Archive for the ‘Disorders and Conditions’ Category

The Stink about Zinc

July 29th, 2010

Zinc, Zicam, Loss of Smell, Hyposmia, Anosmia

Sometimes, it’s hard to smell a rat, and if University of California, San Diego professor Terence M. Davidson, MD is correct, zinc-based cold remedies can make it even harder. Using a statistical method that shows a cause-and-effect relationship between exposure to a substance and the development of a disease, Davidson’s study showed that use of certain cold medicines containing zinc can lead to hyposmia (reduced ability to smell) and anosmia (the loss of the ability to smell).

The FDA jumped on this issue last year when it received 130 reports of loss of smell from users of three Zicam products — Zicam Cold Remedy Nasal Gel, Zicam Cold Remedy Swabs, and Zicam Cold Remedy Swabs for kids. The FDA advised consumers to stop using these products and the manufacturer, Matrixx Initiatives, voluntarily pulled the products from the shelves while making clear that it "vigorously disagrees with the FDA’s allegations."

Davidson’s research team also questioned whether zinc gluconate, which is the active ingredient in the offending products, actually prevents colds or shortens their duration. "Given that they do absolutely no good for colds," he said, "and given that there is potential for harm, I see no point in putting any zinc gluconate products in the nose."

Not surprisingly, Matrixx Initiatives takes issue with the study conclusions. The company says that when people lose their ability to smell, respiratory infections and sinus problems are to blame. In fact, in 10 lawsuits brought against the company, the judges found little to no scientific evidence that zinc products diminished smell. In at least one case, the judge rejected Dr. Davidson as an expert witness, calling his conclusions seriously flawed. It’s interesting to note that Dr. Davidson’s statistical research "proving" the problems with zinc included only 25 people. Meanwhile, opinion in the medical community remains split. For instance, Neurologist Robert I. Henkin, MD, of the Taste and Smell Clinic in Washington, D.C., says, "The most frequent cause of smell loss is the common cold. The role these zinc-based products play in initiating or exacerbating this condition remains very difficult to ascertain."

On the other hand, 340 Zicam users, after ostensibly losing their sense of smell, brought suit against Matrixx Initiatives in 2006 and won their case. Matrixx settled for $12 million. At the time, the company issued a statement saying, "The decision by Matrixx to settle some lawsuits was a business and economic decision. It was not based on any perception that the claims are legitimate."

Nevertheless, over the years, 10 other suits have been brought against the company from users who also claimed diminished or lost sense of smell. CEO Hemelt makes a point of the fact that, as stated above, none of the judges in those ten suits found more than scant evidence that zinc is to blame. But the fact that so many users encountered trouble enough to bother filing suits does make the zinc formula seem a little less friendly.

Dr. Davidson claims that his patients and others who suffered a loss of smell when using Zicam products first experienced an extremely painful sensation of burning in the nose, after which they could no longer smell. Hemelt responds that his company’s independent tests show that such burning resulted equally from the use of the spray and placebos containing no zinc.

Smell aside, according to WebMD, zinc gets mixed reviews, at best, for its effectiveness as a cold remedy. On top of that, potential side effects include upset stomach, mouth irritation, metallic taste, and loss of smell.  A 2006 study concluded that zinc really didn’t help colds. The report read, "We contend that it is unethical to introduce any potentially permanent anosmia-inducing agent such as zinc or other heavy metals into the interior of the nose in a manner that could result in contact with the olfactory region to treat a temporary discomfort such as a common cold or allergy." On the plus side of the ledger, a study reported by Reuters in 2008 showed that zinc acetate lozenges shortened the duration of colds in study subjects. Led by Dr. Ananda S. Prasad from Wayne State University School of Medicine, Detroit, the study looked at the impact of the lozenges on 50 volunteers with colds.  All of the volunteers had cold symptoms for less than 24 hours before taking part in the study. Among the group who received the lozenges, 56 percent were completely "cold free" within four days, as compared to an average of seven days for the placebo group. Also, it’s important to note that the FDA warning did not include zinc lozenges, tablets, or dietary zinc. The loss-of-smell issue appears to apply only to zinc gluconate applied topically.

Perhaps the position taken by the U.S. National Institutes of Health (NIH) makes the most sense. (Did I just say that?) On its website, the NIH Office of Dietary Supplements says, "The effect of zinc treatment on the severity or duration of cold symptoms is controversial. Researchers have hypothesized that zinc directly inhibits rhinovirus binding and replication in the nasal mucosa and suppresses inflammation. However, no data are available to support this hypothesis."

Given the side effects that have been reported for the topical use of zinc, you might do better to avoid the whole mess in the first place and protect yourself by wearing a surgical mask 24/7 and making a point of never shaking anyone’s hand or touching any doorknobs or phones. On the other hand, you could just use a powerful immune builder and a good quality natural antipathogenic formula that includes such ingredients as garlic, oil of oregano, olive leaf extract, and yes…zinc, but internally — not topically.

:hc

Proton Pump Inhibitors and Fractures

June 19th, 2010

Proton Pump Inhibitors, Prilosec, Nexium, Prevacid

On May 25, 2010, the FDA issued a warning to consumers that high doses or long-term use of proton pump inhibitors may increase the risk of fractures of the wrist, hip or spine.  Proton inhibitors are drugs that suppress the secretion of stomach acid and are used in the treatment of peptic ulcers, acid reflux, frequent heartburn, and associated conditions. I could say, “I told you so.” In fact, I probably just did. In any case, it’s good to see the FDA catching up with common sense.

