healthy New Year: Realistic goals you can reach in 1999
December 31, 1998
Instead of the usual New Year's resolutions such as "fit into
a size 6 dress" or "work out every day," consider taking a few smaller
steps toward better health in 1999. CBS News Health Correspondent Dr. Emily Senay suggests
New Year's goals that can lead you toward a healthier lifestyle.
For many people, the holiday season is one of the most stressful times of year. The danger
of high stress is that it can weaken the immune system, making the body vulnerable to
colds or more serious illnesses.
To help alleviate stress, you can:
Set realistic goals. Make a list of things you want to accomplish, and keep it to the most
important goals. If the list overwhelms you, scratch off the least important ones.
Get exercise when you feel tense. Even just walking around is helpful.
As many stress experts say, "breathe." Take eight seconds to inhale, hold for
eight seconds, and exhale slowly for eight seconds. Repeat until you feel the stress slip
Avoid caffeine. Studies have shown that caffeine can increase stress hormones. Limit your
intake to one cup of coffee or other caffeinated beverage in the morning.
Get More Folic Acid
While you can't change your genes, you can reduce your risk for certain diseases by
watching what you eat. Folic acid, also called folate or Vitamin B9, can be found
naturally in many foods.
The federal government now requires that all breads be fortified with folic acid because
it reduces the chance of babies in the womb developing neural tube defects such as spina
bifida. Pregnant women can avoid this by eating foods rich in folic acid.
For women of childbearing years, eating fortified foods may not be enough. They should
consult their doctor about taking a 400 mg supplement daily. Research shows that folic
acid may help reduce the risk of heart disease in older people, too.
You can get more folic acid from the following foods:
Vegetables such as spinach, broccoli, turnip greens, and asparagus
Green peas, black beans, navy beans, soybeans, black-eyed peas, nuts, and sunflower seeds
Chicken or beef liver
Breads and many cereals and pastas are fortified with folic acid
Get More Sleep
Not getting enough sleep can lead to poor health, says Dr. Senay. Like stress, it weakens
the immune system, which can lead to colds and other illnesses.
Sleep deprivation can also interfere with a person's ability to think clearly, and can
If you find yourself falling asleep at inappropriate times, or you find it easy to take a
nap, you may be one of the millions of Americans who are not getting enough sleep.
Dr. Senay recommends taking the following steps to help remedy the problem:
Try to go to bed and get up at the same time every day.
Adopt a routine that helps you wind down before you go to bed.
Use your bedroom for only two things -- sleep and sex.
Avoid caffeine, and don't use alcohol to help you fall asleep. Alcohol may seem to help at
first, but it disturbs your overall sleep patterns.
Get More Calcium
Calcium is a key nutrient everyone needs for better health. It helps keep your bones
strong, and it may guard against cancer and help your heart as well.
Why is calcium so vital for your health? We know it helps prevent osteoporosis, or brittle
bone disease, in both women and men. Recent research has found that calcium can also help
control or prevent the symptoms of pre-menstrual syndrome. Another study found that men
who ate a diet high in calcium had a reduced risk of colon cancer.
Ideally, you should get all the calcium you need from your food, but consult your doctor
about taking a supplement, especially if your are over 50 or post-menopausal.
You can find calcium in:
milk and dairy products
vegetables such as broccoli and spinach
tofu, black beans, kidney beans, and almonds
canned sardines or salmon with bones
some brands of orange juice are fortified with calcium
B prevalent in US despite vaccine
December 31, 1998
Although the hepatitis B vaccine has been available since 1981,
hepatitis B infection remained as prevalent in the US in the early 1990s as it was in the
early 1980s, according to a report in the January issue of the American Journal of Public
Health, a journal of the American Public Health Association.
Dr. Geraldine M. McQuillan and colleagues with the Centers for Disease Control and
Prevention (CDC) explain this finding by the fact that widespread vaccination programs
were not launched until the early to mid-1990s.
