Adults living with children eat more saturated fat -- the equivalent of nearly an entire frozen pepperoni pizza each week -- than do adults who do not live with children, according to a University of Iowa and University of Michigan Health System study.
This press release issued by Eurekalert says the finding was based on data from the federal government's National Health and Nutrition Examination Survey III. The UI-led study was made public Saturday, and the paper will appear in the Jan. 4, 2007, online edition of the Journal of the American Board of Family Medicine.
Most family diet studies have examined how adults influence children's eating habits, but few studies have considered how children or their habits may be associated with adults' food intake, said Helena Laroche, M.D., an associate in internal medicine and pediatrics at the University of Iowa Roy J. and Lucille A. Carver College of Medicine and the study's primary author.
"The analysis shows that adults' fat intake, particularly saturated fat, is higher for those who live with children compared to adults who don't live with children," Laroche said.
Saturday, December 30, 2006
FDA calls cloned meats, milk safe
By Jeremy Manier
Tribune staff reporter
Published December 28, 2006, 10:16 PM CST
Supporters of cloning livestock have maintained for years that meat and milk from cloned cattle look and taste the same as food that comes from animals made the old-fashioned way.
On Thursday the U.S. Food and Drug Administration took that claim a step further by issuing a report that concludes cloned animals are as safe to eat as ordinary livestock. The FDA's official risk assessment could clear the way within the next year for approval of food products from cloned animals and their offspring.
In fact, the scientific review was positive enough that the main bar to FDA authorization may be an American public that tends to view cloning as a suspect and troubling technology.
Groups that oppose putting cloned animals in the food supply slammed the FDA report, arguing that there's been little time to study long-term health effects of cloning or its effects on food. The first cloned mammal, Dolly the sheep, was born in 1996, and since then agricultural researchers have cloned pigs, cattle and goats, though always in small numbers.
The FDA's report concluded that studies have found no difference in the composition of food from cloned animals versus their normal counterparts.
"Meat and milk from clones and their offspring are as safe as food we eat every day," said Stephen Sundlof, director of the FDA's center for veterinary medicine.
Cloned animals are expensive to produce, and it's unlikely that significant amounts of meat or milk from such livestock would go directly into the food supply. Instead, agricultural companies envision cloning as a breeding tool. Breeders would clone prize specimens and then use each clone to yield offspring through conventional breeding techniques.
Concern over health issues
But consumer groups that oppose cloning said studies suggest the technique may result in health problems for some animals. Activists contend that some clones have weakened immune systems and may require more drugs to be free of disease-causing bacteria such as E. coli.
Many opponents also were troubled by the FDA's indication that it would not require labeling of food derived from cloned animals. A fact sheet the FDA provided for consumers states there is "no science-based reason" for using labels to identify food from clones.
Even if that's true, labeling "doesn't have to be for any scientific reasons," said Michael Hansen, senior scientist at Consumers Union, the non-profit organization that publishes Consumer Reports. Some consumers, he said, object to genetic tampering of any kind.
"A lot of people oppose cloning for [personal] reasons, and they'd want to know if this is in their food," he said. "Those reasons are perfectly valid."
Aware of the negative gut reaction many people have to using clones in the food supply, the FDA issued responses Thursday to what it called cloning myths. The agency's material compares clones to identical twins, describing the latter as "naturally occurring clones."
It's true that both clones and identical twins have duplicate complements of DNA, the chemical code that passes on inherited traits. But clones are produced quite differently than normal identical twins, and that technique is the source of researchers' questions about cloning's health effects.
Scientists make clones by removing the DNA from an egg cell and replacing it with DNA from the cell of an adult. The cloning process appears to reset the adult's genetic code so that it can execute the developmental program of an embryo, but that transformation may not be perfect in all cases. Some scientists believe the embryonic clone may use, or "express," its genes in ways that could affect the clone's health when it grows up.
Perhaps because of those differences in gene expression, most embryonic clones do not survive to birth, though experts say the rate has improved as researchers learn more.
Cloned cattle and sheep also are prone to a problem called large offspring syndrome, in which the fetus grows to an abnormally large size. But that issue is not unique to cloning; it also arises in animals produced by other techniques, such as in-vitro fertilization.
For the purposes of the FDA's risk analysis, the agency was especially interested in the composition of milk and meat taken from cloned animals. The agency looked at studies that compared clones with normal animals on numerous chemical measures, including levels of proteins, amino acids, fatty acids and vitamins. The data came from companies that are producing cloned animals, as well as from academic and government researchers.
'Identical to normal animals'
The comparisons showed that cloned animals were practically indistinguishable from ordinary ones, said Matthew Wheeler, a researcher in animal reproduction technology at the University of Illinois at Urbana-Champaign who was one of three external peer reviewers of the FDA report.
"It's quite clear that in the animals that were presented, the compositional analysis was identical to that of the normal animals," Wheeler said.
Wheeler agreed with critics of the FDA report that there should be more extensive studies on the safety of cloned food products, but he said it would be impractical to wait decades until all the results are in. He also said the FDA's critics are right about the need for labels.
"This technology does have some advantages, and I truly believe that, but I also think the public has a right to know," Wheeler said.
A taste of what might happen if cloned food products get final approval can be found in the freezers at Cyagra Inc., an Elizabethtown, Pa., company that has produced animal clones on a small scale since 2001. Steve Mower, director of marketing for the company, said he and his co-workers decided to try the meat themselves after the company slaughtered 11 cloned cattle as part of a meat analysis study.
"I've been eating cloned beef for two years now, and I can tell you there's no difference," Mower said. "I'm still as overweight now as I was then."
jmanier@tribune.com
jmanier@tribune.com
Tribune staff reporter
Published December 28, 2006, 10:16 PM CST
Supporters of cloning livestock have maintained for years that meat and milk from cloned cattle look and taste the same as food that comes from animals made the old-fashioned way.
On Thursday the U.S. Food and Drug Administration took that claim a step further by issuing a report that concludes cloned animals are as safe to eat as ordinary livestock. The FDA's official risk assessment could clear the way within the next year for approval of food products from cloned animals and their offspring.
In fact, the scientific review was positive enough that the main bar to FDA authorization may be an American public that tends to view cloning as a suspect and troubling technology.
Groups that oppose putting cloned animals in the food supply slammed the FDA report, arguing that there's been little time to study long-term health effects of cloning or its effects on food. The first cloned mammal, Dolly the sheep, was born in 1996, and since then agricultural researchers have cloned pigs, cattle and goats, though always in small numbers.
The FDA's report concluded that studies have found no difference in the composition of food from cloned animals versus their normal counterparts.
"Meat and milk from clones and their offspring are as safe as food we eat every day," said Stephen Sundlof, director of the FDA's center for veterinary medicine.
Cloned animals are expensive to produce, and it's unlikely that significant amounts of meat or milk from such livestock would go directly into the food supply. Instead, agricultural companies envision cloning as a breeding tool. Breeders would clone prize specimens and then use each clone to yield offspring through conventional breeding techniques.
Concern over health issues
But consumer groups that oppose cloning said studies suggest the technique may result in health problems for some animals. Activists contend that some clones have weakened immune systems and may require more drugs to be free of disease-causing bacteria such as E. coli.
Many opponents also were troubled by the FDA's indication that it would not require labeling of food derived from cloned animals. A fact sheet the FDA provided for consumers states there is "no science-based reason" for using labels to identify food from clones.
Even if that's true, labeling "doesn't have to be for any scientific reasons," said Michael Hansen, senior scientist at Consumers Union, the non-profit organization that publishes Consumer Reports. Some consumers, he said, object to genetic tampering of any kind.
"A lot of people oppose cloning for [personal] reasons, and they'd want to know if this is in their food," he said. "Those reasons are perfectly valid."
Aware of the negative gut reaction many people have to using clones in the food supply, the FDA issued responses Thursday to what it called cloning myths. The agency's material compares clones to identical twins, describing the latter as "naturally occurring clones."
It's true that both clones and identical twins have duplicate complements of DNA, the chemical code that passes on inherited traits. But clones are produced quite differently than normal identical twins, and that technique is the source of researchers' questions about cloning's health effects.
Scientists make clones by removing the DNA from an egg cell and replacing it with DNA from the cell of an adult. The cloning process appears to reset the adult's genetic code so that it can execute the developmental program of an embryo, but that transformation may not be perfect in all cases. Some scientists believe the embryonic clone may use, or "express," its genes in ways that could affect the clone's health when it grows up.
Perhaps because of those differences in gene expression, most embryonic clones do not survive to birth, though experts say the rate has improved as researchers learn more.
Cloned cattle and sheep also are prone to a problem called large offspring syndrome, in which the fetus grows to an abnormally large size. But that issue is not unique to cloning; it also arises in animals produced by other techniques, such as in-vitro fertilization.
For the purposes of the FDA's risk analysis, the agency was especially interested in the composition of milk and meat taken from cloned animals. The agency looked at studies that compared clones with normal animals on numerous chemical measures, including levels of proteins, amino acids, fatty acids and vitamins. The data came from companies that are producing cloned animals, as well as from academic and government researchers.
'Identical to normal animals'
The comparisons showed that cloned animals were practically indistinguishable from ordinary ones, said Matthew Wheeler, a researcher in animal reproduction technology at the University of Illinois at Urbana-Champaign who was one of three external peer reviewers of the FDA report.
"It's quite clear that in the animals that were presented, the compositional analysis was identical to that of the normal animals," Wheeler said.
Wheeler agreed with critics of the FDA report that there should be more extensive studies on the safety of cloned food products, but he said it would be impractical to wait decades until all the results are in. He also said the FDA's critics are right about the need for labels.
"This technology does have some advantages, and I truly believe that, but I also think the public has a right to know," Wheeler said.
A taste of what might happen if cloned food products get final approval can be found in the freezers at Cyagra Inc., an Elizabethtown, Pa., company that has produced animal clones on a small scale since 2001. Steve Mower, director of marketing for the company, said he and his co-workers decided to try the meat themselves after the company slaughtered 11 cloned cattle as part of a meat analysis study.
"I've been eating cloned beef for two years now, and I can tell you there's no difference," Mower said. "I'm still as overweight now as I was then."
jmanier@tribune.com
jmanier@tribune.com
Vietnam reports first suspected bird flu cases in humans in a year
HANOI, Vietnam: Four members of a family in southern Vietnam have been hospitalized with symptoms of bird flu, a doctor said Saturday, the first suspected human cases in the country in more than a year.
A 36-year-old woman and her three children aged three to 13 were admitted to Nam Can Hospital in Ca Mau province this past week with fevers, coughing, decreased white blood cells and damaged lungs, said Ho Van Van, a doctor at the hospital.
The family had four chickens and five ducks, and ate one of the chickens, which had fallen sick and died, on Dec. 23, he said.
Swab samples from the four patients are being tested for the deadly H5N1 strain of bird flu, Van said. Health officials have disinfected the family's house and neighborhood, he added.
Vietnam has been widely seen as a model for how to fight bird flu using extensive vaccinations of poultry, careful surveillance and slaughters of birds in affected areas.
However, earlier this month, it reported its first bird flu outbreaks in poultry in a year in Ca Mau and two other provinces in the Mekong Delta.
The outbreaks killed or forced the slaughter of more than 13,000 birds in the three provinces.
Prime Minister Nguyen Tan Dung decided on Friday to send 11 Cabinet members to the provinces to direct the fight against bird flu, Communist Party newspaper Nhan Dan (People) reported Saturday.
Vietnam has recorded at least 42 human deaths from the H5N1 virus since late 2003, according to the World Health Organization. The country's last reports human case was in November 2005.
At least 157 people out of 261 known to have been infected with H5N1 worldwide have died, WHO says.
Most of those who died came into direct contact with sick birds, but experts fear the virus could mutate into a form that can be easily passed among people, potentially sparking a pandemic.
A 36-year-old woman and her three children aged three to 13 were admitted to Nam Can Hospital in Ca Mau province this past week with fevers, coughing, decreased white blood cells and damaged lungs, said Ho Van Van, a doctor at the hospital.
The family had four chickens and five ducks, and ate one of the chickens, which had fallen sick and died, on Dec. 23, he said.
Swab samples from the four patients are being tested for the deadly H5N1 strain of bird flu, Van said. Health officials have disinfected the family's house and neighborhood, he added.
Vietnam has been widely seen as a model for how to fight bird flu using extensive vaccinations of poultry, careful surveillance and slaughters of birds in affected areas.
However, earlier this month, it reported its first bird flu outbreaks in poultry in a year in Ca Mau and two other provinces in the Mekong Delta.
The outbreaks killed or forced the slaughter of more than 13,000 birds in the three provinces.
Prime Minister Nguyen Tan Dung decided on Friday to send 11 Cabinet members to the provinces to direct the fight against bird flu, Communist Party newspaper Nhan Dan (People) reported Saturday.
Vietnam has recorded at least 42 human deaths from the H5N1 virus since late 2003, according to the World Health Organization. The country's last reports human case was in November 2005.
At least 157 people out of 261 known to have been infected with H5N1 worldwide have died, WHO says.
Most of those who died came into direct contact with sick birds, but experts fear the virus could mutate into a form that can be easily passed among people, potentially sparking a pandemic.
Gloves still off after fast-food health alert
Fast-food giant McDonald's is reviewing its food-handling procedures after a hepatitis A scare and claims by staff that workers aren't washing their hands as often as they should.
Health authorities were on high alert yesterday for a possible outbreak of infectious hepatitis A after a sick McDonald's worker handled food at one of Auckland's busiest restaurants.
The worker may have exposed hundreds of customers to the virus during an evening shift at the Greenlane restaurant just over a fortnight ago. He has been stood down but told he is welcome to return to work once he gets the all-clear.
No cases have been linked with the McDonald's worker, but public health officials have warned that anyone who ate at the restaurant on Friday, December 15, from 7pm to 2am, is at risk and should contact their doctor if they show any symptoms. The virus has a two-week incubation period.
The Auckland Regional Health Service said there was no reason to think McDonald's food-handling procedures had contributed to the health scare.
Five people have called a hotline set up for customers concerned they may have contracted the virus.
The scare has re-ignited the debate over whether fast-food staff should wear gloves. At McDonald's, only staff who handle raw meat have to wear them.
Auckland Medical Officer of Health Dr Greg Simmons and Otago University senior food science lecturer Dr David Everett both say gloves act as a barrier to germs and decrease the chances of hepatitis A being spread.
However, McDonald's is defending its food-handing practices, saying staff have to wash their hands every 20 to 30 minutes. But McDonald's workers spoken to yesterday by the Herald on Sunday said this seldom happened.
"We're being made to wash our hands every half an hour for 20 seconds today," said one employee. "But in all honesty, this wasn't going on as much as it should." Another admitted "it's a little unusual that we don't wear gloves".
When the Herald on Sunday visited Greenlane McDonald's yesterday there was little evidence of staff regularly washing their hands.
One worker was seen wiping her nose and then handling burger buns and lettuce. On other occasions, workers handling money also handled french fries.
McDonald's spokesman Mark Hawthorne said there were arguments for and against using gloves, and that was why the company was reviewing its food-handling procedures. If the review suggested McDonald's should bring in gloves for its 6000 New Zealand workers, that would be introduced within three to six months.
He said its research had shown that gloves did not establish an absolute barrier to contamination and in some cases could lead to a false sense of good hygiene.
Wearing gloves is not essential under New Zealand law, but hand washing is. The Food Hygiene Regulations 1974 specify hand washing as the main method of reducing the transfer of germs from hands to food. Food handlers also have to thoroughly wash their hands, even if they wear gloves.
The Food Safety Authority said improper glove use could be just as unhygienic as inadequate hand washing, as most gloves used for food preparation were permeable, allowing germs from dirty hands to escape through the gloves on to food. And glove wearers who could not feel food scraps or juice on their hands might wash their hands less frequently.
However, Everett said, fast-food workers rarely stuck to the rules about frequent hand washing.
Simmons said wearing gloves while handling food decreased the chances of hepatitis A being spread, as gloves acted as an extra layer of protection if faecal matter stuck to hands even after washing and drying.
"So in this situation, if you wore gloves for everything ... you could argue that gloves could have made a difference," he said.
However, he did not advocate a blanket policy for fast-food workers to wear gloves. Once people were wearing them, they thought they were bulletproof, he said.
Of all the fast-food chains in New Zealand, only Wendy's and Subway workers wear gloves on their food preparation line.
While there was no ongoing risk of hepatitis A at McDonald's Greenlane, Hawthorne said with 6000 workers in New Zealand there were always going to be slip-ups, but the company believed most staff followed its food-handling procedures.
McDonald's Greenlane customers spoken to yesterday were in favour of gloves for staff handling food. Regular customer Danny Dalauidao said his concern was that cashiers handling money were also handling food.
The Greenlane case is not the first time McDonald's has been in trouble over hepatitis A. In 2002 a Wisconsin restaurant was closed temporarily after a 19-year-old staff member was hospitalised because of the virus.
HEPATITIS A: THE FACTS
How it spreads: The disease is usually spread by consuming food or drink handled by someone infected with the disease.
Signs and symptoms: Fatigue, jaundice, loss of appetite, abdominal pain, nausea, fever, diarrhoea and dark urine.
Long-term effects: Hepatitis A symptoms may appear two to seven weeks after exposure to the infected source, but usually occur about four weeks after exposure. There are no chronic long-term effects from the disease, but around 15 per cent of people infected will have prolonged or relapsing symptoms over a 6 to 9 month period.
Prevention: The single most effective way to prevent the spread of the hepatitis A virus is careful hand washing after using the toilet. After a person recovers from hepatitis A, they are immune to it for life and do not continue to carry the virus.
Treatment: There are no special medicines or antibiotics that are used to treat people once the symptoms of hepatitis A have appeared. Although symptoms might take months to disappear completely, bed rest and plenty of fluids are all that are generally needed for recovery.
Health authorities were on high alert yesterday for a possible outbreak of infectious hepatitis A after a sick McDonald's worker handled food at one of Auckland's busiest restaurants.