Proton pump inhibitors are sold both over-the-counter and by prescription. Prescription varieties include esomeprazole (Nexium), dexlansoprazole (Dexilant), omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), pantoprazole (Protonix), and rabeprazole (Aciphex). Over-the-counter varieties include omeprazole (Prilosec OTC, Zegerid OTC) and lansoprazole (Prevacid 24HR). According to Dr. Joyce Kovak, FDA’s Division of Gastroenterology Products Deputy Director for Safety, “Epidemiology studies suggest a possible increased risk of bone fractures with the use of proton pump inhibitors for one year or longer, or at high doses. Because these products are used by a great number of people, it’s important for the public to be aware of this possible increased risk and, when prescribing proton pump inhibitors, health care professionals should consider whether a lower dose or shorter duration of therapy would adequately treat the patient’s condition.”

The increased risk of fracture is no trifle. In a University of Washington study, pharmacologist Shelly L. Gray and colleagues followed 130,487 women over an average of eight years. They found a 25 percent increased risk of fracture among these women. 

As I’ve written before, by suppressing the secretion of stomach acid, proton pump inhibitors reduce the body’s ability to absorb minerals. Stomach acid — specifically, hydrochloric acid (HCL) — plays a critical role in separating minerals from the foods that bind them. Unfortunately, supplements don’t compensate for those lost minerals, because low HCL levels allow the minerals to combine with other substances, and so they become more difficult for the body to absorb. Low HCL levels particularly inhibit the absorption of iron, zinc, and calcium, making deficiencies a highly likely outcome of long-term proton inhibitor use. 

But this is hardly news. A 2009 study showed a number of “unexpected consequences” of proton pump inhibitor use. In addition to increased risk of fracture, the study pointed to altered B-12 and iron absorption, increased odds of contracting pneumonia, and increased odds of C. difficile infection. These potential consequences add up to a high price to pay — considering that there are equally effective natural alternatives.

The C. difficile infection issue is telling. You might be familiar with C. difficile as the culprit in the sometimes deadly infections that have accompanied the use of antibiotics. A bacterium that is normally found in the body, C. difficile is usually kept under control by gut flora and normal levels of HCL in the stomach. But under conditions of low stomach acid, this harmful bacterium thrives and can create dangerous infections. C. difficile causes severe diarrhea, is hard to treat, and again, can cause fatal complications. A Beth Israel Deaconess Hospital study conducted in Boston looked at more than 100,000 patients discharged from the hospital over five-year period. The study found that among these patients, infections with the C. difficile bacterium increased by 366 percent as doses of proton inhibitors increased. At the Boston Medical Center, another study of 1,166 patients being treated for C. difficile infections found a 36 percent risk of recurrence of the infection among patients taking proton pump inhibitors.

The real problem is that proton pump inhibitors do what so many other drugs do: suppress symptoms rather than address the actual causes of the condition. Mess with the balance of the body and you get symptomatic relief along with a host of other, perhaps far worse, problems.

So what’s an acid reflux sufferer to do? Fortunately there are effective, natural alternatives.

  • You can supplement with a good digestive enzyme formula to reduce the need for stomach acid.
  • Take a teaspoon of apple cider vinegar mixed with water and a little honey at each meal.
  • Drink less with your meals. Fluids dilute stomach acid, which triggers the stomach to produce more to compensate.
  • Eat less at one time. This allows the body to digest your meal with lower levels of stomach acid required.

But to really understand the issue of proton pump inhibitors and stomach physiology, check out Your Stomach, Part 3.

:hc

Pollen Deepens Depression

June 15th, 2010

Allergies & Depression

If you find that your mood gets worse in the summer, you may be able to blame it on the trees. A study out of the department of psychiatry of the University of Maryland School of Medicine showed that people with mood disorders like depression or bi-polar disorder, and who are also allergic to tree pollens or rag weed, experience worse depression in the presence of those allergens.

The researchers followed 100 people who had been diagnosed with depression or bipolar disorder. Of these, 53 percent also were allergic to tree pollen and ragweed. And among that 53 percent, their scores on tests for depression were significantly worse in high-pollen season than in low-pollen season. In fact, the worse the allergy symptoms, the greater the change in scores from low season to high. In an article for WebMD, Partam Manalai, a researcher involved in the study, said, “The worse the allergy symptoms, the worse [patients'] depression scores [on a standardized test used to assess depression and mania]…In patients with allergy and depression, prophylactic treatment of these conditions may prevent worsening of mood during peak allergen season.”

Earlier studies support the connection between allergies and depression, and not just in those with mood disorders. A 2002 study focused on patients who were allergic to ragweed and followed them from high-pollen season to low-pollen season and back to the next year’s high-pollen season. According to study co-author, Paul Marshall, a clinical neuropsychologist in the department of psychiatry at Hennepin County Medical Center in Minneapolis, “We saw … that behaviors associated with positive mood — enthusiasm, attentiveness, alertness — went down during ragweed season, then up during winter, then back down during the following ragweed season.”

Of course, it’s no wonder. If you’re stuffed up, sneezing, watery eyed, and headachey, it seems natural that you’d also be irritable, lethargic, and plain old down. Feeling miserable makes you feel…well, miserable, like a lion that’s grumpy because it has a thorn in its paw. But the connection between allergies and depression may be deeper than the obvious. For one thing, it may have to do with the fact that your body releases proteins called proinflammatory cytokines in an effort to protect you from allergens that enter your system. Dr. Marshall says, “It’s thought that those cytokines directly affect the central nervous system, causing the release of a chemical in the brain called IL-1 beta that induces sickness behavior, such as weakness, lethargy, low mood and the inability to concentrate.”

Bruce Bender, head of the division of pediatric behavioral health at the National Jewish Medical and Research Center in Denver, adds another interesting wrinkle. He says that research shows that people suffering allergy symptoms don’t sleep well. “Poor concentration and mood in seasonal allergy patients may be a secondary effect of a very poor night’s sleep.” Over-the-counter antihistamines may actually contribute to a poor night’s sleep because they’ll make you sleepy shortly after you take them, but they wear off halfway through the night, causing you to wake up.

