Can Soda Tax Curb Obesity?
Posted by on July 23, 2011 - 8:14am

To many, a tax on soda is a no-brainer in advancing the nation’s war on obesity. Advocates point to a number of studies in recent years that conclude that sugary drinks have a lot to do with why Americans are getting fatter.   But obese people tend to drink diet sodas, and therefore taxing soft drinks with added sugar or other sweeteners is not a good weapon in combating obesity, according to a new Northwestern University study.

An amendment to Illinois Senate Bill 396 would add a penny an ounce to the cost of most soft drinks with added sugar or sweeteners, including soda, sweet iced tea and coffee drinks. Related to the purpose of the tax, the legislation excludes artificially sweetened and diet sodas.

“After doing the analysis, it really turns out to be the case that obese people like diet soda so much more than regular soda that you can do whatever you want to the price,” said Ketan Patel, a fourth-year doctoral student in economics. “You’re not going to get that much change in obese people’s weight because they already drink diet soda.”

Patel, who recently presented his paper “The Effectiveness of Food Taxes at Affecting Consumption in the Obese: Evaluating Soda Taxes” at a U.S. Department of Agriculture conference on food policy in Washington, D.C., said he initially didn’t know if the diet soda preference was going to be a large factor in evaluating the effectiveness of the soda tax.

“The concern I had was that maybe obese people are less price sensitive,” Patel said. “So if obese people are less price sensitive, then raising the price through a tax will affect their behavior less.”

But that concern became irrelevant since diet drinks are not being considered in the proposed obesity tax.

Beyond its ineffectiveness in reducing obesity, such a tax also would punish consumers that are not overweight or obese, Patel said.

Is there a scenario in which increasing the tax would have an effect on weight? Patel said that could depend on whether people are at a stable weight or whether people are already eating too many calories and therefore their weight will continue to increase. If increasing weights are the status quo, then a tax could prevent people who are currently overweight or normal weight from becoming obese. More research needs to be done on this aspect, however, Patel said.

For this study, Patel used a large data set of sodas price and sales data with individual level data on demographic characteristics and body mass index (BMI) to estimate consumer preferences while allowing for substantial diversity in those preferences. After obtaining estimates of consumer preferences, Patel simulated how a tax would change the choices that consumers make and used the results of the simulation to estimate changes in weight using a weight change model from existing nutrition literature.

In the meantime, however, lawmakers say it does not look likely that the tax will be imposed anytime soon as there is little support for the measure after a recent income tax hike in Illinois.

by Hilary Hurd Anyaso,  law and social sciences editor. Northwestern U.

Menstrual cycle hormones influence seizure frequency
Posted by on July 21, 2011 - 8:12am

Monthly hormone cycle changes

Researchers are exploring how hormone levels impact certain brain activity during the menstrual cycle and the results may influence how birth control pills doses are prescribed to women with conditions like epilepsy in the future.

Increased levels of certain reproductive steroids correspond to more frequent generalized tonic-clonic seizures (GTCS) in women with epilepsy, according to new research from Beth Israel Deaconess Medical Center in Boston.

Scientists found that female epilepsy patients had 30 percent more GTCS a day during anovulatory cycles (menstrual cycles where an egg is not released) than during ovulatory cycles. Previous research has shown that anovulatory cycles are associated with higher levels of the sex hormones estradiol and progesterone.

Study author Andrew Herzog and colleagues analyzed data from the three-month Progesterone Trial Study, which investigated the use of progesterone therapy for focal onset seizures. Of the 281 women who participated in the study, 92 had both ovulatory and anovulatory cycles during the study. Only the daily frequency of GTCS, and not that of complex partial seizures or simple partial seizures, increased significantly during anovulatory cycles.

Other studies have shown that women with epilepsy are more likely to have anovulatory cycles than women who don't have epilepsy. The research was published July 14 in the journal Epilepsia.

IUDs and implants effective reversible contraceptive methods
Posted by on July 19, 2011 - 7:28am

Sample IUD

Long-acting reversible contraceptive ( LARC ) methods—namely intrauterine devices ( IUDs ) and implants—are the most effective forms of reversible contraception available and are safe for use by almost all reproductive-age women, according to a Practice Bulletin released  by The American College of Obstetricians and Gynecologists ( The College ). The new recommendations offer guidance to ob-gyns in selecting appropriate candidates for LARCs and managing clinical issues that may arise with their use.

