High Blood Pressure Awareness Lags (March 27, 2003)
CHARLESTON, S.C. (Ivanhoe Newswire) -- Older Americans could use a little education on high blood pressure, say researchers reporting in the most recent issue of Archives of Internal Medicine.

Even though the vast majority of the people these researchers surveyed reported having their blood pressure taken in the past year, nearly half were unaware of the results of the reading.

Researchers polled a representative sample of about 1,500 men and women age 50 and over to find out what they know about high blood pressure. Ninety-four percent said they had a blood pressure test within the past 12 months, but 46 percent didn't know their own blood pressure reading. Twenty-seven percent of the group acknowledged having high blood pressure, but 37 percent reported being on medication to treat the condition.

Eighty percent of those who said they had high blood pressure reported taking their medications exactly as their doctor had prescribed. Twenty percent were no longer taking their medications or were not taking them as prescribed. Among this group, one in five said the cost of the medication was the biggest concern.

Over half of the patients on medication -- 60 percent -- also said they believed medications alone aren't enough to control blood pressure, and 90 percent admitted lifestyle changes play a role in blood pressure control. About three-quarters reported making a lifestyle change to control their blood pressure, and 61 percent said the change had been effective.

When asked what information they would like to have on high blood pressure, about a third of the patients said they wanted to know more about alternative therapies. About 25 percent were interested in finding out how to prevent the condition.

The authors conclude, "The results of this survey may have important implications for health care education, policy, and research."

SOURCE: Archives of Internal Medicine, 2003;163:681-687

Even a Little Lead is Harmful (March 27, 2003)
BALTIMORE (Ivanhoe Newswire) -- Even small amounts of lead can increase the risk of high blood pressure in women going through -- or nearing -- menopause.

Studies have shown men are at an increased risk for high blood pressure from lead exposure, but the problem may be even bigger in women in or near menopause, report researchers from the University of Maryland. Increased bone demineralization during this period naturally increases lead stores in the body.

Researchers evaluated blood lead levels among more than 2,000 women ages 40 to 59 and found a significant increase in high blood pressure among women with lead levels less than current U.S. occupational exposure limits or those considered acceptable among children.

Women in the study participated in household interviews and underwent physical exams as part of a larger nutritional study. After testing their blood for lead and taking their blood pressure readings, researchers divided the women into four groups, depending on blood lead levels. Results show those in the highest quartile had a 3.4-fold increase in high blood pressure incidence when compared to those in the lowest quartile. The blood levels seen in the highest quartile were less than currently recommended levels for both adults and children.

Authors of the study write, "From a public health perspective, the most important and troubling implication of these findings is that lead appears to increase blood pressure in women at very small increments ... well below what is considered deleterious in adults. These results provide support for continued efforts to reduce lead levels in the general population, especially women."

SOURCE: Journal of the American Medical Association, 2003;289:1523-1532

Uterine Fibroid Caution (March 24, 2003)
PHILADELPHIA (Ivanhoe Newswire) -- Research shows by age 35, one out of two white women and four out of five black women will be told they have uterine fibroids. These noncancerous tumors grow in the uterus. While a new non-surgical procedure may get rid of them, there's controversy surrounding it.

Fran appreciates each day with her daughter, Samantha. She went seven years without getting pregnant. A routine exam showed she had fibroid tumors. "So as far as did I have symptoms, I guess I did, I just didn't know I was having symptoms," Fran tells Ivanhoe.

Interventional radiologist Robert Worthington-Kirsch, M.D., treated her with a procedure called uterine artery embolization. It places tiny particles into the vessels that feed the fibroids.

"The fibroids shrink and turn to scar and they stop causing the symptoms that are bothering the patient," says Dr. Kirsch, of Image Guided Surgery Associates in Philadelphia.

Obstetrician/Gynecologist Jay Goldberg, M.D., recently studied 50 cases of pregnancy after embolization. Despite the treatment's success, he says his paper raises some questions. "The risk of premature delivery increased from 5 percent to 10 percent in the general population to 28 percent after embolization, which is a pretty significant jump," Dr. Goldberg tells Ivanhoe.

Miscarriage rates increased from between 5 percent and 10 percent in the general population to up to 32 percent in women who had embolization. The rate of breech babies nearly tripled.

