Newer Contraceptive Methods Needed Among Developing Countries
Posted by on May 23, 2011 - 8:24am

Seven out of 10 women in Sub-Saharan Africa, South Central Asia and Southeast Asia who want to avoid pregnancy but are not using modern contraceptives report reasons for nonuse that indicate currently available methods do not satisfy their needs, according to new Guttmacher research. The findings suggest that substantially bringing down unintended pregnancy rates in these developing regions will require increased investment in the development of new methods that better address women’s concerns and life circumstances.

The report, Contraceptive Technologies: Responding to Women’s Needs, focuses on the three regions that together account for the majority of women in the developing world with an unmet need for contraception. Overall, 40% of pregnancies in these regions—about 49 million—are unintended. Each year, these pregnancies result in 21 million unplanned births, an equal number of abortions (three-quarters of which are unsafe) and 116,000 maternal deaths.

“The findings make clear that meeting the need for contraception requires not only increased access and counseling, but the development of new methods that better meet women’s needs,” says Jacqueline E Darroch, senior fellow at the Guttmacher Institute and one of the study’s authors.

To gain insight into why so many women in developing countries are not using modern contraceptives, researchers analyzed nationally representative data from Demographic and Health Surveys and other sources. They found that the majority of women with an unmet need for contraception are 25 or older and live in rural areas, and about four in 10 are poor. The reasons women most frequently given for not using a method are concerns about health risks or side effects (23%); infrequent sex (21%); being postpartum or breast-feeding (17%); and opposition from their partners (10%).
The findings shed light on the types of methods that could have the greatest impact on increasing contraceptive use: Developing new contraceptive methods that have negligible side effects, are appropriate for breast-feeding women and could be used on demand has the potential to greatly reduce unmet need for contraception. So would methods that women can use without their partner’s knowledge.

The report shows that overcoming method-related reasons for contraceptive nonuse could reduce unintended pregnancy by as much as 59% in these regions. Unintended births and induced abortions could be reduced by similar proportions, and 70,000 maternal deaths could be prevented. However, the researchers note that new contraceptive methods alone will not overcome all reasons for nonuse. Other causes, including poor access to and quality of contraceptive services must also be addressed.

Currently, 104 million women in Sub-Saharan Africa, South Central Asia and Southeast Asia have an unmet need for modern contraceptive methods because of method-related reasons. Taking into account projected population growth, this number will increase to 161 million in the next four decades if concerns about currently available methods are not addressed. The researchers note that there has been a lack of attention and resources dedicated to contraceptive research and development, and that there is a vital, immediate need to reinvigorate the field.
In addition to long-term work to develop new contraceptive methods, they point out that adaptations to current methods could make them more widely acceptable and easier to use. They conclude that immediate headway toward satisfying unmet need could be made by ensuring that women and couples receive more accurate information about the risk of unintended pregnancy and have greater access to quality counseling and services that offer a range of methods.
The report, Contraceptive Technologies: Responding to Women’s Needs, was funded by a grant from the Bill & Melinda Gates Foundation. The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of the Bill & Melinda Gates Foundation.
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Source:  Guttmacher Institute

Night Owls at Risk for Weight Gain
Posted by on May 21, 2011 - 8:57am

Staying up late every night and sleeping in is a habit that could put you at risk for gaining weight. People who go to bed late and sleep late eat more calories in the evening, more fast food, fewer fruits and vegetables and weigh more than people who go to sleep earlier and wake up earlier, according to a new Northwestern Medicine study.

Late sleepers consumed 248 more calories a day, twice as much fast food and half as many fruits and vegetables as those with earlier sleep times, according to the study. They also drank more full-calorie sodas. The late sleepers consumed the extra calories during dinner and later in the evening when everyone else was asleep. They also had a higher body mass index, a measure of body weight, than normal sleepers.

The study is one of the first in the United States to explore the relationship between the circadian timing of sleeping and waking, dietary behavior and body mass index. The study was published online in the journal Obesity and is expected to appear in a late summer print issue.