"LARC methods are the best tool we have to fight against unintended pregnancies, which currently account for 49% of US pregnancies each year," said Eve Espey, MD, MPH, who helped develop the new Practice Bulletin. "The major advantage is that after insertion, LARCs work without having to do anything else. There's no maintenance required."

More than half of women who have an unplanned pregnancy were using contraception. The majority of unintended pregnancies among contraceptive users occur because of inconsistent or incorrect contraceptive use. LARCs have the highest continuation rates of all reversible contraceptives, a key factor in contraceptive success.

IUDs and contraceptive implants must be inserted in a doctor's office. Two types of IUDs—small, T-shaped devices that are inserted into the uterus—are available. The copper IUD, which effectively prevents pregnancy for 10 years, releases a small amount of copper into the uterus, preventing fertilization. In addition, copper interferes with the sperm's ability to move through the uterus and into the fallopian tubes. The device can also be used for emergency contraception when inserted within five days of unprotected sex.

Women using the copper IUD will continue to ovulate, and menstrual bleeding and cramping may increase at first. Though data suggest that these symptoms lessen over time, heavy menstrual bleeding and pain during menstruation ( dysmenorrhea ) are main causes of discontinuation among long-term copper IUD users. Women considering IUDs should be informed of this adverse effect beforehand.

The hormonal IUD releases progestin into the uterus that thickens cervical mucus and thins the uterine lining. It may also make the sperm less active, decreasing the ability of egg and sperm to remain viable in the fallopian tube. The hormonal IUD may make menstrual cycles lighter and is also FDA-approved for the treatment of heavy bleeding. The hormonal IUD prevents pregnancy for five years.

Contraceptive implant

The contraceptive implant is a matchstick-sized rod that is inserted under the skin of the upper arm and allows the controlled release of an ovulation-suppressing hormone for up to three years. It is the most effective method of reversible contraception available with a pregnancy rate of 0.05%.

Despite the many benefits of LARC methods, the majority of women in the US who use birth control choose other methods. Fewer than 6% of women in the US used IUDs between 2006 and 2008. According to The College, lack of knowledge about LARCs and cost concerns may be to blame. "Women need to know that today's IUDs are much improved from earlier versions, and complications are extremely rare. IUDs are not abortifacients—they work before pregnancy is established—and are safe for the majority of women, including adolescents and women who have never had children. And while upfront costs may be higher, LARCs are much more cost-effective than other contraceptive methods in the long run," Dr. Espey said.

According to a December 2009 Committee Opinion released by The College, LARCs should be offered as first-line contraceptive methods and encouraged as options for most women. "The benefits of IUDs and the contraceptive implant in preventing unplanned pregnancy could be profound with widespread adoption of these methods, and ob-gyns are in a great position to effect change," Dr. Espey said.

Practice Bulletin #121 "Long-Acting Reversible Contraception: Implants and Intrauterine Devices" is published in the July 2011 issue of Obstetrics & Gynecology.

Marilyn Monroe sculpture: icon or sexism
Posted by on July 18, 2011 - 3:48pm

It's the talk of Chicago:   the new 26 foot tall sculpture of Marilyn Monroe on Pioneer Court on Michigan Avenue.   Sculpted by Seward Johnson, known for his massive figures taken from famous paintings and photos, this highly visible piece of art is drawing lots of comments : "Beautiful"--- "it exploits women"--- "she was an icon and a piece of history"---"hey, you can see her panties!"   Even some of my favorite columnists are suggesting that if they want to feature important women, why Marilyn?

If you haven't see it yet, the statue depicts Marilyn in her famous white dress caught in the draft of a street vent  (you know the one).   I consider myself a feminist and have fought for many women's issues related to sexism and discrimination.   I also love greater-than-life-sized outdoor sculptures because they  make you notice art (there is a waiting line to take pictures of  big Marilyn).   These works create interest in a city filled with blocks of highrises.

I admit, I'm not thrilled that some people (mainly boys and men) are standing under her skirt and taking pictures of her underwear. This is  especially puzzling since the original photo was considered a bit racy because it showed her lovely legs---from toe to hip!  You really could not see (what it turns out to be) quite modest panties.  Go to Oak Street Beach if you want skimpy!  Are they looking because they never saw what was under her skirt in the original photos?   Are they hoping to be shocked?  I doubt anyone today is so repressed that they get some kind of kick out of this view--you just need to turn on the TV or open a magazine if you want to see sexy underwear.

