Posted by on April 24, 2015 - 9:39am

The Women's Health Research Institute has teamed up with North American leaders to advocate for sex inclusion in basic research.   Teresa K Woodruff, PhD, director of WHRI, and Melina R Kibbe, MD, WHRI Leadership Council member and vascular surgeon have joined nine other academic leaders in sex based medicine on an opinion piece entitled Sex inclusion in basic research drives discovery.  Published in the April 2015 edition of PNAS the article reinforces why sex inclusion is one of "most underappeciated differences in biomedical research".   It addresses the objections that have been made against inclusion of females in preclinical research by naysayers who are resisting a more equitable policy.  

While most of the discussion on this topic has revolved around biological sex differences, this article begins the discussion of the complex interdependency of sex and gender in animal research.

This article emerged from a workshop held at Stanford University in September 2014.  Besides Northwestern Feinberg School of Medicine, the other authors represent John Hopkins, Stanford U, U of California Irvine, U of Toronto, Georgia State, U of Maryland, McGill U, U of California Berkeley.

Posted by on April 22, 2015 - 8:43am

We need a certain amount of fat in our diets to stay healthy. Fats provide needed energy in the form of calories. Fats help our bodies absorb important vitamins—called fat-soluble vitamins—including vitamins A, D and E. Fats also make foods more flavorful and help us feel full. Fats are especially important for infants and toddlers, because dietary fat contributes to proper growth and development.

“Fats are really the most concentrated source of energy in the foods we eat, and our bodies need that energy,” says NIH nutritionist Dr. Margaret McDowell. “Fats are truly an essential nutrient.”

Problems arise, though, if we eat too much fat. Dietary fats have more than twice as many calories per gram as either proteins or carbohydrates like sugar and starch. Excess calories, of course, can pack on the pounds and raise your risk for diabetes, cancer and other conditions.

“Some fats are better for our bodies than others,” McDowell says. “We should really aim to eat the right types of fats.”

 Unsaturated fats are considered “good” fats. They’re sometimes listed as “monounsaturated” and “polyunsaturated” fat on Nutrition Facts labels. These can promote health if eaten in the right amounts. They are generally liquid at room temperature, and are known as oils. You’ll find healthful unsaturated fats in fish, nuts and most vegetable oils, including canola, corn, olive and safflower oils.

The so-called “bad” fats are saturated fats and trans fats. They tend to be solid at room temperature. Solid fats include butter, meat fats, stick margarine, shortening, and coconut and palm oils. They’re often found in chocolates, baked goods, and deep-fried and processed foods.

“When we eat too many solid fats, we put our bodies at risk. These fats tend to raise total blood cholesterol, as well as the part of cholesterol known as low-density lipoprotein (LDL) cholesterol (bad cholesterol),” says McDowell.  LDL can lead to the buildup of plaque in the arteries and cardiovascular problems.

Experts say that the total fat intake for adults ages 19 and older should be 20% to 35% of the calories eaten each day. For children ages 4 to 18, it should be 25% to 35%.  Less that 10% of our fat calories should come from saturated fatty acids.

Other NIH-funded research found that, when it comes to weight loss, the source of calories—whether from fat, protein or carbohydrate—isn’t as important as the number of calories you consume. But when it comes to risk factors for heart disease, replacing some carbohydrates with protein or unsaturated fats can greatly improve blood cholesterol. In a specialized diet designed to lower blood pressure, using unsaturated fats in place of some carbohydrates boosted blood levels of “good” cholesterol (HDL cholesterol) and caused a more healthful drop in blood pressure. 

Source:  National Institutes of Health

Posted by on April 20, 2015 - 8:09am

Current e-cigarette use among middle and high school students tripled from 2013 to 2014, according to data published by the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration’s Center for Tobacco Products (CTP). Findings from the 2014 National Youth Tobacco Survey show that current e-cigarette use (use on at least 1 day in the past 30 days) among high school students increased from 4.5 percent in 2013 to 13.4 percent in 2014, rising from approximately 660,000 to 2 million students. Among middle school students, current e-cigarette use more than tripled from 1.1 percent in 2013 to 3.9 percent in 2014—an increase from approximately 120,000 to 450,000 students.

