Obesity Linked to Prostate Cancer, Study Finds

TUESDAY, April 23 (HealthDay News) -- Obese men are more likely to have precancerous changes detected in benign prostate biopsies and are at increased risk for eventually developing prostate cancer, new research suggests.

For the study, researchers examined data from nearly 500 men who were followed for 14 years after undergoing an initial prostate biopsy that was found to be noncancerous, or benign.

Prostate abnormalities were detected in 11 percent of the patients, and these abnormalities were strongly associated with obesity, said study author Andrew Rundle, an associate professor of epidemiology at Columbia University Mailman School of Public Health in New York City.

After taking into account factors including family history of prostate cancer, the researchers concluded that obesity at the time of the initial biopsy was associated with a 57 percent increased risk of developing prostate cancer during the 14 years of follow-up.

This association, however, was seen only for prostate cancer that occurred earlier in the follow-up period, according to the study, which was published in the April 23 issue of the journal Cancer Epidemiology, Biomarkers & Prevention.

"We don't absolutely know what the true biology is," Rundle said in a news release from the American Association for Cancer Research. "In some ways, this reflects the association between the body size and larger prostate size, which is thought to reduce the sensitivity of the needle biopsy. It is possible that the tumors missed by initial biopsy grew and were detected in a follow-up biopsy."

The association found in this study does not prove cause and effect.

Rundle noted that previous studies "have attempted to determine if there are subpopulations of men diagnosed with benign conditions that may be at a greater risk for developing prostate cancer. This is one of the first studies to assess the association between obesity and precancerous abnormalities."

These findings indicate that obesity "should be considered a factor for more intensive follow-up after a benign prostate biopsy," Rundle said.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: American Association for Cancer Research, news release, April 23, 2013

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Hospitalization OK for Psych Patients Can Take Hours

WEDNESDAY, April 24 (HealthDay News) -- U.S. psychiatrists spend a total of 1 million hours on the phone each year getting insurance companies to approve hospitalization for patients with severe mental illnesses, a new study reports.

For the study, which was published April 23 in the journal Annals of Emergency Medicine, researchers looked at psychiatrists in the Boston area and found that they spent an average of 38 minutes per patient on the phone getting insurance authorization.

About one in 10 cases took more than an hour to get approval, and one case took up five hours of the psychiatrist's time, the investigators found.

Each year in the United States, there are about 1.6 million psychiatric admissions for patients with private insurance. An average of 38 minutes of phone time per patient to get insurance authorization works out to about 1 million hours of "wasted" time for psychiatrists nationwide, according to the news release from the Physicians for a National Health Program.

The three-month study did not include uninsured patients or those covered by Medicare, which does not require prior authorization.

Most of the patients that required hospitalization had been deemed suicidal or, in some cases, posed a danger to others. The time spent obtaining insurance authorization delayed care for the patient in need and prevented psychiatrists from seeing other patients, the study authors noted. Only one of the 53 requests for authorization was denied, they pointed out.

The average time that patients spent in an emergency department (ED) awaiting hospital admission was 8.5 hours. The shortest wait was three hours and the longest was 20 hours, according to the study findings.

Mental health disorders affect nearly one-quarter of American adults a year, but less than one-third of them receive psychiatric care, according to background information in the news release.

"Society pays for inadequate psychiatric care; more than half of all prison inmates and a third of all homeless people are mentally ill. Massachusetts is considered a model for health reform, yet we found that seriously ill patients routinely spent hours stranded in the ED due to insurance bureaucracy. The hours psychiatrists spend obtaining those authorizations could be far better spent treating our patients," study lead author Dr. Amy Funkenstein, a child psychiatry fellow at Brown University, said in the news release.

She led the study while she was a psychiatric resident at Cambridge Health Alliance (CHA) and Harvard Medical School.

Study senior author Dr. J. Wesley Boyd, attending psychiatrist at CHA, said that "private insurers are obstructing care by requiring authorizations before a qualified psychiatrist can hospitalize a dangerously ill patient. With doctors, nurses and emergency departments already overburdened, adding a time-consuming bureaucratic task that doesn't help patients is unconscionable," he said in the news release.

