Reduce AMD Risk in Women
Medical News: Ophthalmology
By Michael Smith, North American Correspondent, MedPage Today
Published: February 23, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.
BOSTON, Feb. 23 -- Daily B-vitamin and folic-acid supplements reduced the risk of age-related macular degeneration (AMD) in women, researchers here said. Action Points
--------------------------------------------------------------------------------
Explain to interested patients that a link has been proposed between blood levels of homocysteine and age-related macular degeneration, opening the possibility that lowering those levels might reduce the risk of the disease.
Note that this study, in which folic acid and two B vitamins were used to reduce homocysteine levels in women, showed a marked reduction in the risk of the disease.
In a randomized clinical trial, taking vitamin B6 and B12 (pyridoxine hydrochloride and cyanocobalamin) along with folic acid reduced the risk of the condition by 34%, according to William Christen, Sc.D., of Brigham and Women's Hospital, and colleagues.
The supplements reduced the risk of visually significant macular degeneration by 41%, they reported in the Feb. 23 issue of Archives of Internal Medicine.
The findings are "the strongest evidence to date in support of a possible beneficial effect" in prevention of the condition, the researchers said.
And -- because the findings apply to the early stages of disease -- they may be the first identified way, other than not smoking, to reduce the risk in people otherwise at average risk, the researchers said.
The findings come from the Women's Antioxidant and Folic Acid Cardiovascular Study, a randomized, double-blind, placebo-controlled trial whose main goal was to see if the combination treatment could prevent cardiovascular events among women at high risk for cardiovascular disease.
Participants were randomly assigned to get a daily combination of 2.5 milligrams of folic acid, 50 milligrams of vitamin B6, and one milligram of vitamin B12, or matching placebos.
The study included 5,442 female healthcare professionals 40 or older either with pre-existing cardiovascular disease or at least three cardiovascular disease risk factors.
At baseline, 5,205 of these participants did not have a diagnosis of age-related macular degeneration and were included in this analysis.
The main outcome measures were any form of age-related macular degeneration and visually significant disease, defined as confirmed incident age-related macular degeneration leading to visual acuity of 20/30 or worse.
After an average of 7.3 years of treatment and follow-up, the researchers found:
55 cases of age-related macular degeneration in the treatment group and 82 in the placebo group, for a relative risk of 0.66, with a 95% confidence interval from 0.47 to 0.93, which was significant at P=0.02.
26 cases of visually significant degeneration in the treatment group and 44 in the placebo group, for a relative risk of 0.59 with a 95% confidence interval from 0.36 to 0.95, which was significant at P=0.03.
The benefit of treatment "began to emerge at approximately two years of follow-up and persisted throughout the trial," the researchers said.
Although women in the treatment group in a substudy had a significant reduction (at P<0.001) in their geometric mean plasma homocysteine levels (18.5%, 0.31mg/L), it is still not conclusive evidence that lowering levels of the protein caused the reduction in AMD risk, Dr. Christen and colleagues said.
Other treatment mechanisms are possible, they said, including a direct antioxidant effect on the choroidal vasculature.
They also noted that "our findings for AMD are in sharp contrast to the null findings for CVD observed in other completed trials to lower homocysteine levels in persons with pre-existing vascular disease, despite substantial lowering of homocysteine concentrations by study treatment in those trials."
The researchers concluded that their findings could be due to chance and need confirmation, but "it may be worthwhile to consider whether the discordant findings for AMD and CVD reflect important differences between the choroidal and systemic vasculature with respect to responsiveness to the lowering of homocysteine levels."
The study was supported by the National Heart, Lung, and Blood Institute and the National Eye Institute. Vitamin E and its placebo were provided by Cognis Corp. and all other agents and their placebos were provided by BASF Corp.
Dr. Christen reported research grants from DSM Nutritional Products, Inc, (Roche).
Primary source: Archives of Internal Medicine
Source reference:
Christen WG, et al "Folic acid, pyridoxine, and cyanocobalamin combination treatment and age-related macular degeneration in women: The Women's Antioxidant and Folic Acid Cardiovascular Study" Arch Intern Med 2009; 169(4): 335-341.
Additional Ophthalmology Coverage »
By Michael Smith, North American Correspondent, MedPage Today
Published: February 23, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.
BOSTON, Feb. 23 -- Daily B-vitamin and folic-acid supplements reduced the risk of age-related macular degeneration (AMD) in women, researchers here said. Action Points
--------------------------------------------------------------------------------
Explain to interested patients that a link has been proposed between blood levels of homocysteine and age-related macular degeneration, opening the possibility that lowering those levels might reduce the risk of the disease.
Note that this study, in which folic acid and two B vitamins were used to reduce homocysteine levels in women, showed a marked reduction in the risk of the disease.
In a randomized clinical trial, taking vitamin B6 and B12 (pyridoxine hydrochloride and cyanocobalamin) along with folic acid reduced the risk of the condition by 34%, according to William Christen, Sc.D., of Brigham and Women's Hospital, and colleagues.
The supplements reduced the risk of visually significant macular degeneration by 41%, they reported in the Feb. 23 issue of Archives of Internal Medicine.
The findings are "the strongest evidence to date in support of a possible beneficial effect" in prevention of the condition, the researchers said.
And -- because the findings apply to the early stages of disease -- they may be the first identified way, other than not smoking, to reduce the risk in people otherwise at average risk, the researchers said.
