Monday, July 22, 2013

Weight-Loss Surgery May Affect Fat-Related Genes

News Picture: Weight-Loss Surgery May Affect Fat-Related Genes

THURSDAY, April 11 (HealthDay News) -- Weight-loss surgery changes the levels of genes involved in burning and storing fat, a new study says.

The findings may help lead to the development of new drugs that mimic this weight-loss-associated control of gene regulation, said the authors of the study published online April 11 in the journal Cell Reports.

"We provide evidence that in severely obese people, the levels of specific genes that control how fat is burned and stored in the body are changed to reflect poor metabolic health," senior author Juleen Zierath, a professor with the Karolinska Institute in Sweden, said in a journal news release.

"After [weight-loss] surgery, the levels of these genes are restored to a healthy state, which mirrors weight loss and coincides with overall improvement in metabolism," Zierath explained.

Weight-loss surgery -- also called bariatric surgery -- can help obese people lose large amounts of weight in a short time. The surgery also leads to early remission of type 2 diabetes in many patients.

-- Robert Preidt MedicalNews
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Cell Reports, news release, April 11, 2013



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what does jogging do?

Okay so I've thought I'd start jogging today on my wii. I just wanna know if I try doing this everyday and jog a mile and a half in 10 minutes would it tighten my belly and legs? In also going to do squats, lunges, and lift my weights. If I don't jog ill do sit ups/crunches. I know if I really watch what I eat my stomach will shrink and that's what I want instead of the excess fat on my lower belly. Anyone know?

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New Diabetes Drug Expected This Week

mature woman

April 11, 2013 -- A new oral diabetes drug is expected to arrive on pharmacy shelves in the U.S. this week.

Many people predict that Invokana (canagliflozin), approved by the FDA in March, will be a brisk seller. That's partly because it treats type 2 diabetes in a new way.

It’s also because Invokana not only helped patients improve blood sugar control, but also lose weight and control their high blood pressure, according to maker Janssen Pharmaceutical Companies.

Losing weight can help people control their diabetes.

In one 26-week study, those on Invokana lost about 6 to 8 pounds, while those in the placebo group lost only about a pound. 

But the drug has side effects, including infections of the urinary tract, penis, and vagina. This leads some experts to have less enthusiasm for the new medicine. 

It will also cost a lot more than other diabetes drugs. The wholesale cost for Invokana is $8.77 a pill, according to Katie Mahony, a spokeswoman for Janssen. Retail cost for the 100-milligram starting dose, without co-pays or coverage, is about $10 a pill, or $300 a month.

The popular diabetes drug metformin can cost as little as 25 cents a pill.

"It's another way to control diabetes without injections," says Anthony McCall, MD. He is the James M. Moss Professor of Medicine at the University of Virginia School of Medicine in Charlottesville. He was not involved in the development of the new drug.

A new pill is welcome, McCall says, for some of the estimated 24 million Americans with type 2 diabetes, especially as an alternative to injecting insulin.

"People do have strong feelings about injectable medications," he says. However, he and other experts say they don't expect Invokana to replace other drugs, but rather to offer another option.

In type 2 diabetes, the body doesn’t make enough insulin or doesn't use it properly. As a result, blood sugar (glucose) levels rise, leading to complications such as heart disease, kidney damage, and nerve problems.

Invokana works by blocking glucose from being reabsorbed by the kidneys. That raises the amount of glucose urinated, and lowers the amount of glucose in your blood. 

The new drug is known as a selective sodium glucose co-transporter inhibitor, or SGLT2. Other drug companies are also working on this type of drug.

Other diabetes drugs work in differently. Some lower the amount of glucose made by the liver, while others stimulate the pancreas to release more insulin. And still many others work in different ways.

While Invokana isn't expected to replace other diabetes drugs, ''it's certainly promising," says Aaron Cypess, MD, PhD, of the Joslin Diabetes Center and an assistant professor of medicine at Harvard Medical School. "It's a mechanism we understand and that makes sense."


