Kids who eat out eat more in a day

Kids and calories: Take a kid to a restaurant or serve him take-out food and chances are that child will end up eating more calories that day than on a day with only home-cooked meals, a new study confirms. The findings may not be surprising, but parents may find some of the details eye-opening. For example, kids ages 2 to 11 got more excess calories from sit-down restaurants than fast food places. And meals from either type of establishment cut the day's milk consumption while raising soda intake.(Reuters)

Smoking at the hospital: Quitting smoking is hard. Latest evidence: Nearly one in five hospitalized smokers kept smoking during their stay at one Massachusetts hospital, despite getting onsite smoking cessation counseling and despite the fact that smoking was only allowed in outdoor shelters. (HealthDay)

Meningitis update: Thirty people have now died in a fungal meningitis outbreak linked to tainted steroid injections, the U.S. Centers for Disease Control and Prevention said Monday. The case count is at 419 and includes ten joint infections. (Associated Press)

Today's talker: Guys, here's a quick test to take in the shower: Look down. If you can't see your own genitals, it may be time to admit you have a weight problem. That's the concept behind a new campaign in England called The Big Check. Researchers there say about one third of guys in a recent study failed the test. It might be a good way to get U.S. men to focus on their weight, too, one doctor tells NBC News: "While it may be a crude judging tool, it's certainly not a bad eyeball test."

Even fit aging people won't escape heart problems

CHICAGO -- Here's a reality check for health-conscious baby boomers: Even among those in good shape, at least 1 in 3 will eventually develop heart problems or have a stroke.

The upside is that that will happen about seven years later than for their less healthy peers.
The findings come in an analysis of five major studies involving nearly 50,000 adults aged 45 and older who were followed for up to 50 years.

The best odds are in the healthiest adults – those who don't smoke, have diabetes, high blood pressure or high cholesterol. Still, among 55-year-olds in that category, about a third can expect to develop heart or other cardiovascular problems as they age.

Dr. Vincent Bufalino, a Chicago area cardiologist and spokesman for the American Heart Association, said the study is "a wake-up call that this disease is very prevalent in the United States and even if you're doing a good job, you're not immune."

The researchers estimated risks older people face for developing these ailments in their lifetime, or by their 80s or 90s. They also estimated how many years they'll live free of heart disease and related problems, depending on the most common risk factors.

Pooling follow-up data from the five analyzed studies, the researchers found that the healthiest 45-year-olds lived up to 14 years longer free of heart ailments than those with at least two risk factors. The healthiest 55-year-olds lived up to about seven years longer than their less healthy peers.

The study was published online Monday in the Journal of the American Medical Association and released in connection with the American Heart Association conference meeting in Los Angeles. The National Heart, Lung and Blood Institute paid for the research.

The authors estimated higher lifetime risks than previous studies, but their analysis involved a broader range of ailments, including heart failure and strokes.

While prevalence of heart disease and related deaths have declined nationwide in recent years, more than 82 million Americans – roughly one-third – have some form of cardiovascular disease, according to the American Heart Association.

Most people in the analysis had high blood pressure or at least one of the other risk factors.

The results shouldn't be discouraging, said lead author Dr. John Wilkins, an assistant professor of preventive medicine and cardiology at Northwestern University's medical school in Chicago. Maintaining an optimal lifestyle, by eating sensibly and staying active, is still the best way to live a long, healthy life, he said.

Heart disease remains the nation's leading cause of death, and the study reinforces the idea that "cardiovascular disease is part of the aging process," said Cleveland Clinic heart specialist Dr. David Frid, who was not involved in the research. Bodies wear out, "and ultimately, just exposure to living is going to cause people to develop some of these underlying problems," Frid said.

Redheads' genes add to melanoma risk

Redheads have long been known to be at a higher risk for melanoma, the deadliest type of skin cancer, because their fair and sometimes freckly skin provides less natural protection against UV radiation from the sun - or so doctors had thought.

