(HealthDay News) -- The Memorial Day holiday is the traditional kick-off of the summer barbecue season in the United States, but research has shown that grilling can create cancer-causing compounds in meat, experts say.
Among the compounds are heterocyclic amines (HCAs), which are created when heat acts on amino acids, and creatinine in animal muscle.
The longer the cooking time and the higher the heat, the more HCAs, say experts at the University of California, Davis, Cancer Center. That means that barbecuing produces the most HCAs, followed by pan-frying and broiling. Baking, poaching, stir-frying and stewing produce the least HCAs.
The UC Davis experts offer the following advice for limiting HCAs:
Before you barbecue meat, partially cook it in the microwave and then throw out the juices that collect in the cooking dish. Finish cooking the meat on the grill. Precooking a hamburger for a few minutes in the microwave reduces HCAs by up to 95 percent.
Flip hamburgers often. Doing so every minute reduces HCAs by up to 100 percent. This is likely because constant flipping keeps internal meat temperatures lower.
Marinate meat before grilling. This can greatly reduce HCAs. For example, one study found that chicken marinated for 40 minutes in a mixture of brown sugar, olive oil, cider vinegar, garlic, mustard, lemon juice and salt cut HCAs by 92 percent to 99 percent.
Don't cook meat to "well done." Use a meat thermometer and cook poultry to an internal temperature of 165-180 degrees F, ground beef, pork and lamb to 160-170 degrees F, and beef steaks and roasts to 145-160 degrees F.
One or two days before you barbecue, eat cruciferous vegetables such as broccoli, cabbage, cauliflower, kale and brussels sprouts. These vegetables contain compounds that activate enzymes in the body that detoxify HCAs.
More information
The U.S. Food and Drug Administration offers outdoor eating and food safety tips.
Sunday, May 27, 2007
Tuesday, May 22, 2007
PSA Test Still Important to Detect Prostate Cancer, Studies Find
(HealthDay News) -- Despite questions as to whether early screening for prostate cancer is accurate, new research suggests it continues to be important.
And even more encouraging news indicates that statins, drugs designed to lower cholesterol, might also reduce the risk of developing prostate cancer. Both sets of findings were presented Sunday at the American Urological Association's annual meeting, in Anaheim, Calif.
Screening for prostate cancer has become controversial, particularly the issue of whether a prostate-specific antigen (PSA) blood test is useful as an early detector of malignancy. Two studies presented at the conference indicate it is still worthwhile to have such a test.
In one study, Dr. Hans Lilja, from Memorial Sloan-Kettering Cancer Center in New York City, and colleagues found that PSA testing of men in their 40s was predictive of developing prostate cancer later. In fact, the higher the initial PSA, the greater was the probability that the cancer would be aggressive, the research showed.
As recently as last month, a study published in the Journal of the National Cancer Institute found that PSA tests "perform poorly in distinguishing between those who develop a lethal prostate cancer from those at low or no risk of disease progression."
But among the patients in the Sloan-Kettering study, risk for prostate cancer was concentrated, with 89 percent of advanced cancers occurring in men with the top 10 percent of PSA levels, the researchers found.
Lilij thinks that men should have an initial PSA test when they are in their 40s rather than waiting. "It is surprising that this marker can predict cancer 20 years later," he said. "We should focus our efforts on those men who are on the highest risk for cancer."
Another study found that among patients who had a radical prostatectomy (removal of the prostate and some of the tissue surrounding it), those who had been screened for prostate cancer were more likely to have malignancy confined to the prostate, compared with men who had not been screened.
"Patients should be screened," said lead researcher Dr. Alexandre E. Pelzer, from the Medical University Innsbruck, Austria. "Screening reduces mortality from prostate cancer by 50 percent in our part of Austria, where screening is done, compared with other parts of the country where it isn't," he said.
Another debate in prostate cancer care is whether patients diagnosed with the disease should be treated immediately or whether watchful waiting is best.
In one study, Dr. Marc A. Dall'Era, and colleagues from the University of California, San Francisco, found that it was not possible to predict how fast the cancer would progress among the study subjects who had what was termed low-risk prostate cancer.
In the study, more than 400 men had their cancer watched monthly. "Among the men on active surveillance, about 28 percent progressed," Dall'Era said. "Over five years, none of the men died from prostate cancer," he added.
Men who opted for treatment were those who had the highest grade tumors, Dall'Era added.
In another study, Dr. Bradley A. Erickson, from Northwestern University, and colleagues collected data on 347 older men who selected watchful waiting. Among these men, 36 percent showed progression and/or underwent secondary treatment. Overall mortality was 30 percent, with 8 percent dying from prostate cancer.
"Men who were more likely to die were those with higher PSA and those whose cancer progressed," Erickson said. "This is the first study to that gives us a natural history of PSA screening."
In a second group of studies, researchers presented evidence that statins might reduce prostate cancer risk.
In the first report, Dr. Janet Colli, and colleagues from the University of Alabama, Birmingham, were able to make an association between declining prostate cancer rates in the United States and statin use.
The researchers said they found the declining death rates were most noticeable among white men who used statins. "There was a very strong correlation between declining prostate cancer mortality rates and declining high cholesterol levels in white males," Colli said.
Colli thinks statin use may be one reason for this decline in prostate cancer mortality. "Future studies are needed to determine the effect of statins on prostate cancer," she said.
In a second study, a research team led by Dr. Robert J. Hamilton, from Duke University Medical Center, found statins lower PSA levels. "In 1,200 men, we found an average 4.1 percent decline in PSA after starting their statin," Hamilton said. "The PSA dropped more if the patient was on a higher dose of a statin."
Moreover, men whose PSA was highest saw the greatest drop in PSA levels after starting statins, Hamilton said. "These men had an average of a 15 percent drop in their PSA," he noted.