Finally, for those interested in pushing to the very edges of scientific research, some energy psychology approaches contend that allergies begin with trauma that occurs in the presence of a particular substance. For instance, if your mother yells at you while you’re eating wheat, you might not be able to digest the wheat and your body gets the message that wheat is bad, and treats it as an allergen in the future. If this is true, pollens that trigger allergic reactions may stir up unconscious memories connected to the onset of the allergy. And if it isn’t true, it still makes for nice dinner conversation.

So what can allergy sufferers do to sensibly treat their symptoms and stave off depression?  Dr. Bender recommends a combination of nasal steroids (by prescription) and saline nasal rinses. According to WebMD, nasal steroids are far different from the anabolic steroids abused by athletes. They are delivered only to the lungs and nasal passages if used properly and don’t have adverse side effects, unless you consider nasal irritation and the possibility for nasal bleeding adverse. But dig a little deeper and you’ll find plenty of reason to avoid nasal steroids. For instance, a 1997 study published in the Journal of the American Medical Association describes a study finding that regular use of inhaled steroids over a period of three months or longer increased the risk of glaucoma by 44 percent, and of cataracts by 300 percent! Plus, inhaled steroids may delay healing of wounds, exacerbate diabetes symptoms, cause headache, sore throat, vomiting, suppress the immune system, and quicken osteoporosis.

A more sensible course might be to combine nasal saline rinses with proteolytic enzymes if you’re suffering from allergy symptoms. As I’ve written before, proteolytic enzymes regulate every metabolic function of the body. When taken as a dietary supplement, they reduce inflammation and maximize the immune system — just what the doctor ordered for allergy sufferers, without the nasty side effects. By the way, if you’re using nasal irrigation, the recommendation is to do it three to four times a week, as opposed to twice a day since there are indications that if done too often, they can actually promote sinus infections.

Better yet, ward off symptoms in the first place by getting to the root of whatever is causing your allergies. If you follow the Baseline of Health approach to allergies, emphasizing detoxing, proper diet, and supplementation, you can not only minimize, but possibly even eliminate seasonal allergies. I’ve described an effective allergy reduction protocol in previous blogs and newsletters. Not only will this approach improve your allergies without subjecting you to potentially dangerous drugs, but it will also enhance your overall health while keeping you from developing tree-rage.

In the meantime, stay away from grumpy lions with thorns in their paws.

:hc

Chocoholic Lament: Health Blog

June 8th, 2010

Chocolate Impacts Mood

Is this you? Things are bad, and then they get worse, so you reach for the chocolate.  You chew on the sweet melting mass. The rich cocoa butter coats your palette, the aroma fills you with pleasure, and even before you swallow, you are already visualizing the next chunk that you’ll slide into your mouth.  You briefly feel better, but soon, you’re back to the — perhaps deeper — depression, and you reach for more chocolate.

It’s a cultural cliché that people eat chocolate when they feel gloomy. Why does chocolate impact mood? There are more than 600 chemicals in chocolate, and some of them influence the level of feel-good brain chemicals. For instance, studies have shown that chocolate stimulates the release of dopamine, otherwise known as the “love” hormone, and serotonin, which eases pain. Apparently, when you eat chocolate, the hypothalamus releases the neurotransmitter beta-endorphin which has an opiate effect on the body. According to Professor Gordon Parker of the Blackdog Institute in Australia, who led a 2007 study of the impact of chocolate on mood, “The opioids are morphine-like and lower pain and that also flows through into mental well-being.”  But the opiate effect of chocolate does not necessarily lead to bliss or even relief, a new study concludes. While it’s clear that chocolate triggers the brain to release feel-good chemicals, the study found that chocolate may not really provide the relief that depressed people seek.

Certainly, depressed people do crave the treat — the study confirmed that fact. Dr. Beatrice Golomb, a professor of medicine at the University of California at San Diego led the research. Her team surveyed more than 900 people about their chocolate consumption and overall diet. After screening out those who were taking antidepressants, the researchers found that people who weren’t depressed consumed an average of 5.4 portions of chocolate per month, with a portion defined as a small chocolate bar or an ounce of chocolate candy. Moderately depressed people consumed 8.4 servings per month, and those who were highly depressed consumed an average of 12.4 servings per month. In other words, the depressed subjects ate more than twice the amount of chocolate compared to the happier subjects, and this ratio held steady for both men and women.

Did the depressed people eat more in general? No. The researchers controlled for caloric intake, and they found that the depressed subjects had equivalent intake of calories, fat, and carbohydrates compared to the non-depressed subjects. Only the chocolate differential existed.  This indicates some special and unique connection between chocolate and depression, but the researchers say the exact nature of that connection remains unclear.

Dr. Golomb theorizes that people might eat chocolate as a form of self-medication when sad. Well, that’s hardly news to the chocolate-feasting depressive. Again, it’s a cultural cliché, and as already stated, studies have indicated that chocolate elevates mood. But Dr. Golomb also says that chocolate might function like alcohol, making depressed people feel better in the short run, but having negative impacts on health and mood in the long run, especially if the chocolate tends more toward the high in saturated fats and ugly additives varieties, rather than the purer, organic dark chocolate.

