Month: October 2011

Smoking

2.5 Million Children Exposed to Secondhand Smoke in California?

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The answer is yes, according to a new policy brief from the UCLA Center for Health Policy Research.

Despite having the second-lowest smoking rate in the nation, California is still home to nearly 2.5 million children under the age of 12 who are exposed to secondhand smoke, according to a new policy brief from the UCLA Center for Health Policy Research.

Using data from several cycles of the California Health Interview Survey, the study’s authors estimate that 561,000 children are directly exposed to secondhand smoke in the home. Another 1.9 million are at risk because they live in a home where another family member is a smoker, even though smoking may not be allowed in the home itself.

Secondhand smoke exposes children to a greater risk of developing asthma, respiratory infections and countless other ailments. Research shows that children raised by smokers have a greater risk of becoming smokers themselves.

“The next frontier in the campaign against smoking is to reduce smoking at home,” said Sue Holtby, the study’s lead author and a senior researcher at the Public Health Institute, which works with the UCLA Center for Health Policy Research in conducting the California Health Interview Survey. “California’s fight against tobacco has been a major public health success story, but we still need to spread awareness and ensure that every family knows the dire consequences of addiction.”

Other findings:

  • African American children three times more likely to live with smokers
  • Children living in households at or above 300 percent of the federal poverty level (FPL) are far less likely to be exposed to secondhand smoke
  • Rural children at greater risk than urban
  • Although Los Angeles doesn’t have the highest percentage of smoking households (10.8 percent) it has a surprisingly high percentage (4.1 percent) of households with children where smoking in the home is allowed, relative to other regions.

The entire policy brief is here.

Again, please for your health, quit smoking or better yet – never start.

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Obesity

Poll Watch: Half of German Adults are Obese and Overweight

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According to the latest Gallup Poll.

Half of German adults are obese (13.7%) and overweight (36.4%), similar to the 54.5% in the United Kingdom, but significantly less than the 62.1% in the United States.

These data were collected as part of the Gallup-Healthways Well-Being Index from March to September 2011 in Germany, the U.K., and the U.S.

The Gallup-Healthways Well-Being Index uses respondents’ self-reports of their height and weight to calculate body mass index (BMI) scores. Individual BMI values of 30 or higher are classified as “obese,” 25.0 to 29.9 are “overweight,” 18.5 to 24.9 are “normal weight,” and 18.4 or less are “underweight.”

Still lower than the United States which is at 62.1%.

But, like the U.S. and U.K – way too high!

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Diet

After Finishing Dieting, Hormonal Changes May Lead to Weight Gain?

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The answer is YES, according to a new study.

By some estimates, as many as 80% of overweight people who manage to slim down noticeably after a diet gain some or all of the weight back within one year.

A shortage of willpower may not be the only reason for this rebound weight gain. According to a new study in the New England Journal of Medicine, hunger-related hormones disrupted by dieting and weight loss can remain at altered levels for at least a year, fueling a heartier-than-normal appetite and thwarting the best intentions of dieters.

“Maintaining weight loss may be more difficult than losing weight,” says lead researcher Joseph Proietto, Ph.D., a professor of medicine at the University of Melbourne’s Heidelberg Repatriation Hospital, in Victoria, Australia. “This may be due to biological changes rather than [a] voluntary return to old habits.”

Scientists have known for years that hormones found in the gut, pancreas, and fatty tissue strongly influence body weight and processes such as hunger and calorie burning. And the reverse is also true: A drop in body fat percentage, for instance, causes a decrease in the levels of certain hormones (such as leptin, which signals to your brain when you’re full) and an increase in others (such as ghrelin, which stimulates hunger).

What wasn’t so well known, until now, was whether these changes in hormone levels persist after an individual loses weight. To find out, Proietto and his colleagues put 50 overweight or obese men and women on a very low-calorie diet for 10 weeks, then tracked their hormone levels for one year.

So, how do you maintain your weight loss?

Or, is being obese inevitable?

That’s not to say that weight regain is inevitable, or that these drives can’t be overcome through willpower. Although the hormone changes noted in the study are very real physical effects, Proietto says, personality and psychological factors may play a role in an individual’s ability to manage chronic hunger.

“This may explain why some people maintain weight loss for longer than others,” he says. “Maintenance of weight loss requires continued vigilance and conscious effort to resist hunger.”

