Tag Archives: Serena Gordon

Programmed to pack pounds?

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The genetic traits that helped our ancestors battle food scarcity could today be contributing to excess weight and related illnesses. (Courtesy Spectrum Health Beat)

By Serena Gordon, HealthDay


It’s not easy maintaining a healthy weight. Even when you manage to drop a few pounds, they often return.


Why would the body seem to encourage obesity?


New research suggests the answer lies far back in human evolution, with an anti-starvation mechanism that primes the body to store fat.


The key to this mechanism is a protein dubbed “RAGE,” according to New York University scientists working with mice. They believe RAGE evolved to help keep ancient humans from starving when food was scarce.


But today, in times of plenty, there’s a glitch at work: RAGE is produced to combat the cellular stress caused by overeating.


The protein seems to mistake this stress as similar to starvation, and so it switches off the body’s ability to burn fat. The result: fat becomes easy to accumulate, but tough to shed.


Still, there’s a silver lining to all of this, the NYU team said, because the research might lead to anti-obesity drugs.


“Our thinking is that RAGE is targetable. When we put mice with no RAGE expression at all on a high-fat diet, they ate the food but were not becoming obese,” explained study author Dr. Ann Marie Schmidt, from the NYU School of Medicine.


And a lack of RAGE appeared to be safe, at least for mice.


“When you totally delete RAGE in mice, they have normal reproduction and no problems with cognition,” she said.


The researchers hope that because RAGE seems to be active just during times of metabolic stress instead of during everyday functions, taking it away won’t create problems.


But don’t pin your hopes on a RAGE-deleting drug just yet.


Schmidt was quick to note that any such drug is a long way off yet because the research is currently in mice. Findings from animal studies don’t always translate to humans.


Still, Schmidt said the potential is exciting.


In addition to limiting the body’s ability to burn fat, RAGE also may contribute to inflammation throughout the body. So, along with taming obesity, it’s possible that removing the RAGE protein might help with some of the inflammatory consequences of obesity, such as diabetes, cancer, hardening of the arteries and Alzheimer’s disease, according to the researchers.


Dr. Michael Wood, medical director for bariatric surgery at the Detroit Medical Center’s Harper University Hospital, said the study was interesting, although very early.


And, Wood said, “obesity is a very complicated problem, and I think these findings are an oversimplification.”


But Wood noted that it’s possible the RAGE protein plays a role in excess weight. It’s just not likely the only factor in the development of obesity.


“I don’t think there’s one switch or any one thing that can solve this complicated issue. There’s no magic bullet for obesity,” he said.


Right now, if someone wants to lose weight, they have to commit to lifestyle changes, Wood said.


And, that’s true even if someone has weight-loss surgery. He added that the most significant change comes from eating fewer calories. Exercise is a healthy habit, but only a small component of weight loss.


The study was published online recently in the journal Cell Reports. Funding was provided by the American Heart Association, the U.S. Public Health Service and the American Diabetes Association.


Reprinted with permission from Spectrum Health Beat.



Allergies linked to heartburn meds

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Taking as few as six doses of heartburn medication each year may lead to an increased need for allergy medicine. (Courtesy Spectrum Health Beat)

By Serena Gordon, HealthDay


There are numerous drugs to treat digestive woes caused by heartburn or stomach ulcers. But solving one health problem may be causing another.


New research from Austria found that people who use drugs that suppress stomach acid were almost twice as likely to need drugs to control allergy symptoms.


And people over 60 who used these drugs were more than five times as likely to also need an allergy medication, the study reported.


“Many people have gastric (stomach) complaints and many people take anti-acid medicine. The longer the treatment with these medicines, the higher the risk of allergies,” said study senior author Dr. Erika Jensen-Jarolim, a clinical immunologist at the Medical University of Vienna.


How might these two conditions be connected?


Jensen-Jarolim said that, normally, the acidic environment in the stomach helps break down food-derived proteins that can cause allergies.


But if you take acid-suppressing drugs, the food you eat isn’t broken down into small enough pieces.


Intact allergens are sent to the intestine, where they can cause an allergic reaction and inflammation.


The implications from this study could be far-reaching.


According to the American College of Gastroenterology, more than 60 million Americans have had heartburn at least once in the past month.


Heartburn—gastroesophageal reflux disease, or GERD—occurs when stomach acid backs up into the esophagus (the tube connecting your throat and stomach), the American College of Gastroenterology said.


Symptoms include a feeling of burning behind the breastbone that can move up to the neck. Some people notice the bitter taste of bile in the back of the throat.


To treat this discomfort and pain, people often take acid-reducing medications. These include popular drugs called proton pump inhibitors, or PPIs.


Medications in this class include prescription and over-the-counter drugs like Prilosec (omeprazole), Prevacid (lansoprazole) and Nexium (esomeprazole).


Another class of medications is called H2 blockers. This class includes Tagamet HB (cimetidine), Pepcid (famotidine) and Zantac (ranitidine). There is also a medication called Carafate (sucralfate) that’s an aluminum compound.


All of these medications were linked to an increased use of allergy medications.


But there was a higher prevalence of allergy medication use after a sucralfate prescription, according to the study.


The study included prescription information from 97% of people in Austria. The data covered four years, from 2009 to 2013.


The researchers noted that as few as six doses of anti-acid medication each year were linked to an increased need for allergy medication. The risk of needing allergy medication rose with more frequent use of acid-reducing drugs.


Women and older people taking acid-reducing drugs were more likely to need allergy drugs.