A 2007 study by the Blackdog Institute in Australia may shed some light on this bipolar impact of chocolate on mood. According to study leader Professor Gordon Parker, the way chocolate affects your mood depends on your personality — whether you’re what he calls a ‘craver,’ versus an emotional eater. He says that for cravers, “the anticipation of enjoying the chocolate and the pleasure in eating it seems to stimulate the dopamine system in the brain, and provides an enjoyable experience. But the emotional eaters, people who eat chocolate to relieve boredom, stress or clinical depression, are looking for an opioid effect to improve their mood and, sadly, for many this doesn’t work. At best, the chocolate only provides temporary relief. But this is quickly followed by a return to, or even a worsening, of their earlier negative state.”

Of course, the line between being a craver and an emotional eater may be thinner than a mitochondria’s membrane, but nevertheless, Susan Albers, a psychologist at Cleveland Clinic in Ohio believes that the chocolate fix may be anything but. “Emotional chocolate eaters may be looking for an immediate change that exercise or antidepressants can bring,” she says. But a “crash” often follows the chocolate rush, she says, and “the crash will make the depression worse.” She also says that exercise and antidepressants are superior to chocolate because they create lasting mood improvement, and while she’s right about the exercise, the advisability of taking antidepressants is open to debate, as I’ve mentioned many times before.

The problem at hand here, though, is that the “chocolate high” is so short lived, and as a salve for depression, it’s unable to sustain mood, especially for those who eat chocolate for emotional reasons.  So as pleasurable as eating chocolate may be, there will inevitably be a letdown. Dr. Albers offers some advice on how to eat chocolate for maximum impact: “When we eat chocolate, we tend to think about the next piece before we finish the one we are eating. I teach people to slow down the process by opening up the chocolate slowly, listening to it crinkle, and slowing down the whole process so they actually taste it and realize that a small amount can make them feel a lot better.”

Then again, if you don’t want to listen to your chocolate wrapper crinkle, you can listen to the advice of yet another brilliant psychologist, Scott Bea, of the Cleveland Clinic: “If you crave chocolate a lot, examine your mood state and deduce if depression is a factor in your life.”  On the other hand, if you’re not depressed, you can stop worrying, declare yourself a craver rather than an emotional chocoholic and listen to the wisdom of Charles M. Schultz, Snoopy’s creator: “All you need is love. But a little chocolate now and then doesn’t hurt.”

:hc

Narcissism Rising: Health Blog

April 20th, 2010

Narcissistic Personality Disorder

In Greek mythology, Narcissus was a youth who fell in love with his own image reflected in a pool and wasted away from unsatisfied desire. Although Narcissus himself may have faded away, it appears his descendents are in full flower. In an era where a book entitled You: The Owner’s Manual rapidly becomes a Number One bestseller both at Amazon.com and on the New York Times Bestseller’s List and then spawns a series of related “You” books, it shouldn’t surprise anyone that narcissism has reached epidemic proportions. Several recent studies jointly conducted by San Diego State University (SDSU) and the University of South Alabama have found that rates of narcissistic personality traits have increased sharply among college students in the past 15 years.

The first study, published in Social Psychology and Personality Science, analyzed results of a test called the Narcissistic Personality Inventory (NPI). The standardized test, which you can take by clicking here, was administered to 16,475 college students nationwide at several intervals between 1982 and 2006. By 2006, two-thirds of the respondents scored high for narcissism, an increase of 30 percent compared to1982. Young men scored higher than young women, but rates of increase among females outpaced males.

Certainly the fact that two out of every three college-age kids measured high for narcissism is alarming, but here’s something even more disturbing. A separate study administered the NPI test to over 20,000 college students between 2002 and 2007, and found that rates of increase escalated at twice the pace in the recent six-year interval compared to the previous 15-year span. At the current rates of increase, almost every college freshman will be a narcissist in the not-so-distant future.

Lest you conclude that everyone in the US, regardless of age, already has become a mirror-obsessed, self-centered egoist, here’s yet one more puzzle piece. A third study, this one conducted by the National Institutes of Health, surveyed 35,000 Americans of all ages, and found that three times as many people in their 20s suffer from Narcissistic Personality Disorder compared to people over age 65. Then again, one might think that some of these older respondents could have been narcissistic once upon a time, in their youth, and then outgrew it. But according to the researchers, only three percent of the older group experienced Narcissistic Personality Disorder at any point in their lives, compared to 10 percent of respondents in their 20’s. Note that clinical Narcissistic Personality Disorder represents the extreme end of the narcissism scale, where simple self-absorption grows into such pathology that the individual has trouble functioning normally in the world. The fact that 10 percent of young adults have at some point in their short lives had a positive diagnosis for this extreme personality disorder is extraordinary, and certainly these high levels of the disorder are something new.

The symptoms of narcissism are well known to anyone teaching at the high school or college level. Students show little empathy for others, manifest extreme materialism and overconfidence, disregard authority, and react aggressively to any criticism. Dr. Jean Twenge of San Diego State University, who led the most recent study, found that 30 percent of the respondents agreed with the statement, “If I show up to every class, I deserve at least a B.” While this sort of attitude may cause some annoyances in the classroom, it’s later in life that the truly destructive manifestations may appear. Twenge says narcissism can lead individuals to create bad marriages, indulge in wanton infidelity, act abusively at work, lie, cheat, and even justify engaging in such activities as Ponzi schemes [or looting the world's financial system].

The researchers blame the “self-esteem movement” of the 1980’s for the plethora of narcissistic kids. Remember Mr. Rogers singing “You are Special“? Now, apparently, kids at preschool sing new lyrics to the tune of “Frere Jacques” “I am special, I am special. Look at me, look at me.” The researchers contend that such activities push kids from realistic self-perception over to the realm of clinical narcissism. Plus, Twenge says, “Current technology fuels the increase in narcissism. “By its very name, MySpace encourages attention-seeking, as does YouTube.”

