Weight loss programs fall short of long-term success

By jeremyc | April 9, 2015

According to a new study, many weight loss programs fall short of success in the long term. Commercial weight loss programs are growing increasingly popular in the US, where around two-thirds of adults are obese or overweight.

This new review was led by Kimberly A. Gudzune, MD, of the Johns Hopkins University School of Medicine, who said, “Primary care doctors need to know what programs have rigorous trials showing that they work, but they haven’t had much evidence to rely on.”

For this study, the researchers reviewed 45 past studies involving patients in a weight loss program and comparing them to patients who were not part of the program. The studies covered Weight Watchers, Atkins, eDiets, Jenny Craig and other seven other weight loss programs. All the programs focused on nutrition along with behavioral counseling and social support.

Just two of the programs, Jenny Craig and Weight Watchers, were found to have helped patients successfully keep off excess weight in the long term. After a year, Weight Watchers patients had a 2.6 percent or higher weight loss as compared to their control group. This percentage was 4.9 percent for the Jenny Craig group.

While some of the other programs had short-term success, there were no long-term studies of their success. SlimFast, Atkins and other few programs had mixed results in the long term.

Study author Jeanne Clark said, “We want people to experience the health benefits of weight loss - lower blood pressure, cholesterol and blood sugar, and lower risk of developing diseases like diabetes. Those benefits are long-term goals; losing weight for three months, then regaining it, has limited health benefits. That’s why it’s important to have studies that look at weight loss at 12 months and beyond.”

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Cardiac arrests during exercise more survivable than heart attacks

By jeremyc | April 8, 2015

According to a new study, the risk of sudden heart attacks during exercise or sports activity was low, and the rate of survival in such cases was higher than other heart attacks.

The study was led by Sumeet S. Chugh, MD, of the Heart Institute at Cedars-Sinai Medical Center in Los Angeles, who said, “Our study findings reinforce the idea of the high-benefit, low-risk nature of exercise in middle age.”

For this study, the researchers looked at over 1,200 cases of sudden cardiac arrest or SCA in 2002-2013 from the Oregon Sudden Unexpected Death Study. All these cases had patients in the 35-65 years age group. Of the total number of cases, just 63 occurred during sporting activities, out of which 45 occurred during the activity itself, while 14 occurred within an hour of ending the activity.

Also, 58 percent of the cases occurred within sports facilities. Jogging was the most common activity linked to sudden cardiac arrests at 27 percent, followed by basketball at 17 percent and cycling at 14 percent. Men had an 18 times greater likelihood of having sudden cardiac arrests during sports than women.

Also, most patients who had sports-related cardiac arrests had at least one heart disease risk factor. The researchers said, “The findings from this study should in no way discourage patients with … risk factors from engaging in regular, appropriate physical exercise within a framework of simple guiding rules from the treating physician.”

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Pediatric melanoma rates see decline

By jeremyc | April 6, 2015

The rate of melanoma, a type of aggressive skin cancer, is decreasing among children according to a new study, contracting the belief that more children are suffering of melanoma.

The study also contradicts past research that has found that melanoma was becoming increasingly common among children as well as adults.

The lower rate of melanoma in adolescents and older teens may be due to public health campaigns that advocate protective measures like sunscreens, the researchers of the study said.

The study was co-led by Laura B. Campbell, MD, a pediatrician at the Stanford University School of Medicine in California. The lead author was Jeremy S. Bordeaux, MD, a dermatologist at UH Case Medical Center and UH Rainbow Babies and Children’s Hospital.

Campbell said, “We took an in-depth look at whether or not the number of new cases of melanoma per year in children and adolescents was increasing in the recent decade.” Bordeaux said, “Although it is encouraging to observe decreasing melanoma incidence overall, it is concerning that this decrease is occurring in those cases of melanoma with good [chances for recovery].”

The researchers found that melanoma in children occur in around 5-6 cases among every one million. Data from 2000-2010 was used for this study, and 1,185 new pediatric melanoma cases were reported during this period. This was a 12 percent reduction each year on average.

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Pesticide residue may lower semen quality

By jeremyc | April 4, 2015

According to a new Harvard study, men who ate fruits and vegetables with high pesticide residues had lower normal and overall sperm counts.

This marks the first study that connects pesticide residue intake with men’s semen quality. The study was led by Jorge Chavarro, assistant professor of nutrition and epidemiology at the Harvard T. H. Chan School of Public Health in Boston.

Chavarro said, “These findings should not discourage the consumption of fruit and vegetables in general. In fact, we found that consuming more fruits and vegetables with low pesticide residues was beneficial. This suggests that implementing strategies specifically targeted at avoiding pesticide residues, such as consuming organically-grown produce or avoiding produce known to have large amounts of residues, may be the way to go.”