The worker may have exposed hundreds of customers to the virus during an evening shift at the Greenlane restaurant just over a fortnight ago. He has been stood down but told he is welcome to return to work once he gets the all-clear.
No cases have been linked with the McDonald's worker, but public health officials have warned that anyone who ate at the restaurant on Friday, December 15, from 7pm to 2am, is at risk and should contact their doctor if they show any symptoms. The virus has a two-week incubation period.
The Auckland Regional Health Service said there was no reason to think McDonald's food-handling procedures had contributed to the health scare.
Five people have called a hotline set up for customers concerned they may have contracted the virus.
The scare has re-ignited the debate over whether fast-food staff should wear gloves. At McDonald's, only staff who handle raw meat have to wear them.
Auckland Medical Officer of Health Dr Greg Simmons and Otago University senior food science lecturer Dr David Everett both say gloves act as a barrier to germs and decrease the chances of hepatitis A being spread.
However, McDonald's is defending its food-handing practices, saying staff have to wash their hands every 20 to 30 minutes. But McDonald's workers spoken to yesterday by the Herald on Sunday said this seldom happened.
"We're being made to wash our hands every half an hour for 20 seconds today," said one employee. "But in all honesty, this wasn't going on as much as it should." Another admitted "it's a little unusual that we don't wear gloves".
When the Herald on Sunday visited Greenlane McDonald's yesterday there was little evidence of staff regularly washing their hands.
One worker was seen wiping her nose and then handling burger buns and lettuce. On other occasions, workers handling money also handled french fries.
McDonald's spokesman Mark Hawthorne said there were arguments for and against using gloves, and that was why the company was reviewing its food-handling procedures. If the review suggested McDonald's should bring in gloves for its 6000 New Zealand workers, that would be introduced within three to six months.
He said its research had shown that gloves did not establish an absolute barrier to contamination and in some cases could lead to a false sense of good hygiene.
Wearing gloves is not essential under New Zealand law, but hand washing is. The Food Hygiene Regulations 1974 specify hand washing as the main method of reducing the transfer of germs from hands to food. Food handlers also have to thoroughly wash their hands, even if they wear gloves.
The Food Safety Authority said improper glove use could be just as unhygienic as inadequate hand washing, as most gloves used for food preparation were permeable, allowing germs from dirty hands to escape through the gloves on to food. And glove wearers who could not feel food scraps or juice on their hands might wash their hands less frequently.
However, Everett said, fast-food workers rarely stuck to the rules about frequent hand washing.
Simmons said wearing gloves while handling food decreased the chances of hepatitis A being spread, as gloves acted as an extra layer of protection if faecal matter stuck to hands even after washing and drying.
"So in this situation, if you wore gloves for everything ... you could argue that gloves could have made a difference," he said.
However, he did not advocate a blanket policy for fast-food workers to wear gloves. Once people were wearing them, they thought they were bulletproof, he said.
Of all the fast-food chains in New Zealand, only Wendy's and Subway workers wear gloves on their food preparation line.
While there was no ongoing risk of hepatitis A at McDonald's Greenlane, Hawthorne said with 6000 workers in New Zealand there were always going to be slip-ups, but the company believed most staff followed its food-handling procedures.
McDonald's Greenlane customers spoken to yesterday were in favour of gloves for staff handling food. Regular customer Danny Dalauidao said his concern was that cashiers handling money were also handling food.
The Greenlane case is not the first time McDonald's has been in trouble over hepatitis A. In 2002 a Wisconsin restaurant was closed temporarily after a 19-year-old staff member was hospitalised because of the virus.
HEPATITIS A: THE FACTS
How it spreads: The disease is usually spread by consuming food or drink handled by someone infected with the disease.
Signs and symptoms: Fatigue, jaundice, loss of appetite, abdominal pain, nausea, fever, diarrhoea and dark urine.
Long-term effects: Hepatitis A symptoms may appear two to seven weeks after exposure to the infected source, but usually occur about four weeks after exposure. There are no chronic long-term effects from the disease, but around 15 per cent of people infected will have prolonged or relapsing symptoms over a 6 to 9 month period.
Prevention: The single most effective way to prevent the spread of the hepatitis A virus is careful hand washing after using the toilet. After a person recovers from hepatitis A, they are immune to it for life and do not continue to carry the virus.
Treatment: There are no special medicines or antibiotics that are used to treat people once the symptoms of hepatitis A have appeared. Although symptoms might take months to disappear completely, bed rest and plenty of fluids are all that are generally needed for recovery.
Sign-up push is on for health coverage
The state's landmark law to broaden healthcare coverage is about to face its biggest challenge: persuading about 100,000 uninsured Massachusetts residents to sign up for health insurance and pay part of the bill.
Starting Tuesday, individuals who earn between $9,804 and $29,412 annually can purchase subsidized health insurance called Commonwealth Care. Those who don't do so by July 1 will face penalties, including the loss of their personal state income tax deduction.
But getting them to pay for health coverage poses a marketing challenge for the four health plans that have exclusive rights to sell the subsidized insurance for three years under the law that was enacted in April. To entice residents to sign up, insurers are rolling out an advertising campaign that includes billboards and radio spots. They are also offering incentives such as gift cards to Target and Wal-Mart , discounts for Pilates and yoga classes, and reimbursement for Weight Watchers membership. And the state is planning to supplement the advertising with its own educational and outreach programs.
Lower-income residents' monthly premiums will depend on their income. Many low-wage earners have gotten by for years without insurance, relying instead on walk-in clinics and free emergency-room care. They may not want to pay for something that they have received at no cost.
"That will create a formidable marketing challenge for the four plans to explain this new program. It needs to be explained on an individual basis," said John E. McDonough , executive director of Health Care For All, an advocacy group that played a key role in shaping healthcare reform.
The plans selling the subsidized insurance are HealthNet, part of Boston Medical Center; Neighborhood Health Plan, which focuses on community health centers in the Boston region; Network Health, part of Cambridge Health Alliance, a regional system that serves low-income residents; and Fallon Community Health Plan, an HMO that is strongest in Worcester and surrounding communities. The basic elements of the plans are determined by the Commonwealth Health Insurance Connector Authority, which is overseeing implementation. The state has contact information for about 73,000 of the uninsured residents because they have previously received free care from hospitals or other providers. The Connector will mail letters to them over nine weeks starting Tuesday, informing them of the program and urging them to choose a plan.
Each insurer is required to offer three levels of coverage with the same mandated benefits. The least expensive level is for residents at the lower end of the income range and includes copayments of $10 or less for visits to doctors , $50 copays for hospital stays, and comprehensive prescription drug coverage. Other benefits of the basic package include ambulance service, comprehensive care for mental health and substance abuse, rehabilitation services for a variety of diseases, and free eyeglasses every two years.
"These plans are equivalent to anything you'd get in the commercial world," said Melissa Boudreault , director of Commonwealth Care for the connector.
Two more expensive subsidized plans are for residents with higher incomes. They provide the same benefits, but have additional out-of-pocket expenses.
Monthly premiums for those in the lowest income bracket range from $18 to $58, depending on which insurer they choose. Subscribers whose income is near the top of the subsidized-plan range will pay from $70 to $180 monthly. Family coverage is also available under the subsidized plans. For example, a family of four would qualify if its annual income is between $20,004 and $60,012.
The plans have already started promoting the new insurance. HealthNet has paid for billboard, bus, print, television, and radio advertising. In addition to traditional advertising, Network Health is working with community groups and charities, and reaching out to doctors who treat uninsured patients.
"You have a real challenge telling people who aren't insured what coverage is and why you should pay every single month even if you're not sick," said John Cragin , senior director of Commonwealth Care for Boston Medical Center/HealthNet. "But you're also trying to reach employees of companies that don't offer health insurance and part-timers earning between $20,000 and $30,000 who don't qualify for benefits."
Ultimately, the threat of penalties could make the difference in persuading many to sign up, said Michael Nickey , manager of Connector programs for Neighborhood Health Plan.
"These folks in general have a desire to be in the healthcare system," he said. "It's important to promote the importance of comprehensive healthcare. But if individuals don't have health insurance, there will be consequences to that, and it's an integral part of the law."
Despite the state mandates, the plans will be able to compete on three fronts:
The geographic networks of hospitals and clinics each provide. For instance, HealthNet has coverage throughout most of the state, while Fallon is mostly limited to central Massachusetts and some communities near Boston.
Prices. For instance, the basic-level plan in Greater Boston will cost $18 a month through HealthNet, but $58 through Neighborhood Health Plan.
Add-on health and wellness programs in all three levels of coverage.
Plan officials emphasized aspects of their insurance that they say will win them customers.
"We're the only Commonwealth Care plan that's available throughout the Commonwealth," said Cragin.
Deborah Enos , chief executive of Neighborhood Health Plan, said the insurer will provide its services largely through community health centers -- places where many potential members already go for care.
At Network Health, executive director Christina Severin said her company will focus on value and low premiums. It has the lowest or second-lowest prices for all levels of coverage.
Each plan is also striving to outdo the others by including features and programs that range from practical to gimmicky. Fallon will reimburse members up to $200 for health club memberships, Weight Watchers, yoga and Pilates classes, as well as offering chiropractic care.
Neighborhood Health Plan will give members their choice of a $25 gift card to CVS, Target, Walgreen's, Wal-Mart, and other retailers when they visit a doctor for the first time, and they will receive a $25 Stop and Shop gift card after completing a health questionnaire. Network Health will also hand out a $25 gift card for an initial doctor's visit, and a $10 gift card to Brooks Pharmacy for diabetes patients who get screenings.
The various strategies provide insight into the challenges of persuading low-income residents to start paying for health insurance.
"It's hard work," said Beth Helenius, Fallon's senior director of business and product development. "These people tend to wait until something is really wrong before they go to the doctor. It's going to take time before they take advantage of the benefits of being part of an insurance plan."
Jon Kingsdale , executive director of the Connector, said health insurance can be a tough sell.
"We'll be very interested to see how many of the eligible population we can reach, how many are interested and how many buy," he said. "You cannot underestimate how many times you have to hit people with a message before they hear it and respond to it."
But some are already encouraged by the initial response to the fully subsidized plans that went into effect in October and now cover about 29,000 residents of the estimated 47,000 whose annual incomes are below the federal poverty level.
"We've learned that it's really easy for people to critique the healthcare reform law," said Severin, of Network Health. "But we recently enrolled a 28-year-old who hadn't been to the doctor in 10 years. These people are thrilled with Commonwealth Care, and they think it's really meaningful to them."
Starting Tuesday, individuals who earn between $9,804 and $29,412 annually can purchase subsidized health insurance called Commonwealth Care. Those who don't do so by July 1 will face penalties, including the loss of their personal state income tax deduction.
But getting them to pay for health coverage poses a marketing challenge for the four health plans that have exclusive rights to sell the subsidized insurance for three years under the law that was enacted in April. To entice residents to sign up, insurers are rolling out an advertising campaign that includes billboards and radio spots. They are also offering incentives such as gift cards to Target and Wal-Mart , discounts for Pilates and yoga classes, and reimbursement for Weight Watchers membership. And the state is planning to supplement the advertising with its own educational and outreach programs.
Lower-income residents' monthly premiums will depend on their income. Many low-wage earners have gotten by for years without insurance, relying instead on walk-in clinics and free emergency-room care. They may not want to pay for something that they have received at no cost.
"That will create a formidable marketing challenge for the four plans to explain this new program. It needs to be explained on an individual basis," said John E. McDonough , executive director of Health Care For All, an advocacy group that played a key role in shaping healthcare reform.
The plans selling the subsidized insurance are HealthNet, part of Boston Medical Center; Neighborhood Health Plan, which focuses on community health centers in the Boston region; Network Health, part of Cambridge Health Alliance, a regional system that serves low-income residents; and Fallon Community Health Plan, an HMO that is strongest in Worcester and surrounding communities. The basic elements of the plans are determined by the Commonwealth Health Insurance Connector Authority, which is overseeing implementation. The state has contact information for about 73,000 of the uninsured residents because they have previously received free care from hospitals or other providers. The Connector will mail letters to them over nine weeks starting Tuesday, informing them of the program and urging them to choose a plan.
Each insurer is required to offer three levels of coverage with the same mandated benefits. The least expensive level is for residents at the lower end of the income range and includes copayments of $10 or less for visits to doctors , $50 copays for hospital stays, and comprehensive prescription drug coverage. Other benefits of the basic package include ambulance service, comprehensive care for mental health and substance abuse, rehabilitation services for a variety of diseases, and free eyeglasses every two years.
"These plans are equivalent to anything you'd get in the commercial world," said Melissa Boudreault , director of Commonwealth Care for the connector.
Two more expensive subsidized plans are for residents with higher incomes. They provide the same benefits, but have additional out-of-pocket expenses.
Monthly premiums for those in the lowest income bracket range from $18 to $58, depending on which insurer they choose. Subscribers whose income is near the top of the subsidized-plan range will pay from $70 to $180 monthly. Family coverage is also available under the subsidized plans. For example, a family of four would qualify if its annual income is between $20,004 and $60,012.
The plans have already started promoting the new insurance. HealthNet has paid for billboard, bus, print, television, and radio advertising. In addition to traditional advertising, Network Health is working with community groups and charities, and reaching out to doctors who treat uninsured patients.
"You have a real challenge telling people who aren't insured what coverage is and why you should pay every single month even if you're not sick," said John Cragin , senior director of Commonwealth Care for Boston Medical Center/HealthNet. "But you're also trying to reach employees of companies that don't offer health insurance and part-timers earning between $20,000 and $30,000 who don't qualify for benefits."
Ultimately, the threat of penalties could make the difference in persuading many to sign up, said Michael Nickey , manager of Connector programs for Neighborhood Health Plan.
"These folks in general have a desire to be in the healthcare system," he said. "It's important to promote the importance of comprehensive healthcare. But if individuals don't have health insurance, there will be consequences to that, and it's an integral part of the law."
Despite the state mandates, the plans will be able to compete on three fronts:
The geographic networks of hospitals and clinics each provide. For instance, HealthNet has coverage throughout most of the state, while Fallon is mostly limited to central Massachusetts and some communities near Boston.
Prices. For instance, the basic-level plan in Greater Boston will cost $18 a month through HealthNet, but $58 through Neighborhood Health Plan.
Add-on health and wellness programs in all three levels of coverage.
Plan officials emphasized aspects of their insurance that they say will win them customers.
"We're the only Commonwealth Care plan that's available throughout the Commonwealth," said Cragin.
Deborah Enos , chief executive of Neighborhood Health Plan, said the insurer will provide its services largely through community health centers -- places where many potential members already go for care.
At Network Health, executive director Christina Severin said her company will focus on value and low premiums. It has the lowest or second-lowest prices for all levels of coverage.
Each plan is also striving to outdo the others by including features and programs that range from practical to gimmicky. Fallon will reimburse members up to $200 for health club memberships, Weight Watchers, yoga and Pilates classes, as well as offering chiropractic care.
Neighborhood Health Plan will give members their choice of a $25 gift card to CVS, Target, Walgreen's, Wal-Mart, and other retailers when they visit a doctor for the first time, and they will receive a $25 Stop and Shop gift card after completing a health questionnaire. Network Health will also hand out a $25 gift card for an initial doctor's visit, and a $10 gift card to Brooks Pharmacy for diabetes patients who get screenings.
The various strategies provide insight into the challenges of persuading low-income residents to start paying for health insurance.
"It's hard work," said Beth Helenius, Fallon's senior director of business and product development. "These people tend to wait until something is really wrong before they go to the doctor. It's going to take time before they take advantage of the benefits of being part of an insurance plan."
Jon Kingsdale , executive director of the Connector, said health insurance can be a tough sell.
"We'll be very interested to see how many of the eligible population we can reach, how many are interested and how many buy," he said. "You cannot underestimate how many times you have to hit people with a message before they hear it and respond to it."
But some are already encouraged by the initial response to the fully subsidized plans that went into effect in October and now cover about 29,000 residents of the estimated 47,000 whose annual incomes are below the federal poverty level.
"We've learned that it's really easy for people to critique the healthcare reform law," said Severin, of Network Health. "But we recently enrolled a 28-year-old who hadn't been to the doctor in 10 years. These people are thrilled with Commonwealth Care, and they think it's really meaningful to them."
Alberta dad donates part of liver to toddler son; more donors needed
Markus DeJong sits up in his hospital bed, smiles and lifts his grey sweatshirt to reveal a scar that stretches wide across his little belly like the red outline of a rising sun.
The family calls his angry red stitches "train tracks." For the little two-year-old, they're a one-of-a-kind gift from Dad.
"No more owies," Markus told reporters Friday at the Stollery Children's Hospital, which has now completed 14 liver transplants on children this year but needs more donors at a time when help is dropping off.
His parents - Mark DeJong and Tanya Visser of Lethbridge, Alta. - said he was healthy at birth but after three weeks became irritable and wouldn't sleep.
The boy's skin colour was jaundiced and when it got worse, they sought help.
"He was green like Baby Hulk," said Tanya, holding her son at his bedside.
He was diagnosed with a tumour that kept growing and threatened to become cancerous. Time was a factor.
Mark, a 30-year-old oil worker in the southern Alberta city, said the waiting list for a donor was up to two years. Tests showed he was a compatible donor. He didn't hesitate to agree to the operation, which was done Nov. 6.
"It came to the time that they had to do it," he said. "His health could have faded quite drastically.
"The tumour was the size of a mandarin orange and it was pressing against the kidneys, causing blood-flow problems."
Part of Mark's liver was removed but will grow back in two months.
"It's the most fabulous gift that a parent could give at the holiday season. Markus got discharged out of hospital on Christmas Eve," said hepatologist Susan Gilmour, the doctor in charge.
Gilmour said while Markus will be on drugs the rest of his life to prevent his body from rejecting the transplant and must continually guard against infections, he should be able to lead a healthy, normal life.
"They're in preschool, they're in school, they're in swimming lessons, they belong to Cubs. We have patients who are on select hockey teams," she said.
Gilmour said the procedure is somewhat rare - only about one in four child patients have a parent who is compatible in blood and size to be able to donate a liver.
