Saturday, March 29, 2014

TV linked to poor snacking habits, cardiovascular risk in middle schoolers

Middle school kids who park themselves in front of the TV for two hours or more each day are more likely to consume junk food and have risk factors for cardiovascular disease, even compared to those who spend an equal amount of time on the computer or playing video games, according to research. Read More

Friday, March 21, 2014

Measles Outbreak Alert: Information and Photos from the CDC

Whatcom County, located in northwestern Washington State, has just had its first case of measles since 1995. In addition, there is a measles outbreak occurring presently in British Columbia, Canada.

Given that vaccination rates are not 100%, the return of measles has triggered an aggressive public health alert in order to contain any new outbreaks that may occur.

In the pre-vaccine era, measles regularly affected a large percentage of the population in the U.S., primarily children. It killed about 1 to 3 people out of a thousand infected, and caused permanent brain damage in about 1 to 2 people out of a thousand people infected.

Measles information from the CDC

  • Measles is a highly contagious rash illness that is transmitted from person to person by direct contact with respiratory droplets or airborne spread. 
  • About 90% of susceptible exposed individuals will get infected.
  • The average incubation period for measles is 10 to 14 days from exposure to rash (range: 7–21 days).
  • Persons with measles are infectious 4 days before through 4 days after rash onset.
  • Commonly reported complications are pneumonia (6%), otitis media (7%), and diarrhea (8%)
  • In low to middle income countries where malnutrition is common, measles is often more severe and the case-fatality ratio can be as high as 25%
  • Measles can be severe and prolonged among immunocompromised persons, particularly those who have leukemias, lymphomas, or HIV infection. Among these persons, measles can occur without the typical rash and a patient can shed measles virus for several weeks after the acute illness. However, a fatal measles case without rash also has been reported in an apparently immunocompetent person.
  • A persistent measles virus infection can result in subacute sclerosing panencephalitis (SSPE), a rare and usually fatal neurologic degenerative disease.Signs and symptoms of SSPE appear an average of 7 years after measles infection, but might appear decades later.
  • Widespread use of measles vaccine has led to the virtual disappearance of SSPE in the United States, but imported cases still occur.

CDC - Measles: Photos

From the Whatcom County department of health:

Precautions To Take When Scheduling Visits for Measles Assessment
  • Instruct telephone and triage staff to assess for rash illnesses prior to the patient coming to the facility
  • Patient MUST wear a mask before they enter the facility. (surgical masks are sufficient). Examine patients in their vehicle if necessary.
  • Rapidly isolate persons with suspected measles in a private room and call the Health Department. In hospital settings, patients with suspected measles should be placed immediately in a negative-pressure isolation room if one is available and, if possible, should not be sent to other parts of the facility.
  • Only staff who have documented immunity to measles should be present in the room with the patient.
  • Airborne precautions must be implemented during the exam. (N-95 masks are preferable, when available, for staff to use while in the room).
  • The exam room should not be occupied for at least two hours after the patient leaves.
More information:

Wednesday, March 19, 2014

Links explored between physical activity, learning

The association between physical activity and learning has been evidenced in many studies. The results have suggested that being physically active produces positive effects on many cognitive functions, such as memory, attention, information processing and problem solving. Unfortunately, these previous studies have used fairly small datasets and have yielded fairly little information on the actual underlying mechanisms. Read More

Smokers lack motivation

While the results of smoking may be expected to decrease fitness, new research has found that smokers are less physically active, lack motivation and are more likely to suffer symptoms of anxiety and depression. Read More

Monday, March 17, 2014

Older adults: Build muscle and you'll live longer

The more muscle mass older Americans have, the less likely they are to die prematurely, new research shows. The findings add to the growing evidence that overall body composition -- and not the widely used body mass index, or BMI -- is a better predictor of all-cause mortality. "In other words, the greater your muscle mass, the lower your risk of death," said the study's co-author. "Thus, rather than worrying about weight or body mass index, we should be trying to maximize and maintain muscle mass." Read More

Exercise in older patients improves health

This 12-week fitness program increased motivation and encouraged people to continue with regular physical activity even after they completed the program.  Read More

Even a 5% weight loss can prevent and treat obstructive sleep apnea

This is no surprise - even a small amount of weight loss helps prevent and treat obstructive sleep apnea. Read More