The findings come from the Women's Antioxidant and Folic Acid Cardiovascular Study, a randomized, double-blind, placebo-controlled trial whose main goal was to see if the combination treatment could prevent cardiovascular events among women at high risk for cardiovascular disease.
Participants were randomly assigned to get a daily combination of 2.5 milligrams of folic acid, 50 milligrams of vitamin B6, and one milligram of vitamin B12, or matching placebos.
The study included 5,442 female healthcare professionals 40 or older either with pre-existing cardiovascular disease or at least three cardiovascular disease risk factors.
At baseline, 5,205 of these participants did not have a diagnosis of age-related macular degeneration and were included in this analysis.
The main outcome measures were any form of age-related macular degeneration and visually significant disease, defined as confirmed incident age-related macular degeneration leading to visual acuity of 20/30 or worse.
After an average of 7.3 years of treatment and follow-up, the researchers found:
55 cases of age-related macular degeneration in the treatment group and 82 in the placebo group, for a relative risk of 0.66, with a 95% confidence interval from 0.47 to 0.93, which was significant at P=0.02.
26 cases of visually significant degeneration in the treatment group and 44 in the placebo group, for a relative risk of 0.59 with a 95% confidence interval from 0.36 to 0.95, which was significant at P=0.03.
The benefit of treatment "began to emerge at approximately two years of follow-up and persisted throughout the trial," the researchers said.
Although women in the treatment group in a substudy had a significant reduction (at P<0.001) in their geometric mean plasma homocysteine levels (18.5%, 0.31mg/L), it is still not conclusive evidence that lowering levels of the protein caused the reduction in AMD risk, Dr. Christen and colleagues said.
Other treatment mechanisms are possible, they said, including a direct antioxidant effect on the choroidal vasculature.
They also noted that "our findings for AMD are in sharp contrast to the null findings for CVD observed in other completed trials to lower homocysteine levels in persons with pre-existing vascular disease, despite substantial lowering of homocysteine concentrations by study treatment in those trials."
The researchers concluded that their findings could be due to chance and need confirmation, but "it may be worthwhile to consider whether the discordant findings for AMD and CVD reflect important differences between the choroidal and systemic vasculature with respect to responsiveness to the lowering of homocysteine levels."
The study was supported by the National Heart, Lung, and Blood Institute and the National Eye Institute. Vitamin E and its placebo were provided by Cognis Corp. and all other agents and their placebos were provided by BASF Corp.
Dr. Christen reported research grants from DSM Nutritional Products, Inc, (Roche).
Primary source: Archives of Internal Medicine
Source reference:
Christen WG, et al "Folic acid, pyridoxine, and cyanocobalamin combination treatment and age-related macular degeneration in women: The Women's Antioxidant and Folic Acid Cardiovascular Study" Arch Intern Med 2009; 169(4): 335-341.
Additional Ophthalmology Coverage »
Tuesday, February 17, 2009
As Duties Weigh Obama Down, His Faith in Fitness Only Increases
By Eli Saslow
Washington Post Staff Writer
Thursday, December 25, 2008; A01
Being elected president forces a man to take inventory of his life, so Barack Obama has trimmed his schedule to the bare essentials. He's not in the White House yet, but gone are the hours he once spent reading novels, watching television and obsessing over the daily transactions of Chicago's sports teams. He eats out only once every few weeks. He visits friends rarely, if at all.
But one habit endures: Obama has gone to the gym, for about 90 minutes a day, for at least 48 days in a row. He always has treated exercise less as recreation than requirement, but his devotion has intensified during the past few months. Between workouts during his Hawaii vacation this week, he was photographed looking like the paradigm of a new kind of presidential fitness, one geared less toward preventing heart attacks than winning swimsuit competitions. The sun glinted off chiseled pectorals sculpted during four weightlifting sessions each week, and a body toned by regular treadmill runs and basketball games.
The more Obama's life intensifies, friends said, the more he relies on the gym -- which is why he might be taking office in the best shape of his life. The gym is where he releases stress, maintains a routine and thinks without interruption. He sometimes wears headphones and barricades the outside world.
"He does it every day like clockwork," said Marty Nesbitt, one of Obama's closest friends from Chicago. "He doesn't think of it as something he has to do -- it's his time for himself, a chance for him to reflect. It's his break. He feels better and more revved up after he gets in his workout."
To accommodate Obama during the 18-month presidential campaign, aides arranged workouts for him in several dozen states. The staff called gyms a few days before his arrival and persuaded them to close late or open early to oblige the candidate's schedule. Once, on July 17, Obama visited a gym three times within 16 hours. Other days -- often before primary election nights -- he flew in half a dozen friends to play a few hours of pickup basketball.
"That's one of the first things you learn working for him: You better make sure he gets his workout," said Jim Cauley, who managed Obama's 2004 U.S. Senate campaign. "If there isn't any time, he's not going to feel his best that day. If he only gets 30 or 40 minutes, he's still not really happy.
"You have to make time for him to exercise, at least an hour or so. You block it out and put it on the schedule, because that's what makes him happy."
Since the election, Obama's daily schedule has revealed an intense focus. Until he went to Hawaii for the holidays, his routine in Chicago was unchanging: breakfast at home with his family before heading to his downtown transition office, where he puts in as many as 10 hours a day. At night, dinner at his Hyde Park home, and more talking to advisers and reading preparatory documents. On some days, he spent as little as five or 10 minutes outdoors.
But every morning around 7:30 he traveled by motorcade to the gym at Regents Park, a luxury apartment complex where his friend Michael Signator owns a condominium on the 18th floor, and where he usually worked out with Reggie Love, a personal aide and a former Duke University basketball player, or with Marvin Nicholson, his travel coordinator.
