Could Heavier Folks Be at Lower Risk for ALS?

 It's not often that anything good is associated with obesity. Yet heavy folks and those who bulk up as they age may have less risk for the deadly disease amyotrophic lateral sclerosis (ALS), a new study

finds.
The Norwegian study found that over several decades, people who packed on the most weight had a 37% lower risk of ALS compared to those who maintained their figure or got thinner.
ALS -- also called Lou Gehrig's disease -- is a rare neurodegenerative disease that kills nerve cells in the brain and spinal cord. You lose control of your muscles, which can lead to paralysis and death two to five years after diagnosis, researchers said.
"This study provides a basis for future research to focus on possibilities to prevent or treat ALS on factors linked to body size and energy expenditure," said lead researcher Dr. Ola Nakken.
Nakken, of the University of Oslo in Norway, cautioned that these findings can't prove that being overweight prevents ALS, as only an association was observed. Nor should you think the findings give you license to fatten up. They don't, he said.
Although the reasons why weight might be protective aren't known, Nakken thinks that increased bulk may add to a person's energy reserve.
"It has become increasingly clear that motor neurons, which are the main cells involved in ALS, are remarkably vulnerable to energy depletion," Nakken said.
It's also possible that genetic factors that lower the risk for ALS may also play a part in weight gain, without one causing the other. In addition, environmental factors may be associated with both weight and the risk of ALS, the researchers said.
"Physical activity and smoking are examples of such factors. However, adjusting for this in our study did not change the results," Nakken said.
According to the ALS Association, about 5,000 Americans are diagnosed with ALS each year. The disease usually strikes people between the ages of 40 and 70, but can occur earlier.
Family history of ALS plays no role in 90% of the cases. The other 10% are caused by an inherited gene mutation.
For the study, Nakken and his team collected data on nearly 1.5 million Norwegians ages 20 to 70 between 1963 and 1975. They tracked cases of ALS until 2017. Nearly 3,000 developed the disease in that time period, with most followed an average of 33 years.
Those who started out at a normal weight but gained pounds over time had a 17% lower risk for ALS for each 5-point increase in body mass index (BMI), the study found. BMI is a measurement of body fat based on height and weight.
Over the length of the study, those who were obese when it began had 34% lower odds of developing ALS, compared with those with low to normal BMI. Overweight people had an 18% lower risk, the researchers reported.
The study results were published online June 26 in the journal Neurology.
However, some cautions are in order, one neurologist suggested.
The understanding of how ALS and other neurodegenerative diseases develop doesn't include weight as either a cause or a preventative, said Dr. Carmel Armon, from the department of neurology at Tel Aviv University Sackler School of Medicine in Israel.
"We also cannot speculate that elevated BMI directly increases the resistance of the motor neurons to the development of ALS," he said.
Armon is co-author of an accompanying journal editorial. He warned against gaining weight in the hope of preventing ALS.
"The health risks of high BMI outweigh any protective effect it might confer on ALS occurrence," Armon said. "The findings do not allow us to conclude such a protective effect exists."

Just 30 Minutes of Light Exercise a Week May Keep Deadly Stroke at Bay

 Just a little exercise may help protect you against a type of deadly bleeding stroke, a new study suggests.
As many as half of people who suffer a subarachnoid hemorrhage die within three months.
While smoking and high blood pressure have been shown to increase the risk of this deadly stroke, there has been little evidence on whether exercise can help reduce it.
For this study, researchers examined data from about 70,000 people in Finland and concluded that as little as 30 minutes a week of light exercise reduces the risk by about 5%.

The risk falls as the amount of exercise increases, according to the study published June 25 in the journal Scientific Reports.
"Even moderate physical exercise, such as a 30-minute walk or bike ride four days a week reduces the risk... by roughly 20%, regardless of age and gender," principal author Dr. Joni Lindbohm said in a University of Helsinki news release.
"As such, the finding did not really come as a surprise, as exercise is known to work well in preventing many other cardiovascular diseases. However, the extent and comprehensive nature of the benefit among various groups of people was a positive surprise," she added.
The study also found that exercise can reduce the risk caused by smoking and high blood pressure. For smokers, exercise lowers the odds up to two times more than in the general population.
"However, what must not be overlooked is the fact that smoking remains the number one risk factor for [this stroke] and that quitting smoking is the principal way of preventing the appearance of the disorder," Lindbohm said.
Study co-author Dr. Miikka Korja, head of neurosurgery at Helsinki University Central Hospital, reflected on the reduced risk.
"Even with no accurate scientific evidence of the biological mechanism of action produced by exercise... the reduced risk is most likely connected with a reduction in a systemic inflammatory state, which also affects the walls of cerebral arteries," he said.

Vyndaqel

US FDA Accepts Regulatory Submissions for Review of Tafamidis to Treat Transthyretin Amyloid Cardiomyopathy

January 14, 2019 - Pfizer Inc. (NYSE: PFE) announced today that the US Food and Drug

Administration (FDA) accepted for filing the company’s New Drug Applications (NDAs) for tafamidis for the treatment of transthyretin amyloid cardiomyopathy (ATTR-CM). Pfizer has submitted two NDAs based on two forms of tafamidis: meglumine salt and free acid. Tafamidis is the only product to complete a Phase 3 trial evaluating its efficacy, safety, and tolerability in patients with ATTR-CM, a rare, fatal, and underdiagnosed condition.1,2
The tafamidis meglumine form (20 mg capsule) has been granted Priority Review. The FDA grants Priority Review to medicines that may offer significant advances in treatment or may provide a treatment where no adequate therapy exists. The target Prescription Drug User Fee Act (PDUFA) action date for a decision by the FDA is in July 2019.
The tafamidis free acid form (61 mg capsule) will be under Standard Review. This form is bioequivalent to the 80 mg tafamidis meglumine dose, which was administered as four 20 mg capsules in the pivotal trial; it was developed for patient convenience to enable a single capsule for daily administration. The target PDUFA action date for a decision by the FDA is in November 2019.
“The diagnosis of ATTR-CM is often delayed, primarily because disease awareness is low and patients often present with symptoms similar to more common causes of heart failure. In fact, we believe less than one percent of patients living with this disease are currently diagnosed,” said Brenda Cooperstone MD, Senior Vice President and Chief Development Officer, Rare Disease, Pfizer Global Product Development. “The FDA’s filing acceptance is an encouraging step toward our goal of further raising awareness and providing a treatment option for ATTR-CM patients who are in desperate need of an approved pharmacologic therapy. We look forward to working with the FDA to bring the first treatment for this deadly disease to patients.”
The submission is based on findings from the pivotal Phase 3 Transthyretin Amyloid Cardiomyopathy (ATTR-ACT) study, which evaluated the efficacy, safety, and tolerability of tafamidis meglumine compared to placebo for the treatment of patients with ATTR-CM. In the primary analysis of the study, tafamidis met the primary endpoint, demonstrating a significant reduction in the hierarchical combination of all-cause mortality and frequency of cardiovascular-related hospitalizations compared to placebo over a 30-month period in patients with wild-type or hereditary ATTR-CM (P=0.0006). Tafamidis was well tolerated, with an observed safety profile comparable to placebo.3 The primary results were presented in a Hot Line session at the ESC Congress 2018 in Munich, Germany, and simultaneously published online in the New England Journal of Medicine (NEJM) in August 2018. Results from additional sub-group analyses were presented during the Late Breaking Clinical Trials session at the Heart Failure Society of America 22nd Annual Scientific Meeting in Nashville, TN, in September 2018. For 

Upadacitinib

AbbVie Announces New Drug Application Accepted for Priority Review by FDA for Upadacitinib for Treatment of Moderate to Severe Rheumatoid Arthritis

NORTH CHICAGO, Ill., Feb. 19, 2019 /PRNewswire/ -- AbbVie (NYSE: ABBV), a research-based global biopharmaceutical company, has announced that the U.S. Food and Drug Administration (FDA) has accepted for priority review its New Drug Application (NDA) for upadacitinib for the treatment of adult patients with moderate to severe rheumatoid arthritis. Upadacitinib is an investigational once-daily oral JAK1-selective inhibitor being studied for multiple immune-mediated diseases.1-13 AbbVie anticipates a regulatory decision in Q3 2019.
The NDA is supported by data from the global upadacitinib SELECT Phase 3 rheumatoid arthritis program evaluating more than 4,000 patients with moderate to severe rheumatoid arthritis across five of six Phase 3 studies.3-7 In all SELECT Phase 3 studies, upadacitinib met all primary and ranked secondary endpoints. The most frequent serious adverse events were infections.3-7 Top-line results from these clinical studies were previously announced.
Upadacitinib is also under review by the European Medicines Agency for the treatment of adult patients with moderate to severe rheumatoid arthritis.
About the SELECT Study Program3-8

The robust SELECT Phase 3 rheumatoid arthritis program evaluates more than 4,900 patients with moderate to severe rheumatoid arthritis in six studies, five of which support regulatory submission for upadacitinib. The studies include assessments of efficacy, safety and tolerability across a broad range of rheumatoid arthritis patients. Key measures of efficacy evaluated include ACR responses, Disease Activity Score (DAS28-CRP) and inhibition of radiographic progression.