Jensen-Jarolim said she hopes doctors will heed the study findings and prescribe acid-suppressing medications with care. She also hopes that consumers buying over-the-counter anti-acids will remember that these are medications and any medication can have side effects.


For those concerned about allergies, but who may still need acid-reducing drugs, she recommended taking these medications for the shortest time possible.


Dr. Elie Abemayor, chair of the division of gastroenterology at Northern Westchester Hospital in Mount Kisco, N.Y., reviewed the findings, and said it’s always important to weigh the benefits of a drug against the risk.


And while the findings were “concerning,” Abemayor said it’s important to recognize that this study is observational and cannot prove a cause-and-effect relationship.


“I would still take these drugs if I needed them. I don’t think this study will change the way they’re prescribed,” he said.


But he added that if you don’t really need the drugs for a long time, it’s a good idea only to take them as needed.


The findings were published recently in the journal Nature Communications.


Reprinted with permission from Spectrum Health Beat.


Use it or lose it

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Waistline and cardiorespiratory fitness are but two areas where health suffers when a sedentary lifestyle takes hold. The good news: The body responds just as quickly to positive lifestyle changes. (Courtesy Spectrum Health Beat)

By Serena Gordon, HealthDay


A new study proves that the old adage “use it or lose it” is definitely true when it comes to fitness.

After just two weeks of sedentary behavior, formerly fit people had:

  • A decline in heart and lung health
  • Increased waist circumference
  • Greater body fat and liver fat
  • Higher levels of insulin resistance

“The study showed that two weeks of reduced physical activity—from approximately 10,000 steps per day down to 1,500 per day—caused changes in health markers that are associated with Type 2 diabetes and cardiovascular disease,” said study author Kelly Bowden Davies. She’s a lecturer at Newcastle University and the University of Liverpool in the United Kingdom.

But the good news from the study is that the body seems to quickly bounce back once you start moving again.


“It’s important to note that when people resumed their normal activity levels after this period, the negative health changes were reversed,” she said.


The researchers recruited 28 healthy, regularly active adults. Eighteen were women. The average age of the study volunteers was 32.


Their average body mass index—a rough measure of body fat based on height and weight measurements—was just over 24. A BMI under 24.9 is considered normal weight.


The study volunteers had been quite active, normally clocking about 10,000 steps daily.


Bowden Davies said most of this was just from daily activity, rather than structured exercise. She said they usually participate in no more than two hours of structured exercise weekly.


The researchers asked the volunteers to cut their activity drastically. They dropped an average of just over 100 minutes a day, the researchers said.


After two weeks of couch potato life, the study volunteers underwent a battery of testing. These results were compared to findings measured when the study started.


Bowden Davies said cardiorespiratory fitness levels dropped by 4% in just two weeks.


Waist circumference rose by nearly one-third of an inch. Liver fat increased by 0.2%. Total body fat went up by 0.5%. Insulin resistance increased and triglyceride (a type of blood fat) levels went up slightly.


Fourteen days after resuming activity, these measures all bounced back, the investigators found.


“Even subtle increases in activity can have a positive effect on health. Moving more and breaking up sedentary activity is encouraged,” Bowden Davies added.


Dr. John Osborne, an American Heart Association spokesman, said this was a very interesting and somewhat surprising study.


The findings validate advice he gives his patients.


“If you can be a shark or a turtle, be a shark—always moving. This study showed you can lose the benefits of exercise very quickly, but the good news is that when they became sharks again, all the benefits came right back.”


Another expert who reviewed the study, Dr. Edmund Giegerich, chief of endocrinology and vice chairman of medicine at NewYork-Presbyterian Brooklyn Methodist Hospital in New York City, was also somewhat surprised by the magnitude of changes that happened in just two weeks.


Giegerich said the study confirms how important it is to stay active.


“Going from being sedentary to more active can help a great deal in preventing the onset of Type 2 diabetes. Just try to be more active. You’ll feel better, and if you’re trying to lose weight, it can help a little. You don’t have to run a marathon. Walking is fine. Just get up and get moving,” he advised.


Both experts pointed out that the study was small—and in a larger group, the findings might be different.

The study was also only done for a short period of time.


Bowden Davies, Osborne and Giegerich all suspect that if people who are at a lower fitness level stop almost all of their activity that the results might even be worse.


The study was presented recently at the European Association for the Study of Diabetes meeting, in Barcelona. Findings presented at meetings are typically viewed as preliminary until they’re published in a peer-reviewed journal.


Reprinted with permission from Spectrum Health Beat.



Got insomnia? Watch your heart health

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People with a genetic predisposition to insomnia had a higher risk of heart disease, heart failure and stroke that affected large blood vessels, according to a recent study. (Courtesy Spectrum Health Beat)

By Serena Gordon, HealthDay


If you spend a lot of nights watching the clock instead of sleeping, new research suggests you may need to be as concerned about your heart health as you are about lost shut-eye.


People with genetic variants linked to insomnia have an increased risk of heart disease, heart failure and stroke, according to the study.


“Good sleep is important for reducing the risk of cardiovascular disease,” said study author Susanna Larsson. She’s from the Karolinska Institute in Stockholm, Sweden.


“A potential explanation for our observed associations between insomnia and heart disease and stroke is that insomnia problems potentially lead to the metabolic syndrome, including high blood pressure, increased body weight and type 2 diabetes, which increase the risk of coronary artery disease and stroke,” she said.


Insomnia affects up to 30% of the general population, the study authors said. More than 200 genetic variants are associated with insomnia complaints.


For the new study, the researchers looked at health information on more than 1.3 million people in Europe. The investigators compared whether or not genetic variants linked to insomnia were also associated with the risk of heart conditions and stroke.