For the last two decades, an estimated 200,000 to 300,000 people in the US have contracted
the hepatitis B virus annually. The virus is associated with inflammation of the liver and
an increased risk of liver cancer. It can be transmitted via blood transfusions, sex, and
The CDC researchers analyzed data from the National Health and Nutrition Examination
Survey II (NHANES II), which was conducted between 1976 and 1980, and NHANES III conducted
between 1988 and 1994. NHANES II included more than 28,000 people in the US, while NHANES
III included an estimated 40,000. The survey design includes the results of blood tests
for hepatitis B.
The overall prevalence of hepatitis B infection did not change significantly between
NHANES II, when it was 5.5%, and NHANES III, when the prevalence was 4.9%, the researchers
In both surveys, the prevalence of hepatitis B was low until age 12, when it increased
significantly. In addition, prevalence was higher than average among those who had
multiple sex partners, those who began having sex at an early age, cocaine users, and men
who had sex with men, McQuillan and colleagues report.
"In both surveys and in all racial/ethnic groups, the prevalence of hepatitis B virus
infection did not begin to increase until puberty, suggesting that sexual transmission is
the primary mode of spread in the United States," they explain.
In light of this finding, it is "not surprising" that the prevalence of
hepatitis B infection did not decline between the early 1980s and the early 1990s, they
add. Although a Hepatitis B vaccine was first licensed in the US in 1981, federal
hepatitis B vaccination programs for infants did not begin until late 1992, and programs
for adolescents did not start until 1995.
Vaccination of healthcare workers and others with work-related risks of infection began in
1981, but did not become widespread until 1991, according to the CDC researchers.
"Data from NHANES demonstrate that children have a low but appreciable risk of
hepatitis B virus infection that increases significantly at adolescence, presumably with
the onset of sexual activity and other high-risk behaviors; this supports the need to
routinely vaccinate," McQuillan and co-authors conclude. "Future NHANES should
provide a means to evaluate the age-specific effect of hepatitis B immunization on
SOURCE: American Journal of Public Health 1999;89:14-18.
to aspirin, but benefits outweight the risks
December 23, 1998
One of the most interesting realizations of the past decade has
been that aspirin yup, plain old aspirin, is truly a miracle drug. But even miracle drugs
have a downside.
It's been known for many years that aspirin "thins out" the blood, reducing its
ability to clot. That explains its wondrous capacity for reducing the risk for ischemic
strokes, in which arterial blockage deprives the brain of blood flow and oxygen. But
aspirin's great effect on the blood has a drawback: a recently published study found that
it increases the risk for a brain hemorrhage leading to another kind of stroke. Are its
pluses and minuses a draw? Not really, say the experts - and Johns Hopkins professor of
medicine Dr. Michael Klag agrees.
"We now know that increased risk is about an 80 percent increased incidence of
hemorrhagic stroke," says Klag. "However, the risk of a man, for example, who's
fifty having a heart attack or an ischemic stroke is so much greater, that the benefits of
aspirin outweigh the risks in groups like we have here in the U.S."
In other words, says Klag, if you're taking aspirin to reduce the risk for heart trouble,
there's no reason to stop.
survival in men with sepsis
December 31, 1998
Following severe injury-induced blood loss, male sex hormones
appear to depress immune function, leaving men at increased risk of life-threatening
infection, or "sepsis." But giving men the hormone dehydroepiandrosterone (DHEA)
after injury may restore immune function, lowering their risk of sepsis and increasing
their odds of survival, researchers report in the December issue of the Archives of
"Our study indicates that administration of DHEA after hemorrhagic shock restores the
depressed immune functions and improves survival from subsequent sepsis," according
to Dr. Martin K. Angele and colleagues at Brown University School of Medicine in
Providence, Rhode Island.
"Since short-term therapy with the steroid hormone DHEA has no adverse effects,
administration of this inexpensive agent in male patients should be considered a novel and
useful adjunct for the treatment of immune dysfunction encountered in trauma
patients," the investigators write.
Several previous studies had found that, in men who were resuscitated after suffering
traumatic injury and hemorrhagic shock, certain immune responses remained depressed for as
long as 10 days. These men also had "an increased susceptibility to and mortality due
to subsequent sepsis," the authors explain.