Measurable amounts of pesticide residues are found in several conventionally-grown vegetables and fruits. For this study, the researchers looked at data on 155 men who participated in a 2007-2012 reproductive health study. The study included analyses of the participants’ diets and semen samples. The researchers also used data on pesticide residues from the US Department of Agriculture Pesticide Data Program.

On analysis, it was found that men who had over 1.5 servings of vegetables and fruits with high residue levels had lower sperm counts than those men who ate the least amounts of high-residue vegetables and fruits.

However, the researchers suggested that men still eat vegetables for better reproductive health.

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Behavioral therapy underused ADHD in kids

By jeremyc | April 2, 2015

According to a new study by the US Centers for Disease Control and Prevention (CDC), behavioral therapy is not being used as often as it should be for treating attention deficit hyperactivity disorder (ADHD) children.

This marks the first national study to assess the current treatment trends for ADHD children. Behavioral therapy is often recommended as the first choice because it is safest, especially for young patients.

However, the CDC found that behavioral therapy was not being used, while medication therapy was likely being overused. The researchers expressed concerns that the overuse of medication in young children could lead to brain development issues.

The study was led by Susanna Visser, DrPH, an epidemiologist at the National Center on Birth Defects and Developmental Disabilities at the CDC. She said, “Treatment decisions for ADHD in children can be complex. Parents, health professionals, psychologists, and educators can work together to ensure that children receive the best treatment available. The good news is that we now have strong clinical guidelines to support the more than 5 million children living with ADHD.”

In the 2011 ADHD treatment guidelines published by the American Academy of Pediatrics (AAP), behavioral therapy alone is recommended for preschool-aged ADHD patients, while a combination of behavioral and medication therapy is recommended for 6-17 years old patients. The AAP also recently recommended short-acting medicines for younger children, but only if behavioral therapy is ineffective.

This particular study used data on over 40,000 children from the 2009-2010 National Survey of Children with Special Health Care Needs. They assessed data on children with ADHD and special healthcare needs.

On analysis, it was found that less than 50 percent of ADHD children received behavioral therapy. However, the study was completed before the AAP guidelines came into effect.

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Exercise can help COPD patients overcome physical, work limitations

By jeremyc | March 31, 2015

New evidence from the US Centers for Disease Control and Prevention (CDC) suggests that with chronic obstructive pulmonary disease (COPD) patient reported physical limitations and trouble with working.

However, the CDC also found that the rate of such issues was lower among COPD patients who were non-smokers and more physically active. The study was led by Anne Wheaton, PhD, of the National Center for Chronic Disease Prevention and Health Promotion, CDC.

Wheaton said, “COPD is an important contributor to both mortality and disability in the United States.”

COPD refers to a group of conditions that includes chronic bronchitis and emphysema. These diseases cause symptoms such as chronic cough and shortness of breath, and COPD is often linked to a history of smoking.

For this study, the researchers looked at the 2013 Behavioral Risk Factor Surveillance System’s data. On analysis, they found that an estimated 15.7 million adults had COPD, and the rate was greater among older adults.

COPD patients were found to face more physical activity and employment related limitations than their peers. For example, 24.3 percent of CPD patients reported an inability to work, as compared to just 5.3 percent of non-COPD adults.

Also, 49.6 percent of COPD patients reported some activity limitation due to health problems, as compared to 16.9 percent of other adults. These limitations included trouble climbing stairs o walking.

The researchers wrote, “Among adults with COPD, nonsmokers who also reported being physically active were least likely to report all of the activity limitation measures, whereas those not physically active, regardless of smoking status, were most likely to report the activity limitations.”

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US may see Shigellosis outbreak

By jeremyc | March 30, 2015

A new US Centers for Disease Control and Prevention (CDC) report indicates that an outbreak of intestinal disease called Shigellosis may be coming to the country through foreign travelers.

The disease is called by an intestinal bug known as Shigella, and has already seen several outbreaks. Tom Frieden, Director of the CDC, said, “These outbreaks show a troubling trend in Shigella infections in the United States.”

These infections cause symptoms such as stomach cramps, fever and diarrhea that lasts for five or seven days. Shigellosis is highly contagious and can spread through contact with fecal matter. This kind of contact can occur through not washing hands properly or through contaminated water. Even those infected people exhibiting no symptoms yet can spread the illness.

Between May 2014 and February 2015, outbreaks of shigellosis have occurred in 32 US states and 243 patients have been affected, according to the CDC. Most of the cases were even resistant to the antibiotic ciprofloxacin (brand name Cipro).

In the past, just 2 percent of shigellosis cases within the US had shown resistance to this medications. However, recent outbreaks have seen 90 percent of the tested samples were resistant.