The study found that people with a genetic predisposition to insomnia had a higher risk of heart disease, heart failure and stroke that affected large blood vessels. Other types of stroke were not increased.


The researchers also noted that the risk of a potentially dangerous irregular heart rhythm known as atrial fibrillation wasn’t linked to insomnia.


Certain conditions, including heart disease and risk factors for heart disease, such as sleep apnea, may cause difficulty sleeping—and that makes it hard to tease out which condition comes first.


But, that’s a strength of this research, Larsson said.


Because they used genetic information to define insomnia instead of symptoms, it’s easier to see if sleep woes are directly related to the increased risk of heart problems and stroke.


There’s a flip side to that argument, however.


Because it’s not clear if the study volunteers actually had sleep troubles, or if they just had genes that made insomnia more likely, it’s hard to say if insomnia symptoms are truly the cause of these heart concerns and strokes.


Dr. John Osborne, an American Heart Association spokesperson and director of cardiology at State of the Heart Cardiology in Southlake, Texas, said he won’t be losing any sleep over the findings.


“It’s interesting and they used a powerful statistical technique that appears to be pretty accurate at identifying causal relationships. But the study didn’t identify how severe insomnia was or if people just have a tendency to insomnia,” he explained.


And, he said, the links they did find between insomnia and other conditions were only weak associations. Plus, the study was done in a European population. The findings may not be the same in more diverse groups of people.


Still, both experts said it’s a good idea to get the sleep you need for your health.


Larsson suggested that “individuals with poor sleep should try to change their habits and reduce stress in order to improve their sleep. Our genetic make-up has only a very minor influence on our risk of insomnia, which is mainly driven by behaviors, stress and other environmental factors.”


Osborne said stress management can help with sleep, as can avoiding stimulating substances like cigarettes and caffeine. He said to talk to your primary care doctor if you’re having a lot of trouble getting a full night’s sleep.


The study was published recently in the journal Circulation.


Reprinted with permission from Spectrum Health Beat.



Low-fat diet—a tool in breast cancer fight?

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Researchers found that women following a low-fat diet reduced their overall calories, changed their cooking methods and reduced portion sizes of meat and dairy products. (Courtesy Spectrum Health Beat)

By Serena Gordon, HealthDay


Health experts have long touted the benefits of a low-fat diet for preventing heart disease, but now a large study suggests it might do the same against breast cancer.


Researchers found that eating low-fat foods reduced a woman’s risk of dying from breast cancer by 21%. What’s more, the women on low-fat diets also cut their risk of dying from any cause by 15%.


“This is the only study providing randomized controlled trial evidence that a dietary intervention can reduce women’s risk of death from breast cancer,” said study author Dr. Rowan Chlebowski.


He is from the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center in Torrance, Calif.


Diet has long been suspected to be a factor in cancer.


Obesity has been linked to 12 different types of cancers, including postmenopausal breast cancer, according to the American Institute for Cancer Research. And, a diet full of healthy foods, such as vegetables, fruits, whole grains and legumes is thought to help protect against cancer.


Chlebowski noted that previous studies have shown a higher cancer incidence in countries where people tend to eat more fat.


The latest study looked at the effect a low-fat diet might have on the incidence of breast cancer and death.


Nearly 49,000 postmenopausal women from 40 centers across the United States were included in the study. The women were between the ages of 50 and 79 and had no history of previous breast cancer.


Eighty percent of the women were white, which Chlebowski said matched the population when the study began.


Between 1993 and 1998, the women were randomly assigned to one of two dietary groups. One group was assigned to a normal diet. This diet had about 32% of their calories from fat. The low-fat group had a target of 20% or less of calories from fat.


Chlebowski said the low-fat diet was close in content to the Dietary Approaches to Stopping Hypertension diet, or DASH diet. This emphasizes eating vegetables, fruits, legumes and whole grains, while avoiding high-fat meats and dairy products, according to the U.S. National Heart, Lung, and Blood Institute.


The low-fat group lost a modest amount of weight. Chlebowski said there was about a 3% difference in weight between the groups. He said the researchers factored the weight difference into their calculations and that weight alone didn’t affect the risk of death.


Women in the low-fat group adhered to the diet for about 8.5 years and both groups were followed for an average of nearly 20 years.


The women in the low-fat group weren’t able to achieve the 20%-or-less target for fat, but they did manage around 25%, according to the researchers. And they did increase their intake of fruits, vegetables and grains.


“The diet was more moderate than originally planned. But we saw a diet of 25% to 27% fat is largely achievable,” Chlebowski said.


He said the researchers don’t know if any individual components of the diet were more important than others, but they hope further study will tease that out.


In the meantime, Chlebowski said he thinks the message should be one of dietary moderation rather than looking for any one particular food or food group.


He said the women in the low-fat study group reduced their overall calories, changed their cooking methods and reduced their portions of meat and dairy products.


The findings are to be presented soon at the American Society of Clinical Oncology annual meeting in Chicago. Findings presented at meetings are typically viewed as preliminary until they’ve been published in a peer-reviewed journal.


ASCO breast cancer expert Dr. Lidia Schapira, from Stanford University, noted that this study shows “what we put on the plate matters. It’s worth coaching and pushing patients to put more fruits and vegetables on their plates.”


She added that even when women didn’t reach the more stringent dietary fat goal of 20%, they still showed a health advantage from trying to reduce the fat in their diets.


Dr. Monica Bertagnolli, president of ASCO, said these findings were “really, really striking.”


