Lots of Hidden Sugars Out There!
Posted by on April 23, 2010 - 3:25pm

Recently, the American Heart Association came out with guidelines for sugar intake.    Women should limit their sugar intake to 25 grams per day and men to 37.5 grams/day.  This seems reasonable until you look at some of the "hidden" or "added" sugars and realize you can reach your daily limit at breakfast!  For example, bagels can have up to 10 grams of sugar and if you add certain peanut butters, that's another 3 grams.    Granolas are notoriously high---that's why they taste so good.  Some granolas  have 30 grams of sugar/cup.     Plain yogurt has about 12 grams of sugar but added flavoring can bring you up to  35 grams.

Even if you keep under your daily limit through breakfast, your day could be a challenge.   Ketchup has 4 grams of added sugar/tablespoon.....and we're more worried about the fat in french fries!!!

But, wait a minute!   There are some caveats that make this news less alarming.   Naturally occurring sugars in fruits and dairy products are less concerning because those foods add needed nutrients to the body.  However, food  labels do not distinguish between natural and added sugars, making label checking even more complicated.   These new guidelines only apply to "added" sugars which add nothing to your nutrient needs.  When reading food labels check the ingredients...they can help you identify 'added' sugars (e.g., lots of foods list additives like corn syrup!)   So, you can still eat lots of fruits and veggies with their naturally occurring sugar! ---just don't dip them in onion dip or ketchup.

OSA Success in San Diego
Posted by on April 20, 2010 - 8:37pm

The Oncofertility Saturday Academy (OSA) program model, developed at Northwestern University's Institute for Women's Health Research, is designed to prepare and inspire high school girls to become the next generation of women leaders in science and medicine.  The program model has been replicated and implemented at multiple sites across the nation, including San Diego and Portland.  The success of the OSA program model is dependent on the active involvement of high school science teachers.  The role of the science teacher in OSA is to support and guide the high school girls as they learn advance science and health concepts and apply their knowledge to hands-on laboratory and clinical activities.  OSA learning modules are delivered directly by scientists and clinicians working in the fields of reproductive sciences, cancer biology and oncofertility.

Ericka Senegar-Mitchell, PhD, is the lead high school science teacher with OSA San Diego.

The OSA network is proud to announce the recent awards presented to Ericka Senegar-Mitchell.  Ericka is the lead high school science teacher involved with the OSA San Diego site.  This school year Ericka has receive two prestigious awards, including the Teacher of the Year from Serra High where she is teaches biology and biotechnology.  On top of that, last month she won the California State Teacher of the Year.  Ericka will continue to be recognized, as she is being nominated for the San Diego County Teacher of the Year and the California State Teacher of the Year. OSA San Diego is offered to high school students through a partnership between the University of California at San Diego and BeWise (Better Education for Women in Science and Engineering).

Ericka is a dedicated science educator who is changing the lives of her students inside and outside of the classroom.  Ericka’s depth of knowledge and experience working directly with high school students on a daily basis has strengthen the OSA network.  As the OSA network continues to expand nationally, and one day globally, we will strive to identify high school teachers who are as passionate and innovative as Ericka Senegar-Mitchell.

Will Better Health Insurance Coverage Reduce Obesity?
Posted by on April 14, 2010 - 9:31am

The Agency for Healthcare Research and Quality issued its 2009 National Healthcare Quality Report and National Healthcare Disparities Report on April 13.  The 2009 reports include a new section on lifestyle modifications because preventing or reducing obesity is a crucial national goal. The reports found:

  • One-third of obese adults have NEVER received advice from their doctor about exercise.
  • Obese adults who are black, Hispanic, poor or have less than a high school education are LESS likely to receive diet advice from their doctors.
  • Most overweight children and one-third of obese adults report that they have NOT been told by their doctor that they are overweight.
  • Most American children have NEVER received counseling from their health care provider about exercise, and almost half have NEVER received counseling about healthy eating.

The reports indicate that the lack of health insurance slows improvement in health care quality and reduction of disparities.  For many services, not having insurance is the single strongest predictor of poor quality care, exceeding the effects of race,  ethnicity, income or education.

So, the BIG question....will expanding health insurance to more people change some of these statistics????   Let's hope so.