Hamilton said studies need to be done to see if statins actually protect against prostate cancer.
He added the concern that statins may not prevent cancer, but rather mask the malignancy through the decline in PSA levels, so some prostate cancers may go undiagnosed.
In a third study, a group headed by Dr. Teemu J. Murtola from the University of Tampere, Finland, collected data on 78,484 Finnish men between the ages of 55 and 67.
They found that there were fewer cases of prostate cancer among men who used statins. "There was a dose-dependent reduction in prostate cancer among users of statins, but not among users of other cholesterol drugs," Murtola said. "The overall risk of prostate cancer was around half of that of non-statin users."
In addition, Murtola's team found that PSA levels were also lower among study subjects without cancer who used statins.
"The association of statins with the reduced risk of prostate cancer should be made known to men taking statins," Murtola said.
More information
For more information on prostate cancer, visit the U.S. National Cancer Institute.
And even more encouraging news indicates that statins, drugs designed to lower cholesterol, might also reduce the risk of developing prostate cancer. Both sets of findings were presented Sunday at the American Urological Association's annual meeting, in Anaheim, Calif.
Screening for prostate cancer has become controversial, particularly the issue of whether a prostate-specific antigen (PSA) blood test is useful as an early detector of malignancy. Two studies presented at the conference indicate it is still worthwhile to have such a test.
In one study, Dr. Hans Lilja, from Memorial Sloan-Kettering Cancer Center in New York City, and colleagues found that PSA testing of men in their 40s was predictive of developing prostate cancer later. In fact, the higher the initial PSA, the greater was the probability that the cancer would be aggressive, the research showed.
As recently as last month, a study published in the Journal of the National Cancer Institute found that PSA tests "perform poorly in distinguishing between those who develop a lethal prostate cancer from those at low or no risk of disease progression."
But among the patients in the Sloan-Kettering study, risk for prostate cancer was concentrated, with 89 percent of advanced cancers occurring in men with the top 10 percent of PSA levels, the researchers found.
Lilij thinks that men should have an initial PSA test when they are in their 40s rather than waiting. "It is surprising that this marker can predict cancer 20 years later," he said. "We should focus our efforts on those men who are on the highest risk for cancer."
Another study found that among patients who had a radical prostatectomy (removal of the prostate and some of the tissue surrounding it), those who had been screened for prostate cancer were more likely to have malignancy confined to the prostate, compared with men who had not been screened.
"Patients should be screened," said lead researcher Dr. Alexandre E. Pelzer, from the Medical University Innsbruck, Austria. "Screening reduces mortality from prostate cancer by 50 percent in our part of Austria, where screening is done, compared with other parts of the country where it isn't," he said.
Another debate in prostate cancer care is whether patients diagnosed with the disease should be treated immediately or whether watchful waiting is best.
In one study, Dr. Marc A. Dall'Era, and colleagues from the University of California, San Francisco, found that it was not possible to predict how fast the cancer would progress among the study subjects who had what was termed low-risk prostate cancer.
In the study, more than 400 men had their cancer watched monthly. "Among the men on active surveillance, about 28 percent progressed," Dall'Era said. "Over five years, none of the men died from prostate cancer," he added.
Men who opted for treatment were those who had the highest grade tumors, Dall'Era added.
In another study, Dr. Bradley A. Erickson, from Northwestern University, and colleagues collected data on 347 older men who selected watchful waiting. Among these men, 36 percent showed progression and/or underwent secondary treatment. Overall mortality was 30 percent, with 8 percent dying from prostate cancer.
"Men who were more likely to die were those with higher PSA and those whose cancer progressed," Erickson said. "This is the first study to that gives us a natural history of PSA screening."
In a second group of studies, researchers presented evidence that statins might reduce prostate cancer risk.
In the first report, Dr. Janet Colli, and colleagues from the University of Alabama, Birmingham, were able to make an association between declining prostate cancer rates in the United States and statin use.
The researchers said they found the declining death rates were most noticeable among white men who used statins. "There was a very strong correlation between declining prostate cancer mortality rates and declining high cholesterol levels in white males," Colli said.
Colli thinks statin use may be one reason for this decline in prostate cancer mortality. "Future studies are needed to determine the effect of statins on prostate cancer," she said.
In a second study, a research team led by Dr. Robert J. Hamilton, from Duke University Medical Center, found statins lower PSA levels. "In 1,200 men, we found an average 4.1 percent decline in PSA after starting their statin," Hamilton said. "The PSA dropped more if the patient was on a higher dose of a statin."
Moreover, men whose PSA was highest saw the greatest drop in PSA levels after starting statins, Hamilton said. "These men had an average of a 15 percent drop in their PSA," he noted.
Hamilton said studies need to be done to see if statins actually protect against prostate cancer.
He added the concern that statins may not prevent cancer, but rather mask the malignancy through the decline in PSA levels, so some prostate cancers may go undiagnosed.
In a third study, a group headed by Dr. Teemu J. Murtola from the University of Tampere, Finland, collected data on 78,484 Finnish men between the ages of 55 and 67.
They found that there were fewer cases of prostate cancer among men who used statins. "There was a dose-dependent reduction in prostate cancer among users of statins, but not among users of other cholesterol drugs," Murtola said. "The overall risk of prostate cancer was around half of that of non-statin users."
In addition, Murtola's team found that PSA levels were also lower among study subjects without cancer who used statins.
"The association of statins with the reduced risk of prostate cancer should be made known to men taking statins," Murtola said.
More information
For more information on prostate cancer, visit the U.S. National Cancer Institute.