She noted, “This was not an incredibly restrictive diet. People were able to adhere to it pretty well.”


And yet, the incidence of breast cancer went down by 8% in the women on low-fat diets.


“They were getting fewer breast cancers and even when they did get breast cancer, their death rate was reduced,” Bertagnolli said.


Reprinted with permission from Spectrum Health Beat.


Fibromyalgia origin: Insulin resistance?

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Studies have shown differences in the brains of fibromyalgia sufferers, sometimes with areas of lower blood flow than expected. Similar problems have been seen in people with diabetes. (Courtesy Spectrum Health Beat)

By Serena Gordon, HealthDay


Fibromyalgia is a mysterious and misunderstood illness, but researchers may have uncovered at least one key to the disease’s origin: insulin resistance.


The new research compared a small group of people with fibromyalgia to two groups of healthy people and noted that a long-term measure of blood sugar levels was higher in the people with fibromyalgia.


Insulin resistance develops when the body starts to struggle with breaking down sugar.


To see if treating those higher blood sugar levels might help, the researchers gave people who had blood sugar levels in the pre-diabetic range or higher a diabetes medication called metformin.


People taking metformin reported significantly lower pain scores, according to the study.


“We combined metformin with standard drugs used for fibromyalgia and saw a much greater degree of pain relief,” said study author Dr. Miguel Pappolla. He is a professor of neurology at the University of Texas Medical Branch at Galveston.


In fact, Pappolla said, the additional pain relief was so significant that the researchers actually called patients on different days to re-check their pain scores.


Because this is a preliminary finding, the researchers aren’t sure how insulin resistance might contribute to fibromyalgia or how metformin might reduce pain. “Metformin may have some analgesic (pain-relieving) activity on its own,” Pappolla said.


Fibromyalgia is a condition that causes widespread pain, fatigue, sleep problems and distress, according to the U.S. Centers for Disease Control and Prevention.


Even celebrities aren’t spared from this painful condition—Lady Gaga reportedly had to cancel concerts on her tour due to pain from fibromyalgia.


Though the cause of the disorder isn’t clear, it appears that people with fibromyalgia may be more sensitive to pain than other people—what the CDC calls abnormal pain processing.


Pappolla said that studies have shown differences in the brain between people with fibromyalgia and those without, such as areas with a lower blood flow than expected.


The researchers noted that similar problems have been seen in people with diabetes.


The study included 23 people with fibromyalgia.


The researchers compared their hemoglobin A1c levels to large groups of healthy people from two other studies.


Hemoglobin A1c is a simple blood test that measures what someone’s blood sugar levels were during the past two or three months. A level of 5.7% to 6.4% is considered pre-diabetes, according to the American Diabetes Association. A level of 6.5% or higher means a person has diabetes.


Only six of those with fibromyalgia had normal blood sugar levels. Sixteen had levels considered pre-diabetes and one met the criteria for diabetes.


When the researchers compared the average blood sugar levels of the fibromyalgia group to healthy age-matched people in the other studies, they saw that the blood sugar levels were higher in the people with fibromyalgia, suggesting insulin resistance.


The findings were published online recently in the journal PLOS ONE.


Dr. Edward Rubin, an anesthesiologist and pain management specialist at Long Island Jewish Medical Center, said, “It’s interesting that there’s a possible connection between fibromyalgia and blood sugar. We’ve been attacking the symptoms of fibromyalgia, but we don’t have a good understanding of the root cause of fibromyalgia.”


Rubin, who wasn’t involved in the study, said there may be enough evidence here to try metformin along with other medications used for fibromyalgia for people whose blood sugar levels fall outside of the normal range, to see if they have a positive response.


Dr. Bharat Kumar, from the University of Iowa Hospitals and Clinics, said this study shows people with the disease that there is hope.


“People with fibromyalgia are often told (falsely) that they have a disease that simply cannot be managed. This article shows that it’s not true. Although it’s unclear if metformin will work for every person suffering from fibromyalgia, there is active research into finding solutions for this frustrating and overlooked condition,” he said.


Kumar said it’s biologically plausible that insulin could have an effect on pain.


“We know that other hormone abnormalities can cause fibromyalgia-like symptoms, so (this finding) is not too surprising,” he added.


Still, he said, he didn’t expect that metformin would be a “silver bullet” for all fibromyalgia pain. He said there are likely a number of causes of the disease.


Reprinted with permission from Spectrum Health Beat.

New guidelines on ADHD

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New guidelines for ADHD treatment emphasize the need for ongoing medical care and coordination within the school and community. (Courtesy Spectrum Health Beat)

By Serena Gordon, HealthDay


Attention-deficit hyperactivity disorder is in the news a lot and now newer research has prompted a leading pediatricians’ group to update its guidelines for diagnosing and treating the disorder for the first time since 2011.


Dr. Mark Wolraich, lead author of the guidelines, noted that there weren’t any dramatic differences between these and previous guidelines.


But, he said, these latest updates keep the American Academy of Pediatrics guidelines in sync with the same diagnostic and treatment criteria used by child and adolescent psychiatrists.


ADHD “is not a ‘new’ diagnosis. It’s a real diagnosis that needs treatment,” Wolraich said.


“There are two forms of treatment effective for ADHD: medications, especially stimulant medications, and behavioral treatments. Neither treatment is curative,” he said, but they can help manage the symptoms.


Wolraich is an emeritus professor at the University of Oklahoma, in Oklahoma City.


More than 9% of U.S. children between the ages of 2 and 17 have been diagnosed with ADHD, according to the guideline authors.


