Individualized Diet Useful to Relieve Interstitial Cystitis (IC) Flareups
Posted by on June 13, 2011 - 6:08am

There is a lot of information on the web promoting various diets for interstitial cystitis (IC), a painful bladder condition with many different symptoms.  Both the IC clinical guidelines of the American Urological Association (AUA) and the chronic pelvic pain practice bulletin of the American College of Obstetrical Gynecology (ACOG) recommend dietary modification as a useful approach for helping to manage IC and chronic pelvic pain.

However, research into the link between IC and food is very limited. At this time, there is no special “IC Diet.”

IC affects 3-8 million women in the U.S.   Men also have it but to a smaller degree, an estimated 1-4 million.   However, in men, it is often mistaken for chronic prostatitis.  Research has found that there is a lot of variability among IC patients. Some people with IC report that certain foods appear to irritate their bladders and cause painful IC flares. And they find that making a few strategic changes to what they eat and drink can help to control IC symptoms including pain, frequency, and urgency. Other IC patients find that diet does affect their flares.

Some 2,100 IC patients responded to a survey conducted by the Interstitial Cystitis Association (ICA) on complementary and alternative medicines (CAM). Diet topped the list of helpful CAM treatments. The ICA distinguished between looking for and eliminating your individual food triggers and strictly eliminating all the foods on a given “IC Diet” food list. Results were the same in both cases, strongly suggesting that you can eat happy and healthy with a wide variety of items in your diet and still keep your symptoms at bay. The survey also found that newly diagnosed patients find diet changes significantly more helpful than long-standing IC patients.

The ICA recommends eating a healthy, balanced diet. Meet with a registered dietitian (RD) to learn more about how to identify which foods and beverages might bother your IC. Also, find out if your health insurance covers the cost of nutrition counseling.
What We Know about IC & Diet
What to Eat—and What Not to Eat
Differing Approaches on IC & Diet

Source: Interstitial Cystitis Association

Vitamin D and Obesity in Women
Posted by on June 10, 2011 - 7:08am

Overweight women with low Vitamin D levels who lose more than 15% of their body weight experience a significant increase in levels of this nutrient, according to a new study by researchers at Fred Hutchinson Cancer Center. "Since vitamin D is generally lower in persons with obesity, it is possible that low vitamin D could account, in part, for the link between obesity and diseases such as cancer, heart disease and diabetes," said Caitlin Mason, PhD, lead author of the study published in the American Journal of Clinical Nutrition.

Vitamin D promotes calcium absorption and is needed for bone growth and bone healing.   Along with calcium, vitamin D helps protect older adults from osteoporosis.  This nutrient also influences cell growth, neuromuscular and immune function and reduces inflammation.

The study involved 439 overweight-to-obese, sedentary, postmenopausal Seattle-area women, ages 50 to 75 who were randomized into four groups:   exercise only, diet only, exercise plus diet and no intervention.  Those who lost between 5-10% of their weight saw some moderate increase in vitamin D levels, but women who lost more than 15% of their weight experienced a nearly threefold increase in vitamin D, independent of dietary intake of the nutrient.   Optimal levels of vitamin D are between 20 and 50 ng/mL.  Levels below 20 ng/mL are inadequate for bone health and levels above 5o ng/mL can have adverse side effects such as an increased risk of kidney stones.

Cancer Survivors Can't Shake Pain, Fatigue, Insomnia, Foggy Brain
Posted by on June 8, 2011 - 10:40am

When people finish treatment for cancer, they want to bounce back to their former vital selves as quickly as possible. But a new Northwestern Medicine study -- one of the largest survivor studies ever conducted – shows many survivors still suffer moderate to severe problems with pain, fatigue, sleep, memory and concentration three to five years after treatment has ended.

