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We give you many useful information about health

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We give you many useful information about health

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We give you many useful information about health

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Rabu, 09 November 2011

Babies on obesity path? New sign may offer answer

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CHICAGO (AP) — Researchers say there's a new way to tell if infants are likely to become obese later on: Check to see if they've passed two key milestones on doctors' growth charts by age 2.

Babies who grew that quickly face double the risk of being obese at age 5, compared with peers who grew more slowly, their study found. Rapid growers were also more likely to be obese at age 10, and infants whose chart numbers climbed that much during their first 6 months faced the greatest risks.

That kind of rapid growth should be a red flag to doctors, and a sign to parents that babies might be overfed or spending too much time in strollers and not enough crawling around, said pediatrician Dr. Elsie Taveras, the study's lead author and an obesity researcher at Harvard Medical School.

Contrary to the idea that chubby babies are the picture of health, the study bolsters evidence that "bigger is not better" in infants, she said.

But skeptics say not so fast. Babies often grow in spurts and flagging the speediest growers could lead to putting infants on diets — a bad idea that could backfire in the long run, said Dr. Michelle Lampl, director of Emory University's Center for the Study of Human Health.

"It reads like a very handy rule and sounds like it would be very useful — and that's my concern," Lampl said. The guide would be easy to use to justify feeding infants less and to unfairly label them as fat. It could also prompt feeding patterns that could lead to obesity later, she said.

Lampl noted that many infants studied crossed at least two key points on growth charts; yet only 12 percent were obese at age 5 and slightly more at age 10. Nationally, about 10 percent of preschool-aged children are obese, versus about 19 percent of those aged 6 to 11.

Lampl and Edward Frongillo, an infant growth specialist at the University of South Carolina, voiced concern in an editorial accompanying the study in the journal Archives of Pediatrics & Adolescent Medicine, released online Monday. They argue that more research is needed to confirm whether the study's recommendation is really a useful way to flag infants for obesity.

"The potential to do more harm than good is actually very high," Frongillo said.

Taveras said the kind of rapid growth noted in the study should be used to raise awareness about potential risks but is not a reason to put babies on a diet.

The study involved 45,000 infants and children younger than age 11 who had routine growth measurements during doctor checkups in the Boston area from 1980 through 2008.

Growth charts help pediatricians plot weight, length in babies and height in older kids in relation to other children their same age and sex. Pediatricians sometimes combine an infant's measures to calculate weight-for-length — the equivalent of body-mass index, or BMI, a height-to-weight ratio used in older children and adults.

The charts are organized into percentiles. For example, infants at the 75th percentile for weight are heavier than 75 percent of their peers.

The study authors used seven major cutoffs on the charts — the 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles — to calculate growth pace. An infant whose weight-for-length jumped from the 19th percentile at 1 month to the 77th at 6 months crossed three major percentiles — the 25th, 50th and 75th — and would be at risk for obesity later in childhood, the authors said.

Larger infants were most at risk for obesity later on, but even smaller babies whose growth crossed at least two percentiles were at greater risk than those who grew more slowly.

About 40 percent of infants crossed at least two percentiles by age 6 months. An analysis of more than one-third of the study children found that 64 percent grew that rapidly by age 2.

Dr. Joanna Lewis, a pediatrician at Advocate Lutheran General Hospital in Park Ridge, Ill., said she supports the idea that infancy is not too young to start thinking about obesity.

Still, she emphasized that rapid growth in infancy doesn't mean babies are doomed to become obese. "It's not a life sentence," and there are steps parents can take to keep their babies at a healthy weight without restrictive diets, she said.

Lewis said many of her patients are large babies whose parents feed them juice or solid food despite guidelines recommending nothing but breast milk or formula in the first six months.

"The study reinforces what we try to tell parents already: Delay starting solids and don't put juice in a bottle," Lewis said.

Lewis also advises parents that when starting infants on solid food, have the whole family sit down and eat together. Research has shown that obesity is less common in children raised in families that have frequent meals together at home.

