Are there lifestyle changes that can help my cancer recovery?

Posted July 03, 2013, 2:00 am

I’m a cancer survivor. Should I be following special guidelines for diet and exercise?

Advances in cancer treatment and earlier detection are allowing more people to live longer after a cancer diagnosis. Today, more than 12 million Americans are cancer survivors. And many of them look to diet and exercise to help prevent cancer recurrence, live longer or just feel better.

Recently, the American Cancer Society (ACS) reviewed and summarized the scientific evidence about the role of diet and exercise for cancer survivors. They found that the same things that prevent cancer from developing in the first place also help keep it from coming back. The ACS published its findings in a report called “Nutrition and Physical Activity Guidelines for Cancer Survivors.”

The ACS found that to reduce the chance of cancer returning and increase the chance of surviving, cancer-free, after a cancer diagnosis, survivors should:

Achieve and maintain a healthy weight;Get enough physical activity (at least 150 minutes per week);Eat a healthy diet that emphasizes vegetables, fruits and whole grains;

The ACS also provided specific advice for survivors of a variety of major cancers. I’ve put a summary of the guidelines below.

The ACS also advised:

Cancer survivors should work with a registered dietitian who has special certification in cancer care. He or she can provide specific, evidence-based advice.Many cancer survivors have trouble taking in enough calories each day. Eating smaller and more frequent meals can help. Or try special fortified or nutrient-dense foods.Use dietary supplements cautiously. Taking more than the recommended daily amounts (RDA) of vitamins and minerals does not improve treatment outcomes or long-term survival. In fact, it can interfere with some cancer treatments. For example, taking a beta-carotene supplement may encourage the growth of lung cancer.Exercise can help fight fatigue, keep you functioning and improve your quality of life. Discuss when to start exercising, and how much, with your doctor.Obesity appears to increase the risk of breast (and possibly other) cancer recurrence. Losing weight and keeping it off can help improve survival.

When some of my patients hear advice like the ACS has given, they are skeptical. To them, cancer is a powerful force, and it seems unlikely that a healthy lifestyle could do much to tame it. I tell them that the advice is supported by large and well-done scientific studies. There is little doubt from those studies, for example, that survivors of breast cancer who are overweight have a worse prognosis than those of normal weight. Or that those who exercise regularly have a better prognosis than those who don’t.

We even are beginning to understand why. A research study was published recently which showed regular exercise leads to hormonal changes that discourage the growth of breast cancer cells. It’s not anecdotal: It’s science.

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Gaining weight from medication changes

Has anyone had experience with gaining weight from medication changes? As of last fall, I weighed around 125lb on a 5'4 frame. My insurance company messed with my birth control prescription (I was on Yaz with no weight gain) and my weight sky-rocketed to almost 15 lbs more. Summer clothes that used to be a bit loose are now on the much snugger, should-I-even-be-wearing-this, side. 

I'm in graduate school and work full time, so I have a regretfully sedentary lifestyle with the exception of hitting the gym a few times a week, which I've always done. I've been eating even healthier and more low-cal than ever before for the last two months to combat the weight gain, and it's still there. I've also recently been diagnosed with Crohns and have a hard time keeping my body from rejecting what I eat. Yet the weight is still there! I just can't get rid of it, let alone keep it from rapidly gaining. I've been off the medication for a week now. I knew not to expect instant results, but I still feel incredibly hopeless. 

Has anyone else had a similar experience with birth control weight gain? How long did it take for it come off naturally? I can't cut my calories much more without being super unhealthy and there just aren't enough hours in a week for me to double my gym visits. 

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Scientists Spot Cancer Metabolism Changes

SUNDAY, April 21 (HealthDay News) -- Hundreds of potential targets for new cancer drugs that could starve tumors have been identified by scientists who analyzed gene expression data from 22 types of malignancies.

The study revealed a number of cancer-associated changes in the metabolism of cells. To support their uncontrolled growth, cancer cells need to reprogram and "supercharge" a cell's normal metabolism, the researchers explained.

Pinpointing these metabolic changes could prove important in efforts to develop drugs that interfere with cancer metabolism, according to the study, which was published online April 21 in the journal Nature Biotechnology.

"The importance of this new study is its scope," lead investigator Dennis Vitkup, an associate professor of biomedical informatics at Columbia University Medical Center, said in a center news release. "So far, people have focused mainly on a few genes involved in major metabolic processes. Our study provides a comprehensive, global view of diverse metabolic alterations at the level of gene expression."

One of the major findings was that cancer-induced changes in metabolism are significantly different in various types of tumors.