Boys are more than twice as likely as girls to be diagnosed with the disorder. Kids with ADHD often have symptoms of another mental disorder—such as depression or anxiety—and they may also have learning and language problems.

Updates to the guidelines include:

  • Changing the age at which symptoms need to have first started. Previously, symptoms needed to begin before age 7. That’s now been raised to age 12.
  • In patients older than 17, fewer problem behaviors are needed to make an ADHD diagnosis. Wolraich said as children get older, symptoms can change and behaviors such as hyperactivity usually diminish.
  • Emphasizing the need to rule out other causes of ADHD-like symptoms and to identify other conditions that may occur with ADHD, such as depression, anxiety, substance use, autism or trauma.
  • Highlighting the need for ongoing medical care and coordination within the school and community.
  • Recommending parent training in behavior management as a first-line treatment for preschoolers. Wolraich said behavior modification is an effective treatment that generally has two phases of treatment. The positive phase rewards a child for appropriate behavior—and the reward may just be praising, such as, “Johnny, I like the way you’re sitting in your chair.” The second phase includes consequences, such as “time-out.” But, he said, if you don’t have the positive side of treatment, time-out isn’t as helpful.

While the guidelines didn’t specifically recommend behavior management training for teachers and parents in high school students with ADHD, they noted that studies have found some value in this treatment for older kids.


Dr. Victor Fornari, vice chair of child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y., said it’s important for pediatricians to be familiar with the up-to-date guidelines, because “as many as 10% of all kids meet the criteria for ADHD and many children with mild to moderate symptoms can be evaluated and treated by their pediatrician.”


Fornari said if treatment doesn’t go smoothly or there are ongoing behavior problems or other mental health concerns, pediatricians can often collaborate with a child and adolescent psychiatrist to get additional guidance.


Both Wolraich and Fornari said pediatricians play a vital role in ADHD diagnosis and treatment because they already have an established relationship with the child and family.


“People may not fully appreciate that ADHD that’s untreated can lead to adverse outcomes. Failing to treat can lead to academic and conduct disturbances, and earlier substance use disorders. Children who are identified earlier and treated are more successful,” Fornari said.


The new guidelines were published online recently in the journal Pediatrics.


Reprinted with permission from Spectrum Health Beat.

Dining out with allergies is tough

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Although 170 foods have been reported to cause allergic reactions, there are eight common foods that cause allergies: milk, egg, peanut, tree nuts, wheat, soy, fish and shellfish. (Courtesy Spectrum Health Beat)

By Serena Gordon, HealthDay


When you have serious food allergies, eating at a restaurant can literally mean risking your life. But new research suggests you can take steps to protect yourself when dining out.


In fact, the more steps you take to protect yourself from exposure to the allergic substance, the less likely you are to have an allergic reaction, the study found.


The researchers asked 39 people with allergies (or their parents) about 25 behaviors people might do before eating out. Nineteen of those surveyed had experienced a food allergy reaction while dining at a restaurant.


“Overall, when you look at the results and the strategies that people used, people who had an allergic reaction [after eating out] used significantly less strategies compared to non-reactors. Non-reactors used an average of 15 strategies, reactors used an average of six,” said study author Dr. Justine Ade, a pediatric resident at University Hospitals’ Rainbow Babies and Children’s Hospital in Cleveland.


Up to 15 million people may have food allergies, according to the nonprofit organization FARE (Food Allergy and Research Education). Although 170 foods have been reported to cause allergic reactions, there are eight common foods that cause allergies in the United States: milk, egg, peanut, tree nuts, wheat, soy, fish and shellfish. FARE reports that sesame allergy is also a growing threat.


Eating food outside the home has been linked to numerous deaths in people with food allergies, according to the researchers.


Although the study didn’t evaluate how well any particular strategy worked, it did note how often people used individual strategies.

The top 5 strategies people use

  • Speaking to the waiter on arrival (80 percent)
  • Ordering food with simple ingredients (77 percent)
  • Double-checking food before eating (77 percent)
  • Avoiding restaurants with higher likelihood of contamination (74 percent)
  • Reviewing ingredients on a restaurant website (72 percent)

The strategies used least often

  • Placing food allergy order separately (23 percent)
  • Using a personal allergy card (26 percent)
  • No longer eating at restaurants (39 percent)
  • Choosing a chain restaurant (41 percent)
  • Going to a restaurant during off-peak hours (44 percent)

Ade said it may sound like a lot of work just to eat out, but “these are things that become second nature for some people, and it probably takes less than five minutes to do most of these things.”


People with food allergies aren’t the only ones who worry about what’s on their restaurant plate. Alice Bast, CEO of Beyond Celiac, a nonprofit health and awareness group, said that every time someone with celiac disease eats out, they play “gluten roulette.”


Celiac disease is a digestive disorder, and symptoms are triggered when someone with the disease eats gluten, a protein found in wheat, barley and rye.


“Dining out is one of the biggest challenges of living with celiac disease,” Bast said. “When you’re out of control of your food, it’s easy to feel anxious about the possibility of becoming sick. There are always risks when someone else is preparing your meal, especially if they don’t take it seriously, or if they are just unaware of how to take the appropriate precautions.”


Both experts said it’s important to be vigilant and take the steps that you can to make sure your food is as safe as it can be. In the case of food allergies, Ade said it’s important to carry an epinephrine injection pen every time you eat out.


Ade presented the findings at the American College of Allergy, Asthma and Immunology annual meeting, in Seattle. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.


Reprinted with permission from Spectrum Health Beat.