The members-only gym features a sauna, a whirlpool and a row of machines pressed against a bay of windows overlooking Lake Michigan. Obama, 47, devotes half of his workout to weight lifting and the other half to a cardiovascular rotation that includes a stationary bicycle, elliptical machine and treadmill. Between his warm-up and cool down, he sometimes moves through a dozen different exercises in an hour.
"It's something he takes seriously, and that's why he's in great shape," said Alexi Giannoulias, a friend of Obama's and a former professional basketball player. "When people picture him running or whatever, they might think he's just going through the motions. But he goes hard. He's fit. He could convince you he's half his age."
Even Obama's closest friends said they marvel at how he has maintained his commitment. He went to Regents Park at 9 a.m. the day after his victory rally in Grant Park, on Thanksgiving Day and hours before traveling to Washington for his first tour of the White House. On Friday, Obama rushed to the gym before boarding a plane for his 12-day stay in Hawaii. He woke up the next morning on vacation, went to a gym and exited 45 minutes later in a sweat-soaked gray shirt.
For the small group of reporters tasked with following Obama's every move, his fitness has become a running joke repeated in the stories they file. They sit at McDonald's while he exercises in Hawaii. They eat calorie-rich scones while he sweats at Regents Park. One reporter for the Christian Science Monitor, filing his report about one of the president-elect's gym trips last month, noted: "While Mr. Obama worked at maintaining his lithe look, your pear-shaped pooler spent quality time at a local coffee shop."
Obama still suffers from one vice -- smoking -- although he has worked hard to quit since he started the presidential campaign. He's down from three or four cigarettes each day to what he terms the occasional "slip."
When Obama visited the White House in November, he toured the gym with President Bush and talked about exercise, said his wife, Michelle. It is one interest the two men share. Bush equipped Air Force One with a stationary bicycle, and he spends weekends biking with friends -- with anyone and everyone, really -- at Camp David. He has often said that exercise has helped him cope with the pressures of the job.
Several presidents have found creative ways to stay in shape while in the White House. John Quincy Adams swam in the Potomac, Theodore Roosevelt boxed and Herbert Hoover invented his own sport -- an awkward combination of volleyball and tennis -- to play at 7 each morning. Harry S. Truman installed a horseshoe pit. Bill Clinton liked to jog and then head for breakfast at McDonald's.
Obama, who favors a post-workout snack of a protein bar and organic iced tea, has already disclosed some of his own plans for his new home. He wants to build a full basketball court where he can hold games on the White House grounds, and to maintain his usual routine of exercising at least six days a week.
It's a schedule he started as a 22-year-old student at Columbia University in New York, and it immediately transformed him. In his 1995 autobiography, "Dreams From My Father," Obama said he was a casual drug user and an underachiever until he decided to start running three miles each day. He stopped staying out late, fasted on Sundays and became a voracious reader, spending most of his time alone in his apartment reading classic literature and philosophical texts.
Physical fitness yielded mental fitness, Obama decided, and the two concepts have been married in his mind ever since.
"It's always been a priority in his daily routine," said Christopher Lu, a marathon runner who worked as Obama's legislative director in the Senate and was named Cabinet secretary last week. "I think it's an example of how disciplined he is. It's one of the things that really keeps him balanced."
© 2008 The Washington Post Company
Monday, February 9, 2009
More 'Screen Time' Linked to Poor Fitness in Girls
But teenage boys don't seem to be as susceptible, study suggests
Wednesday, January 7, 2009
WEDNESDAY, Jan. 7 (HealthDay News) -- Teenage girls who spend more than two hours of "screen time" a day watching TV, surfing the Web or text-messaging are less likely to be physically fit, a new Australian study finds.
Interestingly, boys who were part of the same study were more likely to be able to "sit and be fit," said lead author Louise Hardy, a postdoctoral fellow at the New South Wales Centre for Overweight and Obesity at the University of Sydney.
Boys, particularly older teenage boys, may be less affected by the time they spend watching TV, playing computer games, and other small-screen activities because their growth spurts have led to sufficient muscle mass to maintain fitness and still engage in a large amount of sedentary behavior, the study suggested.
Boys are also more likely to play sports as well as computer games, said Dr. Goutham Rao, clinical director of the Weight Management and Wellness Center at the Children's Hospital of Pittsburgh. An adolescent boy who's on the swim team, for instance, may also spend a lot of time playing a video game like "World of Warcraft," he said.
"There is a culture of physical fitness among boys, and there also is a culture of sedentary activity," he added.
From his experience, Rao said, "there is only a small subset of teenage girls who engage in physical activity regularly." He added that he finds that adolescent girls at his center are more interested in small-screen communication devices, such as texting, than they are in video games.
The Australian researchers said their study may be the first to associate "sedentariness" -- a measure of cardio-respiratory fitness -- with the widely accepted American Academy of Pediatrics' guidelines that children from 2 to 18 years old not spend more than two hours a day on small-screen recreation.
"This is important because ensuring that one has good cardio-respiratory fitness reduces the risk of developing cardiovascular disease," Hardy said. For the study, the researchers measured cardio-respiratory fitness based on the number of laps run at a set pace.
The study, which relied on data collected in 2004, defined small screen activity as watching TV, videos and recreational computer use. The data came from a survey of a representative sample of 2,750 Australian students in sixth, eighth, and 10th grades.