Monday, May 14, 2007
Pregnant women restricted to bed rest can and should do safe, specially-designed physical activity, say experts at the American Ph
(HealthDay News) -- Cardiologists should be giving more of the clot-preventing drug Plavix than is now recommended before performing the artery-opening procedure called angioplasty, a new study says.
The analysis of 10 previous studies found that giving angioplasty patients double the current recommended dose of Plavix -- 600 milligrams rather than 300 -- cut the combined risk of heart attack and cardiac death by half, according to Dr. Anthony Abbate.
Abbate, an assistant professor of medicine at Virginia Commonwealth University, was expected to present the findings on Friday at the Society for Cardiovascular Angiography and Interventions' annual meeting, in Orlando, Fla.
The higher dose did not increase the risk of serious bleeding, a major concern with Plavix, the analysis found.
"The evidence shown by this meta-analysis is very powerful," said Dr. Gregory Dehmer, president of the society and a professor of medicine at Texas A&M College of Medicine. "Although Plavix is powerful stuff, the meta-analysis did not find an excessive amount of bleeding. So we have a lower risk of myocardial infarction [heart attack] with no significant increase in adverse side effects."
The 10 studies analyzed by Abbate and Dr. Giuseppe G. Biondi-Zoccai, an assistant professor of cardiology at the University of Turin in Italy, included 1,500 patients who had angioplasty. Most had either 300 milligrams or 600 milligrams of Plavix before the procedure.
The incidence of cardiac death or nonfatal heart attack was 50 percent lower in the following 30 days in those getting the higher dose of Plavix. Only 3.1 percent of those getting the 600-milligram dose had in-hospital heart attacks, compared to 6.4 percent of those getting the 300-milligram dose. The overall 30-day incidence of death or heart attack was 3.8 percent for the higher dose and 7.3 percent for the lower dose, according to the study.
"This research has important clinical and cost implications," Biondi-Zoccai said in a prepared statement.
Current guidelines by the American Heart Association, the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions say that physicians should "strongly consider" giving 300 milligrams of Plavix before angioplasty, a medical procedure to open narrowed or blocked blood vessels of the heart.
"Those guidelines are in the process of having an update," Dehmer said, adding that new guidelines are expected "in the next few months."
"In practical terms, many practitioners are concerned about the current recommendations," Dehmer said. "One concern is that should the patient require elective bypass surgery, does a higher dose of clopidogrel [the generic name of Plavix] increase the risk of excessive bleeding?
"Also there is the bleeding risk. It is addressed in this meta-analysis, which shows very minimal potential downside," he added.
But the final word is not in yet, said Dr. Marc S. Sabatine, associate professor in the cardiovascular division of Brigham and Women's Hospital in Boston. That will come from a major international study, to include up to 14,000 angioplasty patients, which is still enrolling participants, he said.
The smaller studies included in the current meta-analysis aren't definitive, Sabatine said, because there can be "publication bias," meaning that studies showing a positive result are more likely to get into print.
Timing also plays a role in treatment, he noted. Plavix must be activated in the liver, which takes about six hours, so giving it earlier makes it more effective.
But even with those side considerations, "many laboratories are considering switching to 600 milligrams," Sabatine said.
More information
For more on angioplasty, visit the U.S. National Library of Medicine.
The analysis of 10 previous studies found that giving angioplasty patients double the current recommended dose of Plavix -- 600 milligrams rather than 300 -- cut the combined risk of heart attack and cardiac death by half, according to Dr. Anthony Abbate.
Abbate, an assistant professor of medicine at Virginia Commonwealth University, was expected to present the findings on Friday at the Society for Cardiovascular Angiography and Interventions' annual meeting, in Orlando, Fla.
The higher dose did not increase the risk of serious bleeding, a major concern with Plavix, the analysis found.
"The evidence shown by this meta-analysis is very powerful," said Dr. Gregory Dehmer, president of the society and a professor of medicine at Texas A&M College of Medicine. "Although Plavix is powerful stuff, the meta-analysis did not find an excessive amount of bleeding. So we have a lower risk of myocardial infarction [heart attack] with no significant increase in adverse side effects."
The 10 studies analyzed by Abbate and Dr. Giuseppe G. Biondi-Zoccai, an assistant professor of cardiology at the University of Turin in Italy, included 1,500 patients who had angioplasty. Most had either 300 milligrams or 600 milligrams of Plavix before the procedure.
The incidence of cardiac death or nonfatal heart attack was 50 percent lower in the following 30 days in those getting the higher dose of Plavix. Only 3.1 percent of those getting the 600-milligram dose had in-hospital heart attacks, compared to 6.4 percent of those getting the 300-milligram dose. The overall 30-day incidence of death or heart attack was 3.8 percent for the higher dose and 7.3 percent for the lower dose, according to the study.
"This research has important clinical and cost implications," Biondi-Zoccai said in a prepared statement.
Current guidelines by the American Heart Association, the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions say that physicians should "strongly consider" giving 300 milligrams of Plavix before angioplasty, a medical procedure to open narrowed or blocked blood vessels of the heart.
"Those guidelines are in the process of having an update," Dehmer said, adding that new guidelines are expected "in the next few months."
"In practical terms, many practitioners are concerned about the current recommendations," Dehmer said. "One concern is that should the patient require elective bypass surgery, does a higher dose of clopidogrel [the generic name of Plavix] increase the risk of excessive bleeding?
"Also there is the bleeding risk. It is addressed in this meta-analysis, which shows very minimal potential downside," he added.
But the final word is not in yet, said Dr. Marc S. Sabatine, associate professor in the cardiovascular division of Brigham and Women's Hospital in Boston. That will come from a major international study, to include up to 14,000 angioplasty patients, which is still enrolling participants, he said.
The smaller studies included in the current meta-analysis aren't definitive, Sabatine said, because there can be "publication bias," meaning that studies showing a positive result are more likely to get into print.