Thursday, March 13, 2014

Abdominal fat accumulation prevented by unsaturated fat

New research shows that saturated fat builds more fat and less muscle than polyunsaturated fat. This is the first study on humans to show that the fat composition of food not only influences cholesterol levels in the blood and the risk of cardiovascular disease but also determines where the fat will be stored in the body. Gaining weight on excess calories from polyunsaturated fat appears to cause more gain in muscle mass, and less body fat than overeating a similar amount of saturated fat. Read More

Large waist linked to poor health, even among those in healthy body mass index ranges

Having a big belly has consequences beyond trouble squeezing into your pants. It's detrimental to your health, even if you have a healthy body mass index (BMI), a new international collaborative study has found. Men and women with large waist circumferences were more likely to die younger, and were more likely to die from illnesses such as heart disease, respiratory problems, and cancer after accounting for body mass index, smoking, alcohol use and physical activity. Read More

Wednesday, March 12, 2014

The Obese Get Less Than One Minute of Vigorous Activity per Day

This research found that in the U.S. most people spend more than 15 hours per day sleeping and sitting. Obese people were found to spend less than one minute per day in vigorous activity. Read More

The Effect of Moderate Exercise on Strok Risk in Women

This study found that moderate exercise, e.g. brisk walking, may decrease a woman's stroke risk by a full 20 percent.  Read More

Monday, March 10, 2014

Self-rated physical fitness in midlife an indicator of dementia risk

How would you rate your own physical fitness? Is it good, satisfactory or maybe even poor? Surprisingly, your answer may reveal your future risk of getting dementia. A recent collaborative study from Finland, involving the follow-up of 3,559 adults for 30 years, has found that a simple question about self-rated physical fitness in midlife may reveal individuals who are at an increased risk of developing dementia. Those who reported poor self-rated physical fitness in midlife, at the mean age of 50 years, were four times more likely to get dementia during the next three decades compared to those with good self-rated physical fitness. Read More

Lower IQ and poorer cardiovascular fitness in teen years increase risk of early-onset dementia

Men who at the age of 18 years have poorer cardiovascular fitness and/or a lower IQ more often suffer from dementia before the age of 60. This is shown in a recent study encompassing more than one million Swedish men. Read More

Attitude during pregnancy affects weight gain, research shows

Overweight or obese women with the mentality that they are 'eating for two' are more likely to experience excessive weight gain while pregnant, according to research. Researchers interviewed 29 post-partum women who were overweight or obese before pregnancy. Participants in the study were asked about their diet habits, experience with morning sickness and physical activity habits during pregnancy. Those who gained the appropriate amount of weight stuck to a meal plan and chose foods carefully. These women also had little or no increase in the amount of calories they consumed during pregnancy and exercised as much or more than they had before the pregnancy. Women who gained excessive weight described the experience as "eating for two." They had fewer goals and exercised less than usual during their pregnancy. They also made less healthy food choices and ate more as a result of cravings. Read More

Sunday, March 9, 2014

Exercise, surgically removing belly fat improves cognition in obese, diabetic mice

Cognitive decline that often accompanies obesity and diabetes can be reversed with regular exercise or surgical removal of belly fat, scientists report. A drug already used to treat rheumatoid arthritis also helps obese/diabetic adult mice regain their ability to learn and comprehend, while transplanting belly fat to a normal mouse reduces those abilities. Studies in humans and animals indicate that obesity and diabetes -- which often go hand in hand -- essentially triple the risk of mild cognitive impairment as well as Alzheimer's.Read More

Dangers of ... sitting? Regardless of exercise, too much sedentary time is linked to major disability after 60

If you're 60 and older, every additional hour a day you spend sitting is linked to doubling the risk of being disabled -- regardless of how much exercise you get, reports a new study. The study is the first to show sedentary behavior is its own risk factor for disability, separate from lack of moderate vigorous physical activity. In fact, sedentary behavior is almost as strong a risk factor for disability as lack of exercise. Read More

Thursday, March 6, 2014

A repeated measures experiment of green exercise to improve self-esteem in UK school children.