She said getting donors is still one of the big hurdles for the Stollery, which led the country with 20 child liver transplants in 2005 but still has a waiting list of 12 children in Western Canada and the North.
"Donation in the Alberta region has declined over the last one to three years," she said.
"That has its effect on adults in that they succumb to their liver disease. And for us in pediatrics, we're not able to transplant the children in the timely fashion that we'd like to. They get incredibly sick, they take longer to recover and we hope there's no permanent effects from getting that sick."
The liver is the most metabolically complex human organ. It fights infection, controls blood sugar, neutralizes toxins and builds proteins and hormones.
It is the only organ that can regenerate itself and will actually grow to the appropriate size for both donor and recipient.
In 2005 there were about 50 liver transplants done on children in Canada. The average number per year is 35 to 40.
The average wait time for liver transplants for children in the Edmonton health region is nine months. For adults in Canada it's about two years.
The latest data from the Canadian Institute for Health Information shows that 3,914 patients were on waiting lists for an organ at the end of 2003, a slight decrease from the start of the decade. Patients waiting for a kidney transplant comprised three quarters of the waiting list.
The data showed that 250 patients - the equivalent of five a week - died while waiting for new organs, including 100 waiting for a liver.
-
Facts on the liver from the Canadian Liver Foundation:
-The liver is the largest and most metabolically complex organ in humans.
-The liver performs over 500 different functions including fighting off infection, neutralizing toxins, manufacturing proteins and hormones, controlling blood sugar and helping to clot the blood.
-It is the only organ that can regenerate itself thus making it possible for one person to donate part of their liver to another person. When a portion of the liver is transplanted, the donor's liver will regenerate back to its original size while the transplanted portion will grow to the appropriate size for the recipient.
-At any one time, the liver contains 10 per cent of the blood in your body.
-Dr. Thomas E. Starzl performed the first human liver transplant in 1963 at the University of Colorado Medical School.
-The first liver transplant in Canada was performed by Dr. Pierre Daloze in Montreal in 1970.
-For the Greeks, the liver was considered the seat of the emotions. They examined the livers of sacrificed oxen or goats to determine whether their military campaigns would succeed. They viewed the liver as being the organ in closest contact with divinity.
The family calls his angry red stitches "train tracks." For the little two-year-old, they're a one-of-a-kind gift from Dad.
"No more owies," Markus told reporters Friday at the Stollery Children's Hospital, which has now completed 14 liver transplants on children this year but needs more donors at a time when help is dropping off.
His parents - Mark DeJong and Tanya Visser of Lethbridge, Alta. - said he was healthy at birth but after three weeks became irritable and wouldn't sleep.
The boy's skin colour was jaundiced and when it got worse, they sought help.
"He was green like Baby Hulk," said Tanya, holding her son at his bedside.
He was diagnosed with a tumour that kept growing and threatened to become cancerous. Time was a factor.
Mark, a 30-year-old oil worker in the southern Alberta city, said the waiting list for a donor was up to two years. Tests showed he was a compatible donor. He didn't hesitate to agree to the operation, which was done Nov. 6.
"It came to the time that they had to do it," he said. "His health could have faded quite drastically.
"The tumour was the size of a mandarin orange and it was pressing against the kidneys, causing blood-flow problems."
Part of Mark's liver was removed but will grow back in two months.
"It's the most fabulous gift that a parent could give at the holiday season. Markus got discharged out of hospital on Christmas Eve," said hepatologist Susan Gilmour, the doctor in charge.
Gilmour said while Markus will be on drugs the rest of his life to prevent his body from rejecting the transplant and must continually guard against infections, he should be able to lead a healthy, normal life.
"They're in preschool, they're in school, they're in swimming lessons, they belong to Cubs. We have patients who are on select hockey teams," she said.
Gilmour said the procedure is somewhat rare - only about one in four child patients have a parent who is compatible in blood and size to be able to donate a liver.
She said getting donors is still one of the big hurdles for the Stollery, which led the country with 20 child liver transplants in 2005 but still has a waiting list of 12 children in Western Canada and the North.
"Donation in the Alberta region has declined over the last one to three years," she said.
"That has its effect on adults in that they succumb to their liver disease. And for us in pediatrics, we're not able to transplant the children in the timely fashion that we'd like to. They get incredibly sick, they take longer to recover and we hope there's no permanent effects from getting that sick."
The liver is the most metabolically complex human organ. It fights infection, controls blood sugar, neutralizes toxins and builds proteins and hormones.
It is the only organ that can regenerate itself and will actually grow to the appropriate size for both donor and recipient.
In 2005 there were about 50 liver transplants done on children in Canada. The average number per year is 35 to 40.
The average wait time for liver transplants for children in the Edmonton health region is nine months. For adults in Canada it's about two years.
The latest data from the Canadian Institute for Health Information shows that 3,914 patients were on waiting lists for an organ at the end of 2003, a slight decrease from the start of the decade. Patients waiting for a kidney transplant comprised three quarters of the waiting list.
The data showed that 250 patients - the equivalent of five a week - died while waiting for new organs, including 100 waiting for a liver.
-
Facts on the liver from the Canadian Liver Foundation:
-The liver is the largest and most metabolically complex organ in humans.
-The liver performs over 500 different functions including fighting off infection, neutralizing toxins, manufacturing proteins and hormones, controlling blood sugar and helping to clot the blood.
-It is the only organ that can regenerate itself thus making it possible for one person to donate part of their liver to another person. When a portion of the liver is transplanted, the donor's liver will regenerate back to its original size while the transplanted portion will grow to the appropriate size for the recipient.
-At any one time, the liver contains 10 per cent of the blood in your body.
-Dr. Thomas E. Starzl performed the first human liver transplant in 1963 at the University of Colorado Medical School.
-The first liver transplant in Canada was performed by Dr. Pierre Daloze in Montreal in 1970.
-For the Greeks, the liver was considered the seat of the emotions. They examined the livers of sacrificed oxen or goats to determine whether their military campaigns would succeed. They viewed the liver as being the organ in closest contact with divinity.
USC transplants have worst death rates in U.S.
The University of Southern California (USC) Hospital has among the worst death rates in liver transplants throughout the country, it was reported on Friday.
The hospital liver transplant program used to be among the best hospitals in liver transplants after its launch in 1996, the Los Angeles Times said.
In a span of two and a half years, 38 of 164 USC Hospital liver patients died within a year of their transplants, twice as many as expected, according to the most recent national data, the paper said.
The data largely factor in the condition of patients and donated organs.
The reasons for USC's declining success rate -- the death rate began climbing in 2003 -- remain largely a mystery, The Times reported.
Prompted by an article in The Times in July, regulators and outside experts hired by the hospital are investigating.
There are several possible explanations: It could be that the program was choosing the wrong patients for transplants or using organs of poor quality, according to the paper. It could be that the team mishandled surgeries or follow-up care. Or it could be a combination of reasons, including bad luck.
Officials at USC's Keck School of Medicine, which runs the clinical side of the program, and at the hospital, owned by Tenet Healthcare Corp., declined to be interviewed, The Times reported.
But in a joint statement in September, both pointed to an answer: They were consciously taking high-risk patients to provide extremely sick people with "a chance at life despite the risks of lowering our survival statistics".
The program appears to have gone too far, according to top transplant experts who reviewed medical records for The Times.
"They're pushing it as hard as they can and having the results that you'd expect to see," Dr. David Mulligan, chairman of transplant surgery at Mayo Clinic Hospital in Phoenix, Arizona who also sits on the board of a national oversight group, told The Times.
The hospital liver transplant program used to be among the best hospitals in liver transplants after its launch in 1996, the Los Angeles Times said.
In a span of two and a half years, 38 of 164 USC Hospital liver patients died within a year of their transplants, twice as many as expected, according to the most recent national data, the paper said.
The data largely factor in the condition of patients and donated organs.
The reasons for USC's declining success rate -- the death rate began climbing in 2003 -- remain largely a mystery, The Times reported.
Prompted by an article in The Times in July, regulators and outside experts hired by the hospital are investigating.
There are several possible explanations: It could be that the program was choosing the wrong patients for transplants or using organs of poor quality, according to the paper. It could be that the team mishandled surgeries or follow-up care. Or it could be a combination of reasons, including bad luck.
Officials at USC's Keck School of Medicine, which runs the clinical side of the program, and at the hospital, owned by Tenet Healthcare Corp., declined to be interviewed, The Times reported.
But in a joint statement in September, both pointed to an answer: They were consciously taking high-risk patients to provide extremely sick people with "a chance at life despite the risks of lowering our survival statistics".
The program appears to have gone too far, according to top transplant experts who reviewed medical records for The Times.
"They're pushing it as hard as they can and having the results that you'd expect to see," Dr. David Mulligan, chairman of transplant surgery at Mayo Clinic Hospital in Phoenix, Arizona who also sits on the board of a national oversight group, told The Times.
Pet owners report poorer health: study
Pet owners are often thought of as energetic folks who play with their pooches, but researchers in Finland found they are actually less healthy than people without pets.
Researchers at the University of Turku found the result in a population study of more than 21,000 working-aged people.
Pet owners smoked slightly more often and exercised less often than those who did not have pets, the team reports in this week's online issue of PloS One.
Dog owners exercised more than those without dogs, but this did not have an effect on their body mass index.
Pet ownership was most common among people aged 40 or older, who tend to settle down as couples in single family homes. They were also slightly more likely to have a low social standing or education.
Among people working in agriculture, four out of five had a pet, compared with 41 per cent for other occupations.
Pet owners reported poorer health, including high blood pressure, diabetes, ulcer, sciatica, migraine, depression and panic attacks. Socio-demographic differences and risk factors explained the differences between the two groups, the researchers said.
"Pet owners had a slightly higher BMI than the rest, which indicates that people having a pet (particularly a dog) could use some exercise," the team concluded.
"A great challenge is awaiting public health workers in making a combined exercise and nutrition program for the kind of middle-aged population group that has established itself in life, has a low level of basic education, and owns the most pets, particularly living in rural locations."
In contrast, an earlier study of rural residents by researchers at the University of Guelph concluded pet owners tended to be younger, currently married or living with someone and more physically active than non-pet owners.
Pet ownership seemed to be tied to maintaining or slightly increasing levels of physical health, based on a test of the ability to perform daily tasks.
The relationship between pet ownership and well-being was more complex for older people, the team concluded in a 1999 issue of the Journal of the American Geriatrics Society.
At the Atlantic Veterinary College, researchers are testing whether fitting overweight dogs with pedometers will motivate dog owners to get more exercise for their pets and themselves.
Researchers at the University of Turku found the result in a population study of more than 21,000 working-aged people.
Pet owners smoked slightly more often and exercised less often than those who did not have pets, the team reports in this week's online issue of PloS One.
Dog owners exercised more than those without dogs, but this did not have an effect on their body mass index.
Pet ownership was most common among people aged 40 or older, who tend to settle down as couples in single family homes. They were also slightly more likely to have a low social standing or education.
Among people working in agriculture, four out of five had a pet, compared with 41 per cent for other occupations.
Pet owners reported poorer health, including high blood pressure, diabetes, ulcer, sciatica, migraine, depression and panic attacks. Socio-demographic differences and risk factors explained the differences between the two groups, the researchers said.
"Pet owners had a slightly higher BMI than the rest, which indicates that people having a pet (particularly a dog) could use some exercise," the team concluded.
"A great challenge is awaiting public health workers in making a combined exercise and nutrition program for the kind of middle-aged population group that has established itself in life, has a low level of basic education, and owns the most pets, particularly living in rural locations."
In contrast, an earlier study of rural residents by researchers at the University of Guelph concluded pet owners tended to be younger, currently married or living with someone and more physically active than non-pet owners.
Pet ownership seemed to be tied to maintaining or slightly increasing levels of physical health, based on a test of the ability to perform daily tasks.
The relationship between pet ownership and well-being was more complex for older people, the team concluded in a 1999 issue of the Journal of the American Geriatrics Society.
At the Atlantic Veterinary College, researchers are testing whether fitting overweight dogs with pedometers will motivate dog owners to get more exercise for their pets and themselves.
Rival to IVF 'is safer and cheaper'
Women who have difficulty conceiving will be able to benefit from a new method of IVF that is cheaper and safer than conventional fertility treatments, doctors say.
Clinical trials in Denmark have shown that a pioneering technique known as in-vitro maturation (IVM) has a success rate of 30 per cent, comparable to standard IVF procedures. The patient, however, does not have to take expensive fertility drugs that can carry serious side-effects.
With conventional IVF doctors stimulate the release of mature eggs using hormone drugs and collect them during a woman’s monthly cycle before fertilising them in the laboratory with a man’s sperm.
The IVM method involves taking undeveloped eggs from ovaries and maturing them in the laboratory before fertilisation, while using hardly any drugs or no drugs at all.
More than 400 healthy babies have so far been born to women using the technique, which could reduce the cost of fertility treatment by up to half and give thousands more women the chance to conceive.
Professor Svend Lindenberg, a Danish scientist who has helped more than 1,000 women become pregnant using IVM, told a London fertility conference that the process had now achieved “stunning results”.
“We have demonstrated that it is possible to take an egg and fertilise it without having to use the heavy-duty drug approach,” he said. “We are achieving results that are better than nature and as good as high-stimulation IVF, without the risk of potentially life-threatening ovarian hyperstimulation and, of course, saving thousands of pounds per cycle in the cost of drugs.”
Professor Lindenberg, who works at the Nordica Fertility Centre in Copenhagen, explained: “We give a very low dose of a stimulating drug for three days early in the cycle and rescue up to ten eggs. For the first 24 hours a tiny amount of stimulating hormone is added to the culture, in fact one hundreth of the dose the woman would receive, and after that the eggs go on to mature in the culture alone.”
Under present IVF methods many women have been reluctant to donate their eggs for IVF because the drugs they must take can lead to life-threatening complications and an increased risk of cancer.
The demand for donor eggs is huge — potential recipients outnumber donors by two to one in Britain. In Denmark the move to IVM has been driven by women who are reluctant to take drugs, often because the problem lies with the male partner and not themselves, Professor Lindenberg said.
The technique is not suitable for all women; it works best in those who are under 37 years of age, have regular cycles or polycystic ovary syndrome, where women frequently fail to ovulate naturally. “This is part of a worldwide move against high-dose stimulation IVF,” Professor Lindenberg said. There was now no excuse to continue giving women high dosages of stimulation to the detriment of their health and their financial and emotional wellbeing.
IVM has previously been successful in creating animal embryos but the process has only recently been tried on human eggs. It was originally developed by Bob Edwards who, with Patrick Steptoe, were resposible for Louise Brown, the world’s first IVF baby.
It has been made easier by the development of finer needles to aspirate the eggs from an ovary and new scanning techniques that now show doctors the best follicles to select when seeking eggs to remove.
Clinical trials in Denmark have shown that a pioneering technique known as in-vitro maturation (IVM) has a success rate of 30 per cent, comparable to standard IVF procedures. The patient, however, does not have to take expensive fertility drugs that can carry serious side-effects.
With conventional IVF doctors stimulate the release of mature eggs using hormone drugs and collect them during a woman’s monthly cycle before fertilising them in the laboratory with a man’s sperm.
The IVM method involves taking undeveloped eggs from ovaries and maturing them in the laboratory before fertilisation, while using hardly any drugs or no drugs at all.
More than 400 healthy babies have so far been born to women using the technique, which could reduce the cost of fertility treatment by up to half and give thousands more women the chance to conceive.
Professor Svend Lindenberg, a Danish scientist who has helped more than 1,000 women become pregnant using IVM, told a London fertility conference that the process had now achieved “stunning results”.
“We have demonstrated that it is possible to take an egg and fertilise it without having to use the heavy-duty drug approach,” he said. “We are achieving results that are better than nature and as good as high-stimulation IVF, without the risk of potentially life-threatening ovarian hyperstimulation and, of course, saving thousands of pounds per cycle in the cost of drugs.”
Professor Lindenberg, who works at the Nordica Fertility Centre in Copenhagen, explained: “We give a very low dose of a stimulating drug for three days early in the cycle and rescue up to ten eggs. For the first 24 hours a tiny amount of stimulating hormone is added to the culture, in fact one hundreth of the dose the woman would receive, and after that the eggs go on to mature in the culture alone.”
Under present IVF methods many women have been reluctant to donate their eggs for IVF because the drugs they must take can lead to life-threatening complications and an increased risk of cancer.
The demand for donor eggs is huge — potential recipients outnumber donors by two to one in Britain. In Denmark the move to IVM has been driven by women who are reluctant to take drugs, often because the problem lies with the male partner and not themselves, Professor Lindenberg said.
The technique is not suitable for all women; it works best in those who are under 37 years of age, have regular cycles or polycystic ovary syndrome, where women frequently fail to ovulate naturally. “This is part of a worldwide move against high-dose stimulation IVF,” Professor Lindenberg said. There was now no excuse to continue giving women high dosages of stimulation to the detriment of their health and their financial and emotional wellbeing.
IVM has previously been successful in creating animal embryos but the process has only recently been tried on human eggs. It was originally developed by Bob Edwards who, with Patrick Steptoe, were resposible for Louise Brown, the world’s first IVF baby.
It has been made easier by the development of finer needles to aspirate the eggs from an ovary and new scanning techniques that now show doctors the best follicles to select when seeking eggs to remove.
Kenya: Rift Valley Fever Claims 9 More Lives
Victor Obure
Nairobi
The killer Rift Valley fever has claimed nine more lives in Garissa District, pushing the death toll to 31 in a span of two weeks.
The fast rising fatalities forced Government officials in the area to close all slaughterhouses in North Eastern Province, where quarantine is already in place to avert further spread of the disease.
The latest victims of the highly contagious viral disease died in remote locations while grazing their livestock, amid fears that the outbreak might have spread to neighbouring districts.
Four herdsmen died in Ijara District while three others lost their lives moments after being ferried on donkey carts to Liboi health centre.
Fresh records indicated that three herdsmen collapsed and bled to death in Sangailu, while another one with symptoms of the killer disease died in Hulugho division.
Two victims died at an isolation ward at the Garissa Provincial General Hospital, where 12 others are admitted.