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Junk Food Bans Help Schoolkids Avoid Unhealthy Snacks: Study

But most elementary schools are in districts or states that don't limit sales of fat, sugar, salt to students

By Robert Preidt

HealthDay Reporter

MONDAY, June 10 (HealthDay News) -- Elementary schools are less likely to sell unhealthy snack foods and drinks if school districts or states have rules that limit the sale of such products, a new study finds.

However, more than three-quarters of public elementary schools in the United States are located in a state or school district that does not limit the sale of items such as sugary drinks, salty snacks, candy or high-fat milk, according to the research published June 10 in the journal JAMA Pediatrics.

For the study, researchers examined the types of foods and drinks offered by schools nationwide between 2008-2009 and 2010-2011. Candy, ice cream, cookies and other sweets were sold by about 32 percent of schools in areas where both school district or state policies limited the sugar content of snack foods, compared with 43 percent of schools where there were no such policies.

Ice cream was sold by just over 10 percent of schools in areas where the state and school district limited the fat content of snack foods, compared with about 21 percent of schools where there was no such policy. Cookies, cakes and other high-fat baked goods were sold by nearly 12 percent of schools in areas with such a policy and by about 25 percent of schools in areas with no such policy, the investigators found.

In the case of sugary drinks, school district policies had more impact than state laws: Sugar-sweetened beverages were sold by close to 4 percent of schools when school districts banned them, compared with 13 percent of schools when there was no school district ban.

However, the sale of sugary beverages by schools was not affected by state bans -- especially in the South -- where sugary drinks were sold by one-quarter of schools in states that banned the sale of the drinks in schools.

The study was funded by the Robert Wood Johnson Foundation through its national research program, Bridging the Gap.

"We found that states and districts can influence the types of snacks and drinks sold at school," study lead author Jamie Chriqui, an investigator at Bridging the Gap, said in a foundation news release. "These policies can go a long way in helping kids have healthy choices during the school day, but more states and districts need to get strong policies on the books to have a meaningful impact nationally."

However, Chriqui and colleagues found that many states and school districts do not have specific nutritional rules for school snacks and drinks. Among U.S. elementary schools:

78 percent were in a district and state that did not limit the sodium (salt) content of snacks or ban high-fat milk.77 percent were in a district and state that allowed the sale of candy.75 percent were in a district and state that did not prohibit the sale of sports drinks, sodas and sugar-sweetened fruit drinks. 58 percent were in a district and state that did not limit the sugar content of snacks.

"Too many of our nation's schools are still selling junk foods and sugary drinks to young children," Chriqui said.

"But the good news is that this is the first generation of children to be enrolled in school at a time when educators and policymakers are focused on preventing childhood obesity -- that's why it's so critical to enact or change policies that make schools healthier places for students," she added in the news release.


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Changes to Psychiatry's 'Bible' Could Widen Definition of ADHD

Experts disagree over whether this will help or harm in the long runExperts disagree over whether this will help or

By Serena Gordon

HealthDay Reporter

FRIDAY, April 12 (HealthDay News) -- When the latest version of what is considered the "bible" of psychiatry is unveiled in May, experts believe several changes in it will broaden both the definition and diagnosis of attention-deficit/hyperactivity disorder -- or ADHD.

But experts also differ on whether the shifts in thinking about this neurodevelopmental disorder will be a good thing.

Dr. James Norcross, a child and adolescent psychiatrist at the University of Texas Southwestern Medical Center at Dallas, outlined the major changes that should be coming in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is published by the American Psychiatric Association.

"One is the latest age that someone can have the onset of symptoms," Norcross explained. "In the current version, it's seven years. That will be changed to 12 years in the DSM-5, which may make things easier for adults and adolescents, because they'll be able to better recall some of the challenges that may have occurred."

Another big change that Norcross expects is that those over 17 will only have to meet five criteria, instead of six, to be diagnosed with ADHD. "This could increase the number of adults [who] are diagnosed because the criteria were largely developed for children, and they're not necessarily things we see in adults," he explained. For example, one of the criteria for hyperactivity has been squirming in your seat.

The last significant expected change is that ADHD will no longer be grouped with conduct disorder and oppositional defiant disorder. Instead, it will be grouped with neurodevelopmental disorders.