Timing also plays a role in treatment, he noted. Plavix must be activated in the liver, which takes about six hours, so giving it earlier makes it more effective.
But even with those side considerations, "many laboratories are considering switching to 600 milligrams," Sabatine said.
More information
For more on angioplasty, visit the U.S. National Library of Medicine.
Simple Workout Urged for Pregnant Women on Bed Rest
(HealthDay News) -- Pregnant women restricted to bed rest can and should do safe, specially-designed physical activity, say experts at the American Physical Therapy Association (APTA).
Each year in the United States, an estimated 700,000 women with high-risk pregnancies (including nearly all those carrying triplets or more) are put on bed rest, the APTA said. But, in many cases, the incapacitating effects of total bed rest are not being addressed, leaving some expectant mothers ill-prepared for pre- and post-partum physical and psychological challenges.
"As a result of prolonged bed rest, pregnant women experience an array of symptoms ranging from cardiovascular deconditioning, musculoskeletal discomforts, stressful postures and positions, skin breakdown, muscle weakness, as well as psychological issues such as guilt, stress, and depression," Jean Irion, a professor of physical therapy at the University of South Alabama in Mobile, said in a prepared statement.
Irion teaches physical therapists across the United States to develop safe physical activity programs for pregnant women on bed rest.
"Physical therapy is often equated with exercise, and many physicians equate exercise to a strong potential for exacerbating a given high-risk condition, so they don't suggest pregnant women restricted to bed rest see a physical therapist. This is a huge mistake," according to Irion.
She said physical therapists work to minimize loss of muscle tone and strength and to make the women as comfortable as possible.
"We're not training these women to compete in a triathlon following delivery. Our aim is for these women to maintain some strength, flexibility and range of motion in the upper and lower extremities, so they'll be prepared for the demands of lifting carrying, and holding their babies," Irion said.
More information
The Nemours Foundation has more about bed rest during pregnancy.
Each year in the United States, an estimated 700,000 women with high-risk pregnancies (including nearly all those carrying triplets or more) are put on bed rest, the APTA said. But, in many cases, the incapacitating effects of total bed rest are not being addressed, leaving some expectant mothers ill-prepared for pre- and post-partum physical and psychological challenges.
"As a result of prolonged bed rest, pregnant women experience an array of symptoms ranging from cardiovascular deconditioning, musculoskeletal discomforts, stressful postures and positions, skin breakdown, muscle weakness, as well as psychological issues such as guilt, stress, and depression," Jean Irion, a professor of physical therapy at the University of South Alabama in Mobile, said in a prepared statement.
Irion teaches physical therapists across the United States to develop safe physical activity programs for pregnant women on bed rest.
"Physical therapy is often equated with exercise, and many physicians equate exercise to a strong potential for exacerbating a given high-risk condition, so they don't suggest pregnant women restricted to bed rest see a physical therapist. This is a huge mistake," according to Irion.
She said physical therapists work to minimize loss of muscle tone and strength and to make the women as comfortable as possible.
"We're not training these women to compete in a triathlon following delivery. Our aim is for these women to maintain some strength, flexibility and range of motion in the upper and lower extremities, so they'll be prepared for the demands of lifting carrying, and holding their babies," Irion said.
More information
The Nemours Foundation has more about bed rest during pregnancy.
New Cholesterol Check Gauges Kids' Heart Risk
(HealthDay News) -- Whether America's fast-food-and-video-game culture, or some other confluence of factors is to blame, there's no denying that adolescents' health is at risk.
Little wonder, then, that one group of researchers has begun to take a serious look at the long-term health consequences of kids' inactivity. And they are using cholesterol levels as a window into these youngsters' futures.
Obesity, inactivity and cholesterol are closely linked, and data from the latest U.S. National Health and Nutrition Examination Survey (NHANES) finds that 17 percent of U.S. teens are overweight. Just one in four high school students packs enough physical activity into their day, and 12 percent get little or no daily exercise, reports the U.S. Centers for Disease Control and Prevention.
So, measuring kids' cholesterol in a really detailed way may make sense.
"There is growing scientific evidence indicating that cholesterol levels in childhood and adolescence have an effect on the development of plaque in the arteries, which is a clear indication of cardiovascular disease risk," explained study leader Ian Janssen, an assistant professor in the School of Kinesiology and Health Studies at Queens University in Ontario, Canada.
"There is also strong evidence indicating that children and youth with high cholesterol will continue to have high cholesterol in adulthood," he added. "Thus, it is important to start treatment and prevention efforts early."
Using data from the NHANES on more than 6,000 kids aged 12 to 20, Janssen and his colleagues developed age- and gender-specific reference points for total cholesterol, LDL ("bad") cholesterol, HDL ("good) cholesterol and triglyceride fat levels. The new tables, published last year in the journal Circulation, take into account fluctuations in cholesterol and fat that occur as a child matures.
The new reference data are meant to improve upon current guidelines, published by the U.S. National Cholesterol Education Program, which do not account for age-related fluctuations.
Still, Janssen admits that the guidelines have not yet been routinely adapted into clinical care settings in the United States. "These sorts of changes to clinical practice typically take years to manifest," he said.
Dr. Marc S. Jacobson, director of the Center for AtherosclerosisAtherosclerosis Prevention at Schneider Children's Hospital in New Hyde Park, N.Y., said it's unclear how the new tables will be received in the United States.
"It complicates lives of people like me who treat adolescents with lipid problems because instead of just having one number, you have to have four graphs and plot them out by age," he said.
"Instead of having one cut point," he continued, "you have a graph that you have to plot out a percentile. With each lipid profile, you have to decide which percentile this is for that individual's age. And when it goes up and when it goes down, did it go down because of treatment? Or did it go down because of advancing puberty?"