A military helicopter was deployed to airlift patients from remote and inaccessible areas. North Eastern Provincial medical officer of health, Dr Omar Ahmed, confirmed the latest deaths, adding that four out of the nine patients put under observation at Ijara District hospital died on Thursday morning.
Dr Ahmed also expressed fears that the disease was fast spreading into urban centres, including Garissa municipality, after two cases were reported at Iftin sub district hospital in Central division.
Consumption of animal products going on
The veterinary department also raised alarm over possible spread of the disease to neighbouring Wajir District after several animals were reported to have died from the disease.
And as the death toll rose, consumption of animal products went on unabated in major towns in northern Kenya as some hotel owners knowingly or unknowingly disregarded the directive.
This forced Garissa District Commissioner, Mr Joseph Imbwaga, to convene an impromptu public meeting to sensitise residents on the importance of observing the ban.
Area leaders including Assistant minister for Home affairs, Mr Hussein Maalim, and Garissa Mayor, Mr Siyat Osman, on Thursday mobilised civic leaders to propagate an awareness campaign on the outbreak. The leaders also called on President Kibaki to declare the current outbreak, coupled by floods in the area, a national disaster since pastoralists were about to starve following a ban on their staple diets.
Nairobi
The killer Rift Valley fever has claimed nine more lives in Garissa District, pushing the death toll to 31 in a span of two weeks.
The fast rising fatalities forced Government officials in the area to close all slaughterhouses in North Eastern Province, where quarantine is already in place to avert further spread of the disease.
The latest victims of the highly contagious viral disease died in remote locations while grazing their livestock, amid fears that the outbreak might have spread to neighbouring districts.
Four herdsmen died in Ijara District while three others lost their lives moments after being ferried on donkey carts to Liboi health centre.
Fresh records indicated that three herdsmen collapsed and bled to death in Sangailu, while another one with symptoms of the killer disease died in Hulugho division.
Two victims died at an isolation ward at the Garissa Provincial General Hospital, where 12 others are admitted.
A military helicopter was deployed to airlift patients from remote and inaccessible areas. North Eastern Provincial medical officer of health, Dr Omar Ahmed, confirmed the latest deaths, adding that four out of the nine patients put under observation at Ijara District hospital died on Thursday morning.
Dr Ahmed also expressed fears that the disease was fast spreading into urban centres, including Garissa municipality, after two cases were reported at Iftin sub district hospital in Central division.
Consumption of animal products going on
The veterinary department also raised alarm over possible spread of the disease to neighbouring Wajir District after several animals were reported to have died from the disease.
And as the death toll rose, consumption of animal products went on unabated in major towns in northern Kenya as some hotel owners knowingly or unknowingly disregarded the directive.
This forced Garissa District Commissioner, Mr Joseph Imbwaga, to convene an impromptu public meeting to sensitise residents on the importance of observing the ban.
Area leaders including Assistant minister for Home affairs, Mr Hussein Maalim, and Garissa Mayor, Mr Siyat Osman, on Thursday mobilised civic leaders to propagate an awareness campaign on the outbreak. The leaders also called on President Kibaki to declare the current outbreak, coupled by floods in the area, a national disaster since pastoralists were about to starve following a ban on their staple diets.
Beneficiaries Act As Medicare Drug Enrollment Deadline Ends
Medicare Enrollment Deadline
As the December 31 deadline looms for people with Medicare to change or choose their health and drug coverage, tens of thousands of beneficiaries are taking action daily to review their current coverage and make any necessary changes for 2007. With only three days left during open enrollment, Medicare is urging people who did not enroll in a plan before or who need to make a change in their current coverage to do so as soon as possible to minimize inconvenience at the pharmacy in January.
"We continue to urge all people with Medicare to focus on Open Enrollment and compare the cost, coverage and their satisfaction with their current 2006 plan with their 2007 options. If the beneficiary is satisfied with their current plan's benefits in 2007 after comparing it with other plans, they don't need to do anything. If they find other options that better meet their needs, there is still time to change," said Leslie V. Norwalk, Acting Administrator for the Centers for Medicare & Medicaid Services (CMS). "Many are taking action now with the assistance of thousands of our partners across the country, with assistance from family and friends, and with our important resources at 1-800-Medicare and www.Medicare.gov It can't be emphasized enough: this is an important time for beneficiaries to make the most of their Medicare for 2007."
Throughout the Open Enrollment Period there continues to be a high level of activity on 1-800-MEDICARE and at the thousands of counseling events around the country. To sustain awareness, CMS is executing a multi-faceted outreach campaign nationally and locally to ensure that people with Medicare receive personalized assistance to make a confident decision in health and drug coverage plan selection.
Medicare enrollment opportunities are many and varied:
* Online: Since November 15, the Medicare Online Enrollment Center has processed more than 280,000 enrollments as of December 27th. There have been 61 million page views on Medicare.gov since October 15th, or about 1 million per day, and 30 million page views of the Plan Finder during that time.
* In-person: in more than 12,700 events nationwide, Medicare has been working closely with its partners across the country to provide counseling opportunities where people with Medicare live, work, play and pray. As part of its "Check-Up Season," CMS has partnered with faith-based communities to conduct education and health events at houses of worship. The Medicare "Mobile Office Tour" also continues, logging more than 70,000 miles to 165 cities with more than 200 stops since the tour began September 1. These events also highlight the preventive services available through Medicare, including flu and pneumococcal shots and diabetes screenings.
* At the pharmacy: national and local chain and independent pharmacies are working closely with CMS to provide assistance and information during the Open Enrollment period. Some examples include:
Thousands of individual independently owned and operated pharmacies providing assistance to beneficiaries across the country through in-store informational days, medication reviews and community presentations.
o CVS: Medicare Tuesdays—More than 40,000 in-store informational sessions during Open Enrollment; during the initial enrollment period more than 1 million seniors attended Medicare Tuesday events.
o Kroger: CMS-trained pharmacists are assisting customers in comparing plan options.
o Medicine Shoppe International: Providing outreach within many local communities, including senior centers, assisted living and long-term care facilities.
o Rite Aid: All 9,000 pharmacists are specially trained on Medicare Part D to help seniors and caregivers navigate plan options.
o Walgreens: Planned more than 34,000 in-store education events, 700 community events and targeted Part D mailings during Open Enrollment.
o Wal-Mart: Providing more than 4,000 in-store and community outreach events as well as a one-minute consult guide for pharmacists; also designating a Part D specialist at each store pharmacy counter.
On the phone: 1-800-MEDICARE continues to be an important 24/7 source for personalized assistance during Open Enrollment. Since November 15, Customer Service Representatives received more than 5 million calls to 1-800-MEDICARE as of December 27th.
In addition, CMS is taking immediate action to ensure that beneficiaries who did not receive timely information from their current prescription drug plans will be given additional time to compare their 2006 and 2007 coverage and cost details and change plans if they choose. CMS is extending the enrollment period for the affected beneficiaries because the agency's top priority is ensuring that all beneficiaries have sufficient time and information to compare the cost and coverage of their 2006 and 2007 plans and make an informed decision about what plan best meets their needs. Affected beneficiaries will receive a letter from their current plan informing them that they will be able to change their plan if they so choose--anytime between January 1, 2007 and February 15, 2007.
"While independent surveys indicate people with Medicare are very satisfied with their current coverage, our goal during this time is to get people with Medicare to focus on getting the most out of their Medicare benefits and to use all of the information and sources of assistance possible to make informed and confident decisions," stated Norwalk.
As the December 31 deadline looms for people with Medicare to change or choose their health and drug coverage, tens of thousands of beneficiaries are taking action daily to review their current coverage and make any necessary changes for 2007. With only three days left during open enrollment, Medicare is urging people who did not enroll in a plan before or who need to make a change in their current coverage to do so as soon as possible to minimize inconvenience at the pharmacy in January.
"We continue to urge all people with Medicare to focus on Open Enrollment and compare the cost, coverage and their satisfaction with their current 2006 plan with their 2007 options. If the beneficiary is satisfied with their current plan's benefits in 2007 after comparing it with other plans, they don't need to do anything. If they find other options that better meet their needs, there is still time to change," said Leslie V. Norwalk, Acting Administrator for the Centers for Medicare & Medicaid Services (CMS). "Many are taking action now with the assistance of thousands of our partners across the country, with assistance from family and friends, and with our important resources at 1-800-Medicare and www.Medicare.gov It can't be emphasized enough: this is an important time for beneficiaries to make the most of their Medicare for 2007."
Throughout the Open Enrollment Period there continues to be a high level of activity on 1-800-MEDICARE and at the thousands of counseling events around the country. To sustain awareness, CMS is executing a multi-faceted outreach campaign nationally and locally to ensure that people with Medicare receive personalized assistance to make a confident decision in health and drug coverage plan selection.
Medicare enrollment opportunities are many and varied:
* Online: Since November 15, the Medicare Online Enrollment Center has processed more than 280,000 enrollments as of December 27th. There have been 61 million page views on Medicare.gov since October 15th, or about 1 million per day, and 30 million page views of the Plan Finder during that time.
* In-person: in more than 12,700 events nationwide, Medicare has been working closely with its partners across the country to provide counseling opportunities where people with Medicare live, work, play and pray. As part of its "Check-Up Season," CMS has partnered with faith-based communities to conduct education and health events at houses of worship. The Medicare "Mobile Office Tour" also continues, logging more than 70,000 miles to 165 cities with more than 200 stops since the tour began September 1. These events also highlight the preventive services available through Medicare, including flu and pneumococcal shots and diabetes screenings.
* At the pharmacy: national and local chain and independent pharmacies are working closely with CMS to provide assistance and information during the Open Enrollment period. Some examples include:
Thousands of individual independently owned and operated pharmacies providing assistance to beneficiaries across the country through in-store informational days, medication reviews and community presentations.
o CVS: Medicare Tuesdays—More than 40,000 in-store informational sessions during Open Enrollment; during the initial enrollment period more than 1 million seniors attended Medicare Tuesday events.
o Kroger: CMS-trained pharmacists are assisting customers in comparing plan options.
o Medicine Shoppe International: Providing outreach within many local communities, including senior centers, assisted living and long-term care facilities.
o Rite Aid: All 9,000 pharmacists are specially trained on Medicare Part D to help seniors and caregivers navigate plan options.
o Walgreens: Planned more than 34,000 in-store education events, 700 community events and targeted Part D mailings during Open Enrollment.
o Wal-Mart: Providing more than 4,000 in-store and community outreach events as well as a one-minute consult guide for pharmacists; also designating a Part D specialist at each store pharmacy counter.
On the phone: 1-800-MEDICARE continues to be an important 24/7 source for personalized assistance during Open Enrollment. Since November 15, Customer Service Representatives received more than 5 million calls to 1-800-MEDICARE as of December 27th.
In addition, CMS is taking immediate action to ensure that beneficiaries who did not receive timely information from their current prescription drug plans will be given additional time to compare their 2006 and 2007 coverage and cost details and change plans if they choose. CMS is extending the enrollment period for the affected beneficiaries because the agency's top priority is ensuring that all beneficiaries have sufficient time and information to compare the cost and coverage of their 2006 and 2007 plans and make an informed decision about what plan best meets their needs. Affected beneficiaries will receive a letter from their current plan informing them that they will be able to change their plan if they so choose--anytime between January 1, 2007 and February 15, 2007.
"While independent surveys indicate people with Medicare are very satisfied with their current coverage, our goal during this time is to get people with Medicare to focus on getting the most out of their Medicare benefits and to use all of the information and sources of assistance possible to make informed and confident decisions," stated Norwalk.
Housework wards off breast cancer
Women who keep their homes clean and tidy are less likely to develop breast cancer than those who let the dust and dishes pile up, according to a new report.
Researchers found regular moderate exercise such as housework provides greater protection from the disease than more strenuous but less frequent sporting activity.
Being active in the home cut the likelihood of pre-menopausal women developing breast cancer by 29 per cent compared with being inactive, and reduced the risk for post-menopausal women by 19 per cent.
Around 44,100 cases of breast cancer are diagnosed in the UK every year and more than 12,400 women die from the disease. Physical activity and maintaining a healthy weight have also been found to reduce the risk of some cancers in men.
Previous studies have identified a link between exercise and reduced breast cancer risk in post-menopausal women, but this is one of the first to include a large number of pre-menopausal women.
The researchers analysed data on work, leisure and housework activity levels among 218,169 women aged 20 to 80 from nine European countries including the UK.
They followed the women for an average of 6.4 years, during which time 3,423 developed breast cancers. When all forms of activity were combined, being active appeared to offer a protective effect only to post-menopausal women.
However when the results were examined in more detail it was found that women who did the most housework had significantly reduced risks while work- and recreation-based activity had less effect.
On average, the pre-menopausal participants spent 17.7 hours a week doing housework while the post-menopausal women spent 16.1 hours a week on it.
Writing in the January edition of the journal Cancer Epidemiology Biomarkers and Prevention, Dr Petra Lahmann of the Medical Research Council's Human Nutrition Research unit in Cambridge, said: "Increased non-occupational physical activity and, in particular, increased household activity, were significantly associated with reduced breast cancer risk, independent of other potential risk factors.
"Our results . . . provide additional evidence that moderate forms of physical activity, such as household activity, may be more important than less frequent but more intense recreational physical activity in reducing breast cancer risk."
Dr Lesley Walker of Cancer Research UK, said: "We already know that women who keep a healthy weight are less likely to develop breast cancer. This study suggests that being physically active may also help and that something as simple and cheap as doing the housework can help."
Researchers found regular moderate exercise such as housework provides greater protection from the disease than more strenuous but less frequent sporting activity.
Being active in the home cut the likelihood of pre-menopausal women developing breast cancer by 29 per cent compared with being inactive, and reduced the risk for post-menopausal women by 19 per cent.
Around 44,100 cases of breast cancer are diagnosed in the UK every year and more than 12,400 women die from the disease. Physical activity and maintaining a healthy weight have also been found to reduce the risk of some cancers in men.
Previous studies have identified a link between exercise and reduced breast cancer risk in post-menopausal women, but this is one of the first to include a large number of pre-menopausal women.
The researchers analysed data on work, leisure and housework activity levels among 218,169 women aged 20 to 80 from nine European countries including the UK.
They followed the women for an average of 6.4 years, during which time 3,423 developed breast cancers. When all forms of activity were combined, being active appeared to offer a protective effect only to post-menopausal women.
However when the results were examined in more detail it was found that women who did the most housework had significantly reduced risks while work- and recreation-based activity had less effect.
On average, the pre-menopausal participants spent 17.7 hours a week doing housework while the post-menopausal women spent 16.1 hours a week on it.
Writing in the January edition of the journal Cancer Epidemiology Biomarkers and Prevention, Dr Petra Lahmann of the Medical Research Council's Human Nutrition Research unit in Cambridge, said: "Increased non-occupational physical activity and, in particular, increased household activity, were significantly associated with reduced breast cancer risk, independent of other potential risk factors.
"Our results . . . provide additional evidence that moderate forms of physical activity, such as household activity, may be more important than less frequent but more intense recreational physical activity in reducing breast cancer risk."
Dr Lesley Walker of Cancer Research UK, said: "We already know that women who keep a healthy weight are less likely to develop breast cancer. This study suggests that being physically active may also help and that something as simple and cheap as doing the housework can help."
Cancer Linked to Abnormal Number of Chromosomes
A century ago, a German biologist named Theodor Boveri suggested that one of the causes of cancer was aneuploidy.
The suggestion made sense, because many cancer cells have too many or two few chromosomes, but in all these years no one has been able to prove it, mainly because of the difficulty of inducing aneuploidy in experimental models.
Now researchers here say they've demonstrated that Boveri was on target. Aneuploidy does cause cancer, declared Don Cleveland, Ph.D., of the University of California at San Diego.
But surprisingly, Dr. Cleveland and colleagues found, the same condition can also prevent cancer in some circumstances. That finding may open up new therapeutic avenues, Dr. Cleveland and colleagues reported in the January issue of Cancer Cell.
The researchers reported a series of experiments in vitro and in experimental animals genetically engineered to have reduced levels of CENtromere-associated Protein-E (CENP-E).
That protein, Dr. Cleveland and colleagues said, is essential to the process of mitosis, but appears to have little other function in the cell.
The researchers first showed that cells from mouse fibroblasts, modified so they contained one normal and one disrupted CENP-E allele, tended to give rise to aneuploid daughter cells more often than wild-type cells.
For that reason, the researcher created a line of nude mice with only one functioning CENP-E allele and compared them, as they aged, to wild-type counterparts.
Cells from all the animals demonstrated increased aneuploidy as they aged, but those with reduced levels of CENP-E had more aneuploid cells at every time point, Dr. Cleveland and colleagues reported.
The link with cancer was demonstrated by observing CENP-E-deficient and wild-type mice between the ages of 19 and 21 months, and comparing the incidence of spontaneous tumors.
Lymphomas of the spleen were detected in 10% of the modified mice, but in none of the wild-type mice -- a difference that was statistically significant at P=0.0402. Also, the researchers saw a statistically significant threefold increase in lung tumors in the modified mice, compared with normal littermates (P=0.0492).
The observation "validates Boveri's initial hypothesis, the researchers said: "Aneuploidy can indeed promote tumorigenesis in the absence of other observable defects."
But, surprisingly, aneuploidy appeared to confer a protective effect against liver cancer. Among the wild-type mice, 14% had one or more liver tumors, while the modified mice had half that rate and none had more than one tumor.
The difference in numbers did not reach statistical significance, but the tumors in the wild-type mice were also larger on average - a difference that was significant at P=0.0037.
In these wild-type mice, about one in five cells becomes aneuploid at every cell division, the researchers said, and increasing the rate of aneuploidy in the modified mice appeared to protect against tumors.
Dr. Cleveland and colleagues then asked what would happen if they tried to induce tumors using the carcinogen DMBA (7,12-dimethylbenz[a]anthracene). Thirty-eight animals were given a single dose of DMBA and examined at eight months for tumors.
The researchers found that 40% of the wild-type animals had a single lung tumor and an additional mouse that did not develop a lung tumor contained one ovarian and two mammary tumors.