“We were surprised to see how prevalent these symptoms still are,” said study co-investigator Lynne Wagner, an associate professor of medical social sciences at Northwestern University Feinberg School of Medicine and the Robert R. Lurie Comprehensive Cancer Center. “This is one of the first looks at what’s really happening for survivors in terms of symptoms and treatment among community-based treatment settings across the U.S.”

The persistent pain in survivors who are cancer-free and no longer receiving any treatment is particularly puzzling, Wagner noted, because good treatment exists. “It seems we haven’t come a long way in managing pain despite a lot of medical advances, ” she said. “This is eye opening. It tells us we need to be better in clinical practice about managing our survivors’ pain.”

Cancer survivors seem to slip through the cracks in healthcare in terms of getting treatment for their pain and other symptoms. “We don’t have a great system to provide care to cancer survivors,” Wagner said. “Cancer survivors are left trying to put the pieces together to find optimal care. They ideally need to see someone who is knowledgeable about the long-term affects of treatment.” She pointed to the example of the STAR (Survivors Taking Action & Responsibility) Survivorship Program at Lurie Cancer Center, a comprehensive long-term follow-up program for survivors of pediatric cancer.

The study included a sample of 248 survivors of breast, colorectal, lung and prostate cancer. The survivors were primarily female and white, and most were more than five years post-diagnosis. They also had been treated in community settings -- where 80 percent of people with cancer are treated in the United States -- as opposed to academic medical centers. This group best represents the typical experience of cancer survivors around the country, Wagner said.

The most common symptoms reported by survivors were fatigue (16 percent), disturbed sleep (15 percent), cognitive difficulties (13 percent) and pain (13 percent.)  Survivors need education programs for transitioning from treatment to life as a cancer survivor, and this education should include skills for managing these difficult and chronic symptoms, Wagner said. Medical providers also need to be educated about survivors’ lingering symptoms.

“It is acceptable for someone actively going through cancer treatment to have pain medications, but when they transition to being survivors, that acceptance goes away,” Wagner said. “If they ask for pain medication again, doctors may worry that they are getting addicted.“

The study also pointed out the need to develop better ways to address sleep problems, fatigue and lasting difficulties with memory and concentration. Non-drug interventions for improving sleep are effective, Wagner said, and researchers need to tailor these for cancer survivors. Exercise is the most effective weapon against cancer-related fatigue, but it’s challenging to adhere to an exercise regime when you don’t feel well. “We need to see how we can be more effective in promoting physical activity among survivors,” Wagner said.

Researchers also documented any treatment interventions for study participants’ symptoms and then repeated an assessment of the symptoms four weeks later.“We generally found the same severity of these symptoms one month later, suggesting they tend to be chronic,” Wagner said.  Participants concluded more research was needed on the prevalence of these symptoms.

By Marla Paul, Northwestern Science Writer

Tanning beds still popular despite dangers; is sunless tanning an alternative?
Posted by on June 6, 2011 - 2:34pm

A recent survey confirmed that 32% of respondents  (3800 white, non-hispanic females ages 14-22) reported using a tanning bed in the past year .   These results are pretty alarming since the U.S. Department of Health and Human Services and the World Health Organization's International  panel have declared ultraviolet (UV) radiation from the sun and artificial light sources such as tanning beds and sun lamps, as a known carcinogen.  Studies show indoor tanning increases a person's risk of melanoma, the most serious type of skin cancer,  by 75%.

According to the Mayo Clinic, sunless tanning products are  a practical alternative to sunbathing, but they have to be used carefully.   They have been around for years and continue to improve (remember the earlier versions that streaked your legs and colored the palms of your hands orange!).    Sunless tanner are products that provide a tanned appearance without exposure to the sun or a tanning booth.   The active compound is dihydroxyacetone (DHA), a color additive that temporarily darkens the skin by reacting with amino acids in the skin surface.   The coloring does not wash off (like it does with cosmetic bronzers) but it fades as the top layer of skin sloughs off, typically in a few days.  The U.S. Food and Drug Administration does not regulate sunless tanners but it does regulate color additives which includes DHA.  However, its use is restricted to external use only which by the FDA definition excludes applying to the eye area (lids, lashes, skin below the eyebrow and skin below the eye)  or any body surface covered by mucous membrane such as the lips.   The FDA has not issued any safety data on the misting action of tanning booths.