New research shows that genetic factors of the skin pigment that's predominantly found in redheads may be what's to blame for the increased melanoma risk.

Melanoma is the leading cause of death from skin disease, with more than 76,000 cases expected to be diagnosed in 2012 in addition to nearly 9,200 deaths caused by the cancer.

Fisher's study is published in the Oct 31 issue of Nature.

Human skin contains different types of the pigment melanin, a natural substance that gives the skin its color.

There's a dark brown/black form called eumelanin which is predominantly found in those with dark hair or skin, and also a lighter red/blond pigment called pheomelanin, which is the predominant pigment in individuals with red hair, freckles and fair skin.

According to the researchers, skin type alone can't explain the rise in melanoma risk among redheads because this increased risk has also seen been seen in skin areas not directly exposed to sun. They tested that theory on two strains of mice that were genetically identical, except one group was bred to have a gene that would give mice more dark-colored pigment and the other group was bred to possess the pigment-producing gene that causes red hair and fair skin in humans.

The researchers used a method to activate a melanoma-causing gene that typically requires UV radiation to create melanoma cancer cells in a lab setting. However, they were surprised to find half of the red mice had developed melanoma within months without UV exposure, compared with only a few dark mice.

Next the researchers wanted to see whether the red pigment itself may cause cancer, testing it on a group of "albino redheads," which were fair-skinned mice who had their pigment production genetically disabled. They found that by completely removing the so-called "red-pigment pathway," the mice were completely protected against melanoma.

The researchers say melanoma risk for redheads might instead be caused by "oxidative damage," from molecules called reactive oxygen species (ROS) which damage cells' DNA. The researchers found higher levels of DNA damage caused by ROS in the skin of red mice, but not in the albino redhead mice.

"Right now we're excited to have a new clue to help better understand this mystery behind melanoma, which we have always hoped could be a preventable disease," Fisher said. "The risk for people with this skin type has not changed, but now we know that blocking UV radiation - which continues to be essential - may not be enough."

Since sunscreen may not offer full protection, the researchers recommend that redheads be especially vigilant looking for changes in their skin, and to never hesitate to get checked out by a dermatologist.

"The big danger here is that somebody will say, 'Oh, well if I can't do anything about it, then I can go to a suntanning salon and go tanning on the beach and just call it fate.' That's not the case," Dr. Meenhard Herlyn, director of the Wistar Institute Melanoma Research Center in Philadelphia, told The Los Angeles Times. "One still has to be very conscientious about not getting a sunburn and getting the damage."

Eugene Healy, a clinical dermatologist at the University of Southampton, U.K., however downplayed the findings to Nature News. He said while the mechanism reported in the study is interesting, it is probably a less common melanoma trigger than UV radiation. "You almost never see melanoma, for example, on the buttocks," said Healy.

Lung cancer rates in women 'to soar' by 2040

"Lung cancer rates soaring for women after tobacco manufacturers target them by saying smoking helps you stay slim," the Daily Mail claims.

Elsewhere, BBC News reports that over the next 30 years the number of women with lung cancer is set to rise significantly faster than the number of men with lung cancer.

Where does the news come from?

The news stories come from a study of projected trends in cancer rates and cancer survival overall that was originally published online in the British Journal of Cancer in August 2012.

The study, conducted by researchers at King’s College London and University College London, was funded by the charity Macmillan Cancer Support. It used existing information about trends in cancer rates and cancer survival in England to build a UK computer model to predict how these numbers will change over the next three decades.

The research looked at breast, lung, bowel and prostate cancer, and all cancers combined. Overall, the study authors predicted that the total number of cancer survivors in the UK could increase from 2.1 million in 2010 to 5.3 million by 2040.

The study has been the subject of previous publicity by Macmillan and has twice appeared in the news, with warnings about a 'breast cancer timebomb' and a 'tripling in cancer cases in the over 65s'.