Now, on to the historical side. I have pictures of my mother and her lady friends taken in the 1950's-60's when their platinum blond hairdos and bright red lips and nails were the style of the day.  They wore high heels and pretty suits and dresses.  These women were mothers who also worked as den mothers, teacher assistants and secretaries.  They belonged to bridge and bunco clubs and ran fashion shows and bingo events to raise money for their churches and schools.   Some of these women were the first in their families to have enough money to dress fashionably.    My mother was hard working, lots of fun, and never the "little lady".  She even started a business when she turned 50!

The bottom line:    I think the statue is a fun and engaging piece of art that makes me smile(and think of my mother!).   Marilyn was a cultural icon who was a celebrity and had a life that ended far too young.     As far as those nitwits photographing under her skirt, get a life.   Her shoes are more interesting!

Take steps to keep mosquitos and ticks from bugging you this summer
Posted by on July 16, 2011 - 1:58pm

Summer allows more time for children to play outdoors, but when kids (and grown-ups, too) are covered with bug bites after spending time outside, we start to worry about disease spread by ticks, such as Lyme disease, or by mosquitoes, such as West Nile virus. Luckily, there are simple steps to prevent bites and diseases spread by bugs.  The US Center for Disease and Prevention Control offers some good suggestions.  Click HERE to see the fact sheet.  It also provides information on Lyme disease and maps that show West Nile activity.

 

Do women have what it takes to be leaders?
Posted by on July 15, 2011 - 7:04am

Of course! But stereotypes about leadership still pose barriers to women’s advancement.

So much has changed since 1963, when Betty Friedan’s influential “The Feminine Mystique” provoked a national discussion about the deep dissatisfaction women were feeling about the limitations of their lives. Many women came to believe that discrimination limited their opportunities, especially in relation to leadership roles.

But a new Northwestern University meta-analysis (an integration of a large number of studies addressing the same question) shows that even today leadership continues to be viewed as culturally masculine. Thus, women suffer from two primary forms of prejudice.

Women are viewed as less qualified or natural in most leadership roles, the research shows, and secondly, when women adopt culturally masculine behaviors often required by these roles, they may be viewed as inappropriate or presumptuous.

These reactions to women leaders reflect gender stereotypes. Previous research found that predominantly “communal” qualities, such as being nice or compassionate, are associated with women, and predominantly “agentic” qualities, such as being assertive or competitive, are associated with men.  It is these agentic qualities that are believed to be essential to successful leadership. Because men fit the cultural stereotype of leadership better than women, they have better access to leadership roles and face fewer challenges in becoming successful in them.

The good news for women is that the project’s analyses indicate that this masculine construal of leadership is weaker now than it was in earlier years. Despite this shift toward more androgynous beliefs about leadership, it remains culturally masculine — just not as extremely so as in the past. However, this masculinity lessens somewhat for lower-level leadership positions and in educational organizations.

The implications of the meta-analysis are straightforward, said Alice Eagly, professor of psychology and faculty fellow in the Institute for Policy Research at Northwestern and a co-author of the study.

“Cultural stereotypes can make it seem that women do not have what it takes for important leadership roles, thereby adding to the barriers that women encounter in attaining roles that yield substantial power and authority."

“Women’s experiences will differ depending on their culture,” she said. “We would like to have more data from different nations, and also sub-cultural data within the United States that takes race and social class into account, but that’s something to look to in the future.”

The project “Are Leader Stereotypes Masculine? A Meta-Analysis of Three Research Paradigms” is in the July issue of the Psychological Bulletin.

Written by Hilary Hurd Anyaso, law and social sciences editor at Northwestern

Sex Differences in GI Surgery Outcomes
Posted by on July 13, 2011 - 7:53am

In the first study to consider the impact of gender on patient outcomes in major gastrointestinal surgeries, researchers at UC San Diego Health System have found that women are more likely to survive after the procedure than men. The pattern is even more pronounced when comparing women before menopause with men of the same age.

Results, now published online in the Journal of Surgical Research in a paper titled “The Battle of the Sexes: Women Win Out in Gastrointestinal Surgery,” shed light on major differences between patients which impact treatment success, and open pathways to creating new therapies aimed at improving survivability of surgical patients.

“Science is just now understanding that one size does not necessarily fit all, as each individual person may respond differently to disease and treatment. However, medical outcomes could be optimized by tailoring therapies based upon each individual’s unique genetic make-up as well as other characteristics. Gender is among the most important traits,” said Carrie Y. Peterson, MD, a surgical resident physician at UC San Diego Health System who is combining her clinical residency with scientific research training, and first author of the paper.