If you are getting a sunless tan spray, it is important that you take adequate precautions to cover your eye area and lips.   DHA is not approved for internal use so take care not to inhale or ingest the product.  Also, most sunless tanning products do NOT contain sunscreen so if you go out in the sun, be sure to lather up with sunscreen.

On a final note, tanning pills generally contain the pigment, canthaxanthin.   While this chemical has been approved as a food additive, it is not approved as a tanning agent.  The amount of canthaxanthin in tanning pills is much more concentrated than what is used as a food coloring additive, and serious side effects such as liver disease have been reported.   Avoid the tanning pills.

 

 

An Update on Home Birth and Midwife Legislation
Posted by on June 4, 2011 - 10:58am

Vermont Gov. Peter Shumlin recently signed into law legislation requiring health care insurance policies to cover midwifery services and home births. Supporters of the law said this law is critical in improving access to comprehensive health services for women, reducing system costs and strengthening the quality of care that mothers receive during pregnancy and childbirth.

“Access to midwifery care and home birth should not be limited only to those who can afford those services out of pocket,” Gov. Shumlin said. “This law will ensure that all expectant mothers get the coverage and care they want and deserve.”  The Governor also noted that the change will help hold down health care expenses.  Advocates, including the Vermont Public Interest Research Group, said that because pregnancy is not an illness and 84 percent of births are low-risk, there is no reason to restrict coverage to hospitalization for low-risk labor and delivery.

Midwifery services for home births are currently covered by Medicaid and the Vermont Health Access Plan. New Hampshire and New York also have similar laws on the books.  In some states, the main objector to midwifery and home births is often the state medical society.  While safety is certainly a primary concern, home births using a midwife are generally less expensive and avoid large hospital costs, questioning the real rationale for fighting home births in low risk women. Any thoughts?

 

 

Beware of Limitations for Breast Thermograpy
Posted by on June 2, 2011 - 6:14pm

Today, June 2, 2011, the U.S.  Food and Drug Administration (FDA) warned women not to substitute breast thermography for mammography to screen for breast cancer. Some health care providers are promoting breast thermography on their websites and claiming that thermography is superior to mammography as a screening method for breast cancer, because it does not require radiation exposure or breast compression.

The FDA is unaware of any valid scientific evidence showing that thermography, when used alone, is effective in screening for breast cancer. To date, the FDA has not approved a thermography device (also referred to as a telethermographic device) for use as a stand-alone to screen or diagnose breast cancer. However, the FDA has previously cleared thermography devices for use only as an adjunctive diagnostic tool for breast cancer screening and diagnosis. Therefore, thermography devices should not be used as a stand-alone method for breast cancer screening or diagnosis.

Additional information can be found at the LINK.

 

Most U.S. Teen Pregnancies Unintended
Posted by on June 2, 2011 - 8:57am

In 2009, a total of  409,840 infants were born to 15−19 year olds, for a live birth rate of 39.1 per 1,000 women in this age group. Nearly two-thirds of births to women younger than age 18 and more than half of those among 18−19 year olds are unintended. The US teen birth rate fell by more than one-third from 1991 through 2005, but then increased by 5 percent over two consecutive years. Data for 2008 and 2009, however, indicate that the long-term downward trend has resumed. The U.S. teen pregnancy and birth, sexually transmitted diseases (STDs), and abortion rates are substantially higher than those of other western industrialized nations.

Teen pregnancy and childbearing bring substantial social and economic costs through immediate and long-term impacts on teen parents and their children.

