Archive for January, 2012

Carolyn Schatz

Anorexia, bulimia, and other eating disorders in midlife and beyond

Eating disorders don’t afflict only adolescents and young women, but plague older women, too, and may be shrouded in even greater shame and secrecy. Many women don’t seek help, especially if they fear being forced to gain weight or stigmatized as having a “teenager’s disease.” As reported in the February 2012 Harvard Women’s Health Watch, clinicians are reporting an upswing in requests from older women for help with eating disorders. For some of these women, the problem is new; others have struggled with anorexia, bulimia, binge eating, or another eating disorder for decades. Eating problems at midlife and beyond stem from a variety of causes, ranging from grief and divorce to illness, shifting priorities, and heightened awareness of an aging body.

Howard LeWine, M.D.

Heart’s “fountain of youth” starts flowing early

If you want to have a healthy heart in your senior years, take care of it while you’re young. In a large study, researchers from Northwestern University found that a 45-year-old man who had normal blood pressure and cholesterol levels, who didn’t smoke, and who didn’t have diabetes had just a 1.4% chance of having a heart attack or stroke during the rest of his life. Having one major risk factor boosted the risk 20-fold. The results were similar for men and women, blacks and whites. Lead researcher Donald Lloyd-Jones said that making it to middle age with no heart disease risk factors is like “the fountain of youth for your heart.”

Patrick J. Skerrett

Doctors debate use of email for communicating with their patients

Among doctors, there is some controversy over whether or not to use email to communicate with patients. The Wall Street Journal offered a peek into the controversy by asking two prominent doctors to write about why they do, and don’t, use email to communicate with their patients. Writing in favor of email was Dr. Joseph C. Kvedar, a dermatologist and founder of the Center for Connected Health, a Harvard-affiliated organization that aims to move health care from the hospital and doctor’s office into the day-to-day lives of people who need help. Taking the opposite side was Dr. Sam Bierstock, an ophthalmologist who is now the president of Champions in Healthcare, an information technology consulting group. Both doctors make good points making me think that, at least for a while, the use of email will probably come down to personal preference, for doctors and the rest of us.

Patrick J. Skerrett

Health care largely ignored in State of the Union address

During last night’s State of the Union address, President Obama spent just 44 words on health reform. That’s far fewer than he’s used in the past. Although health care reform may not be a hot issue right now, it is still something that affects us all. What would you have wanted President Obama to have said about it in the State of the Union address?

Patrick J. Skerrett

Smokers with cancer benefit from quitting, but need extra help

Many people have trouble quitting smoking even after learning they have cancer, according to a new study from Harvard-affiliated Massachusetts General Hospital. Five months after learning they had cancer, just over one-third (37%) of smokers diagnosed with lung cancer and two-thirds (66%) of those with colorectal cancer were still smoking. The results underscore how difficult it can be to quit smoking. A diagnosis of cancer can be a powerful motivator, but it isn’t always enough—extra help is often needed to quit. Kicking a smoking habit is good for health anytime. It is even more important after a diagnosis of cancer.

Robert Shmerling, M.D.

Older women may need fewer bone tests

The bone-thinning condition known as osteoporosis can be a big problem for older people. That’s why older folks are urged to have their bones checked with a test that measures bone density. Exactly how often to have the test hasn’t yet been set. By following 5,000 older women for almost 17 years, researchers found that the timing of the next bone mineral test should depend on the result of the current one. People who get a normal result can wait 15 years, those with moderate osteopenia should have the test every five years, while those with severe osteopenia should have it every year.

Patrick J. Skerrett

National plan aims to bolster fight against Alzheimer’s

By the year 2050, experts estimate that 16 million Americans will be living with this Alzheimer’s disease. In an effort to head off the explosion, President Obama has signed into law the National Alzheimer’s Project Act. This ambitious project aims to attack Alzheimer’s disease by improving early diagnosis, finding effective prevention and treatment strategies, providing better support for family caregivers, and more. A newly released draft of the project, which a panel of experts is reviewing this week, sets a 2025 deadline for achieving these and other goals. One big drawback—the act doesn’t provide concrete details about how to fund the research and implementation efforts needed to meet the goals.

Michael Craig Miller, M.D.

When are obsessions and compulsions in children a problem?

It is normal for children at some points in their development to be concerned about sameness and symmetry and having things perfect. But when such beliefs or behaviors become all-consuming and start interfering with school, home life, or recreational activities, the problem may be obsessive-compulsive disorder (OCD). Obsessions are irrational thoughts, images, and impulses that a person feels as unrealistic, intrusive, and unwanted. To relieve the anxiety caused by these obsessions, a youth may engage in compulsive rituals. Two main types of treatment are used to help youths better manage OCD: a form of talk therapy known as cognitive behavioral therapy, and medication. The ideal approach is to try cognitive behavioral therapy before turning to medication.

Lloyd Resnick

Let’s protect a million hearts—including yours

A bold initiative called Million Hearts aims to prevent one million heart attacks and strokes from happening over the next five years. As explained in the Harvard Heart Letter, the initiative is spearheaded by the federal Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services. Its main focus is to encourage more widespread and appropriate use of simple, effective, and inexpensive heart-protecting actions, dubbed the ABCS. These include taking daily low-dose Aspirin, if prescribed; managing Blood pressure and Cholesterol levels; quitting Smoking. The Harvard Heart Letter adds D for Diet and E for Exercise.

Patrick J. Skerrett

Chefs, nutrition experts give the low-fat muffin a makeover

Most store-bought muffins deliver the same wallop of highly processed flour and sugar as donuts. Low-fat versions may actually be worse, since they contain extra sugar and salt. To restore the muffin to its rightful place as a healthy breakfast or snack option, chefs and dietitians from the Culinary Institute of America worked on a muffin makeover with nutrition experts from the Harvard School of Public Health (HSPH). They created recipes for five muffins: blueberry, cranberry orange, jalapeno cheddar corn, lemon chickpea, and banana nut. The team replaced half of the white flour with whole wheat or other whole-grain flours, used heart-healthy oils in place of some or all of the butter, added nuts when possible, and cut the size of the muffins.