"They're trying to group disorders by similar pathology, and this is a better description of ADHD. More and more, it's being shown to be a biological process," Norcross explained.

Overall, Norcross said he thought the changes were positive and that they might remove some of the stigma that's been attached to an ADHD diagnosis.

However, another expert said the changes could lead to overdiagnosis of the disorder, and a subsequent jump in the prescribing of stimulants to treat the disorder.

"In trying never to miss a case, they may mislabel millions of people with a disorder they don't have. Everyone has problems with distractibility, but when ADHD is real, it starts early, it's intense and it's unmistakable," said Dr. Allen Frances, chair of the task force for the DSM-4 and former chair of psychiatry at Duke University School of Medicine in Durham, N.C. The fourth edition of the DSM has been in force since 1994.

"We're already overdiagnosing ADHD. Almost 20 percent of teen boys get the diagnosis of ADHD, and about 10 percent of boys are on stimulant drugs. We don't need to make it easier to diagnose ADHD," Frances said.


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Annual Dental Cleaning May Be Enough for Some: Study

But people at risk of gum disease need more frequent appointments, researcher saysBut people at risk of gum disease need more

By Robert Preidt

HealthDay Reporter

MONDAY, June 10 (HealthDay News) -- For many people, once-a-year dental cleaning may be enough to prevent gum disease that leads to tooth loss, according to a new study.

"Twice-yearly cleanings have been recommended for over 50 years without supporting evidence," study author William Giannobile, a professor of dentistry and biomedical engineering at the University of Michigan, said in a university news release.

But the results of this study "showed that one yearly cleaning is likely to be enough for patients with no risk factors," he said. "Patients with one or more risk factors, which represent over half of the population, should visit at least twice a year and likely more in some cases."

For the study, which was published online June 10 in the Journal of Dental Research, Giannobile and colleagues looked at data from more than 5,100 adults who visited the dentist regularly for 16 straight years, had no history of gum disease and received one or two cleanings each year.

The researchers examined the link between the frequency of teeth cleanings and long-term tooth loss in the participants, as well as three key gum disease risk factors: smoking, diabetes and genetics.

Two dental cleanings a year provided significant benefits to people with one or more of the three risk factors, while people with two or three of the risk factors may require more than two cleanings a year. But one cleaning per year appears sufficient for people with none of the risk factors, according to the study.

"The future of health care is personalized medicine," Giannobile said. "This study represents an important step toward making it a reality, and in a disease that is widespread, costly and preventable."

"We have long known that some individuals are at greater risk of [gum] disease, but tools haven't been available to adequately identify those at increased risk and prevent disease progression," he said.


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The Alchemy of Writing — More Tips from a Pro


Ernest Hemingway used to leave his final sentence of each day half finished. It gave him an easy starting point for the next morning.

This interview on the creative process is part II in an interview with award-winning author Fred Waitzkin. Part I can be found here.

Reading time:
- Bolded points (teaser) – 3 minutes
- All – 15 minutes

TF: But what about “inspiration”? Does it exist for you?

For me, inspiration is primarily energy. If I feel energy for a paragraph or a description I can almost always get to the essence of it. If I feel dead to myself, I don’t have a chance. I am always looking for energy. Where can I find it? What or who can give it to me? How can I amp up what I have?

A story can help us here. An older friend of mine was once depressed about his advancing years. He lacked zest or motivation for his regular gym workouts. He couldn’t concentrate on his career. One evening this man found himself in an elevator with a woman, a housekeeper who had worked for him in the past. But she was wearing outside clothes, a tight fitting sweater. She was young and beautiful. They talked a little. There was chemistry. She got off the elevator at his floor. They chatted in the hall. She said that she found him attractive. But he could feel this even before she said the words. She embraced him. And that was it. Nothing more happened between them. He was married and not looking for an affair. But he felt a big surge of life. He felt renewed, deeply so. There was a bounce to his step. He returned to the gym feeling ten years younger… There are many ways to experience the girl in the elevator.

If I’m beginning an important new project I try to get away for a few days to feel a different spirit–islands work for me. My mother was a great painter. She spent much of her life on Martha’s Vineyard because the tree line outside her house felt ominous and that spurred her work along with the sound and smell of the ocean.