Beware the ball pit

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A lab analysis of plastic balls from play areas found bugs responsible for pink eye, urinary tract infections, bloodstream infections, heart inflammation and more. (Courtesy Spectrum Health Beat)

By Serena Gordon, HealthDay


If the cacophony of children screaming and throwing tiny plastic balls everywhere hasn’t prompted you to forgo ball pits, a new study may just send you scurrying for the door.


The research found that ball pits were awash in microbes, some potentially quite dangerous.


The study team found 31 bacterial species and one species of yeast. Some of those bugs are responsible for pink eye, urinary tract infections, bloodstream infections, heart inflammation and more.


“Be aware of this if you take your child to a physical therapy clinic, especially if the child has a compromised immune system,” said senior study author Dobrusia Bialonska, assistant professor of environmental microbiology at the University of North Georgia.


“You might consider asking for no treatment in the ball pit. We definitely showed that there are things on the balls that can potentially hurt a child who is immune-compromised,” she said.


Does that mean all kids need to steer clear of ball pits in fast food restaurants or other play spaces?


No, Bialonska said.


“We’re talking about pediatric physical therapy patients that may have some immune problems and may be more fragile. If kids are healthy, let them go and play. It may help build their immune system,” she said.


But kids should wash their hands when they jump out of the pit, especially if they’re going to eat after playing, Bialonska quickly added.


Ball pits became popular in the 1980s when they began popping up in commercial restaurant chains across the United States. But these play areas are often contaminated with visible dirt, vomit, urine and feces, researchers said. Numerous bacteria had already been identified in ball pits, but researchers wanted to learn how those used for physical therapy for children might compare.


The study team collected samples from six ball pits in Georgia physical therapy clinics. They randomly selected nine to 15 balls from each location, then swabbed the whole surface of each ball to find any microbes.


There were microorganisms on all of the balls, though some had very few. The researchers said it’s not unusual or concerning to see microbes anywhere humans are present. There should be concern when there are a lot of microbes, however.


Researchers noted a significant variation in the extent of microbial contamination from clinic to clinic. That suggests a need to develop guidelines for cleaning the balls and the pit area when they are used for physical therapy in potentially vulnerable kids, researchers said.


Bialonska said there are no standards or directions for cleaning these areas. She said someone had used a commercial washing machine to clean the balls. Others have tried using ultraviolet light to disinfect the balls.


Dr. Maryann Buetti-Sgouros, chair of pediatrics at Northern Westchester Hospital in Mount Kisco, N.Y., was not involved with the research, but reviewed the study.


“Common sense has to dictate how you address risks as a parent,” she said. “If there’s somewhere germy, what will you do to decrease the risk? A little bit of germs isn’t awful. Carry antibiotic wipes.”


Another expert agreed.


“Many of the microbes isolated are part of our normal flora,” said Dr. Salman Khan, an infectious disease physician at Lenox Hill Hospital in New York City. “However, some of these have the potential to cause disease in patients with immunocompromising conditions and open wounds.”


Buetti-Sgouros said she doesn’t think ball pits are inherently worse than other places where kids play, but the balls cannot be sterilized between uses and are going to get covered in bacteria.


If you’re taking a child for physical therapy where there is a ball pit, she suggested asking how the balls are sterilized. “In this study, one of the clinics didn’t have as much bacteria. What were they doing differently?” she said.


Buetti-Sgouros also pointed out that injuries are a concern at ball pits and other kid play areas, such as those with multiple indoor trampolines.


“Again, let common sense dictate. But, I’d rather see kids outside where there’s ventilation and air,” she said.


The study was recently published in the American Journal of Infection Control.


Reprinted with permission from Spectrum Health Beat.



Don’t overlook OTC nasal sprays

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Over-the-counter nasal steroid sprays are generally the most effective type of allergy medicine, experts say. (Courtesy Spectrum Health Beat)

By Serena Gordon, HealthDay

 

Seasonal allergies make life miserable for millions of Americans.

 

So, in a bid to ease some of that discomfort, experts from two leading groups of allergists created a task force that has just issued new practice guidelines on the best ways to quell those bothersome symptoms.

 

The consensus? For most people, nasal steroid sprays are the way to go, according to the American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology.

 

The sprays are easy to get—many are available over-the-counter. And, they’re relatively inexpensive.

 

For the OTC versions, a month of treatment is about $15 to $20. OTC brand names include Nasacort, Nasonex, Flonase and Rhinocort, while prescription brands include Beconase, Qnasl and Veramyst, according to the AAAAI.

 

But the biggest reason the experts are recommending nasal sprays is that they’re generally more effective than other types of allergy medicine for the initial treatment of seasonal allergies, according to the new guidelines.

 

Plus, they have relatively few side effects, according to Dr. Punita Ponda, associate chief of allergy and immunology at Northwell Health in Great Neck, N.Y.

 

Nasal sprays aren’t perfect, however.

 

“They can cause itching of the nose, dryness of the nose and nosebleeds,” Ponda said. But, she added, using the proper spray technique can help lessen these side effects. She suggested asking your doctor to show you how to use these devices.

 

Seasonal allergies are often called hay fever and they span the seasons. The Nemours Foundation reports that people can be allergic to one or more types of pollen or mold, and the type dictates when symptoms strike.

 

For example, in the Middle Atlantic states, tree pollen is the culprit from February through May, followed by grass pollens from May through June, and weed pollens from August through October. Mold spores, meanwhile, typically peak from midsummer through the fall, depending on where you live, according to the foundation.

 

The new guidelines recommend nasal steroid sprays as the initial treatment for people aged 12 and older instead of an oral antihistamine such as Benadryl, Zyrtec, Claritin and Allegra.