Cabotegravir and rilpivirine

Janssen Announces Submission of New Drug Application to U.S. FDA For the First Monthly, Injectable, Two-Drug Regimen of Rilpivirine and Cabotegravir for Treatment of HIV

Cork,Ireland, April 29, 2019 – The Janssen Pharmaceutical Companies of Johnson & Johnson have announced that a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA)

has been submitted by ViiV Healthcare for the investigational once-monthly, injectable, two-drug regimen of Janssen’s rilpivirine and ViiV’s cabotegravir for the treatment of HIV in adults whose viral load is suppressed and who are not resistant to cabotegravir or rilpivirine.
The submission is based on the ATLAS (Antiretroviral Therapy as Long-Acting Suppression) and FLAIR (First Long-Acting Injectable Regimen) pivotal Phase 3 studies that included more than 1,100 patients from 16 countries. These studies demonstrated that the combination of rilpivirine and cabotegravir, injected monthly, was as effective as a standard of care, daily, oral three-drug regimen in maintaining viral suppression throughout the 48-week study period. These results were presented in March at the 2019 Conference on Retroviruses and Opportunistic Infections.
“We believe this once-monthly injectable regimen has the potential to offer many people living with HIV a treatment option that does not require taking pills every day,” said Brian Woodfall, M.D., Global Head, Development, Infectious Diseases, Janssen Biopharma, Inc. “In our quest to change the trajectory of health for humanity, we will continue to innovate in the field of HIV. We look forward to working with ViiV and the FDA on the steps needed to get the first long-acting injectable HIV treatment to patients.”
This novel regimen is being co-developed as part of a collaboration between Janssen and ViiV Healthcare. The two companies plan to submit regulatory applications for the two-drug regimen of rilpivirine and cabotegravir to the European Medicines Agency, Health Canada and other global agencies in the coming months.
As part of the regulatory submission package to the FDA, a second NDA was submitted for an oral tablet formulation of cabotegravir that would be taken once-daily as an oral lead-in with the already-approved oral tablet formulation of rilpivirine (marketed by Janssen as EDURANT®).
About ATLAS (NCT02951052)
ATLAS is a Phase 3, open-label, active-controlled, multicenter, parallel-group, non-inferiority study designed to assess the antiviral activity and safety of a two-drug regimen of long-acting, injectable rilpivirine and cabotegravir dosed every four weeks compared to continuation of current oral anti-retroviral therapy (ART) of two nucleoside reverse transcriptase inhibitors (NRTIs) plus an integrase strand transfer inhibitor (INI), non-nucleoside reverse transcriptase inhibitor (NNRTI), or protease inhibitor (PI) among virally suppressed individuals. The primary endpoint for ATLAS is the proportion of participants with plasma HIV-1 RNA ≥50 c/mL per the FDA Snapshot algorithm at Week 48 (Missing, Switch, or Discontinuation = Failure, Intent-to-Treat Exposed [ITT-E] population). Subjects were required to be virally suppressed for six months or longer, on a first or second regimen, with no prior failure.
About FLAIR (NCT02938520)
FLAIR is a Phase 3, randomized, open-label, multicenter, parallel-group, non-inferiority study designed to assess the antiviral activity and safety of a two-drug regimen of intramuscular, long-acting, injectable rilpivirine and cabotegravir in virologically suppressed adults living with HIV, following 20 weeks of induction therapy with Triumeq® compared to continuation of the oral dolutegravir-based treatment regimen. The primary endpoint for FLAIR is the proportion of participants with plasma HIV-1 RNA ≥50 c/mL per the FDA Snapshot algorithm at Week 48 (Missing, Switch, or Discontinuation = Failure, Intent-to-Treat Exposed [ITT-E] population).
About rilpivirine long-acting

Rilpivirine long-acting is an investigational, injectable, prolonged-release suspension for intramuscular injection being developed by Janssen Sciences Ireland UC and is not approved by regulatory authorities anywhere in the world.
About cabotegravir

Cabotegravir is an investigational integrase inhibitor (INI) and is not approved by regulatory authorities anywhere in the world. Cabotegravir is being developed by ViiV Healthcare for the treatment and prevention of HIV and is currently being evaluated as a long-acting, prolonged-release formulation for intramuscular injection and also as a once-daily oral tablet for short-term use prior to long-acting injection.
About the Janssen Pharmaceutical Companies of Johnson & Johnson

At Janssen, we’re creating a future where disease is a thing of the past. We’re the Pharmaceutical Companies of Johnson & Johnson, working tirelessly to make that future a reality for patients everywhere by fighting sickness with science, improving access with ingenuity, and healing hopelessness with heart. We focus on areas of medicine where we can make the biggest difference: Cardiovascular & Metabolism, Immunology, Infectious Diseases & Vaccines, Neuroscience, Oncology, and Pulmonary Hypertension.
Learn more at www.janssen.com and follow us at www.twitter.com/JanssenGlobal. Janssen Biopharma Inc., and Janssen Sciences Ireland UC are members of the Janssen Pharmaceutical Companies of Johnson & Johnson.
Notice to Investors Concerning Forward-Looking Statements
This press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995 regarding rilpivirine and development of potential preventive and treatment regimens for HIV. The reader is cautioned not to rely on these forward-looking statements. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of Janssen Sciences Ireland UC, any of the other Janssen Pharmaceutical Companies and/or Johnson & Johnson. Risks and uncertainties include, but are not limited to: challenges and uncertainties inherent in product research and development, including the uncertainty of clinical success and of obtaining regulatory approvals; uncertainty of commercial success; manufacturing difficulties and delays; competition, including technological advances, new products and patents attained by competitors; challenges to patents; product efficacy or safety concerns resulting in product recalls or regulatory action; changes in behavior and spending patterns of purchasers of health care products and services; changes to applicable laws and regulations, including global health care reforms; and trends toward health care cost containment. A further list and descriptions of these risks, uncertainties and other factors can be found in Johnson & Johnson's Annual Report on Form 10-K for the fiscal year ended December 30, 2018, including in the sections captioned “Cautionary Note Regarding Forward-Looking Statements” and “Item 1A. Risk Factors,” and in the company’s most recently filed Quarterly Report on Form 10-Q, and the company’s subsequent filings with the Securities and Exchange Commission. Copies of these filings are available online at www.sec.gov, www.jnj.com or on request from Johnson & Johnson. None of the Janssen Pharmaceutical Companies nor Johnson & Johnson undertakes to update any forward-looking statement as a result of new information or future events or developments.
Source: Janssen Pharmaceutical Companies of Johnson & Johnson