Peterson and colleagues performed a retrospective review of the National Institute of Health database from 1997 to 2007 and identified a total of 307,124 patients with gastrointestinal surgeries. Over 50 percent of them were women, who, according to the study, are 21.1 percent less likely to die after major stomach or intestinal surgery than men. In particular, female patients had lower mortality in gastric, small intestine, large intestine, hepatic, and pancreatic surgeries.

To control for the effect of menopause, researchers analyzed the rates of in-hospital deaths for patients over the age of 50 and those patients who were between 18 and 40 years old. Women between 18 and 40 were 33 percent less likely to die than men of a similar age, and women over the age of 50 were 17 percent less likely to die than age-matched men. “The results suggest that female hormones might enhance the immune system – a process previously shown in animal models and also observed in trauma patients,” said Peterson. “Thus, there is a hope that negating the effects of testosterone or giving estrogen to male patients could be considered part of a treatment plan.”

Furthermore, researchers defined additional factors that might contribute to higher survivability rates in women. According to the data, females more frequently had operations performed for elective reasons (58.23 versus 53.57 percent), and were more likely to have their surgeries performed in teaching hospitals (52.01 versus 50.96), which often offer the latest therapies and additional patient care provided by residents.

“Women are probably more proactive with their health in general than men, have more reasons to seek health care, and access the system more readily. This may lead to addressing health care needs and surgical interventions earlier in the history of the disease, resulting in an elective operation,” said David C. Chang, PhD, MPH, MBA, director of Outcomes Research in the Department of Surgery at the University of California, San Diego School of Medicine and senior author of the paper. “Men, in turn, may tend to delay presenting for a doctor visit until symptoms are severe and require urgent or complex intervention.”

Source: University of California, San Diego Health Sciences

Women are tough when it comes to soccer injury
Posted by on July 11, 2011 - 9:15am

With the Women’s World Cup in full swing (congrats to the US team for upsetting Brazil in the semifinals!), soccer fans can now rest assured that women are less likely than men to fake on-field injuries, according to a new study by researchers at Wake Forest Baptist Medical Center published in the July issue of the journal Research in Sports Medicine.

“Injuries are common in women’s soccer and seem to be on the rise at the international level,” said Daryl Rosenbaum, M.D., an assistant professor of Family and Community Medicine at Wake Forest Baptist. “The goals of our study were to determine the frequency of apparent injury incidents in women’s international soccer and estimate what proportion of these incidents is authentic. It is clear from this study that female players don’t fake injuries at the same rate as their male counterparts.”

Rosenbaum said that in 2008, the International Federation of Association Football (FIFA),  issued a directive calling for “the football family to unite in denouncing injury simulation and working to eradicate this scourge from the game.” Results of a study conducted in 2010 by Rosenbaum show that the faking or exaggerating of injuries at the men’s international level may be a valid concern. He hopes his research will help determine if injury simulation in soccer is due to the nature of the sport or is specific to certain types of participants.

For the latest study, video recordings of 47 televised games from two international women’s tournaments were reviewed to identify incidents in which a player behaved as if injured. Apparent injuries were considered “definite” if a player withdrew from participation within five minutes or if bleeding was visible; the remaining incidents were considered “questionable.” A total of 270 apparent injuries were observed, a rate of 5.74 per game. The “definite” injury rate was only 0.78 per match compared to 4.96 for “questionable” injuries.

Rosenbaum found that only 13.7 percent of apparent injuries met their definition for a definitive injury.  He and his colleagues  saw six apparent injuries per match in the 2007 Women’s World Cup but team physicians from the tournament reported only 2.3 injuries per match implying some possible questionnable injuries.

Rosenbaum’s research indicates that apparent injury incidents for women are much less frequent than for men, however, occurring at a rate of 5.74 per match as compared to 11.26 per men’s match. The proportion of apparent injuries that were classified as “definite” was nearly twice as high for women, 13.7 percent, as compared to 7.2 percent for men.

Rosenbaum said “questionable” injuries are more likely to be associated with contact and referee sanctions than “definite” injuries, which may indicate that players may use these situations to try to deceive referees. There was no evidence that teams that did this frequently won more often, nor was there any evidence that players used injury simulation as a way to try and rest or kill time.

“In the end, I think this study shows that women are less likely than men to fake soccer injuries,” Rosenbaum said. “What isn’t clear is if injury simulation is used to gain a tactical advantage. Only the players themselves know the answer to that question.”