I look for energy all over the place. Often just riding my bike along the river for three miles from my house to the office heightens my mood. Then I make a cup of green tea and look at my work from the previous evening. I always read back several pages before I try to write anything new. Moving back through interesting material seems to give me momentum to push ahead…

But what if there is no energy? I read the paper. I switch on sports talk radio. I look at my watch. I pace. I am eyeing the lunch hour. It’s getting closer to lunch. One hour before I meet my friend Jeff for turkey burgers. Forty-five minutes. Now I’m getting nervous. Thirty-five minutes before I have to leave my office! Suddenly I feel an urgency. I CAN’T leave for lunch without writing one good paragraph. I’m sweating, feeling the time pressure… and the words pour out. Sometimes a writer can do more in a fervent half hour than in a dreary eight-hour day. I’ve often played this game with myself.

There are many energy tricks. Sometimes in the afternoon when I’m groggy I wander over to Starbuck’s for a coffee. But it’s not just caffeine. I know all the women who work there. They know me. We chat. I love these talks–okay, innocent flirtations. Sometimes I even get a free latte. When I get back to my office I usually feel fired up.

Here is a story about deep mining for inspiration. Early on in the composition of The Dream Merchant I had an impression of the woman whom I wanted to be the great love of my central character’s life. She would be something like the girlfriend of Eddie the pool hustler, played by Paul Newman, in the great movie, The Hustler. She would be beautiful but a little worn from love and tough living. But her accessibility made her all the more desirable. The actress who played that part, by the way, was Piper Laurie although when I thought about what my character looked like, she was more voluptuous like Marilyn Monroe. This character would be hugely important in my book. She would have to be Jim’s match—she would love Jim and ruin him. Only problem was, I had never known someone like this.

I talked about the problem with Josh [his son, the subject of Searching for Bobby Fischer] and one day he proposed an idea. “There is someone I want you to meet,” he said. He arranged lunch for me with a young actress, Maya, a girlfriend of a friend of his. We met in a restaurant. Maya was sensual, the right body type, and gorgeous. I spent more than an hour describing the character I wanted to write—her name was Ava. Maya listened but said virtually nothing. She was a sweet girl—NOT Ava. This great idea was beginning to feel like a failure. But then when we were leaving the restaurant she turned to me and her entire being had darkened, she had become sultry and damaged. It was thrilling. She was becoming Ava. She was Ava. It gave me chills.

For the next year we would meet in my office about once a month. I would send Ava, no Maya, a long email describing what I needed from Ava in the next chapter of my novel. Then during the course of an hour or two together we would imagine the scenes or she would act them out. When Maya left me at the end of a session I was shot out of a gun to write the new material into the novel. As time went on, I did less talking and Maya held court. After a year of this she had truly become Ava. I put her in dangerous situations and she embodied Ava’s responses, her muted passion, her madness, a reckless impulse to bolt to the edge of the cliff. Would she fall? I think it was deep fascinating work for both of us…Just to say, I’ve never tried to create a character in this manner before or since. But I could never have written Ava without Maya.

TF: Do you have any friends you rely on to help breakthrough deadlock? If so, why do you find them helpful?

I have a couple of friends that I rely upon. They are very perceptive about the human heart. I’ll talk quite specifically about what isn’t working in a section of my book. I listen closely to what they think. I’ve done this many times. My wife Bonnie has helped me many times like this.

Here is the curious thing. Often her advice or the idea of a friend isn’t what I end up doing. But listening to the ideas engenders a new idea. The whole point is that you have to get moving. Movement begets movement. You need to get unstuck.

TF: There are many people with brilliant ideas, fascinating lives, and a good feel for language–but who have never seriously taken on the art of writing. What is some specific advice you would give to up and coming writers?

If a young person is not passionately motivated, talent aside, I would never encourage him to try to become a professional writer.

Even if you love writing, and it possesses you with missionary zeal, it is such a hard thing to do. First you need to learn the art, and the path is littered with generations of talented writers that couldn’t sit alone in a room and apply themselves for thousands of hours to become really good. Then there are legions of devoted writers who did good work but couldn’t crack the profession, they couldn’t get published or if they did they couldn’t make a living. It is a very tough field.

