In the folk song “Dem Bones,” every bone is connected to the next one in line. Here’s an interesting wrinkle on that idea: The gum bone, or at least problems with it, are connected to all sorts of health problems. Gum disease—which begins when the sticky, bacteria-laden film known as plaque builds up around your teeth—is closely linked to premature birth, heart disease, diabetes, and other chronic health problems. Now, a report in the August issue of the American Journal of Preventive Medicine finds that treating gum disease (also called periodontal disease) can lead to better health — as evidenced by lower health care costs and fewer hospitalizations — among people with common health conditions. The common thread between gum disease and chronic health conditions is inflammation. Eliminating the gum infection may dampen that harmful response throughout the body.
An report in this week’s Proceedings of the National Academy of Sciences calculates several environmental costs of raising cows for meat and milk, poultry and pork for meat, and chickens for eggs. According to the report, per calorie of food that we consume, dairy, poultry, pork, and eggs have similar environmental costs. Compared with their average, beef production generated five times more greenhouse gases, needed six times more fertilizer and 11 times more irrigation water, and used 28 times the land. The same four costs for growing potatoes, wheat, and rice were two-fold to six-fold lower than the nonbeef foods in land use, greenhouse gas emissions, and fertilizer use, and about the same for irrigation water.
Every day, millions of Americans use the Nutrition Facts labels on food packages to make healthy choices. The U.S. Food and Drug Administration has recently proposed changes to make the labels even more useful. It’s an important move that could help curb the skyrocketing number of Americans with type 2 diabetes, osteoarthritis, and other weight-related conditions. The proposed new label will list information about added sugars, update daily values for sodium and dietary fiber, list the amount of potassium and vitamin D, and remove the “Calories from Fat” category while continuing to list types of fat. For foods that come in larger packages but could be consumed in one sitting, manufacturers would have to use a two-column label showing calorie and nutrition information for both a single serving and the entire package. These changes are a step in the right direction, but don’t go far enough with sugar, ingredient listing, and nutrient claims.
It’s not uncommon for people to blame the weather for making their arthritis or back pain flare up. A team of Australian researchers has one word for that: bunk. They followed nearly 1,000 people who were seen for acute low back pain in several Sydney primary care clinics noted the weather conditions when the back pain started, as well one week and one month earlier. And they found … nothing. No connection between back pain and temperature, rain, humidity, or air pressure. The results were published online in the journal Arthritis Care & Research. This isn’t the first word on the pain-weather connection, and won’t be the last. If animals can sense earthquakes, then it may be possible for people with back pain, arthritis, or other types of pain to sense changes in the weather that the rest of us don’t notice. But we need good proof.
Breaking a smoking habit can be hard. Nicotine is so addictive that smoking, or using tobacco in other forms, may be the toughest unhealthy habit to break. But it’s possible to quit. Nicotine replacement, in the form of nicotine patches, gum, sprays, inhalers, and lozenges, can help overcome the physical addiction. Medications such as varenicline (Chantix) and bupropion (Zyban) can also help. They can help reduce the cravings for a cigarette, and may also make smoking less pleasurable. Two new studies show that adding one or both of these medications to nicotine replacement can help improve quit rates. This research doesn’t suggest that smokers take varenicline and bupropion as a first step in smoking cessation. But when nicotine replacement alone hasn’t helped, adding varenicline with or without bupropion may lead to success.
With all the warnings against soaking up too much sun, getting ready to go outside can feel like you need a checklist like astronauts use when suiting up for a 6-hour spacewalk in the full blast of the sun’s radiation. Putting on sunscreen and following other sun-smart strategies is for a good cause: preventing melanoma—the most dangerous kind of skin cancer. Curiously, doctors tend not to talk about sunscreen use with their patients. One study showed that, in 18 billion outpatient visits, primary care doctors mentioned sunscreen to just 0.07% of their patients, or roughly 1 in 1,400. But even though your doctor may not mention it, you know better: Put on a broad spectrum sunscreen with an SPF of at least 30 before you go out. Reapply every two to three hours, or more if you are in the water or sweating. Wear a wide-brimmed hat or sun-protective clothing.
The annual pelvic exam, an oft-dreaded part of preventive care for women, may become the as-needed pelvic exam, thanks to new guidelines from the American College of Physicians. For decades, doctors have believed this exam may detect problems like ovarian cancer or a bacterial infection even if a woman had no symptoms. But an expert panel appointed by the American College of Physicians now says that healthy, low-risk women do not need to have a pelvic exam every year. The exam isn’t very effective at finding problems like ovarian cancer or a vaginal infection, and it often causes discomfort and distress. Sometimes it also leads to surgery that is not needed. The new guidelines only apply to the pelvic exam, and only in healthy women.
Nearly 7 million adults in the United States suffer from psoriasis. This condition is characterized by red patches of skin covered with silvery scales, often on the elbows and knees. But today doctors understand psoriasis as an inflammatory condition that may affect more than just the skin. People with psoriasis are more likely to have other conditions linked to inflammation, including heart disease, diabetes, obesity, and inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis. And nearly a third of people with psoriasis develop psoriatic arthritis, which causes stiff, painful joints and other debilitating symptoms. Several studies suggest that weight loss and vigorous exercise, both of which help combat inflammation, may help thwart psoriasis as well.
“Replacing” a hormone the body normally makes when it is running low isn’t necessarily the safest thing to do. Women and their doctors learned this with estrogen after menopause. Now the FDA is sounding a warning that testosterone therapy can cause potentially dangerous blood clots in men. Such blood clots, called deep-vein thrombosis (DVT) and pulmonary embolism kill as many as 180,000 Americans each year, more than the number of people who die from breast, prostate, colon, and skin cancers combined. The new warning is not related to the FDA’s evaluation of possible links between testosterone therapy and stroke, heart attack, and death. Experts recommend testosterone therapy for men with a low testosterone level and one or more of the “classic” symptoms. For the rest? They get a talk-with-your-doctor recommendation. The warnings highlight that taking testosterone isn’t risk free. Combined with the lack of evidence about who really benefits, it means that the decision to start testosterone therapy is an individual one. A man must weigh the potential benefits against the potential increased risks of heart attack, stroke, and blood clots. If the balance tips in favor of moving forward, then trying testosterone is reasonable thing to do.
Four Harvard Health books won Wil Solimene Awards for Excellence in Medical Communication this weekend. They are Almost Addicted, by J. Wesley Boyd, MD, PhD, and Eric Metcalf, MPH; Chicken Soup for the Soul: Say Goodbye to Stress, by Jeff Brown, MD; Almost Depressed, by Jefferson Prince, MD, and Shelley Carson, PHD; and The Harvard Medical School Guide to Tai Chi, by Peter M. Wayne, PhD, and Mark L. Fuerst.