Teen pregnancy accounts for more than $9 billion per year in costs to U.S. taxpayers for increased health care and foster care, increased incarceration rates among children of teen parents, and lost tax revenue because of lower educational attainment and income among teen mothers. Pregnancy and birth are significant contributors to high school drop out rates among girls. Only about 50% of teen mothers receive a high school diploma by age 22, versus nearly 90% of women who had not given birth during adolescence.

The children of teenage mothers are more likely to have lower school achievement and drop out of high school, have more health problems, be incarcerated at some time during adolescence, give birth as a teenager, and face unemployment as a young adult.    These effects remain for the teen mother and her child even after adjusting for those factors that increased the teenager’s risk for pregnancy; such as, growing up in poverty, having parents with low levels of education, growing up in a single-parent family, and having low attachment to and performance in school.

Teen pregnancy prevention is one of  the Center for Disease Prevention and Control's (CDC)  top six priorities, a “winnable battle” in public health and of paramount importance to health and quality of life for our youth.

Evidence-based teen pregnancy prevention programs typically address specific protective factors on the basis of  knowledge, skills, beliefs, or attitudes related to teen pregnancy.  Topics that should be included in a pregnancy prevention programs are:

  • Knowledge of sexual issues, HIV, other STDs, and pregnancy (including methods of prevention).
  • Perception of HIV risk.
  • Personal values about sex and abstinence.
  • Attitudes toward condoms (pro and con).
  • Perception of peer norms and behavior about sex.
  • Individual ability to refuse sex and to use condoms.
  • Intent to abstain from sex, or limit number of partners.
  • Communication with parents or other adults about sex, condoms, and contraception.
  • Individual ability to avoid HIV/STD risk and risk behaviors.
  • Avoidance of places and situations that might lead to sex.
  • Intent to use a condom.

Non-Hispanic black youth, Hispanic/Latino youth, American Indian/Alaska Native youth, and socioeconomically disadvantaged youth of any race or ethnicity experience the highest rates of teen pregnancy and childbirth. Together, black and Hispanic youth comprise nearly 60% of U.S. teen births in 2009, although they represent only 35% of the total population of 15–19 year old females. CDC is focusing on these priority populations because of the need for greater public health efforts to improve the life trajectories of adolescents facing significant health disparities, as well as to have the greatest impact on overall U.S. teen birth rates. Other priority populations for CDC’s teen pregnancy prevention efforts include youth in foster care and the juvenile justice system, and otherwise living in conditions of risk.

Sources:  CDC, National Vital Statistics Reports and the Guttmacher Institute.

 

Tips for Cleaning Fruits and Vegetables
Posted by on May 29, 2011 - 8:50am

Fruits and vegetables are an important part of a healthy diet.  Your local markets carry an amazing variety of fresh fruits and vegetables that are both nutritious and delicious.  Previous blogs on this site have discussed ways to reduce your risks due to agricultural toxins in pesticides.  As you enjoy fresh produce, it is also  important to handle these products safely in order to reduce the risks of foodborne illness.

Federal health officials estimate that nearly 48 million people are sickened by food contaminated with harmful germs each year, and some of the causes might surprise you. Although most people know animal products must be handled carefully in the kitchen to prevent illness, many don’t realize that produce can also be the culprit in outbreaks of foodborne illness. In recent years, the United States has had several large outbreaks of illness caused by contaminated fruits and vegetables—including spinach, tomatoes, and lettuce.

Glenda Lewis, an expert on foodborne illness with the Food and Drug Administration, says fresh produce can become contaminated in many ways. During the growing phase, fruits and veggies may be contaminated by animals, harmful substances in the soil or water, and poor hygiene among workers. After produce is harvested, it passes through many hands, increasing the contamination risk. Contamination can even occur after the produce has been purchased, during food preparation, or through inadequate storage.