“The extra daily calories can mean a significant amount of weight gain – two pounds per month – if they are not balanced by more physical activity,” said co-lead author Kelly Glazer Baron, a health psychologist and a neurology instructor at Northwestern University Feinberg School of Medicine.

“We don’t know if late sleepers consume the extra calories because they prefer more high-calorie foods or because there are less healthful options at night,” said co-lead author Kathryn Reid, research assistant professor in neurology at the Feinberg School.

The study shows not only are the number of calories you eat important, but also when you eat them -- and that’s linked to when you sleep and when you wake up, noted senior author Phyllis Zee, M.D., professor of neurology and director of the Sleep and Circadian Rhythms Research Program at Feinberg and medical director of the Sleep Disorders Center at Feinberg and Northwestern Memorial Hospital.

“Human circadian rhythms in sleep and metabolism are synchronized to the daily rotation of the earth, so that when the sun goes down you are supposed to be sleeping, not eating,” Zee said. “When sleep and eating are not aligned with the body’s internal clock, it can lead to changes in appetite and metabolism, which could lead to weight gain.”

The research findings could be relevant to people who are not very successful in losing weight, Zee said. “The study suggests regulating the timing of eating and sleep could improve the effectiveness of weight management programs,“ she said.

The findings also have relevance for night-shift workers, who eat at the wrong time of day related to their bodies’ circadian rhythms. “It’s midnight, but they’re eating lunch,” Zee said. “Their risk for obesity as well as cardiovascular, cerebrovascular and gastrointestinal disorders is higher.”

The study included 51 people (23 late sleepers and 28 normal sleepers) who were an average age of 30. Late sleepers went to sleep at an average time of 3:45 a.m., awoke by 10:45 a.m., ate breakfast at noon, lunch at 2:30 p.m., dinner at 8:15 p.m. and a final meal at 10 p.m. Normal sleepers on average were up by 8 a.m., ate breakfast by 9 a.m., lunch at 1 p.m., dinner at 7 p.m., a last snack at 8:30 p.m. and were asleep by 12:30 a.m.

Participants in the study recorded their eating and sleep in logs and wore a wrist actigraph, which monitors sleep and activity cycles, for at least seven days.

Late sleepers function in society by finding jobs where they can make their own hours, Baron noted, such as academics or consultants. “They find niches where they can live this lifestyle, or they just get by with less sleep,” she said.

Northwestern researchers are planning a series of studies to test the findings in a larger community and to understand the biological mechanisms that link the relationship between circadian rhythms, sleep timing and metabolism.
by Marla Paul, health sciences editor, Feinberg School of Medicine. Contact her at marla-paul@northwestern.edu

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Wage Gender Gap Continues in the U.S.
Posted by on May 19, 2011 - 2:55pm

U.S. Female college graduates have a median starting salary offer 17% lower than male college graduates according to a new National Association of Colleges and Employers. The report found that females with new bachelor degrees were offered an average of $36,451 compared to $44,159 for their male counterparts.  Even when salary is adjusted by college major (14 were included), men come out ahead in all except two areas:  engineering and liberal arts/humanities.    Report author Edwin Koc noted that while gender pay disparities are often linked to women more frequently leaving the work force, he did not feel that was the cause in this study.

Just when you begin to believe work discrimination is over when it come to sex and gender, another report comes out that questions the progress women have made when it comes to pay equity.  When the Equal Rights Amendment (ERA) to the U.S. Constitution failed to pass in the mid-70s many felt that progress was still being made in areas like sex harrassment, access to formerly male dominant fields, etc. and took their placards home.  Now, with the economy on the downturn, perhaps it is time to lift up those placards again and fight against fiscal discrimination for women!

Battling the Weight-loss Plateau
Posted by on May 18, 2011 - 10:47am

Have you been losing weight and despite staying on your diet and exercising, your weight suddenly stays the same?   Don't get discouraged, it's normal for weight loss to slow down and even stop.   This phenomenon is called the "weight-loss plateau" and it's more common than you think.  Even the best planned weight loss program can become stalled.

