Archive for June, 2013

Stephanie Watson

Volunteering may be good for body and mind

There’s something gratifying about volunteering. Whenever I work a charity event—which I try to do with some regularity—I often get more out of it than I give. A new study suggests that volunteering has positive implications that go beyond mental health, and may include better physical health. They study, from Carnegie Mellon University, found that adults over age 50 who volunteered on a regular basis were less likely to develop high blood pressure than non-volunteers. High blood pressure is an important indicator of health because it contributes to heart disease, stroke, and premature death. It’s impossible for this study to prove that volunteering was directly responsible for the lower blood pressure readings, but the results are in line with other findings on the topic. Aristotle once surmised that the essence of life is “To serve others and do good.” If this line of research is any indication, serving others might also be the essence of good health.

Howard LeWine, M.D.

New trial muddies the water about diet, exercise, and diabetes

Long-awaited results from a nearly 10-year trial exploring the effect of changes in diet and exercise among people with diabetes weren’t what most people expected. The Look AHEAD trial found that intensive efforts to lose weight by eating less and exercising more didn’t provide any more protection against heart disease—a common co-traveler with diabetes—than standard diabetes support and education. The spin from some media reports is that weight loss doesn’t reduce heart disease risk among people with type 2 diabetes, but I think that’s the wrong interpretation. The results of the Look AHEAD trial don’t contradict the value of lifestyle changes. People in the intensive change group improved their blood sugar with fewer drugs, saving an estimated $600 per year, they were also less likely to have developed chronic kidney disease and less self-reported vision problems. The Look AHEAD results reinforce for me that diabetes care needs to be tailored to the individual.

Howard LeWine, M.D.

Better use of medicines could save billions

Wiser use of prescription medications by everyone—doctors and their patients—could save the U.S. health care system more than $200 billion a year. That’s the conclusion of a new report, Avoidable Costs in U.S. Healthcare, from the IMS Institute for Healthcare Informatics. Inefficient or ineffective use of medications lead to six million hospitalizations, four million trips to the emergency room and 78 million visits to doctors and other care providers each year, according to the report. Those are huge numbers. Although $213 billion represents less than 8% of what Americans spend on health care each year, it’s still a staggering sum. It also exacts human costs that aren’t reflected in the estimates. The report identifies 6 things that can be improved to address the problem: 1) not taking medications as directed, 2) taking too many medications, 3) delayed treatment, 4) overuse of antibiotics, 5) medication errors, and 6) underuse of generic medications.

Daniel DeNoon

Cities can learn lessons about diabetes from rural areas

City dwellers often think of rural America as a throwback to past “good old days.” But when it comes to obesity and diabetes, people living outside urban areas offer a frightening glimpse of the future. While more than 8% of Americans now have diabetes, in some rural counties 20% of the residents have diabetes. Those counties also tend to have high rates of obesity. Barriers to healthy living contribute to both obesity and diabetes. So does lack of primary care physicians. One answer may be greater reliance on community health workers—lay people trained to provide diabetes education and outreach. In Birmingham, Alabama, the Cities for Life program has doctors refer people with diabetes to “patient navigators” who help them find local resources such as nearby exercise classes or mobile farmers’ markets.

Patrick J. Skerrett

Infection, autoimmune disease linked to depression

Depression, bipolar disorder, and other mental health problems arise when something goes wrong with brain function. What causes that malfunction is an open question. A new study from Denmark suggests that a serious infection or autoimmune disease could trigger a mood disorder. How might an infection or autoimmune disorder lead to a mood or other mental health disorder? Infection causes localized and body-wide inflammation. Inflammation generates substances called cytokines that have been shown to change how brain cells communicate. In autoimmune diseases, the body’s defense system attacks healthy tissues rather than threatening invaders. It’s possible that in some cases the wayward immune reaction could target brain cells and other nerve cells throughout the body.

Patrick J. Skerrett

Ask questions to get the most out of a health care visit

During visits with your doctors or other health care providers, do you speak up and ask questions? If the answer is “yes,” congratulations. You’ve taken an important step to getting the most out of your health care visits. You’re also in the minority. Most people have trouble asking their doctors questions. It can be even harder to disagree with your doctor, or make known your preferences for care and even your worries. There are many reasons for poor patient-doctor communication. One is what Timothy J. Judson and colleagues call the asymmetry of power. Medical lingo is another key barrier. The federal Agency for Healthcare Research and Quality’s “Questions to Ask Your Doctor” campaign and the Joint Commission’s “Speak Up Initiatives” offer free information to help people ask the sometimes difficult questions needed for good health care.

Daniel Pendick

Healthy fats may fight early-stage prostate cancer

Each year, nearly a quarter of a million American men learn they have prostate cancer. Most are diagnosed with early-stage cancer that has not spread beyond the prostate gland. Traditional treatments include surgery, radiation therapy, and a “watch and wait” strategy called active surveillance. A new study published online this week in JAMA Internal Medicine indicates that diet may be an important add-on. The study, part of the ongoing Harvard-based Health Professionals Follow-up Study, suggests that eating more foods that deliver healthy vegetable oils can help fight the second leading cause of cancer death in men. Earlier studies have implicated the traditional Western diet, which is relatively high in red meat and other sources of animal fats, with a higher risk for developing prostate cancer in the first place, while eating more vegetable oils and vegetable protein may help prevent it.

Patrick J. Skerrett

What you can do about floaters and flashes in the eye

“Floaters” and flashes are a common sight for many people. Floater is a catchall term for the specks, threads, or cobweb-like images that occasionally drift across the line of vision. Flashes are sparks or strands of light that flicker across the visual field. Both are usually harmless. But they can be a warning sign of trouble in the eye, especially when they suddenly appear or become more plentiful. That can be the sign of a tear in the retina, the patch of light-sensitive cells along the back of the eye that captures images and sends them to the brain. A retinal tear can lead to a retinal detachment, which can lead to permanent vision loss.

Patrick J. Skerrett

Matchless strategy for tick removal; 6 steps to avoid tick bites

What’s the best way to remove a tick burrowed into your skin? Don’t use one of the folk remedies, like touching it with a hot match, covering it with petroleum jelly or nail polish, or freezing it. These are all supposed to make the tick “back out” of the skin on its own. But they often have the opposite effect, forcing the tick to hold tight, burrow deeper, and possibly deposit more of its disease-carrying secretions into the wound, which increases the risk of infection. Instead, do what the Centers for Disease Control and Prevention recommend: Use a pair of fine-tipped tweezers to grasp the tick as close to the skin as possible. Then pull it out with a steady motion. Once the tick has been removed, clean the skin with soap and water. Dispose of the tick, which is probably still alive, by placing it in alcohol or flushing it down the toilet. For most people who are bitten by a tick, removal ends the saga. For others, though, it is just beginning, since the bite of a tick can transmit Lyme or other tick-borne disease

Heidi Godman

Move over Mediterranean—a vegetarian diet is equally good for health

The Mediterranean diet has been getting a lot of press as being the very best for health. But there’s another diet that appears to be equally good: a vegetarian diet. A study published in JAMA Internal Medicine found that people who ate a vegetarian diet were 12% less likely to have died over the course of the five-year study than nonvegetarians. The benefits were especially good for men, who had a significant reduction in heart disease. This study underscores the idea that meat consumption influences long-term health, and not in a good way. Should you consider ditching the Mediterranean diet and becoming a vegetarian instead? Either one is healthier than the typical American diet, so it’s really a matter of personal choice.