Health Newsletter:March 2008
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Contents |
[edit] U.S. Dietary Guidelines May Have Contributed To Obesity
Dr. Paul Marantz of the Albert Einstein College of Medicine, New York has taken a closer look at the current obesity epidemic. He and his coauthors are observing that Americans have listened to the recommendations to reduce their fat intake. This recommendation which first made its appearance in 1980 pointed out the risk of a high fat diet and its connection to cardiovascular disease. Even though there is enough evidence that a modification of fat intake could reduce cholesterol, the government guidelines against fat have not managed to improve cardiovascular disease outcome. The authors of the publication noted that Americans have slightly reduced their fat intake, but their carbohydrate and total calorie intake have actually increased. The consequence is logical: higher calorie intake is contributing to the rise in obesity and the increase in adult onset diabetes. Dr. Marantz drew on records from the Centers for Disease Control and Prevention to arrive at these results. From 1971 to 2001 fat intake has decreased by 9% in women and 5% in men, but carbohydrate intake went up by 6% in women and 7% in men. Total daily caloric intake went up by 335 calories in women and by 168 calories in men. Both genders showed an increase in obesity. While 55% of men and 41% of women were overweight or obese in 1971, by 2001 the rate had risen to 70% in men and 62% in women. The reasons for this are very likely due to many factors. Aggressive marketing of low-fat foods may have given the public the impression, that these foods can be consumed without consequences. Another reason likely is that fat in the diet can induce satiety and stop us from eating excess calories. It has not helped to label fat in the diet as an enemy instead of pointing out that small amounts of heart healthy fats in the daily diet are an important part of our nutritional team players and allies in the quest to good health.
American Journal of Preventative Medicine, Feb. 8, 2008
[edit] High Death Rate In India Due To Smoking
Dr. Prabhat Jha of the Centre for Global Health Research, Toronto has published research regarding the risk of mortality associated with smoking in India, involving data from 1.1 million Indian homes. Data of deceased individuals, all of them in the age group between 30 and 69 years of age, showed that 37% of the men and 5% of the women had been smokers, and smoking doubled the risk for both sexes due to medical causes. Smoking did not only rate as a risk for lung and respiratory cancers but also for tuberculosis, vascular and respiratory disease. Smoking as a causal relationship was estimated to be responsible for 1 in 5 deaths in men and 1 in 20 deaths in women. With the population growth in India the number of death in the age group of 30 to 69 related to smoking is estimated to increase by 3% per year. Currently available data suggests that the rate of smoking is high especially among men in India. Data from other nations show, that smoking bans in public places are effective in turning these statistics around. Italy used to be one of the European nations, where smoking in public was common and as a result the exposure to second hand cigarette smoke was not only an inconvenience but a serious health risk. Cardiovascular events like heart attacks showed a decrease among men and women in Italy after the smoking ban in public places was put into effect in 2005. The findings were related to the improved indoor air quality. There was an increase of sales in stop smoking aids like nicotine replacement products. Sales of cigarettes showed a decrease. Giulia Cesaroni from a local health unit in Rome remarked that even a small reduction in the incidence of cardiovascular disease can have enormous public health implications, as coronary artery disease is the leading cause of deaths in Italy. Compared to before the ban heart attack rates of middle aged (35- to 64-years) Italians dropped by 11%, 65- to 74-year-olds had a reduction of 8%, but those in the 75-84 year age group showed no benefit (as coronary artery disease in them likely was irreversible).