According to the Mayo Clinic, here's why this happens.   A rapid weight loss is common during the first few weeks of a well planned diet.  When calories are reduced the body gets needed energy by releasing its stores of glycogen, a type of carbohydrate stored in the liver and muscles.   Glycogen holds a lot of water so when it is used up at the beginning of a diet, it also releases the water--about 4 grams per gram of glycogen, resulting in a sudden weight loss that is mostly water.

Once your diet progresses and  you start burning lean muscle tissue, your metabolism slows.  Metabolism is the process of converting food into energy.  When you lose weight you lose fat and lean muscle and this weigh-loss changes once your metabolism slows.   At this point,  you need to increase your exercise or decrease your food intake if you want to lose more weight.   If you continue the diet/exercise regimen you started with, you will maintain your weight but probably not continue to drop many pounds.

To get past this weight loss plateau, you need to

  • Review your eating/exercise habits and be sure you haven't "cheated" along the way
  • Cut more calories--try reducing your diet by 200 more calories
  • Increase your workout...either in time or intensity
  • Try to increase movement during the day----take stairs instead of the elevator, run your errands on foot.
  • Applaud your success and make sure your goals are reasonable--just don't fall back.

 

 

Green Tea and Tai Chi--a Healthy Partnership
Posted by on May 16, 2011 - 12:13pm

Green tea has become an international mainstay beyond the Orient.   Many observational studies have shown that green tea is full of potent polyphenols (an antioxidant) that lower the risk of several chronic degenerative diseases such as heart disease and osteoporosis.  A recent study from Dr. Chwan-Li (Leslie)  Shen, an associate professor and a researcher at the Laura W. Bush Institute for Women's Health at Texas Tech University Health Sciences Center looked at the mechanism behind this correlation and believes it may have to do with lowering chronic levels of inflammation.

Dr. Shen has developed an animal model to study  green tea consumption and its protective effect on the breakdown of the bone's microarchitecture.  In humans, this can lead to osteoporosis, a condition common in postmenopausal women.  In her most recent study, she investigated the potential for green tea to work synergistically with tai chi, a moderately aerobic exercise popular among Chinese cultures.  Together, can these two interventions enhance bone strength?

Her randomized controlled study (the gold standard) included 171 postmenopausal women (average age was 57) who had weak bones but not full fledged osteoporosis.  They were divided into 4 groups:

  • Placebo (starch pill) and no tai chi
  • Green tea polyphenols (GTP)  and no tai chi (TC)
  • Placebo and tai chi
  • GTP plus TC

Blood and urine samples were collected on all women for 6 months and muscle strength assessed..

The GTP + TC group showed enhanced markers of bone health and muscle strength at 3 and 6 months.   Of greatest interest was the Dr. Shen's finding that both GTP and TC had on biological markers of oxidative stress, the precursor to inflammation.  Inflammation is not only a factor in osteoporosis but other chronic diseases as well.  Her findings were presented in a poster at the Experimental biology meetings in April.   Further studies are needed to confirm and better understand the mechanisms involved.

In the meantime, drinking green tea and trying tai chi sounds like a good idea, especially for premenopausal women!

An Apple a Day May Keep Bad Cholesterol Away!
Posted by on May 13, 2011 - 7:55am

A new study discovered that apples promoted good cholesterol levels in the participating women.   Researchers from Florida State University were surprised at the results of their study that included 160 females aged 45-85 randomly selected to received either 75 grams of dried apples or dried prunes for a whole year.  The apple consumption group significantly reduced the blood levels of total cholesterol and low density cholesterol (LDL- bad cholesterol) by 14% and 23%, respectively. Good cholesterol (HDL) increased in the study group by 4%.  The atherogenic  (plaque building) risk ratios of lipid  and C-reactive protein levels were also improved in the apple group.