Stand-Up for Women's Health
Posted by on April 13, 2010 - 4:36pm

In celebration of National Women's Health Week, the Institute for Women's Health Research at Northwestern University is hosting an evening of laughter, good cheer and networking.    It will be held on May 12, 2010 at 6 pm at the Chicago Center for the Performing Arts and featuring well know Chicago comedienne Patti Vasquez.   To view an invitation, click here.

When cheaper and easier isn’t better
Posted by on March 31, 2010 - 1:39pm

“By not studying sex differences, researchers could be missing out on potential new treatments for both men and women”,  says Rhonda Voskuhl.  Finally, Science Magazine is speaking our language!  I felt like I was reviewing talking points from one of my own presentations when reading the NewsFocus article titled, “Of Mice and Women: The Bias in Animal Models”  http://www.sciencemag.org/cgi/content/full/327/5973/1571.  Unfortunately, it is no surprise to us at the Institute for Women’s Health Research that basic scientists are not designing studies that include both male and female animal models.  One reason our Institute was established was to break down this barrier by providing funding to the NU research community to design studies with sex and gender in mind, in addition to stressing the importance of analyzing results based on sex.

You might be asking, it’s 2010, why would researchers only study one sex?  Cost and ease.  It’s cheaper to house less animals in a research facility, the NIH may not provide enough funds to conduct studies in both sexes, researchers don’t want to deal with the estrous cycle (which in rodents is every 4 days) and the data is “cleaner” because the hormones responsible for the estrous cycle DUE effect biology.

A few important points this article highlights:

  • The vast majority of journal articles published in 2009 reported results of research in male animals only.
  • Many articles fail to report the sex of subjects at all.
  • In studies that include both males and females, 2/3 fail to analyze the results based on sex.

The results from animal studies in basic science laboratories are what help determine the design of clinical research studies in humans.  If we don’t include female animals from the start, then male-only data is what gets transferred into the clinical arena.  Then, there is the issue of recruiting equal numbers of men and women into clinical trials.  If trials are predominantly made up of male participants then once again, the results that get published and become the foundation for drug and medical device development are applicable in men, but may not (and often times do not) apply to women.

What suggestions are provided in the article?

  • If the NIH set guidelines to channel limited resources to areas that show clear sex differences such as cardiovascular disease or pain, researchers would have to include both sexes in order to get money.
  • Mining NIH data from large patient trials could help identify sex differences in people that would be worth studying in animals.
  • The Office for Research on Women’s Health could provide targeted funding opportunities.
  • Pressure from academic journals to adopt a set of guidelines for studies using animals, including the expectation to provide rationale for studying only one sex and the implications for not studying the other, could force authors go back to the drawing board.

We hope that articles similar to this will continue to be published in high impact journals and finally “get scientists thinking about the issue of sex bias” and its implications for how we practice medicine today.

We've Come a Long Way, Baby.....NOT!
Posted by on March 30, 2010 - 1:13pm

Yesterday, I started writing a blog explaining why sex and gender research was important.  I got bogged down in historical background, mandates, and the usual boring facts and justifications.   While doing this, my desktop binged and one of several daily notices from federal agencies popped up on my computer.   Since I was having writer's block, I decided to check these new emails....and BINGO....there is was!     A news release from the National Institute on Drug Abuse (NIDA), one the Institutes at the  National Institutes of Health (NIH).   The title of the press release was "Common Mechanisms of Drug Abuse and Obesity".   It summarized a study funded by NIDA  that will appear in a prestigious journal in May.   The study found that some of the same brain mechanisms that fuel drug addictions in humans accompany the emergence of compulsive eating behaviors and the development of obesity in animals.  The investigators found that when they gave rats access to varying levels of high-fat foods, they found unrestricted availability alone can trigger addiction-like responses in the brain, leading to compulsive eating behaviors  and the onset of obesity.  According to one of the study authors, "The results of this study could provide insight into a mechanism for obesity".

This was all very interesting but what popped out at me was a sentence in the fifth paragraph:   Researchers conducted this study in three groups of male rats over a 40-day period. What about female rats!  Do they behave the same?    Will this study translate to a human study before these findings are tested in female rats?   What we do know is that obesity rates are higher in women.   How many women reading this have experienced a change of eating urges during their periods? Do hormones play a role here?