Cooking With Whole Grains

 When it comes to getting the best taste and the greatest nutritional value from grains, keep it whole grain.
Quinoa, oats, short-grain brown rice and wild rice, polenta (which is made from corn) and barley are most nutritious in their whole, unprocessed form. That's because the bran is still intact, and the bran is where most of the minerals, vitamins and plenty of fiber reside.
Processed and packaged foods are rarely made from 100 percent whole grains. Think of them as empty carbs with lots of preservatives, so switch to these flavorful grains to load up on nutrition, including essential minerals and even some protein.
Tip: Don't be fooled by the word "multi-grain" on packages -- this does not mean that a variety of or even any whole grains were used.
Brown rice is high in magnesium and tryptophan, barley is high in selenium and tryptophan, and steel cut oats are high in manganese and zinc. These grains are simple to prepare. Bring water to a boil, add your grains and cook on low heat for about 45 minutes until tender. Remove from the heat and keep covered for 5 minutes to allow the grains to fluff, then stir with a fork.
Quinoa is another excellent choice, high in iron and manganese, plus it's quicker to cook than the other grains. Rinse a cup of dry quinoa under cold running water, then add it to 2 cups of boiling water. Cover and simmer for about 20 minutes.
Use cooked grains in any dish that calls for white rice or pasta. If you're eating them plain, you can still get creative with tasty "add-ins" like dried cranberries on breakfast oatmeal or barley, a drizzle of balsamic on brown rice and a sprinkle of Parmesan on quinoa.
More Great Grains
Amaranth
Bulgur
Buckwheat
Kasha (toasted buckwheat)
Spelt
Farro
Millet

Exercise Secrets to a Better Bottom

 If you're bored with doing squats for a better bottom, it's time to vary your workout.
For a study sponsored by the American Council on Exercise (ACE), scientists at the University of Wisconsin-La Crosse evaluated popular exercises for the glutes to find the ones that are most effective.
Popular Glutes Strength-Training Exercises
Four-way hip extensions
Horizontal leg press
Lunges
Quadruped hip extensions
Single leg squats
Step-ups
Traditional squats
Vertical leg press
The traditional squat is still a great choice, but not the only one. In fact, if you want to target the hamstrings along with the glutes, quadruped hip extensions and step-ups are very effective. So are lunges, single-leg squats and four-way hip extensions.
To get started, the experts at ACE recommend a super set of quadruped hip extensions followed by the step-ups. First, you do both exercises with one leg, and then you repeat them with the other leg, without any rest in between.
For the hip extensions, get on hands and knees and contract your abs a bit to stabilize your core. Next, keeping the right knee bent at a 90-degree angle, lift your right leg until your thigh and the sole of your foot are parallel with the floor. With control, return to the starting position. Do eight to 12 reps.
Immediately move to the step-ups. Stand behind a 15-inch-high step with a dumbbell in each hand. Place your right foot on the step and transfer all your weight to that leg. Push down with your right foot to straighten the leg, bringing yourself up on the step. (Only the right leg is engaged -- the left leg is passive.) Now step down, leading with your right foot. Do eight to 12 reps.
Immediately repeat both exercises with the left leg.
Build up to three full sets of the entire sequence.

Stretches for Calves, Hamstrings and Quads

 Stretching your leg muscles can improve your flexibility and prevent injury. Here are three stretches that you can do every day and at every age.
Start with a calf stretch. Stand at arm's length from a wall and place your palms flat on the wall at shoulder height for support. Now take one big step backward with one leg. Keep that leg straight as you bend the front knee. Lean forward, but keep your back heel planted firmly on the floor. You should feel the stretch in your lower leg. Hold for 20 to 30 seconds, then switch legs and repeat. Repeat three to five times with each leg.
Now move to a hamstring stretch. Lie flat on your back and extend one leg straight up to the ceiling. Loop an exercise band around the ball of that foot and hold the ends of the band firmly around both hands. Now pull on the band to create tension, drawing your foot slightly toward your head. Hold for 20 to 30 seconds, then switch legs and repeat. Repeat three to five times with each leg.
Finish with a quad stretch. Stand a few feet in front of a step or low stool. Extend one leg behind you so that you are resting that foot on the step. Bend your front knee slightly without letting it extend beyond your toes. Hold for 20 to 30 seconds, then switch legs and repeat. Repeat three to five times with each leg.
For safety, never bounce when stretching. This can cause muscles to tighten and lead to injury. Ease into every stretch with slow, steady movement. And only stretch a warm body -- after a workout is perfect. But if you're not working out, a few minutes of walking is enough of a prep.

Head Injuries Tied to Motorized Scooters Are Rising: Study

 Head injuries from riding electric scooters without a helmet are on the rise, a new study reports.
Between 2008 and 2017, nearly 32,000 injuries were estimated nationwide, according to a review of records in the Consumer Product Safety Commission's National Electronic Injury Surveillance system. Accidents tripled from about 2,300 in 2008 to nearly 7,000 in 2017.
Most of those injured were adult men, but a third of the injuries happened to kids between 6 and 12 years of age, researchers said.
The most common injuries were closed head injuries, such as concussions, and bleeding or bruising of the brain, the researchers found. Facial cuts and abrasions were also common.
In accident records that made note of helmet use, 66% of those injured weren't wearing one. Use of helmets increased with age from 19% among toddlers to 67% among senior riders. Helmet laws vary from state to state.
Researchers emphasized that electric scooters aren't toys and can reach speeds of up to 30 mph.
"The United States should standardize electric scooter laws and license requirements should be considered to decrease the risky behaviors associated with motorized scooter use," said study lead author Dr. Amishav Bresler. He's a resident in the department of otolaryngology-head and neck surgery at Rutgers New Jersey Medical School in Newark.
"In 2000, Italy implemented a law mandating helmet use for all types of recreational scooter drivers -- legislation that reduced head trauma in scooter riders from about 27 out of 10,000 people before the law passed to about 9 out of 10,000 people afterward," Bresler said in a Rutgers news release.
The report was
ed online recently in the American Journal of Otolaryngology.

AHA News: With Grit and Gratitude, Stroke Survivor Plays On

THURSDAY, May 23, 2019 (American Heart Association News) -- Dave Kim can hardly remember a time he wasn't making music. He plays three instruments – most notably the electric violin – and has performed at countless weddings and in concerts around the world, opening for such acts as Hootie and the Blowfish.
So after having a stroke in August 2016 at age 42, he called upon his music training to help him recover.
While in intensive care, Kim used what strength he had to focus, not on the proper notes or certain chords or harmonies, but on his right thumb. He willed that thumb to move. On Day Five, it did.
Then came research, including the discovery that the way musicians' brains were formatted could help aid stroke recovery.
"When communication cuts off from the brain to the limbs," he said, "the brain finds other ways to communicate with the limbs." That ability is called neuroplasticity. Reading about it gave Kim impetus to work on each finger, each arm, each leg.
"I found that everything I've done in my life is therapy," he said.
Kim had his stroke while recording a music video in his California home. Mid-song, his right arm gave way. Then his right leg went limp. He was able to call a doctor friend. A neighbor drove him to the hospital. Kim's blood pressure was measured at a dangerous 230/130. An MRI showed a blood clot in the brain.
The stroke left him unable to stand, much less play his beloved instruments. He felt trapped in his body and, he said, "buried alive." He feared being in the hospital forever and nobody remembering him.
But when Kim shared his plight on social media, dozens and dozens of fans and friends came to visit. They posted well wishes. Their support overwhelmed his spirits.
"I do matter," Kim realized.
Longtime friend Will O'Brien said that when he visited Kim in the hospital, he could sense a change. Not in the obvious physical way, but more deeply. The stroke, he said, gave Kim "a new lease on life. It was one of those tragic events he turned into a true blessing."
After leaving the hospital, Kim spent three weeks in rehab, working to regain the ability to walk, to play music, to do everyday tasks often taken for granted. He also learned about strokes – which he, like many people, thought only happen to the elderly.
Looking back, he sees signs that pointed the way to his stroke. Each of his parents had had one. He was overweight and not eating a healthy diet. He didn't exercise. His cholesterol level and his blood pressure were high. And while he cherished time with his two young sons, raising them as a single parent was stressful.
Kim is now on medications that have helped lower his blood pressure and reduce his cholesterol. He's eating better. He's lost weight and has a lot more energy. And he's changed for the better in another way, too, because of something he gleaned while at the hospital: Acceptance.
"Once I had acceptance, I kind of had some gratitude," he said. "I've had a tremendous life."
When something tragic happens to people, O'Brien said, it brings out their true character. They ask, "Who am I at the core?" And, "Is this a chance to be a victim or to bring a message of positivity?"
Kim chose positivity.
He now uses his experience and his talent to help others in such ways as speaking out on stroke awareness. And though he made his name by recording popular music, his life mission now is to inspire people through mindful and meditative music.
"For sure I've learned about myself," he said. "I just have a lot of grit, a lot of gratitude, and confidence to believe in myself."