The challenge, then, is to make sense of that information, he explained. "It argues that you almost have to take it into account because you could say if the LDL changes, is it the treatment or is it a change in puberty?"
Currently, the federal government recommends cholesterol screening for children and teens with at least one parent with high cholesterol or a family history of early heart disease.
"Typically high-risk adolescents should be screened, and probably every year or two," Janssen said. "A high-risk adolescent would be one who's had a parent or grandparent with premature cardiovascular disease or high cholesterol, or a teen with other risk factors, such as obesity and high blood pressure."
Other risk factors, such as high blood pressure, obesity, diabetes or smoking, also would trigger cholesterol testing in doctors' offices, "and that covers a lot of kids now," Jacobson noted.
The issue is destined to garner greater attention when a U.S. National Heart, Lung, and Blood Institute (NHLBI) panel updates guidelines on cholesterol screening in children and teens. The new guidance is scheduled for release in April 2008, said Dr. Rae-Ellen Kavey, senior medical officer with the Pediatric Cardiovascular Risk Reduction Program in NHLBI's Office of Prevention, Education, and Control.
"Stay tuned," Kavey said, "because there really is going to be new information."
More information
Find out more about cholesterol at the U.S. National Heart, Lung, and Blood Institute.
Little wonder, then, that one group of researchers has begun to take a serious look at the long-term health consequences of kids' inactivity. And they are using cholesterol levels as a window into these youngsters' futures.
Obesity, inactivity and cholesterol are closely linked, and data from the latest U.S. National Health and Nutrition Examination Survey (NHANES) finds that 17 percent of U.S. teens are overweight. Just one in four high school students packs enough physical activity into their day, and 12 percent get little or no daily exercise, reports the U.S. Centers for Disease Control and Prevention.
So, measuring kids' cholesterol in a really detailed way may make sense.
"There is growing scientific evidence indicating that cholesterol levels in childhood and adolescence have an effect on the development of plaque in the arteries, which is a clear indication of cardiovascular disease risk," explained study leader Ian Janssen, an assistant professor in the School of Kinesiology and Health Studies at Queens University in Ontario, Canada.
"There is also strong evidence indicating that children and youth with high cholesterol will continue to have high cholesterol in adulthood," he added. "Thus, it is important to start treatment and prevention efforts early."
Using data from the NHANES on more than 6,000 kids aged 12 to 20, Janssen and his colleagues developed age- and gender-specific reference points for total cholesterol, LDL ("bad") cholesterol, HDL ("good) cholesterol and triglyceride fat levels. The new tables, published last year in the journal Circulation, take into account fluctuations in cholesterol and fat that occur as a child matures.
The new reference data are meant to improve upon current guidelines, published by the U.S. National Cholesterol Education Program, which do not account for age-related fluctuations.
Still, Janssen admits that the guidelines have not yet been routinely adapted into clinical care settings in the United States. "These sorts of changes to clinical practice typically take years to manifest," he said.
Dr. Marc S. Jacobson, director of the Center for AtherosclerosisAtherosclerosis Prevention at Schneider Children's Hospital in New Hyde Park, N.Y., said it's unclear how the new tables will be received in the United States.
"It complicates lives of people like me who treat adolescents with lipid problems because instead of just having one number, you have to have four graphs and plot them out by age," he said.
"Instead of having one cut point," he continued, "you have a graph that you have to plot out a percentile. With each lipid profile, you have to decide which percentile this is for that individual's age. And when it goes up and when it goes down, did it go down because of treatment? Or did it go down because of advancing puberty?"
The challenge, then, is to make sense of that information, he explained. "It argues that you almost have to take it into account because you could say if the LDL changes, is it the treatment or is it a change in puberty?"
Currently, the federal government recommends cholesterol screening for children and teens with at least one parent with high cholesterol or a family history of early heart disease.
"Typically high-risk adolescents should be screened, and probably every year or two," Janssen said. "A high-risk adolescent would be one who's had a parent or grandparent with premature cardiovascular disease or high cholesterol, or a teen with other risk factors, such as obesity and high blood pressure."
Other risk factors, such as high blood pressure, obesity, diabetes or smoking, also would trigger cholesterol testing in doctors' offices, "and that covers a lot of kids now," Jacobson noted.
The issue is destined to garner greater attention when a U.S. National Heart, Lung, and Blood Institute (NHLBI) panel updates guidelines on cholesterol screening in children and teens. The new guidance is scheduled for release in April 2008, said Dr. Rae-Ellen Kavey, senior medical officer with the Pediatric Cardiovascular Risk Reduction Program in NHLBI's Office of Prevention, Education, and Control.
"Stay tuned," Kavey said, "because there really is going to be new information."
More information
Find out more about cholesterol at the U.S. National Heart, Lung, and Blood Institute.
Pool Safety Tips Keep Everyone's Head Above Water
(HealthDay News) -- Drowning is the second leading cause of death among American children ages 14 and younger, but a few simple measures can greatly reduce the risk of such tragedies, experts say.
Every year, about 760 children in that age group die from accidental drowning, and about 3,000 are treated at emergency departments after near-drowning incidents, according to Children's Healthcare of Atlanta and Safe Kids Georgia.
It doesn't have to be that way, they say. "The most important precaution is active supervision. Simply being near your child is not necessarily supervising," spokeswoman Beverly Losman said in a prepared statement.
She noted that while 94 percent of parents say their supervise their children while they're swimming, many of those parents admit that they do other distracting activities at the same time, such as talking, eating, reading or looking after another child.
"A supervised child is in sight at all times with your undivided attention focused on the child. When there are children in or near the water, adults should take turns serving as the designated 'water watcher' paying undivided attention," Losman said.