Why am I upset?    It took decades of advocacy from women to create mandates at the NIH, the major funder of health research, that requires the inclusion of women in federally funded research studies.  Recently, there has been a growing debate on whether or not researchers are adequately meeting this mandate.   While there are more women's cancer studies (that may be inflating the % of women who are in studies), diseases like heart disease still do not have equal representations of men and women in clinical trials.    This mandate does not trickle down to animal studies, allowing researchers to continue to do basic science work in male animals that are, after all, "easier" (Translated:   they don't have complicated hormone cycles).   Too many studies have been conducted in males (animal and human) over the last few decades and the results applied to the whole population--sometimes with detrimental effects.  The Adverse Reporting system at the FDA has many more reports of adverse effects of drugs in women than in men......has anyone asked if these drugs have been adequately tested in women???

So, what needs to be done?    The inclusionary mandates for research studies requiring both sexes, need to include animal studies.   After all, isn't it much cheaper to do preliminary studies in animal models BEFORE they are applied to humans?  Researchers also need to report findings by sex....even if the answer is "they are the same".   Is anyone else asking these questions? Have women really come 'a long way'?

Vaginal Births after Cesarian Deemed Reasonable
Posted by on March 26, 2010 - 3:23pm

This blog is a follow-up to our March 3 blog where we announced the NIH Consensus Development conference scheduled on March 8-10 to discuss the safety issues surrounding vaginal birth after previous Cesarian section.    AHRQ has released a report from that meeting that found that vaginal birth after cesarean section is a safe and reasonable choice for a majority of women.  Each year, more than 1 million cesarean surgeries are performed, and in 2007 nearly one in three births was cesarean in the U.S.  A steady increase in repeat cesarean births over the past decade has been attributed, in part, to studies that suggested there may be significant harms associated with vaginal birth after cesarean section.  Investigators found evidence which showed that while rare, maternal mortality was significantly higher for elective repeat cesarean versus trial of labor.  Additionally, risks for uterine rupture and perinatal death remain rare, but elevated for trial of labor.  Other important outcomes such as hemorrhage/transfusion, adhesions, surgical injury, and wound complications remain uncertain due to lack of consistent definition and reporting.  Moreover, investigators also found increasing evidence that women with multiple cesarean deliveries were at significant risk of life threatening conditions.  Led by Jeanne-Marie Guise, M.D., M.P.H., researchers note that evidence-based research regarding factors, such as medical liability, economics and hospital staffing that may influence patient, provider and hospital-related decisions between both types of delivery is not sufficient.  The report, Vaginal Birth After Cesarean: New Insights, was conducted by AHRQ’s Oregon Health and Science University Evidence-based Practice Center and was prepared for the NIH Consensus Development Conference held on March 8-10. Click here to review the entire draft report.

Unintentional Drug Poisoning on the Rise
Posted by on March 19, 2010 - 9:53am

In recognition of Poison Prevention Week (March 14-20), the Center for Disease Control (CDC) is highlighting the growing issue of unintentional drug poisoning in the United States.   More than 26,000 deaths from unintentional drug poisoning occurred in the U.S. in 2006.  Opioid pain medications (e.g., oxycodones and methadone) were involved in more than half of these deaths.  In recent years, this cause of death has more than doubled between 1999 and 2006.   In 2006, 17,740 drug overdose deaths occurred among males and 8,660 among females.  Male rates exceed females rates in every age group.    However, male rates have doubled and female rates have nearly tripled since 1999.  In response to this growing problem the CDC has developed an issue brief titled Unintentional Drug Poisoning in the United States.

29 High School Girls Prepared and Inspired to Pursue Career Goals
Posted by on March 18, 2010 - 12:58pm

Ashley J. and Aryana M. practice taking each other's blood pressure.

On Thursday, March 11, 2010 the Institute for Women's Health Research in collaboration with Young Women's Leadership Charter School graduated 29 high school girls from the Oncofertility Saturday Academy.  Over 100 guests - parents, siblings, aunts, uncles and faculty - came to the graduation to celebrate the high school girls new science and health knowledge and experiences gained over the past two months.  Each high school girl came prepared with a graduation reflection speech to share how the program impacted them in personal, social, and academic ways.  The Chicago Tribune interviewed three high school girls on the night of graduation and published an article titled, "Program Opens Girls' Eyes to Science."

