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Read more »Tuesday, September 17, 2013
Think You're Stressed? Maybe You Should Have Your Heart Checked
Those who thought pressure was affecting their health twice as likely to suffer heart attack, study says
By Steven Reinberg
HealthDay ReporterTHURSDAY, June 27 (HealthDay News) -- People who think stress is affecting their health may be setting themselves up for a heart attack, a new study contends.
The researchers found that these people had double the risk of a heart attack compared with people who didn't think stress was harming their health.
"People's perceptions about the impact of stress on their health are likely to be correct," said study author Hermann Nabi, a senior research associate at the Centre for Research in Epidemiology and Population Health at INSERM in Villejuif, France.
"They may need to take actions when they feel that it is the case," he added.
These findings have both clinical and theoretical implications, Nabi said.
"From a clinical perspective, they suggest that complaints of adverse impact of stress on health should not be ignored in clinical settings as they may indicate increased risk of developing coronary heart disease," he said.
From a theoretical perspective, the findings imply that the perceived impact of stress on health is a valid concept that should be considered in future studies aimed at examining the association between stress and health outcomes, Nabi added.
The report was published June 27 in the online edition of the European Heart Journal.
Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said that "stress and reactions to stressful situations have been associated with increased risk of cardiovascular disease in many studies."
However, few studies have looked at whether an individual's perception of stress is associated with cardiovascular outcomes, he said.
And it's not clear if reducing stress would affect the risk for heart attack, Fonarow said.
"Further studies are needed to determine whether stress reduction or other risk reduction strategies can reduce cardiovascular events in men and women who perceive they are under stress that is adversely impacting their health," he said.
For the study, Nabi's team collected data on more than 7,000 men and women who took part in the Whitehall II study, which has followed London-based civil servants since 1985.
Participants were asked how much they felt that stress or pressure in their lives had affected their health. Based on their answers, they were placed into one of three groups: "not at all," "slightly or moderately," or "a lot or extremely."
Participants were also asked about their levels of stress and other lifestyle factors such as smoking, drinking, diet and physical activity.
The researchers also collected medical information, such as blood pressure, diabetes status and weight, and other data, including marital status, age, sex, ethnicity and socioeconomic status.
Over 18 years of follow-up, there were 352 heart attacks or deaths from heart attack.
After taking all of these factors into account, the investigators found those who said their health was a "lot or extremely" affected by stress had more than double the risk of a heart attack compared with those who said stress had no effect on their health.
Adam Lambert at the American Idol Season 12 Finale in Los Angeles
Daft Punk day finally arrives… But does it live up to its astronomical hype? Plus, the latest from Maya Jane Coles, London Grammar, Laura Marling, Eddie Berman and a special Virgin Records announcement »
Read more »C-Sections in U.S. Stable After 12-Year Rise: CDC
Guidelines discouraging early elective deliveries may have helped
By Steven Reinberg
HealthDay ReporterTHURSDAY, June 27 (HealthDay News) -- Cesarean deliveries in the United States have leveled off for the first time in 12 years, although they still account for almost one-third of live births, U.S. health officials report.
"It's about time," said Dr. Mitchell Maiman, chairman of obstetrics and gynecology at Staten Island University Hospital in New York City, who was not involved in the report.
The trend toward C-sections, which increased 60 percent between 1996 and 2009, was worrisome, he said. "It was bad for mothers and babies, and now finally it seems we have been able to halt it or maybe even reverse it a tiny bit," Maiman said.
"But we have a long way to go because the C-section rate is way higher than it should be," he added.
After rising from 21 percent of births in 1996 to about 33 percent in 2009, the 2011 rate held steady at about 31 percent, according to figures released Thursday by the U.S. Centers for Disease Control and Prevention (CDC).
Guidelines from the American College of Obstetricians and Gynecologists (ACOG) and other medical groups have helped to curb elective surgical deliveries, Maiman said. Those guidelines discourage cesarean delivery before 39 weeks without a medical indication.
Staten Island University Hospital has followed such guidelines for more than 15 years, Maiman said. The C-section rate there is about 22 percent, well below the national average.