She offered these other precautions:
Pools and spas should be surrounded on all four sides by a fence at least five feet high with gates that close and latch automatically. This type of isolation fencing could prevent 50 percent to 90 percent of child drownings in residential pools, studies estimate.
Consider a pool alarm and alarms on doors, windows and gates leading to the pool.
Pools and spas with a single drain should have an anti-entrapment drain cover and a safety vacuum release system to prevent children from being caught underwater in the powerful suction of the drain.
Don't leave toys in or near a pool where they may attract unsupervised children.
When children are about age 4, enroll them in swimming lessons. But don't assume that swimming lessons make a child "drownproof" -- they still need active supervision when swimming.
Remember that inflatable swimming aids, such as water wings, are not flotation devices and don't prevent drowning.
Keep rescue equipment, a phone and emergency numbers by the pool.
Monday, May 07, 2007
New Study Stresses Mammogram's Importance in Breast Cancer Decline
(HealthDay News) -- The decline in U.S. breast cancer cases is caused not only by fewer women using hormone replacement therapy but also by the use of mammography screening, new research suggests.
"Two distinct patterns are observed in breast cancer trends," wrote Dr. Ahmedin Jemal, strategic director for cancer surveillance for the American Cancer Society, in a report published in the May 3 online edition of the journal Breast Cancer Research.
After colleagues presented an abstract at a breast cancer symposium that attributed the 7 percent decline in U.S. breast cancer cases in the years 2002 to 2003 to the reduced use of hormone replacement therapy, Jemal's team decided to look at an older data base.
The researchers who linked the decline to reduced hormone use looked at a large data base from 2002 and 2003 called SEER (Surveillance, Epidemiology, and End Results). In 2002, a large federally funded trial -- part of the Women's Health Initiative -- was halted when evidence emerged of an increased risk of heart disease and breast cancer due to hormone therapy.
After that, women in large numbers went off their hormone replacement regimens.
But Jemal's team looked at older SEER data bases, from 1975 to 2003. The researchers looked at breast cancer incidence rates by tumor size, tumor stage, and whether the tumor was estrogen-receptor positive or negative among women who were age 40 or older in the years studied.
They found that the decline in breast cancer cases also dropped prior to the 2002-2003 SEER data, although the decrease was less dramatic -- about 5 percent between 1999 and 2000 there was a 5 percent drop, according to Jemal.
"The point is breast cancer started to decrease before 2002," Jemal said. And screening mammograms were the reason, he added.
The decline in breast cancer rates directly attributed to mammography, he said, has now leveled off.
"The message for women over 40 is still, they should get a mammogram every year so the tumor [if there is one] can be detected," Jemal said.
The new study is "a more nuanced analysis," said Roshan Bastani, professor and associate dean for research at the University of California, Los Angeles, and associate director for cancer prevention and control at the university's Jonsson Comprehensive Cancer Center. "It shows there were declines in breast cancer that started before the recent declines."
While from a public health perspective a plateau may have been reached when it comes to the benefits of screening mammography, Bastani added, it's still crucial for women over age 40 to keep their mammogram appointments. "About 75 percent of [U.S.] women are getting screened. That has not changed since 1999," she said.
More information
To learn more about breast cancer, visit the American Cancer Society.
"Two distinct patterns are observed in breast cancer trends," wrote Dr. Ahmedin Jemal, strategic director for cancer surveillance for the American Cancer Society, in a report published in the May 3 online edition of the journal Breast Cancer Research.
After colleagues presented an abstract at a breast cancer symposium that attributed the 7 percent decline in U.S. breast cancer cases in the years 2002 to 2003 to the reduced use of hormone replacement therapy, Jemal's team decided to look at an older data base.
The researchers who linked the decline to reduced hormone use looked at a large data base from 2002 and 2003 called SEER (Surveillance, Epidemiology, and End Results). In 2002, a large federally funded trial -- part of the Women's Health Initiative -- was halted when evidence emerged of an increased risk of heart disease and breast cancer due to hormone therapy.
After that, women in large numbers went off their hormone replacement regimens.
But Jemal's team looked at older SEER data bases, from 1975 to 2003. The researchers looked at breast cancer incidence rates by tumor size, tumor stage, and whether the tumor was estrogen-receptor positive or negative among women who were age 40 or older in the years studied.
They found that the decline in breast cancer cases also dropped prior to the 2002-2003 SEER data, although the decrease was less dramatic -- about 5 percent between 1999 and 2000 there was a 5 percent drop, according to Jemal.
"The point is breast cancer started to decrease before 2002," Jemal said. And screening mammograms were the reason, he added.
The decline in breast cancer rates directly attributed to mammography, he said, has now leveled off.
"The message for women over 40 is still, they should get a mammogram every year so the tumor [if there is one] can be detected," Jemal said.
The new study is "a more nuanced analysis," said Roshan Bastani, professor and associate dean for research at the University of California, Los Angeles, and associate director for cancer prevention and control at the university's Jonsson Comprehensive Cancer Center. "It shows there were declines in breast cancer that started before the recent declines."
While from a public health perspective a plateau may have been reached when it comes to the benefits of screening mammography, Bastani added, it's still crucial for women over age 40 to keep their mammogram appointments. "About 75 percent of [U.S.] women are getting screened. That has not changed since 1999," she said.
More information
To learn more about breast cancer, visit the American Cancer Society.
Dads' Parenting Style Influences Childhood Obesity
(HealthDay News) -- Fathers' parenting styles have a major influence on children's weight, says an Australian study that looked at almost 5,000 children, ages 4-5, and their parents.
The researchers found that fathers with permissive (no limits on their children) or disengaged parenting styles were more likely to have overweight or obese children, while fathers with a consistent (clear limits, following through with instructions, etc.) style were less likely to have children with a higher body mass index (BMI).