This is the first time since the survey started collecting data on e-cigarettes in 2011 that current e-cigarette use has surpassed current use of every other tobacco product overall, including conventional cigarettes. E-cigarettes were the most used tobacco product for non-Hispanic whites, Hispanics, and non-Hispanic other race while cigars were the most commonly used product among non-Hispanic blacks.

“We want parents to know that nicotine is dangerous for kids at any age, whether it’s an e-cigarette, hookah, cigarette or cigar,” said CDC Director Tom Frieden, M.D., M.P.H. “Adolescence is a critical time for brain development. Nicotine exposure at a young age may cause lasting harm to brain development, promote addiction, and lead to sustained tobacco use.”

Hookah smoking roughly doubled for middle and high school students, while cigarette use declined among high school students and remained unchanged for middle school students. Among high school students, current hookah use rose from 5.2 percent in 2013 (about 770,000 students) to 9.4 percent in 2014 (about 1.3 million students).

The increases in e-cigarette and hookah use offset declines in use of more traditional products such as cigarettes and cigars. There was no decline in overall tobacco use between 2011 and 2014. Overall rates of any tobacco product use were 24.6 percent for high school students and 7.7 percent for middle school students in 2014.

“In today’s rapidly evolving tobacco marketplace, the surge in youth use of novel products like e-cigarettes forces us to confront the reality that the progress we have made in reducing youth cigarette smoking rates is being threatened,” said Mitch Zeller, J.D., director of FDA’s Center for Tobacco Products. “These staggering increases in such a short time underscore why FDA intends to regulate these additional products to protect public health.”

This report concludes that further reducing youth tobacco use and initiation is achievable through regulation of the manufacturing, distribution, and marketing of tobacco products coupled with proven strategies.  Several states have passed laws establishing a minimum age for purchase of e-cigarettes or extending smoke-free laws to include e-cigarettes, both of which could help further prevent youth use and initiation.

For broadcast-quality video and audio clips featuring FDA’s Center for Tobacco Products Director Mitch Zeller speaking about the findings from the 2014 National Youth Tobacco Survey, visit http://dmr.homefrontdc.com/697/ctp-nyts-findings.

Posted by on April 18, 2015 - 9:35am

We are well aware that cigarette smoking has a direct link to lung cancer.  Did you know that the latest Surgeon General's report identified 21 other diseases that have a causal relationship to cigarettes?

The list included 12 types of cancer, 6 categories of cardiovascular disease, diabetes, chronic obstructive pulmonary disease, and some pneumonias.  But a new report put  out by the American Heart Association, the National Cancer Institute and several major medical centers that pooled data on millions of subjects of both sexes and age 55 years and older found other concerns for smokers. In this study,  mortality was followed from 2000 to 2011.

 There were 181,377 deaths overall---19% in smokers and 14% in non smokers. The study reconfirmed the increase morality due to smoking in the conditions listed above.    However, 17% of the smokers with increased mortality helped identify new conditions impacted by smoking:   renal failure, intestinal ischemia, hypertensive heart disease, infections, various respiratory conditions, breast cancer and prostate cancer---conditions not part of the earlier "21". 

While the study provides a more complete lists of conditions increased due to smoking, it also reinforces the fact that the rate of death from almost any cause was two to three time higher in current smokers when compared to non smokers.  While more study is needed to rule our other behaviours and determine how smoking effects treatment, the study demonstrates how important it is to reduce smoking espeically in young people.   Smoking also impacts one's  quality of life and will often cause mortality due to chronic conditions a decade earlier in smokers.  It sure makes sense to put those cigarettes away.