 

The task force didn’t find evidence of an improvement in results if oral antihistamines were added to treatment, and these drugs may cause sleepiness.

 

In people 15 and over, the task force recommends starting treatment with a nasal steroid spray instead of a leukotriene receptor antagonist (such as Singulair or Accolate). Again, the nasal spray appears to be more effective. Singulair and Accolate are prescription drugs, so cost depends on your insurance plan.

 

For people with moderate to severe seasonal allergies who are older than 12, the task force suggests adding an intranasal antihistamine to treatment with a nasal steroid inhaler. The additional medication provided additional benefit for those with more severe allergies, the task force said.

 

Ponda noted that the task force didn’t recommend intranasal steroids for kids under 12.

 

“It may be easier to give oral antihistamines than intranasal steroids to children, and there’s concern about possible growth suppression. Oral antihistamines were thought to be useful for this group,” she said.

 

Dr. Luz Fonacier, who directs the allergy training program at NYU Winthrop Hospital in Mineola, N.Y., also pointed out that the medications in “this guideline for initial treatment of mild seasonal (allergies) may be obtained OTC, and therefore may have been tried by the patient.”

 

She said that for people who aren’t helped by nasal steroids, oral antihistamines, nasal antihistamines and leukotriene receptor antagonists may lessen symptoms.

 

Ponda said if nasal steroids and additional drugs don’t control allergy symptoms well, or if someone just gets tired of having to use medications regularly, allergy shots are also an option.

 

“Allergy shots have been shown to be cost-effective compared to medications. Usually, you get one shot a week for six months, and then once a month for three to five years. It’s definitely a commitment, but it’s the only treatment that’s actually disease-modifying. Allergy shots actually make a person less allergic or non-allergic,” Ponda explained.

 

The new guidelines were published online in the Annals of Internal Medicine.

 

Reprinted with permission from Spectrum Health Beat.

Climate change could change the sneezin’ season

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The increase in carbon dioxide in the atmosphere also causes ragweed to produce more pollen, so these plants are becoming more potent. (Courtesy Spectrum Health Beat)

By Serena Gordon, HealthDay

 

If you live in the north and you’ve never experienced hay fever, new research predicts that climate change has an unwelcome surprise in store for you.

 

Warmer temperatures in the northern United States will allow ragweed—the plant that triggers hay fever—to flourish in areas it’s never been before. About 35 years from now, the study predicts, ragweed will be found in New Hampshire, Maine, Vermont and upstate New York.

 

But the news isn’t all bad. Folks sneezing due to ragweed in the southern United States should get some relief as the temperatures get too warm for ragweed to grow well.

 

Ragweed will decline substantially in central Florida, northeastern Virginia and the southern Appalachian Mountains, according to the researchers.

 

“Ragweed is a major cause of allergies and asthma. Climate change will make some areas worse for ragweed, and some areas may get better,” said Michael Case, of The Nature Conservancy. He co-authored the study when he was a postdoctoral researcher at the school of environmental and forest sciences at the University of Washington in Seattle.

 

Ragweed is a native North American plant. It produces a lot of fine, powdery pollen from August to November. This pollen causes symptoms in people who are allergic to ragweed, including sneezing, watery eyes, itchy throat, runny nose and headaches, the researchers said.

 

Case and his co-author, Kristina Stinson, an assistant professor of plant ecology at UMass Amherst, created a model that included data on hundreds of areas with ragweed today, along with the conditions that allow ragweed to thrive.

 

The researchers then added information from 13 global climate-prediction models. These models were developed using two different pathways of potential greenhouse gas emissions.

 

When all of this information was combined, the new model predicted the northward creep of ragweed.

 

After that—from the 2050s to the 2070s—areas with ragweed may see a slight contraction. The researchers said this is because temperatures and precipitation may become more variable.

 

The study authors pointed out that their model was not designed to know if ragweed could become a problem as far north as Canada or further west in the United States because their model didn’t have information on those areas.

 

Marian Glenn, an emeritus professor in the department of biological sciences at Seton Hall University in South Orange, N.J., reviewed the findings.

 

“This is another example of plants that are migrating north as the climate warms. This is happening with viruses and diseases that are considered tropical, now that the agents that cause those diseases can survive through winter,” she said.

 

“The increase in carbon dioxide in the atmosphere also causes ragweed to produce more pollen, so these plants are becoming more potent,” Glenn explained.

 

And that means climate change will make ragweed season longer and more aggravating for allergy sufferers, she added.

 

Case agreed that ragweed season will probably last longer. And ragweed isn’t the only plant affected.

 

“Climate change is extending the growing season for everything,” he said. However, because ragweed is abundant, it made it possible to study that one particular plant.

 

Case said the study has practical implications. For example, weed control boards should now be aware that they might have to start monitoring for ragweed. And allergy sufferers and their doctors also need to be aware that ragweed may start becoming a problem in areas that haven’t seen it before.

 

The findings were published online recently in the journal PLOS One.

Kid study: Hot soup causes 2 in 10 scald burns

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Kid study: Hot soup causes 2 in 10 scald burns (Courtesy Spectrum HealthBeat)

By Serena Gordon, HealthDay

 

Many kids love a quick bowl of instant soup or tasty noodles, but these fast foods cause almost 10,000 scald burns in children each year in the United States, a new study estimates.

 

What’s more, researchers found that two out of every 10 scald burns that send kids to the ER are caused by microwavable instant soup spills.