Back in the 80’s, experts thought that boosting self-esteem would help kids to achieve more and do better in school, and they did indeed find links between high self-esteem and good grades. But here’s an example of how research data can be misinterpreted. Twenge says that the positive, healthy correlation between self-esteem and high performance represents cases where kids performed well and so their self-esteem naturally went up. But telling kids they’re great before they manifest any corresponding achievement simply leads them to expect rewards for doing nothing.

Where will all this narcissism lead? Twenge says that, “The increase in narcissistic traits is just the tip of the iceberg. Even more disturbing is how narcissism and attention-seeking have become rampant in our culture, from girls sending naked pictures of themselves on cell phones to plastic surgery rates more than doubling in just ten years.” And I would add those medical doctors who believe that they and their brethren are the only ones in the world who know anything at all about health and healing. How narrow minded. How narcissistic. How limiting. It’s also certainly rather chilling to think about the escalation of narcissism in conjunction with the escalation in rates of obesity. Do we face a future of fat narcissists who most likely will have a very difficult time exerting self-control and will instead find reasons to justify their self-indulgent ways even more than the generations that preceded them? Perhaps instead of teaching kids to sing “I am special. Look at me,” we ought to be serenading them with the old show tune from Bye Bye Birdie: “Kids, what’s the matter with kids today?” — just to restore balance.

:hc

Sleep Hygiene—It’s an Ethnic Thing: Health Blog

April 10th, 2010

Bedtime Routines and Sleep

When it comes to snoozing, we know that age makes a difference, with kids needing more sleep than adults. But does ethnicity matter? Recently, the National Sleep Foundation, a nonprofit organization based in Washington, D.C., conducted a survey looking at just that issue. The survey asked 1,000 whites, African Americans, Asians, and Hispanics between the ages of 25 and 60 about their sleep and bedtime routines. Survey results showed that while all groups report that they don’t get enough sleep, there were interesting differences among the ethnicities.  

First, the similarities. In each of the four groups, six out of 10 individuals reported not getting enough sleep. (Hardly a surprise.) The average number of hours spent sleeping varied less than an hour from one ethnicity to the next, with Caucasians getting an average of six hours and 52 minutes a night.  African Americans reported about 40 minutes less, at 6 hours and 14 minutes.  Asians and Hispanics were in the middle, reporting averages of six hours and 48 minutes and six hours and 34 minutes respectively.

The chief differences among the groups resided in what kept them up late, versus what put them to sleep. Asians, for example, were the least likely to watch TV within one hour of bedtime every night (or almost every night) and were much more likely than the other groups to be on the computer or the Internet during The Late Show.  Blacks were much more likely than the other groups to report praying or doing other religious activity within one hour of bedtime, and Hispanics were much more likely than the other groups to be completing household chores during the hour before bed. Asians were the least likely of the groups to report consuming alcohol within one hour of bedtime.

Sexual activity before bed also varied among the groups. Ten percent of African Americans reported having sex before bed almost every night, compared to four percent of whites and only one percent of Asians. On the other hand, in all ethnic groups, a significant percentage reported often being too tired for sex. And who slept with whom (or what) also differed. Whites were most likely to sleep with a pet (16 percent, versus only two percent of Blacks and four percent of Asians); and 72 percent of whites reported sleeping with their significant other, a far higher percentage than in other groups. Among Hispanics, 54 percent slept with their significant other, compared to only 48 percent of Asians and African Americans. On the other hand, Hispanics and Asians were more likely than the others to share a bedroom with their children.

Interestingly, a segment within each ethnic group did report getting a good night’s sleep almost every night. These respondents, and particularly the African Americans among them, were more likely than those who did NOT report having a good night’s sleep to have done one of the following activities almost every night within an hour of going to bed: praying or engaging in some religious practice, listening to the radio or music, having sex, or exercising. Of these activities, the biggest help, by far, seemed to be engaging in religious practice.

As for what kept the respondents from being able to snooze, the survey found that about 20 percent of African-Americans, Whites, and Hispanics reported money worries as keeping them up at night, versus only nine percent of Asians. More African Americans also reported that what kept them up was worrying about losing their jobs, while more Hispanics lost sleep over health concerns. African Americans had more sleep apnea than other groups, and Whites reported the most insomnia, while Asians were the least likely to discuss sleep problems with a doctor.

Thomas J. Balkin, Ph.D., chairman of the National Sleep Foundation, said, “A significant proportion of all ethnic groups are experiencing sleepiness that impacts their day to day living.” Balkin also said that most people require seven to nine hours of sleep to feel rested.

Although, it’s hardly news that people aren’t getting enough sleep, the nine hour figure seems a bit high, especially considering that studies have shown that sleeping more than seven hours a night may be as deadly as not sleeping enough.

The experts put forth the usual tips for getting a good night’s sleep: leave worries at work, avoid alcohol, don’t eat right before bed, and so on. An interesting twist was offered by Dr. Frisca Yan-Go, MD, who directs the Sleep Disorders Center at Santa Monica-University. She explains that the reason it’s important to turn off the computer and TV a few hours before sleep is that, “The brightness will inhibit melatonin — it only secretes during darkness.” Melatonin is a hormone that is essential to sleep and a healthy immune system.

What’s more interesting, perhaps, is to take all the information gleaned from the study and form a composite picture of what makes for a good night’s sleep, regardless of ethnicity. Given that Caucasians get the most sleep of all the groups, and that Caucasians tend to sleep with a partner and a pet and no kids, there’s a clue. In fact, it would seem that the recipe for a good night’s sleep would be to kick out the kids and install a partner in the bed, pile on a poodle or a beagle and a cat or two, do a prayer session, have sex while listening to music, win the lotto so you don’t have to worry about money, and turn off the computer and the TV…and then tuck in.