In contrast, lung tumors were seen in 31% of the modified mice and tumors tended to be smaller. No tumors were seen in any other organs, the researchers said.
In a final surprise, the researchers found that mice with reduced levels of CENP-E as well as a complete lack of the tumor suppressor gene p19/ARF did better than mice that were also missing p19/ARF but had normal CENP-E.
The elevated aneuploidy increased tumor-free survival by 93 days, which was highly statistically significant at P=0.0079.
"When we created mice missing a tumor suppressor gene that also had a high rate of aneuploidy, tumor development was actually sharply delayed," Dr. Cleveland said.
One possible explanation suggested by the authors is a "mutational meltdown." Thus, "high levels of chromosomal instability can prevent clonal expansion," they wrote, "since cells that have acquired a rare transformative karyotype through multiple chromosome missegregations are likely to lose that karyotype in the next round of cell division."
One implication of the finding may be that deliberately creating aneuploidy in tumors might have a therapeutic effect, he added.
The suggestion made sense, because many cancer cells have too many or two few chromosomes, but in all these years no one has been able to prove it, mainly because of the difficulty of inducing aneuploidy in experimental models.
Now researchers here say they've demonstrated that Boveri was on target. Aneuploidy does cause cancer, declared Don Cleveland, Ph.D., of the University of California at San Diego.
But surprisingly, Dr. Cleveland and colleagues found, the same condition can also prevent cancer in some circumstances. That finding may open up new therapeutic avenues, Dr. Cleveland and colleagues reported in the January issue of Cancer Cell.
The researchers reported a series of experiments in vitro and in experimental animals genetically engineered to have reduced levels of CENtromere-associated Protein-E (CENP-E).
That protein, Dr. Cleveland and colleagues said, is essential to the process of mitosis, but appears to have little other function in the cell.
The researchers first showed that cells from mouse fibroblasts, modified so they contained one normal and one disrupted CENP-E allele, tended to give rise to aneuploid daughter cells more often than wild-type cells.
For that reason, the researcher created a line of nude mice with only one functioning CENP-E allele and compared them, as they aged, to wild-type counterparts.
Cells from all the animals demonstrated increased aneuploidy as they aged, but those with reduced levels of CENP-E had more aneuploid cells at every time point, Dr. Cleveland and colleagues reported.
The link with cancer was demonstrated by observing CENP-E-deficient and wild-type mice between the ages of 19 and 21 months, and comparing the incidence of spontaneous tumors.
Lymphomas of the spleen were detected in 10% of the modified mice, but in none of the wild-type mice -- a difference that was statistically significant at P=0.0402. Also, the researchers saw a statistically significant threefold increase in lung tumors in the modified mice, compared with normal littermates (P=0.0492).
The observation "validates Boveri's initial hypothesis, the researchers said: "Aneuploidy can indeed promote tumorigenesis in the absence of other observable defects."
But, surprisingly, aneuploidy appeared to confer a protective effect against liver cancer. Among the wild-type mice, 14% had one or more liver tumors, while the modified mice had half that rate and none had more than one tumor.
The difference in numbers did not reach statistical significance, but the tumors in the wild-type mice were also larger on average - a difference that was significant at P=0.0037.
In these wild-type mice, about one in five cells becomes aneuploid at every cell division, the researchers said, and increasing the rate of aneuploidy in the modified mice appeared to protect against tumors.
Dr. Cleveland and colleagues then asked what would happen if they tried to induce tumors using the carcinogen DMBA (7,12-dimethylbenz[a]anthracene). Thirty-eight animals were given a single dose of DMBA and examined at eight months for tumors.
The researchers found that 40% of the wild-type animals had a single lung tumor and an additional mouse that did not develop a lung tumor contained one ovarian and two mammary tumors.
In contrast, lung tumors were seen in 31% of the modified mice and tumors tended to be smaller. No tumors were seen in any other organs, the researchers said.
In a final surprise, the researchers found that mice with reduced levels of CENP-E as well as a complete lack of the tumor suppressor gene p19/ARF did better than mice that were also missing p19/ARF but had normal CENP-E.
The elevated aneuploidy increased tumor-free survival by 93 days, which was highly statistically significant at P=0.0079.
"When we created mice missing a tumor suppressor gene that also had a high rate of aneuploidy, tumor development was actually sharply delayed," Dr. Cleveland said.
One possible explanation suggested by the authors is a "mutational meltdown." Thus, "high levels of chromosomal instability can prevent clonal expansion," they wrote, "since cells that have acquired a rare transformative karyotype through multiple chromosome missegregations are likely to lose that karyotype in the next round of cell division."
One implication of the finding may be that deliberately creating aneuploidy in tumors might have a therapeutic effect, he added.
Belly size an indicator of heart disease
The size of a person's belly is a better indicator of heart disease than how obese he or she is, says a new study.
Body Mass Index (BMI) was earlier used as a measure to predict heart disease risk. But a person could have a high BMI because he or she is muscular as opposed to fat, according to the health portal Medical News Today.
Carlos Iribarren and colleagues of the research division of Kaiser Permanente of Northern California in Oakland studied another factor known as sagittal abdominal diameter (SAD), a measure of "visceral obesity".
SAD is also called "supine abdominal height" which has been used to predict mortality in men, and is a measure of the girth around the abdomen - half way between the top of the pelvis and lower ribs.
It is considered a more reliable measure of a person's girth than the waistline, and the measurement is taken by a health professional using a caliper.
The scientists performed a cohort study involving 101,765 male and female members of the Kaiser Permanente of Northern California. They had been through health checks between 1965 and 1970 where their SAD was recorded, and a follow-up check was done 12 years later.
After adjusting for a number of social and lifestyle factors such as age, sex, education, BMI, smoking, alcohol and Hormone Replacement Therapy (HRT) in women, they found that men in the top 25 percent of SAD girth measurement had a 42 percent higher risk of coronary heart disease (CHD) than those in the bottom 25 percent of SAD girth measurement.
For women the figure was 44 percent, said the study published in the American Journal of Epidemiology.
The researchers also looked at the results within categories of BMI. They found that within the same BMI range, the SAD measure was a reliable predictor of CHD risk.
"Two people with the same Body Mass Index (even if their weight was 'normal') would effectively have different risks of developing CHD depending on the size of their belly - the larger the belly the bigger the risk", the researchers said.
They also found that SAD was a consistent predictor for CHD across racial groups. However, the younger a person was, regardless of race, the stronger the link between SAD and eventually having CHD.
Body Mass Index (BMI) was earlier used as a measure to predict heart disease risk. But a person could have a high BMI because he or she is muscular as opposed to fat, according to the health portal Medical News Today.
Carlos Iribarren and colleagues of the research division of Kaiser Permanente of Northern California in Oakland studied another factor known as sagittal abdominal diameter (SAD), a measure of "visceral obesity".
SAD is also called "supine abdominal height" which has been used to predict mortality in men, and is a measure of the girth around the abdomen - half way between the top of the pelvis and lower ribs.
It is considered a more reliable measure of a person's girth than the waistline, and the measurement is taken by a health professional using a caliper.
The scientists performed a cohort study involving 101,765 male and female members of the Kaiser Permanente of Northern California. They had been through health checks between 1965 and 1970 where their SAD was recorded, and a follow-up check was done 12 years later.
After adjusting for a number of social and lifestyle factors such as age, sex, education, BMI, smoking, alcohol and Hormone Replacement Therapy (HRT) in women, they found that men in the top 25 percent of SAD girth measurement had a 42 percent higher risk of coronary heart disease (CHD) than those in the bottom 25 percent of SAD girth measurement.
For women the figure was 44 percent, said the study published in the American Journal of Epidemiology.
The researchers also looked at the results within categories of BMI. They found that within the same BMI range, the SAD measure was a reliable predictor of CHD risk.
"Two people with the same Body Mass Index (even if their weight was 'normal') would effectively have different risks of developing CHD depending on the size of their belly - the larger the belly the bigger the risk", the researchers said.
They also found that SAD was a consistent predictor for CHD across racial groups. However, the younger a person was, regardless of race, the stronger the link between SAD and eventually having CHD.
Risk of acute pancreatitis due to statin use present, but low
Washington, Dec 30: While cholesterol-lowering drugs do increase the risk of painful inflammation of the pancreas, the side effect is relatively rare, according to Sonal Singh, M.D., from Wake Forest University School of Medicine, and colleagues
"Acute pancreatitis is a fairly common condition and cholesterol-lowering drugs have been implicated in some cases," said Singh. "Since millions of people around the world take these drugs, our aim was to quantify the risk."
The study, reported in the current issue of Drug Safety, is the first to estimate the risk of pancreatitis from drugs such as Lipitor(r) and Pravachol(r), known as statins. Researchers found that while the drugs increased the risk of pancreatitis by 40 percent - the occurrence is still fairly rare. Out of every 300,000 people taking the drugs for a year, only one would be expected to develop the condition.
"Nevertheless, there are likely to be many millions of people on long-term statins, which means that scores of patients will face the serious complications of acute pancreatitis," said Singh.
Singh added the safety of commonly used medications has come under scrutiny because of post-marketing discoveries that some drugs, such as Vioxx(r), have potentially dangerous side effects. He said that drugs are initially tested in studies involving small numbers of carefully selected patients and that some side effects may not show up until millions of people begin taking them.
Singh`s evidence-based study reviewed 33 spontaneous reports of statin induced pancreatitis from the Canadian Adverse Drug Event Monitoring System and 20 published case reports. They also pooled the results from two observational studies on the association between statins and pancreatitis.
"We found that all statins can cause pancreatitis, so switching from one to another will not help," said Singh. "The data also suggest that pancreatitis can occur after several months of statin use, suggesting that this is usually not an immediate reaction. We also found both that patients on both low and high doses developed pancreatitis. Hence starting at a low dose of statin may not be sufficient to prevent the side effect of pancreatitis," she added.
Pancreatitis is an inflammation of the pancreas, a large gland behind the stomach and close to the upper part of the small intestine, which secretes digestive enzymes. Acute pancreatitis is usually caused by gallstones or by drinking too much alcohol, but in many cases, the cause is not known. The painful condition often begins in the upper abdomen and may last for a few days.
Acute pancreatitis can be a severe, life-threatening illness with many complications. About 80,000 cases occur in the United States each year.
Bureau Report
"Acute pancreatitis is a fairly common condition and cholesterol-lowering drugs have been implicated in some cases," said Singh. "Since millions of people around the world take these drugs, our aim was to quantify the risk."
The study, reported in the current issue of Drug Safety, is the first to estimate the risk of pancreatitis from drugs such as Lipitor(r) and Pravachol(r), known as statins. Researchers found that while the drugs increased the risk of pancreatitis by 40 percent - the occurrence is still fairly rare. Out of every 300,000 people taking the drugs for a year, only one would be expected to develop the condition.
"Nevertheless, there are likely to be many millions of people on long-term statins, which means that scores of patients will face the serious complications of acute pancreatitis," said Singh.
Singh added the safety of commonly used medications has come under scrutiny because of post-marketing discoveries that some drugs, such as Vioxx(r), have potentially dangerous side effects. He said that drugs are initially tested in studies involving small numbers of carefully selected patients and that some side effects may not show up until millions of people begin taking them.
Singh`s evidence-based study reviewed 33 spontaneous reports of statin induced pancreatitis from the Canadian Adverse Drug Event Monitoring System and 20 published case reports. They also pooled the results from two observational studies on the association between statins and pancreatitis.
"We found that all statins can cause pancreatitis, so switching from one to another will not help," said Singh. "The data also suggest that pancreatitis can occur after several months of statin use, suggesting that this is usually not an immediate reaction. We also found both that patients on both low and high doses developed pancreatitis. Hence starting at a low dose of statin may not be sufficient to prevent the side effect of pancreatitis," she added.
Pancreatitis is an inflammation of the pancreas, a large gland behind the stomach and close to the upper part of the small intestine, which secretes digestive enzymes. Acute pancreatitis is usually caused by gallstones or by drinking too much alcohol, but in many cases, the cause is not known. The painful condition often begins in the upper abdomen and may last for a few days.
Acute pancreatitis can be a severe, life-threatening illness with many complications. About 80,000 cases occur in the United States each year.
Bureau Report
There is no shame in taking prescription
Dear Carolyn: After a few years of back and forth with psych meds (took them, decided I was better and weaned myself off, repeat), my doctor and, to some extent, I have come to the conclusion that I'll have to be on them for a long time, if not forever. I'm having a tough time coming to terms with that idea. Any thoughts on how to make sense of it without the stigma? Washington
Dear Washington: If you were diabetic, you would take insulin without shame. It's as much about chemicals with you, it's just a different set of chemicals.
That's how I would make sense of it.
Carolyn: Re: Psych drugs. To take this a large step further, I had a friend whose brother committed suicide. The backlash she received from people was discouraging and infuriating. As a result, she was having a hard time coping with the loss and the stigma. The only thing I could think to say to her was similar to your response - your brother died of a disease. Period. Mourn him as though he died of cancer. It helped. Anonymous
Dear Anon: Thank you.
To take it another very large step further, how many people with cancer die because society stigmatizes treatment?
Backlash creators, please note.
Carolyn: Recently I attended a party and my roommate gave me the opportunity to get a woman's phone number. At the time I was drunk and more interested in her friend but took the number anyway. I called her and told her, nicely, I was interested in her friend. She said she would pass the message. What do you think my chances are of meeting with the other woman? Maryland
Dear Maryland: Zero.
Or, 100 percent, if you gravely misunderestimated the beauty of the woman you called.
You have to appreciate the cruelty of that.
Carolyn: Re: Maryland. How do guys not realize how horrendously tacky it is to approach a woman only to get info about her friend? This happened to me all the time in college, when I had a particularly attractive roommate. She and I both found this behavior crass, and she never went out with anyone who "approached" her this way.
Dear Washington: If you were diabetic, you would take insulin without shame. It's as much about chemicals with you, it's just a different set of chemicals.
That's how I would make sense of it.
Carolyn: Re: Psych drugs. To take this a large step further, I had a friend whose brother committed suicide. The backlash she received from people was discouraging and infuriating. As a result, she was having a hard time coping with the loss and the stigma. The only thing I could think to say to her was similar to your response - your brother died of a disease. Period. Mourn him as though he died of cancer. It helped. Anonymous
Dear Anon: Thank you.
To take it another very large step further, how many people with cancer die because society stigmatizes treatment?
Backlash creators, please note.
Carolyn: Recently I attended a party and my roommate gave me the opportunity to get a woman's phone number. At the time I was drunk and more interested in her friend but took the number anyway. I called her and told her, nicely, I was interested in her friend. She said she would pass the message. What do you think my chances are of meeting with the other woman? Maryland
Dear Maryland: Zero.
Or, 100 percent, if you gravely misunderestimated the beauty of the woman you called.
You have to appreciate the cruelty of that.
Carolyn: Re: Maryland. How do guys not realize how horrendously tacky it is to approach a woman only to get info about her friend? This happened to me all the time in college, when I had a particularly attractive roommate. She and I both found this behavior crass, and she never went out with anyone who "approached" her this way.
Friday, December 29, 2006
Meat cloning decision provokes fury
The sale of milk and meat from cloned animals moved a step closer today after the US Government ruled that the products were safe to eat and could be sold in supermarkets without labelling.
The landmark draft decision, taken by the US Food and Drugs Administration, was condemned by consumer groups and food safety experts, who gave warning of the implications for food consumption throughout the world.
FDA officials said that they saw little problem with the controversial technology, which could result in cloned food being sold in the US within months without any labels identifying its origins. They added that cloned food products, if approved, could also be exported.
Authorities in Britain have yet to address the issue of the sale of food from cloned animals, including those approved by the US — cattle, pigs and goats. However, precedents set by the FDA are often followed by UK and European authorities. The Food Standards Agency said last night that it had not received an applications for the marketing of food products from cloned animals in the United Kingdom.
The move would have to be approved by the European Union before such products could be introduced, even if they were only being imported from the US. The UK’s Advisory Committee for Novel Foods would also be consulted.
The FDA, which overseas food safety for the US Government, determined after a five-year review that food from cloned livestock was as safe to eat as food from conventionally bred animals. The decision was all the more controversial because the agency declared that special labels were not needed to alert shoppers to its origin.
Decrying the ruling, consumer groups gave warning that cloned food would enter the food chain untested on humans, and from a field of science in which cloned animals are often born sick or with severe abnormalities. “Consumers are going to be having a product that has potential safety issues and a whole load of ethical issues tied to it, without any labelling,” said Joseph Mendelson, legal director of the Washington-based Centre for Food Safety.
Some US consumer groups maintain that surrogate mothers, in which the cloned animals are grown, are treated with high levels of hormones. They claim that clones are often born with severely compromised immune systems and receive massive doses of antibiotics, opening the way for large quantities of pharmaceuticals to enter the food supply.
The US National Academy of Sciences also warned recently that the commercialisation of cloned livestock for food production could increase the incidence of food-borne illness, such as E-coli infections.
Barbara Mikulski, a Democrat senator from Maryland, wrote in an open letter to the FDA: “Just because a scientist can manufacture food in the laboratory, should Americans be required to eat it?” Experts say it would probably take years for sales of cloned food to begin in earnest, because the technology’s high cost makes it prohibitive for most farmers. It costs about $15,000 (£7,500) to clone one dairy cow. But already several hundred cattle among America’s nine million have been cloned.
The FDA pointed out that many consumers confuse cloning with genetic modification. To produce a clone, the nucleus of a donor egg is removed and replaced with the DNA of a cow or other animal. A tiny electric shock coaxes the egg to grow into a copy of the original animal. Supporters of the technology say that it will be used primarily for breeding good milk and meat producers, and that produce will most likely be drawn from offspring, rather than the cloned animal.
The FDA said that meat and milk from clones was as safe to consume as products derived from naturally raised animals. Within six to eighteen months, cloned animals were “virtually indistinguishable” from conventionally-bred livestock, it said. “Meat and milk from cattle, swine and goat clones is as safe to eat as the food we eat every day,” said Stephen F. Sundlof, director of the FDA Centre for Veterinary Medicine.