"Our study clearly demonstrates that there are no single and universal changes in cancer metabolism," study co-author Dr. Matthew Vander Heiden, an assistant professor at MIT, said in the news release. "That means that to understand transformation in cancer metabolism, researchers will need to consider how different tumor types adapt their metabolism to meet their specific needs."

Targeting metabolism may be a way to strike cancer at its roots, according to Vitkup.

"You can knock out one, but the cells will usually find another pathway to turn on proliferation. Targeting metabolism may be more powerful, because if you starve a cell of energy or materials, it has nowhere to go," he explained.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Columbia University Medical Center, news release, April 21, 2013

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New Study: Diet and Exercise Changes Work Best Together, Not One at a Time

It's the age-old question for people looking to get healthy: Eat better or start working out? Now, a study published yesterday in the Annals of Behavioral Medicine finds that for best results, we should make both of these changes at once -- and that dieting first may actually sabotage later attempts at a regular exercise routine.

This may seem obvious: Of course you're going to get healthier faster if you're doing two good-for-you things, rather than just one. But previous research on this topic has been inconsistent; some experts believe that trying to address several health issues at once can be overwhelming or counterproductive, and that taking baby steps to improve one thing a time is the best approach.

Stanford University researchers set out to see how food and fitness, specifically, work together, versus separately. For 12 months, they provided counseling to four groups of volunteers: One learned to make dietary and exercise changes at the same time, one changed diet first and then exercise a few months later, one did the opposite, and one did not learn to make any diet or exercise changes.

Even though they had more new goals to think about at once (150 minutes of exercise per week, five to nine servings of produce per day, reducing saturated fat), the diet-plus-exercise group was most likely to meet them all by the end of the study period. The exercise-first group also did an OK job with improvements over the course of the whole year.

But those who started with diet first had a much harder time ramping up their exercise routines a few months later. Finding time to work out may be harder for busy people swapping in healthier foods, the researchers say -- and if you're already doing the easier one, there may be less incentive to make a more difficult change later on.

Okay, so, shameless plug time: We're big believers in making lots of good things happen all at once -- that's why we designed our Drop 10 Diet to include healthy recipes AND a killer workout program so you can shape up fast for summer. We already knew that it was a winning combination (check out these success stories!), but it's nice to know that science has our back, too. And yes, you can totally get started today!

Do you find that eating healthy and working out go hand in hand? Tweet us your thoughts at @amandaemac and @SELFmagazine.

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Image Credit: Terry Doyle

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Brain Changes Seen in Relatives of People With Alzheimer's

By Denise Mann
HealthDay Reporter

WEDNESDAY, April 17 (HealthDay News) -- If Alzheimer's disease runs in your family, you may be more likely to have brain changes associated with the disorder even before symptoms such as memory and thinking problems occur, according to new research.

An estimated 5.2 million Americans have Alzheimer's disease, a number expected to increase dramatically as the baby boomer generation ages. The Alzheimer's Association predicts that the number of people aged 65 and older with the condition will reach 7.1 million by 2025.

To get a better handle on risk for Alzheimer's disease, researchers at Duke University looked at brain scans of more than 250 adults aged 55 to 89. Some had no signs of memory or thinking problems, while others did.

The researchers also analyzed genes and other markers in spinal fluid that are known to help predict Alzheimer's risk. A variation in the APOE gene was seen among those participants who were at greater risk for earlier onset of Alzheimer's.

Individuals who had a parent or sibling with Alzheimer's disease showed silent brain changes, the study found.

Specifically, close to 50 percent of healthy participants with a positive family history would have met the criteria for early Alzheimer's disease based on measurements of their cerebrospinal fluid, but just 20 percent of those without a family history would have fulfilled such criteria. The findings appear online April 17 in the journal PLoS ONE.

"In early-onset Alzheimer's disease, the genetics are much more clear-cut and we can test family members and know if they will develop Alzheimer's," said senior author Dr. P. Murali Doraiswamy, a professor of psychiatry and medicine at Duke.

It is not as clear-cut, however, when it comes to later-onset Alzheimer's, Doraiswamy said. "The genetics are much more complex, and although we know these individuals are at a slightly greater risk, we don't know when they start developing silent brain changes," he said. "[The new study is] documenting very clearly that asymptomatic family members have twice the rate of silent brain changes and that these changes happen in certain pathways known to be related to Alzheimer's disease."

The findings may help advance research that seeks to prevent Alzheimer's disease by using drugs, he said, and it's not a reason to panic and start to think the worst if you have a family history of the disease. "The findings don't suggest you should worry any more or any less," he said.