Dr. Goldberg, of Thomas Jefferson University Hospital in Philadelphia, says, "Before you can say it's safe for women to get pregnant with this afterwards, really you need to do better studies that are looking at this."

Dr. Kirsch disagrees. He says, "The majority of women who become pregnant after embolization and chose to keep their pregnancies have gone on to have more or less uncomplicated pregnancies with delivery of healthy children."

Until more is known, both doctors agree you should talk it over with your physician carefully.

If you're considering embolization, first ask your OB/GYN what he or she knows about it and then seek out a physician who has done many of these procedures. To find those physicians, log onto http://www.sirweb.org.
If you would like more information, please contact:

Karen Hauben
Image Guided Surgery Associates
5735 Ridge Ave. Suite 106
(215) 508-5216

National Uterine Fibroids Foundation
(877) 553-NUFF

Protein Intake and Kidney Function (March 24, 2003)
BOSTON (Ivanhoe Newswire) -- High-protein diets have become very popular in the United States. Recently the American Heart Association revised their guidelines suggesting that a high-protein diet may have adverse effects on the kidneys. A new study shows this is only true if the person had kidney problems before starting the high-protein diet.

Research shows in a person with moderate to severe kidney insufficiency, a low-protein diet can slow kidney function decline. However, the impact of a high-protein diet has not been established. Researchers from Brigham and Women's Hospital and Harvard Medical School conducted a study to look at the association between protein in the diet and kidney function in women.

The study used information from participants in the Nurses' Health Study. More than 1,600 women in this study were 42 to 68 years old in 1989 and gave blood samples in 1989 and 2000. The women answered food-frequency questionnaires to determine their protein intake.

Researchers report a high-protein diet was not associated with a loss of kidney function in women with normal kidney function. However, the study found a high protein diet could have adverse effects on women who already had mild kidney insufficiency. Specifically, authors report those women who had mild kidney problems accelerated the decline of their kidneys if they had a high-protein diet, particularly a high intake of nondairy animal protein. Authors of the study comment, "Additional large prospective studies of adequate duration are needed to further address this issue."

SOURCE: Annals of Internal Medicine, 2003;138:460-468

Halting Diabetes (March 21, 2003)
NEW YORK (Ivanhoe Newswire) -- While it's not a cure, a new short-term therapy for type 1 diabetes appears to halt the progression of the disease, with no serious side effects. That's promising news for the 1 million Americans with what is also known as insulin dependent diabetes.

Catherine Price is a natural on the piano. She has type 1 diabetes but doesn't let it slow her down. She keeps her disease in tight control.

"It's a tightrope and if you're off on either side there are consequences," says Price. She has it better than many diabetics, thanks to a two-week experimental treatment she received shortly after diagnosis. Researchers say hOKT3g1 is the first short-term therapy that appears to slow progression of the disease.

Endocrinologist Kevan Herold, M.D., says: "We know that it inactivates the cells that are responsible for the development of type 1 diabetes. So somehow or another, it turns them off so that they don't continue to destroy the insulin-producing cells."

While it's unclear how long the effects will last, two years later Price is producing more of her own insulin than she probably would have without the treatment.

"People who control their diabetes very well will have a much lower risk of developing the long-term complications, such as eye disease, kidney disease and others. And if you're able to make some of your own insulin, it's a lot easier to do that," says Dr. Herold, of the Columbia Presbyterian Medical Center in New York.

Price says: "I'm just really happy about it. Because if I didn't have that, I can't even imagine how hard it would be."

Researchers are conducting additional studies to see if hOKT3g1 might also be effective in treating people who've had type 1 diabetes longer, and also in delaying the onset of the disease.

If you would like more information, please contact:

Tina Gellhorn
Administrative Assistant
Columbia University
PH 10 Room 203E
630 West 168th Street
New York, NY 10032
(212) 342-3253
cg482@columbia.edu

Smoking Intervention Successful (March 20, 2003)
CHICAGO (Ivanhoe Newswire) --Socioeconomically disadvantaged women who are taught about the dangers of secondhand smoke to their children and are provided support from their pediatrician are twice as likely to stop smoking than those who are not.

This is the finding from a recent study on a pediatric-based smoking cessation intervention program for low-income women by researchers at the University of Illinois at Chicago.