 

 

Posted by on April 15, 2015 - 2:58pm

In the last few weeks, we saw the Rolling Stone retract a highly read article about an alleged gang rape at the U of Virginia that raised a lot of questions about the ethics of journalism.  In short, many of the accusations posed by the reporter were not backed up by facts and in the end cast a dark cloud over the university and the fraternities that were involved.  Theconversation.com, an online news source written by academics and scholars, posted an article by Ivan Oransky, an associate professor at New York University, and Adam Marcus, that asks whether or not journalism should use the scientific method with its rigourous investigation, questioning of evidence, testing and revised hypotheses as a good model for self-correction.   This article also takes a look at the scientific method itself and whether or not it, too, has some shortcomings and is vulnerable to human biases.   

If you are a fan of truth in reporting and rigor in science, you will find this article thoughtful.   Unlike a Rolling Stone:  is science really better than journalism at self-correction? 

Posted by on April 14, 2015 - 11:10am

Equal Pay Day is finally here! Equal Pay Day (April 14, 2015)  is the symbolic day when women's earnings catch up to men's earnings for the previous year.  The most recent data shows that on average for every dollar paid to a man, a woman receives 78 cents.  That is one penny more than the statistic women have been stuck at for the past decade and this gap is of course even wider for women of color!

So what can you do to ensure equal pay for women?  You can start by asking your local member of congress to support an important piece of legislation, the Paycheck Fairness Act.  This act would update the Equal Pay Act of 1963 by closing loopholes that prevent the original legislation from fully addressing the gender pay gap.  Contact your state representatives and urge them to support the Paycheck Fairness Act because women deserve better!   

Posted by on April 14, 2015 - 9:10am

While rare, breast cancer does affect women under the age of 45. In young women, the disease is more often hereditary than it is in older women. Young women, however, may not realize they are at risk for this disease. The Centers for Disease Control and Prevention’s (CDC) new Bring Your Brave campaign will feature young women telling their personal stories about how their lives have been affected by breast cancer. The goals of the campaign are to motivate young women to learn about the disease and its prevention, learn their family history of cancer, and engage in conversations with their health care provider.

CDC is looking for stories from women ages 18-44 who:

  • Found a lump or abnormal change in their breast that turned out not to be breast cancer.
  • Have a mother, sister or first counsil who had breast cancer before age 50 and is BRCA+
  • Have a family history of breast and/or ovarian cancer
  • Have undergone genetic counseling/testing and fit one of the following:  have had breast cancer and a BRCA mutation, have a family history of breast/ovarian cancer nad BRCA mutation, are of Ashkenazi Jewish heritage with a personal/family history of breast cancer and BRCA mutation.

CDC is also looking for stories from women of any age who have been diagnosed with breast cancer before age 50, have a BRCA mutation, AND have a daughter age 18 through 40. Both women must be willing to share their story about hereditary cancer, learning about family history, and having a BRCA mutation.

To be considered for this project women must:

Not smoke or use illegal drugs.
Have completed their cancer treatment (if applicable) at
least one year ago.
If you are interested in participating or know of someone who might be, please contact CDC for more information by May 15th.

Web www.cdc.gov/BringYourBrave/casting
Email BYBRecrutiment@cdc.gov
Phone (202) 729-4099

Posted by on April 11, 2015 - 9:37am

Teen childbearing can carry health, economic, and social costs for mothers and their children. Teen births in the US have declined, but still more than 273,000 infants were born to teens ages 15 to 19 in 2013. The good news is that more teens are waiting to have sex, and for sexually active teens, nearly 90% used birth control the last time they had sex. However, teens most often use condoms and birth control pills, which are less effective at preventing pregnancy when not used consistently and correctly.

Intrauterine devices (IUDs) and implants, known as Long-Acting Reversible Contraception (LARC), are the most effective types of birth control for teens. LARC is safe to use, does not require taking a pill each day or doing something each time before having sex, and can prevent pregnancy for 3 to 10 years, depending on the method. Less than 1% of LARC users would become pregnant during the first year of use.

