Physical Activity Helps People with Osteoarthritis Walk Faster
Posted by on January 24, 2011 - 2:45pm

When a traffic light at a busy intersection flashes the WALK sign, people with knee osteoarthritis worry they can’t walk fast enough to make it across the street in time. New Northwestern Medicine research shows people with this common arthritis are more likely to walk fast enough if they lead physically active lives.“The more active people are, the faster they can walk,” said Dorothy Dunlop, associate professor of medicine at Northwestern University Feinberg School of Medicine and lead author of the study. “This is strong evidence that even a small increase in activity is related to better walking function. The bar for improvement isn’t that high. This should motivate people to get moving, even if they have pain or stiffness."The study is published in the January 2010 issue of Arthritis & Rheumatism.

Knee osteoarthritis is a leading cause of disability in adults. As it progresses, it can threaten an individual’s ability to live independently. Maintaining function and independent living is an important goal for the more than 27 million U.S. adults with osteoarthritis.   Osteoarthritis may first appear between ages 30 and 40, and is present in almost everyone by age 70. Before age 55, it affects men and women equally, but after age 55 the incidence is higher in women.

“This study provides encouragement for people who are on the low end of the physical activity spectrum to increase their physical activity,” said Dunlop. “You don’t have to be in the top physical activity group before you start to see improvements in your walking speed.“

Physical activity produces big benefits for people with knee osteoarthritis. In addition to improving the ability to walk, physical activity also promotes healthy joint cartilage and reduces pain, depression and fatigue, Dunlop noted.

Federal guidelines recommend adults with arthritis should participate in at least 2.5 hours a week of moderate intensity, low-impact activity in sessions lasting 10 minutes or more. Even if people can’t meet these levels, Dunlop said they should be as physically active as possible.

Researchers divided participants into four physical activity groups, from lowest to highest, using a general activity score. In the lowest physical activity group, less than half, or 49 percent, walked fast enough to cross the street before the light changed. (Traffic lights generally allow a walking speed of four feet per second.) In the next three higher physical activity groups, 63 percent, 71 percent and 81 percent, respectively, walked fast enough to cross the street.

Author:  Marla Paul is the health sciences editor at the Northwestern Feinberg School of Medicine.

Osteoporosis Screening Recommended for All Women over Age 65
Posted by on January 21, 2011 - 3:09pm

In an update to its 2002 recommendation, the U.S. Preventive Services Task Force (USPSTF) now recommends that all women ages 65 and older be routinely screened for osteoporosis. This is the first final recommendation statement to be published since the USPSTF implemented a new process in July 2010 in which all of its draft recommendation statements are posted for public comment on the USPSTF Web site prior to being issued in final form.

The USPSTF also recommends that younger women with increased risk factors for osteoporosis be screened if their fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors. White women are used as the benchmark because they have a markedly higher rate of osteoporosis and fractures than other ethnic groups. Risk factors for osteoporosis include tobacco use, alcohol use, low body mass and parental history of fractures.

The USPSTF did not indicate a specific age limit at which screening should no longer be offered because the risk for fractures continues to increase with age and the evidence indicates that benefits can be realized within 18 to 24 months after starting treatment. The USPSTF also looked at whether to recommend screening men for osteoporosis but found insufficient evidence to make a recommendation at this time. This new final recommendation will become effective when it appears in the January 18 online issue of Annals of Internal Medicine and will also be available on the USPSTF Web site.

Osteoporosis screening involves a measurement of bone density, which is currently covered by Medicare. The most commonly used bone density measurement tests are dual-energy x-ray absorptiometry (DXA) of the hip and lumbar spine, as well as quantitative ultrasound of the heel, although current diagnostic and treatment criteria are based on DXA tests alone. The USPSTF noted that there is a lack of evidence about how often screening should be repeated in women whose first test is negative.

In postmenopausal women who have no prior fractures caused by osteoporosis, the USPSTF found convincing evidence that drug therapies (including bisphosphonates, parathyroid hormone, raloxifene and estrogen) reduce the risk for osteoporosis-related fractures.  It should be noted that risks regarding long term use of some of these therapies are being studied and other blogs on this site discuss that.

Osteoporosis, a condition that occurs when bone tissue thins or develops small holes, can cause pain, broken bones and loss of body height. Osteoporosis is more common in women than men and is more common in whites than any other racial group. For all demographic groups, the rates of osteoporosis rise with increasing age.

The USPSTF is an independent panel of private-sector experts in prevention and evidence-based medicine that conducts rigorous, impartial assessments of the scientific evidence and makes recommendations on the effectiveness of a broad range of clinical preventive services, including screening, counseling and preventive medications. The USPSTF does not consider costs or cost-effectiveness in creating recommendations. The Agency for Healthcare Research and Quality (AHRQ) is authorized by statute to convene the USPSTF and provide scientific and administrative support.