Despite national campaigns aimed at educating the public about the health hazards to children from secondhand smoke, smoking among socioeconomically disadvantaged women continues at rates double that of the nation as a whole. The intervention group included women of childbearing age who smoked and received a motivational message from their child's pediatrician, a guide to quitting smoking, and a 10-minute motivational interview with a nurse. They also received three outreach telephone counseling calls from a nurse in the three months following their initial visit. Researchers measured the number of women in the intervention group who stopped smoking and compared that to the number of women who received no intervention. The authors report more than 80 percent of the women stopped smoking in the intervention group, which was twice as many as those in the control group.

The authors conclude a pediatric clinic smoking cessation intervention has long-term effects in socioeconomically disadvantaged women. The results should encourage pediatricians to implement clinical guidelines for smoking cessation into pediatric practice. They say the public health benefits for women and children could be significant.

SOURCE: Archives of Pediatric & Adolescent Medicine, 2003;157:295-302

A Step Closer to Stop Cancer (March 19, 2003)
By Shanida Smith, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire) -- Metastasis, or spread of cancer, in the blood could one day be stopped by research closely examining a protein in blood platelets.

Platelets contain a large amount of the protein CD40L initially found only in the immune system. When platelets are activated, they release CD40L. The protein induces an inflammatory response in the blood vessel walls seen in cancer and vascular disease.

Researcher Ali Amirkhosravi, Ph.D., from the Florida Hospital Cancer Institute, says, "Cancer is one of the diseases that can cause platelet activation, and if platelets get activated, this protein may facilitate the processes of metastasis and angiogenesis."

Researchers are comparing normal mice with mice genetically modified to not have the protein. Preliminary results show much less coagulation, or clotting, in the mice with the protein after being injected with tumor cells. "Many agents that inhibit coagulation result in the reduction of tumor metastasis in these animals," says Amirkhosravi. Researchers say clotting is present in cancer patients who have blood-borne metastasis. Researchers are trying to understand the process so they can interfere with it.

Amirkhosravi says anti-coagulant and anti-platelet agents combined may be able to stop the spread of cancer in the future. He says, "As an adjuvant therapy, it'll be very helpful."


SOURCE: Ivanhoe Health Correspondent Shanida Smith's Interview with Ali Amirkhosravi, Ph.D.

Researchers say Heparin Allergy Widespread (March 19, 2003)
By Shanida Smith, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire) -- Researchers from Florida Hospital say more people may be subject to a drug allergy than many emergency room health care providers know.

Researchers say the blood clots that are "expected" after surgery are actually allergic reactions to heparin, a drug commonly used to stop clotting. Researchers say about 50 percent to 60 percent of all patients who have open-heart surgery develop a heparin antibody. When they return to the emergency room with a blood clot, they are most likely given heparin to unclot it. The allergic reaction may cause massive clotting, which can lead to amputation if not prevented or treated.

Lead researcher John Francis, Ph.D., says awareness is key to fighting the condition called heparin-induced thrombocytopenia. He says, "We're educating nurses so they can say, 'Hey doc, you need to take a look at this.'"

Researchers have recruited 150 patients for the study so far. Preliminary results show 10 percent of those patients are allergic. Francis says this indicates, "There are people in this country getting heparin that shouldn't."

Francis adds the incidence of heparin-induced thrombocytopenia is a major problem. He says the average settlement for heparin-related cases in the United States is $2 million. "Almost every hospital has a major heparin case brewing," he says.

As a result of their research, researchers at Florida Hospital are using three drugs known as direct thrombin inhibitors instead of heparin during surgery. They are also using the drugs to treat reactions to heparin. The FDA approved two of the drugs. Test results show the third drug, bivalirudin, is also a safe and effective agent in patients with heparin-induced thrombocytopenia.

SOURCE: Ivanhoe Health Correspondent Shanida Smith's Interview with John Francis, Ph.D., March 17, 2003

HRT and Quality of Life (March 19, 2003)
HOUSTON (Ivanhoe Newswire) -- Hormone replacement therapy (HRT) does not appear to improve a woman's quality of life, according to a new study. Researchers say this study is another reason why women without menopausal symptoms should not take combination HRT.