When Healthy Eating Turns Into a Dangerous Obsession

 When eating healthy becomes an around-the-clock obsession, it could be a sign of trouble.
An extreme preoccupation with clean eating is an eating order called orthorexia nervosa. Though less well-known than anorexia nervosa or bulimia -- and not as well-documented -- a new study review says orthorexia can also have serious emotional and physical consequences.
"Orthorexia is really more than just healthy eating," said review co-author Jennifer Mills, an associate professor of health at York University in Toronto. "It's healthy eating taken to the extreme, where it's starting to cause problems for people in their lives and starting to feel quite out of control."
The review of
ed research from around the world on the disorder was recently
ed in the journal Appetite.
Mills and her colleague Sarah McComb looked at risk factors and links between orthorexia and other mental disorders. Orthorexia, unlike some other eating disorders, is not yet recognized in the standard psychiatric manuals.
Healthy eating to the extreme
No clear line divides healthy eating from orthorexia's extreme eating.
The foods someone with orthorexia might avoid are the same as those someone with healthy habits might avoid -- such as preservatives, anything artificial, salt, sugar, fat, dairy, other animal products, genetically modified foods or those that aren't organic.
It boils down to whether avoiding foods leads to obsession -- excessive time and energy thinking and fretting about what to eat. Some people may eliminate numerous categories of food and eat only a very small number of things. People with orthorexia are typically less concerned about cutting calories than with the perceived quality of their food.
"They often are taking more and more time thinking about the foods they're needing to purchase, particular foods, that makes it really difficult for them to just live their lives," said Lauren Smolar, who wasn't involved with the review. She is director of programs for the nonprofit National Eating Disorders Association (NEDA). "It can result in malnutrition or weight loss in a really difficult and potentially dangerous way."
A person with orthorexia might be so focused on types of food and how that food is prepared that it becomes impossible to eat anything not made at home.
"It can lead to all kinds of related problems, like isolation, or not being able to eat at other people's houses or not being able to eat in a restaurant for fear that the food won't have been prepared in a very pure, clean way," Mills said. "Those are the kinds of things that might lead someone to feel that it's taking over their life."
Cultural trends could be fueling those fears, Mills said. With the internet and social media, people have unlimited access to information -- some of it good and some not based on scientific evidence.
Eating trends that restrict certain foods are concerning, said Smolar, who added that dieting is one of the biggest triggers for eating disorders. All foods are good in moderation, she said, and a diverse diet is best.
Though many think of eating disorders as a problem affecting young women, orthorexia appears to be experienced equally by men and women, the study found.
People who follow a vegan or vegetarian diet or who have a poor body image are at a higher risk.
For some, the underlying cause is another eating disorder, and clean eating is seen as a socially acceptable way to restrict calories, Mills said. For others, obsessive-compulsive or anxiety disorder may manifest in the need to eat in this very rigid way.
"In that sense it is very similar to what we see in other kinds of obsessive-compulsive disorder, where somebody might be afraid that they're going to get sick or they're going to be getting exposed to germs if they don't wash their hands enough or if they don't do something in a very particular way," Mills said.
Getting help
Orthorexia should be taken seriously, Mills said. Talk to your primary care doctor about any concerns. Meeting with a psychologist who specializes in anxiety disorders, eating disorders or body image also can be helpful, she said.
NEDA offers an online screening tool that assesses risk and a helpline where you can talk through concerns and learn about resources.
"As awareness grows, more people are recognizing symptoms and seeking opportunities for help," Smolar said. "It's something that I think we still have a lot to learn about."

Hot Water Soak May Help Ease Poor Leg Circulation

 Could soaking in hot water followed by light exercise work as well on peripheral artery disease (PAD) as a longer bout of exercise does?
The authors of a new study suggest it could, but some PAD experts aren't convinced.
Peripheral artery disease affects about 8.5 million Americans. Only about one in four people in the United States is even aware of the disease, however.
PAD occurs when cholesterol builds up in blood vessels supplying blood to the legs. This slows or even blocks the flow of blood. Symptoms include pain or cramping when walking (claudication), loss of muscle mass, skin that's cool to the touch, and sores or ulcers on the legs or feet that are slow to heal, according to the U.S. Centers for Disease Control and Prevention.
Regular physical activity and supervised exercise programs are key treatments for PAD. If someone is a smoker, quitting smoking is crucial. Treatment also includes controlling blood pressure, cholesterol and diabetes, the CDC says.
In the new study, researchers compared blood pressure and walking distance in two groups, each with 11 PAD patients.
One group did up to 90 minutes of walking and resistance training once or twice a week. The other group -- dubbed the heat therapy group -- soaked in a pool with warm water (about 102 degrees Fahrenheit) for 20 to 30 minutes and then did up to 30 minutes of calisthenics three to five times a week. They were encouraged to submerge up to their shoulders.
"There was no evident difference between the effects observed in heat therapy via spa bathing and a supervised exercise program," wrote Ashley Akerman and colleagues from the University of Otago and Dunedin Public Hospital in New Zealand.
Three PAD specialists who reviewed the findings said it's too soon to say that having a hot water soak allows you to forgo a longer exercise session.
"Because the study participants got out of the water and performed 15 to 30 minutes of calisthenics, the study can't say whether or not heat therapy is a replacement for exercise," said Bruno Roseguini. He is an assistant professor of health and kinesiology at Purdue University in West Lafayette, Ind.
Roseguini also noted that the study wasn't an equal comparison. The exercise group averaged just one session a week compared to the heat therapy group that averaged four times a week.
Dr. Darren Schneider, director of the Center for Vascular and Endovascular Surgery at NewYork-Presbyterian and Weill Cornell Medicine in New York City, said heat therapy might help people walk more. Pain is common when people with PAD walk.
"People who get pain when they walk, don't want to walk," Schneider said. "So this therapy is not necessarily a replacement for walking, but this might help get some improvement in walking."
For people who can't walk, such as patients with joint disease or knee problems, Schneider said this might be an alternative.
Dr. Yi-Ming Yang, associate director of peripheral intervention at Lenox Hill Hospital in New York City, called the idea of using heat therapy to alleviate symptoms of claudication "provocative."
"While [this study] didn't achieve the goal of showing heat therapy being more effective than supervised exercise, it did seem to demonstrate that heat therapy somewhat improved the patients' ability to walk, by an average of 10%, similar to what supervised exercise achieved," he said.
Yang said the heat therapy likely increased circulation around the clogged or narrowed blood vessels in the legs.
All three experts pointed out that the study was small, with just 22 people total, so any findings would need to be replicated in a larger study.
But would it hurt if you decided to give this hot water treatment a try on your own?
Roseguini said being under supervision is best. If you decided to try it on your own anyway, it would have to be done carefully, especially if you tried to use hotter water, such as in a hot tub.
"You've probably seen warnings at hot tubs for people with heart disease. There's a risk of blood pressure falling," he said. Someone whose blood pressure is seriously low could get dizzy and fall, or possibly even pass out.
As for more locally applied heat, such as a heating pad, Roseguini said that method is likely too small to create changes in the body's temperature. And, that's what may have induced the improved circulation. His group is studying whether water-circulating pants that heat up the lower body might help.
The study was recently
ed in the American Journal of Physiology -- Heart and Circulatory Physiology.

A Healthy Baby Starts With a Healthy Mom

 Having a healthy baby starts before you get pregnant, Penn State doctors say.
Nearly half of all pregnancies in the United States are unplanned, said Dr. Andrew Lutzkanin, a physician in the department of family and community medicine.
"Fortunately, most women of childbearing age are healthy," he said. "And most pregnant women are motivated to make lifestyle changes, because they're not just doing it for themselves."
Research has shown that a woman's physical, spiritual and emotional health before pregnancy can affect the health of the baby, Lutzkanin said.
"You want to be as healthy as possible going into it," he said.
His recommendations include:
Following a healthy diet low in fat and cholesterol, with plenty of fruits and vegetables and lean meats.
Exercising for at least 20 minutes most days of the week.
Keeping well-hydrated.
Maintaining a healthy weight.
Not smoking.
Taking 400 mcg of folic acid daily.
Avoiding alcohol.
Getting chronic medical conditions under control.
Lutzkanin said many doctors realize they need to do more to help women cope with mental health problems after having a baby, particularly postpartum depression.
"Now, we are constantly screening for it, especially if there is a history," he said. "Pregnancy is a stressful period with a lot going on, so we want them to get on a good regimen of medication and counseling before pregnancy if possible."