:hc

Are Cruises Hazardous? Health Blog

April 3rd, 2010

Dangers of Cruise Ships

Cruising proponents tout the absolute relaxation onboard, the gorgeous ocean vistas, the fun of visiting many ports, and perhaps most of all, the meals. Where else but on a cruise can you eat breakfast, lunch, and dinner plus drink as much as you can manage day after day with nary a dish to wash nor morsel to prepare? The luxury of it all apparently seduces many into forgetting the calorie count. A study by a New York nutritionist found that people on cruises eat far more than at home — up to 4000 calories a day without blinking. In fact, the average cruise passenger packs on five pounds in a seven-day stint at sea.

But that’s not what this blog is about, because there’s another more acute danger posed by cruises. With a thousand or so people packed into confined, shared spaces, eating the same food, diseases have an ideal breeding ground. And so, the news periodically reports on a cruise that went awry when nearly everyone onboard got ill. 

The latest bad news cruise was on a Celebrity line boat roaming the Caribbean islands, when an outbreak of norovirus — a contagious bug that causes acute intestinal distress — put a damper on the fun. Apparently, 420 of the 1,800 passengers (more than 20 percent) and 27 crew members experienced stomach aches, vomiting, and diarrhea. And this was the third time in a row that this particular boat, the Mercury, set off on a cruise only to turn around when passengers experienced mass illness on board. To remedy the situation, Celebrity scrubbed the boat for three days straight. The magic apparently worked, because a fourth cruise made it back to port without problem.

More than 100 disease outbreaks have occurred on ships since 1970, and that number no doubt underestimates the real number because many outbreaks don’t get reported or even noticed. Passengers claim that when they came down with a stomach illness, they watched the medical crew record it as mere “motion sickness,” pointing to one way that stomach issues get underreported. But according to the World Health Organization, it’s not norovirus that’s the biggest pain in the gut — it’s contaminated cuisine and beverages.

“Most of the detected gastrointestinal disease outbreaks were associated with cruise ships and were linked to food or water consumed onboard ship,” says a WHO report. “Factors contributing to outbreaks included contaminated bunkered water, inadequate disinfection of potable water, potable water contaminated by sewage on ship [yuck], poor design and construction of potable water storage tanks, deficiencies in food handling, preparation, and cooking, and use of seawater in the galley.”

Although intestinal problems are the biggest complaint, outbreaks of other types of illnesses, including Legionnaires’Disease and several types of influenza, have ruined vacations for numerous passengers in recent years. To address the issue, the CDC has instituted a Vessel Sanitation Program. Among other things, it requires all ships to file a report when more than three percent of the passengers and crew get sick. The program does seem to be having an impact: only 13 outbreaks of disease were reported on US cruise ships in 2009, way down from 34 in 2006.

Most people who cruise each year manage to enjoy the experience with little more to worry about than the expanding waistline syndrome or getting sick. But getting sick while on a cruise is only half the problem! During a five-month period from April to August 2007, cruise ships reported 207 serious “incidents” to the FBI. These incidents included missing people presumed overboard, robberies, and sexual assaults. In fact, sexual assault is the most common crime reported on cruise ships. Of even greater concern is the increase in incidents of piracy. According to the International Maritime Bureau, piracy on the sea has tripled in the past 10 years, with more than 100 incidents reported in 2003 and 145 people killed, assaulted, kidnapped or reported missing in the first three months of that year. Most piracy occurs in the waters around Indonesia and on cargo ships, so the average cruise passenger has little to worry about in that regard, but still, it does add a pinch of excitement to the cruise knowing it’s remotely possible…no pun intended.

In fact, trouble is possible enough that the cruise industry spent $2.9 million on federal lobbying during a year-and-a-half period, raising concerns that the industry may not present the full picture of cruising dangers to the public. But the reality is that you’re probably going to enjoy your cruise without much to complain about other than warm beer and the annoying tourists seated at your table. Over 10 million Americans cruise annually and only a few thousand, at most, get sick or robbed. Unless you’re especially unlucky, the biggest danger, really, is the possibility that you’ll succumb to gluttony and suffer the health consequences.

:hc

Boredom Kills: Health Blog

March 18th, 2010

Boredom and Heart Problems

What’s wrong with being a boring kind of guy,” asked George Bush senior in 1988, back when he was running for president? As it turns out, a new study may have an answer for him. What’s wrong with being boring, as it turns out, is that if your boring demeanor doesn’t kill you, it might bore other people, which in turn could kill them — literally.

The study, out of University College in London and published in the International Journal of Epidemiology, found that bored people die earlier. The study included over 7,500 London civil servants aged 35 to 55 who completed questionnaires at several intervals back in the mid 1980’s. The questionnaires asked how much boredom the subjects had experienced at work in the previous month. Then 20 years later, the researchers tracked down the participants and discovered that the most bored among them had died from heart problems at two-and-a-half times the rate of those who hadn’t reported feeling bored.

A 250 percent jump in mortality by way of boredom is no small factor. If your job is so routine that you have trouble keeping your eyes open at your desk, you might consider filing for disability, before your early demise makes collecting funds unlikely. At the least, quitting may make sense. However, before you write your “Dear Boss” letter — know that the experts say it’s probably not the boredom per se that will shorten your life, but rather, it’s those things that boredom incites.

For one thing, it’s no secret that bored people often use food to jazz things up. The bored worker sits in the cubicle and tells himself, “If I just finish checking this account, then I can reward myself with a snack.” According to an article published in American Demographics, eating out of boredom is common enough that a study was commissioned to track the preferred treats of the bored in 2000, finding that 36 percent of bored people prefer chips to other snack foods. (And now we know why you can’t eat just one.) The easy access to vending machines, cafeterias, and snacks in the office lunchroom can make office environments particularly dangerous, eating-wise. Boredom also leads some to the bottle. In fact, a study back in 2007 found that most teens who drink do so out of boredom.