But whenever I happen to meet someone who is talented and possessed by writing, and particularly a youngster, it is a great pleasure to have a chat. However, the conversation needs to be personal to have any real meaning. I need to know my “new friend” somewhat deeply, to feel the play of his mind and what turns him on before I would presume to offer advice. There are many different ways to be a writer.

For a teenager who is dreamy, who makes uncanny associations like a poet, it can be ruinous to force onto him a rigorously academic approach to writing, even with a good teacher. Teaching him to compose organized mannered essays, like all the other smart boys in class, can make him inhibited and ultimately edit the imagination from this unusual fellow. For another classmate who plans to be a lawyer, proper carefully constructed essays are perfect.

A writer has a core, a sensibility to draw from like pulling gold from his own acre of earth. What you have to say on the page will be different than what I would say. Good writers have their own voice. A paragraph by Philip Roth sounds like Roth. His sensibility and prose rhythms are all through his pages. Same for Hemingway or Thomas Mann. A young writer can deepen his voice and make it richer. But a writer is on perilous ground when he moves away from his core into an area he doesn’t know, when he “lies” or when he cheapens himself with compromises.

Let me give you an example. I have a young friend who is gifted with words and sentences. The scenes he writes are emotional. And he feels impelled to write. He’s got the right stuff. This young man has led a difficult life. He is an orphan. As a teen he became an addict and alcoholic. He suffered greatly getting clean. He’s known a lot of women and hurt some badly. Okay, in shorthand, that’s his base. It is very rich with pain and dark-side-of-the-moon adventures. But whenever he writes more than a paragraph he feels the need to say that in his new life he is redeemed and he is so grateful. He proselytizes. The embarrassment about his past life is thwarting this writer who has such an interesting story to tell. It makes it hard for him to dig deeply. It is difficult to get over such habits like a quarterback who has an awkward throwing motion. But he can do it if he wants it badly enough.

Here is one generalization that might be useful: A good writer needs to become intimately involved with “fictive truth.” Bullshitting never works in writing—a good reader can always tell when a writer knows what he is talking about. If you write about the ocean, you must know the movement of the ocean, the smell and taste. Don’t try to invent it. It will smell like a fake. When you are trying to create a character he or she must be “true.” Fiction is not making up stuff out of whole cloth. It is always linked to a writer’s experience. Fiction is a wonderful tango between the writer’s experience and his imagination.

When I write a scene I always put it to a personal test: does it relate to something that has happened in my own life either directly or by analogy? Perhaps something similar happened to my father or a close friend. If I can feel it deeply, and if I know my craft, then chances are you will feel it. If I am guessing, chances are I will fall on my face. Even if you are writing fiction, research isn’t cheating. If you are writing about the ocean, go out on a boat when it’s rough, feel queasy in a breaking sea, smell the salt water. Then read Conrad’s great passages on the ocean for inspiration, or Jack London’s. In The Dream Merchant it was part of my plan that the last third of the book would take place in the dense rain forest of Brazil. I didn’t dare write that section of the book until I travelled there and spent a month in the jungle.

TF: What inspired you to write The Dream Merchant? Tell us a story or two that will help us understand the process behind the book. How did you draw from real life characters when writing fiction?

The inspiration for The Dream Merchant came from many people. Certainly the earliest influence was my father who was a lighting fixture salesman–a great one. I have often referred to him as the Beethoven of fluorescents. During his best years in the fifties, my dad sold the commercial lighting for nearly every new skyscraper in NYC: The Seagram building, the Saucony building, the United Nations building–his jobs sounded to me like poetry. As a boy I would look out at the magnificent night skyline of Manhattan as though it were my father’s work. Like Jim in the novel, my father did some terrible things—he destroyed men who got in his way—but it did not dampen my love for him. I knew that I wanted to explore this undiscriminating father adoration in my book. That was a key connection between Jim and the narrator, insofar as the narrator loves Jim despite his profligacy and shocking moral drift. By the same token, Jim idolizes his own father who has a considerable history of sins.