Promising research is being done to discover ways to restore hormone levels in people who lose weight, Burant says. Preliminary studies from Columbia University, for example, have found that when dieters are injected with replacement leptin hormones, it’s easier for them to maintain or continue weight loss.

“When diabetics don’t have enough insulin in their bodies, we give them back insulin in order to maintain their blood glucose,” Burant says. Researchers should be finding a way to do the same for people who have lost weight, he adds, “whether it’s with a drug, a dietary supplement, or certain nutrients—something that will stimulate the release of these hormones.”

Proietto agrees that finding an appetite suppressant of this sort is the next logical step in hormone and obesity research. Until then, he says, weight-loss surgery is a possible option for some severely obese people who have not been able to keep weight off by other methods.

For now, I will continue to monitor my diet and exercise regularly. Perhaps there will be a vaccine to help the severely obese, and certainly that is a better option than surgery.

Stay tuned…..

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Diigo Links

Flap’s Smiles and Health Headlines: October 26, 2011

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These are Flap’s Health Headlines for October 26th.

    • From 234 pounds to the Miss America pageant –“Every Friday, Bree Boyce dreaded her high school gym class. Students had to run a mile under 11 minutes, and those who couldn’t finish in time would have to walk around the track for the rest of the period.

      Weighing 234 pounds, Boyce never made it in time.

      “There were a few times I tried to run because I was so embarrassed and afraid of what other kids might say. After many failed attempts, I gave up hope,” said Boyce.

      Every day, Boyce wore a baggy T-shirt and a pair of faded, size 18 jeans to school. She ducked and dodged anytime someone tried to take her picture. She deflected attention from her weight by cracking jokes.

      Five years later and 112 pounds lighter, Boyce is no longer the camera-shy girl hiding inside saggy, shapeless tees.

      She struts onstage in body-hugging evening gowns and swimsuits. She embraces the spotlight as the reigning Miss South Carolina. And she has been a guest co-host on “The View,” chatting openly about her weight.”

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  • China arrests 18 in illegal transplant crackdown-“Police in eastern China have arrested 18 people after a raid on two clinics offering illegal organ transplants, state news agency Xinhua reported on Wednesday.

    The clinics in Jinan, Shandong’s provincial capital, were raided on Sunday as doctors were preparing a kidney transplant, Xinhua cited local police as saying.

    “Police were tipped off earlier this month, and then launched a probe with the city’s health bureau against the two clinics. They found that vehicles and people regularly shuttled between the two clinics, which were not far away from each other,” the report said.

    China in 2007 banned organ transplants from living donors, except spouses, blood relatives and step or adopted family members, but launched a national system to coordinate donations after death in 2009. The organ shortage has driven a trade in illegal organ trafficking in the country.

    “Reports about illegal transplants indicate there appears to be a large underground network profiting from the country’s demand for donor organs,” Xinhua added.

    Police this month arrested three doctors for “illegally harvesting human organs” in northern Hebei province, it said. The doctors were all from Shandong.

    Nearly 1.5 million people in China need organ transplants each year, but only 10,000 can get one, according to the Health Ministry.”

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  • High fizzy soft drink consumption linked to violence among teens-“Teens who drink more than five cans of non-diet, fizzy soft drinks every week are significantly more likely to behave aggressively, suggests research published online in Injury Prevention. This includes carrying a weapon and perpetrating violence against peers and siblings.”

    US lawyers have successfully argued in the past that a defendant accused of murder had diminished capacity as a result of switching to a junk food diet, a legal precedent that subsequently became known as the “Twinkie Defense” — a twinkie being a packaged snack cake with a creamy filling.

    Responses were assessed in the light of factors likely to influence the results, including age and gender, alcohol consumption, and average amount of sleep on a school night.

    Those who drank 5 or more cans of soft drinks every week were significantly more likely to have drunk alcohol and smoked at least once in the previous month.

    But even after controlling for these and other factors, heavy use of carbonated non-diet soft drinks was significantly associated with carrying a gun or knife, and violence towards peers, family members and partners.

    When the findings were divided into four categories of consumption, the results showed a clear dose-response relationship across all four measures.

    Just over 23% of those drinking one or no cans of soft drink a week carried a gun/knife, rising to just under 43% among those drinking 14 or more cans. The proportions of those perpetrating violence towards a partner rose from 15% in those drinking one or no cans a week to just short of 27% among those drinking 14 or more.