Although the study found an association between having a family history of Alzheimer's and showing brain changes related to the disease, it did not prove a cause-and-effect relationship.

"Having a family history does not mean you will get Alzheimer's disease," said Dr. Richard Isaacson, director of the Alzheimer's division at the University of Miami Miller School of Medicine. You may be at a higher risk for developing it, but it is not predestined, said Isaacson, who was not involved with the new study.

"Make brain-healthy choices now to help lower this risk," he suggested. "We know that if it is good for the heart it is good for the brain." Such choices include engaging in regular physical activity and eating a healthy low-fat diet.

"It's also important to keep your brain fit by doing something you enjoy -- whether crossword puzzles or learning a foreign language -- every day," Isaacson said.

"If you have a family history, get educated and informed about positive lifestyle choices and consider taking part in an Alzheimer's prevention trial," he said. "We can finally say 'Alzheimer's disease' and 'prevention' in the same sentence, and that is a great thing."

Copyright © 2013 HealthDay. All rights reserved. SOURCES: P. Murali Doraiswamy, M.D., professor of psychiatry and medicine, Duke University Medical Center, Durham, N.C.; Richard Isaacson, M.D., director, Alzheimer's division, University of Miami Miller School of Medicine; April 17, 2013, PLoS ONE

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Guideline Changes Have Asperger's Community on Edge

By Lisa Esposito
HealthDay Reporter

THURSDAY, April 18 (HealthDay News) -- People with Asperger's syndrome -- mild autism with normal or sometimes superior verbal ability and intelligence -- are at a crossroads: Their diagnosis is about to disappear.

In 1994, Asperger's was recognized as its own disorder in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-4). For some people, realizing that they fit into the Asperger's diagnosis was a "eureka" moment of sorts.

In mid-May, however, the American Psychiatric Association (APA) will unveil the latest edition of the diagnostic manual. In the DSM-5, the Asperger's term will not exist -- and many people with Asperger's are upset.

Hallmark symptoms -- significant impairment in work and social functioning, inability to understand nonverbal communication, repetitive behaviors and restricted routines -- will be folded into the term "autism spectrum disorders," ranging from the mildest to most severe autism.

The APA says that with the change, diagnosis will become more accurate and consistent.

"The intent was that it would make diagnosis more straightforward," said Catherine Lord, a member of the APA group that updated the diagnoses. "They're not necessarily different disorders because, at least biologically, nobody can differentiate Asperger's from autism."

"One of the good things that the idea of Asperger's syndrome did was make people aware that somebody can have quite significant social deficits but be a very intelligent person," said Lord, director of the Center for Autism and the Developing Brain at New York-Presbyterian Hospital. "The goal of our committee is not to lose those people but to say they can be recognized within this broader concept of autism spectrum disorders."

But many with Asperger's believe they will fall off the spectrum and lose access to needed services. And they fear that their very identity is at stake.

Some people with Asperger's syndrome "formed their first identity of normality within the group," said Liane Holliday Willey, senior editor of the Autism Spectrum Quarterly and an autism consultant in Grand Rapids, Mich. She has Asperger's.

So does Brian King, an Illinois-based relationship coach and licensed clinical social worker. With the change, he said, "people who have embraced the Asperger's label are now thinking, 'I have an Asperger's support group. I call myself an Aspie. If you take that from me, who am I?'"

It's not clear how many people have Asperger's. Estimates vary anywhere from three in every 1,000 to one in every 200 people. But experts say the impact of the change will be widespread.

In the United States, DSM diagnoses are closely aligned with health insurance billing. Internationally, governments and social agencies use the manual to approve funding for services and research.

"[The DSM] has repercussions throughout the world, especially the English-speaking world," said Tony Attwood, an adjunct professor at the Minds & Hearts clinic in Brisbane, Australia.

"I think the banning of the term Asperger's syndrome is too premature," Attwood said. "They're very upset [in Australia]. So they have to explain to, for example, employers, that they are now to be called autistic and have mild autism."

In October, APA member Lord published a study that found only about 10 percent of children would lose their autism diagnosis under the new criteria. Attwood, however, said estimates of people who will lose funding eligibility range anywhere from 10 percent to 75 percent.

King said people who are not obviously struggling may lose out.

"If there is some kid in college who's an intellectual juggernaut -- they can pass socially, who can think his or her way through social situations -- but is so in need of services on campus, in need of accommodations, that's the person I'm worried about," King said. "The one who, underneath it all, is suffering, but is so good at passing that they're off the radar of a lot of diagnosticians."