Without my father there could never have been Jim. But Jim is not a portrait of Abe Waitzkin—not by a long shot. They were both larger than life salesmen. Neither was impeded by conscience or restraint. Abe was perhaps more ruthless. Jim was much more lusty. My dad didn’t care much about women. Jim was a physical powerhouse. Abe was a dominant personality but he was sickly.

The great comedian, Lenny Bruce, has a small but important role in my novel. To write him I felt that I had to know this one-of–a-kind-personality inside and out. If I didn’t get into his skin the scenes would be fake and would ruin the book. I read books about him and his wife and I listened to performance tapes. I learned his dark slicing humor until I could write it myself. I did write it. After a half year I felt like I was Lenny Bruce. Then Lenny moved through the scenes naturally—he fit right in. It was a pleasure writing in his voice. I’ve already talked about Maya who became my Ava, Jim’s wife. Lenny Bruce and Ava become lovers. They go to very dangerous places together. For a while it was hard for me to stop being Lenny Bruce.

Here is an interesting story about inspiration. More than twenty-five years ago, when I was writing feature magazine pieces, I happened to read a short article in Time Magazine about illegal gold mining in the jungles of Brazil. The piece described secluded enclaves deep within the rain forest called garimpos where men slaved in deep muddy pits trying to collect gold to feed their impoverished families living in the cities. Their employers hideously exploited these scrawny little men, lured them into the camps by offering beautiful women. These poor men spent their hard earned gold on a single night of desire. Then they had to go back to the mudpits to work for another month before they could return home. It was an endless cycle. The workers were sometimes murdered by marauders or they died of disease or animal attacks. Many never made it home. This whole jungle scene was so exotic, violent, sensual and unlikely that I felt I had to write about it. I signed a contract to do a long piece for Harper’s magazine and was preparing to leave for Brazil when I received a contract from Random House to write Searching for Bobby Fischer. I abandoned the Brazil trip to write about Josh and the chess world, which greatly irritated the editors at Harper’s–they didn’t return my calls after this. Anyhow, the scene in Brazil haunted me for years and once I began my novel I decided that my character would ultimately save himself or perhaps perish in the Brazilian rain forest. I wrote the earlier sections of the novel aiming for Brazil.

TF: Tell us about the Amazon trip. What were you researching? What did you learn? Why was it so important to go there?

Oh man, what a trip. Josh wouldn’t let me go by myself. He was determined to protect his old man in the jungle. By then Josh was already one of the top martial artists in the world–he had won the Tai Chi Push Hands World Championships in Taiwan a year before, and now he was training Brazilian Jiu Jitsu [Tim note: Josh later became the first black belt under the legendary Marcelo Garcia, the Michael Jordan of BJJ]. I was thrilled for him to come but not so much for protection as camaraderie—so that we’d see it all together. By then I’d already written the first half of The Dream Merchant and as I’ve already said, I’d been pointing toward Brazil. I’d been writing about a great salesman who takes ethical short cuts to make it big and then loses everything. The deep jungle was the perfect pallet for the changes I wanted in Jim who by now was ready to cross any line to win big again—and he did. I wanted the last third of the novel to switch gears and come on like a firestorm—this was my homerun idea. But to work, as I’ve already said, the Brazilian scene would have to be truly rendered, all the smells, the violence, the animals, the decadence, the disease, the astonishing beauty.

Josh and I flew to Manaus, which is an island city surrounded by rivers and jungle. It’s a haunting place, sultry from the heat and danger of the jungle all around. My character Jim would own a big estate in Manaus, where he would sell his gold to buyers, and then after several days he would travel back to jungle—the jungle became Jim’s greatest passion. But first, to set up his operation he needed to hire an army of gunmen to protect his garimpo from marauders in the rain forest, to guard the gold. Josh and I travelled to gun dealers to learn the business of small private armies. We met with gunmen, talked about their malevolent work. We visited steak restaurants where Jim would dine with his top men. We visited poor shacks on the fetid riverbanks where he recruited hundreds of miners and we went to huge ornate brothels that catered to miners, where Jim hired gorgeous sad-eyed girls to work on their backs for him in the remote camp. Really, Jim constructed a little jungle empire that mirrored his runaway ambition.