FDA says to choose produce that isn’t bruised or damaged, and make sure that pre-cut items—such as bags of lettuce or watermelon slices—are either refrigerated or on ice both in the store and at home. In addition, follow these recommendations:

  • Wash your hands for 20 seconds with warm water and soap before and after preparing fresh produce.
  • Cut away any damaged or bruised areas before preparing or eating.
  • Gently rub produce while holding under plain running water. There’s no need to use soap or a produce wash.
  • Wash produce BEFORE you peel it, so dirt and bacteria aren’t transferred from the knife onto the fruit or vegetable.
  • Use a clean vegetable brush to scrub firm produce, such as melons and cucumbers.
  • Dry produce with a clean cloth or paper towel to further reduce bacteria that may be present.
  • Throw away the outermost leaves of a head of lettuce or cabbage.
  • Store perishable produce in the refrigerator at 40 degrees or below.

Source:  Food and Drug Administration

An Estimated 90% of People Diagnosed with Lupus are Women
Posted by on May 27, 2011 - 7:48am

Classic Butterfly Rash

Yet many people do not know what lupus is and how serious it can be.  Lupus is a chronic autoimmune disease that can affect various parts of the body, including the skin, joints, heart, lungs, blood, kidneys, and brain.  Normally the body's immune system makes proteins called antibodies that protect the body against viruses, bacteria and other foreign invaders. These foreign invaders are called antigens.

In an autoimmune disorder like lupus, the immune system cannot tell the difference between foreign substances and its own cells and tissues. The immune system then makes antibodies that, simply put, attack the body itself. This causes inflammation, pain and damage to various organs.

Inflammation is considered the primary feature of lupus. Inflammation causes pain, heat, redness, swelling and loss of function, inside and/or outside the body.   For many people, lupus can be a manageable disease with relatively mild symptoms. For others, it may cause serious and even life-threatening problems.

Sometimes people with lupus experience a "flare." This occurs when some symptoms appear or get worse for short periods then disappear or get better. Even if you take medicine for lupus, you may find that there are times when the symptoms become worse. Learning to recognize that a flare is coming can help you take steps to cope with it. Many people feel very tired or have pain, a rash, a fever, stomach discomfort, headache, or dizziness just before a flare.  It is not infectious, rare or cancerous.

It’s estimated that more than 16,000 Americans develop lupus each year.  We do not know the cause, but scientists believe some people are predisposed to the disease.  In the United States, lupus is more common among African Americans, Asians, Hispanics, and Native Americans than Caucasians.

Symptoms of lupus include:

  • Muscle and joint pain
  • Fever greater that 100∘F
  • Prolonged or extreme fatigue
  • Anemia (low red blood cell count)
  • Kidney problems
  • Chest pain, especially when breathing deeply
  • Rashes especially on the face
  • Light sensitivity
  • Hair loss
  • Abnormal blood clotting
  • Eye problems (dry eyes, inflammation, rashes0
  • Seizures
  • Mouth or nose ulcers

To learn more about lupus visit:  Could I have Lupus. If you want to test your knowledge on lupus, take this QUIZ.

Markers to Detect Early Ovarian Cancer Are Needed
Posted by on May 25, 2011 - 7:48am

A long awaited assessment of potential biomarkers for detecting early ovarian cancer shows that elevated levels of the CA-125 protein still remains the best predictor of disease progression.  The CA-125 test has been around for several decades and can help determine the effectiveness of cancer treatments in patient with ovarian cancer, but it is not very useful as a screening tool.  A report released in March in Cancer Prevention Research indicated none of the 28 potential serum markers tested in the study outperformed the CA-125.

To be an effective screening tool, the biomarker would need to detects signals from the  tumors six months before diagnosis.   CA-125 has it strongest signal within six months after diagnosis.

Although the results may seem disappointing, the findings provide information that will help future efforts to detect the disease early.  Many researchers have said that if no single marker could detect ovarian cancer, then panels of markers might get the job done.

To learn more about this work, visit this National Cancer Institute Bulletin site.

 

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