Some obstetricians welcomed the new findings. "It's great that the overall C-section rate has remained flat," said Dr. Jeffrey Ecker, director of obstetrical clinical research at Massachusetts General Hospital in Boston.
"It has been difficult to demonstrate that the rise of the C-section rate over the past decade has been associated with any meaningful improvement in babies' or mothers' health," said Ecker, who is also chair of ACOG's committee on obstetric practice.
Ecker would prefer to see even fewer cesarean deliveries, but "there is no perfect rate," he said. However, "there are opportunities to move the rate down safely," he added.
The report, based on information from the Natality Data File from the National Vital Statistics System, found that the decline wasn't uniform.
At 38 weeks' gestation, the cesarean delivery rate decreased 5 percent -- a trend seen in 30 states. However, at 39 weeks -- full term -- it rose 4 percent. Thirty-eight weeks is considered early term.
Lead author Michelle Osterman, a health statistician at CDC's National Center for Health Statistics, said it's not possible to pin down the reason for the increase at 39 weeks, which was noted in 23 states. Nor could she predict whether the numbers will continue to hold.
"You never know what's going to happen, and we don't make projections," she said. "But it's significant that [the rate of C-sections] hasn't increased in the past three years."
Understanding Calcium: Supplements, Calcium Carbonate, Calcium Citrate, and More
Experts share their advice about what to consider when choosing a calcium supplement.
Are you getting enough calcium in your diet? Maybe not, especially if you're a woman or a teenage girl. Although Americans have improved at this in recent years, we're still not getting enough calcium to maintain our bone health.
How much is that? It depends on your age. According to the Institute of Medicine, the recommended daily amount of calcium to get is:
1-3 years: 700 milligrams daily4-8 years: 1,000 milligrams daily9-18 years: 1,300 milligrams daily19-50 years: 1,000 milligrams daily51-70 years: 1,200 milligrams daily for women; 1,000 milligrams daily for men71 and older: 1,200 milligrams dailyThe Institute of Medicine says that most in the U.S. get enough calcium, except for girls 9 to 18 years old. Although women’s recommended calcium needs to increase with menopause, postmenopausal woman taking supplements may also be at greater risk of getting too much calcium.
"We know that peak bone mass occurs around age 30, so it's very important in childhood and adolescence to have a healthy intake of calcium early on," says Marcy B. Bolster, MD. She is a professor of medicine in the division of rheumatology and immunology at the Medical University of South Carolina and director of the MUSC Center for Osteoporosis and Bone Health.
"After age 30, we start to gradually lose bone, and that loss accelerates for women at the time of menopause. So it's very important to stave off bone loss with adequate calcium intake."
Your health care provider may recommend calcium supplements. But with so many choices of calcium supplements, where should you start? Here's what you need to know.
"I tell my patients to take the kind that they tolerate best and is least expensive," Bolster says. She says she recommends calcium carbonate because "it's inexpensive, won't cause discomfort, and is a good source of calcium."
Some people's bodies may have problems making enough stomach acid, or may be taking medications that suppress acid production. For them, says J. Edward Puzas, MD, a calcium citrate supplement might be better because it "dissolves a little better than calcium carbonate for these people." Puzas is a professor of orthopedics and director of orthopedic research at the University of Rochester Medical Center in New York.
What about other types of supplements, like calcium plus magnesium, coral calcium, and so on? Not necessary, the experts tell WebMD. But they note that supplements that combine calcium with vitamin D -- which is essential for the body to appropriately absorb calcium -- provide an added benefit.
The body can absorb only about 500 milligrams of a calcium supplement at any one time, says Puzas, so you can't just down a 1000-mg supplement first thing in the morning and call it a day.
Instead, split your dose into two or three servings a day. "The best way to take it is with a meal; calcium is absorbed better that way," Puzas says. If your daily diet includes calcium-containing foods and drinks, you may not need multiple doses.
Public Funding Spurs Couples to Seek Fertility Treatment
By Kathleen DohenyHealthDay Reporter
WEDNESDAY, May 15 (HealthDay News) -- Public funding of assisted reproductive technology, including in vitro fertilization (IVF) treatments, broadens the range of couples who seek treatment for infertility by attracting a more diverse population, according to new research from Canada.