The women in the study group also lost an average of 3.3 pounds even though the apples added another 240 calories to the usual daily diet.  Dr. Bahram Arjmandi who led the study, suggested that weight loss may be due to the pectin in apples which satisfies hunger.   Early animal studies had already suggested that apple and its components, e.g. apple pectin and polyphenols, improve lipid metabolism and lower the production of proinflammatory molecules. The authors believed that this study was the first  to look at the cardioprotective effects of daily consumption of apple for one year in postmenopausal women.

Of course, more studies will need to be done to reconfirm these results and look at the cellular interactions but we already know that apples are a good source of fiber, so why not have "an apple a day!"

 

More Health Studies Needed on Lesbian, Gay, Bisexual and Transgendered Populations
Posted by on May 11, 2011 - 8:39am

According to a new report from the Institute of Medicine, researchers need to engage more lesbian, gay, bisexual and transgendered people in health studies.   The scarcity of research (among this population) yields an incomplete picture of LGBT health status and needs, which is further fragmented by the tendency to treat sexual and gender minorities as a single homogeneous group.

We have only recently  learned that race and sex play an important role in health status.      "It was only when researchers made deliberate efforts to engage women and racial and ethnic minorities in studies that we discovered differences in how some diseases occur in and affect specific populations.   Routine collection of information on race and ethnicity has expanded our understanding of conditions that are more prevalent among various groups or that affect them differently.   We should strive for the same attention to and engagement of sexual and gender minorities in health research," said Robert Graham, professor of family medicine at U. of Cincinnati College of Medicine in Ohio and chair of the committee issuing the report.

Because LGBT individuals make up a minority of the population, researchers face challenges in recruiting sufficient numbers of these individuals to yield meaningful data.   Stigma experienced by gender and sexual minorities can make them reluctant to disclose their orientation, worsening the problem.

The report recommends that federally funded surveys should proactively collect data on sexual orientation and gender identity, just as they routinely gather information on race and ethnicity.  Information on patients' sexual orientation and gender identity also should be collected in electronic health records, provided that privacy concerns can be satisfactorily addressed, the committee said.   The U.S.  National Institute of Health should support the development of standardized measures of sexual orientation and gender identity for use in federal surveys and other areas of data collection.

At our Institute of Women's Health Research at Northwestern U., we grappled with this issue for our Illinois Women's Health Registry which now has over 6000 women enrolled who are interested in participating in research.   Almost 3 % of our participants have identified themselves at lesbian.   One of the unresolved issues is how to include transgendered individuals who may be male or female at birth (their biological sex) but now live as female or male, respectively (their gender identity).   Can they only complete the Registry if they are born female, yet would that deny their gender identity as male?   This is certainly a complex issue and one that needs attention as sexual orientation becomes more mainstreamed and accepted.  The health risks of this populations could be significant since individuals undergoing a sex change are exposed to a variety of drugs and hormones that could influence health.  Guidance in this area would be very helpful to us.

Risk for Macular Degeneration Reduced by Omega-3 in Women
Posted by on May 9, 2011 - 11:07am

Age related macular degeneration (AMD) is a medical condition in primarily older adults that results in a loss of vision in the center of the visual field (the macula) because of damage to the retina in the eye.  AMD makes it difficult or impossible to read or recognize faces, although enough peripheral vision remains to allow other daily activities like eating and cooking.

Typical view for someone with AMD

A new study done by researchers at Brigham and Women's Hospital and Harvard Medical School collected data including diet from 38,022 women who were not diagnosed with AMD.  After 10 years, they confirmed  235 cases of AMD.  After adjusting for age and treatment, they found that the women who consumed the most omega 3 fatty acid (found in fish) has a 38% lower risk of developing AMD.   In terms of fish intake, they found that consumption of one or more servings of fish per week, when compared to less than one serving per month, was associated with a 42 percent lower risk of AMD.  The full article is published in the Archives of Ophthalmology.