The lung cancer figures were highlighted this week in a press release from Macmillan, which says that lung cancer is still a killer but that research into the disease is not as well funded as other types of cancer.

Macmillan highlights the fact that lung cancer receives a quarter of the research funding compared to breast cancer, even though lung cancer kills more than 13,000 women a year in England and Wales.

What does the report say about lung cancer?

The study predicts that lung cancer cases will double from 65,000 in 2010 to 137,000 in 2040.

The number of women with lung cancer in the UK is set to quadruple within the next 30 years, from around 26,000 in 2010 to about 95,000 in 2040. In contrast, lung cancer rates in men are predicted to increase by 8%, from 39,000 in 2010 to 42,000 in 2040.

The model used in the research is based on the assumption that current trends in lung cancer will remain the same, but this may not be the case.

However, this study does reinforce the importance of long-term planning in order to anticipate the health needs of an increasing ageing population.

What could explain the projected trends?

As is the case with cancer generally, the projected increase in lung cancer rates is largely due to an ageing population, say the researchers.

Lung cancer is more common in older people, probably because they have been smoking for longer than younger smokers and the longer you smoke, the higher your risk of lung cancer.

The difference in projected rates among men and women is thought to reflect the difference in smoking rates between the sexes in the past. It is well-established that smoking is the main cause of lung cancer and that current lung cancer rates generally reflect smoking rates among the population 20 to 30 years earlier. The report does not cover this point in detail, but it does point out that male lung cancer incidence rates in England have declined, mainly because the number of men who smoke has reduced since the 1970s.

Other research has found that lung cancer incidence rates in men peaked in the 1970s and have decreased by more than 45% since then, reflecting the decline in smoking rates among men after World War II.

However, from the mid 1970s to the late 1980s lung cancer rates among women increased by around 45%, probably reflecting a later 'peak' in smoking among women, although they are now increasing more slowly.

What evidence is there that tobacco companies marketed cigarettes to women as a slimming aid?

A report from the World Health Organisation (WHO) that looked at the history of tobacco marketing to women globally found that tobacco companies linked cigarettes to fashion and slimness as early as 1927.

The report quotes an advertisement from the time that encouraged women to 'Light a Lucky [Lucky Strike] and you'll never miss sweets that make you fat'.

In the 1960s and 70s women became a major target for the tobacco industry. The launch of Virginia Slims by Philip Morris in 1968 deliberately targeted women by associating smoking with glamour, thinness and independence. The WHO report points out that the tobacco industry has used promotional campaigns, sponsorship and the internet to market cigarettes to women. A recent article in the journal Tobacco Control highlighted the emergence of pro-smoking smartphone apps.

In the UK tobacco advertising is illegal but this is not the case globally, particularly in countries in the developing world.

The WHO report highlights the fact that tobacco companies are now aggressively targeting Asian women, quoting the cynical words of a Bensons & Hedges marketing strategy that says that men 'represent the cigarette world of yesterday, rather than the market of tomorrow'.

The possible influence – or not – of cigarette marketing upon smoking rates in women is not addressed by the British Journal of Cancer study.

However, the Daily Mail should be congratulated for raising awareness about the issue of tobacco marketing aimed at women, especially those in the developing world.

Why has Macmillan focused on lung cancer?

Lung cancer is the leading cause of death from cancer in the UK. Ciarán Devane, Macmillan's chief executive, says: "For most cancers in the UK, we are looking at how we can cope with a population of long-term survivors with health complications. With lung cancer we are a long way from even being able to consider these issues."

He argues that lung cancer survival needs to improve, with more funding for research into the disease and its treatment.

Stigma slows fight against lung cancer

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Lung cancer and stigma: The USA's biggest cancer killer gets a disproportionately small share of public attention and research dollars. One big reason is that lung cancer is seen largely as a self-inflicted "smoker's disease," says a new report from FairWarning, a nonprofit online publication. The fact that many people with the disease die too quickly to become advocates for their own cause also plays a role. With many dying within a few months, "there's not much time to fit a walkathon in," one expert says.