 

“We suspect that, in terms of risk, parents may think things coming out of the microwave may be somewhat safer than things coming off the stove,” said study author Dr. Courtney Allen. She is a pediatric emergency medicine fellow at Emory University in Atlanta.

 

But since so many burns are caused by microwavable instant soup and noodles, “any school-age child consuming these products needs to be adequately supervised,” she said.

 

Dr. Michael Cooper, director of Staten Island University Hospital’s burn center in New York City, said the study mirrors what he often sees in practice.

 

“We do see instant soup and noodle burns with kids in this age group,” he said.

 

The good news is that most of the children were treated in the emergency room and then sent home, Cooper noted. Most didn’t have to stay in the hospital and they would likely heal in two weeks or less.

 

“These burns are painful, but most appear to be superficial,” he explained.

 

Cooper said the scenario he often sees is that the parent has heated the prepackaged container of soup and given it to the child. While eating, the child knocks it over and gets burned.

 

A simple solution might be taking the noodles or soup from the original container and transferring them to a bowl the child is accustomed to using, Cooper suggested. A bowl probably isn’t as tall as some of the instant-food containers.

 

For the study, the researchers reviewed data from the U.S. National Electronic Injury Surveillance System from 2006 to 2016. They looked for kids aged 4 to 12 with scald burns caused by microwavable instant soup, instant noodles, cups of soup, or water for making instant soup.

 

Scald burns associated with instant soups and noodles affected more than 9,500 children each year, the findings showed. The average age of a child with such a burn was 7 years old.

 

The most commonly burned site was the child’s torso—about 40 percent of burns occurred here.

 

Allen said the database didn’t specify whether kids had cooked the foods in the microwave themselves, or if parents or another caregiver had done so.

 

She added that injuries may occur when someone grabs a hot container from the microwave and flinches because it’s so hot, spilling it on themselves.

 

Allen also noted that instant noodles absorb the liquid during cooking. So if a child drops a container of noodles, the hot food may stick to the body.

 

Cooper said the study shows a need for more education of parents, grandparents and other caregivers. “People need to be more aware that these burns can happen,” he said.

 

The study is scheduled for presentation at an American Academy of Pediatrics meeting in Orlando. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

 

Reprinted with permission from Spectrum HealthBeat.

Is your workplace making you fat?

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Courtesy Spectrum Health Beat

By Serena Gordon, HealthDay

 

The dilemma is all too familiar: It’s Monday morning, you walk into your office and see that someone has left a big box of donuts in the break room. Then, your co-worker tells you there will be cake later for yet another birthday celebration.

 

One thing’s for sure. You’re not alone.

 

A new federal government survey found that about one-quarter of Americans “acquire” nearly 1,300 calories at work every week. Even worse, the survey only included foods people didn’t bring to work themselves, and food they didn’t purchase from outside vendors.

 

“The majority of the calories people got at work, people didn’t pay for—70 percent of the calories were free,” said study co-author Stephen Onufrak, an epidemiologist at the U.S. Centers for Disease Control and Prevention.

 

The food and beverages that were most commonly obtained at work, he said, were:

  • Coffee
  • Sugar-sweetened soft drinks
  • Sandwiches
  • Tea
  • Cookies
  • Brownies
  • French fries
  • Pizza
  • Salad
  • Water
  • Diet soft drinks

When the researchers looked at the foods by calories, pizza was the leading source of calories obtained at work, followed by sandwiches and regular soft drinks.

 

Onufrak said the foods obtained at work might have been lunch—some workplaces did have onsite cafeterias and foods purchased at an employee cafeteria were included in the survey.

 

The study included more than 5,200 people from a nationally representative group that completed a U.S. Department of Agriculture survey in 2012 and 2013. The volunteers answered questions about the foods they obtained at work over a seven-day period. They only reported food they acquired at work, and they didn’t say whether or not they ate the foods.

 

Onufrak said the survey didn’t ask about what people ate at home, so it’s hard to know for sure if they continued eating foods that were high in refined sugar, salt and empty calories once they left the office. But he said that based on other research he’s done, “a lot of the eating patterns we saw tend to be consistent.”

 

The findings show that employers have an opportunity to improve their workers’ health, he said.

 

“If you look at data on worksite wellness programs, they’re effective at getting people to have healthier behaviors, reducing health care costs and reducing absenteeism. I think encouraging a healthy diet is an essential part of a worksite wellness program,” Onufrak explained.

 

Nutritionist Samantha Heller noted that offering healthy fare could provide a benefit to employers, because employees who eat well “will feel better, will have more energy and can focus better.”

 

Heller, who’s with NYU Langone Medical Center in New York City, added, “When we feed our bodies well, our bodies and brains respond. It’s a win-win for the company and the employees.”

 

But what if your workplace doesn’t offer healthy options? The best option may be to bring your own lunch, Heller suggested. That way, you’re in charge of what foods are available to you, and it saves you money.

 

If you don’t bring your own lunch, she said, you should do some scouting to see what healthy food choices are available around your workplace. And it’s a good idea to do this when you aren’t hungry.

 

And what about all those free sweets at work?

 

“People bring a lot of treats to work. People like to feed each other to show affection. But it’s OK to say no to the birthday cake or the brownies. It’s always going to be somebody’s birthday or another celebration. Decide ahead of time that you’re going to say no to treats at work,” Heller advised.

 

Onufrak is scheduled to present the findings at the American Society for Nutrition annual meeting in Boston. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

 

For help developing better eating habits, visit Spectrum Health Nutrition Counseling or schedule a personalized appointment by calling 616.391.1875.

 

Reprinted with permission from Spectrum Health Beat.