___

Online:

Journal: http://www.archpediatrics.com

Growth charts: http://www.cdc.gov/growthcharts

___

AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

Associated Press

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Jumat, 14 Oktober 2011

Worried about vitamin safety? Experts offer advice

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In this Thursday, Oct. 13, 2011 photo illustration, multivitamins are poured from a bottle in Philadelphia. Two studies released in Oct. 2011 raised gnawing worries about the safety of vitamin supplements and a host of questions. Vitamins have long had a "health halo" - many people think they won't hurt and at worst might be unnecessary. The industry calls them an insurance policy against bad eating. But our foods increasingly are pumped full of them - even junk foods and drinks often are fortified with nutrients to give them a healthier profile - so the risk is rising that we're getting too much. Add a supplement and you may exceed the upper limit. (AP Photo/Matt Rourke) In this Thursday, Oct. 13, 2011 photo illustration, multivitamins are poured from a bottle in Philadelphia. Two studies released in Oct. 2011 raised gnawing worries about the safety of vitamin supplements and a host of questions. Vitamins have long had a "health halo" - many people think they won't hurt and at worst might be unnecessary. The industry calls them an insurance policy against bad eating. But our foods increasingly are pumped full of them - even junk foods and drinks often are fortified with nutrients to give them a healthier profile - so the risk is rising that we're getting too much. Add a supplement and you may exceed the upper limit. (AP Photo/Matt Rourke) The nutritional label of a box of multivitamins is photographed in Philadelphia on Thursday, Oct. 13, 2011. Two studies released in Oct. 2011 raised gnawing worries about the safety of vitamin supplements and a host of questions. Vitamins have long had a "health halo" - many people think they won't hurt and at worst might be unnecessary. The industry calls them an insurance policy against bad eating. But our foods increasingly are pumped full of them - even junk foods and drinks often are fortified with nutrients to give them a healthier profile - so the risk is rising that we're getting too much. Add a supplement and you may exceed the upper limit. (AP Photo/Matt Rourke) The nutritional label of a box of multivitamins is photographed in Philadelphia on Thursday, Oct. 13, 2011. Two studies released in Oct. 2011 raised gnawing worries about the safety of vitamin supplements and a host of questions. Vitamins have long had a "health halo" - many people think they won't hurt and at worst might be unnecessary. The industry calls them an insurance policy against bad eating. But our foods increasingly are pumped full of them - even junk foods and drinks often are fortified with nutrients to give them a healthier profile - so the risk is rising that we're getting too much. Add a supplement and you may exceed the upper limit. (AP Photo/Matt Rourke)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); Two studies this week raised gnawing worries about the safety of vitamin supplements and a host of questions. Should anyone be taking them? Which ones are most risky? And if you do take them, how can you pick the safest ones?

Vitamins have long had a "health halo." Many people think they're good for you and at worst might simply be unnecessary. The industry calls them an insurance policy against bad eating.

But our foods are increasingly pumped full of them already. Even junk foods and drinks often are fortified with nutrients to give them a healthier profile, so the risk is rising that we're getting too much. Add a supplement and you may exceed the upper limit.

"We're finding out they're not as harmless as the industry might have us believe," said David Schardt, a nutritionist at the consumer group Center for Science in the Public Interest.

This week, a study of nearly 40,000 older women found a slightly higher risk of death among those taking dietary supplements, including multivitamins, folic acid, iron and copper. It was just an observational study, though, not a rigorous test.

Another study found that men taking high doses of vitamin E — 400 units a day — for five years had a slightly increased risk of prostate cancer.

As many as one-third of Americans take vitamins and nearly half of people 50 and older take multivitamins, surveys suggest. Americans spent $9.6 billion on vitamins last year, up from $7.2 billion in 2005, according to the Nutrition Business Journal. Multivitamins top the list, at nearly $5 billion in sales.

Yet there is no clear evidence that multivitamins lower the risk of cancer, heart disease or any other chronic health problems. No government agency recommends them "regardless of the quality of a person's diet," says a fact sheet from the federal Office of Dietary Supplements. And vitamins aren't required to undergo the strict testing required of U.S.-approved prescription medicines.

Some fads, such as the antioxidant craze over vitamins A and E and beta-carotene, backfired when studies found more health risk, not less. And studies that find more disease in people with too little of a certain vitamin can be misleading: Correcting a deficiency so you have the right daily amount is different from supplementing beyond recommended levels.

The best way to get vitamins is to eat foods that naturally contain them, said Jody Engel, a nutritionist with Office of Dietary Supplements. "Foods provide more than just vitamins and minerals, such as fiber and other ingredients that may have positive health effects."

Schardt adds: "It's virtually impossible to overdose on the nutrients in food."

Some folks may need more of certain nutrients and should talk with their doctors about supplements:

— Postmenopausal women regarding calcium and vitamin D to protect bones.

