One doctor's prescription for exercise: Do it where you gather, even 10 minutes at a time.
Monday, November 22, 2010
Work Stress Raises Women’s Heart Risk
From The New York Times
In a large study, women who reported high job strain faced a 40 percent increase in cardiovascular disease and an 88 percent increase in risk for heart attacks.
Now Who Wants A Salad With That School Lunch?
Now Who Wants A Salad With That School Lunch?
by April Fulton
NPR - November 22, 2010
by April Fulton
NPR - November 22, 2010
Salad bars in schools seem to encourage kids to eat more fresh fruits and veggies, especially if they are displayed attractively, as NPR's Allison Aubrey and others have reported.
But how to pay for it?
When the First Lady talks up school salad bars at an elementary school in Miami later today, she may face some tough questions about how much green the feds will contribute to the greens on display.
NPR's Pam Fessler puts the odds of passing the $5.4 billion child nutrition bill -- which funds school lunch and other programs -- this year at "good."
This is in part because House leaders have agreed to take up the Senate's lower-cost version.
Now that lower-cost version has some drawbacks -- like less money per lunch, and a taking of future increased dollars promised to the food stamp program, now known as SNAP benefits.
But with Republicans taking the helm in the House in January, Democrats and many anti-hunger groups are starting to realize the Senate bill may just be the best they can get, Fessler says.
Also, the Obama administration has pledged to restore the funding before the cuts take effect in 2013.
That promise has been good enough for House Democrats Jim McGovern of Massachusetts and Rosa De Lauro of Connecticut, who earlier had fought the Senate funding levels.
"We have been assured that they will work with Congress to restore this cut and use their current authorities to protect the integrity of SNAP and further improve children's access to the nutrition programs," says a Dear Colleague letter the two sent out last week with House Education and Labor Committee Chairman George Miller.
House leaders plan to take up the Senate bill on December 1st or 2nd.
UPDATE: The fruit and vegetable industry, along with a family farming group, announced today they would partner with the First Lady's Let's Move Campaign to help schools raise money to get salad bars. Read all about it here. [Copyright 2010 National Public Radio]
Tuesday, October 26, 2010
Another reason to stop smoking (as if you really needed one)
Heavy Smoking Linked to Alzheimer's in Study
MONDAY, Oct. 25 (HealthDay News) -- Heavy smoking in middle age seems to increase the risk for developing Alzheimer's disease or another dementia, a large new study suggests.
"We found that people who reported heavy smoking in midlife had more than a 100 percent increase in risk of Alzheimer's disease and vascular dementia," said lead researcher Rachel A. Whitmer, a research scientist in Kaiser Permanente's Division of Research in Oakland, Calif.
"We have known that smoking is a risk factor for cancer, stroke and cardiovascular disease," she said. "This adds to the evidence that what is bad for the heart is bad for the brain."
The report is published in the Oct. 25 online edition of the Archives of Internal Medicine.
For the study, Whitmer's group collected data on 21,123 ethnically diverse people in the Kaiser Permanente health care system who were surveyed between 1978 and 1985, when they were 50 to 60 years old.
During an average follow-up of 23 years, the researchers found that 25.4 percent were diagnosed with dementia, including Alzheimer's (1,136 people) or vascular dementia (416 people), which is the second most common form of dementia after Alzheimer's disease. Vascular dementia is caused by damage to the arteries in the brain.
Compared with non-smokers, those who smoked more than two packs of cigarettes a day in midlife had a "dramatic increase" in the incidence of dementia -- more than a 157 percent increased risk of developing Alzheimer's disease and a 172 percent increased risk of developing vascular dementia, Whitmer's team found.
Former smokers and people who smoked less than half a pack a day did not appear to be at increased risk of Alzheimer's or vascular dementia, the researchers note.
The associations between smoking and dementia did not change even after adjusting for race or gender, high blood pressure, high cholesterol or heart attack, stroke or weight, they add.
A link between Alzheimer's and smoking has been shown before, but this new study pinpoints the specific risk for middle-age smokers for developing both Alzheimer's and vascular dementia, the researchers say.
Smoking, an established risk factor for stroke, may contribute to the likelihood of vascular dementia by causing small clots in the brain. Smoking also contributes to oxidative stress and inflammation, which may be linked to the risk of developing Alzheimer's disease, the researchers say.