Health Highlights: May 24, 2019

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
WHO Releases Snake Bite Strategy
The World Health Organization's first worldwide strategy on snake bites seeks to halve the number of people killed or disabled by snakes by 2030.
Increased access to anti-venom and other treatments are among the measures included in the strategy, the Associated Press reported Thursday.
Every year, nearly 3 million people worldwide suffer bites by potentially poisonous snakes, causing as many as 138,000 deaths.
Doctors Without Borders said in a statement that it's "cautiously optimistic" WHO's strategy could be a "turning point" in tackling snake bites, the AP reported.
Snake bites are "a hidden epidemic," according to the agency.
-----
More Than 62,000 Pounds of Raw Beef Products Recalled
More than 62,000 pounds of raw beef products have been recalled by Aurora Packing Company, Inc., of Illinois, due to possible contamination with E. coli O157:H7, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) said Wednesday.
The products, which were packaged on April 19, 2019, and have the number "EST. 788" inside the USDA mark of inspection, were distributed across the United States.
More than 40 products are included in the recall, and most are cuts of steak, like ribeyes, as well as ribs and brisket cuts, CNN reported.
There have been no confirmed reports of illness related to the recalled products, according to FSIS.
For 

U.S. Dentists Prescribe 37 Times More Opioids Than in England: Study

 Despite the nation's opioid epidemic, U.S. dentists are far more likely to prescribe addictive opioid painkillers than their British counterparts, a new study reveals.
In 2016, American dentists wrote 37 times as many opioid prescriptions as British dentists: 1.4 million versus 28,000.
And while 22% of all prescriptions from American dentists were for opioids, that figure was 0.6% in England. Dentists are one of the most frequent prescribers of opioids in the United States, second only to family practitioners, according to the study.
"We have all probably had the experience of a terrible toothache," said lead author Katie Suda, an associate professor of pharmacy at the University of Illinois in Chicago. "But all dentists treat pain worldwide, so we would not expect a large difference in which pain medication is prescribed, and our results show that U.S. dentists prescribe opioids more frequently than is likely needed."
She and her colleagues outline their findings in the May 24 issue of JAMA Network Open.
The American Dental Association (ADA) responded to the study with a statement pointing to its own efforts to combat unnecessary opioid prescribing.
"Since 2011, the ADA has advocated to keep opioid pain relievers from harming dental patients and their families and worked to raise professional awareness on medication alternatives to opioids," the statement said. "A growing body of research supports ADA policy that dentists should prescribe non-steroidal anti-inflammatory drugs (NSAIDs) alone or in combination with acetaminophen over opioids as first-line therapy."
To explore the issue, investigators tracked 2016 prescription patterns at brick-and-mortar pharmacies, mail-order pharmacies, and outpatient dispensaries across the United States and England.
During 2016, British dentists issued fewer than one opioid prescription for every 1,000 Britons. In the United States, meanwhile, the rate stood at 35 prescriptions for every 1,000 Americans.
On average, each British dentist issued one opioid prescription in 2016, while each U.S. dentist wrote 58.
As to what might explain the gap, Suda pointed to differences in the pain-relief protocols dentists follow in the two countries.
"In the U.K., dentists have guidelines specific to the treatment of oral pain," she noted. "Unfortunately, U.S. dentists do not have guidelines to help them decide which medications to prescribe to patients. The U.K. dentists also have more stringent prescribing rules."
For example, the United Kingdom allows dentists only to prescribe a single opioid, a relatively low-strength codeine known as "dihydrocodeine." That limitation pushes British dentists to embrace alternative, but often effective, non-opioid pain relievers, such as NSAIDs and acetaminophen.
By contrast, U.S. dentists are free to rely on a variety of opioid options. In 2016, 62% of the opioids they prescribed were hydrocodone-based medications, followed by codeine (23%), oxycodone (9%) and tramadol (5%).
And 10% of the opioids prescribed by American dentists were especially risky because of their high potential for abuse or misuse, the study found. Oxycodone and long-lasting opioids were two such problematic options. Neither is available for dental patients in the United Kingdom.
Dr. Susan Rowan is Suda's University of Illinois colleague and a clinical associate professor of dentistry. She described the findings as a "wake-up call."
Rowan said the analysis should encourage "greater consideration of abuse potential and alteration in prescribing practices among U.S. dentists," as well as greater consideration of non-opioid pain relievers.
"The American Dental Association and the American Dental Education Association recognize that the opioid epidemic is a major public health concern that needs to be addressed from all fronts," Rowan added.
In its response, the ADA said U.S. dentists wrote nearly a half-million fewer opioid prescriptions over a five-year period, 18.1 million in 2017, compared to 18.5 million in 2012.
The association also referenced a policy adopted last year, calling for mandatory continuing education of dentists regarding opioids. The policy recommends dentists prescribe no more medicine than a patient needs for one week.
"To combat opioid abuse, the ADA has urged all 163,000 member dentists to double down on their efforts to prevent opioids from harming patients and their families," the statement said.

How to Burn Calories During Everyday Tasks

 Looking for ways to burn extra calories? Don't just stand there -- these moves allow you to multitask for fitness.
Whenever you're stuck in a long line, do toe raises to work foot and calf muscles. Simply lift both your heels off the ground and roll up to your tiptoes. Hold for five seconds and then roll back down. The American Council on Exercise suggests alternating between slow and fast rolls to reach all muscle fibers.
Isometrics are another option, and no one will be able to tell what you're doing. Cycle through your various muscle groups by contracting one group at a time. Start with your calves and work up to your thighs and glutes. Then do your abs, pecs, biceps and triceps. To contract, tighten and hold each muscle group for a full 30 seconds before moving on to the next group. These contractions are easy to do if you're standing on a bus or train or even as you ride the elevator to your office.
Make brushing your teeth even more effective by doing squats.
To add a fitness component to your TV viewing, trade in your cushy spot on the sofa for a stability ball. You'll work your core muscles and improve posture just by sitting on it. Keep small hand weights nearby and grab them for sets of upper body exercises during the commercials.

Does Taking Screens Away Help Sleep-Deprived Teens?

 Cutting teens' evening screen time can improve their sleep in just one week, a new study finds.
Research shows that exposure to too much light in the evening -- particularly blue light from smartphones, tablets and computers -- can affect the brain's clock and production of the sleep hormone melatonin, resulting in reduced sleep time and quality.
It's believed to be a bigger problem among kids and teens than among adults. This study by researchers in the Netherlands zeroed in on how screen time affects teens' sleep.
On average, teens who spent more than four hours a day looking at a screen took 30 minutes longer to fall asleep, woke up 30 minutes later and had more signs of sleep loss, including moodiness, fatigue and poor concentration, than teens with less than an hour a day of screen time, the study found.
Researchers then assessed how blocking blue light with glasses and forbidding screen time during the evening affected sleep patterns of 25 frequent screen users.
After just one week, the teens had fewer signs of sleep loss -- and they were falling asleep and waking up 20 minutes sooner.
"Here we show very simply that these sleep complaints can be easily reversed by minimizing evening screen use or exposure to blue light," study author Dirk Jan Stenvers said in a society news release. "Based on our data, it is likely that adolescent sleep complaints and delayed sleep onset are at least partly mediated by blue light from screens."
He's a clinical fellow in the Department of Endocrinology and Metabolism at Amsterdam UMC, a medical and research center.
The next step is to determine whether reducing screen time improves sleep over the long term, and whether adults get the same benefits.
"Sleep disturbances start with minor symptoms of tiredness and poor concentration but in the long-term we know that sleep loss is associated with increased risk of obesity, diabetes and heart disease," Stenvers said. "If we can introduce simple measures now to tackle this issue, we can avoid greater health problems in years to come."
The study was presented May 19 at the European Society of Endocrinology's annual meeting in Lyon, France. Research presented at meetings is typically considered preliminary until
ed in a peer-reviewed journal.