    Similarly, violence towards peers rose from 35% to more than 58%, while violence towards siblings rose from 25.4% to over 43%.
    In all, for those teens who were heavy consumers of non-diet carbonated soft drinks, the probability of aggressive behaviour was 9 to 15 percentage points higher — the same magnitude as the impact of alcohol or tobacco — the findings showed. “There may be a direct cause-and-effect-relationship, perhaps due to the sugar or caffeine content of soft drinks, or there may be other factors, unaccounted for in our analyses, that cause both high soft drink consumption and aggression,” conclude the authors.

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  • U.K. dentist alleges ‘porcelain pornography’-“Patients who come in for cosmetic work are often seeking the perfect smile. But some dentists are compromising sound enamel and dentin to give patients unnecessary porcelain crowns and veneers, according to Martin Kelleher, BDS, MSc, a consultant in restorative dentistry at the King’s College London Dental Institute.

    In an editorial published this summer in Faculty Dental Journal (July 2011, Vol. 2:3, pp. 134-141), Dr. Kelleher discussed the dangers of aggressive, expensive, and at times unnecessary treatment of minor cosmetic problems with brittle porcelain.

    In fact, Dr. Kelleher has coined a new term for this phenomenon: “porcelain pornography.”

    It is increasingly common to see patients who have received restorative treatment that was probably of more benefit to the profits of the dentists than to the patients’ long-term dental health, he stated in the editorial.

    “In my view, many of these unfortunate patients are being robbed twice — first of their money and again of their (even more precious) sound tooth structure,” he wrote. “I call this ‘double mugging.’ ”

    According to Dr. Kelleher, the overuse of porcelain crowns and veneers originated in the U.S. to produce the “very even, very white look” Hollywood look, and various factors may have contributed to the growth of this trend.

    Some possible reasons could be patient demand from a largely superficial and image-obsessed society, Dr. Kelleher told DrBicuspid.com. “Payment systems, a fix-it culture, money, or speed could also be factors in some specific circumstances,” he said.”

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Medicare Payment Advisory Commission

ObamaCare Declares War on Doctors

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Think anyone will want to go into medicine? And, who will accept Medicare?

Early retirement for physicians and dentists will mean a very real shortage of medical/dental providers.

Go here and sign the petition.

The worst fears about Obamacare are now being realized in a decision on Monday by the Medicare Payment Advisory Commission (MPAC) established by the law to supervise $500 billion in Medicare cuts.

 MPAC, whose decisions have the force of law, has voted to impose drastic pay cuts on all doctors under Medicare and, by extension, under Medicaid (which tends to follow suit).  The cuts will effectively reduce the real pay for specialists by 50% over the next ten years — including a 25% reduction over the next three years — and cut general practitioners’ pay by one-third over ten years (and that assumes that inflation stays down at 3% a year).

MPAC has ruled that specialists must accept a 6% cut in their fees per year for each of the next three years followed by a seven year freeze in their fees without any adjustment for inflation.  If inflation stays very low — at 3% per year — this cut amounts to an 18% cut in nominal pay and a 50% cut in real pay for specialists.  General practitioners will face a ten year freeze on their pay, reducing their real compensation by one-third assuming ongoing low inflation.  Higher inflation, of course, would make the cuts in real pay even more drastic.
 
The consequences of the MPAC decision will be immediate and drastic:

  • Many physicians, and many more specialists, will refuse to treat Medicare patients.  It will become very, very difficult to see a cardiologist or an oncologist or a gastroenterologist or OB-GYN specialist if you are on Medicare unless you are willing to pay out of pocket or have the kind of health insurance coverage from a private source that would reimburse for their care.
  • More and more medical care will be turned over to nurses or physician assistants, and fewer people will ever get to see a doctor on Medicare.
  • Private health insurers will follow in the footsteps of the Medicare program and likely slash their fees as well.
  • Fewer students will enter medicine, and a major shortage of doctors will reduce the quality of medical care in America drastically.

The MPAC cuts will bring American doctors’ incomes more into line with European doctors who typically earn half or less of what their American counterparts earn — and deliver worse medical care as a result.
 
We have got to stop these MPAC cuts from taking effect.  The very future of Medicare and of our entire health care system is at stake.  If they are allowed to stand, Medicare will become akin to Medicaid or public housing — a program for poor people who cannot afford to pay for medical care from specialists outside the system.

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