"Insurers hope that clinicians will be so hassled by authorization procedures that they won't seek admission for their patients, saving insurance companies money," Boyd, who is also an assistant clinical professor of psychiatry at Harvard Medical School, suggested in the news release. "Placing profits ahead of the health of patients when mental illness makes them vulnerable is immoral. A single-payer Medicare-for-all health care system would represent a great leap forward for patients and providers alike."

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Physicians for a National Health Program, news release, April 23, 2013

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Skipping Breakfast May Raise Diabetes Risk

Overweight women who ate morning meal had lower blood sugar, better insulin response in small study

By Kathleen Doheny

HealthDay Reporter

SUNDAY, June 16 (HealthDay News) -- Eating breakfast every day may help overweight women reduce their risk of diabetes, a small new study suggests.

When women skipped the morning meal, they experienced insulin resistance, a condition in which a person requires more insulin to bring their blood sugar into a normal range, explained lead researcher Dr. Elizabeth Thomas, an instructor of medicine at the University of Colorado.

This insulin resistance was short-term in the study, but when the condition is chronic, it is a risk factor for diabetes, Thomas said. She is due to present her findings this weekend at the Endocrine Society's annual meeting in San Francisco.

"Eating a healthy breakfast is probably beneficial," Thomas said. "It may not only help you control your weight but avoid diabetes."

Diabetes has been diagnosed in more than 18 million Americans, according to the American Diabetes Association. Most have type 2 diabetes, in which the body does not make enough insulin or does not use it effectively.

Excess weight is a risk factor for diabetes.

The new study included only nine women. Their average age was 29, and all were overweight or obese.

Thomas measured their levels of insulin and blood sugar on two different days after the women ate lunch. On one day, they had eaten breakfast; on the other day, they had skipped it.

Glucose levels normally rise after eating a meal, and that in turn triggers insulin production, which helps the cells take in the glucose and convert it to energy.

However, the women's insulin and glucose levels after lunch were much higher on the day they skipped breakfast than on the day they ate it.

On the day they did not eat breakfast, Thomas explained, "they required a higher level of insulin to handle the same meal."

"There was a 28 percent increase in the insulin response and a 12 percent increase in the glucose response after skipping breakfast," she said. That's a mild rise in glucose and a moderate rise in insulin, she noted.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"Their study doesn't prove causation," said Dr. Joel Zonszein, a professor of clinical medicine at the Albert Einstein College of Medicine and director of the Clinical Diabetes Center at Montefiore Medical Center, in New York City.

The study found only a link or association between breakfast skipping and higher insulin levels. More research is needed for confirmation, another expert said.

"This is a small, but very interesting, study," said Dr. Ping Wang, director of the University of California, Irvine, Health Diabetes Center. "The findings will have to be verified with larger studies."

Whether the effect is short-term or long-term is not known, Wang said.

Zonszein recommends against either skipping meals or eating very frequent meals, the so-called nibbling diet. "Studies done in Europe have shown that a large meal in the middle of the day is better than a large meal at dinner," he said.

However, he acknowledged that pattern is more of a habit in Europe than in the United States. Even so, he advises his patients to eat a good breakfast, a good lunch and a lighter dinner.

Other ways to reduce diabetes risk, according to the American Diabetes Association, are to control weight, blood pressure and cholesterol and to be physically active.

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Jessica Pare at a Mad Men reception in NY

Aqua green is a definite DO this season, and Mad Men's Jessica Pare is hitting all the right notes in this embellished-hem number. We only wish she chose a more colourful shoe, don't you?

Top Shoes & Bags For Spring

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Fewer Young Americans Lack Health Care Coverage

But 45 million Americans overall still don't have health insurance

By Dennis Thompson

HealthDay Reporter

TUESDAY, June 18 (HealthDay News) -- The number of young adults without health care coverage in the United States has declined significantly over the past few years, according to a new government report released Tuesday.