There was no association between the mothers' parenting styles and children's weight, said the study authors from the Centre for Community Child Health (CCCH) at the Royal Children's Hospital, Melbourne, and the Murdoch Children's Research Institute.
The findings were to be presented this weekend at the annual meeting of the Pediatric Academic Societies, in Toronto.
"This study of a large cross section of Australian preschoolers has, for the first time, suggested that fathers could be at the frontline in preventing early childhood obesity. Mothers are often blamed for their children's obesity, but this study suggests that for more effective prevention, perhaps we should focus on the whole family," Melissa Wake, an associate professor at CCCH, said in a prepared statement.
"Given the importance of the family unit in a child's preschool years, and its influence on their nutrition and physical activity levels, it is timely to look at the parenting roles of both parents and the impact they have on a child's tendency to be overweight or obese," Wake said.
She noted that more than 60 percent of the fathers and more than 40 percent of the mothers in the study were overweight or obese.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases offers advice for parents on healthy eating and physical activity for children.
The researchers found that fathers with permissive (no limits on their children) or disengaged parenting styles were more likely to have overweight or obese children, while fathers with a consistent (clear limits, following through with instructions, etc.) style were less likely to have children with a higher body mass index (BMI).
There was no association between the mothers' parenting styles and children's weight, said the study authors from the Centre for Community Child Health (CCCH) at the Royal Children's Hospital, Melbourne, and the Murdoch Children's Research Institute.
The findings were to be presented this weekend at the annual meeting of the Pediatric Academic Societies, in Toronto.
"This study of a large cross section of Australian preschoolers has, for the first time, suggested that fathers could be at the frontline in preventing early childhood obesity. Mothers are often blamed for their children's obesity, but this study suggests that for more effective prevention, perhaps we should focus on the whole family," Melissa Wake, an associate professor at CCCH, said in a prepared statement.
"Given the importance of the family unit in a child's preschool years, and its influence on their nutrition and physical activity levels, it is timely to look at the parenting roles of both parents and the impact they have on a child's tendency to be overweight or obese," Wake said.
She noted that more than 60 percent of the fathers and more than 40 percent of the mothers in the study were overweight or obese.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases offers advice for parents on healthy eating and physical activity for children.
Certain ACE Inhibitors Cut Elderly Dementia Risk
(HealthDay News) -- Certain types of ACE inhibitor hypertension drugs may help cut the risk of dementia in older adults, say researchers at the Wake Forest University School of Medicine.
They analyzed data from the long-term Cardiovascular Health Study of almost 5,900 people over age 65 in the United States.
The researchers found that "centrally acting" ACE (angiotensin-converting enzyme) inhibitors may help reduce inflammation that might contribute to dementia.
Centrally acting ACE inhibitors are able to cross the blood-brain barrier and reach the brain.
"For older adults who are going to take an ACE inhibitor for blood pressure control, it makes sense for their doctors to prescribe one that goes into the brain," lead researcher Dr. Kaycee Sink, an assistant professor of internal medicine/gerontology, said in a prepared statement.
She and her colleagues found that for each year that people took centrally acting ACE inhibitors, they had a 50 percent lower rate of mental decline than people taking other kinds of hypertension drugs.
Mental decline was measured using the Modified Mini-Mental State Exam, which evaluates memory, language, abstract reasoning and other cognitive functions.
"These results suggest that there is more to treating blood pressure than achieving a goal of 140/80," Sink said. "Which drug you choose for blood pressure can have broader implications. We know that ACE inhibitors protect against heart failure and kidney failure, and now there is evidence that some of them may also protect against dementia."
The study was expected to be presented this weekend at the annual meeting of the American Geriatrics Society, in Seattle.
More information
The American Medical Association has more about dementia.
They analyzed data from the long-term Cardiovascular Health Study of almost 5,900 people over age 65 in the United States.
The researchers found that "centrally acting" ACE (angiotensin-converting enzyme) inhibitors may help reduce inflammation that might contribute to dementia.
Centrally acting ACE inhibitors are able to cross the blood-brain barrier and reach the brain.
"For older adults who are going to take an ACE inhibitor for blood pressure control, it makes sense for their doctors to prescribe one that goes into the brain," lead researcher Dr. Kaycee Sink, an assistant professor of internal medicine/gerontology, said in a prepared statement.
She and her colleagues found that for each year that people took centrally acting ACE inhibitors, they had a 50 percent lower rate of mental decline than people taking other kinds of hypertension drugs.
Mental decline was measured using the Modified Mini-Mental State Exam, which evaluates memory, language, abstract reasoning and other cognitive functions.
"These results suggest that there is more to treating blood pressure than achieving a goal of 140/80," Sink said. "Which drug you choose for blood pressure can have broader implications. We know that ACE inhibitors protect against heart failure and kidney failure, and now there is evidence that some of them may also protect against dementia."
The study was expected to be presented this weekend at the annual meeting of the American Geriatrics Society, in Seattle.
More information
The American Medical Association has more about dementia.
HEALTH EFFECTS OF XENOBIOTICS
We Are All Toxic!There is not a person on this earth that does not have some hazardous chemicals in their tissues; exposure to them has been linked to several cancers and to a broad range of reproductive problems, including birth defects.
The increasing incidence of some of these conditions, and our continued exposure to a cocktail of these chemicals, is alarming. On of the patterns being observed in developed countries is the increase in chronic diseases associated with environmental factors: indeed, a quarter of all diseases have been attributed to environmental causes, and there can be little doubt that exposure to hazardous chemicals is one of them.