More current data might be even more striking because of the growth of new screen technologies such as XBoxes, PSPs, and Wiis, Hardy suggested. The impact of new small-screen technology may show up in a repeat of the research scheduled for 2010, she said.
The findings will be published in the February issue of the American Journal of Preventive Medicine.
The researchers said the study was limited in its ability to make a cause-and-effect relationship between more small-screen time and less physical activity because other factors might be involved.
The question of whether less physically fit girls are more likely to engage in sedentary activities is one that Rao said he'd like to see pursued in future research.
HealthDay
Copyright (c) 2009 ScoutNews, LLC. All rights reserved.
Exercise may lower teens' risk of type 2 diabetes
Friday, January 16, 2009
NEW YORK (Reuters Health) - New research shows that teenagers who are moderately active burn more calories and metabolize blood sugar more efficiently than their sedentary peers -- a fact that may protect them from type 2 diabetes.
Type 2 diabetes develops when the body can no longer properly use the blood-sugar regulating hormone insulin, causing blood sugar, or blood "glucose," levels to soar. The disorder is closely linked to obesity, but studies in adults have shown that regular exercise can prevent or delay its onset.
Whether the same is true of children and teenagers has been unclear.
The question is important because rising rates of childhood obesity are leading to rising rates of type 2 diabetes.
For the new study, reported in the journal Diabetes Care, researchers at the University of Alabama at Birmingham outfitted 32 male and female teenagers with accelerometers -- small devices worn on the hip that record the body's movement throughout the day.
The researchers found that teens who were moderately active over 1 week generally had a higher metabolism at rest than those who were more sedentary. They also had better results on tests of glucose tolerance, a measure of how well the body metabolizes carbohydrates. People with impaired glucose tolerance may go on to develop diabetes.
While the study was short-term, the results suggest that regular exercise could help protect teenagers from both obesity and type 2 diabetes, write Amy S. Thomas and her colleagues.
They also point out that the teenagers in the study got very little vigorous exercise; instead moderate activity, like walking, seemed to improve metabolism.
Further studies, the researchers conclude, are needed to see physical activity translates into lower rates of obesity and diabetes.
SOURCE: Diabetes Care, January 2009.
NEW YORK (Reuters Health) - New research shows that teenagers who are moderately active burn more calories and metabolize blood sugar more efficiently than their sedentary peers -- a fact that may protect them from type 2 diabetes.
Type 2 diabetes develops when the body can no longer properly use the blood-sugar regulating hormone insulin, causing blood sugar, or blood "glucose," levels to soar. The disorder is closely linked to obesity, but studies in adults have shown that regular exercise can prevent or delay its onset.
Whether the same is true of children and teenagers has been unclear.
The question is important because rising rates of childhood obesity are leading to rising rates of type 2 diabetes.
For the new study, reported in the journal Diabetes Care, researchers at the University of Alabama at Birmingham outfitted 32 male and female teenagers with accelerometers -- small devices worn on the hip that record the body's movement throughout the day.
The researchers found that teens who were moderately active over 1 week generally had a higher metabolism at rest than those who were more sedentary. They also had better results on tests of glucose tolerance, a measure of how well the body metabolizes carbohydrates. People with impaired glucose tolerance may go on to develop diabetes.
While the study was short-term, the results suggest that regular exercise could help protect teenagers from both obesity and type 2 diabetes, write Amy S. Thomas and her colleagues.
They also point out that the teenagers in the study got very little vigorous exercise; instead moderate activity, like walking, seemed to improve metabolism.
Further studies, the researchers conclude, are needed to see physical activity translates into lower rates of obesity and diabetes.
SOURCE: Diabetes Care, January 2009.
Hero pilot Chesley (Sully) Sullenberger sweats lost book
BY BILL HUTCHINSON
DAILY NEWS STAFF WRITER
Tuesday, February 3rd 2009, 7:37 PM
Living up to his squeaky clean image, the US Airways captain (Chesley [Sully] Sullenberger) has informed his hometown library that he may not be able to return a borrowed book - about ethics, of all things.
The former fighter pilot has a good excuse: The book was lost when he was forced to make a splash landing on the frigid Hudson River last month.
Sullenberger and co-pilot Jeffrey Skiles have been credited with saving themselves and 153 passengers and crew.
Officials at the Danville, Calif., library revealed that the flying ace rang them up saying the book is still in the crashed airliner's cargo hold and could he get an extension and a waiver on overdue fees.
The book had been borrowed from the Fresno State University library.
Peter McDonald, dean of library services at Fresno State, said he was bowled over by Sully's sense of responsibility.
"Clearly this is a wonderful, feel-good story, and we honor Mr. Sullenberger both for what he did on the Hudson and for his quick response to a lost book," McDonald told the Fresno Bee newspaper.
Citing privacy issues, McDonald refused to reveal the book's title and said Sullenberger's name should have been kept confidential.
"But now that the story's broke, we thank him again and we will replace the book in his honor," said McDonald, adding that any overdue fees will be forgiven.
Sullenberger, 58, had just taken off from LaGuardia Airport Jan. 15 when his Airbus jet flew into a flock of birds, causing both engines to conk out.
Unable to make it safely to an emergency landing strip, Sullenberger decided to ditch the plane in the river.
A similar scare happened yesterday in Denver when a United Airlines jet was forced to return to the airport after a bird was sucked into one of its engines on takeoff.
The Boeing 757 landed safely and none of the 151 passengers and crew was injured.
whutchinson@nydailynews.com
DAILY NEWS STAFF WRITER
Tuesday, February 3rd 2009, 7:37 PM
Living up to his squeaky clean image, the US Airways captain (Chesley [Sully] Sullenberger) has informed his hometown library that he may not be able to return a borrowed book - about ethics, of all things.