 

Global Health: Make Contraception More Available
Posted by on July 6, 2011 - 8:23am

Improving maternal health has been a primary goal of the international community led by three United Nations Agencies (UN Populations Fund (UNFPA), the World Bank and the World Health Organization) since they launched the Safe Motherhood Initiative in 1987.  Over the years their goals have been reviewed and updated, and in 2007, in recognition to the close links between maternal health and other reproductive conditions, a second target--ensuring universal access to reproductive health services was added to the Millennium Development Goals (MDG).

According to UNFPA, about 200 million women and girls globally who want to use contraceptives do not have access to them. In a survey conducted in Uganda, 41% of the women who responded wished to space their pregnancies further apart--a key health factor for both mothers and children--but lacked access to contraception and family planning services. The Ugandan government has failed to respond with resources to address this need despite the fact that their country has one of the highest maternal mortality rates in the world.   In other countries like Zambia and Ethiopia, empty dispensaries are all too common.

Lack of access to birth control leads to abortions and according to the World Health Organization, an estimate 20 million unsafe abortions take place each year.  Worldwide, at least 68,000 women annually die from such procedures, and another estimated 5 million women per year suffer long-term injury.(Grimes DA et al. Lancet Reprod Health Ser. 2006).

Considering what we spend on defense and bailing out unscrupulous banks, the cost of contraception is pennies, yet the lives it could save are immense.

 

 

Can Topical Skin Gel Shrink Some Breast Cancer Tumors?
Posted by on July 5, 2011 - 10:00am

A clinical trial to see if a gel containing an active form of tamoxifen, an anti-estrogen therapy, can provide the drug's benefits with decreased risk of adverse health effects compared to those who take the oral tamoxifen is being conducted at Northwestern Medicine.

The new study drug is being tested on participants recently diagnosed with the earliest form of non-invasive breast cancer. Women who are treated for this kind of cancer (called ductal carcinoma in situ or DCIS) are usually advised to take oral tamoxifen for five years if their DCIS is hormone sensitive. In this research study, half the women receive the study gel and half the women receive the oral tamoxifen.

Tamoxifen, when taken as a pill for five years, reduces the risk of cancer recurrence in the same spot by a third and prevents the occurrence of half of new breast cancers. The therapy, however, has an increased risk of blood clots, uterine cancer and hot flashes. As a result, many women decline the treatment.

“The gel is a way to minimize exposure to the rest of the body and concentrate the drug in the breast where it is needed," said principal investigator Seema Khan, M.D., co-leader of the breast cancer program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University and a surgical oncologist at Northwestern Memorial Hospital. "Delivery of the drug through the skin of the breast means there will be very little drug circulating through the bloodstream and the body. This should reduce the possibility of blood clots."

Khan compared it to the current practice of delivering estrogen  via a skin patch to avoid the risk of blood clots. And because the circulating levels of the topical drug are very low, the gel should be unlikely to cause other side effects such as hot flashes and the increased risk of uterine cancer.

Another problem with oral tamoxifen is that it does not help all women who take it, because it needs to be activated in the liver by specific enzymes, and about a third of women lack these enzymes. These women may not receive full benefits from the pill, and the gel may be more effective for these women because the active form of the topical drug is being delivered directly into the breast tissue, noted Khan.

The participants in the trial must have a recent diagnosis of DCIS. In this form of breast cancer, abnormal cells multiply and form a growth within a milk duct. This form of cancer is noninvasive, meaning it hasn't spread from the milk duct to other parts of the breast.

Because of increased screening with mammograms, diagnoses of this early breast cancer have increased dramatically in recent years. While the cancer isn't life threatening when caught early, it requires treatment to prevent the condition from becoming invasive. Most women with this type of breast cancer are effectively treated with breast-conserving surgery and radiation.

The study is funded by the National Cancer Institute, and the study design has been approved by the FDA. Trial sites are at Northwestern University and Washington University. Participants will be randomized to take the tamoxifen pill or the active form of tamoxifen topical gel for six weeks prior to scheduled routine surgery. Researchers will measure the tumor growth rate to see if the reduction in growth rate is equally good in women who receive the gel and those who receive the pill.

Participants are currently being enrolled in the trial. For more information, visit http://www.cancer.northwestern.edu/toptam or call Katherine Page at k-page@northwestern.edu (312) 695-1408.

By Marla Paul

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