Lice treatment: A new prescription lotion for head lice called ivermectin left 75% of kids pest-free two weeks after one treatment in a new study, meaning it may work better than older remedies. But it wasn't tested directly against other treatments and lacks long-term safety data. So some experts say it's still a last resort. (Health Day)

Mumps outbreak: A mumps outbreak that hit Orthodox Jewish communities in New York and New Jersey in 2009-2010 spread largely through religious schools that used intense face-to-face teaching -- enabling the virus to spread even among people who had been vaccinated, researchers say. (Reuters)

Today's talker: Will your child share Halloween candy today? Or share toys at playtime? It may depend on whether anyone is watching, a new study suggests. The study found five-year-old children were more generous with a stash of stickers when they could see and be seen by the child on the receiving end and when their offerings were put in see-through boxes, rather than opaque containers. It seems children are like adults, a researcher says: "The more others know about their actions, the more likely they are to act generously." (NBC News)

How Diwali sweets can be good for you

During Diwali, the last thing you’d want is a dietician telling you what not to eat!

Nutrition experts are often subject to comments like “Oh! She is watching me” or “How many calories is this? Can I eat it?” And, the table laden with sweet dishes laboriously prepared for the festival is the last place where anyone needs to hear talk of calorie counts!!

So, this year, let’s talk about the goodness of Diwali sweets and how you can eat them.

There are some main ingredients that go into making several Diwali sweets, which excluding the sugar and maida, are healthy like nuts, saffron, besan, milk and desi ghee.

Did I say ghee? Ghee has been used in every household in India for ages, in Vedic rituals and Ayurvedic preparations. Not the kind one buys off the shelf from supermarkets, but yes, fresh ghee made from cow’s milk, unadulterated, without additives and made at home. Ghee has both saturated fat and cholesterol, but also antioxidants. Therefore, in limited amounts it is healthy. As with all saturated fats, ghee should be kept to less than 10% of the total fat intake. This means about 6gm of ghee in a day for someone on 2000 kcal diet. Due to its intense flavour, a small amount is enough to get the taste and feel of texture.


Nuts and seeds are also part of the Indian sweet making process and we have made an art out of that too! Potential calories, protein, good fats, minerals, antioxidants, fibre are all packed into these small delicious things, literally in a nutshell!

Saffron, the quintessentially exotic flavouring ingredient that we inherited from Persia around 500 BC, is one of the most expensive spices in the world. It adds natural colour to our kesari (sheera) and shrikand, and is also effective as a remedy for sleeplessness, indigestion, flatulence, asthma, whooping cough, menstrual cramps, vomiting and gets mentioned in ancient Sanskrit texts as anti-venom.

Besan – what would we do without this multi-purpose ingredient that we turn into curries, savouries and sweets! The protein content and fibre in besan controls blood sugar and cholesterol. Bengal gram has one of the lowest glycaemic index among all foods.

Milk-based sweets are the best loved – healthy for all, wholesome and part of our cuisine and culture.

Those who have a health reason to avoid fats and sugars but still want to enjoy the luxury of eating during Diwali should opt for sweets made with artificial sugar, use skimmed milk and reduce amount of pure ghee.
Eat singular portions and not handful or plateful of sweets and savouries

Space out the sweet eating at times after a main meal, should you eat at all and not as a snack between meals
Avoid sweets that are commercial or have maida in them. Go for sweets that have healthier ingredients like the ones mentioned above.

And above all, remember the saying that “Even ambrosia (or nectar of life) in large quantities is poisonous”. Everything in the right proportion is good and healthy!