FDA Approves Emgality (galcanezumab-gnlm) to Help Tame Cluster Headaches

 The U.S. Food and Drug Administration on Tuesday gave the nod to Emgality, an injected medication that's the first to cut the frequency of cluster headaches.
Episodic cluster headaches are "an extremely painful and often debilitating condition," the FDA's Dr. Eric Bastings noted in an agency news release. He's deputy director of the Division of Neurology Products in the FDA's Center for Drug Evaluation and Research.
Cluster headaches occur in quick sequence, "often at the same time(s) of the day, for several weeks to months," the agency said.
Attacks typically hit patients multiple times each day and can last anywhere from 15 minutes to three hours.
"The headaches are accompanied by symptoms that may include:bloodshot eyes, excessive tearing of the eyes, drooping of the eyelids, runny nose and/or nasal congestionand facial sweating," the FDA added.
However, Emgality (galcanezumab-gnlm) appears to be the first drug to help ease patients' misery.
In a three-week clinical trial involving 106 patients, patients who took the drug had an average of almost nine fewer weekly cluster headaches, compared to about five fewer attacks among people who got a "dummy" placebo self-injection.
Dr. Noah Rosen directs Northwell Health's Headache Center in Great Neck, N.Y. While not involved in the the clinical trial, he serves on a cluster headache advisory board.
Rosen agreed that "there are very few treatment options for patients with cluster headache -- a sad situation for what is commonly accepted as one of the most painful head pain conditions a person can suffer."
He explained that Emgality is one "of a new class of antibodies targeting part of the inflammatory process involved in select headache disorders including migraine and cluster headaches."
The drug appears to be a more targeted and well-tolerated means of cutting down on cluster headache frequency, Rosen said.
The FDA noted that some patients may develop a "hypersensitivity" to Emgality that can include a rash, hives and labored breathing.
"If a serious hypersensitivity reaction occurs, treatment should be discontinued," the agency said. "Hypersensitivity reactions could occur days after administration and may be prolonged."
Emgality was first approved by the FDA in September 2018 for the treatment of migraines.

Common Infant Vaccine May Also Shield Kids From Type 1 Diabetes

 Vaccinating against the common infant infection rotavirus not only cuts a child's odds of getting sick, it might also prevent them from developing type 1 diabetes later in life, new research suggests.
Infants who got all of the recommended doses of the "stomach flu" virus vaccine had a 33% lower risk of developing type 1 diabetes compared with unvaccinated babies, according to a study led by Mary Rogers. She's an epidemiologist at the University of Michigan, in Ann Arbor.
Type 1 diabetes involves the death of insulin-producing cells in the pancreas. People with the illness require daily insulin shots, and long-term effects on their health can be severe.
The new study relied on national insurance data on over 1.5 million kids born before or after the rotavirus vaccine was made available to babies in 2006.
Type 1 diabetes "is an uncommon condition, so it takes large amounts of data to see any trends across a population," Rogers explained in a university news release.
While children who had all three doses of the vaccine seemed to be protected against type 1 diabetes, those who didn't complete the regimen were not, the researchers noted. Rogers stressed that the study cannot prove that the vaccine prevents type 1 diabetes, only that there's an association.
"It will take more time and analyses to confirm these findings," she said. "But we do see a decline in type 1 diabetes in young children after the rotavirus vaccine was introduced."
Getting the full, recommended dose of rotavirus vaccine was crucial, however. The U.S. Centers for Disease Control and Prevention recommends that babies begin receiving the multidose vaccine by 15 weeks of age at the latest, and finish receiving it before 8 months of age. The rotavirus vaccine is delivered via oral drops, not a needle.
An Australian study
ed earlier in 2019 found similar results, Rogers noted. And she estimated that if all U.S. children were fully immunized against rotavirus, there might be eight fewer cases of type 1 diabetes per 100,000 children each year.
Right now, one in four infants don't get all three of the recommended doses of the rotavirus vaccine, the Michigan team noted. That's important, because being fully vaccinated reduces the chance of being hospitalized for rotavirus infection by 94%, the study authors said.
Rogers stressed that the research is still in its early stages.
"Five years from now, we will know much more," she said. "The first groups of children to receive the rotavirus vaccine in the United States are now in grade school, when type 1 diabetes is most often detected. Hopefully, in years to come, we'll have fewer new cases -- but based on our study findings, that depends upon parents bringing in their children to get vaccinated."
The report was
ed online June 13 in the journal Scientific Reports.

American Soldiers' Hearts in Worse Shape Than Civilians'

 New research shatters the image of U.S. soldiers as the epitome of fitness and primed for battle: Instead, they are less likely to have ideal blood pressure than their civilian counterparts.
In fact, less than one-third of active Army personnel have ideal blood pressure (120/80 mm Hg), compared with over half of the general population, the researchers found.
"It's unexpected that, given the recruitment process, Army personnel at these ages are worse off than the civilian population," said researcher Dr. Darwin Labarthe. He is a professor of preventive medicine at Northwestern Feinberg School of Medicine in Chicago.
Military recruits are excluded from service if they have high blood pressure, Labarthe explained.
Dr. Byron Lee, director of the electrophysiology laboratories and clinics at the University of California, San Francisco, added, "The findings in this study are astonishing. Soldiers should have better heart health than the general population, but they don't. I wonder if the stress or salty diets in the military could be the reason."
Labarthe isn't sure why military personnel tend to have higher blood pressure. It's something he intends to investigate. But he's not ruling out Lee's theory that stress, particularly in combat, and diet may play a role.
In addition, the Army draws many recruits from disadvantaged populations who are already at risk of developing high blood pressure, he noted.
The other concern Labarthe has is what happens to these soldiers as they age? It's very possible that they will carry their heart issues with them throughout their lives, he said.
"This is a problem that can be remediated and we should be tackling that," he said.
For the study, Labarthe and his colleagues evaluated more than 263,000 active duty soldiers, aged 17 to 64, who were examined in 2012. This group was compared with a similar group of civilians who took part in the 2011 to 2012 National Health and Nutrition Examination Survey.
The investigators compared the groups for such factors as smoking, weight, blood pressure and diabetes. Overall, more soldiers didn't smoke or have diabetes than civilians.
Labarthe's initial assumption had been that because military personnel are active and exercise a lot, they would be healthier. But the rates of good heart health were low in both groups, he said.
Among those aged 17 to 29, only 16% of the civilian population and less than 10% in the Army were ideal in all the categories of health that the researchers studied.
According to Labarthe, heart disease affects the Army more than any other chronic disease, and it's on the rise. In 2014, 9% of soldiers had heart disease, compared with 7% in 2007.
Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said that cardiovascular disease is a leading cause of death and disability among men and women.
"Improving the cardiovascular health of the military and the general population should be a greater priority," Fonarow said. "Evidence-based approaches to improve cardiovascular health exist, but much more effective strategies to implement these healthy behaviors are needed."
The report was
ed online June 5 in the Journal of the American Heart Association.

Getting Your Nutrients: From the Source or Supplements?

 Americans are making shifts in the supplements they take -- fewer multivitamins and vitamins C and E, more fish oil and vitamin D. Many think of supplements as magic bullets, but studies don't always support their supposed benefits.
Some research is positive. Vitamin D is important for good health and very hard to get naturally from foods or, if you live in northern latitudes, from the sun. So you might need a supplement to meet daily needs. But first ask your doctor for a blood test to check your level and, if it's low, whether it's safe for you to sit in the sun twice a week for 15 minutes to allow your body to make D naturally.
Significant studies show that it's better to get certain nutrients directly from food. For instance, while foods high in omega-3 fatty acids, from walnuts to oily fish, have been linked to reduced risk of heart disease, the omega-3s in fish oil capsules may not deliver the same benefits.
A 2018 study conducted by the U.S. Department of Agriculture found that many supplements -- from vitamins A and D to the minerals selenium and chromium -- contain higher amounts of the nutrient than stated on the label. That's a concern because some good-for-you supplements can be harmful at high doses -- even calcium, which is highly touted for bone health. If you can't get enough calcium through diet and bone density testing shows that you need to supplement, ask your doctor about safe limits.
In fact, whether you're thinking about an herbal supplement or a proven vitamin or mineral, talk to your health care provider first. Some may interact with medications you take or could pose a risk if you have an illness or are scheduled for surgery.