A repeated measures experiment of green exercise to improve self-esteem in UK school children.
PLoS One. 2013;8(7):e69176
Authors: Reed K, Wood C, Barton J, Pretty JN, Cohen D, Sandercock GR

Exercising in natural, green environments creates greater improvements in adult's self-esteem than exercise undertaken in urban or indoor settings. No comparable data are available for children. The aim of this study was to determine whether so called 'green exercise' affected changes in self-esteem; enjoyment and perceived exertion in children differently to urban exercise. We assessed cardiorespiratory fitness (20 m shuttle-run) and self-reported physical activity (PAQ-A) in 11 and 12 year olds (n = 75). Each pupil completed two 1.5 mile timed runs, one in an urban and another in a rural environment. Trials were completed one week apart during scheduled physical education lessons allocated using a repeated measures design. Self-esteem was measured before and after each trial, ratings of perceived exertion (RPE) and enjoyment were assessed after completing each trial. We found a significant main effect (F (1,74), = 12.2, p<0.001), for the increase in self-esteem following exercise but there was no condition by exercise interaction (F (1,74), = 0.13, p = 0.72). There were no significant differences in perceived exertion or enjoyment between conditions. There was a negative correlation (r = -0.26, p = 0.04) between habitual physical activity and RPE during the control condition, which was not evident in the green exercise condition (r = -0.07, p = 0.55). Contrary to previous studies in adults, green exercise did not produce significantly greater increases in self-esteem than the urban exercise condition. Green exercise was enjoyed more equally by children with differing levels of habitual physical activity and has the potential to engage less active children in exercise.

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Tuesday, March 4, 2014

Can exercise-related improvements in immunity influence cancer prevention and prognosis in the elderly?

Can exercise-related improvements in immunity influence cancer prevention and prognosis in the elderly?
Maturitas. 2013 Sep;76(1):51-6
Authors: Bigley AB, Spielmann G, LaVoy EC, Simpson RJ

Cancer incidence increases with advancing age. Over 60% of new cancers and 70% of cancer deaths occur in individuals aged 65 years or older. One factor that may contribute to this is immunosenescence - a canopy term that is used to describe age-related declines in the normal functioning of the immune system. There are multiple age-related deficits in both the innate and adaptive systems that may play a role in the increased incidence of cancer. These include decreased NK-cell function, impaired antigen uptake and presentation by monocytes and dendritic cells, an increase in 'inflammaging', a decline in the number of naïve T-cells able to respond to evolving tumor cells, and an increase in functionally exhausted senescent cells. There is consensus that habitual physical exercise can offer protection against certain types of cancer; however the evidence linking immunological mechanisms, exercise, and reduced cancer risk remain tentative. Multiple studies published over the last two decades suggest that exercise can mitigate the deleterious effects of age on immune function, thus increasing anti-cancer immunity. The potential ameliorative effect of exercise on these mechanisms include evidence that physical activity is able to stimulate greater NK-cell activity, enhance antigen-presentation, reduce inflammation, and prevent senescent cell accumulation in the elderly. Here we discuss the role played by the immune system in preventing and controlling cancer and how aging may retard these anti-cancer mechanisms. We also propose a pathway by which exercise-induced alterations in immunosenescence may decrease the incidence of cancer and help improve prognosis in cancer patients.

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Associations between vitamin D receptor polymorphisms and breast cancer risk.

Associations between vitamin D receptor polymorphisms and breast cancer risk.
Tumour Biol. 2013 Dec;34(6):3823-30
Authors: Wang J, He Q, Shao YG, Ji M, Bao W

Many epidemiologic studies have investigated the association between vitamin D receptor (VDR) gene polymorphisms and breast cancer risk, but the results were inconsistent. We performed a meta-analysis of 31 studies on VDR polymorphisms, including FokI, BsmI, TaqI, and ApaI, and breast cancer risk published before May 2013. For FokI, the allele of f was found to be associated with increased risk of breast cancer compared with F (OR, 1.19; 95% CI, 1.03-1.36). Patients with ff genotype were at significantly higher risk of breast cancer compared with those with FF genotype (OR, 1.95; 95% CI, 1.66-2.29). In subgroup analysis by race, Fok1 polymorphism was significantly associated with breast cancer risk for Caucasian population (f vs. F: OR, 1.35; 95% CI, 1.14-1.59; ff vs. FF: OR, 2.18; 95% CI, 1.86-2.54; ff vs. FF + Ff: OR, 1.16; 95% CI, 1.03-1.30). For ApaI, aa genotype was associated with increased breast cancer risk in Asian population based on four studies (aa vs. Aa + AA, OR, 1.49; 95% CI, 1.12-1.98). No significant association was found between breast cancer risk and ApaI and TaqI polymorphism in different models and populations. Our updated meta-analysis showed that Fok1 polymorphism is associated with breast cancer risk both in general population and in Caucasian population. ApaI polymorphism might be associated with breast cancer risk in Asian population. Large well-designed epidemiological studies are necessary to clarify the risk identified in the current meta-analysis.

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Sunday, March 2, 2014

Predictors of short-term outcome to exercise and manual therapy for people with hip osteoarthritis.