— Women planning on pregnancy regarding folate, or folic acid, to prevent birth defects.

— People over age 50 and vegans who may need vitamin B12. "As we get older, a number of us no longer produce enough acid in the stomach to extract the B12 in food," Schardt explained.

— Pregnant women, who may need extra iron.

— Breastfed infants and possibly other infants concerning vitamin D.

Vitamin D is a nutrient many of us may need to supplement. Last fall, the Institute of Medicine, a panel of scientists who advise the government, raised the recommended amount but also warned against overdoing it. People ages 1 to 70 should get 600 international units a day, older folks 800 units.

If you do need a supplement, beware: Quality varies. Consumerlab.com, a company that tests supplements and publishes ratings for subscribers, has found a high rate of problems in the 3,000 products it has tested since 1999.

"One out of 4 either doesn't contain what it claims or has some other problems such as contamination or the pills won't break apart properly," said company president Dr. Tod Cooperman.

For example, one gummy bear calcium product had 250 percent of the amount of vitamin D claimed on the label. Another liquid product made with rose hips had just over half the amount of vitamin C listed.

"You don't have to pay a lot. Price is not necessarily linked to quality," he said. "The quality doesn't really relate to where you're buying it. I know many people are surprised by that or don't want to believe it, but that is the case. We find good and bad products in every venue."

Mark Blumenthal, executive director of the American Botanical Council, suggests looking for "seals of approval" or certifications of quality from groups that spot-test supplements such as the USP, or United States Pharmacopeia; NSF International and NPA, the Natural Products Association.

Experts offered this advice:

— Keep it simple. The more ingredients there are in a supplement combo, the more chance that one of them will not be the right amount, Cooperman said.

— Consider a supplement combo tailored to your gender and age, the Office of Dietary Supplements suggests. Multivitamins often contain little iron, and ones for seniors give more calcium and vitamin D than products aimed at younger adults.

— Take vitamin D with dinner. A study found significantly more absorption of that nutrient when it was consumed at the largest meal, which tends to have more fat, than at breakfast, Cooperman said.

— Watch out for vitamin K — it promotes clotting and can interfere with common heart medicines and blood thinners such as warfarin, sold as Coumadin and other brands.

— Current and former smokers are advised to avoid multivitamins with lots of beta-carotene or vitamin A; two studies have tied them to increased risk of lung cancer.

— For cancer patients, "vitamins C and E might reduce the effectiveness of certain types of chemotherapy," Engel said.

— People having surgery should know that some vitamins can affect bleeding and response to anesthesia.

With any supplement — ask your doctor.

__

Online:

Vitamin facts: http://ods.od.nih.gov/factsheets/list-VitaminsMinerals

and http://ods.od.nih.gov/factsheets/MVMS-HealthProfessional

FAQs: http://ods.od.nih.gov/Health_Information/ODS_Frequently_Asked_Questions.aspx

Dietary advice: www.dietaryguidelines.gov

Vitamin E and prostate study: http://jama.ama-assn.org/content/306/14/1549

Video interview with author: http://jama.ama-assn.org/content/306/14/1549/suppl/DC1

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Associated Press

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Senin, 10 Oktober 2011

Exercise may offer drug-free migraine prevention

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By Megan Brooks

NEW YORK | Fri Oct 7, 2011 5:52pm EDT

NEW YORK (Reuters Health) - Regular aerobic exercise worked just as well as relaxation therapy or the antiepileptic drug topiramate in preventing migraine headaches in a Swedish trial.

"This non-pharmacological approach may therefore be an option for the prophylactic treatment of migraine in patients who do not benefit from or do not want daily medication," wrote Dr. Emma Varkey and her colleagues from the Institute of Neuroscience and Physiology, University of Gothenburg, in the journal Cephalalgia.

Varkey's team randomly assigned their subjects to one of three regimens for three months: aerobic exercise on a stationary bike (40 minutes three times per week), a standard form of relaxation therapy or daily topiramate.

Previous studies have shown that relaxation therapy and topiramate are both effective for migraine prevention, the investigators note in their paper.

The 91 women in the trial were all from a single headache clinic in Sweden. They were between 18 and 65 years old, had neurologist-diagnosed migraine, with or without aura, and got headaches two to eight times per month.

All three treatments reduced the frequency of some women's migraine attacks by as much as three quarters, although the average reduction was more modest.