Making Breastfeeding Easier
Posted by on January 20, 2011 - 11:45am

The U.S. Surgeon General Regina M. Benjamin today issued a Call to Action to Support Breastfeeding outlining steps that can be taken to remove some of the obstacles faced by women who want to breast feed their babies.   While 75% of U.S. babies start out breast feeding, the Centers for Disease Control and Prevention (CDC) says, only 13 % are are exclusively breastfed at the end of six month.   The rates are particularly low among African-American infants.

Many mothers who attempt to breastfeed say several factors impede their efforts, such as a lack of support at home, lack of information on breastfeeding from health care clinicians, a lack of time and privacy to breastfeed or express milk at the workplace, and an inability to connect with other breastfeeding mothers in the community.

Breastfeeding protects babies from infections and illnesses that include diarrhea, ear infections, and pneumonia.   Breastfed babies are also less likely to develop asthma, and those who are breastfed for six months are less likely to become obese.  Mothers themselves who breastfeed have a decreased risk of breast and ovarian cancers according to the Call to Action.

A study published in Pediatrics estimated that the nation would save $13 billion per year in health care and other costs if 90% of U.S. babies were exclusively breastfed for six months.   Dr. Benjamin added that, by providing accommodations for nursing mothers, employers can reduce their company's health care costs and lower their absenteeism and turnover rates.

On a personal note, I just got back from Brazil and noticed the number of women that were casually nursing their babies in public---at the beach, in airports and even in restaurants.   The U.S. has not quite reached this level of acceptance and, hopefully, this initiative by the surgeon general will help move us forward.    Having a female surgeon general may make the difference!  Check out the Call to Action, it has a lot of excellent resources!

Sex Differences in Concussion Symptoms
Posted by on January 13, 2011 - 2:09pm
Professional Women Having Less Children
Posted by on January 9, 2011 - 1:28pm


A recent report from the Pew Research Center, which analyzed 1992-1994 and 2006-2008 fertility and education data from the US Census Bureau showed that overall, American women were more likely to have no children in 2006-2008 than they were in the early 1990s. Further, women with a masters, professional, or doctoral degree are less likely to have children than women without an advanced degree. However, this subgroup of highly educated women was more likely to have children in 2006-2008 than they were in 1992-1994. The authors do not offer an explanation for this trend.

Are We Getting Enough Vitamin D and Calcium?
Posted by on January 6, 2011 - 8:26am

Calcium and Vitamin D are essential nutrients known for their role in bone health.   However, a lot of vitamin companies have been touting these two substances for all kinds of health benefits beyond the skeletal system. This has created some confusion about nutritional messaging.

To help clarify this issue, the US and Canadian governments requested the Institute of Medicine (IOM) to assess the current data and outcomes related to these two nutrients.  Their findings were released in a brief on  November 2010 and are they are summarized below.

The overall conclusion was that most Americans and Canadians are receiving adequate amount of calcium and vitamin D.  However, there is some emerging evidence that too much of either substance can be harmful.  The committee looked at a full range of health outcomes ranging from a variety of health conditions including cancer, pregnancy, hypertension and bone health.   What they found is that a strong body of scientific evidence substantiates the importance of these two substances in bone health.   However, their review in areas outside of bone health, found that those studies often produced mixed or inconclusive results.   Higher levels of these products above the normal recommended amounts (there is a chart with recommendations by age group in the brief) have been linked to other health problems, challenging the concept "more is better".

Major Women's Health Topics of 2010
Posted by on December 31, 2010 - 1:30pm

WebMD recently featured an article about the top stories in women's health.  They reported the five most popular stories were:

  • Period (menstrual) Problems
  • Fatigue
  • Super Foods that Women need
  • Thyroid Problems
  • Sex and Relationships

Our own Institute for Women's Health Research Blog featured evidence-based articles on many of these topics.   In fact, judging from the number of comments we received from our readers, among our most active blogs were the ones about diet and weight, sleep problems, gynecologic problems, and heart health.     We'd love to hear from our followers on topics they would like us to explore in 2011.   The Institute for Women's Health Research is committed to providing information that is authoritative and based on the latest research.    If you follow us, you will sometime see that the research we present contradicts the current information on a specific disease or condition.     That is the nature of scientific research---it is ever evolving.   It is important that we continue to support the advancement of women's health research and make sure scientists explore topics using a sex and gender lens.   For far too long, most research was done in males and applied to women.     When we look at both men and women, we learn more about the complex human body---- and everyone benefits!

Thank you for reading our blog and let's hope the new year finds a world that is more tolerant, kind, equitable and healthy!