For children with Asperger's, early intervention, which includes parent training, is considered ideal. One question is whether early intervention will be easier or harder to obtain under the new criteria.

"In California, for example, if you have an Asperger's diagnosis, you are not eligible for the autism services as a young child," Lord said. But Attwood said he's concerned that with the change, "parents may not be eligible for early intervention services before the child goes to school."

Lord said a family "must be ready if they meet someone who doesn't understand the new criteria to be able to say, 'Look, one principle is a lack of social reciprocity. And even though my son is 12 years old and very bright and does go to school and does love his teacher and does take turns well, he still really struggles with ... understanding what a friend is even though he has play dates and does do things.'"

Eric Lipshaw, 21, a student at Oakland University in Rochester, Mich., is "110 percent" against the diagnosis change.

"I get disability support services, assistance on campus," Lipshaw said. "They give me a scribe for my handwriting -- that's illegible. They have note-takers and anything else we need."

Some job seekers with Asperger's turn to agencies that specialize in people with disabilities. Other adults need social security benefits or residential services. Some will lose these services along with the Asperger's diagnosis, Attwood said.

Karen Rodman, president and founder of Families of Adults Affected with Asperger's Syndrome, said although the Asperger's listing in DSM-4 was inadequate it was better than not using the term at all.

Rodman, whose husband has Asperger's and Tourette syndrome, said people with the diagnosis and their family caregivers already have unmet needs for assistance that will only get worse with the change.

One undercurrent in the debate has been the suspicion that the change was made to cut costs. Attwood and King both said that although that might or might not have been an intention, it will be an effect.

"The medical insurance companies and other agencies will save money," Attwood said. "I can't say that this has been the driving force of the change; all I know is that this is the highly probable outcome. With fewer people being diagnosed, it's going to be less expensive for the agencies that support such individuals -- either government or private."

Some people with Asperger's may fit under "social communication disorder" in the new DSM-5.

The manual also is adding "sensory sensitivity" to the autism spectrum criterion. This involves extreme sensitivity to a person's environment, including the touch of other people, the sensation of the clothing they wear, and sights, smells and sounds around them. Attwood praised this addition.

"The ultimate impact of the DSM is going to be wait-and-see," King said. "It's a guideline, not an absolute end-all and be-all of how to treat this. A clinician can use their own judgment based on their own experience."

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Catherine Lord, Ph.D., director, Center for Autism and the Developing Brain, New York-Presbyterian Hospital/Weill Cornell Medical College, New York City; Liane Holliday Willey, senior editor, Autism Spectrum Quarterly, and autism consultant, Grand Rapids, Mich.; Brian R. King, L.C.S.W., relationship coach, Illinois; Tony Attwood, adjunct professor, Minds & Hearts Clinic, Brisbane, Australia; Eric Lipshaw, college student, Oakland University, Rochester, Mich.; Karen Rodman, president and founder, Families of Adults Affected With Asperger's Syndrome

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Brain Changes Seen in Relatives of People With Alzheimer's

Study finding doesn't mean you'll get the disease if family members have it, experts stress

By Denise Mann

HealthDay Reporter

WEDNESDAY, April 17 (HealthDay News) -- If Alzheimer's disease runs in your family, you may be more likely to have brain changes associated with the disorder even before symptoms such as memory and thinking problems occur, according to new research.

An estimated 5.2 million Americans have Alzheimer's disease, a number expected to increase dramatically as the baby boomer generation ages. The Alzheimer's Association predicts that the number of people aged 65 and older with the condition will reach 7.1 million by 2025.

To get a better handle on risk for Alzheimer's disease, researchers at Duke University looked at brain scans of more than 250 adults aged 55 to 89. Some had no signs of memory or thinking problems, while others did.

The researchers also analyzed genes and other markers in spinal fluid that are known to help predict Alzheimer's risk. A variation in the APOE gene was seen among those participants who were at greater risk for earlier onset of Alzheimer's.

Individuals who had a parent or sibling with Alzheimer's disease showed silent brain changes, the study found.

Specifically, close to 50 percent of healthy participants with a positive family history would have met the criteria for early Alzheimer's disease based on measurements of their cerebrospinal fluid, but just 20 percent of those without a family history would have fulfilled such criteria. The findings appear online April 17 in the journal PLoS ONE.

"In early-onset Alzheimer's disease, the genetics are much more clear-cut and we can test family members and know if they will develop Alzheimer's," said senior author Dr. P. Murali Doraiswamy, a professor of psychiatry and medicine at Duke.