Strobes at Concerts May Cause Epileptic Seizures

 A 20-year-old collapsed at a music festival with a first-time epileptic seizure. While terrifying, his case wasn't unique, according to researchers who found that flashing strobe lights triple seizure risk in susceptible concertgoers.
"Regardless of whether stroboscopic light effects are solely responsible or whether sleep deprivation and/or substance abuse also play a role, the appropriate interpretation is that large [electronic dance music] festivals, especially during nighttime, probably cause at least a number of people per event to suffer epileptic seizures," wrote the authors. The lead author is Newel Salet of VU Medical Centre in Amsterdam, the Netherlands.
For the study, the researchers collected data on concertgoers who needed medical help at 28 daytime and nighttime dance festivals in the Netherlands in 2015. Total attendance was more than 400,000.
Signs of possible epileptic seizure included loss of consciousness, muscle twitching, tongue biting and urinary incontinence.
Nearly 242,000 people attended night concerts where strobes were used, and nearly 159,000 went to daytime festivals where strobes were less intense because of sunlight. Among them, almost 3,000 needed medical assistance, 39 for epileptic seizure.
Seizure risk was nearly four times higher at nighttime festivals with the heavy-duty strobes than at daytime events, the researchers found.
Part of the study included analyzing use of the party drug ecstasy, which has been linked to a greater risk of epileptic seizures. But the researchers ruled out the drug as the sole cause of seizures.
The report was
ed online June 11 in the journal BMJ Open.
This study could not prove that strobe lights caused these seizures, only that the two seem connected.
"We think, however, that our numbers are probably an underestimate of the total number of people who had epileptic seizures," Salet and colleagues said in a journal news release.
Epilepsy triggered by flashing lights is called photosensitive epilepsy. The authors recommended that anyone at risk for a reaction to strobes should avoid electronic music festivals. If you do go, be sure to get enough sleep, don't take drugs and don't stand close to the stage. If you experience "aura" -- perceptual changes that often precede a seizure -- leave immediately.

Health Tip: Campfire Safety

-- Though a campfire is a great place for sing-a-longs and s'mores, it also is prone to mishaps.
Each year, campfire accidents send thousands of people to the emergency room, says the National Fire Protection Association.
The association encourages:
Keep campfires 25 feet away from structures.
Avoid starting campfires on windy, dry days.
Watch children and pets while the fire is burning.
Attend to the fire at all times.
Always have a source of water nearby.
Make sure the fire is completely out before leaving the site.

AHA News: Study Provides Rare Look at Stroke Risk, Survival Among American Indians

THURSDAY, June 13, 2019 (American Heart Association News) -- Race matters when it comes to who is more likely to have a stroke and to die from one. For American Indians, just how much it matters has been unclear due to a lack of research.
But results of a new study indicate they are more likely than white Americans to have a stroke but less likely than black Americans. And for those who do have a stroke, American Indians are more likely to die within a month compared to both white and black stroke patients.
"There are huge health challenges that American Indian people still experience and there are also remarkable strengths and resilience within their communities, all of which are largely unrecognized by the general population," said Clemma Muller, an assistant research professor in the College of Medicine at Washington State University and lead author of the study
ed Thursday in the Journal of the American Heart Association.
Muller said the emerging diabetes epidemic among American Indians and barriers to health care access may contribute to the disparities, although she cautioned the mortality findings would need to be confirmed in future studies.
Stroke is the No. 5 cause of death in the United States and a leading cause of disability. Yet little is known about American Indians' experience with the condition, Muller said. They are underrepresented in research and often have their race misclassified, she said.
In the new study, researchers pooled data from two large studies on cardiovascular disease -- one comprised of American Indians living in primarily rural areas in Arizona, Oklahoma, North Dakota and South Dakota, and the other comprised of black and white people from Minnesota, Mississippi, North Carolina and Maryland.
Of the 17,360 participants included in the analysis, 3,182 were American Indian, 3,765 were black and 10,413 were white. The studies shared a similar design and timeline, which allowed researchers to compare results across the groups.
"This is a very interesting and important study," said Dr. David Lee Gordon, professor and chair of the department of neurology at the University of Oklahoma Health Sciences Center, who was not involved with the study. "As far as I know, it's the first dive into stroke incidence and survival among American Indians (compared to other racial groups)."
Gordon said regional differences may contribute to variations in stroke rate and mortality. Since there's little geographic overlap between the American Indian participants and the black and white participants, he said it's difficult to untangle the effect of race from the influence of geographic location on stroke rates. It's very likely factors beyond getting good health care and diabetes care are having an impact, Gordon said.
Muller said she'd like to see a study performed in a large diverse group for whom researchers can standardize the design and better control potential variables to examine racial differences in stroke incidence and survival.
"For many people, this isn't on the radar. We talk about racial disparities in stroke but when I go and look, it's blacks, Asians and Hispanics," said Muller. "A lot of people don't even notice that American Indians aren't represented."

2 Hours/Week in Nature: Your Prescription for Better Health?

2 Hours/Week in Nature: Your Prescription for Better Health?

Should Air Quality Checks Be Part of Your Travel Planning?

 Before you book that next trip, you might want to check the air pollution levels of the city you choose as your vacation destination.
A new study finds that just a brief visit in cities with bad air can lead to breathing problems that may take at least a week to subside.
Researchers assessed the lung and heart health of 34 healthy young adults from New York City who traveled abroad for at least a week. Most of them visited family in cities with consistently high levels of air pollution, including Ahmedabad and New Delhi in India; Rawalpindi, Pakistan; and Xian, China.
Visiting a city with high levels of air pollution reduced measures of lung function by an average of 6%, and by as much as 20% in some people, according to the study led by researchers from New York University School of Medicine.
Participants who visited cities with high levels of air pollution reported as many as five respiratory symptoms such as coughing and breathing problems, while those who visited cities with lower air pollution levels had fewer or no symptoms.
Two patients sought medical attention because of their respiratory symptoms.
"We had several reports that tourists were feeling sick when visiting polluted cities, so it became important for us to understand what was really happening to their health," senior study investigator Terry Gordon said in a university news release. He's a professor in NYU's department of environmental medicine.
"What travelers should know is that the potential effects of air pollution on their health are real and that they should take any necessary precautions they can," said lead investigator M.J. Ruzmyn Vilcassim, an NYU postdoctoral fellow.
Travelers who visit cities with high levels of air pollution should consider wearing masks or consulting a doctor before departure if they have preexisting lung or heart problems, Gordon advised.
It might also be a good idea to avoid traveling to some locations during certain months. For instance, farmers burn their fields during the winter months in New Delhi, which increases levels of air pollution in the city, Gordon explained.
The findings were
ed May 30 in the Journal of Travel Medicine.

How Your Marital Status Affects Your Odds of Dying From Heart Disease

 Your gender and marital status hold telling clues about your risk of dying of heart disease, a large British study suggests.
It found that widowed and divorced men have significantly higher odds of death due to heart disease than women of the same marital status. But single men are more likely to survive heart failure than single women.
Compared to widows, men whose spouses die have an 11% higher risk of death after a heart attack. Widowers with heart failure are also 10% more likely to die; and widowers with atrial fibrillation or a-fib, an abnormal heart rhythm, are 13% more likely to die, the study found.
Similarly, divorced men with a-fib have a 14% higher risk of death than divorced women. Even among married people with a-fib, that risk was 6% higher for men.
But single men with heart failure actually had a 13% lower risk of death compared to single women.
"These findings suggest that widowed or divorced men, and single women, may be most in need of support in order to help minimize their individual risk of dying from these conditions," Metin Avkiran, associate director of the British Heart Foundation, said in a foundation news release.
The findings come from an analysis of marital status and death rates of more than 1.8 million people treated for heart disease in Northern England between 2000 and 2014.
Lead author Dr. Rahul Potluri is a clinical lecturer in cardiology at Aston Medical School in Birmingham. He said when it comes to heart disease, focusing solely on a patient's medical problem is not enough.
"It's important we look into providing holistic care and explore other factors, such as their support network, which can also have a big impact on a person's health," Potluri said in the news release.
He and his colleagues discussed their findings Tuesday at a meeting of the British Cardiovascular Society, in Manchester. Research presented at meetings is typically considered preliminary until
ed in a peer-reviewed journal.