The Women's Health Initiative (WHI) and other clinical trials showed there are significant health risks associated with combination hormone use. Studies show some women taking estrogen plus progestin are at an increased risk for a heart attack, stroke, blood clots and breast cancer compared to women not on hormones. There has not been much research about the effects of HRT on health-related quality of life factors such as mental health, sexual satisfaction and depressive symptoms. Researchers from Baylor College of Medicine evaluated quality of life factors in more than 16,000 women who took part in the WHI.

The WHI included women aged 50 to 79 years. The women were either on combination HRT or a placebo. They answered questions about their quality of life at the beginning of the study, after one year and after three years.

The study showed no significant difference on general health, vitality, mental health, depressive symptoms or sexual satisfaction between the women on HRT and those on placebo. The use of combination HRT was found to have a small benefit when it came to sleep disturbance, physical functioning and body pain after one year. However, at three years there was no significant benefit on HRT.

Researchers conclude estrogen plus progestin does not have a beneficial effect on health-related quality of life factors. The difference noted in sleep, physical function and pain was small and only seen in the first year. They write, "For most women, these small benefits do not outweigh the risks of heart attack, stroke, blood clots and breast cancer associated with combined hormone therapy."

In an accompanying editorial, Deborah Grady, M.D., M.P.H., from the University of California, San Francisco, says postmenopausal therapy with estrogen and progestin results in an increased risk of disease, does not make asymptomatic women feel better and does not improve cognition. Dr. Grady comments, "There is not a role for hormone therapy in the treatment of women without menopausal symptoms." She adds, "We clearly need to identify new treatments that are highly effective and safe."

SOURCE: The New England Journal of Medicine, 2003;348:1-14

Not All Fat Created Equal (March 18, 2003)
BALLERUP, Denmark (Ivanhoe Newswire) -- It's not how fat you are but where your fat is located that could be a bigger health risk, according to a new study. The study shows elderly women with excess fat located in the arms, legs, hips and buttocks had less atherosclerosis than women whose fat was stored mostly in their abdomen.

Women and men tend to gain weight differently. Men often gain weight in their belly, and this fat is strongly associated with the development of atherosclerosis. Atherosclerosis is the buildup of artery-clogging plaque that can lead to a heart attack or stroke. Women tend to gain weight in their lower body and the association between weight gain and atherosclerosis in women is not clear. Danish researchers conducted a study to determine if excess fat in different areas in women affected the risk for cardiovascular problems.

The study included 1,356 women who were between 60 years and 85 years old. Researchers measured body fat in the abdomen area called central fat and in the lower body and arms called peripheral fat. They used X-rays to view atherosclerosis in the aorta and then classified the women based on how much buildup they each had. Researchers then divided the women based on their central and peripheral fat mass and compared that with their buildup in the arteries.

Researchers report women with high central fat and low peripheral fat had the most severe problems with blood sugar and cholesterol metabolism and the most atherosclerosis. Women with low central fat and high peripheral fat had the best blood sugar metabolism. The least severe atherosclerosis was found in generally obese women.

In elderly women, researchers say, the localization of fat mass around the abdomen is more of a risk factor than overall obesity. However, the American Heart Association President Robert Bonow, M.D., says, "Although this is a very interesting study suggesting that all fat is not the same in women, until we know more, it's still important to avoid weight gain. Since we can't design our bodies and direct fat to specific locations, it's important to exercise and watch our weight."

SOURCE: To be published in an upcoming issue of Circulation

Nutrients Reduce Risk of Low Birth Weight (March 18, 2003)
BALTIMORE (Ivanhoe Newswire) -- A new study shows a folic acid-iron supplement taken by a pregnant woman can reduce the risk of low birth weight for her unborn child.

Birth weight is closely associated with the health and survival of infants in the developing world. While studies have shown better nutrition by the mother can increase birth weight, the effects of vitamin supplementation has not been widely studied. Researchers from Johns Hopkins Bloomberg School of Public Health conducted a study evaluating a variety of nutrients to determine if they played a role in the size of a baby at birth.

Nearly 5,000 women from a rural community in southeastern Nepal were included in the research. For the study, 426 communities were randomized to five different regimens for pregnant women. The women received either daily supplements of folic acid, folic acid-iron, folic acid-iron-zinc or multiple micronutrients all given with vitamin A or vitamin A alone. Researchers then assessed the birth weights of the infants after they were born.