The former fighter pilot has a good excuse: The book was lost when he was forced to make a splash landing on the frigid Hudson River last month.
Sullenberger and co-pilot Jeffrey Skiles have been credited with saving themselves and 153 passengers and crew.
Officials at the Danville, Calif., library revealed that the flying ace rang them up saying the book is still in the crashed airliner's cargo hold and could he get an extension and a waiver on overdue fees.
The book had been borrowed from the Fresno State University library.
Peter McDonald, dean of library services at Fresno State, said he was bowled over by Sully's sense of responsibility.
"Clearly this is a wonderful, feel-good story, and we honor Mr. Sullenberger both for what he did on the Hudson and for his quick response to a lost book," McDonald told the Fresno Bee newspaper.
Citing privacy issues, McDonald refused to reveal the book's title and said Sullenberger's name should have been kept confidential.
"But now that the story's broke, we thank him again and we will replace the book in his honor," said McDonald, adding that any overdue fees will be forgiven.
Sullenberger, 58, had just taken off from LaGuardia Airport Jan. 15 when his Airbus jet flew into a flock of birds, causing both engines to conk out.
Unable to make it safely to an emergency landing strip, Sullenberger decided to ditch the plane in the river.
A similar scare happened yesterday in Denver when a United Airlines jet was forced to return to the airport after a bird was sucked into one of its engines on takeoff.
The Boeing 757 landed safely and none of the 151 passengers and crew was injured.
whutchinson@nydailynews.com
Tuesday, February 3, 2009
Mobile dental service closing
By Rod Thompson
POSTED: 01:30 a.m. HST, Feb 03, 2009
HILO » After 12 years of bringing dental services in two specially equipped vans to needy Big Islanders, the Mobile Care Health Project will close in June, St. Francis Healthcare System announced.
The mobile project has succeeded in sparking dental care at seven nonprofit community health center sites, St. Francis said.
The program, operated by St. Francis and the Office of Social Ministry of the Catholic Church, got its start in response to a preventable death due to dental infection in 1992, St. Francis said.
Lance Lawrence, 38, developed a dental infection that year but, being a welfare recipient, could not find a dentist in time to treat the infection. Before he died, his neck had swollen to three times its normal size, according to an account at the time.
Mobile Care, vans outfitted with dental chairs and equipment, was created in response, but it was always meant as a temporary solution, said Carol Ignacio, of the Office for Social Ministry.
It has served 18,600 patients and provided services worth $1.6 million, St. Francis said.
The Mobile Care van in East Hawaii will be taken over next month by the Bay Clinic in Hilo. The West Hawaii van will be operated by a new Pediatric Dental Clinic in Kealakekua in July, and a new van will be operated soon by the Hamakua Health Center.
HILO » After 12 years of bringing dental services in two specially equipped vans to needy Big Islanders, the Mobile Care Health Project will close in June, St. Francis Healthcare System announced.
The mobile project has succeeded in sparking dental care at seven nonprofit community health center sites, St. Francis said.
The program, operated by St. Francis and the Office of Social Ministry of the Catholic Church, got its start in response to a preventable death due to dental infection in 1992, St. Francis said.
Lance Lawrence, 38, developed a dental infection that year but, being a welfare recipient, could not find a dentist in time to treat the infection. Before he died, his neck had swollen to three times its normal size, according to an account at the time.
Mobile Care, vans outfitted with dental chairs and equipment, was created in response, but it was always meant as a temporary solution, said Carol Ignacio, of the Office for Social Ministry.
It has served 18,600 patients and provided services worth $1.6 million, St. Francis said.
The Mobile Care van in East Hawaii will be taken over next month by the Bay Clinic in Hilo. The West Hawaii van will be operated by a new Pediatric Dental Clinic in Kealakekua in July, and a new van will be operated soon by the Hamakua Health Center.
--Star-Bulletin
POSTED: 01:30 a.m. HST, Feb 03, 2009
HILO » After 12 years of bringing dental services in two specially equipped vans to needy Big Islanders, the Mobile Care Health Project will close in June, St. Francis Healthcare System announced.
The mobile project has succeeded in sparking dental care at seven nonprofit community health center sites, St. Francis said.
The program, operated by St. Francis and the Office of Social Ministry of the Catholic Church, got its start in response to a preventable death due to dental infection in 1992, St. Francis said.
Lance Lawrence, 38, developed a dental infection that year but, being a welfare recipient, could not find a dentist in time to treat the infection. Before he died, his neck had swollen to three times its normal size, according to an account at the time.
Mobile Care, vans outfitted with dental chairs and equipment, was created in response, but it was always meant as a temporary solution, said Carol Ignacio, of the Office for Social Ministry.
It has served 18,600 patients and provided services worth $1.6 million, St. Francis said.
The Mobile Care van in East Hawaii will be taken over next month by the Bay Clinic in Hilo. The West Hawaii van will be operated by a new Pediatric Dental Clinic in Kealakekua in July, and a new van will be operated soon by the Hamakua Health Center.
HILO » After 12 years of bringing dental services in two specially equipped vans to needy Big Islanders, the Mobile Care Health Project will close in June, St. Francis Healthcare System announced.
The mobile project has succeeded in sparking dental care at seven nonprofit community health center sites, St. Francis said.