Aryana M. reads her OSA graduation speech with confidence.

Aryana M. walked proudly up to the podium, wearing her white laboratory coat, and with confidence read her speech.  "Women are capable of doing anything if they put their minds to it. Determination is the key to what can be achieved and how it can be achieved. As I have participated in Oncofertility Saturday Academy for two years, I have grown into a very determined young lady who has the goal of pursuing a career in bioengineering. Every Saturday we encounter new experiences with lab work, clinical simulations, healthy lunches, and hard core work out sessions. With each experiment and session we had many learning experiences for future life situations."

To date a total of 65 high school girls have participated in the Oncofertility Saturday Academy.  100% of students who participate in OSA go on to college.  Currently, of the 32 who are in college, 28 are actively pursuing science majors.  The Oncofertility Saturday Academy is one of four academies offered by the Women's Health Science Program for High School Girls and Beyond, a program created by the Institute for Women's Health Research.

Bisphosphonates in the News
Posted by on March 11, 2010 - 10:23am

The FDA recently issued the following communication report:     Patients and healthcare professionals may have questions about oral bisphosphonate medications and atypical subtrochanteric femur fractures – fractures in the bone just below the hip joint. Oral bisphosphonates are commonly prescribed to prevent or treat osteoporosis in postmenopausal women. Common brand names of medications in this class include Fosamax, Actonel, Boniva, and Reclast.  Recent news reports have raised the question about whether there is an increased risk of this type of fracture in patients with osteoporosis using these medications. At this point, the data that FDA has reviewed have not shown a clear connection between bisphosphonate use and a risk of atypical subtrochanteric femur fractures. FDA is working closely with outside experts, including members of the recently convened American Society of Bone and Mineral Research Subtrochanteric Femoral Fracture Task Force, to gather additional information that may provide more insight into this issue.

Based on published case reports of atypical subtrochanteric femur fractures occurring in women with osteoporosis using bisphosphonates, FDA, in June 2008, requested information from all bisphosphonate drug manufacturers regarding this potential safety signal. All available case reports and clinical trial data were requested. FDA's review of these data did not show an increase in this risk in women using these medications.
In addition, FDA reviewed a December 2008 article in the Journal of Bone and Mineral Research by Abrahamsen et al1, that analyzed data from two large observational studies in patients with osteoporosis. The authors concluded that atypical subtrochanteric femur fractures had many similar features in common with classical osteoporotic hip fractures, including patient age, gender, and trauma mechanism. The data showed that patients taking bisphosphonates and those not taking bisphosphonates had similar numbers of atypical subtrochanteric femur fractures relative to classical osteoporotic hip fractures.

The FDA will continue to review new information as it becomes available and will update the public once the agency's review is complete.

Healthcare professionals should continue to follow the recommendations in the drug label when prescribing oral bisphosphonates. Patients should not stop taking their medication unless told to do so by their healthcare professional. Patients should talk to their healthcare professional about any concerns they have with these medications.

Additional Information for Patients

If you currently take an oral bisphosphonate you should:

* Not stop taking your medication unless told to do so by your healthcare professional.
* Talk to your healthcare professional if you develop new hip or thigh pain or have any concerns with your medications.
* Report any side effects with your bisphosphonate medication to FDA's MedWatch program.

Additional Information for Healthcare Professionals

FDA recommends that healthcare professionals should:

* Be aware of the possible risk of atypical subtrochanteric femur fractures in patients taking oral bisphosphonates.
* Continue to follow the recommendations in the drug label when prescribing oral bisphosphonates.
* Discuss with patients the known benefits and potential risks with using oral bisphosphonates.
* Report any adverse events with the use of oral bisphosphonates to FDA's MedWatch program.

References:

1. Abrahamsen B., Eiken P., Eastell R. Subtrochanteric and Diaphyseal Femur Fractures in Patients Treated With Alendronate: A Register-Based National Cohort Study. J Bone Miner Res. 2009 Jun;24(6):1095-102.

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