Results of earlier animal studies have suggested that male sex hormones play a role in
suppressing immune function after trauma-induced blood loss. In one study, administration
of flutamide -- a substance that blocks the effects of testosterone -- restored depressed
immune responses and improved survival rates in animals who developed sepsis after severe
To determine what effect DHEA -- the most abundant steroid in the bloodstream -- might
have on risk of sepsis and survival after trauma and hemorrhagic shock, Angele and
colleagues performed a series of experiments on anesthetized male mice.
The researchers induced hemorrhagic shock in the animals, followed by sepsis.
Mice treated with DHEA for 3 days after the procedure had the strongest immune function
and highest survival rates, followed by mice given a single dose of DHEA, Angele and
colleagues report. Mice that did not receive DHEA had the highest rates of sepsis, and the
lowest survival rates.
"The finding that DHEA markedly improves the depressed immune functions and survival
of animals subjected to subsequent sepsis suggests that short-term treatment with DHEA
after trauma-hemorrhage is a safe and novel approach for preventing immunodepression and
for decreasing the mortality rate due to subsequent sepsis," the authors conclude.
SOURCE: Archives of Surgery 1998;133:1281-1288.
homocysteine levels dangerous for elderly
December 30, 1998
High levels of the amino acid homocysteine, put elderly men at
increased risk for heart attack and stroke, according to the results of a study of nearly
Studies have previously linked high homocysteine levels to vascular disease in the young
and middle-aged. This report, published in Arteriosclerosis, Thrombosis and Vascular
Biology, the journal of the American Heart Association, is the first to focus on the
The study authors, led by Dr. Coen D.A. Stehouwer, of the National Institute of Public
Health and the Environment in Bilthoven, the Netherlands, measured homocysteine levels of
study subjects on two occasions, 10 years apart.
At the start of the study, the participants ranged in age from 64 to 84. Those with higher
homocysteine levels were more likely to have experienced heart attack or stroke.
During the 10-year follow-up, high levels of the amino acid were ``associated with a
modest, borderline significant increase in the risk of dying of coronary heart disease
and, in (non-hypertensive) subjects, with a large increase in the risk of fatal
cerebrovascular disease and a nonsignificant increase in the risk of first-ever stroke,''
the authors write.
Study participants with high blood pressure had a higher likelihood of experiencing
strokes, but high homocysteine levels did not seem to increase their risk.
High homocysteine levels are extremely common in the elderly, according the study authors.
This amino acid is thought to contribute both to the thickening of arteries, and the
impairment of their ability to dilate.
Homocysteine levels depend on genetics and nutrition, decreasing with greater intake of
folic acid and other B vitamins, and increasing after meat and dairy consumption.
``Because high homocysteine levels can be reduced by simple treatment with folic acid and
vitamin B-6 even in the absence of deficiencies of these vitamins,'' the study authors
comment, ''studies are now needed of the effect of treatment with these vitamins and with
vitamin B-12 on cardiovascular disease not only among the middle-aged, but also in the
SOURCE: Arteriosclerosis, Thrombosis, and Vascular
can be first-line treatment for high cholesterol
December 23, 1998
Adding oat bran or another type of fiber known as psyllium to your
diet may help lower levels of harmful cholesterol, a new study from Mexico suggests.
But don't think that eating a few bran muffins for breakfast will neutralize the effect of
a burger and fries at lunch. Besides eating cookies fortified with fiber, all of the men
in the study reduced the amount of fat in their diets.
In the study, 66 men ages 20 to 45 consumed cookies containing one of three types of
fiber: oat bran, psyllium or wheat bran, according to the study in the December issue of
the Journal of the American College of Nutrition.
At the end of eight weeks, those who ate the oat bran cookies reduced their LDL, or
"bad," cholesterol levels by an average of 26 percent, the study showed. And
those in the psyllium group experienced a nearly 23-percent drop in levels of the fatty
substances, which are believed to increase the risk of heart disease.