The Indian data based on www.nejm.org (February 13, 2008); the Italian study was published in Circulation 2008 (Feb. 11)
[edit] Kids With Sleep Apnea May Need Surgery
Obstructive sleep apnea can have a significant impact on those who suffer from it. The condition is often ignored or dismissed with the comment that the sleeper is just “a bad snorer”. What will be alarming to a parent is the fact that children with the condition called “obstructive sleep apnea” stop breathing periodically throughout the night and snore very loudly. Another consequence may be a child who is chronically tired and as a result is doing poorly in school. Ron Mitchell, MD, professor of pediatric otolaryngology at St.Louis University likens the impact of obstructive sleep apnea on the quality of life to conditions similar to chronic asthma or rheumatoid arthritis. In normal weight children the condition stems from the enlargement of tonsils and adenoids, which can aggravate upper airway collapse during sleep. Obstructive sleep apnea affects boys and girls equally. About 2% to 4% of children aged 4 to 6 have the condition, but Dr. Mitchell suspects that the number is probably higher, as parents don’t always recognize and report the problem. For those children in whom sleep apnea is caused by the enlargement of tonsils and adenoids surgery, a tonsillectomy and adenoidectomy, provides dramatic relief. The study from St. Louis University found that it was successfully resolving sleep problems for 80% to 90% of affected children.
February 13, 2008 issue of The Laryngoscope
[edit] The Culprits For Periodontal Disease
When people think of hazards to dental health, the first thought will be about tooth decay, lack of brushing and flossing and eating candies and other sugar-laden foods. Periodontal disease is often neglected, and yet it is just as threatening to teeth and gums. Destructive periodontal disease will lead to loss of the supporting tissues of the teeth and as a result, there will be loose or shifting teeth and ultimately tooth loss. Generally these findings were seen in older population groups. It was thought that the disease would rarely occur in patients younger than 35 years of age and the theory was that dental plaque was the likely cause. Lifestyle choices were not thought to play a large role. Recent findings told a different story. A cohort study consisting of 903 participants examined self-reported tobacco and marijuana smoking and dental examinations were also done. The authors of the study found that tobacco smoking as well as cannabis (marijuana) smoking was linked with a higher incidence of destructive periodontal disease before the age of 32 years. In comparison to this dental plaque was not contributing to a higher incidence of periodontal disease in this younger age group. Another risk for destructive periodontal disease in the youngest age group (as young as 12 to 18 years of age) was impaired glucose intolerance (a condition leading to diabetes). Due to those findings it is obvious that brushing and flossing are not the only weapons against periodontal disease. Healthy eating habits and cessation of smoking are equally important for dental health.
Journal of American Medical Association 2008; 299(5): pages 574-575
[edit] Early Breast Cancer Diagnosis With PET/CT Scan Combination
Breast cancer remains a disease that can strike women in any age group. Despite the immense amount of ongoing research and new treatment modalities, the disease presents puzzles to researchers and treating physicians and enormous challenges to patients. Early diagnosis, accurate staging of the disease and prompt treatment remain the most important points. Breast self examinations on a regular basis are just one aspect. Mammography screening can pick up the disease earlier, and a biopsy of any suspicious area can tell more about the type of cells that cause it. A particularly aggressive type is inflammatory breast cancer. It is not characterized by a suspicious lump. The only symptom is diffuse redness and swelling in the breast of the patient. This type of cancer can metastasize within six months. It accounts for 1 to 5% of all breast cancers in North America and has a five year survival rate of 25 to 50% of the patients. A team of researchers from the University of Texas M.D.Anderson Cancer Center in Houston led by Dr. Selin Carkaci examined a combination approach of high tech tests for early diagnosis and treatment. Dr. Carkaci pointed out that breast cancer is not a localized disease, but one that is systemic involving the entire body. Based on this knowledge 41 patients with the highly aggressive form of inflammatory breast cancer were examined with a combination PET/CT whole body scan. It was possible to identify cancer in patients’ lymph nodes with 98% accuracy. Early metastasis could be found in 49 % of patients. PET/CT scan combinations detect cancer in its earliest stages, when changes are happening at the cellular level. Other tests like Mammograms, ultrasound and MRI scans can only identify disease when there is destruction of the normal anatomy. The accurate depiction of the cancer within the body is important for an effective treatment plan. PET/CT combination scans are used in cancer diagnosis for a variety of tumors where distant metastases are expected. It is especially significant for inflammatory breast cancer patients, where it offers a promise for earlier diagnosis resulting in more effective treatment plans.
The Medical Post, December 18, 2007, page 15