"The brain is not immune to long-term damage from smoking," Whitmer said.
Two smaller studies of predominantly white participants also suggested that mid-life smoking raised the risk of developing Alzheimer's, researchers noted.
Commenting on the new study, William Thies, chief medical and scientific officer at the Alzheimer's Association, said "this is a sound confirmation of something that's been known for a while."
Another expert, Dr. Samuel E. Gandy, the Mount Sinai Professor of Alzheimer's Disease Research at Mount Sinai School of Medicine in New York City, said the findings are promising.
"Environmental factors in Alzheimer's disease have been long sought, and, until now, only head injury has emerged," Gandy said. "Unlike head injury, a tobacco smoking association is especially important because that is a risk that can be modified."
Wednesday, October 20, 2010
The "Original" Dr Portnay
I'm not the only Dr Portnay. The "original" Dr Portnay is an Internist/Endocrinologist working in the Boston area. He's one of the smartest clinicians I know. He has been my teacher for the past 39 years.
Here is a copy of his letter to the editor that was recently published in The Boston Globe.
YOUR ARTICLE "Mass. recasting health payments: Officials draft plans for new system to compensate doctors, hospitals'' (Metro, Sept. 27) is correct in that we need new ways to pay for health care. The proposed system of global payments sounds and appears attractive, but it reminds me of the managed care (HMO capitation) that we had in the 1990s.
Under that system, physicians were criticized for being so-called gatekeepers, and were blamed for limited care probably because it cost physician capitation dollars. Patients became angry at their primary care physicians for limiting access to care that patients thought they needed or wanted. This system failed miserably in spite of the cost savings.
My question to those advocating global payments for care is: How will this be different?
Billerica
GO DAD - I LOVE YOU. YOU'RE THE BEST!!!!
Thursday, October 7, 2010
Noisy Workplace Contributes to Heart Disease
Reed Miller
October 6, 2010 (Vancouver, British Columbia) — Analysis of data from the National Health and Nutrition Examination Survey (NHANES) shows that chronic exposure to occupational noise may contribute to coronary heart disease, especially among young men who smoke [1].
Some small studies suggest that noise may increase the risk of coronary disease and hypertension, but the findings have not been consistent, so Dr Wenqi Gan (University of British Columbia, Vancouver) and colleagues examined a cross-section of NHANES participants, because the survey is representative of the whole US. The results of their study are published online October 5, 2010 in Occupational and Environmental Medicine.
The study includes 6307 participants from NHANES from 1999 to 2004, age 20 and older and employed at the time of the interview. Most of the 1236 participants who reported they are chronically exposed to loud noise at work (21.2%) are male (83.3%). The average age of the noise-exposed participants is 40, and they are more likely than the nonexposed participants to be white, have a lower level of education, smoke, and be exposed to secondhand smoke. They also have a higher average body-mass index and are more likely to be regular drinkers.
Compared with participants who are never exposed to loud noise at work, those chronically exposed to occupational noise have a two- to threefold increased prevalence of angina pectoris, MI, CHD, and isolated diastolic hypertension, the study shows. After adjustment for various covariates, the odds ratios for angina pectoris, coronary disease, and isolated diastolic hypertension are 2.91, 2.04, and 2.23, respectively.
The association of noise exposure with angina pectoris, MI, and coronary disease is particularly strong for participants who are over 50 years old, male, and current smokers. However, the study did not find a significant correlation between noise exposure and increased levels of cardiovascular biomarkers, including blood lipids and circulating inflammatory mediators.
"This study suggests that excess noise exposure in the workplace is an important occupational health issue and deserves special attention," the authors conclude. They suggest that noise may contribute to the risk of myocardial ischemia or infarction because it is a "potent external stressor," like sudden emotional stress or physical exertion, and thereby activates the sympathetic nervous system and endocrine system, leading to coronary vasoconstriction and subsequent partial or complete coronary occlusion in people with or without preexisting coronary atherosclerotic plaque. The stress of noise could also lead to disruption of a vulnerable coronary plaque, the authors suggest.
The researchers acknowledge that their study did not include participants who had been exposed to workplace noise in the past but no longer work in that environment, and "the temporal relationship between noise exposure and the development of coronary heart disease is uncertain. . . . Future prospective cohort studies are necessary to clarify the relationship between previous noise exposure and the risk of CHD."
Heartwire © 2010 Medscape, LLC
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