Frieden said, “Drug-resistant infections are harder to treat and because Shigella spreads so easily between people, the potential for more - and larger - outbreaks is a real concern. We’re moving quickly to implement a national strategy to curb antibiotic resistance because we can’t take for granted that we’ll always have the drugs we need to fight common infections.”

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Bariatric surgery could improve joint replacement surgery results

By jeremyc | March 29, 2015

Weight loss or bariatric surgery before a joint replacement surgery could help improve the results of the surgery, according to two new studies.

The senior author for these studies was Emily Dodwell, MD, of the Hospital for Special Surgery in New York City.

Adam Powell, PhD, president of Payer+Provider and a health care economist, said, “The researchers in these studies wished to evaluate whether or not bariatric surgery before total knee arthroplasty (TKA) is a good value by estimating the ratio of incremental cost to its incremental benefit.”

“They found that it was what would be deemed a good value by many insurers. To make this estimate, they used a Markov Model - a mathematical model which examines transitions between states. These preliminary findings suggest that further research should be conducted on the benefits of promoting bariatric surgery before TKA.”

Dodwell said, “Up to 50 percent of hip replacements are performed in obese patients at some institutions. Obesity is associated with longer hospital stays, higher overall costs and higher failure rates, necessitating costly revision surgery.”

Dodwell and her team compared the treatment costs of obese patients who were suffering from hip or knee osteoarthritis. One group of patients underwent joint replacement surgery without losing weight, while another group went through a two-year weight loss program and then underwent hip or knee replacement surgery.

Dodwell said, “Our findings indicate that surgical weight loss prior to joint replacement is likely a cost-effective option from a public payer standpoint in order to improve outcomes in obese patients who are candidates for joint replacement.” She added, “Some health care systems do not include weight loss surgery as a covered benefit, and it is possible that studies such as this will be helpful in re-evaluating whether weight loss surgery may be a reasonable covered benefit.”

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Prenatal air pollution may impact cognition and behavior

By jeremyc | March 28, 2015

According to a recent small-scale study, prenatal exposure to air pollution may be linked to reduced white matter in the brain, which could affect behavior and cognition.

The study specifically found that this affect could be linked to a type of pollution due to polycyclic aromatic hydrocarbons (PAHs). This type of pollution may contribute to a lower amount of white matter in the brains of children, which could cause a slower thinking ability and behavior problems such as attention deficit hyperactivity disorder (ADHD).

The study was led by Bradley S. Peterson, MD, of Children’s Hospital Los Angeles. The researchers wrote in the study report, “Every unit reduction in exposure to PAHs during gestation and early postnatal life should yield a proportionate reduction in white matter disturbance and its associated cognitive and behavioral effects. If confirmed, our findings have important public health implications given the ubiquity of PAHs in air pollutants among the general population.”

Burning coal, smoking and vehicle exhaust are common sources of PAHs, along with indoor activities like using space heaters and cooking. Past researcher has found that PHAs could affect the brains of unborn children.

For this study, the researchers assessed 40 black and Hispanic children in urban areas, from the time they were in the womb to until they were seven-nine years old. The mothers of the children were assessed for PAH exposure as well, and the children went through brain imaging and intelligence tests.

On analysis, the researchers found that children exposed to more PAHs had a greater chance of having reduced white matter on their brains’ left sides, as compared to those children who were not as exposed to PAHs.

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Heart disease more common among those whose parents were smokers

By jeremyc | March 27, 2015

According to a recent study, young adults whose parents smoked had the most signs of heart damage in the future.

The study was led by Costan G. Magnussen, PhD, of the Menzies Institute for Medical Research at the University of Tasmania in Australia. It found that there was a buildup of plaque even in those children who had only one smoker parent, or whose parents tried limiting their children’s exposure to smoke.

Plaque refers to a buildup of fatty deposits or cholesterol in the arteries, which could lead to heart problems, heart disease or stroke.

The researchers found that the risk of carotid plaque development in adulthood was 1.7 times greater among children who were exposed to one or two parental smokers, as compared to children who had non-smoker parents. Among children whose parents tried to limit their exposure to smoke, the risk dropped to just 1.6 times normal.

For this study, the researchers looked at over 1,500 children who were part of the Cardiovascular Risk in Young Finns Study in 1980. They used ultrasound tests in 2007 to look into the children’s carotid arteries.

Magnussen said, “For parents who are trying to quit smoking, they may be able to reduce some of the potential long-term risk for their children by actively reducing their children’s exposure to secondhand smoke (i.e., not smoking inside the home, car, or smoke well away from their children).”

Topics: Smoking Cessation | No Comments »

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