Posts by Beverly Merz
These days, more and more adults bike to work, combining their daily workout with their daily commute, all while helping the environment. Unfortunately, biking is getting riskier. A study in this week’s Journal of the American Medical Association found that, between 1998 and 2013, the rate of bike injuries rose by 28% and the rate of people admitted to the hospital because of bike injuries rose by 120%. People over 45 had the greatest increase in injuries. And the majority of bike accidents now happen on city streets. The good news is that you can help protect yourself by learning and following the rules of the road, staying alert, and keeping some common-sense safety tips in mind.
Vitamin D holds promise for many things, like building bone, preventing heart attacks and strokes, reducing cancer risk, and more. But that promise isn’t fully backed by science. For example, a controlled clinical trial published this week in JAMA Internal Medicine found that a vitamin D supplements didn’t build bone in postmenopausal women with blood levels of vitamin D below the threshold generally considered necessary for good health. Many researchers are looking ahead to results from an ongoing trial called VITAL, which aims to gather the kind of solid evidence that will let us know for sure whether taking relatively high doses of vitamin D can ward off heart attack, stroke, or cancer. The results are expected by the end of 2017. It’s also possible to get vitamin D the old-fashioned way: go out in the sun between 10 a.m. and 3 p.m. with at least 10% of your skin exposed. Stay out long enough to absorb the sun but not long enough to be burned.
People with allergies to grass pollen may have cheered last year when the FDA approved a no-needles treatment —a daily tablet you dissolve under your tongue. These tables deliver low doses of grass pollen to the bloodstream. This is done to “teach” the immune system not to wage war on grass pollen. It turns out that these tablets don’t work that well. An analysis of 13 controlled clinical trials indicates that dissolvable tablets are only slightly more effective than placebos in curtailing classic symptoms of grass pollen allergy—runny nose, itchy eyes, and tickly throat. To make matters worse, more than 60% of people who used the tablets experienced irritating side effects.
The search for an effective, easy-to-use treatment for sleep apnea has been going on for years. The gold standard is a breathing machine known as continuous positive airway pressure (CPAP). A report published online this week by JAMA Internal Medicine describes a mouth-guard-like device that may work for people with mild sleep apnea, but that may not be much help for those with severe sleep apnea. The 18 million Americans with obstructive sleep apnea sufferers are a powerful incentive for device manufacturers, and there are myriad alternatives to CPAP in the marketplace and under development. Swedish researchers tested a custom-fitted mandibular advancement device among people with self-reported sleep apnea. It worked, but a placebo device worked almost as well.
Calorie counts adorn the exterior of cans and bottles of sodas, juices, sports drinks, and many other beverages. Should alcoholic beverages and drinks also come with calorie counts? Yes, argues Dr. Fiona Sim, chair of the United Kingdom’s Royal Society for Public Health, in an editorial in The BMJ. She explores well-supported links between alcohol drinking and obesity. Beginning in December 2015, alcohol-related calorie counts will be available in the United States to some people who dine out. The Food and Drug Administration is requiring restaurant chains with 20 or more outlets to provide calorie information for food and some alcoholic drinks. The calorie counts may come as a wake-up call for drinkers who are accustomed to thinking of an average drink as containing 100 to 150 calories. That figure may be true for the standard 1.5-ounce shot of distilled spirits, 12-ounce bottle of beer, or 5-ounce glass of wine, but the “generous pour” at many bars and restaurants often doubles the amount. Moreover, concoctions containing syrups, liqueurs, juices, cream, and other ingredients can send the calories soaring.
President Obama’s announcement of a Precision Medicine Initiative was one of the few items in this year’s State of the Union address to garner bipartisan support. And for good reason. Precision medicine, also known as personalized medicine, offers the promise of health care based on your unique DNA profile and the profiles of a million other individuals. Getting to precision care will require new diagnostic tests. It will also need a new regulatory framework to make sure that technologies aren’t launched before they’ve been proven to be safe and effective, according to a Perspective article in The New England Journal of Medicine. It may take a few years to design this new vetting system and put it in place. In other words, precision medicine is on the horizon, but it isn’t around the corner.
Sitting in a sauna is one way to chase away the cold. A new report in JAMA Internal Medicine makes this pastime even more appealing: regularly spending time in a sauna may help keep the heart healthy and extend life. Among 2,300 middle-aged Finnish men, those who took a sauna bath four or more times a week were less likely to have died over a 20-year period than those who took a sauna once a week or less. Frequent visits to a sauna were also associated with lower death rates from cardiovascular disease and stroke. Sauna baths are generally safe and likely beneficial for people with well-controlled coronary artery disease or mild heart failure, but may not be so hot for those with unstable angina or a recent heart attack. The high temperature in a sauna can boost the heart rate to a level often achieved by moderate-intensity physical exercise. Is sitting in a sauna the equivalent of exercising? No. But exercising and then taking a sauna seems like a very healthy routine.
A new report from the University of Washington links long-term use of anticholinergic medications and dementia. Anticholinergic drugs block the action of acetylcholine. This substance transmits messages in the nervous system. In the brain, acetylcholine is involved in learning and memory. In the rest of the body, it stimulates muscle contractions. Anticholinergic drugs include some antihistamines, tricyclic antidepressants, medications to control overactive bladder, and drugs to relieve the symptoms of Parkinson’s disease. The study found that people who used anticholinergic drugs were more likely to have developed dementia as those who didn’t use them. Dementia risk increased with the cumulative dose. Taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less. Safer alternatives to anticholinergic drugs exist.
One way to avoid adding extra pounds over the holiday season is by relying on the glycemic index to choose your foods and snacks. The glycemic index is a measure of how fast carbohydrates are turned into sugar. The higher a food’s glycemic index, the faster your body turns that food into sugar, and the sooner the “hunger bell” rings again. This can set into motion the cycle of holiday overeating. One way to go low glycemic: Choose foods your grandmother used to eat—ones that resemble things in nature, and don’t come with long lists of ingredients.
The best test for finding hidden lung cancer in smokers is a low-dose CT scan. Its use has been endorsed by the U.S. Preventive Services Task Force (USPSTF), an independent panel that makes recommendations for screening tests. Most insurers follow the recommendations of the task force, and pay for those services. But some opposition to this by Medicare may mean that the test isn’t covered for some of the people who could benefit from it the most. A new report in the New England Journal of Medicine showed that the cost of adding one good year to a person’s life through CT screening is around $80,000. Tests or procedures that cost less than $100,000 per year added are considered cost effective. The analysis identified two groups for whom screening is the most cost-effective—current smokers and people ages 60-74. People with private insurance will have low-dose CT scans covered. But those with Medicare may not, thanks to the decision of a Medicare advisory committee. The CMS is expected to publish a draft of its decision within the next few days and come to a final decision in early 2015.