Researchers found folic acid alone did not have an effect on birth size. However, folic acid-iron supplementation did increase the birth weights by about 1.3 ounces and reduced the percentage of low birth weight babies from 43 percent to 34 percent. The study shows the folic acid-iron-zinc combination had no effect on birth weight. However, the multiple micronutrients increased birth weight by 2.2 ounces and reduced the percentage of low birth weight babies by 14 percent. None of the supplements reduced the incidence or preterm births. The folic acid-iron and multiple micronutrients also increased head and chest circumference of the babies, but not the length.

Researchers say a folic acid-iron supplement taken by a pregnant woman reduces her risk of having an infant with a low birth weight. While a multiple micronutrient supplement of 14 micronutrients also reduces her risk, authors of the study say the difference is not significant enough to recommend the micronutrient supplement over the folic acid-iron supplement.

SOURCE: British Medical Journal, 2003;326:571-574

Self-Reported Stress Linked to Stroke (March 18, 2003)
COPENHAGEN, Denmark (Ivanhoe Newswire) -- Participants in a Danish study who said they were highly stressed had nearly double the risk of a fatal stroke than people who said they were stress-free. Those who said they felt stress on a weekly basis had a 50-percent increased risk of a fatal stroke compared to those in the least stressed groups.

Researchers say the link may be due to people under stress having more cardiovascular risk factors. Those participants tended to smoke, be less physically active, drink more alcohol, and be treated for high blood pressure. Because stress was associated with so many unhealthy behaviors, researchers could not determine if self-reported stress was an independent risk factor.

Lead researcher Thomas Truelsen, M.D., Ph.D., says there are several possible explanations why stress may be linked to only a higher risk of stroke. He says, "This group of stroke patients may have more severe strokes, have a more complicated rehabilitation period, or some unknown biological mechanism may be important."

For this study, investigators from the Institute of Preventive Medicine in Copenhagen reviewed data from The Copenhagen City Heart Study, which involved 5,604 men and 6,970 women.

According to the American Stroke Association, about 600,000 Americans will have a stroke this year and 160,000 of them will die.

SOURCE: To be published in an upcoming issue of Stroke

Home Visits Benefit Teenage Mothers (March 14, 2003)
CARLTON, Australia (Ivanhoe Newswire) -- Home visits by a nurse after a teenager gives birth can have a positive effect on the infant and mother, according to new research. The study shows not only do the visits improve the health of the infant, but they also help to improve the mother's knowledge about future contraceptive use.

Home visits after having a baby have been advocated as a way to improve outcomes for mothers and infants. However, there has been very little research on the impact home visits could have on teenage mothers. Researchers from the University of Melbourne in Australia conducted a study to see if a post-natal home visiting service is beneficial to teenage moms.

The study included 139 teenage girls who attended a pregnancy clinic. The girls were randomly assigned to receive either five home visits by a nurse or no intervention. The teenagers completed an initial survey that assessed the girls' knowledge of contraception, infant vaccinations and breastfeeding. Six months after the visits were completed, a follow-up survey was given to all of the mothers.

Researchers say the home visits appear to be very beneficial to the infants and mothers. The study found two children in the home visits group had adverse health outcomes compared to nine in the group that did not have home visits. Researchers also report two of the infants died among the mothers not given the home visits, compared to one death in the home visit group. Six infants in the group that did not receive visits ended up in foster care compared with only one child from the mothers who had home visits. Home visits also substantially increased each mother's contraceptive use at the six-month follow-up. However, researchers say the home visits did not increase mothers' knowledge with respect to breastfeeding or infant vaccination schedules.

Dr. Julie Quinlivan, from the University of Melbourne, says, "Opportunities to intervene in the postnatal period exist and should be used." While home visits appear to reduce adverse outcomes for the infant and increase the mother's knowledge about contraception, researchers say there is still more work that can be done. Dr. Quinlivan says, "Further work needs to be done to investigate the long-term effects of home visiting programs, and to devise strategies to increase the number of infants breastfed and the number who receive all their childhood vaccinations."
SOURCE: The Lancet, 2003;361:893-900

Childbearing cuts 'good' cholesterol levels: study (March 10, 2003)
(Reuters Health) - Women who bear a child show a drop in their levels of 'good,' or HDL, cholesterol that persists over time, according to new study findings.