“Someone who is bored may not be motivated to eat well, exercise, and have a heart-healthy lifestyle. That may make them more likely to have a cardiovascular event,” said Dr. Christopher Cannon, of Harvard University and the American College of Cardiology.  In fact, the most bored subjects in the study tended to be far less active than the subjects who weren’t bored.  They also tended to be younger, in lower grades of employment, and more likely to report poor health at the outset.  Women reported boredom at twice the rate of men. (Hey guys, perhaps there’s now a life-affirming reason you can pitch your spouse for watching ultimate fighting on TV.)

This leads to some chicken-egg questions: does poor health and inactivity lead to boredom, or does boredom lead to lethargy, which in turn leads to poor health? Is boredom an outgrowth of having certain “glass half-empty” personality traits, or does it come from being relegated to low-grade, dead-end jobs? Certainly, more young women end up in tedious jobs compared to men, which may account for the elevated boredom levels among young women in the study. And in fact, when job grade was controlled for, the death-by-boredom factor became less significant, as it did when activity level was controlled.

Some theorists think the reason boredom kills goes beyond the fact that the bored tend to neglect themselves. Boredom expert Sandi Mann of the University of Central Lancashire believes that boredom comes from suppressing anger, which raises blood pressure and depresses the immune system. Dr. Cannon thinks boredom comes from depression, and depression is a known risk factor for cardiovascular problems. He also believes that boredom may trigger the release of dangerous hormones that stress the heart. Others blame disconnection and loneliness, which again trigger physical consequences. (Do you sometimes get the feeling that the so called experts have no idea what they’re talking about?)

In any event, the very fact that boredom at work seems to go hand-in-hand with inactivity, poor health, and early death is grist for the mill, making a case for instituting fitness programs at job sites, for varying work routines, and for monitoring employees (particularly young female employees) for levels of engagement.

:hc

Mutant Rabies Peril: Health Blog

March 11th, 2010

Rabies In Arizona

If this story was a Hollywood movie, it might open with armed men in white hazard suits scouting a desolate Arizona suburb, with corpses of people, foxes, skunks, and bats everywhere.  Cut to the edge of town, where a foam-mouthed fox with nasty intent trots crazily into the woods chasing down a small child.  The hero, sensing the evil about to be perpetrated, lifts his gun and fells the fox. Wait a second! I think I’ve seen that movie!

However Hollywood might treat this subject, National Geographic reports that the U.S. Centers for Disease Control and Prevention and other health officials are taking quite seriously the fact that an evolved strain of rabies has been found in skunks and foxes in suburban areas of Arizona. The officials are concerned for two reasons.  First, this strain of rabies seems to be mutating incredibly swiftly. Also, foxes and skunks have been passing the virus to their kin through simple social contact. This differs from the usual transmission method for “normal” rabies, which can only be passed from one animal to another through biting, or in rare cases, through direct contact with infected material that gets into the eyes, nose, mouth or an open wound.

According to Barbara Worgess, director of the Coconino County Health Department in Arizona, the report of the first skunk death due to rabies in 2001 was thought to be the result of a bat bite.  When other skunks started expiring from rabies, health officials became concerned and initiated a skunk vaccination program. Still, more skunks turned up rabid, and the officials were puzzled. “It shouldn’t have been able to pass from skunk to skunk,” said Worgess.  Later lab tests showed that the virus had become contagious within the species — that like with the common cold, just hanging out with an infected skunk put a healthy one at risk.  Now CDC studies confirm that the strain of rabies showing up in skunks and foxes is a mutated version of the one commonly found in bats, a mutation that occurred very quickly.  According to David Berman, the U. S. Department of Agriculture’s director for Arizona, “We’re watching evolution in action on the ground.”

The mutant rabies strain seems to be spreading rapidly, but what really has the officials nervous is the potential for it to jump species and pass on to humans. Given the mutation, you wouldn’t necessarily need to get bitten by a fox to catch the disease from him, nor would you need to bite your beloved, as in the shock horror film “Rabid”, to pass it along the human chain. According to Hinh Ly, a molecular virologist at the Emory University School of Medicine in Atlanta, this should be a “major concern.” The problem is that foxes range far and do well in habitats in and around suburban areas.  Skunks commonly live under houses in these same areas.  Since suburban sprawl has pushed considerable numbers of these animals into congested neighborhoods, the chances for contact between infected animals and pets and humans is real.

Of course, the disease also can be spread by bites (it is not uncommon for hikers to be attacked by rabid animals, for example). But even scarier is the fact that as more animals get infected and congregate, the possibility that the virus will mutate further increases, potentially spawning a new and more dangerous form that could spread across species.  

Officials in Arizona are on the case, trying to prevent an outbreak among pets and people. In the Flagstaff area, they declared a 90-day pet quarantine that required all dogs to be kept on leashes and all cats to be kept inside.  Unfortunately, funds to vaccinate wildlife have been cut due to the recession, as have funds for public vaccination programs. Meanwhile, it’s been an active year for “normal” rabies — even in places like New York City. Recently, 39 rabid raccoons turned up in Central Park and triggered the city to begin trapping the animals and vaccinating them.

By comparison to rabies, swine flu seems like a benign illness. Rabies causes pain, vomiting, insomnia, and the famous signs of fury — thrashing, unquenchable thirst, drooling, spasms, and aggression; and once symptoms appear, death is swift. But health officials don’t expect an imminent human pandemic, because unlike flu, rabies has a very long incubation period. It typically takes 30 to 60 days from the time of exposure to arrival of symptoms, giving individuals plenty of time to get vaccinated — if they know they’ve been exposed. That’s why only about five individuals die of normal rabies in the US annually, though 18,000 get exposed and seek treatment. In other words, most people know enough to get help if exposed to rabid animals or if they receive a bite, and the current treatment works. But what if the mutant strain crosses over to humans where infection doesn’t require a bite — merely social exposure? How would you know you need to get a shot then?

