Archive for September, 2013

Daniel Pendick

Study suggests testing bone health in older people less often may be safe

One key instruction in the operating manual for healthy aging is remaining ever vigilant about osteoporosis. The quest to identify osteoporosis early has led to widespread testing of bone mineral density (BMD), the key measure of bone strength. Medicare pays for the gold-standard test, dual-energy X-ray absorptiometry (DEXA), every two years, regardless of whether their previous scan was normal or not. A study published today found that repeat bone-density testing after four years improved the ability to identify those at higher risk by only 4%. This study raises the fundamental question: Is repeating testing of older people with normal bone strength every two years too much?

Patrick J. Skerrett

Overweight and healthy: the concept of metabolically healthy obesity

Carrying too many pounds is a solid signal of current or future health problems. But not for everyone. Some people who are overweight or obese mange to escape the usual hazards, at least temporarily. This weight subgroup has even earned its own moniker—metabolically healthy obesity. Most people who are overweight or obese show potentially unhealthy changes in metabolism, like high blood pressure, high cholesterol, and insulin resistance. But some people who are overweight or obese manage to avoid these changes and, at least metabolically, look like individuals with healthy weights. Such individuals have near-normal waist sizes, blood pressure, cholesterol, and blood sugar, as well as good physical fitness. Metabolically healthy obesity isn’t common. And it may not be permanent.

Robert Shmerling, M.D.

Studies reinforce life-saving benefits of colon cancer screening

Checking seemingly healthy people for cancer—what doctors call screening—seems like a simple process: Perform a test and either find cancer early and cure it or don’t find it and breathe easy. It works for colon, breast, and cervical cancers, but not for others. For colon cancer, there are several effective screening tests: colonoscopy, sigmoidoscopy, and stool testing. Two new studies in yesterday’s New England Journal of Medicine help further quantify their benefits. In the studies, all three types of test reduced the risk of developing or dying from colon cancer. Colonoscopy worked best, followed by sigmoidoscopy and then stool testing. The biggest challenge for colon cancer screening is getting people to have the available tests. About 50,000 Americans die of colon cancer each year—many of these can be prevented with early screening.

Heidi Godman

Two questions can reveal mobility problems in seniors

The hottest trend in mobility right now is not a smart phone or wireless gadget. The mobility that’s making health headlines is the kind that let us do what we need to do: walk and move. Mobility is essential for getting through the day, whether you need to walk across a room to the bathroom or kitchen, get out of bed or a chair, or walk through a grocery store. Loss of mobility, which is common among older adults, has profound social, psychological, and physical consequences. The cascade of negative effects that comes with immobility can often be prevented or limited. Two questions can help determine if someone is having mobility issues.

Lori Wiviott Tishler, M.D.

Drug-resistant bacteria a growing health problem

Antibiotic-resistant bacteria sicken more than two million Americans each year and account for at least 23,000 deaths. The main cause? Overuse of antibiotics. A new report from the Centers for Disease Control and Prevention, Antibiotic Resistance Threats in the United States, 2013, details the health and financial costs of antibiotic resistance in the United States. In terms of health, antibiotic resistance should be in the CDC’s top 15 causes of death. It also adds as much as $20 billion in direct health-care costs. And the problem could get worse before it gets better. Antibiotic resistance is a problem because commonly used antibiotics will become less able to treat common infections. The CDC identified three types of bacteria as urgent hazards: Clostridium difficile, Enterobacteriaceae, and Neisseria gonorrhoeae. Decreasing the use of antibiotics and preventing infection in the first place are two key steps to halting the problem.

Michael Craig Miller, M.D.

Nighttime overeating can throw weight and health out of sync

For many people, a late-night “snack” is a daily habit. There are two types of nighttime eating disorders. Sleep-related eating disorder is a highly-publicized though uncommon malady. People with this problem eat while sleepwalking or while in a twilight state between sleep and wakefulness. A better-documented problem is night eating syndrome, in which people do the majority of their eating late at night. It may affect 1 or 2 out of 100 people in the general population. Sleeping and eating are almost certainly connected, given the link between lack of sleep and weight gain. So getting plenty of sleep may be a helpful substitute for nighttime trips to the refrigerator. Being mindful of the problem and trying to identify its triggers, or stress-reduction techniques, may help avert trips to the refrigerator. Some people benefit from talk therapy.

Daniel DeNoon

Combine brief bouts of moderate exercise for health

No time in your busy schedule for a long workout? No problem. Combining brief bouts (less than 10 minutes long) of moderate to vigorous exercise over the course of the day also add up to good health, an interesting new study suggests. The findings reinforce suggestions that people should look for simple ways to get short bouts of moderate to vigorous exercise: for example, by parking at the far end of the lot and walking briskly to the entrance, by taking the stairs quickly instead of riding the elevator, or by plugging in your earbuds and dancing energetically to a favorite song. If you are a professional working a desk job at a computer, set a timer and every half hour get up and do a minute or two of something energetic.

Howard LeWine, M.D.

Study: no connection between drinking alcohol early in pregnancy and birth problems

In a new study sure to raise hackles and controversy, an international team of researchers is reporting that pregnant women who drink alcohol during the first trimester of pregnancy and possibly beyond aren’t putting their babies at risk for premature birth or low birth weight, or themselves at risk for high blood pressure complications during pregnancy. This goes against recommendations for women to avoid drinking alcohol during pregnancy. The main reason for this is that heavy use of alcohol during pregnancy has been linked to a long-term and irreversible condition known as fetal alcohol syndrome that can cause long-lasting physical and developmental problems. The medical evidence supporting strict abstinence from alcohol during pregnancy is not very strong. Will there be consensus about whether it’s safe for a pregnant woman to have a glass of wine or a beer once or twice a week? I don’t think we will see that any time soon.

Howard LeWine, M.D.

Lack of sleep boosts food purchases the next day

Savvy shoppers know that it’s a bad idea to shop for food when they are hungry. It’s a formula for filling your cart with high calorie foods, and likely spending more money than expected. Shopping while sleep deprived may have the same effect. That finding came from an interesting experiment done by a team of Swedish researchers. Sleep-deprived men bought more food, and more high-calorie foods, the morning after sleep deprivation than the morning after sleeping well. We’ve known for some time that not getting enough sleep is linked to weight gain. It’s possible that shopping may contribute to this phenomenon. For years, research on weight gain and obesity has focused on genes, foods, diets, and physical activity (or the lack of it). This study from Sweden, along with many others, are showing that our behaviors also play important roles in weight maintenance and weight gain.

Howard LeWine, M.D.

200,000 heart disease, stroke deaths a year are preventable

It’s easy to think of heart disease and stroke as an almost inevitable part of aging in a developed country like the United States. After all, they are our leading causes of death and disability. But the truth is that these are largely preventable conditions. New estimates from the Centers for Disease Control and Prevention (CDC) indicate that one-quarter of all deaths from heart disease and stroke are preventable. And that is almost certainly an underestimate. According to the report, published in Morbidity and Mortality Weekly Report, among American adults under age 75, approximately 200,000 of deaths caused each year by heart disease, stroke, and high blood pressure (hypertension) are preventable. Surprisingly, more than half of those preventable deaths occurred among individuals under age 65. The good news is that the rate of preventable death declined 29% from 2001 to 2010, the last year for which there are complete statistics.