There were many ways to maim oneself or to die in Jim’s jungle world but also it was a captivating place. Josh and I spent several weeks in the deep jungle, with its dense foliage a crazy tangle of living sculpture. We hiked for miles learning to softly push the vegetation aside like swimming. It was the dry season and watermarks on towering ancient trees were ten feet above our heads. In six months, four hundred pound fish would be swimming where we were walking. We swam in the rivers terrified about piranhas, and tiny fish called a candiru that swim up a man’s penis and with sharp spikes become lodged in the urethra. We played with pink porpoises that swam through our legs. We visited abandoned gold mining operations and met with garimpeiros who explained the work of searching mud pits hoping to find gold and pull themselves out of poverty but rarely did. These men were addicted to this difficult work—I suppose they were addicted to hope.

We spent nights in hammocks suspended between acai trees listening to an infernal racquet of insects and the bleating of hunting creatures. We worried incessantly about being attacked by jaguars. Every night we heard them hunting nearby. Travelers in the jungle worried about jaguars. Every native we ran into carried a rifle. We were told that a man by himself in the rain forest was a dead man walking but parties of two or three men were more likely to be left alone by jaguars. There were little cats, the size of house cats called jaguatiricas. They attacked howling like babies in packs of five or six. They ran up a man’s legs and ripped him apart. The little ones scared the hell out of me.

I could go on and on about the Brazilian Amazon: the beauty of the women, the unforgettable people we met. The jungle has a deep intoxicating call–really it is a siren’s call. It was hard for me to leave and return to the states. My character Jim couldn’t bear to leave even though staying would likely cost him his life.

TF: Last but not least: what are your top ten favorite books?

FW: This is a risky question to answer. For one thing, I have loved so many. How can I narrow it to ten? And to further complicate the process, I’ve noticed that books are always changing for me. Some books that I admired at thirty feel dead to me today. I know that I never got more excited reading any novel than Jack Kerouac’s masterpiece, On the Road. But would I revere it as much today, forty years later? Last week I read This Is How You Lose Her by Junot Diaz. I was so taken by the painful truths in these stories and the amorous Latin rhythms of his prose. Before reading Diaz I was telling all of my friends about Jennifer Egan’s A Visit from the Goon Squad. These are my recent infatuations. But did I love these books as much or more than The Sun Also Rises? I just don’t know. Last time I read Hemingway’s classic it was a hard push for me…but ten years before it thrilled me.

Here goes:

1. Love in the Time of Cholera — Gabriel Marquez
2. Heart of Darkness — Joseph Conrad
3. The Great Gatsby –F. Scott Fitzgerald
4. Lolita — Vladimir Nabokov

5.
a. For Whom the Bell Tolls — Ernest Hemingway
b. The Old Man and the Sea — Ernest Hemingway
c. The Sun also Rises — Ernest Hemingway

6. On the Road -- Jack Kerouac
7. Death in Venice — Thomas Mann
8. The Sheltering Sky — Paul Bowles
9. Invisible Cities — Italo Calvino

10.
a. The Train — Georges Simenon
b. American Pastoral — Philip Roth
c. The Spy Who Came in from the Cold – John le Carre

###

Read more about Fred Waitzkin and The Dream Merchant here.

Posted on March 25th, 2013


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Healthy weight, still binging/relapse?

Hi there 

Have managed to get my weight up to 9 stone 10 at 5 foot 7 and would finally say that I am recovered from anorexia-am loving university and flexible eating at the moment :)
I am eating around 2000 calories a day and no longer obsess around food-I am relaxed around meal times and can eat spontaneously

However I am still binging on chocolate most nights, around 500-1000 calories worth even after a full day of meals :/ this is really scaring me as I'm comfortable with my weight right now and really dont want to gain any more!

Any help/advice-why is this happening to me? 


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Strides Made in Preventing Cancer, But Challenges Remain: Report

News Picture: Strides Made in Preventing Cancer, But Challenges Remain: ReportBy Serena Gordon
HealthDay Reporter

THURSDAY, April 11 (HealthDay News) -- When it comes to cancer prevention, the latest report from the American Cancer Society offers mostly good news but some bad news as well.

