Posts by Daniel Pendick
Birth, childhood, adulthood, and death span the book of life. Unfortunately, many people tend to avoid thinking or talking about how they want the final chapter to read. For the seriously ill or elderly—and even those who aren’t—not expressing wishes and desires about health care at the end of life can lead to getting care you wouldn’t have chosen for yourself. Families often bear the brunt of delaying or avoiding a discussion about a loved one’s end-of-life preferences. That often leaves family members making decisions without knowing what their loved one would have wanted. Doctors in Canada just published recommendations for starting the end-of-life conversation. The Conversation Project offers a “starter kit” to help people prepare to discuss their end-of-life wishes. Another resource is Five Wishes, a planning document distributed by the Aging with Dignity Foundation.
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.
• Fast-food restaurants deliver filling, inexpensive meals and snacks. But there’s usually a hidden added cost: a wallop of salt (sodium) that isn’t good for cardiovascular health. Even with the current clamor for reducing sodium in the American diet, and industry promising to do just that, the amount of sodium in prepared foods hasn’t changed much since 2005, according to a report published in the latest issue of JAMA Internal Medicine. The average sodium in chain restaurant items increased 2.6% between 2005 and 2011. In packaged foods, it fell on average 3.5%. While some are calling for tighter government regulation on the sodium content in processed and restaurant foods, you can take action now.
Is red meat bad for your heart? A new study suggests it is, but not for the reasons you might expect—like the saturated fat or cholesterol in red meat. A team from a half dozen U.S. medical centers says the offending ingredient is L-carnitine, an amino acid that is abundant in red meat. Their work shows that eating red meat delivers L-carnitine to bacteria that live in the human gut. These bacteria digest L-carnitine and turn it into a compound called trimethylamine-N-oxide (TMAO), which has been shown to cause atherosclerosis, the disease process that leads to cholesterol-clogged arteries, in mice. There’s still a long way to go before we know the full story about L-carnitine and heart disease, but this work suggests that cutting back on L-carnitine (and avoiding L-carnitine supplements) may be good steps for heart health.
Chronic pain in the muscles and joints can make life miserable. Standard treatments like ice and heat, anti-inflammatory medications, physical therapy, and appropriate exercises can often ease the pain. But when they don’t, acupuncture is an option with a good track record that’s worth considering. Research from an international team of experts adds to the evidence that it does provide real relief from common forms of pain. The team pooled the results of 29 studies involving nearly 18,000 participants. Overall, acupuncture relieved pain by about 50%. The study isn’t the last word on the issue, but it is one of the best quality studies to date and has made an impression. For new pain, an acupuncturist should not always be the first stop. It’s important to get a clear diagnosis of what is causing the pain to rule out serious medical conditions that should be treated right away—and then seek out acupuncture if appropriate.
If you or a loved one has a latex allergy or sensitivity, think twice before reaching for a product that says “latex free” or “does not contain latex.” That’s the latest advice from the FDA, which says no existing tests can show that a product is completely free from latex. Labeling that suggests a product doesn’t contain the substance could cause trouble for individuals with a latex allergy or sensitivity. Natural latex is used to make a host of stretchy products, including adhesive bandages, condoms, gloves used in health care and dishwashing, balloons, rubber band, elastic used in waistbands and socks, baby bottle nipples, pillows, and more. This kind of latex contains proteins that set off some people’s immune systems, leading to an allergic reaction. The FDA’s warning highlights that products advertised as “latex-free” may not always live up to the claim. That’s because products that are made without latex can be contaminated with latex proteins during the manufacturing or packaging process.
Memory slips are aggravating, frustrating, and sometimes worrisome. When they happen more than they should, they can trigger fears of looming dementia or Alzheimer’s disease. But there are many mundane—and treatable—causes of forgetfulness. Here are seven common ones: lack of sleep, some medications, an underactive thyroid, drinking too much alcohol, stress, anxiety, and depression. If memory lapses are bugging you, it’s worth a conversation with your doctor to see if any reversible causes are at the root of the problem. Something like getting more sleep, switching a medication, or a stress reduction program could get your memory back on track.
Getting extra calcium from supplements is supposed to be good for your bones. The latest in a string of studies heightens concern that this simple practice could end up being bad for your heart. The results support growing recommendations to get calcium from food, not pills. The latest evidence comes from the NIH-AARP Diet and Health Study, which has followed the health of nearly 400,000 men and women since 1995. Over 12 years of follow-up, men who took more than 1,000 milligrams (mg) of daily supplemental calcium were 20% more likely to succumb to heart disease than those who didn’t take calcium supplements. There was no connection between calcium supplements and heart disease in women (which has been seen in earlier studies), and no connection with calcium from food. This one study isn’t enough to find calcium guilty of heart disease in the first degree. But it’s not the only research to point the accusing finger. This line of research has some experts placing greater emphasis on a nutritious, calcium-rich diet and weight bearing exercise than on calcium supplements for keeping bones strong.
When it comes to relieving the pain of achy joints, many people reach for a pain-relieving pill like aspirin or ibuprofen. There may be a better way. When the source of pain is close to the surface, applying a cream, gel, patch, or spray that contains a pain reliever right where it hurts can ease pain and help avoid some of the body-wide side effects of oral pain relievers. These so-called topical analgesics work best for more superficial joints like the knees, ankles, feet, elbows, and hands. The active ingredient in most topical analgesics is a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen, naproxen, aspirin, or diclofenac. These medications target inflammation, which contributes to pain, swelling, and stiffness. The advantage of using a topical analgesic is that the medication works locally. Targeting pain more precisely using a medication applied to the skin can help skirt the side effects of oral drugs. This can be a boon for people whose stomachs are sensitive to NSAIDs.
The FDA is urging doctors to lower the starting dose of zolpidem, a popular prescription sleep aid, due to concerns that the drug can linger too long in the body. This causes daytime drowsiness that has led to car accidents. Sleep aids affected by the FDA’s announcement includes generic zolpidem and brand names Ambien, Ambien CR, Edluar, and Zolpimist. The FDA lowered the starting dose for women from 10 milligrams (mg) to 5 mg; for men it is now 5 to 10 mg. The drug should be taken right before going to bed. Taking too much of a sleep drug can give you a “hangover” of daytime drowsiness the next morning that could raise the risk of accidents or falls. Because people respond to medications in their own ways, it’s safest to start taking a sleep drug on a weekend, and start with a dose lower than the maximum recommended starting dose. If you feel drowsy the next day, the dose can be reduced; if it didn’t work, the dose can be increased.