While it's not clear that the change has any effect on heart health, the study's lead author said, it underscores the importance of pursuing a healthy lifestyle during the childbearing years.

Dr. Erica P. Gunderson of Kaiser Permanente Foundation in Oakland, California, and colleagues are following 985 black and 975 white women from four different parts of the US as part of the ongoing Coronary Artery Risk Development in Young Adults Study.

At the beginning of the study, in 1986, women were 18 to 30 years old. About half of black women and more than 80% of white women had no children at the study's outset.

The researchers released 10-year data from the study Friday at the American Heart Association's 43rd Annual Conference on Cardiovascular Disease Epidemiology and Prevention in Miami.

Gunderson and her team found a 3 to 4 milligram per deciliter (mg/dL) drop in HDL cholesterol in both white and black women who gave birth during the study. For women who had children before the study began, there was no change in HDL. Giving birth to two or more children did not cause a further drop in HDL level.

Gunderson told Reuters Health that she and her colleagues took into account other factors that could affect HDL levels, including weight gain, an increase in waist circumference, a change in activity, use of oral contraceptives, smoking and alcohol use.

"Prior to adjustment, we saw some pretty large changes in HDL levels," she noted.

"Something other than weight gain and other lifestyle changes is causing this decline in HDL," Gunderson said. "These effects have persisted long- term."

She noted that the change in HDL levels seen in the study is a "big shift" in the average. "I think it is clinically significant," Gunderson said. "A shift of that magnitude is important."

The findings show, she continued, that "even young women need their risk factors monitored, especially those with other risk factors for heart disease. We have yet to determine if this leads to future heart disease....In the meantime, women should be careful to pursue good health habits during this period of childbearing."

Nationwide Exercise and Heart Failure Study Begins (March 10, 2003)
By Shanida Smith, Ivanhoe Health Correspondent

WINSTON-SALEM, N.C. (Ivanhoe Newswire) -- Wake Forest University Baptist Medical Center will begin to recruit 90 patients next month as part of a national study to determine whether an exercise program can help heart failure patients live longer.

Researchers say the HF-ACTION trial is the first large-scale study designed to determine whether exercise can reduce mortality and hospitalizations for heart failure patients. The study will be conducted over five years with 3,000 patients at 40 sites.

At the Wake Forest site, participants will be selected at random to receive standard care for heart failure or standard care along with exercise training. For the first three months, participants in the exercise group will exercise three times a week under supervision using a treadmill or stationary bike. After three months, they will continue their exercise program at home for three years. The study will provide the exercise equipment patients will use at home.

Cardiologist Dalane W. Kitzman, M.D., lead investigator at Wake Forest, says, "In the not-too-distant past, medical textbooks admonished that patients with heart failure must rest and not undertake any vigorous physical activity. Sometimes weeks of bed rest were prescribed. As we have come to appreciate the benefits of regular exercise for coronary heart disease and high blood pressure, we've made the assumption that exercise is good for heart failure as well."

Dr. Kitzman adds, based on results, "We hope that all heart failure patients will be recommended to undergo a specific program of exercise and it will be reimbursed by medical insurance companies."

SOURCE: Ivanhoe Health Correspondent Shanida Smith's Interview with Dalane W. Kitzman, M.D., March 6, 2003

Stronger Bones (March 10, 2003)
 CORVALLIS, Ore. (Ivanhoe Newswire) -- Fifty-five percent of people ages 50 or older have low bone mass, which puts them at an increased risk of developing osteoporosis and related fractures. A new study shows that even after menopause, women who exercise can slow the bone loss that leads to osteoporosis. But it has to be the right kind of exercise.

All of these women are over 50. Some, like Barbara Black, are over 80.

"When I first started, I thought, 'Well, I'm getting older, it's OK if I have to heave myself out of a chair,'" says Black, who is 82.

Black and her husband raised four children. They hiked, skied, and rode horses. A test showed all that activity wasn't enough to keep her bones strong. She says, "It showed that I had the beginnings of osteoporosis."

Black joined a study and started an exercise program. She lunged, squatted, and stepped with a weighted vest three times a week. After five years, she increased her bone density by 15 percent and reversed her osteoporosis.