Final approval for lifting the current ban on cloned food could come early next year. The agency will accept comments from the public for the next three months before announcing a final decision.
The Consumer Federation of America said that it would run a publicity campaign to ask food companies and supermarkets to refuse to sell cloned food. Polls show already that most Americans do not favour eating such a product, and many food companies are skittish about selling cloned food.
Opponents also maintain that cloning results in high failure rates and distress for the cloned animals. The Centre for Food Safety points to the example of Greg Wiles, whose Maryland farm was the first to have cloned cows. He says he told the FDA that one of his cloned cows was having terrible health problems, but was ignored.
The landmark draft decision, taken by the US Food and Drugs Administration, was condemned by consumer groups and food safety experts, who gave warning of the implications for food consumption throughout the world.
FDA officials said that they saw little problem with the controversial technology, which could result in cloned food being sold in the US within months without any labels identifying its origins. They added that cloned food products, if approved, could also be exported.
Authorities in Britain have yet to address the issue of the sale of food from cloned animals, including those approved by the US — cattle, pigs and goats. However, precedents set by the FDA are often followed by UK and European authorities. The Food Standards Agency said last night that it had not received an applications for the marketing of food products from cloned animals in the United Kingdom.
The move would have to be approved by the European Union before such products could be introduced, even if they were only being imported from the US. The UK’s Advisory Committee for Novel Foods would also be consulted.
The FDA, which overseas food safety for the US Government, determined after a five-year review that food from cloned livestock was as safe to eat as food from conventionally bred animals. The decision was all the more controversial because the agency declared that special labels were not needed to alert shoppers to its origin.
Decrying the ruling, consumer groups gave warning that cloned food would enter the food chain untested on humans, and from a field of science in which cloned animals are often born sick or with severe abnormalities. “Consumers are going to be having a product that has potential safety issues and a whole load of ethical issues tied to it, without any labelling,” said Joseph Mendelson, legal director of the Washington-based Centre for Food Safety.
Some US consumer groups maintain that surrogate mothers, in which the cloned animals are grown, are treated with high levels of hormones. They claim that clones are often born with severely compromised immune systems and receive massive doses of antibiotics, opening the way for large quantities of pharmaceuticals to enter the food supply.
The US National Academy of Sciences also warned recently that the commercialisation of cloned livestock for food production could increase the incidence of food-borne illness, such as E-coli infections.
Barbara Mikulski, a Democrat senator from Maryland, wrote in an open letter to the FDA: “Just because a scientist can manufacture food in the laboratory, should Americans be required to eat it?” Experts say it would probably take years for sales of cloned food to begin in earnest, because the technology’s high cost makes it prohibitive for most farmers. It costs about $15,000 (£7,500) to clone one dairy cow. But already several hundred cattle among America’s nine million have been cloned.
The FDA pointed out that many consumers confuse cloning with genetic modification. To produce a clone, the nucleus of a donor egg is removed and replaced with the DNA of a cow or other animal. A tiny electric shock coaxes the egg to grow into a copy of the original animal. Supporters of the technology say that it will be used primarily for breeding good milk and meat producers, and that produce will most likely be drawn from offspring, rather than the cloned animal.
The FDA said that meat and milk from clones was as safe to consume as products derived from naturally raised animals. Within six to eighteen months, cloned animals were “virtually indistinguishable” from conventionally-bred livestock, it said. “Meat and milk from cattle, swine and goat clones is as safe to eat as the food we eat every day,” said Stephen F. Sundlof, director of the FDA Centre for Veterinary Medicine.
Final approval for lifting the current ban on cloned food could come early next year. The agency will accept comments from the public for the next three months before announcing a final decision.
The Consumer Federation of America said that it would run a publicity campaign to ask food companies and supermarkets to refuse to sell cloned food. Polls show already that most Americans do not favour eating such a product, and many food companies are skittish about selling cloned food.
Opponents also maintain that cloning results in high failure rates and distress for the cloned animals. The Centre for Food Safety points to the example of Greg Wiles, whose Maryland farm was the first to have cloned cows. He says he told the FDA that one of his cloned cows was having terrible health problems, but was ignored.
Obesity battle starts young for urban poor
By the time they reach the age of 3, more than one-third of low-income urban children are already overweight or obese, according to a study released yesterday that provides alarming evidence that the nation's battle of the bulge begins when toddlers are barely out of diapers.
Researchers armed with scales and measuring devices visited nearly 2,000 families in 20 US cities, including Boston, and evaluated the weight and height of 3-year-olds in an unprecedented effort to focus on obesity among the nation's most vulnerable children.
Their finding: 35 percent of the low-income 3-year-olds were overweight or obese, a result more than twice the national rate for obesity among preschool children of all income levels and racial groups. Low-income Hispanic children, the researchers reported in the on line version of the American Journal of Public Health , were the most likely of all to have a weight problem, with 44 percent of those toddlers overweight or obese.
In Boston, where children were found to be slightly less heavy than the 20-city average, health officials yesterday announced they are giving $279,000 to community groups committed to joining the war on obesity, taking the fight directly to the city's streets, schools, and even urban farms. The money will fund outreach campaigns for the young and people of color, such as promoting health through dance and hip-hop music.
"We know that many of the habits that people retain for the rest of their life are established in childhood, so it's a critical period to educate folks about what they can do," said John Auerbach, executive director of the Boston Public Health Commission .
Specialists in pediatric nutrition said the new findings mirror what they witness in their own practices, as the waistlines of even the youngest patients have expanded at a troubling rate. The medical consequences can be significant, physicians said, with toddlers suffering from sleep apnea and misshapen limbs as a result of their weight. In addition, overweight toddlers are at risk of growing up to be overweight, with the attendant constellation of health woes, including diabetes, heart disease, and cancer.
It is a health crisis, the specialists said, fueled by eating too much calorie-laden processed food and drinking too many sweetened beverages while also spending more hours plopped in front of television and computer screens than earlier generations.
But toddlers' weight problems are also a legacy of the obesity epidemic among adults: Overweight mothers tend to give birth to bigger babies who are exposed to insulin imbalances while in the womb that can predispose them to obesity.
"The whole country is struggling with this," said Virginia Chomitz , senior scientist at the Institute for Community Health at the Cambridge Health Alliance . "There's a lot of factors in our environment and our lifestyle that are pushing us toward being fatter. It's an uphill battle to push against that tide."
Pediatricians have watched with concern as children have grown plumper. Since 1971, the share of children nationally who are overweight has doubled, a trend specialists expect will continue. But Rachel Tolbert Kimbro , a researcher at the University of Wisconsin-Madison, as well as scientists from Columbia and Princeton universities, wanted to look at the group that disproportionately bears the burden of obesity: the underprivileged.
Their study, underwritten by federal agencies and private foundations, focused on a group recognized to be especially vulnerable to obesity, the children of urban low-income parents, defined in part as those families receiving federal aid to help buy food for children and their mothers.
"There are so few studies that look at kids this young that we really don't know what trends look like for children who are at age 3 -- we don't know how many 3-year-olds were obese or overweight 10 years ago," Kimbro said. "But there's definitely a sense that this is a new problem, that we're seeing children this young not only overweight and obese but also with the attendant health problems."
Determining whether an adult is overweight is fairly straightforward, but measuring it among children must take into account that they are growing, and not always at the same rate. During certain periods, for instance, girls are expected to weigh more than boys of the same age.
The new study relied on the growth charts developed by the federal government that are a staple of pediatricians' offices. The authors defined as overweight children weighing more than 85 percent of those in their age group. Children weighing in excess of 95 percent of their peers were declared obese.
Using those standards, a 3-year-old girl standing a bit more than 3 feet tall would be considered overweight if she weighed nearly 39 pounds -- 4 pounds above average -- while an obese girl would weigh more than 46 pounds.
In the 20-city analysis, which included cities from Boston to San Jose, Calif., 17 percent of the low-income toddlers fit into the overweight category while 18 percent were categorized as obese. In Boston, 14 percent were overweight and 14 percent were obese.
"Some of the factors that made those young children be overweight at that young age are going to remain there until they become adolescents," said Dr. Nicolas Stettler , a pediatric nutrition specialist at Children's Hospital of Philadelphia .
Doctors at Boston Medical Center , the city hospital that treats the most low-income patients, regularly see the toll exacted by weight on toddlers. Records on children between the ages of 2 and 5 at the hospital show that 39 percent of the Hispanic patients were overweight or obese, said Dr. Carine Lenders , director of Boston Medical's Nutrition & Fitness for Life Program.
Low-income parents often tell Boston Medical Center doctors that fresh fruits and vegetables either aren't accessible in the inner city or cost too much, Lenders said. "And a second issue is the safety in their area," which sometimes limits children's physical activity, she said. "A lot of parents don't feel their kids are safe on the streets, so they keep them in the house, and the best baby sitter in the house is the TV."
Authors of the study said they were troubled by the disparity in weight trends between Hispanic toddlers and the white and African-American children, but could find no clear evidence to explain the difference.
Margarita Alegría , who specializes in the study of healthcare disparities at Cambridge Health Alliance , suggested that some of the difference may be attributable to varying cultural perceptions of what constitutes a healthy baby. Among Hispanics, she said, there may be a tendency to equate chubbiness with health.
Like other specialists, Alegría said all parents should be told about the importance of a healthy diet and active lifestyle for their children. After all, specialists said, no doctor is suggesting that a 3-year-old be placed on a specific weight-loss diet.
"Sometimes," Alegría said, "it's not only saying what women should be doing but also showing how to problem solve, how to access those nutritious foods, and helping them make choices about what is healthy eating and how to read a food label."
Researchers armed with scales and measuring devices visited nearly 2,000 families in 20 US cities, including Boston, and evaluated the weight and height of 3-year-olds in an unprecedented effort to focus on obesity among the nation's most vulnerable children.
Their finding: 35 percent of the low-income 3-year-olds were overweight or obese, a result more than twice the national rate for obesity among preschool children of all income levels and racial groups. Low-income Hispanic children, the researchers reported in the on line version of the American Journal of Public Health , were the most likely of all to have a weight problem, with 44 percent of those toddlers overweight or obese.
In Boston, where children were found to be slightly less heavy than the 20-city average, health officials yesterday announced they are giving $279,000 to community groups committed to joining the war on obesity, taking the fight directly to the city's streets, schools, and even urban farms. The money will fund outreach campaigns for the young and people of color, such as promoting health through dance and hip-hop music.
"We know that many of the habits that people retain for the rest of their life are established in childhood, so it's a critical period to educate folks about what they can do," said John Auerbach, executive director of the Boston Public Health Commission .
Specialists in pediatric nutrition said the new findings mirror what they witness in their own practices, as the waistlines of even the youngest patients have expanded at a troubling rate. The medical consequences can be significant, physicians said, with toddlers suffering from sleep apnea and misshapen limbs as a result of their weight. In addition, overweight toddlers are at risk of growing up to be overweight, with the attendant constellation of health woes, including diabetes, heart disease, and cancer.
It is a health crisis, the specialists said, fueled by eating too much calorie-laden processed food and drinking too many sweetened beverages while also spending more hours plopped in front of television and computer screens than earlier generations.
But toddlers' weight problems are also a legacy of the obesity epidemic among adults: Overweight mothers tend to give birth to bigger babies who are exposed to insulin imbalances while in the womb that can predispose them to obesity.
"The whole country is struggling with this," said Virginia Chomitz , senior scientist at the Institute for Community Health at the Cambridge Health Alliance . "There's a lot of factors in our environment and our lifestyle that are pushing us toward being fatter. It's an uphill battle to push against that tide."
Pediatricians have watched with concern as children have grown plumper. Since 1971, the share of children nationally who are overweight has doubled, a trend specialists expect will continue. But Rachel Tolbert Kimbro , a researcher at the University of Wisconsin-Madison, as well as scientists from Columbia and Princeton universities, wanted to look at the group that disproportionately bears the burden of obesity: the underprivileged.
Their study, underwritten by federal agencies and private foundations, focused on a group recognized to be especially vulnerable to obesity, the children of urban low-income parents, defined in part as those families receiving federal aid to help buy food for children and their mothers.
"There are so few studies that look at kids this young that we really don't know what trends look like for children who are at age 3 -- we don't know how many 3-year-olds were obese or overweight 10 years ago," Kimbro said. "But there's definitely a sense that this is a new problem, that we're seeing children this young not only overweight and obese but also with the attendant health problems."
Determining whether an adult is overweight is fairly straightforward, but measuring it among children must take into account that they are growing, and not always at the same rate. During certain periods, for instance, girls are expected to weigh more than boys of the same age.
The new study relied on the growth charts developed by the federal government that are a staple of pediatricians' offices. The authors defined as overweight children weighing more than 85 percent of those in their age group. Children weighing in excess of 95 percent of their peers were declared obese.
Using those standards, a 3-year-old girl standing a bit more than 3 feet tall would be considered overweight if she weighed nearly 39 pounds -- 4 pounds above average -- while an obese girl would weigh more than 46 pounds.
In the 20-city analysis, which included cities from Boston to San Jose, Calif., 17 percent of the low-income toddlers fit into the overweight category while 18 percent were categorized as obese. In Boston, 14 percent were overweight and 14 percent were obese.
"Some of the factors that made those young children be overweight at that young age are going to remain there until they become adolescents," said Dr. Nicolas Stettler , a pediatric nutrition specialist at Children's Hospital of Philadelphia .
Doctors at Boston Medical Center , the city hospital that treats the most low-income patients, regularly see the toll exacted by weight on toddlers. Records on children between the ages of 2 and 5 at the hospital show that 39 percent of the Hispanic patients were overweight or obese, said Dr. Carine Lenders , director of Boston Medical's Nutrition & Fitness for Life Program.
Low-income parents often tell Boston Medical Center doctors that fresh fruits and vegetables either aren't accessible in the inner city or cost too much, Lenders said. "And a second issue is the safety in their area," which sometimes limits children's physical activity, she said. "A lot of parents don't feel their kids are safe on the streets, so they keep them in the house, and the best baby sitter in the house is the TV."
Authors of the study said they were troubled by the disparity in weight trends between Hispanic toddlers and the white and African-American children, but could find no clear evidence to explain the difference.
Margarita Alegría , who specializes in the study of healthcare disparities at Cambridge Health Alliance , suggested that some of the difference may be attributable to varying cultural perceptions of what constitutes a healthy baby. Among Hispanics, she said, there may be a tendency to equate chubbiness with health.
Like other specialists, Alegría said all parents should be told about the importance of a healthy diet and active lifestyle for their children. After all, specialists said, no doctor is suggesting that a 3-year-old be placed on a specific weight-loss diet.
"Sometimes," Alegría said, "it's not only saying what women should be doing but also showing how to problem solve, how to access those nutritious foods, and helping them make choices about what is healthy eating and how to read a food label."
Medicare drug-plan deadline near
The second annual sign-up period began Nov. 15 and will remain open until midnight on Sunday. Operators will be available to answer questions at 1-800-Medicare and its www.medicare.gov Web site will be able to handle the traffic, Medicare spokesman Jeff Nelligan said. Those who are satisfied with their current coverage don't have to do anything. The next opportunity to choose a plan will be in November next year.
This year, the Centers for Medicare and Medicaid Services is granting an exception to beneficiaries who received their annual notice of change letters after Nov. 15. These required letters from health insurers describe changes to the list of covered drugs, or formularies, that will go into effect next year. About 250,000 beneficiaries received those letters late and will be granted a special enrollment period, beginning Jan. 1 and ending Feb. 15, Nelligan said.
Older Americans no matter how healthy they are would be wise to consider joining a plan if they haven't already, said Brian Poger, president of Senior Educators, an insurance brokerage in San Francisco. Watch interview with Poger.
"It probably does make sense to have drug coverage, regardless of whether you get it in a stand-alone fashion or an integrated fashion," Poger said.
He suggested shopping around not just for the best premium price but for the best total costs and plan features for a person's particular needs. See Vital Signs on what to look for.
"We're actually finding a lot of people that didn't want to spend the premium on the stand-alone drug plans, they just go into an integrated plan, a Medicare Advantage plan, because they get the health and the drug for less than the cost of the drug alone," he said. "I know that seems strange, but with the way the government payments work it actually works out better for both the consumer and the insurance companies."
Unlike stand-alone drug plans, the deadline for enrolling in Medicare Advantage plans isn't until March 31, 2007.
The 'doughnut hole' problem
Beneficiaries with drug coverage pay $24 a month on average for their plan premiums, Nelligan said.
About 8% of those in the program, or less than 3 million people, hit the coverage gap known as the doughnut hole, which in 2007 generally will occur after a person spends $2,400 in drug costs and goes on to spend $3,850 out of his or her own pocket. After spending $3,850 the plan kicks in again.
This year 29% of plans offered coverage in the doughnut hole, with median premiums for plans that included coverage in the gap running $45.37, Nelligan said. Still, the vast majority of plans with coverage in the gap only pay for generic drugs.
Many insurance companies find covering brand-name drugs in the doughnut hole is too expensive to be viable, Poger said.
"It's very difficult to do," he said. "There's only really a couple companies that are still trying to make it work this year and I suspect that's probably going to be a thing of the past unless there's a legislative change."
As of May, Medicare had about 16.6 million beneficiaries enrolled in stand-alone drug plans and another 6.3 million who got their drug coverage through integrated Medicare Advantage plans. About 90% of all Medicare beneficiaries have drug coverage either through the private plans, coverage from their employers or other sources, Nelligan said. Since Nov. 15, Medicare has drawn an estimated 930,000 new enrollments, he said.
Beneficiaries with some type of drug plan in 2006 saw per-person savings of $1,200 compared with not having any coverage, Nelligan said. For those who were eligible but waited to sign up, the penalty for enrolling after the first open enrollment period ended May 15 of last year is 1% a month, meaning beneficiaries who waited until this year to choose a plan face a penalty of 7% unless they had virtually equal coverage from their employer during that time. End of Story
Kristen Gerencher is a reporter for MarketWatch in San Francisco.