Cigarette smoking rates continue to drop, with significant declines seen in high school-aged smoking. But, in response to the now ubiquitous smoke-free areas in most public spaces, cigarette companies upped their marketing for smokeless tobacco products by nearly 120 percent, according to the report released Thursday.

"We're making progress, but we need to keep an eye on the needle to see where the whole front of risk factors is, and how we can put out the best policy to face the ongoing challenges," said Vilma Cokkinides, strategic director of risk factors and screening for the American Cancer Society.

The annual report focused on tobacco use, obesity, nutrition and physical inactivity, ultraviolet radiation and skin cancer, the cervical cancer vaccine and screening tests.

Findings from the tobacco front were mostly positive. Cigarette smoking in American adults declined slightly, from nearly 21 percent to 19 percent between 2005 and 2011. Rates in men dropped from nearly 24 percent to 21.6 percent, and for women, the prevalence of smoking went from slightly over 18 percent to 16.5 percent.

One of the most positive signs in tobacco use was the drop in high school students. In 1997, more than 36 percent of these students smoked. By 2011, that number was cut in half to just above 18 percent, according to the report. About 13 percent of high school students said they smoked cigars and nearly 8 percent used smokeless tobacco.

"One of the most effective ways of stopping children from smoking is price," Cokkinides said. And, one way to raise the price of cigarettes is through taxes, which vary widely from state to state. Missouri's excise tax on a pack of cigarettes is just 17 cents per pack, while New Yorkers pay $4.35 per pack.

Even with tax revenues and settlement agreements, Cokkinides said that the "tobacco industry continues to outspend us."

Another area where industry is suspected of luring in young people is the indoor tanning industry.

"The industry makes young people believe that indoor tanning is safer than outdoors. The image is very strong, and the most vulnerable populations are young women, but we're beginning to address this through access restriction policies and laws," Cokkinides said.

Thirty-three states have enacted legislation that restricts minors' access to tanning facilities, according to the report. Using a tanning booth during your teens and 20s can increase your melanoma risk by 75 percent.

The report also found increasing numbers of young women getting vaccinated with the HPV vaccine, which can prevent many cervical cancers. Rates of mammograms to screen for breast cancer remained relatively stable. Slightly more than four out of five women received Pap screening according to the recommendations, with the exception of women without insurance and those with low education. Colorectal cancer screening rates were also lower in people without insurance.

"There's hope that the Affordable Care Act will help improve access, especially for those without insurance, but it's really going to depend on the state-by-state implementation of the act," Cokkinides explained.

The report also looked at obesity, nutrition and physical inactivity. All of these factors can affect cancer risk. The rise in obesity appears to have slowed down, and possibly even plateaued. However, about 36 percent of adults and 18 percent of teens are already obese. The prevalence of obesity varies widely by state, with Mississippi having the highest rate at 35 percent. The lowest was Colorado at about 21 percent, according to the report.

One expert discussed the obesity-cancer connection.

"Over 116,000 cancers can be prevented every year if more Americans stay lean. It's not a silver bullet, but preventing obesity can help prevent cancer," said Alice Bender, nutrition communications manager at the American Institute for Cancer Research.

Bender said that right now, only about half of Americans are aware of the link between obesity and cancer. There are seven cancers that have good evidence linking them to obesity.

And, a healthy diet with lots of fruits and vegetables can decrease the risk of cancer, as can regular physical activity, according to Bender.

"We're making progress with smoking, but it took years of education and changes in indoor environments that made it harder to smoke. Now, the message is that staying lean will lead to healthier outcomes," Bender said.

"I think this report shows that people are becoming more and more aware that cancer doesn't have to happen all the time," she noted. "There are things we can do to reduce our risk."

MedicalNews
Copyright © 2013 HealthDay. All rights reserved. SOURCES: Vilma Cokkinides, Ph.D., strategic director of risk factors and screening, American Cancer Society; Alice Bender, M.S., R.D., nutrition communications manager, American Institute for Cancer Research; April 11, 2013, American Cancer Society report, Cancer Prevention & Early Detection Facts & Figures 2013



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