It is not as clear-cut, however, when it comes to later-onset Alzheimer's, Doraiswamy said. "The genetics are much more complex, and although we know these individuals are at a slightly greater risk, we don't know when they start developing silent brain changes," he said. "[The new study is] documenting very clearly that asymptomatic family members have twice the rate of silent brain changes and that these changes happen in certain pathways known to be related to Alzheimer's disease."

The findings may help advance research that seeks to prevent Alzheimer's disease by using drugs, he said, and it's not a reason to panic and start to think the worst if you have a family history of the disease. "The findings don't suggest you should worry any more or any less," he said.

Although the study found an association between having a family history of Alzheimer's and showing brain changes related to the disease, it did not prove a cause-and-effect relationship.

"Having a family history does not mean you will get Alzheimer's disease," said Dr. Richard Isaacson, director of the Alzheimer's division at the University of Miami Miller School of Medicine. You may be at a higher risk for developing it, but it is not predestined, said Isaacson, who was not involved with the new study.

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Pesticide Exposure Linked to Changes in Fetal Movement: Study

Findings underscore need to protect developing brain, researcher says

By Robert Preidt

HealthDay Reporter

WEDNESDAY, June 12 (HealthDay News) -- A pregnant woman's exposure to environmental contaminants affects her unborn baby's heart rate and movement, a new study says.

"Both fetal motor activity and heart rate reveal how the fetus is maturing and give us a way to evaluate how exposures may be affecting the developing nervous system," study lead author Janet DiPietro, associate dean for research at the Johns Hopkins Bloomberg School of Public Health, said in a school news release.

The researchers analyzed blood samples from 50 high- and low-income pregnant women in and around Baltimore and found that they all had detectable levels of organochlorines, including DDT, PCBs and other pesticides that have been banned in the United States for more than 30 years.

High-income women had a greater concentration of chemicals than low-income women.

The blood samples were collected at 36 weeks of pregnancy, and measurements of fetal heart rate and movement also were taken at that time, according to the study, which was published online in the Journal of Exposure Science and Environmental Epidemiology.

The researchers found that higher levels of some common environmental pollutants were associated with more frequent and vigorous fetal movement. Some of the chemicals also were associated with fewer changes in fetal heart rate, which normally parallel fetal movements.

"Most studies of environmental contaminants and child development wait until children are much older to evaluate effects of things the mother may have been exposed to during pregnancy," DiPietro said. "Here we have observed effects in utero."

How the prenatal period sets the stage for later child development is a subject of tremendous interest, DiPietro said.

"These results show that the developing fetus is susceptible to environmental exposures and that we can detect this by measuring fetal neurobehavior," she said. "This is yet more evidence for the need to protect the vulnerable developing brain from effects of environmental contaminants both before and after birth."

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Heading Soccer Balls Tied to Damaging Brain Changes

Doing it a lot may increase risk of memory problems in adult soccer players, study says

By Serena Gordon

HealthDay Reporter

TUESDAY, June 11 (HealthDay News) -- Sophisticated scans reveal that soccer players who head the ball a lot show changes in the white matter of their brain that mirror those seen in traumatic head injuries.

In addition, they face a higher risk of developing thinking and memory problems, the researchers report.

"We looked at the relationship between heading and changes in the brain and changes in cognitive functions [thinking and memory], and we found that the more heading people do, the more likely we are to find microscopic structural abnormalities in the brain, and they're more likely to do poorly on cognitive tests, particularly in terms of memory," said study author Dr. Michael Lipton, associate director of the Gruss Magnetic Resonance Research Center at Albert Einstein College of Medicine and medical director of magnetic resonance imaging at Montefiore Medical Center, both in New York City.

However, Lipton noted, "We cannot say heading caused these changes. We found an association, but in no way can we infer causation. You need a longitudinal study that follows people over time to prove causation."

Results of the study were released online June 11 in the journal Radiology.

Soccer is the world's most popular sport. More than 265 million people play the game worldwide, and heading is a common move in soccer. Heading a soccer ball means using your head instead of your feet to play the ball. In competitive games, players head the ball between an average of six and 12 times, according to background information in the study. In this elite level of play, the ball can travel at velocities of 50 miles per hour or more, according to the study.

This isn't the first study to link heading and changes in the white matter in the brain. In an issue of the Journal of the American Medical Association late last year, Harvard researchers compared soccer players to swimmers, and found changes in the white matter in soccer players.