That's the good news.

Not-so-good are the findings that: 45.5 million people, 14.7 percent of the American population, still don't have health care coverage, and 4.9 million kids under the age of 18 also lack health insurance.

The U.S. Centers for Disease Control and Prevention's National Center for Health Statistics used data on 108,131 people contacted for the 2012 National Health Interview Survey to compile the latest profile on health insurance coverage.

Of immediate interest was the apparent impact of the Affordable Care Act, President Obama's landmark health reform law passed in 2010.

The new report found that 27 percent of young adults between the ages of 19 and 25 had no health care coverage in 2012, down from more than 35 percent in 2010, according to report co-author Robin Cohen, a CDC health statistician.

At the same time, the number of young adults covered by a private health plan increased, from 49 percent in 2010 to 58 percent in 2012.

Health policy experts said the increase is most likely due to a provision in the Affordable Care Act (ACA) that allows young adults to remain on their parents' health insurance plan up to age 26.

"You see a significant decline in uninsurance among young adults and a corresponding uptick in private health insurance coverage," said Kathleen Stoll, director of health policy at Families USA, a national nonprofit health reform organization. "That is clearly due to the provisions in the ACA that allowed young adults to stay on their parents' health coverage. That's a positive change you can directly tie to the ACA."

By comparison, the number of uninsured adults aged 26 to 35 remained the same at 27 percent between 2010 and 2012. There also was no big difference in private coverage for this age group, which was about 59 percent in both 2010 and 2012.

The effectiveness of this single provision of the Affordable Care Act should give hope to the 45.5 million Americans still without health insurance in 2012, said Sara Collins, vice president for affordable health insurance at the Commonwealth Fund, a health policy think tank.

That's because most of the major provisions of the ACA take effect in 2014, including the opening of the health insurance exchanges and a major expansion of Medicaid, she noted.

"Going forward, starting next year, we're probably going to start seeing the same thing across the age spectrum," Collins said. "Next year we're likely to see a new trajectory of uninsured rates across the whole population."

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Older Adults' Posture May Predict Future Disability

FRIDAY, April 19 (HealthDay News) -- The shape of an older person's spine may predict their future need for home assistance or admission to a nursing home, according to a new Japanese study.

The findings appeared online recently in the Journals of Gerontology Series A: Biological Sciences and Medical Sciences.

The study included more than 800 people aged 65 and older in Japan, who underwent four types of spinal measurement. The researchers found that only one of the measurements was associated with becoming dependent on help for activities of daily living.

These activities include basic self-care tasks such as bathing, feeding, using the toilet, dressing and getting in or out of a bed or chair.

The measurement that predicted the need of assistance is called the "trunk angle of inclination." This is the angle between the true vertical and straight line from the first thoracic vertebra (near the head) to the first sacral vertebra (in the lower spine), the researchers said in a journal news release.

Over four and a half years of follow-up, about 16 percent of the participants became dependent on help for basic daily activities. Those with the greatest angle of spinal inclination were about three and a half times more likely to become dependent on help for basic daily activities than those with the least spinal inclination, the researchers found.

Although the study found an association between spinal angle and future disability in older adults, it did not establish a cause-and-effect relationship.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Journals of Gerontology Series A: Biological Sciences and Medical Sciences, news release, April 2013

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Choosing food at a restaurant

I'm off out for dinner tonight, and want to pick something that's not totally calorie loaded!

My options:

-Tortilla wrap with either chargrilled veg & mozzarella, or tuna & red onion mayo, and salad and coleslaw

-Baked potato with either baked beans & cheddar cheese, cheddar cheese & coleslaw, or tuna mayo, with salad and coleslaw

-Chickpea and spinach burger with chips/fries, salad and coleslaw.

-Mac & cheese with garlic bread

Unfortunately there's no nutritional info about. I think the mac & cheese would probably be the most fat loaded and calorie heavy. What would you pick?

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