Few teens (ages 15 to 19) on birth control use the most effective types.

  • Less than 5% of teens on birth control use LARC.
  • Most teens use birth control pills and condoms, methods which are less effective at preventing pregnancy when not used properly.
  • There are several barriers for teens who might consider LARC:
    • Many teens know very little about LARC.
    • Some teens mistakenly think they cannot use LARC because of their age.
  • Clinics also report barriers:
    • High upfront costs for supplies.
    • Providers may lack awareness about the safety and effectiveness of LARC for teens.
    • Providers may lack training on insertion and removal.

Providers can take steps to increase awareness and availability of LARC.

  • Title X is a federal grant program supporting confidential family planning and related preventive services with priority for low-income clients and teens.*
    • Title X-funded centers have used the latest clinical guidelines on LARC, trained providers on LARC insertion and removal, and secured low- or no-cost options for birth control.
    • Teen use of LARC has increased from less than 1% in 2005 to 7% in 2013.
  • Other state and local programs have made similar efforts.
    • More teens and young women chose LARC, resulting in fewer unplanned pregnancies.

Source:  CDC.

Posted by on April 8, 2015 - 10:37am

As we learn more about sex differences, it is  easy to understand why both men and women need to be included in clinical research.  But why does the sex of a cell used in basic research matter?    Cell lines and primary cells are often used by basic scientists in proof-of-concept experiments and when trying to figure out how biological mechanisms work.  These early findings help provide valuable clues for developing new drugs, treatments and diagnostic models that eventually can be applied to humans. 

Recently, researchers in Korea have reported that the sex of cell lines and stem cells (the start of the science pipeline)  is often ignored.  Furthermore, most scientific journals still do not require authors to include the sex of the cells used in an experiment. 

A similar problem exists when using animals like mice and rats---though that is starting to change due to outcries from advocates of sex inclusion in ALL research.

Many researchers use commercially available cells so this problem is not just one for the scientific community to solve.   It also behooves commercial enterprises to help change the paradigm of "sexless" experimentation by clearly defining (and providing) the sex of their biological products. This would help researchers to evaluate sex as a variable and ensure the sex distribution of cells is more balanced.  These changes will help advance science that is more accurate and unbiased.

In the end, to truly advance sex based research, we must ensure that changes are made in partnership with all members of the scientific pipeline:  the cell and animal suppliers, the bench scientist, the clinical scientist, the Institutional Review Boards who approve human study designs, the funding agencies, and the Journals who publish scientific outcomes.

With the new focus on "precision medicine", advocates must continue to make sure that sex differences are part of the equation.

Source:  AJP-Cell Physiolo.doi:10.1152/ajpcell.00369.2014

 

Posted by on April 6, 2015 - 9:51am

National STD Awareness Month is not just a reminder for young folks.   Older adults, including senior citizens,  need to pay attention to the messages.  According to the CDC, between 2007 and 2011, chlamydia cases among Americans 65 and older increased 31% and for syphilis 52%.  These percentages are similar to those in the 20- to 24- age group. 

According to the National Survey of Sexual Health and Behavior, among people over 60, more than half the men and 40% of women are sexually active.   Even though pregnancy risk is unlikely in this population, this age group could still harbor and pass on an untreated STD.  Many seniors also grew up before the "safe sex" messaging about condoms took hold and thus their use is lower.

There are several reasons why older adults may be more susceptible or in danger from STDs than younger adults:

  • Lack of regular screening for STDs
  • Menopausal changes in women can lead to less lubrication and thinning of tissues making them more susceptible to infections
  • Less condom use
  • Reduction in immune response in older people.

Social factors that are driving the increase of sexual activity in older adults, and increased exposure to STDs,  include longer healthier lives, new medications like Viagra, and the rise in active retirement living communities where socialization is encouraged.    

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