White matter is the communication network in the brain; it sends messages between neurons (gray matter).

For the current study, Lipton and his colleagues recruited 37 adult amateur soccer players. Their ages ranged from 21 to 44 years old, and the average age was nearly 31. Twenty-eight of the volunteers were men. They played at least one competitive game of soccer each week, and practiced an average of two times a week, according to Lipton. Most had been playing since they were kids.

All underwent a special imaging technique called diffusion tensor magnetic resonance imaging that produces detailed images that show microscopic changes in the white matter of the brain.

The players also filled out a questionnaire about such factors as frequency of heading and prior concussions, and completed a number of tests to measure their thinking and memory skills.

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

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.

His biggest concern is that by expanding the diagnosis of ADHD, more children and adults will be put on stimulant medications, such as Adderall, Ritalin, Concerta and Vyvanse.

"In the short-term, performance is improved, which makes it highly desirable. In the long-run, there's a risk of addiction. Would you think it's OK for people to take steroids to improve their tennis game? It's pill-pushing," Frances said.

"If we decide as a society that the use of stimulants is good, it shouldn't be done through a fake medical diagnosis. Making it a medical diagnosis is what's wrong here," Frances explained. "I'm not against these drugs being legal, but I'm against the backdoor medical diagnosis."

Another concern is that people who have other psychiatric disorders may be wrongly classified as having ADHD.

"Every single psychiatric disorder has distractibility as part of it. If you misdiagnose someone with bipolar disorder as having ADHD and put them on stimulants, you'll throw them into mania," he cautioned.

Norcross agreed that ADHD diagnosis in adults needs to be done very carefully. But, he said the traits of inattention and disorganization often do continue into adulthood. And, for teens and young adults, ADHD can have an impact on education and employment opportunities.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: James Norcross, M.D., child and adolescent psychiatrist, the University of Texas Southwestern Medical Center, Dallas; Allen Frances, M.D., professor emeritus, and former chair, psychiatry, Duke University School of Medicine, Durham, N.C.

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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 run

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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Your Stroke Risk Can Shrink With 7 Lifestyle Changes

Controlling blood pressure is most important, large U.S. study found

By Robert Preidt

HealthDay Reporter

THURSDAY, June 6 (HealthDay News) -- Certain lifestyle changes could greatly reduce your stroke risk, according to a new study.

Researchers calculated stroke risk among nearly 23,000 black and white Americans aged 45 and older. Their risk was assessed using the American Heart Association's Life's Simple 7 health factors: be active, control cholesterol, eat a healthy diet, manage blood pressure, maintain a healthy weight, control blood sugar and don't smoke.

During five years of follow-up, 432 strokes occurred among the participants. All seven factors played an important role in predicting stroke risk, but blood pressure was the most important, according to the study, which was published June 6 in the journal Stroke.

"Compared to those with poor blood pressure status, those who were ideal had a 60 percent lower risk of future stroke," study senior author Dr. Mary Cushman, a professor of medicine at the University of Vermont in Burlington, said in a journal news release.

Cushman and her colleagues also found that people who didn't smoke or quit smoking more than a year before the start of the study had a 40 percent lower stroke risk.

For the study, the researchers categorized the participants' Life's Simple 7 scores as inadequate (zero to four points), average (five to nine points) or optimum (10 to 14 points). Every one-point increase was associated with an 8 percent lower stroke risk. People with optimum scores had a 48 percent lower risk than those with inadequate scores, and those with average scores had a 27 percent lower risk.

Overall, blacks had lower scores than whites, but the association between scores and stroke risk was similar for blacks and whites.

"This highlights the critical importance of improving these health factors since blacks have nearly twice the stroke mortality rates as whites," Cushman said.

Each year, about 795,000 people in the United States have a stroke, which is the No. 4 killer and a leading cause of long-term disability in the country, according to the American Heart Association.

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Brain Changes Could Contribute to Gulf War Illness: Study

Title: Brain Changes Could Contribute to Gulf War Illness: Study
Category: Health News
Created: 3/21/2013 10:35:00 AM
Last Editorial Review: 3/21/2013 12:00:00 AM

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Energy Drinks Linked to Changes in Heart Rhythm

But more research is needed on the caffeine-laden beverages, review says

By Randy Dotinga

HealthDay Reporter

THURSDAY, March 21 (HealthDay News) -- Energy drinks boost blood pressure and may make the heart more susceptible to electrical short circuits, new research suggests.

But it's not clear how much of this effect on blood pressure has to do with caffeine, which also is found in coffee, or whether the effect significantly raises the risk of heart problems.