'Double-Edged Sword': Lung Cancer Radiation Rx May Raise Heart Attack Risk

 Radiation treatment for lung cancer can help extend lives, but it might also raise a patient's odds for heart attacks and heart failure, a new study shows.
Many patients may have no choice but to accept the risk: For about half of people diagnosed with the number one cancer killer, radiation remains the only viable treatment, the research team noted.
"This is alarming data -- to think that one in 10 of the patients I'm treating for this type of cancer will go on to have a heart attack or other major cardiac event," senior author Dr. Raymond Mak, a thoracic radiation oncologist at the Brigham and Woman's Hospital in Boston, said in a hospital news release.
"These cardiac events are happening earlier and more often than previously thought," he added. "More patients are living long enough to experience this risk of cardiac toxicity. We need to start paying attention to this and working together with cardiologists to help these patients."
One expert unconnected to the study agreed that patients face heart risks, but in many cases it's tough to tease out why.
"Although the radiation that we give to patients for lung cancer is of course directed mainly at their tumor, there may be overlap in the beams of radiation that affect the heart," explained Dr. Adam Lackey. He directs thoracic surgery at Staten Island University Hospital in New York City.
But, "since smoking remains the most potent risk for lung cancer, and smoking also is a risk factor for heart disease, many lung cancer patients have a diagnosis of or are at risk for heart disease, as well," he noted.
In the new study, Mak and his colleagues looked at data on 748 lung cancer patients who were treated with radiation therapy. After treatment, about 10% of the patients did go on to have a heart attack or heart failure, where the heart's pumping efficiency is compromised.
While the study couldn't prove cause and effect, Mak's team found that the higher the radiation dose, the greater the risk of having a heart problem. The rate of cardiovascular events was especially high for people who didn't have heart problems before their treatment, the investigators noted.
What to do? Mak's group believes that using the lowest possible dose of radiation is the best course to take.
"When possible, we should be thinking about ways to minimize cardiac radiation dose," Mak said. "Recognizing that we may not always be able to do that, we're now collaborating with our cardiology colleagues to explore early interventions to help mitigate the effects of cardiac injury from radiation therapy."
Dr. Len Horovitz is a pulmonary specialist at Lenox Hill Hospital in New York City. Reading over the findings, he agreed that radiation therapy for lung cancer is one of medicine's "double-edged swords."
"While the mechanism of damage is unclear, it is apparent that embarking on a course of radiation for lung cancer may cause cardiac damage," Horovitz said.
For his part, Lackey agreed that, "as we have pushed the limits of what types of radiation -- and how strong of a dose we give patients who have lung cancer -- it is important to recognize the long-term effects that this radiation may have for lung cancer survivors."
The report was
ed June 10 in the Journal of the American College of Cardiology.

Male Victims of Domestic Violence Often Suffer in Silence

 Men who are victims of domestic violence find it hard to get help and the support they need, British researchers report.
"While both men and women are reluctant to seek professional help for their abuse, there is an added barrier for men voiced in these studies, that they may be falsely accused of being the perpetrator. The men also raised wider concerns about masculinity," said study co-author Dr. Gene Feder, a professor of primary care at the University of Bristol.
He and his colleagues reviewed studies of men in heterosexual and gay relationships.
They found that fears of not being believed or being accused of abuse were factors in not seeking help. Embarrassment and feeling "less of a man" were reported to be other barriers.
Men also worried about their partner and damaging their relationship as well as losing contact with their children. Still others were afraid of telling their family or friends, or getting professional help.
Many men didn't know that professional help was available, the study found, or thought that support services were for women only.
Some men only sought help when their situation became a crisis, the study found.
Those who decided to get help said confidentiality was important, as was seeing the same person over time and not being judged. Men preferred getting help from a woman.
"Our review has revealed that the experience of many men who are victims of domestic abuse is similar to those of women," Feder said in a university news release. "Like women, although male victims wanted the violence to stop, they did not necessarily want to end the relationship."
Domestic violence can have serious consequences on health and well-being. Researchers advise men who are being abused by a partner to seek help first from their primary care doctor, who can connect them with specialized services.
The report was
ed online June 12 in the journal BMJ Open.

Health Tip: Insect Sting First Aid

-- For most insect stings, a person can be treated at home, says MedlinePlus. For non-severe reactions, first aid is as follows:
Do not use tweezers. Scrape a straight-edged object across the stinger for removal.
Wash the site with soap and water.
Apply ice on the site for 10 minutes.
Take an antihistamine, or apply cream.
Watch for signs of infection or severe allergic reaction.
Never apply a tourniquet or give the person a stimulant medication, aspirin or other pain medicine unless ordered by a doctor.
If a person shows signs of a severe allergic reaction -- including trouble breathing, coughing, wheezing, uncontrolled sneezing, congestion or tightness in the lungs -- seek immediate medical attention.

For the study, his team looked at medical records of 20 black adults from 1973 and 2017. The study patients had at least two face scans taken 10 years apart.

Although all of the faces changed over time, they showed only minor changes, compared to similar studies on the aging white population.
"This finding reflects other studies that show black adults have higher bone mineral density, decreased rates of bone loss and lower rates of osteoporosis as compared to the general population," Paskhover said in a university news release.
Facial aging results from a combination of changes to the skin, muscle, fat and bones.
As people age, the loss of mineral density causes bone loss. Bone loss can affect the shape of the nose, lower jowl area, cheekbones, and middle and lower areas of the eye sockets, the researchers explained.
"As bones change, they affect the soft tissue around them, resulting in perceived decreases in facial volume," Paskhover said. "Treatment should consider the underlying bone structure."
The report was
ed online recently in JAMA Facial Plastic Surgery.

Strobes at Concerts May Cause Epileptic Seizures

 A 20-year-old collapsed at a music festival with a first-time epileptic seizure. While terrifying, his case wasn't unique, according to researchers who found that flashing strobe lights triple seizure risk in susceptible concertgoers.
"Regardless of whether stroboscopic light effects are solely responsible or whether sleep deprivation and/or substance abuse also play a role, the appropriate interpretation is that large [electronic dance music] festivals, especially during nighttime, probably cause at least a number of people per event to suffer epileptic seizures," wrote the authors. The lead author is Newel Salet of VU Medical Centre in Amsterdam, the Netherlands.
For the study, the researchers collected data on concertgoers who needed medical help at 28 daytime and nighttime dance festivals in the Netherlands in 2015. Total attendance was more than 400,000.
Signs of possible epileptic seizure included loss of consciousness, muscle twitching, tongue biting and urinary incontinence.
Nearly 242,000 people attended night concerts where strobes were used, and nearly 159,000 went to daytime festivals where strobes were less intense because of sunlight. Among them, almost 3,000 needed medical assistance, 39 for epileptic seizure.
Seizure risk was nearly four times higher at nighttime festivals with the heavy-duty strobes than at daytime events, the researchers found.
Part of the study included analyzing use of the party drug ecstasy, which has been linked to a greater risk of epileptic seizures. But the researchers ruled out the drug as the sole cause of seizures.
The report was
ed online June 11 in the journal BMJ Open.
This study could not prove that strobe lights caused these seizures, only that the two seem connected.
"We think, however, that our numbers are probably an underestimate of the total number of people who had epileptic seizures," Salet and colleagues said in a journal news release.
Epilepsy triggered by flashing lights is called photosensitive epilepsy. The authors recommended that anyone at risk for a reaction to strobes should avoid electronic music festivals. If you do go, be sure to get enough sleep, don't take drugs and don't stand close to the stage. If you experience "aura" -- perceptual changes that often precede a seizure -- leave immediately.