Christine Snow, Ph.D., the director of the Bone Research Laboratory at Oregon State University in Corvallis, says: "Most of us don't bend very deeply and also don't add extra weight. That's what really pushes bones and muscles to respond."

Women in the study who didn't attend class actually lost bone at the hip. The exercisers gained bone mass, and lowered their risk of fracture by up to 20 percent.

"It's the same as a bridge that has really heavy cement vs. a bridge made out of light wood," says Snow.

Black gets up now without using her arms, and, at 82, tests show her bones are even stronger than they used to be.

The exercise program, designed by Snow and her colleagues at Oregon State University, also reduced the risk of falls by increasing leg power and strength and improving balance. If you want to know more about how you can do these exercises at home, log on to http://www.bonesandbalance.com.

If you would like more information, please contact:

Christine Snow, Ph.D.
Director, Bone Research Laboratory
Oregon State University
Corvallis, OR 97331
(541) 737-6788
christine.snow@orst.edu
http://www.bonesandbalance.com

Exercise helps heart failure patients (March 7, 2003)
(Reuters Health) - For many people with heart failure, gone are the days when doctors advised them to rest and avoid physical activity. In guidelines announced this week, the American Heart Association recommends exercise for people with heart failure, even those who are waiting for a heart transplant.

Some people with heart failure, including those with unusual heart rhythms, may need to be monitored during exercise, according to the report. Others may be able to exercise safely at home after they have undergone a supervised training program. 

"It seems counterintuitive, but walking, biking, swimming, dancing--all kinds of aerobic exercises--can help improve the patient's sense of well-being," Dr. Ileana L. Piņa, who headed the AHA committee that wrote the recommendations, said in a statement. Piņa is at Case Western Reserve University in Cleveland, Ohio.

Exercise may provide several benefits to people with heart failure, including improvements in blood-vessel function, exercise capacity and quality of life, according to the report in the March 4th issue of Circulation: Journal of the American Heart Association. Exercise may also improve the flow of oxygen to muscles and lower levels of hormones that can contribute to heart failure symptoms. 

The recommendations focus on aerobic activities, such as riding a stationary bike or walking on a treadmill, but resistance training, such as lifting light weights, may improve muscle strength in people with heart failure, according to the report. The AHA experts caution, however, that the safety of resistance training in people with heart failure needs to be confirmed in larger studies.

The AHA recommends an individualized approach to exercise. People with heart failure should take it easy at first and slowly increase their exercise as they become stronger. 

Although exercise plans will vary from person to person, the AHA recommends warming up and cooling down before and after exercising. 

"We know that a rapid sudden surge of adrenaline is not good for anybody," Piņa told Reuters Health. "When people stop exercising, the adrenaline goes up initially and that could leave a patient vulnerable to (abnormal heart rhythms)."

Exercising 20 to 30 minutes three to five times per week is a good goal, although people who become exhausted after exercise may need to rest a day between sessions, according to the report.

In heart failure, the heart becomes enlarged and loses its ability to pump blood efficiently. Symptoms include breathlessness, fatigue and swelling of the feet due to fluid accumulation.

According to the AHA, nearly 5 million people in the US have heart failure. 

SOURCE: Circulation 2003;107:1210-1225.

Eating breakfast may stave off obesity, diabetes (March 7, 2003)
 (Reuters Health) - The next time you're starting the day on an empty stomach, consider this: a new study suggests that people who eat breakfast daily may be less likely to succumb to obesity and diabetes.

The study was presented Thursday at the American Heart Association's 43rd Annual Conference on Cardiovascular Disease Epidemiology and Prevention.

"In comparison to those who reported eating breakfast twice per week or less often, those reporting eating breakfast every day had 35 percent to 50 percent lower rates of developing obesity and insulin resistance syndrome," researcher Dr. Mark A. Pereira told Reuters Health.

Insulin resistance is a loss of sensitivity to insulin, the key blood-sugar- regulating hormone. This loss of sensitivity is often a precursor to diabetes.

"This was true for white men and women, and black men, but not black women," he added. 

Breakfast may reduce the risk of obesity, type 2 diabetes and cardiovascular disease by controlling appetite and thus reducing the likelihood of overeating later in the day, explained the investigator.