So should you put down your Red Bull or Monster Energy Drink? Not necessarily, experts say.

"I have no real concern that having an energy drink or two will negatively impact most people's health," said Dr. C. Michael White, a professor and head of pharmacy practice at the University of Connecticut. He has studied energy drinks and is familiar with the new review's findings.

However, he said, "there is enough information in this meta-analysis to make me concerned that there may be pockets of the population who may have an increased risk of adverse events, and more work needs to be done to see if this is true."

In other words, it's possible that some people could be especially vulnerable to the effects of energy drinks.

At issue are the caffeine-laden drinks that have become popular among people looking to stay alert, stay awake or get a jolt. Sixteen-ounce cans of drinks like Monster Energy Assault and Rockstar pack in about 160 milligrams of caffeine, compared with roughly 100 milligrams in a 6-ounce cup of coffee.

Energy drinks also come with other ingredients like sugar and herbs, and medical experts have warned that they can spell trouble.

Industry representatives defend energy drinks, saying they contain about as much caffeine by the ounce as coffeehouse drinks. But people often consume much more of the energy drinks at one time.

In the new report, researchers looked at seven studies. Among them, a total of 93 participants drank energy drinks and had their "QT interval" measured, while another 132 underwent blood pressure measurement. In most of the studies, the participants -- aged 18 to 45 -- drank one to three cans of Red Bull.

The QT interval is an electrocardiogram (EKG) measurement of how the heart resets itself electronically while it beats. A longer interval raises the risk that a "short circuit" will develop in the heart and possibly kill a person.

The review found that the QT intervals lengthened after people consumed energy drinks. Federal officials would raise an alarm if a medication produced this level of an effect, said review co-author Dr. Ian Riddock, a preventive cardiologist at the David Grant Medical Center at Travis Air Force Base, in California.

It's not known if the culprit is the caffeine or the other ingredients, "although we tend to think it's the latter," Riddock said.

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Recovery and body changes.

Dear Caloriecount,

I've actually been in recovery from anorexia for past 3 months or so. I am now completely weight restored + @. And to be honest, I am not 100% happy about it, though I am aware of what I'm going through and I am still willing to fully go through this process.

I am aware that now I'm in the healthy range, however, I weigh a bit more than I used to. I also gained more fat in my thighs and stomach and I seem to have smaller breasts and arms than before. In a way, this almost feels like a punishment for what I've done to my body.

I am now into intuitive eating after a bingeing period then trying-to-eat-set-amounts-at-set-time period. Since I started Levlen ED oestrogen tablets 3 weeks ago, I've actually been having random binge urges which I've been responding appropriately. I haven't had period in 7~8 months or so.

Well, the question is... being a typical woman... would I be able to get my pre-ED body back? That is really all I wish for now. Nothing more, nothing less. I just wish all could go back to the normal and I wouldn't be any happier...

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Big Changes in Psychiatry's 'Bible' of Disorders

ByDaniel J. DeNoon
WebMD Health News Reviewed byLouise Chang, MD

Dec. 3, 2012 -- A major revision to the diagnostic "bible" -- which defines what is and what is not a mental illness -- has the final approval of the American Psychiatric Association (APA).

The approval means the final draft of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, will be official when it is published in May 2013.

Ten years in the making, the rewritten manual has been embroiled in controversy. One outspoken critic is Allen J. Frances, MD, chair of the task force that developed the previous edition, DSM-IV.

In a critique published online by Psychology Today, Frances calls the DSM-5 "deeply flawed," with "changes that seem clearly unsafe and scientifically unsound."

The APA defends the DSM-5 as the work of more than 1,500 experts in all fields of psychiatry and psychology from 39 countries.

"We have produced a manual that best represents the current science and will be useful to clinicians and the patients they serve," Dilip Jeste, MD, president of the APA, says in a news release.

Something called "psychotic risk syndrome," one of the most controversial proposed diagnoses, was dropped from the final draft. "Hypersexual disorder" (sex addiction) was also rejected, although the new manual opens the door to "behavioral addictions."