The program, operated by St. Francis and the Office of Social Ministry of the Catholic Church, got its start in response to a preventable death due to dental infection in 1992, St. Francis said.
Lance Lawrence, 38, developed a dental infection that year but, being a welfare recipient, could not find a dentist in time to treat the infection. Before he died, his neck had swollen to three times its normal size, according to an account at the time.
Mobile Care, vans outfitted with dental chairs and equipment, was created in response, but it was always meant as a temporary solution, said Carol Ignacio, of the Office for Social Ministry.
It has served 18,600 patients and provided services worth $1.6 million, St. Francis said.
The Mobile Care van in East Hawaii will be taken over next month by the Bay Clinic in Hilo. The West Hawaii van will be operated by a new Pediatric Dental Clinic in Kealakekua in July, and a new van will be operated soon by the Hamakua Health Center.
--Star-Bulletin
Baseball to Focus Attention on Gehrig’s Disease
Sports of The Times
The Mets On July 4, the 70th anniversary of Lou Gehrig’s immortal “luckiest man on the face of the earth” speech, Major League Baseball will help fight the disease that bears the name of its doomed hero.
In 15 home ballparks that day, baseball will seek to raise money and awareness of amyotrophic lateral sclerosis, or A.L.S., known as Lou Gehrig’s disease, which currently has no cure. Major League Baseball will announce the details of this program Tuesday.
The event is the brainchild of Michael Goldsmith, 57, a law professor in Utah, who was given what he calls a “death sentence” in September 2006, the ominous signs of A.L.S.
Goldsmith’s first impulse was to turn to the sport of his childhood, that nearly perfect world where players hit and run, pitch and catch. After a joyous week at a fantasy camp of the Baltimore Orioles, his favorite team as a boy in New York, Goldsmith began to identify with Gehrig, the great Yankee slugger who retired July 4, 1939, and died June 2, 1941.
In an article in Newsweek in November, Goldsmith challenged baseball to publicly take on the killer disease on the Gehrig anniversary, on the basis that baseball had gotten great mileage from the legend of Gehrig. Goldsmith’s proposal was later amplified in The New York Times.
Then an amazing thing happened. Bud Selig, the commissioner of baseball, read Goldsmith’s suggestion. And Selig called a meeting.
“Baseball is a social institution,” Selig said the other day, referring to baseball’s deep and daily roots.
Although baseball can be criticized for many things, the business often recognizes its civic role, taking up causes like remembering Jackie Robinson and other heroes, and fighting cancer and other diseases. Selig, 74, who is a legitimate baseball buff, has watched the 1942 Gehrig movie, “The Pride of the Yankees,” at least 50 times.
“What I’ve always heard is that Gehrig was exactly as he was portrayed,” Selig said. “There’s no question Babe Ruth was a great player, but people tell me, ‘Commissioner, you don’t know how great Gehrig was.’ ”
Selig was referring to Gehrig’s 2,130-game streak from 1925 to 1939, a record until 1995; his career batting average of .340; and his 493 home runs. With legs like stone pillars, Gehrig also stole home 15 times. The only thing that slowed him was A.L.S., “a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord,” according to the A.L.S. Association.
Goldsmith, who has a slower version of A.L.S., continues to teach at Brigham Young University and lobby against the disease. He has gained allies. Selig turned over the project to Jacqueline Parkes, the chief marketing officer for M.L.B., who, by total coincidence, had a personal connection.
Her father, Dr. James C. Parkes II, an orthopedic surgeon, was the Mets’ team physician from 1974 to 1991. In 1995 he was told he had a neurological ailment that his daughter described as somewhere between A.L.S. and Parkinson’s Disease. He died in 1999, at age 64.
Parkes said she was deeply pleased when Selig told her what they would be doing for the 70th anniversary.
“Typically, we don’t do anniversaries except for 50 or 75, but there is nothing typical about A.L.S.,” she said.
With Parkes at the point, baseball has forged a working partnership with four organizations: Project A.L.S.; A.L.S. Therapy Development Institute; the A.L.S. Association; and M.D.A.’s Augie’s Quest, led by Augie Nieto, a co-founder of the company that created the Lifecycle exercise machine, who is battling his own case of A.L.S.
To Goldsmith’s delight, he was included in every teleconference as Parkes organized the events for July 4, when 30 clubs will auction off items worn by players that day. In this current recession, there is concern about how much money can be raised for research, but clubs and players will be encouraged to contribute. Selig indicated that M.L.B. would make a contribution.
On the anniversary, Gehrig’s speech will be read during the seventh-inning stretch — the real one, written by Gehrig, a Columbia University man, and not the somewhat-altered version that was delivered by Gary Cooper in the movie.
Goldsmith said his own relationship with Gehrig had deepened over the months, “helping me face my fears, face my demons.” He added, “I don’t know if Gehrig was religious, but I do know how physically brave he was.”
Goldsmith has also explored his spiritual side, “what the Buddhists call learning to swim well through the ocean of suffering,” he said. Lately, he has been reading Viktor E. Frankl’s book, “Man’s Search for Meaning,” the spiritual journey of a Holocaust survivor.
Goldsmith says he derives great solace from baseball.
“Their response has been in keeping with the ‘Field of Dreams’ image,” he said, referring to the movie in which faith in baseball links the generations.
“They have been honest, straightforward, about everything,” he said of the M.L.B. officials. “They have exposed me to the sunny side of baseball, not just the financial side. They have a heart.”
Goldsmith hopes to travel to a major league stadium on July 4 and read part of Gehrig’s speech, at an event he envisioned and that baseball will make happen.