Should a new strain of the disease arise, the scientists may need to go back to the lab to develop something different. Meanwhile, it’s unlikely that you’ll have to evacuate your condo unit to avoid marauding hordes of rabid skunks any time soon. But down the road may be a different story.

:hc

Teens Increasingly Unstable: Health Blog

March 3rd, 2010

Teen Depression

“Adolescence is perhaps nature’s way of preparing parents to welcome the empty nest,” say Karen Savage and Patricia Adams in their book, The Good Stepmother. It’s certainly not news that teens tend to be difficult, moody, sulking, and generally not fun to be around. While parents of teens have wondered for decades if it could get any worse, a new study verifies that in fact, teens have more psychological problems today than they did years ago.  A new study of high school and college students has found that teens and young adults have become increasingly more depressed, unstable, and narcissistic today than they were 70 years ago.

The study, which involved researchers at five universities, analyzed psychological data compiled between 1938 and 2007 on over 77,000 high school and college students. The students all took the Minnesota Multiphasic Personality Inventory (MMPI), a personality test that diagnoses mental illness and personality structure. According to the results, kids today are far more troubled than they were back in 1938, during the great Depression. Six times as many youths today tested as clinically depressed compared to back then (six percent versus one percent), and six times as many registered as anxious (five percent in 1938, but a whopping 31 percent now). Another category with soaring rates was “psychopathic deviation.” This refers to a mild form of psychopathology in which individuals think rules don’t apply to them and so act accordingly. The percentage of youth currently in that category has risen to 24 percent from five percent in 1938. In fact, teens today surpassed their 1938 predecessors in virtually every mental illness category by an average of 500 percent, with 85 percent more youth today surpassing the average score for mental health problems compared to 1938.

The depression among youth contributes to the fact that suicide now ranks as the third leading cause of death among those aged 15 to 24, with the rate having tripled since 1970. The subjects reported feeling significantly more isolated, misunderstood, and emotionally sensitive or unstable than in the past. They also were more likely to report worry, sadness, and dissatisfaction with life, and to show signs of narcissism.

The experts say that the precipitous decline in mental health found by the study may seriously underestimate the true scope of the problem, because so many youth these days take antidepressants or anti-anxiety medication, which can mask symptoms.  “Those answering the survey might have had their mental state stabilized already by drugs,” the study authors write. Given that 10 percent of the population aged six and up now takes antidepressant medication, there might be something to that idea, except, as I’ve written before, half the studies on antidepressants have found that they do nothing to boost mood, and so their benefits are arguable. In fact, there’s evidence that antidepressants actually can increase depression and contribute to suicidal ideation among teens.

On or off of medication, it’s clear that teens these days aren’t feeling so good mentally. And to what do the experts attribute all of this degeneration? The lead researcher, Jean Twenge, of San Diego State University, took a hint from Michael Moore’s latest movie and blamed capitalism. “We have become a culture that focuses more on material things and less on relationships,” she writes. “These results suggest that as American culture has increasingly valued extrinsic and self-centered goals such as money and status, while increasingly devaluing community, affiliation, and finding meaning in life, the mental health of American youth has suffered.” In fact, UCLA’s annual survey of college freshmen found in 2008 that 77% of the respondents said it was “essential” or “very important” to be financially well off.

The authors also entertain the possibility that mental health suffers when the economy suffers, but in writing that, they clearly forgot that 1938 was the crest of the depression years, before the economy recovered. Clearly, young people were much happier then. In fact, I reported recently about studies showing that longevity and health actually improve when the economy slumps.

One theory blames parental stress, saying that parents are under so much pressure that they do a lousy job of bringing up kids. “They learn from those they love,” says Dr. Bruce Rabin of the University of Pittsburgh Medical Center. “…if role models are short tempered [or] tell children to leave them alone because they are under a lot of stress…there will be an effect on the child’s mental health development.”

Certainly studies support the idea that community isn’t what it once was. I reported previously on a study that showed that in 1984, the average person had three close confidants, but by 2004, the average person had zero. In spite of creating Facebook communities of hundreds or even thousands subscribers, many teens simply don’t connect in person the way they did in generations past. The quality of friendship isn’t the same.

I also just reported that kids these days spend an average of 13 hours daily connected to media — excluding homework time. This doesn’t leave much time for hanging out with pals…live. And, research shows strong links between depression and time spent immersed in media. One study last year found that each extra hour daily spent watching television boosts the odds of being depressed by eight percent. Part of the problem with the media overload is that it keeps lots of kids up late at night, and studies also show that less sleep correlates to more depression, with teens who go to bed past midnight 24 percent more likely to be depressed and 20 percent more likely to commit suicide compared to kids tucked in by 10.

In fact, there are scores of other theories being bandied about — expectations too high, expectations too low, too much praise, too little praise, and so on. There’s also plenty of evidence showing that eating junk foods and sweets and getting fat compromises mental health. At least on one point, though, the experts concur. In the words of the authors of the study, “Whether this trend has topped out or will continue upward remains to be seen, but these results suggest that the demand for mental health services is likely to increase in the coming decade.” That most likely means big business for the antidepressant manufacturers, given that treatment for mental health seems to increasingly be defined as a prescription for a happy pill…even if it mostly doesn’t work. As I’ve written before, recent trends have led antidepressant prescriptions to triple since 1988 while the percent of depressed patients seeing psychotherapists has declined dramatically.

:hc

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