Hormone (or endocrine) disrupting chemicals inparticular pose a high risk to human welfare and are likely to be causing widespread harm. For example, some man-made chemicals have been linked with:
- a range of effects on the reproductive system including sperm quality and the incidence of male genital abnormalities;
- spontaneous abortion, premature deliveries and low birth weight;
- alterations in the ratio of male to female offspring; and
delays in development of, and deficits in, the mental ability of children. - In addition, some chemicals may play a role in certain diseases such as breast and testicular cancer.
It’s a Big Problem!
Global chemical production has escalated from around one million tonnes a year in 1930 to some 400 million tonnes in 2000. By the end of the 1990s, some 100,000 chemicals had been registered in the EU, of which 30,000 have annual production volumes above one tonne.
Synthetic chemicals can affect human biology in numerous ways. Many are carcinogens, others can cause birth defects, and still others can disrupt the hormone system. These chemicals, on the market today, can be found in everything from pesticides, paints and industrial detergents to cosmetics, furniture and hair dyes. Many of these xenobiotics were present in the September 9-11 calamity, as well as some of the other wars in the Middle East - polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls, polychlorinated dibenzodioxins, polychlorinated dibenzofurans, pesticides, phthalate esters, brominated diphenyl ethers, and other hydrocarbons.
Some accumulate over time and contaminate our water, soil and food, and some are transported long distances on air and ocean currents, so that they contaminate people living in remote areas as far away as the Arctic. Regulations have not kept up with the scale of chemical production. Most chemicals on the market and in everyday use have never been adequately assessed for their human and environmental safety. Of particular concern to World Wildelife Fund (WWF) are chemicals that are very persistent and bioaccumulative, and those that are capable of disrupting the normal functioning of the hormone (or endocrine) system.
Bioaccumulation of XenobioticsOur bodies build up over time very persistent and bioaccumulative xenobiotics – most of these will last many years and probably be one of the main causes of our mortality. This is really quite a new science as most of the toxic reference ranges set by most authorities are based on a one-dose toxic level, not on a bioaccumulative process - scientists must now put on their thinking caps and begin thinking laterally! It is probably a good idea to begin phasing these chemicals out NOW before they kill our grandchildren and great grandchildren!
Endocrine Disrupting Chemicals, Reproductive Problems & Obesity
Previous studies have found that exposure to phthalates—found in cosmetics, shampoos, soaps, lotions, lubricants, paint, pesticides, plastics and in the coating of some timed-release medicines - may be associated with reproductive problems. More than 75 percent of the United States population is thought to have measurable levels of several phthalates in their urine. Researchers have theorized that this class of chemicals, as well as other environmental pollutants, may be lowering testosterone levels in men and may be responsible for the substantial declines in testosterone levels and sperm quality that have occurred in the United States and other countries over the last several decades.
Animal studies have demonstrated that phthalates lower testosterone levels and recent human data has found that phthalates are associated with poor semen quality in men and subtle changes in the reproductive organs in male children. Researchers of the current study decided to investigate the effect of this class of chemicals on obesity after noting that low testosterone appears to cause increased abdominal fat and pre-diabetes in men.
Consequently, if phthalates cause a decrease in testosterone, they theorized, then it could also play a role in weight gain and insulin resistance. The scientists analyzed urine, blood samples and other data from subjects participating in the National Health and Nutrition Examination Survey, a large, multi-ethnic, cross-sectional sampling of the U.S. population conducted routinely by the Centers for Disease Control and Prevention.
After adjusting for confounding factors, the researchers discovered that there was a definite link between levels of several phthalate metabolites and abdominal obesity. Men who had the highest phthalate levels in their urine had more belly fat and a greater prevalence of insulin resistance compared to subjects with lower levels.
This is why it is important to detoxify on a regular basis, clean our liver and gallbladder as well as help to remove these phthalates and other xenobiotics or foreign chemicals – taking HMD can help this process -
Health Effects in Children
Children are exposed to more toxic chemicals in food, air and water than adults because relative to their size, they breathe twice as much air, eat three to four times more food, and drink as much as seven times more water. There is increasing scientific evidence that children face much higher cancer risks from exposure to environmental contaminants than adults.
Only last year, a US study showed that neonate cord blood contained an average of 287 chemicals, of which 180 of these were carcinogens. A similar study in neonates in the Inuit Eskimos living in the North Pole also showed arsenic, lead, mercury and organochlorine pesticides such as DDT which has been banned in the Western world for more than 20 years. This is why the statement “we are all toxic” can no longer be refuted.
Given this level of toxicity from the womb, it should be no surprise that there is a rise in childhood cancers, such as brain cancer, as well as in cancers such as non-Hodgkin’s lymphoma and multiple myeloma among adults. The risk of non-Hodgkin’s lymphoma has been linked to industrial chemicals used in dark hair dyes and the incidence of this disease was seven times greater in children whose parents frequently used home pesticides.
Neurological and Behavioural EffectsThere is evidence that children’s exposure to some man-made chemicals, especially PCBs, can affect their neurological development and mental ability. Xenobiotics commonly present in women, which are passed on to the developing foetus, can affect the behaviour and mental development of their children, particularly in early childhood. However, these effects may persist to such an extent that impaired reading ability and reduced IQs have still been found in American children aged 11. Man-made chemicals are also suspected of contributing to learning disabilities, including attention deficithyperactivity disorder (ADHD) and autism.
Free e-booksFor all those that have not received my FREE e-books on detoxification, please use this link - Free e-book! - (use the username "HMD" and password "ebooks4me") - and you will be able to download them instantly - one is entitled "DETOXIFICATION: Toxic world, Toxic body - The Secrets of Detoxification. The other is entitled "Flushing Gallstones Naturally: Liver Cleansing Without Painful Surgery or Expensive Drugs."
Best wishes,© Dr. George J Georgiou, Ph.D.,ND.,D.Sc (AM)
Natural Medicine Practitioner & Researcher
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