E-mail: geovec@nytimes.com
The Mets On July 4, the 70th anniversary of Lou Gehrig’s immortal “luckiest man on the face of the earth” speech, Major League Baseball will help fight the disease that bears the name of its doomed hero.
In 15 home ballparks that day, baseball will seek to raise money and awareness of amyotrophic lateral sclerosis, or A.L.S., known as Lou Gehrig’s disease, which currently has no cure. Major League Baseball will announce the details of this program Tuesday.
The event is the brainchild of Michael Goldsmith, 57, a law professor in Utah, who was given what he calls a “death sentence” in September 2006, the ominous signs of A.L.S.
Goldsmith’s first impulse was to turn to the sport of his childhood, that nearly perfect world where players hit and run, pitch and catch. After a joyous week at a fantasy camp of the Baltimore Orioles, his favorite team as a boy in New York, Goldsmith began to identify with Gehrig, the great Yankee slugger who retired July 4, 1939, and died June 2, 1941.
In an article in Newsweek in November, Goldsmith challenged baseball to publicly take on the killer disease on the Gehrig anniversary, on the basis that baseball had gotten great mileage from the legend of Gehrig. Goldsmith’s proposal was later amplified in The New York Times.
Then an amazing thing happened. Bud Selig, the commissioner of baseball, read Goldsmith’s suggestion. And Selig called a meeting.
“Baseball is a social institution,” Selig said the other day, referring to baseball’s deep and daily roots.
Although baseball can be criticized for many things, the business often recognizes its civic role, taking up causes like remembering Jackie Robinson and other heroes, and fighting cancer and other diseases. Selig, 74, who is a legitimate baseball buff, has watched the 1942 Gehrig movie, “The Pride of the Yankees,” at least 50 times.
“What I’ve always heard is that Gehrig was exactly as he was portrayed,” Selig said. “There’s no question Babe Ruth was a great player, but people tell me, ‘Commissioner, you don’t know how great Gehrig was.’ ”
Selig was referring to Gehrig’s 2,130-game streak from 1925 to 1939, a record until 1995; his career batting average of .340; and his 493 home runs. With legs like stone pillars, Gehrig also stole home 15 times. The only thing that slowed him was A.L.S., “a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord,” according to the A.L.S. Association.
Goldsmith, who has a slower version of A.L.S., continues to teach at Brigham Young University and lobby against the disease. He has gained allies. Selig turned over the project to Jacqueline Parkes, the chief marketing officer for M.L.B., who, by total coincidence, had a personal connection.
Her father, Dr. James C. Parkes II, an orthopedic surgeon, was the Mets’ team physician from 1974 to 1991. In 1995 he was told he had a neurological ailment that his daughter described as somewhere between A.L.S. and Parkinson’s Disease. He died in 1999, at age 64.
Parkes said she was deeply pleased when Selig told her what they would be doing for the 70th anniversary.
“Typically, we don’t do anniversaries except for 50 or 75, but there is nothing typical about A.L.S.,” she said.
With Parkes at the point, baseball has forged a working partnership with four organizations: Project A.L.S.; A.L.S. Therapy Development Institute; the A.L.S. Association; and M.D.A.’s Augie’s Quest, led by Augie Nieto, a co-founder of the company that created the Lifecycle exercise machine, who is battling his own case of A.L.S.
To Goldsmith’s delight, he was included in every teleconference as Parkes organized the events for July 4, when 30 clubs will auction off items worn by players that day. In this current recession, there is concern about how much money can be raised for research, but clubs and players will be encouraged to contribute. Selig indicated that M.L.B. would make a contribution.
On the anniversary, Gehrig’s speech will be read during the seventh-inning stretch — the real one, written by Gehrig, a Columbia University man, and not the somewhat-altered version that was delivered by Gary Cooper in the movie.
Goldsmith said his own relationship with Gehrig had deepened over the months, “helping me face my fears, face my demons.” He added, “I don’t know if Gehrig was religious, but I do know how physically brave he was.”
Goldsmith has also explored his spiritual side, “what the Buddhists call learning to swim well through the ocean of suffering,” he said. Lately, he has been reading Viktor E. Frankl’s book, “Man’s Search for Meaning,” the spiritual journey of a Holocaust survivor.
Goldsmith says he derives great solace from baseball.
“Their response has been in keeping with the ‘Field of Dreams’ image,” he said, referring to the movie in which faith in baseball links the generations.
“They have been honest, straightforward, about everything,” he said of the M.L.B. officials. “They have exposed me to the sunny side of baseball, not just the financial side. They have a heart.”
Goldsmith hopes to travel to a major league stadium on July 4 and read part of Gehrig’s speech, at an event he envisioned and that baseball will make happen.
E-mail: geovec@nytimes.com
Research Finds New Cause of Ozone Wheezing and Potential Treatments
Researchers at the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health, and Duke University have discovered a cause of airway irritation and wheezing after exposure to ozone, a common urban air pollutant. Using an animal model, the researchers were also able to identify several ways to stop the airways from narrowing. These findings help identify potential new targets for drugs which may eventually help physicians better treat emergency room patients suffering from wheezing, coughing and shortness of breath.
"We found that it is not the ozone itself that causes the body to wheeze, but the way the lungs respond to ozone," said Stavros Garantziotis, M.D., principal investigator in the NIEHS Laboratory of Respiratory Biology and lead author of the paper published online this week in the Journal of Biological Chemistry.