In contrast, a control group of men who ate cookies made with wheat bran _ which is not
believed to reduce cholesterol levels _ experienced a drop of slightly more than 8
percent, reported a team of researchers led by Maria Luz Fernandez, a nutritionist at the
University of Connecticut in Storrs.
The study is good news for people who are trying to lower their cholesterol levels,
according to a California expert.
For many people, oat bran and psyllium "may well be the first line of defense before
we go to cholesterol-lowering drugs," commented Jo Ann Hattner, a clinical
nutritionist at Stanford University Medical Center in Palo Alto. Although some people do
need medication to reduce cholesterol, oat bran and psyllium are "definitely worth a
The men in the study consumed 2.6 grams of oat bran a day, which is easy to obtain from
food, Hattner said. She pointed out that one cup of a toasted oat cereal contains about
one gram of oat bran. The Stanford nutritionist said that psyllium is available at health
food stores or in some over-the-counter laxatives.
But oat bran is not a "magic bullet," Hattner cautioned. "It's important to
remember that they did change their saturated fat intake."
In fact, some research suggests that oat bran is not as effective at lowering cholesterol
in people who eat large amounts of fat, according to Fernandez.
Besides supplying the men with fiber cookies, the researchers counseled them on ways to
cut down on how much fat they consumed. They encouraged the men to eat less meat,
including organs, bacon and sausage. Over the course of the study, the men did eat fewer
fatty foods, based on questionnaires they filled out each week.
The researchers found no significant differences when they compared the eating habits of
the three groups of men.
Journal of the American College of Nutrition
of Santa's health
December 17, 1998
Santa Claus may be able to travel around the world in a single
night, but when it comes to his health, he's no Superman, according to the latest medical
research. That bowl full of jelly, a diet rich in fatty cookies and a lack of regular
exercise all put Santa at risk for a number of health problems.
But adopting a healthier lifestyle won't be as difficult for Santa as it may sound,
according to Dr. Joseph A. Lieberman, the chairman of the department of family and
community medicine at the Christiana Care Health System in Wilmington, Del., and a
clinical professor of family medicine at Jefferson Medical College in Philadelphia. And
Santa's jolly nature already gives him a head start on improving his health, he said.
While Lieberman has never examined Santa himself, he has taken a peek at the Jolly One's
Here is Medical Tribune News Service's annual review of the state of Santa's health.
--Santa needs to trim a few pounds. This may seem obvious, but the importance of weight
loss continues to be a subject of debate in the medical community.
Early this year, the editors of a prestigious medical journal, The New England Journal of
Medicine, published an editorial stating that Americans are too obsessed with trying to
But in the spring, the American Heart Association placed obesity in the same risk-factor
class as smoking, high cholesterol, high blood pressure and a sedentary lifestyle.
And the National Heart, Lung, and Blood Institute in Bethesda, Md., announced new obesity
guidelines, which declared that 55 percent of American adults need to lose weight.
Faced with these mixed messages, Santa should stay calm, according to Lieberman. The
Delaware expert recommended that St. Nick "use an exercise program and dietary
discretion to keep his weight under control," but that he should "not be so
obsessed that it affects his jolly disposition."
--Year-round exercise can boost Santa's health. Besides helping him trim down his bowl
full of jelly, research published this year has highlighted a number of exercise's health
A Finnish study of about 8,000 sets of twins found that those who walked or jogged for
just 30 minutes six or more times a month had a 43 percent lower risk of death than
Exercise may also help ward off Alzheimer's disease, according to a study conducted at
Case Western Reserve University in Cleveland. In a group of 370 people, those who did not
have Alzheimer's had engaged in significantly more exercise during their lifetimes than
people with the disease.
Santa may not have much room for error, since "he's already making his list and
checking it twice," Lieberman commented. "We want to insure that he forestalls
the development of Alzheimer's," he said.
Lieberman recommended that Santa exercise for 20 minutes at least three times a week.
--Lay off the cookies. "An occasional indulgence in cookies is OK, but kiddies may
also want to put out other things," Lieberman advised.