Major Changes in DSM-5

The APA points to several key decisions for the DSM-5, including:

Asperger's disorder, childhood disintegrative disorder, and pervasive developmental disorder will no longer be specific diagnoses. Instead, children with these conditions will receive diagnoses of autism spectrum disorder with different degrees of severity. Binge-eating disorder is now an official diagnosis. "Excessive eating 13 times in three months is no longer just a manifestation of gluttony and the easy availability of really great tasting food," Frances says. But the APA says the change "better represents the symptoms and behaviors of people with this condition." Children with persistent irritability and frequent tantrums (three or more a week for over a year) will receive a diagnosis of disruptive mood dysregulation disorder. The APA says this addresses concerns about the over-diagnosis of ADHD. Frances says it will do the opposite, by turning temper tantrums into mental disorders. Skin picking will be a new disorder related to obsessive-compulsive disorders. Hoarding is a new disorder that will describe "people with persistent difficulty discarding or parting with possessions, regardless of their actual value." Grief used to be considered normal in people with symptoms of depression lasting less than two months after the death of a loved one. Now such people may receive a diagnosis of depressive disorder. "This reflects the recognition that bereavement is a severe psychosocial stressor that can precipitate a major depressive episode beginning soon after the loss of a loved one," the APA says. Frances says the change will substitute "pills and superficial medical rituals for the deep consolations of family, friends, religion, and the resiliency that comes with time and the acceptance of the limitations of life." Substance-use disorder now combines the old categories of substance abuse and substance dependence. The APA says this strengthens the diagnosis. Frances says "first-time substance abusers will be lumped in ... with hard-core addicts." View Article Sources

SOURCES:

DSM-5 web site.

American Psychiatric Association web site.

News release, American Psychological Association.

Frances, A.J. Psychology Today, published online Dec. 2, 2012.

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Simple Changes in Lifestyle to Achieve Weight Loss

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Guest Post Written by Sachin

Losing weight seems a humungous task for somebody who has just started in this direction. During the initial days one looks for various options available on the net that suits them and there is also a tendency to look out for easy ways to achieve weight loss. There are some who start off with a strict weight loss regimen which they are not able to handle after some days or weeks. This result in reverting back whatever benefit was gained with respect to weight loss. There are some simple weight loss tips which if practiced may help in bringing about significant benefits. Some of these have been discussed below.

Serving in smaller plates and bowls greatly helps in reducing the portion size of the food you consume. A three ounce serving on a big plate looks small, but the same serving on a small plate looks larger.

Positive Changes in Life to Control Weight

It has been found that when you sleep six hours or less before starting your day, the tired body craves sugary or high carbohydrate foods to restore the energy it lacks. Doctors from the University of Chicago studied two hormone levels, ghrelin and leptin, in 12 healthy males while monitoring the men’s appetites and activity levels. When the men received less sleep their leptin levels decreased and ghrelin levels increased. Their appetites were significantly larger, resulting in a 45% increased demand for carbohydrates and other high-calorie foods. Thus, providing sufficient rest to the body helps in avoiding cravings for sugary foods.

Exercise smart instead of hard. Walking helps in diminishing “bad cholesterol”, low-density lipoprotein (LDL) while increasing “good cholesterol”, high-density lipoprotein (HDL). It reduces blood pressure and also helps in enhancing mood. Jogging, running and bicycling are high-impact exercises. Start with a few minutes of stretching and then preferred exercise at least 3 days a week. The length of workout should be increased gradually over time.

In a weight loss regimen rewards have a significant role to play. For instance, if you are sacrificing three of your favorite junk foods or candies out of your diet plan, set aside a day when you reward your efforts by eating one of those three foods.

According to researchers some spices like cinnamon, turmeric, paprika, garlic powder, oregano and rosemary have positive benefits on the metabolism of the body.

Hormones, like adrenalin and CRH, are released when you’re too stressed, decreasing your appetite for a short time. This is known as the “fight or flight” response, but when the stressors are events that one can neither fight nor avoid and then you tend to eat more.

In contrast to chicken skin, which contains 30% of the fat that poultry has, edible fruit skins contain most of the nutrients of the fruit. Some of these are blueberries, raspberries, strawberries, prunes, and some others.

Time Management: A Boon to your Life Style

Time management is an often overlooked aspect when going on a weight loss regimen. Planning ahead for the time dedicated for exercise and other important work greatly helps in sustaining your weight loss efforts.

Keeping the kitchen stocked up with fruits, vegetables, healthy meats, grains, cereals, spices, and other relevant items encourages healthy cooking. Apart from these eating healthy home cooked meals is a great way to avoid excess calories which come along with packaged meals and other junk foods.  Whether it’s you who’s cooking, a family member, or house help, one must ensure that every one practices healthy cooking methods, and ingredients. Using less oil, low salt, fresh produce, start showing their results in no time.

Thus if one adheres to these simple weight loss tips one can not only bring about positive changes in one’s lifestyle but also be more healthy and fit.

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