"Animals exposed to ozone produced and released high amounts of a sugar known as hyaluronan,” said John Hollingsworth, M.D., a pulmonologist who is an assistant professor in the Department of Medicine at Duke University Medical Center and senior author of the paper. “We found hyaluronan to be directly responsible for causing the airways to narrow and become irritated. We believe this may contribute to asthma symptoms in humans as well."
The researchers found several proteins which can mediate the hyaluronan effect and can be used as treatment targets. They were also able to block the airway responsiveness by binding the native hyaluronan away, as well as by administering a slightly modified form of hyaluronan. “Although more research is needed before these findings can be translated to humans, we are optimistic these treatment options could prove beneficial to patients,” said Hollingsworth.
"This finding has real-life therapeutic implications,” said Garantziotis. The researchers point out there are approximately 4,500 hospital admissions and 900,000 school absences each year attributed to ozone exposure, especially on high-ozone alert days. “We identified several new approaches to the treatment of ozone-induced airway narrowing."
Ozone has been estimated, in an Environmental Protection Agency analysis, to cost the United States $5 billion a year as a result of premature deaths, hospitalizations and school absences. Inhalation of ozone can lead to irritation of the airways and increased wheezing, particularly in children and adults who have asthma and chronic obstructive lung disease. Ozone is formed in the inner atmosphere in the presence of sunlight from pollutants emitted from vehicles and other sources. Exposure occurs when people inhale air containing ozone.
"This collaborative effort exemplifies the powerful advances we can continue to make to improve human health by teaming the innovativeness of our in-house researchers with our grantees,” said Linda S. Birnbaum, Ph.D., NIEHS director. “This is also a good example of how NIEHS is helping to bring a pool of creative, talented young scientists to the field of environmental health sciences."
Dr. Hollingsworth is an NIEHS Outstanding New Environmental Scientists (ONES) grant award recipient. The ONES program identifies outstanding scientists who are in the early, formative stages of their careers and who intend to make a long-term career commitment to research in the mission areas of the NIEHS.
The NIEHS supports research to understand the effects of the environment on human health and is part of NIH. For more information on environmental health topics, please visit our website at http://www.niehs.nih.gov.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
--------------------------------------------------------------------------------
Reference: Garantziotis S, Li Z, Potts EN, Kimata K, Zhuo L, Morgan DL, Savani RC, Noble PW, Foster WM, Schwartz DA, Hollingsworth JW. Hyaluronan Mediates Ozone-Induced Airway Hyperresponsiveness in Mice. The Journal of Biological Chemistry. Advance Access published on January 21, 2009. doi:10.1074/jbc.M802400200.
--------------------------------------------------------------------------------
"We found that it is not the ozone itself that causes the body to wheeze, but the way the lungs respond to ozone," said Stavros Garantziotis, M.D., principal investigator in the NIEHS Laboratory of Respiratory Biology and lead author of the paper published online this week in the Journal of Biological Chemistry.
"Animals exposed to ozone produced and released high amounts of a sugar known as hyaluronan,” said John Hollingsworth, M.D., a pulmonologist who is an assistant professor in the Department of Medicine at Duke University Medical Center and senior author of the paper. “We found hyaluronan to be directly responsible for causing the airways to narrow and become irritated. We believe this may contribute to asthma symptoms in humans as well."
The researchers found several proteins which can mediate the hyaluronan effect and can be used as treatment targets. They were also able to block the airway responsiveness by binding the native hyaluronan away, as well as by administering a slightly modified form of hyaluronan. “Although more research is needed before these findings can be translated to humans, we are optimistic these treatment options could prove beneficial to patients,” said Hollingsworth.
"This finding has real-life therapeutic implications,” said Garantziotis. The researchers point out there are approximately 4,500 hospital admissions and 900,000 school absences each year attributed to ozone exposure, especially on high-ozone alert days. “We identified several new approaches to the treatment of ozone-induced airway narrowing."
Ozone has been estimated, in an Environmental Protection Agency analysis, to cost the United States $5 billion a year as a result of premature deaths, hospitalizations and school absences. Inhalation of ozone can lead to irritation of the airways and increased wheezing, particularly in children and adults who have asthma and chronic obstructive lung disease. Ozone is formed in the inner atmosphere in the presence of sunlight from pollutants emitted from vehicles and other sources. Exposure occurs when people inhale air containing ozone.
"This collaborative effort exemplifies the powerful advances we can continue to make to improve human health by teaming the innovativeness of our in-house researchers with our grantees,” said Linda S. Birnbaum, Ph.D., NIEHS director. “This is also a good example of how NIEHS is helping to bring a pool of creative, talented young scientists to the field of environmental health sciences."
Dr. Hollingsworth is an NIEHS Outstanding New Environmental Scientists (ONES) grant award recipient. The ONES program identifies outstanding scientists who are in the early, formative stages of their careers and who intend to make a long-term career commitment to research in the mission areas of the NIEHS.
The NIEHS supports research to understand the effects of the environment on human health and is part of NIH. For more information on environmental health topics, please visit our website at http://www.niehs.nih.gov.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
--------------------------------------------------------------------------------
Reference: Garantziotis S, Li Z, Potts EN, Kimata K, Zhuo L, Morgan DL, Savani RC, Noble PW, Foster WM, Schwartz DA, Hollingsworth JW. Hyaluronan Mediates Ozone-Induced Airway Hyperresponsiveness in Mice. The Journal of Biological Chemistry. Advance Access published on January 21, 2009. doi:10.1074/jbc.M802400200.
--------------------------------------------------------------------------------
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