I read another study done on women in Australia that found a similar result and I can't help but wonder if these results would be found in men, too.   My father (as his father) has AMD and he has lived in Florida on the Gulf for more than 40 years.  An avid fisherman, he and my mom  ate fish several times a week but it didn't seem to stop him from getting AMD?  I wonder if family history out trumps omega-3 consumption.    This is another example of why sex-based research (both men and women) is so important!

 

Hair Braids and Weaves Increase Risk of Hair Loss.
Posted by on May 5, 2011 - 2:19pm

Certain hairstyles such as braids and weaves may increase the risk of a irreversible type of baldness called Central Centrifugal Cicatricial Alopecia (CCCA) that starts at the central part of the scalp and spreads out toward the edge of the hairline.

Traction alopecia (baldness) is caused by chronic traction (pulling) on the hair follicle and is seen most commonly in African-American females associated with tight braiding or cornrow hair styles. It is generally present along the hairline. Men who attach hairpieces to their existing hair can experience this type of permanent hair loss if the hairpiece is attached in the same location over a long period of time.

According to a study published in the Archives of Dermatology, "Any style that causes too much tension and traction on the hair....can possibly lead to scarring hair loss."   The study included 326 African American women who completed a questionnaire about hair care methods and health status.

Nearly 60% of the women showed signs of advanced central hair loss with scarring.  Many of these women also had Type 2 diabetes and bacterial infections, suggesting that the hair loss may be related to underlying metabolic irregularities.  Women with hair loss should be given an extensive medical workup, especially for diabetes which can be controlled.

Because braiding and weaves are expensive to do, many women keep these styles for an extended period of time adding to the risk of infection.  While I personally think these hairdos are often stunning and quite beautiful, most professionals dealing with hair loss advise against them, especially over long periods of time.   Braiding for a special event may be okay, but release them in a few days and let your hair rest!

 

 

 

Beware of Bogus STD Treatments
Posted by on May 4, 2011 - 10:52am

Federal regulators say some companies are selling products that make unproven claims to treat sexually transmitted diseases—claims that could pose a threat to public health. The Food and Drug Administration (FDA) says only prescription medicines and diagnostic tools available through a health care professional are effective for STD diagnosis and treatment. FDA and the Federal Trade Commission (FTC) are warning manufacturers and distributors that they could face legal action if the products aren’t removed from the market. The agencies say at least 15 products claim to treat, prevent, or cure STDs and are being sold online and at some retail outlets.

The products—some of which are sold as dietary supplements—claim to treat a range of sexually transmitted diseases, including herpes, chlamydia, genital warts, HIV, and AIDS. Specific brand names being targeted by FDA and FTC include: Medavir, Herpaflor, and Viruxo. To see a complete list of the phony STD remedies, go to this SITE.

FDA’s Dr. Debbie Birnkrant says she’s concerned that someone with an STD will waste precious time using a product that doesn’t work, leading to a delay in medical treatment and possible spread of the infection. “If you aren’t treating your STD with an FDA-approved medication, you’re not just putting your own health at risk—you could be endangering your partner,” she says.

Prescription Only

Birnkrant says there are no non-prescription drugs or dietary supplements that can treat, cure, or prevent sexually transmitted disease. Condoms are the only non-prescription product that can prevent STDs by reducing the chance that an infected person will pass on the disease. STDs can only be diagnosed and treated under the supervision of a health care professional. Some STDs have symptoms that include sores or a discharge, but the majority of infected people have no symptoms at all. Because of this, Birnkrant says people who are sexually active, have had unprotected sex, or have been exposed to a sexually transmitted disease should get medical attention, especially if they have these symptoms:

• burning sensation with urination

• pelvic pain

• discharge from the penis or vagina

• blisters

• sores

There are FDA-approved medications available to treat many sexually transmitted diseases. These products have met federal standards for safety, effectiveness, and quality—and they’re available only by prescription, Birnkrant says. To learn more about sexually transmitted diseases and to learn where you can be tested, go to www.hivtest.org/STDTesting.aspx.

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