Predictors of short-term outcome to exercise and manual therapy for people with hip osteoarthritis.
Phys Ther. 2014 Jan;94(1):31-9
Authors: French HP, Galvin R, Cusack T, McCarthy GM

BACKGROUND: Physical therapy for hip osteoarthritis (OA) has shown short-term effects but limited long-term benefit. There has been limited research, with inconsistent results, in identifying prognostic factors associated with a positive response to physical therapy.
OBJECTIVES: The purpose of this study was to identify potential predictors of response to physical therapy (exercise therapy [ET] with or without adjunctive manual therapy [MT]) for hip OA based on baseline patient-specific and clinical characteristics.
DESIGN: A prognostic study was conducted.
METHODS: Secondary analysis of data from a multicenter randomized controlled trial (RCT) (N=131) that evaluated the effectiveness of ET and ET+MT for hip OA was undertaken. Treatment response was defined using OMERACT/OARSI responder criteria. Ten baseline measures were used as predictor variables. Regression analyses were undertaken to identify predictors of outcome. Discriminative ability (sensitivity, specificity, and likelihood ratios) of significant variables was calculated.
RESULTS: The RCT results showed no significant difference in most outcomes between ET and ET+MT at 9 and 18 weeks posttreatment. Forty-six patients were classified as responders at 9 weeks, and 36 patients were classified as responders at 18 weeks. Four baseline variables were predictive of a positive outcome at 9 weeks: male sex, pain with activity (<6/10), Western Ontario and McMaster Universities Osteoarthritis Index physical function subscale score (<34/68), and psychological health (Hospital Anxiety and Depression Scale score <9/42). No predictor variables were identified at the 18-week follow-up. Prognostic accuracy was fair for all 4 variables (sensitivity=0.5-0.58, specificity=0.57-0.72, likelihood ratios=1.25-1.77), indicating fair discriminative ability at predicting treatment response.
LIMITATIONS: The short-term follow-up limits the interpretation of results, and the low number of identified responders may have resulted in possible overfitting of the predictor model.
CONCLUSIONS: The authors were unable to identify baseline variables in patients with hip OA that indicate those most likely to respond to treatment due to low discriminative ability. Further validation studies are needed to definitively define the best predictors of response to physical therapy in people with hip OA.

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Exercise and Smell

Association of exercise with lower long-term risk of olfactory impairment in older adults.
JAMA Otolaryngol Head Neck Surg. 2013 Oct;139(10):1061-6
Authors: Schubert CR, Cruickshanks KJ, Nondahl DM, Klein BE, Klein R, Fischer ME

IMPORTANCE: The prevalence of olfactory impairment is high in older adults, and this decline in olfactory ability may pose health and safety risks, affect nutrition, and decrease quality of life. It is important to identify modifiable risk factors to reduce the burden of olfactory impairment in aging populations.
OBJECTIVE: To determine if exercise is associated with the 10-year cumulative incidence of olfactory impairment.
DESIGN, SETTING, AND PARTICIPANTS: Observational longitudinal population-based Epidemiology of Hearing Loss Study. Participants without olfactory impairment (n = 1611) were ages 53 to 97 years at baseline and were followed for up to 10 years (1998-2010).
MAIN OUTCOMES AND MEASURES: Olfaction was measured with the San Diego Odor Identification Test at 3 examinations (1998-2000, 2003-2005, and 2009-2010) of the Epidemiology of Hearing Loss Study. The main outcome was the incidence of olfactory impairment 5 (2003-2005) or 10 (2009-2010) years later and the association of baseline exercise with the long-term risk of developing olfactory impairment.
RESULTS: The 10-year cumulative incidence of olfactory impairment was 27.6% (95% CI, 25.3%-29.9%) and rates varied by age and sex; those who were older (hazard ratio [HR], 1.88 [95% CI, 1.74-2.03], for every 5 years) or male (HR, 1.27 [95% CI, 1.00-1.61]) had an increased risk of olfactory impairment. Participants who reported exercising at least once a week long enough to work up a sweat had a decreased risk of olfactory impairment (age- and sex-adjusted HR, 0.76 [95% CI, 0.60-0.97]). Increasing frequency of exercise was associated with decreasing risk of developing olfactory impairment (P value for trend = .02).
CONCLUSIONS AND RELEVANCE: Regular exercise was associated with lower 10-year cumulative incidence of olfactory impairment. Older adults who exercise may be able to retain olfactory function with age.

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