In an email to Reuters Health, Varkey admitted that she was a bit surprised by the small between-group differences. "Topiramate is a drug of first choice which has shown great effects in studies. It was a bit surprising and very interesting that the change in number of migraine attacks was almost similar in all three groups," she said.

"The only parameter where topiramate was better compared with exercise and relaxation was the reduction of pain intensity," Varkey added. "On the other hand, the non-pharmacological options were free from adverse events and the exercise group increased oxygen uptake, which is very positive."

None of the women in the relaxation group or exercise group reported side effects, but eight women (33%) in the topiramate group did and three withdrew from the study as a result. The most commonly reported side effects of the drug included numbness or tingling, fatigue, depressed mood, vertigo and constipation.

Finding that exercise is not inferior to topiramate as a prophylactic measure is "of great value," the researchers note in their report, because patients often seek non-pharmacological options for migraine.

"From a wider health-based perspective, it should be stressed that patients with migraine are less physically active than the general population, and that exercise has positive effects in terms of general well-being and the prevention of disease," they added.

"Additional and larger studies are, of course, needed to verify our results and to gain evidence for exercise as migraine treatment, but our results are hopeful," Varkey told Reuters Health.

SOURCE: bit.ly/oEPhgJ Cephalalgia, September 2, 2011.



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Jumat, 07 Oktober 2011

Fears as GPs offer private option

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5 October 2011 Last updated at 10:23 GMT By Nick Triggle Health correspondent, BBC News Stethoscope GPs in York have targeted patients for private work Fears are being raised over a blurring of the lines between private and NHS care after news emerged of GPs targeting patients for private work.

A York-based practice has written to its patients offering them a range of minor treatments privately, claiming they are not funded by the local NHS.

Doctors' leaders said this could be the start of a worrying trend due to the squeeze on finances and NHS overhaul.

But the government denied the case was related to these factors.

It comes after the Haxby Practice in York, which serves 20,000 patients, wrote to some offering patients the option of having work done privately.

Savings

The letter, seen by the BBC, said local health chiefs had stopped funding a range of services, but added they could still have them done privately at a number of clinics, including one owned by the practice.

These included removing skin tags from £56.30 to treating benign tumours for £243.20.

In total, more than eight procedures were listed, although local NHS managers disputed claims that two of them had been banned.

Continue reading the main story
The dire finances of many trusts means that many more NHS treatments are likely to become unavailable in the future”

End Quote Richard Vautrey British Medical Association Nonetheless, the case has prompted concern in the medical profession.

Royal College of GPs chairman Dr Clare Gerada said: "We believe that the boundary between what a GP offers under their NHS provision, and what is offered for a private fee, is in danger of becoming increasingly blurred.

"The NHS works because patients trust their doctors. This is especially so with GPs, and is something we cannot allow to be diminished."

Dr Richard Vautrey, of the British Medical Association, added: "The dire finances of many trusts means that many more NHS treatments are likely to become unavailable in the future.

"The BMA is very concerned by the potential conflicts of interest that this example exposes. The last thing any GP wants is to see patient trust damaged.

"Unfortunately the direction of travel in NHS policy, particularly combined with the financial situation, does increase the risk of conflicts of interest for GPs which is one the reasons the BMA is so concerned about the Health and Social Care Bill."

'Significant concerns'

The local NHS trust also expressed concern.

Dr David Geddes, medical director of NHS North Yorkshire and York, said: "We have significant concerns about this letter which we will be addressing with them directly and as a matter of urgency. We will then decide what further action is necessary.

"We were not made aware of this letter in advance. Had we been consulted we would have advised against its release."

He also pointed out that even in cases where treatments were not routinely provided, patients could still apply for NHS funding through the exceptional cases process.

A Department of Health spokeswoman said the policy changes being made did not make such cases more likely and instead took issue with the way patients had seemingly been approached.

"Advertising private healthcare options for the purpose of income generation is not an appropriate use of information provided by patients for the purposes of receiving NHS care. The code of conduct for the promotion of NHS-funded services makes this clear."

She added the Health Bill would actually end up strengthening the safeguards to prevent conflicts of interest as regulators will be charged with ensuring doctors stick to the rules.

But John McEvoy, managing partner at the Haxby Group, defended the move, pointing out that the letter had listed other private providers as well as the practice's own clinic.

"They had a choice to go elsewhere," he added.



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