Health of Kidney Disease Patients: Diet and Blood Pressure

Studies investigate aspects of nutrition and blood pressure control in chronic kidney disease patients

Highlights
• Adding fruits and vegetables to the diet improves kidney disease patients’ health.
• Poor nutrition plays a role in the link between poverty and kidney disease.
• Among kidney disease patients, Blacks are more likely to have uncontrolled blood pressure than Whites

Newswise — Three studies presented during the American Society of Nephrology’s Annual Kidney Week provide new information on diet and blood pressure in kidney disease patients.

Nimrit Goraya, MD (Texas A&M College of Medicine) and her colleagues investigated whether adding fruits and vegetables to the diet can improve the health of patients with chronic kidney disease (CKD). Alkaline therapy is used to treat CKD patients with severe metabolic acidosis (when there is too much acid in the body). Dr. Goraya and her team looked to see if adding fruits and vegetables—which are highly alkaline—can benefit CKD patients with less severe metabolic acidosis. For the study, 108 patients were randomized to receive added fruits and vegetables, an oral alkaline medication, or nothing. After three years, consuming either fruits and vegetables or the oral medication reduced a marker of metabolic acidosis and preserved kidney function to similar extents.

“Our findings suggest that an apple a day keeps the nephrologist away,” said Dr. Goraya.

Another team led by Deidra Crews, MD (Johns Hopkins University School of Medicine) wondered whether poor dietary habits might help explain why poverty is linked with CKD. In their study of 2,058 individuals, fiber, calcium, magnesium, and potassium intake were lower, and cholesterol higher, among those in poverty. CKD was present among 5.6% of people in poverty, and 3.8% of those not in poverty.

“An unhealthy diet is strongly associated with kidney disease among poor individuals. Dietary interventions tailored to meet the needs of this population may help to reduce disparities in kidney disease," said Dr. Crews.

A third study looked at blood pressure control among ethnically diverse CKD patients. Racial and ethnic minorities are more likely to develop kidney failure than whites, perhaps due in part to poorer blood pressure control. Delphine Tuot, MD (University of California, San Francisco) and her colleagues examined blood pressure using 18,864 clinical blood pressure measurements from 6618 adults (23% white, 34% black, 18% Hispanic, 21% Asian) with CKD who received primary care in a health network serving San Francisco's uninsured and publicly insured residents. Blood pressure was nearly 20% higher than national estimates with smaller, though still significant, disparities between black and white patients (with blacks having higher rates of uncontrolled blood pressure.)

“Public health care delivery systems like the Community Health Network of San Francisco disproportionately care for vulnerable patients, including those of racial/ethnic minorities, and can serve as front-line agents to reduce disparities of care through implementation of innovative programs,” said Dr. Tuot.
Study co-authors for “Fruits and Vegetables or Oral NaHCO3 Preserve GFR and Reduce Urine Angiotensinogen, a Marker of Kidney Angiotensin II Activity, in Stage 3 CKD” (abstract 2214) include Chanhee Jo, PhD, Jan Simoni, PhD, and Donald E. Wesson, MD.

Study co-authors for “Dietary Habits, Poverty, and Chronic Kidney Disease in an Urban Population” (abstract 842) include Marie Kuczmarski, PhD, Edgar R. Miller, MD, PhD, Alan B. Zonderman, PhD, Michele Kim Evans, MD, and Neil R. Powe, MD.

Study co-authors for “Blood Pressure Control among CKD Patients in a Public Health System” (abstract 2303) include Charles E. McCulloch, PhD, Chi-yuan Hsu, MD, Tanushree Banerjee, PhD, Margaret Handley, PhD, Dean Schillinger,and Neil R. Powe, MD.

ASN Kidney Week 2012, the largest nephrology meeting of its kind, will provide a forum for 13,000 professionals to discuss the latest findings in renal research and engage in educational sessions related to advances in the care of patients with kidney and related disorders. Kidney Week 2012 will take place October 30 – November 4 at the San Diego Convention Center.

The content of these studies does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.