Veggies may be good substitutes, since they are rich in nutrients and fiber. And a study
from Italy found that some vegetables, carrots in particular, may help prevent certain
types of cancer. Vegetables and fruits rich in potassium, such as bananas, may also lower
the risk of stroke, according to a Harvard study of more than 44,000 men.
--Have an occasional glass of wine. While earlier research has shown that a daily drink or
two -- especially red wine -- may help protect the heart, the habit may also help preserve
Santa's sight, according to a study of more than 3,000 adults that found that moderate
wine drinkers were less likely to develop age-related macular degeneration, the leading
cause of blindness among the elderly.
Lieberman agreed, but he warned against drinking while behind the reins. "It would be
wonderful to have wine, but not while he's driving the sled," he advised.
--That jolly disposition counts for something. University of Kentucky researchers have
discovered that optimism may improve more than a person's mood: it may also boost the
immune system. "We should learn a lesson from Santa that a pleasant disposition may
prolong life," Lieberman said.
Santa's outlook may be getting rosier. In a nationwide poll of 2,727 people ages 25 to 74,
older men and women were more likely than younger folks to say that they had felt happy,
cheerful or satisfied in the last month.
Change May Help Prevent Cancer, Doctors Say
Many cancers common in the developed world can be attributed to
environmental factors, which means that they may be largely preventable, British doctors
Diet is one of the most important lifestyle factors, and up to 80 percent of the bowel,
breast and prostate cancer cases may be preventable by dietary change, researchers from
Dunn Clinical Nutrition Center in Cambridge, wrote in the British Medical Journal.
The authors highlighted red and processed meats and alcohol as the highest risk foods and
cited a diet rich in vegetables and fruit as the most protective against cancer.
The researchers also found that there is no evidence that vitamin supplements help to
Other environmental factors known to affect susceptibility to cancer include physical
activity, reproductive and sexual behavior, infection with hepatitis B or C viruses and
exposure to sunlight and chemicals, the scientists said. Enditem
linked to lower breast cancer risk
December 28, 1998
A diet rich in sources of the antioxidant beta-carotene may help
lower a woman's risk of breast cancer after menopause, according to a study in the January
issue of the journal Epidemiology.
Yet unclear, however, is how early in life a woman should begin to pay careful attention
to beta-carotene-rich foods such as spinach, broccoli, and cantaloupe.
``These findings indicate that although diets high in beta-carotene may be associated with
lower breast cancer risk, there does not seem to be evidence of a critical time period
during which such diets are more relevant,'' according to the researchers, Aisha Jumaan of
the Centers for Disease Control and Prevention in Atlanta, Georgia, and multicenter
colleagues in the US and Sweden.
The authors write that a diet high in beta-carotene at least 1.5 years before the date of
diagnosis of breast cancer in subjects, or the date of screening mammography in the
controls, was associated with reduced breast cancer risk. The relationship was stronger in
women whose diets had been rich in sources of beta-carotene for at least 20 years before
diagnosis or screening.
However, the authors note that recall bias may cause small but significant differences in
the eating habits of the subjects to remain undetected. ``Such misclassification might
impair our ability to identify a critical time period when dietary beta-carotene may exert
a protective effect on breast cancer risk,'' they said.
The case-control study included 273 women with breast cancer and 371 women without breast
cancer, who ranged from 40 to 70 years of age. Researchers conducted telephone interviews
with subjects about diet at various periods throughout their lives. The subjects were
selected from of a group of women screened for breast cancer in Sweden.
Beta-carotene intake was divided by quartiles at various reported years before the
reference date, defined as 6 months before the date of diagnosis of breast cancer in the
cases, or 6 months before the date of screening mammography in the controls. Researchers
examined beta-carotene intake at 5-year increments before the reference date in order to
gauge the effect of exposure to beta-carotene on breast cancer risk.
SOURCE: Epidemiology 1999;10:49-53.
cardiac death risk
December 18, 1998
Estrogen replacement therapy (ERT) appears to reduce the risk for
fatal heart attack or stroke in postmenopausal women, according to researchers.