When the province of Quebec began to fund up to three cycles of IVF in August 2010, researchers compared patients who sought that treatment before and after the mandate.
Afterward, "we found larger numbers of lower income, less well-educated, unemployed people seeking fertility treatment," said Phyllis Zelkowitz, director of research in the department of psychiatry and senior investigator at the Lady Davis Institute of the Jewish General Hospital, in Montreal.
The study is published in the May 16 New England Journal of Medicine.
For the study, Zelkowitz and her colleagues compared data on nearly 3,600 couples. Of those, 436 sought treatment before the policy change, 821 immediately after and 2,316 eight months after the policy change.
The investigators found the proportion of treated couples with college degrees declined from 68 percent to 63 percent eight months later. Unemployed couples seeking treatment rose from 3.6 percent to 11.6 percent. And the proportion of patients with household incomes of $65,000 a year or less increased from about 37 percent to more than 47 percent.
For white couples, the proportion dropped from about 67 percent to 63 percent in the eight-month period, after rising immediately after the policy change.
Zelkowitz also found the rate of couples seeking treatment for secondary infertility doubled from 14 percent to 29 percent. Secondary infertility means being unable to get pregnant or carry a pregnancy to term after having one or more biological children.
The mandated policy change came with stipulations, Zelkowitz said. It approved coverage for up to three treatment cycles of IVF. It mandated the transfer of only one embryo per treatment cycle, with a goal of reducing preterm births, she noted.
Preterm births are more common with multiple pregnancies and are riskier to the babies, experts agree.
"One of the goals of the funding was to reduce preterm births, and they have already done that," Zelkowitz said.
The study findings are in conflict with earlier U.S. studies, which have shown that even when patients have access to public funding for assisted reproductive technology, barriers continue to exist, including social, economic and ethnic obstacles. As a result, these earlier studies suggested, the typical patients remain older, wealthier, more-educated white couples.
In the United States, infertility affects about one of eight women of reproductive age and their partners, according to the American Society for Reproductive Medicine.
Currently, 15 states have passed laws that mandate insurers to cover or offer coverage for infertility diagnosis and treatment, but some states exclude coverage for IVF.
Assisted reproductive technology is typically defined as fertility treatments in which both eggs and sperm are handled, such as IVF, but not procedures such as taking medicine to stimulate egg production, according to the U.S. Centers for Disease Control and Prevention.
Only about 5 percent of infertile couples need assisted reproductive technology, the society estimates.
For others, egg stimulation or lifestyle changes such as losing weight or stopping smoking can help them achieve a pregnancy.
However, for those who do need IVF, the cost can be prohibitive. A cycle of IVF costs about $12,400, the society estimates.
The study findings about patient demographics changing after public funding became available do not surprise Dr. Wendy Schillings, a fertility specialist in Allentown, Pa. When she meets patients who have only diagnosis covered, she said, they often delay treatment if they need IVF, hoping to save up the money needed.
Couples who don't have IVF coverage often ask for more embryos to be transferred, she said, and she then counsels them on the risks of multiple births.
"Absolutely lower-income couples can do it [seek treatment] and will do it," Schillings said. However, for those with higher incomes, the decision may involve fewer sacrifices, she added.
Copyright © 2013 HealthDay. All rights reserved. SOURCES: Phyllis Zelkowitz, Ed.D., director of research, department of psychiatry, and senior investigator, Lady Davis Institute, Jewish General Hospital, Montreal, Canada; Wendy Schillings, M.D., fertility specialist, Allentown, Pa.; May 16, 2013, New England Journal of Medicine
There's a book on how to get a Thigh Gap - be mad
Was going through pinterest and came across a new book jumping on the thigh gap wagon - the thigh gap hack
Supposedly it compiles a bunch of "hacks" for women to lose stubborn lower body fat and has a separate protocol for losing fat and overdeveloped muscle.
I can only imagine the vitriol that is about to hit the internet, but clearly there's a market! Maybe now all the thigh gap posts that seem to to devolve into snide/snarky and judgmental remarks can come to an end
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