Alcohol and Breast Cancer
Posted by on December 30, 2010 - 1:24pm

While the role of alcohol consumption has been established as a risk factor for breast cancer, most of the research has focused the relationship on hormonally sensitive breast cancers.  A new study published in the Journal of the National Cancer Institute takes a look at the risk of alcohol and breast cancer subtype.  While the study reconfirmed a higher breast cancer risk from alcohol overall and a higher risk for hormone-receptor positive cancers, it found that the associated alcohol/breast cancer risk was observed in invasive lobular cancer but not for invasive ductal cancers.

This suggests a distinct etiology for these sub-types  of breast cancer and further research is needed.

Older Adults and Anxiety Disorders
Posted by on December 28, 2010 - 3:53pm

Anxiety caused by stressful events like moving or losing a job is a normal part of life. Anxiety disorders, on the other hand, are characterized by persistent, excessive and disabling fear and worry and get progressively worse if left untreated. It is estimated that anxiety disorders affect between 3 and 14 percent of older adults in a given year. To provide an older audience with additional information, NIHSeniorHealth, the health and wellness website for older adults from the National Institutes of Health (NIH), has added a topic about anxiety disorders (http://nihseniorhealth.gov/anxietydisorders/toc.html).

Visitors to the website can learn about the risk factors, symptoms and treatments for generalized anxiety disorder, social phobia, panic disorder, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and specific phobias such as fear of flying or fear of public speaking. Anxiety disorders can severely affect a person’s life, and they are often overlooked in older adults.

"Conditions that commonly occur with age, such as depression, heart disease and diabetes, may have symptoms that mimic or mask anxiety symptoms, making diagnosis in older adults difficult," says Thomas R. Insel, M.D., director of the National Institute of Mental Health (NIMH).  "Often, these health conditions will need to be addressed before a person will respond to treatment for an anxiety disorder."

It can sometimes be difficult to distinguish between common anxiety caused by adapting to difficult life changes — such as fear of falling after a hip replacement—and an actual anxiety disorder. The new topic on NIHSeniorHealth is a good way for older adults to learn more about the way these disorders can affect them.

Information about anxiety disorders is the latest addition to the roster of health topics offered on NIHSeniorHealth (www.nihseniorhealth.gov). A joint effort of the National Institute on Aging (NIA) and the National Library of Medicine (NLM), the website features research-based, easily accessible information on a range of health issues of interest to older people. To improve access for older adults, NIHSeniorHealth includes short, easy-to-read segments of information in a number of formats, including various large-print type sizes, open-captioned videos and an audio version.

600,000 worldwide deaths cause by secondhand smoke
Posted by on December 27, 2010 - 2:48pm

Study Estimates More than 600,000 Deaths Worldwide Caused by Secondhand Smoke

Secondhand tobacco smoke is estimated to have caused more than 600,000 deaths and the loss of more than 10 million disability-adjusted life years (DALYs) worldwide in 2004, according to the first analysis of its kind. Women and children were more likely than men to be exposed to secondhand smoke and to suffer morbidity and mortality from this exposure. The findings were published online November 25 in The Lancet.

Researchers led by Dr. Mattias Öberg of the Karolinska Institute in Stockholm, Sweden, used data for their analysis from the Global Youth Tobacco Survey and 19 additional surveys published between 1980 and 2007. They used models to estimate the burden of disease from secondhand smoke exposure for countries without direct survey data. The research team used the comparative risk assessment method, which is based on the proportion of people exposed to a pollutant and the known relative risk of disease related to that exposure.

The authors estimate that, worldwide, 40 percent of children, 35 percent of female nonsmokers, and 33 percent of male nonsmokers are exposed to secondhand smoke. In 2004, secondhand smoke caused 379,000 deaths from ischemic heart disease, 165,000 deaths from lower-respiratory infections, 36,900 deaths from asthma, and 21,400 deaths from lung cancer. Forty-seven percent of these deaths occurred among women and 28 percent occurred among children.

“Two-thirds of these deaths [among children] occur in Africa and south Asia…. The combination of infectious diseases and tobacco seems to be [deadly] for children in these regions,” wrote the authors. “Prompt attention is needed to dispel the myth that developing countries can wait to deal with tobacco-related disease until they have dealt with infectious diseases.

“The provisions of the WHO Framework Convention on Tobacco Control should be enforced immediately to create complete smoke-free environments in all indoor workplaces, public places, and on public transport,” the authors recommended.

“This landmark study documents the global magnitude of the problem of secondhand smoke exposure and its devastating consequences,” said Dr. Cathy Backinger, chief of NCI’s Tobacco Control Research Branch. “These findings should encourage a sense of urgency for ensuring that nonsmokers are protected from secondhand smoke exposure—a completely preventable health hazard.”

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