This year, the Centers for Medicare and Medicaid Services is granting an exception to beneficiaries who received their annual notice of change letters after Nov. 15. These required letters from health insurers describe changes to the list of covered drugs, or formularies, that will go into effect next year. About 250,000 beneficiaries received those letters late and will be granted a special enrollment period, beginning Jan. 1 and ending Feb. 15, Nelligan said.
Older Americans no matter how healthy they are would be wise to consider joining a plan if they haven't already, said Brian Poger, president of Senior Educators, an insurance brokerage in San Francisco. Watch interview with Poger.
"It probably does make sense to have drug coverage, regardless of whether you get it in a stand-alone fashion or an integrated fashion," Poger said.
He suggested shopping around not just for the best premium price but for the best total costs and plan features for a person's particular needs. See Vital Signs on what to look for.
"We're actually finding a lot of people that didn't want to spend the premium on the stand-alone drug plans, they just go into an integrated plan, a Medicare Advantage plan, because they get the health and the drug for less than the cost of the drug alone," he said. "I know that seems strange, but with the way the government payments work it actually works out better for both the consumer and the insurance companies."
Unlike stand-alone drug plans, the deadline for enrolling in Medicare Advantage plans isn't until March 31, 2007.
The 'doughnut hole' problem
Beneficiaries with drug coverage pay $24 a month on average for their plan premiums, Nelligan said.
About 8% of those in the program, or less than 3 million people, hit the coverage gap known as the doughnut hole, which in 2007 generally will occur after a person spends $2,400 in drug costs and goes on to spend $3,850 out of his or her own pocket. After spending $3,850 the plan kicks in again.
This year 29% of plans offered coverage in the doughnut hole, with median premiums for plans that included coverage in the gap running $45.37, Nelligan said. Still, the vast majority of plans with coverage in the gap only pay for generic drugs.
Many insurance companies find covering brand-name drugs in the doughnut hole is too expensive to be viable, Poger said.
"It's very difficult to do," he said. "There's only really a couple companies that are still trying to make it work this year and I suspect that's probably going to be a thing of the past unless there's a legislative change."
As of May, Medicare had about 16.6 million beneficiaries enrolled in stand-alone drug plans and another 6.3 million who got their drug coverage through integrated Medicare Advantage plans. About 90% of all Medicare beneficiaries have drug coverage either through the private plans, coverage from their employers or other sources, Nelligan said. Since Nov. 15, Medicare has drawn an estimated 930,000 new enrollments, he said.
Beneficiaries with some type of drug plan in 2006 saw per-person savings of $1,200 compared with not having any coverage, Nelligan said. For those who were eligible but waited to sign up, the penalty for enrolling after the first open enrollment period ended May 15 of last year is 1% a month, meaning beneficiaries who waited until this year to choose a plan face a penalty of 7% unless they had virtually equal coverage from their employer during that time. End of Story
Kristen Gerencher is a reporter for MarketWatch in San Francisco.
Cooking, Cleaning And Washing Helps You Ward Off Breast Cancer
A study of 200,000 European women has found that doing housework is more likely to protect you against breast cancer than job- or leisure-based physical activity.
The study is published in Cancer Epidemiology Biomarkers & Prevention.
The research was funded by Cancer Research UK and led by Petra Lahmann of the Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, in Nuthetal, Germany, and a widely constituted international team of researchers.
While much research extols the virtue of physical exercise as a way to reduce breast cancer risk, the evidence on precisely what type of activity is most beneficial is scanty.
Petra Lahmann and colleagues used data on over 200,000 premenopausal and postmenopausal women aged between 20 and 80, from 9 European countries.
They used statistical regression models to work out a metabolic-equivalent rate for the various forms of exercise the women undertook so that they could compare the "physical activity value" of the different forms of exercise.
They also took into account demographic, social and medical factors such as age, age when menstruation started, body mass index, education, geographical location, alcohol consumption, age at first pregnancy, oral contraception and hormone replacement therapy.
The women's physical activities were classified into three groups: recreational, household, and occupational, and a total of all three was also calculated. The women were followed up over a 6.4 year period, during which time 3,423 invasive breast cancers occurred in the group.
The results suggest that total physical activity reduces risk of breast cancer only in postmenopausal women. However, and perhaps more surprisingly, housework on its own reduces breast cancer risk in both pre- and postmenopausal women - the former by 19 per cent and the latter by 29 per cent. The study found no significant link between reduced breast cancer risk and either leisure or work-related physical activity.
The women spent an average of 16 to 17 hours a week on household chores such as washing, cooking and cleaning.
The researchers mention in the study that their findings on housework and reduced breast cancer risk are in line with other research, but point to the low numbers of women in the study who were classed as "active" in job-related activity as to the possible reason why no link was found in that area.
Their main conclusion is that this study supports the growing body of evidence showing strong links between physical activity and reduced breast cancer risk. This is in line with the general message from Cancer Research UK who promote taking regular exercise and maintaining a healthy body weight as the main way to reduce cancer risk.
"Physical Activity and Breast Cancer Risk: The European Prospective Investigation into Cancer and Nutrition."
Petra H. Lahmann, Christine Friedenreich, A. Jantine Schuit, Simonetta Salvini, Naomi E. Allen, Tim J. Key, Kay-Tee Khaw, Sheila Bingham, Petra H.M. Peeters, Evelyn Monninkhof, H. Bas Bueno-de-Mesquita, Elisabet Wirfält, Jonas Manjer, Carlos A. Gonzales, Eva Ardanaz, Pilar Amiano, José R. Quirós, Carmen Navarro, Carmen Martinez, Franco Berrino, Domenico Palli, Rosario Tumino, Salvatore Panico, Paolo Vineis, Antonia Trichopoulou, Christina Bamia, Dimitrios Trichopoulos, Heiner Boeing, Mandy Schulz, Jakob Linseisen, Jenny Chang-Claude, Francoise Clavel Chapelon, Agnès Fournier, Marie-Christine Boutron-Ruault, Anne Tjønneland, Nina Føns Johnson, Kim Overvad, Rudolf Kaaks, Elio Riboli.
Cancer Epidemiology Biomarkers & Prevention, 10.1158/doi:1055-9965.EPI-06-0582
Published online first on December 19, 2006
The study is published in Cancer Epidemiology Biomarkers & Prevention.
The research was funded by Cancer Research UK and led by Petra Lahmann of the Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, in Nuthetal, Germany, and a widely constituted international team of researchers.
While much research extols the virtue of physical exercise as a way to reduce breast cancer risk, the evidence on precisely what type of activity is most beneficial is scanty.
Petra Lahmann and colleagues used data on over 200,000 premenopausal and postmenopausal women aged between 20 and 80, from 9 European countries.
They used statistical regression models to work out a metabolic-equivalent rate for the various forms of exercise the women undertook so that they could compare the "physical activity value" of the different forms of exercise.
They also took into account demographic, social and medical factors such as age, age when menstruation started, body mass index, education, geographical location, alcohol consumption, age at first pregnancy, oral contraception and hormone replacement therapy.
The women's physical activities were classified into three groups: recreational, household, and occupational, and a total of all three was also calculated. The women were followed up over a 6.4 year period, during which time 3,423 invasive breast cancers occurred in the group.
The results suggest that total physical activity reduces risk of breast cancer only in postmenopausal women. However, and perhaps more surprisingly, housework on its own reduces breast cancer risk in both pre- and postmenopausal women - the former by 19 per cent and the latter by 29 per cent. The study found no significant link between reduced breast cancer risk and either leisure or work-related physical activity.
The women spent an average of 16 to 17 hours a week on household chores such as washing, cooking and cleaning.
The researchers mention in the study that their findings on housework and reduced breast cancer risk are in line with other research, but point to the low numbers of women in the study who were classed as "active" in job-related activity as to the possible reason why no link was found in that area.
Their main conclusion is that this study supports the growing body of evidence showing strong links between physical activity and reduced breast cancer risk. This is in line with the general message from Cancer Research UK who promote taking regular exercise and maintaining a healthy body weight as the main way to reduce cancer risk.
"Physical Activity and Breast Cancer Risk: The European Prospective Investigation into Cancer and Nutrition."
Petra H. Lahmann, Christine Friedenreich, A. Jantine Schuit, Simonetta Salvini, Naomi E. Allen, Tim J. Key, Kay-Tee Khaw, Sheila Bingham, Petra H.M. Peeters, Evelyn Monninkhof, H. Bas Bueno-de-Mesquita, Elisabet Wirfält, Jonas Manjer, Carlos A. Gonzales, Eva Ardanaz, Pilar Amiano, José R. Quirós, Carmen Navarro, Carmen Martinez, Franco Berrino, Domenico Palli, Rosario Tumino, Salvatore Panico, Paolo Vineis, Antonia Trichopoulou, Christina Bamia, Dimitrios Trichopoulos, Heiner Boeing, Mandy Schulz, Jakob Linseisen, Jenny Chang-Claude, Francoise Clavel Chapelon, Agnès Fournier, Marie-Christine Boutron-Ruault, Anne Tjønneland, Nina Føns Johnson, Kim Overvad, Rudolf Kaaks, Elio Riboli.
Cancer Epidemiology Biomarkers & Prevention, 10.1158/doi:1055-9965.EPI-06-0582
Published online first on December 19, 2006
Libya condemns foreign pressure in HIV case
TRIPOLI (Reuters) - Western criticism of death sentences handed to five Bulgarian nurses and a Palestinian doctor by a Libyan court shows a lack of respect for the Libyan people, Libya's foreign ministry said late on Thursday.
The medics were sentenced last week for deliberately infecting 426 children in the late 1990s with the virus that causes AIDS. More than 50 of the children have since died.
Some Western scientists say negligence and poor hospital hygiene are the real culprits and the six are scapegoats, but in Libya the verdict came as a welcome act of defiance of the West.
Condemnation poured in from Western governments and rights groups after the sentences were passed, with Bulgaria, the EU which it joins next month and Amnesty International among the swiftest critics. Washington said it was disappointed.
The Libyan government defended the court's ruling, saying it had the authority to handle the case and came to its decision in the presence of international human rights and civil society groups.
"The political stance expressed by the Bulgarian government, the EU countries and others is a clear bias to certain values that are likely to trigger wars, conflicts and cause enmity between religions and civilizations," the foreign ministry said in a statement.
It said the foreign media campaign and political pressure created a dangerous precedent in which Libyans are considered sub-human and treated differently to Bulgarians.
The six medics, who deny the charges, were first found guilty in a 2004 trial and sentenced to death by firing squad.
Analysts said a deal to avoid the executions was still likely given that the ruling could set back oil producer Libya's hopes of better ties with the West.
After the verdicts, Libya's justice and foreign ministers summoned reporters to explain there was every possibility the case could end another way once the appeals process finished.
In its statement, the foreign ministry underlined that the verdicts may not be final as the medics could still appeal to Libya's supreme court.
"The great Jamahiriya (Libya) ... is keen on relations between countries based on dialogue and understanding," it said.
The medics were sentenced last week for deliberately infecting 426 children in the late 1990s with the virus that causes AIDS. More than 50 of the children have since died.
Some Western scientists say negligence and poor hospital hygiene are the real culprits and the six are scapegoats, but in Libya the verdict came as a welcome act of defiance of the West.
Condemnation poured in from Western governments and rights groups after the sentences were passed, with Bulgaria, the EU which it joins next month and Amnesty International among the swiftest critics. Washington said it was disappointed.
The Libyan government defended the court's ruling, saying it had the authority to handle the case and came to its decision in the presence of international human rights and civil society groups.
"The political stance expressed by the Bulgarian government, the EU countries and others is a clear bias to certain values that are likely to trigger wars, conflicts and cause enmity between religions and civilizations," the foreign ministry said in a statement.
It said the foreign media campaign and political pressure created a dangerous precedent in which Libyans are considered sub-human and treated differently to Bulgarians.
The six medics, who deny the charges, were first found guilty in a 2004 trial and sentenced to death by firing squad.
Analysts said a deal to avoid the executions was still likely given that the ruling could set back oil producer Libya's hopes of better ties with the West.
After the verdicts, Libya's justice and foreign ministers summoned reporters to explain there was every possibility the case could end another way once the appeals process finished.
In its statement, the foreign ministry underlined that the verdicts may not be final as the medics could still appeal to Libya's supreme court.
"The great Jamahiriya (Libya) ... is keen on relations between countries based on dialogue and understanding," it said.
Heart disease still big problem in South
CHARLESTON, W.Va. - West Virginia is making slight yet discernible progress in reducing deaths from heart disease, but it remains one of the states hit hardest by the nation's No. 1 killer. Mississippi tops the list. The American Heart Association released its annual look at heart disease in America on Friday, ahead of a January publication of the findings in the medical journal Circulation.
Cardiovascular disease accounted for more than one-third of all deaths in 2004, the most recent year for which data is available, but there are signs of improvement.
Mississippi had the highest fatality rate from cardiovascular disease and coronary heart disease, at nearly 406 deaths per 100,000 people.
Oklahoma was next, with nearly 401 deaths per 100,000; Alabama, with 378 deaths; Tennessee, with nearly 374 deaths per 100,000; and West Virginia, with 373.
There were twice as many angioplasties recorded in Southern states as compared to other regions, and the report found similar ratios of bypass surgery, open-heart surgeries and pacemaker implants.
Wayne Rosamond, an epidemiologist at the University of North Carolina and the chairman of the American Heart Association Statistics Committee, said there are studies now directed at finding out exactly why heart disease has such striking regional differences.
"What drives those shifts is not really well understood," he said.
West Virginia fared slightly better in fatality rates from stroke, ranking ahead of 12 others. The report found that 373 people per 100,000 die from cardiovascular disease in West Virginia, down one from the previous year.
While that may seem like modest progress, the state's death rate has dropped since 1993, when the death rate was 390 out of every 100,000 West Virginians.
Rosamond said signs like that are positive indicators.
"There are a lot of things going on that are good, particularly on the prevention side," Rosamond said.
In particular, he cited a drop in smoking rates among young people and a growing awareness of heart disease among women as signs that prevention efforts are beginning to make a dent in the mortality rate.
Those kinds of changes take years to show up in statistics, though, according to Dr. Anthony Morise, a cardiologist and professor of medicine at West Virginia University.
"You have to get people in a preventive mode," he said. "Those things take a while to translate into a measurable change."
Morise also said he's noticed improvements in the diagnosis and treatment of women, for whom heart disease is the most common fatal illness. Women with heart disease commonly exhibit symptoms not usually found in men, such as unexplained fatigue, and often don't show symptoms like crushing chest pain.
The fact that doctors have gotten better at identifying those symptoms, and patients have grown more aware of what they might be, means that diagnosis has gotten better, Morise said. At the same time, though, as diagnosis improves, heart disease rates will show an increase.
"The more we detect it, the more the incidence rates will go up," he said.
In addition to focusing on heart disease in demographic groups like women and Latinos, the report also underscores the need to study why it is so much more common in the South than in the rest of the country.
Cardiovascular disease accounted for more than one-third of all deaths in 2004, the most recent year for which data is available, but there are signs of improvement.
Mississippi had the highest fatality rate from cardiovascular disease and coronary heart disease, at nearly 406 deaths per 100,000 people.
Oklahoma was next, with nearly 401 deaths per 100,000; Alabama, with 378 deaths; Tennessee, with nearly 374 deaths per 100,000; and West Virginia, with 373.
There were twice as many angioplasties recorded in Southern states as compared to other regions, and the report found similar ratios of bypass surgery, open-heart surgeries and pacemaker implants.
Wayne Rosamond, an epidemiologist at the University of North Carolina and the chairman of the American Heart Association Statistics Committee, said there are studies now directed at finding out exactly why heart disease has such striking regional differences.
"What drives those shifts is not really well understood," he said.
West Virginia fared slightly better in fatality rates from stroke, ranking ahead of 12 others. The report found that 373 people per 100,000 die from cardiovascular disease in West Virginia, down one from the previous year.
While that may seem like modest progress, the state's death rate has dropped since 1993, when the death rate was 390 out of every 100,000 West Virginians.
Rosamond said signs like that are positive indicators.
"There are a lot of things going on that are good, particularly on the prevention side," Rosamond said.
In particular, he cited a drop in smoking rates among young people and a growing awareness of heart disease among women as signs that prevention efforts are beginning to make a dent in the mortality rate.
Those kinds of changes take years to show up in statistics, though, according to Dr. Anthony Morise, a cardiologist and professor of medicine at West Virginia University.
"You have to get people in a preventive mode," he said. "Those things take a while to translate into a measurable change."
Morise also said he's noticed improvements in the diagnosis and treatment of women, for whom heart disease is the most common fatal illness. Women with heart disease commonly exhibit symptoms not usually found in men, such as unexplained fatigue, and often don't show symptoms like crushing chest pain.
The fact that doctors have gotten better at identifying those symptoms, and patients have grown more aware of what they might be, means that diagnosis has gotten better, Morise said. At the same time, though, as diagnosis improves, heart disease rates will show an increase.
"The more we detect it, the more the incidence rates will go up," he said.
In addition to focusing on heart disease in demographic groups like women and Latinos, the report also underscores the need to study why it is so much more common in the South than in the rest of the country.
Living With Kids Could Add Pounds
Here's something parents might get from their kids: fat.
According to a new study, adults living with children eat more saturated fats than adults who don't live with children. The extra fat adds up to almost an entire frozen pepperoni pizza each week.
But it doesn't have to be that way.
"It's not that parents are doomed to the fate of eating terribly," said study author Dr. Helena Laroche, an associate in the department of internal medicine at the University of Iowa College of Medicine, in Iowa City. "Adults influence children, and children influence adults, and it's important that we focus on the whole family."
The epidemic of obesity in the United States is claiming more and more victims. According to the U.S. Centers for Disease Control and Prevention, some 30 percent of adults aged 20 and older are overweight, totaling more than 60 million people. The percentage of young people who are overweight has tripled since 1980. Sixteen percent of children and teens (more than 9 million people) are overweight.
And Americans as a group consume more saturated fat, which is linked to heart disease, and total fat than is recommended. Although the percentage of calories derived from fat and saturated fat decreased from 1971 to 2000, the total intake remained the same or increased because overall food intake went up.