"There were 2,681 young adults included in the study, and they were followed for eight years," said Pereira, who is a research associate at Children's Hospital and assistant professor at Harvard Medical School in Boston. The participants, who were between 25 and 37 years old, were followed for a variety of health outcomes including insulin resistance and obesity.

"In addition to breakfast frequency, the quality of breakfast also appears to be important," noted Pereira. "For example, whole grain breakfast cereals were associated with a reduction in risk, whereas refined grain breakfast cereals were not." 

Only cereals that list a whole grain or bran first in the ingredient list or those that contain a whole grain and have at least 2 grams of fiber per serving are considered to be whole grain cereal, according to a statement from the American Heart Association.

"The study contributes to the knowledge of the role of dietary patterns and risk of obesity and related health outcomes," concluded Pereira, who added that "there are very few, if any, longitudinal studies on breakfast frequency, breakfast quality, and health outcomes." 

The study was funded by the Charles H. Hood Foundation, which Pereira said was "a philanthropic organization with no ties to industry." The study was also funded by the National Heart, Lung, and Blood Institute at the National Institutes of Health.

Childbirth and Incontinence (March 6, 2003)
 BERGEN, Norway (Ivanhoe Newswire) -- Women who have vaginal births aren't the only ones at higher risk for urinary incontinence, find researchers publishing in this week's New England Journal of Medicine.

Women who have caesarean sections are at higher risk as well.

Doctors have long associated childbearing with an increased risk of developing urinary incontinence. However, most believed the risk was mainly limited to those who experienced damage to important muscle tissue or nerves during vaginal delivery. Some suggest pregnancy itself could also cause mechanical or hormonal changes leading to urinary incontinence later in life. If this is true, women who have caesarean sections would be at higher risk too.

Researchers from Norway studied the link between urinary incontinence and childbearing in a large group of women taking part in a urinary incontinence study. Women were divided into three groups: those who had never had children, those who had vaginal births only, and those who had caesarean births only.

Results showed a greater incidence of urinary incontinence in all the women who had children when compared with those who never had children. The incidence was highest in the vaginal birth group at 21 percent. Those in the cesarean group had a 15.9-percent incidence, compared with a 10.1-percent incidence in the group who never had children. Severe incontinence was reported by 8.7 percent of the vaginal birth group, compared to 6.2 percent and 3.7 percent, respectively, of the caesarean and childless groups.

The authors write, "Our study demonstrates an increased risk of urinary incontinence among women who have delivered by cesarean section as compared with [women who have never given birth] and a further increase among women who have had vaginal deliveries. These results suggest that the mechanical strain during labor may add to the risk associated with pregnancy itself."
SOURCE: New England Journal of Medicine, 2003;348:900-907

Upcoming Fibromyalgia Treatments (March 6, 2003)
 By Shanida Smith, Ivanhoe Health Correspondent
SEATTLE (Ivanhoe Newswire) -- Two drugs that may relieve the symptoms of fibromyalgia are expected to enter phase III clinical trials this year. Patients treated with pregabalin and milnacipran in early trials reported significant improvements in pain and fatigue.

Of 529 patients in phase II of the pregabalin study, 29 percent of treated patients reported at least a 50-percent reduction in pain compared to a 13-percent reduction in patients who were given a placebo. The drug also improved sleep quality in patients. Pregabalin is being studied as a treatment for seizures and neuropathy also.

In phase II of the milnacipran study involving 95 patients, 87 percent of treated patients reported improvement compared to 33 percent in the placebo group. About 36 percent of treated patients reported at least a 50-percent reduction in pain intensity compared to 9 percent of patients who were treated with a placebo. Patients also showed improvements in depressed mood. Milnacipran is already approved in other countries, including France and Japan, as an anti-depressant. More than 1 million people have used the drug.

Philip Mease, M.D., chief of rheumatology clinical research at Swedish Hospital Medical Center in Seattle, has worked on both studies. He says fibromyalgia has been a difficult condition to treat but new research is promising. He adds, "Now that the medical community is taking fibromyalgia more seriously because of biological understanding, companies are now willing to put in resources to find ways to help."

Fibromyalgia is a chronic pain syndrome that affects 5.6 million Americans. There are no drugs specifically approved by the U.S. Food and Drug Administration for treatment.


SOURCE: Ivanhoe Health Correspondent Shanida Smith's Interview with Philip Mease, M.D., March 3, 2003