``The most important finding in the present study was the striking decrease in
cardiovascular mortality - especially in sudden cardiac death -- among current users of
ERT compared with former and never users,'' write Dr. Leif Sourander and colleagues at the
University of Turku in Turku, Finland. Their findings are published in the December 19th
issue of The Lancet.
In their study, the Finnish team followed the 1987-1995 medical histories of 7,944
postmenopausal women. Nearly 1,000 of the women started on ERT during the period of the
study, while another 757 were former users of estrogen supplements.
The authors found that current users of estrogen replacement therapies had a 79% reduced
risk of cardiovascular death, compared with never-users.
But the cardiovascular benefits of ERT may depend on continuous use. ``The survival
(rates) for former and never users of ERT are very similar,'' the researchers explain,
''indicating that protection against cardiovascular death can only be achieved with
However, estrogen replacement therapy did not seem to influence whether or not women
actually got cardiovascular disease in the first place, according to the authors. ``The
effect of ERT is more likely to be protection from the progression of an already existing
disease,'' they say, ''...than (from) primary prevention of the disease.''
Contradicting the results of some previous studies, Sourander's team report ``no overall
association... between breast cancer risk and the use of ERT.'' However, they note that
current ERT users had five times the risk for endometrial carcinomas (cancers of the
lining of the uterus) compared with never-users.
SOURCE: The Lancet 1998;352:1965-1969.
commissions study of andro
December 14, 1998
Major league baseball commissioned two Harvard researchers to
conduct a study on the effects of androstenedione, the muscle-building supplement used by
Mark McGwire and other players.
Joel Finkelstein and Benjamin Leder told a gathering of team doctors and trainers at
baseball's winter meetings Saturday there is not enough evidence yet to determine its
overall effect on athletes.
"They said it looks likes andro does raise testosterone levels," said Dr. Jack
Failla, the team doctor for the Pittsburgh Pirates. "But they stressed that it is a
small study right now and they need more time to definitively answer that question."
Baseball began its inquiry into andro shortly after The Associated Press reported in
August that McGwire had been using it for more than a year.
Sometime before the start of the 1999 season, baseball expects to announce its decision on
whether to ban andro, discourage its use, or allow it to be taken unchecked. The
International Olympic Committee, NFL and NCAA already prohibit the supplement.
Officials are concerned about the supplement's potential performance-enhancing ability and
that players are risking the long-term effects associated with prolonged steroid use,
including a higher incidence of heart and liver disease.
"We still need to determine what andro does, whether it has the same effect as
testosterone and anabolic steroids," Failla said. "We know that anabolic
steroids, which are banned, do enhance performance. We are not certain with andro and more
importantly we don't know the side effects."
Champion Nutrition Inc., the company which supplies McGwire with andro, estimates at least
100 ballplayers in the majors and minors use andro. The company wouldn't release names,
but Colorado's Dante Bichette and Tampa Bay's Jose Canseco acknowledge using andro.
The two researchers, along with Dr. Robert B. Millman, medical adviser to the
commissioner's office, and Dr. Joel Solomon, the union's medical adviser, made
presentations Saturday. Millman stresses that research is still in the early stage.
"This was just an educational meeting," Millman said. "There was no policy
discussed. We need to wait until we can get more evidence."
Eugene Orza, who is spearheading the union's investigation, said he thought it was a
positive session but that basebll shouldn't rush into a decision.
"I think the scientists demonstrated just how little we know about the basic
pharmacology of most nutritional supplements, but particularly androstenedione," he
said. "It also became clear by the end of the meeting this is not a time for anyone
to be forming firm judgments in such an uncertain area."
Before finalizing its policy, baseball will consult with the IOC and the medical directors
of all the major professional sports. But the only way to effectively ban andro would be
to implement a random drug-testing program similar to the NFL.
There is no chance that the union, which heard a presentation on andro at its board
meeting in Las Vegas earlier in the week, would ever agree to such testing.
"I can't imagine the circumstances under which we would do that," Orza said.
Still, Orza thought the study would be worthwhile.