While a number of studies have looked at how adults influence children's eating habits, far fewer have looked at how children affect adults.
The authors of this study, appearing in the Jan. 4 online edition of the Journal of the American Board of Family Medicine, compared a group of adults who had children under the age of 17 at home with adults who had no children living at home. Data on the overall sample of 6,600 adults came from the federal government's National Health and Nutrition Examination Survey III (NHANES III). All participants had completed a questionnaire on food intake.
Compared to adults without children in the home, adults living with children ate an extra 4.9 grams of fat daily, including 1.7 grams of saturated fat.
Adults living with children in the home also ate many high-fat foods more frequently, including salty snacks, pizza, cheese, beef, ice cream, cakes and cookies, bacon and sausage, and processed meats and peanuts.
While this research cannot prove definitively that the presence of children causes the higher fat intake among adults, it does point to different eating habits in different types of households.
"Children's and adults' eating is enmeshed," said Susan Kraus, a nutritionist with Hackensack University Medical Center, in Hackensack, N.J. "It's hard to say which came first."
Specifically, adults with children in the home tended to eat "convenience" foods, perhaps related to time pressures and other constraints as well as children's preferences for high-fat, high-sugar foods.
"For a lot of parents, especially if both are working, there are time constraints getting food on the table," Kraus said. "Food also has so much symbolism, of love, attention, reward, it's something that can make life easier."
"Parents also need education just to know there are a lot of different products out there, or even to keep an open mind that a child might try something," Kraus added. "They might be in for a pleasant surprise."
Laroche has several tips for family-friendly, healthy eating:
* Place cut fruit and cut carrots around the house. They're easy for kids and for adults to grab.
* Choose popcorn and low-salt pretzels over high-fat potato chips.
* Children aged 2 and older should drink lower fat milk, not whole milk.
* Cook and bake in olive oil and avoid cooking in butter, lard or solid-stick margarine. This will decrease your intake of saturated fats.
* Only eat fast food and pizza once a week or less.
* When eating out, choose healthier items on the menu; order less and share rather than ordering tons of food and eating it all.
* Don't ditch the effort just because your child refuses to eat something once. "They need to try things more than once," Laroche said. "Studies show that they need to be exposed to things a few times before they'll really try them, and parents shouldn't give up on the first try."
"When they're buying things for their children or for themselves to eat, parents need to think about healthier choices for both of them," Laroche said. "Don't buy pizza just for the children, because they're likely to eat it as well. Focus on healthy foods for everybody."
More information
To learn more about healthy eating for children, visit the U.S. Department of Agriculture.
According to a new study, adults living with children eat more saturated fats than adults who don't live with children. The extra fat adds up to almost an entire frozen pepperoni pizza each week.
But it doesn't have to be that way.
"It's not that parents are doomed to the fate of eating terribly," said study author Dr. Helena Laroche, an associate in the department of internal medicine at the University of Iowa College of Medicine, in Iowa City. "Adults influence children, and children influence adults, and it's important that we focus on the whole family."
The epidemic of obesity in the United States is claiming more and more victims. According to the U.S. Centers for Disease Control and Prevention, some 30 percent of adults aged 20 and older are overweight, totaling more than 60 million people. The percentage of young people who are overweight has tripled since 1980. Sixteen percent of children and teens (more than 9 million people) are overweight.
And Americans as a group consume more saturated fat, which is linked to heart disease, and total fat than is recommended. Although the percentage of calories derived from fat and saturated fat decreased from 1971 to 2000, the total intake remained the same or increased because overall food intake went up.
While a number of studies have looked at how adults influence children's eating habits, far fewer have looked at how children affect adults.
The authors of this study, appearing in the Jan. 4 online edition of the Journal of the American Board of Family Medicine, compared a group of adults who had children under the age of 17 at home with adults who had no children living at home. Data on the overall sample of 6,600 adults came from the federal government's National Health and Nutrition Examination Survey III (NHANES III). All participants had completed a questionnaire on food intake.
Compared to adults without children in the home, adults living with children ate an extra 4.9 grams of fat daily, including 1.7 grams of saturated fat.
Adults living with children in the home also ate many high-fat foods more frequently, including salty snacks, pizza, cheese, beef, ice cream, cakes and cookies, bacon and sausage, and processed meats and peanuts.
While this research cannot prove definitively that the presence of children causes the higher fat intake among adults, it does point to different eating habits in different types of households.
"Children's and adults' eating is enmeshed," said Susan Kraus, a nutritionist with Hackensack University Medical Center, in Hackensack, N.J. "It's hard to say which came first."
Specifically, adults with children in the home tended to eat "convenience" foods, perhaps related to time pressures and other constraints as well as children's preferences for high-fat, high-sugar foods.
"For a lot of parents, especially if both are working, there are time constraints getting food on the table," Kraus said. "Food also has so much symbolism, of love, attention, reward, it's something that can make life easier."
"Parents also need education just to know there are a lot of different products out there, or even to keep an open mind that a child might try something," Kraus added. "They might be in for a pleasant surprise."
Laroche has several tips for family-friendly, healthy eating:
* Place cut fruit and cut carrots around the house. They're easy for kids and for adults to grab.
* Choose popcorn and low-salt pretzels over high-fat potato chips.
* Children aged 2 and older should drink lower fat milk, not whole milk.
* Cook and bake in olive oil and avoid cooking in butter, lard or solid-stick margarine. This will decrease your intake of saturated fats.
* Only eat fast food and pizza once a week or less.
* When eating out, choose healthier items on the menu; order less and share rather than ordering tons of food and eating it all.
* Don't ditch the effort just because your child refuses to eat something once. "They need to try things more than once," Laroche said. "Studies show that they need to be exposed to things a few times before they'll really try them, and parents shouldn't give up on the first try."
"When they're buying things for their children or for themselves to eat, parents need to think about healthier choices for both of them," Laroche said. "Don't buy pizza just for the children, because they're likely to eat it as well. Focus on healthy foods for everybody."
More information
To learn more about healthy eating for children, visit the U.S. Department of Agriculture.
Lasik Vs. Lasek: Both Are Safe, Effective
Vision-correction surgery patients will get just as good results from Lasik as from Lasek, a new study shows.
Both surgeries use lasers to cut flaps in the cornea to correct its shape. Lasek (laser-assisted subepithelial keratectomy) cuts only the outside surface of the cornea. This avoids some of the flap problems that can come with the deeper cut made during Lasik (laser in situ keratomileusis). But Lasek recovery is a bit longer, and there may be more pain after surgery.
Some doctors say Lasek is better. Others swear by Lasik.
Which is better? To find out, University of Illinois at Chicago researcher Dimitri Azar, M.D., and colleagues compared 122 eyes treated with Lasik to 122 eyes treated with Lasek.
"Both procedures seem safe, effective, and predictable," Azar says in a news release.
Eyes treated with Lasek ended up with slightly better vision. But the difference was too small for patients to notice.
"We found that although there were some differences ... that favor the Lasek procedure, the differences were not clinically significant," Azar says.
The findings appear in the December issue of the American Journal of Ophthalmology.
Both surgeries use lasers to cut flaps in the cornea to correct its shape. Lasek (laser-assisted subepithelial keratectomy) cuts only the outside surface of the cornea. This avoids some of the flap problems that can come with the deeper cut made during Lasik (laser in situ keratomileusis). But Lasek recovery is a bit longer, and there may be more pain after surgery.
Some doctors say Lasek is better. Others swear by Lasik.
Which is better? To find out, University of Illinois at Chicago researcher Dimitri Azar, M.D., and colleagues compared 122 eyes treated with Lasik to 122 eyes treated with Lasek.
"Both procedures seem safe, effective, and predictable," Azar says in a news release.
Eyes treated with Lasek ended up with slightly better vision. But the difference was too small for patients to notice.
"We found that although there were some differences ... that favor the Lasek procedure, the differences were not clinically significant," Azar says.
The findings appear in the December issue of the American Journal of Ophthalmology.
Oh, to be young and uninsured: Bad idea
Young people tend to take more risks than older folks, which is why you don't see many 50-year-olds competing in the X Games.
But even if you're not planning to compete in the Skateboard Vert, you shouldn't go a day without health insurance. Bad stuff happens, even to people who are young and healthy and feel invincible.
A serious case of pneumonia could cost you more than $75,000. A head injury from a car accident could set you back $45,000. Bills from a spinal cord injury could exceed $600,000.
Adults younger than 35 are nearly twice as likely to be uninsured as adults 45 and older, according to a report by the Blue Cross and Blue Shield Association. Twenty-seven percent of young adults in their 20s have no health insurance, according to a poll conducted by USA TODAY and the National Endowment for Financial Education.
Several factors contribute to the high uninsured rate among the young. Many young adults lose coverage under their parents' plans when they graduate from college, leaving them uninsured until they find a job. Once they find a job, they may have to wait several months before they're eligible for insurance — if their employer provides it at all.
Fortunately, there are ways to protect yourself from catastrophe without spending a lot of money. Some options:
•Short-term insurance. These policies offer health insurance for six months to a year. They typically cover major accidents and illnesses, but don't cover preventive care and doctor's office visits. Nor do they cover pre-existing conditions, so they're not appropriate for people who have chronic medical problems, says David Andrews, a vice president at Assurant Health, which provides temporary policies. Premiums for a six-month plan range from $32 to $70 a month, according to eHealthinsurance.com.
Many plans allow you to pay a month at a time, so you can stop paying premiums when you get a job. Some are renewable, but the insurer may refuse to extend your policy if you filed claims during the previous short-term period.
•Individual coverage. Individual insurance policies are usually more expensive than short-term plans, but they're a better option for people who need coverage for more than a few months, Andrews says.
If you're willing to carry a high deductible — which means you'll pay most of the costs of routine care — you can buy a plan with low monthly premiums. At HumanaOne, for example, plans for policyholders in their early 20s start at $40 a month with a $5,000 deductible, spokesman Mark Mathis says.
Some individual policies don't cover doctor's visits, while others require a co-payment. In general, though, you'll pay higher premiums for a plan that covers routine medical and dental expenses.
•Coverage under your parents' plan. States are increasingly extending the age at which children can remain on their parents' insurance plans. In New Jersey, children can stay on their parents' plans until age 30, as long as they live in the state and don't have children of their own. In Utah, children can stay on their parents' plans until age 26.
Staying on your parents' plan is a good option if you've suffered from a serious illness or have chronic medical problems. Premiums for an individual policy will likely be prohibitive, and some insurers will refuse to cover you at any price.
To check out your own state's rules for insurance coverage, go to the National Conference of States Legislatures' website, ncsl.org/programs/health/dependentstatus.htm.
•Coverage under COBRA. Even if you're no longer eligible for your parents' plan, you can extend coverage until you have your own insurance. Under the federal Consolidated Omnibus Budget Reconciliation Act, or COBRA, the insurer is required to allow you to purchase group coverage for up to 18 months. The downside: You must pay the entire cost of the premium, including the amount your parent's employer pays, plus administrative costs. In 2006, the average cost of premiums for single coverage was $354 a month, according to the Kaiser Family Foundation.
But if health problems make you a poor candidate for an individual or short-term policy, COBRA may provide the only way to protect yourself until you find a job with health insurance. Maintaining continuous coverage is critical: If you become seriously ill while you're uninsured, you may not be able to obtain health insurance in the future.
You can learn more about COBRA at dol.gov/dol/topic/health-plans/cobra.htm.
But even if you're not planning to compete in the Skateboard Vert, you shouldn't go a day without health insurance. Bad stuff happens, even to people who are young and healthy and feel invincible.
A serious case of pneumonia could cost you more than $75,000. A head injury from a car accident could set you back $45,000. Bills from a spinal cord injury could exceed $600,000.
Adults younger than 35 are nearly twice as likely to be uninsured as adults 45 and older, according to a report by the Blue Cross and Blue Shield Association. Twenty-seven percent of young adults in their 20s have no health insurance, according to a poll conducted by USA TODAY and the National Endowment for Financial Education.
Several factors contribute to the high uninsured rate among the young. Many young adults lose coverage under their parents' plans when they graduate from college, leaving them uninsured until they find a job. Once they find a job, they may have to wait several months before they're eligible for insurance — if their employer provides it at all.
Fortunately, there are ways to protect yourself from catastrophe without spending a lot of money. Some options:
•Short-term insurance. These policies offer health insurance for six months to a year. They typically cover major accidents and illnesses, but don't cover preventive care and doctor's office visits. Nor do they cover pre-existing conditions, so they're not appropriate for people who have chronic medical problems, says David Andrews, a vice president at Assurant Health, which provides temporary policies. Premiums for a six-month plan range from $32 to $70 a month, according to eHealthinsurance.com.
Many plans allow you to pay a month at a time, so you can stop paying premiums when you get a job. Some are renewable, but the insurer may refuse to extend your policy if you filed claims during the previous short-term period.
•Individual coverage. Individual insurance policies are usually more expensive than short-term plans, but they're a better option for people who need coverage for more than a few months, Andrews says.
If you're willing to carry a high deductible — which means you'll pay most of the costs of routine care — you can buy a plan with low monthly premiums. At HumanaOne, for example, plans for policyholders in their early 20s start at $40 a month with a $5,000 deductible, spokesman Mark Mathis says.
Some individual policies don't cover doctor's visits, while others require a co-payment. In general, though, you'll pay higher premiums for a plan that covers routine medical and dental expenses.
•Coverage under your parents' plan. States are increasingly extending the age at which children can remain on their parents' insurance plans. In New Jersey, children can stay on their parents' plans until age 30, as long as they live in the state and don't have children of their own. In Utah, children can stay on their parents' plans until age 26.
Staying on your parents' plan is a good option if you've suffered from a serious illness or have chronic medical problems. Premiums for an individual policy will likely be prohibitive, and some insurers will refuse to cover you at any price.
To check out your own state's rules for insurance coverage, go to the National Conference of States Legislatures' website, ncsl.org/programs/health/dependentstatus.htm.
•Coverage under COBRA. Even if you're no longer eligible for your parents' plan, you can extend coverage until you have your own insurance. Under the federal Consolidated Omnibus Budget Reconciliation Act, or COBRA, the insurer is required to allow you to purchase group coverage for up to 18 months. The downside: You must pay the entire cost of the premium, including the amount your parent's employer pays, plus administrative costs. In 2006, the average cost of premiums for single coverage was $354 a month, according to the Kaiser Family Foundation.
But if health problems make you a poor candidate for an individual or short-term policy, COBRA may provide the only way to protect yourself until you find a job with health insurance. Maintaining continuous coverage is critical: If you become seriously ill while you're uninsured, you may not be able to obtain health insurance in the future.
You can learn more about COBRA at dol.gov/dol/topic/health-plans/cobra.htm.
Indonesia sets bird flu deadline
Indonesia's bird flu chief has said the country aims to eradicate the disease in humans by the end of 2007.
Bayu Krisnamurthi said the aim was to see an end to new human cases and a gradual improvement in animal outbreaks.
Indonesia is the country worst affected by H5N1, and 57 people have died of the virus so far.
It is an ambitious target for a country that has been seen for years as heading in the wrong direction.
But many observers believe Indonesia is beginning to see results in its battle against bird flu.
A new focus earlier this year on targeting the animal disease as the source of the problem has led to a better mapping of the virus and a reduction in reported animal cases.
Indonesia plans to expand its programmes in 2007 to include better public awareness and contingency planning, and a comprehensive switch away from free range farming to minimise future outbreaks.
The expanded programmes have been made possible by large increases in funding from both the Indonesian government and the international community.
Since its arrival in 2003, bird flu has spread to 30 out of Indonesia's 33 provinces.
Most human cases of the disease are currently the result of contact with sick animals.
But experts worry the virus could mutate into a form that is easily passed between humans triggering a pandemic.
Bayu Krisnamurthi said the aim was to see an end to new human cases and a gradual improvement in animal outbreaks.
Indonesia is the country worst affected by H5N1, and 57 people have died of the virus so far.
It is an ambitious target for a country that has been seen for years as heading in the wrong direction.
But many observers believe Indonesia is beginning to see results in its battle against bird flu.
A new focus earlier this year on targeting the animal disease as the source of the problem has led to a better mapping of the virus and a reduction in reported animal cases.
Indonesia plans to expand its programmes in 2007 to include better public awareness and contingency planning, and a comprehensive switch away from free range farming to minimise future outbreaks.
The expanded programmes have been made possible by large increases in funding from both the Indonesian government and the international community.
Since its arrival in 2003, bird flu has spread to 30 out of Indonesia's 33 provinces.
Most human cases of the disease are currently the result of contact with sick animals.
But experts worry the virus could mutate into a form that is easily passed between humans triggering a pandemic.
Protest puff for patients' sake
Chris Wynne, clinical director of radiation oncology at Christchurch Hospital, said yesterday that he knew starting the habit was stupid.
But this was the only way he could highlight the suffering of cancer patients during industrial action by radiation therapists. The therapists are taking action in a dispute over pay with the District Health Boards (DHBs). The next strike will start on January 9 and go for three days.
Wynne, who has tried cigarettes only once before, as a teenager, said he was willing to smoke for "as long as it takes" to highlight the stupidity of the situation.
"I've tried everything sensible so now I am doing something stupid. Appealing to common sense hasn't solved these strikes," he said.
"The union and management are so close but they don't seem to be able to resolve this. The doctors have said if they tell us what the difference is in the money we will make it up, so it isn't even about the money any more."
Deborah Powell, national secretary of the radiation therapists' union, said she sympathised with Wynne.
"I agree with him that this situation is stupid and I can understand his feelings of frustration because we are frustrated too," she said.
"However, the problem is the DHBs and their offer. We are losing staff to Australia because pay and working conditions are better and we need to change that. If this doctor wants to help he should be sitting on Gordon Davies' (chief executive of the Canterbury DHB and national DHB spokesman) doorstep and asking him about money."
Action on Smoking and Health spokeswoman Sneha Paul said Wynne would know the risks of smoking as well as anyone. "Smoking is the single largest cause of preventable deaths, so we would recommend he found another way to express his concern. Every cigarette does you damage."
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