Does the Vaccine Matter?

Does the Vaccine Matter? - The Atlantic (November 2009):

"[S]ome flu experts are challenging the medical orthodoxy and arguing that for those most in need of protection, flu shots and antiviral drugs may provide little to none....

When Lisa Jackson, a physician and senior investigator with the Group Health Research Center, in Seattle, began wondering aloud to colleagues if maybe something was amiss with the estimate of 50 percent mortality reduction for people who get flu vaccine, the response she got sounded more like doctrine than science. “People told me, ‘No good can come of [asking] this,’” she says. “‘Potentially a lot of bad could happen’ for me professionally by raising any criticism that might dissuade people from getting vaccinated, because of course, ‘We know that vaccine works.’ This was the prevailing wisdom.”

The history of flu vaccination suggests other reasons to doubt claims that it dramatically reduces mortality. In 2004, for example, vaccine production fell behind, causing a 40 percent drop in immunization rates. Yet mortality did not rise. In addition, vaccine “mismatches” occurred in 1968 and 1997: in both years, the vaccine that had been produced in the summer protected against one set of viruses, but come winter, a different set was circulating. In effect, nobody was vaccinated. Yet death rates from all causes, including flu and the various illnesses it can exacerbate, did not budge...

The most vocal—and undoubtedly most vexing—critic of the gospel of flu vaccine is the Cochrane Collaboration’s Jefferson, who’s also an epidemiologist trained at the famed London School of Tropical Hygiene, and who, in Lisa Jackson’s view, makes other skeptics seem “moderate by comparison.” Among his fellow flu researchers, Jefferson’s outspokenness has made him something of a pariah....

“Tom Jefferson has taken a lot of heat just for saying, ‘Here’s the evidence: it’s not very good,’” says Majumdar. “The reaction has been so dogmatic and even hysterical that you’d think he was advocating stealing babies.” Yet while other flu researchers may not like what Jefferson has to say, they cannot ignore the fact that he knows the flu-vaccine literature better than anyone else on the planet. He leads an international team of researchers who have combed through hundreds of flu-vaccine studies. The vast majority of the studies were deeply flawed, says Jefferson. “Rubbish is not a scientific term, but I think it’s the term that applies.” Only four studies were properly designed to pin down the effectiveness of flu vaccine, he says, and two of those showed that it might be effective in certain groups of patients, such as school-age children with no underlying health issues like asthma. The other two showed equivocal results or no benefit.

Flu researchers have been fooled into thinking vaccine is more effective than the data suggest, in part, says Jefferson, by the imprecision of the statistics....

As with vaccines, the scientific evidence for Tamiflu and Relenza is thin at best. In its general-information section, the CDC’s Web site tells readers that antiviral drugs can “make you feel better faster.” True, but not by much. On average, Tamiflu (which accounts for 85 to 90 percent of the flu antiviral-drug market) cuts the duration of flu symptoms by 24hours in otherwise healthy people. In exchange for a slightly shorter bout of illness, as many as one in five people taking Tamiflu will experience nausea and vomiting. About one in five children will have neuropsychiatric side effects, possibly including anxiety and suicidal behavior....

Why, then, has the federal government stockpiled millions of doses of antivirals, at a cost of several billion dollars? And why are physicians being encouraged to hand out prescriptions to large numbers of people, without sound evidence that the drugs will help? The short answer may be that public-health officials feel they must offer something, and these drugs are the only possible remedies at hand. “I have to agree with the critics the antiviral question is not cut-and-dried,” says Fauci. “But [these drugs are] the best we have.” The CDC’s Nancy Cox also acknowledges that the science is not as sound as she might like, but the government still recommends their use. And as with vaccines, she considers additional randomized placebo-controlled trials of the antiviral drugs to be “unethical” and thus out of the question....

The annals of medicine are littered with treatments and tests that became medical doctrine on the slimmest of evidence, and were then declared sacrosanct and beyond scientific investigation. In the 1980s and ’90s, for example, cancer specialists were convinced that high-dose chemotherapy followed by a bone-marrow transplant was the best hope for women with advanced breast cancer, and many refused to enroll their patients in randomized clinical trials that were designed to test transplants against the standard—and far less toxic—therapy. The trials, they said, were unethical, because they knew transplants worked. When the studies were concluded, in 1999 and 2000, it turned out that bone-marrow transplants were killing patients. Another recent example involves drugs related to the analgesic lidocaine. In the 1970s, doctors noticed that the drugs seemed to make the heart beat rhythmically, and they began prescribing them to patients suffering from irregular heartbeats, assuming that restoring a proper rhythm would reduce the patient’s risk of dying. Prominent cardiologists for years opposed clinical trials of the drugs, saying it would be medical malpractice to withhold them from patients in a control group. The drugs were widely used for two decades, until a government-sponsored study showed in 1989 that patients who were prescribed the medicine were three and a half times as likely to die as those given a placebo....

As it stands, more than 50 percent of health-care workers say they do not intend to get vaccinated for swine flu and don’t routinely get their shots for seasonal flu, in part because many of them doubt the vaccines’ efficacy....

“There’s no worse place to go than the hospital during flu season,” says Majumdar. Those who don’t have the flu are more likely to catch it there, and those who do will spread it around, he says. “But we don’t tell people this.”

All of which leaves open the question of what people should do when faced with a decision about whether to get themselves and their families vaccinated. There is little immediate danger from getting a seasonal flu shot, aside from a sore arm and mild flu-like symptoms. The safety of the swine flu vaccine remains to be seen. In the absence of better evidence, vaccines and antivirals must be viewed as only partial and uncertain defenses against the flu. And they may be mere talismans. By being afraid to do the proper studies now, we may be condemning ourselves to using treatments based on illusion and faith rather than sound science."

Lack of Sleep Increases the Risk of Catching a Cold

Really? - The Claim - Lack of Sleep Increases the Risk of Catching a Cold. - Question - NYTimes.com:

"THE FACTS As cold season approaches, many Americans stock up on their vitamin C

and echinacea. But heeding the age-old advice about catching up on sleep might be more important.

Studies have demonstrated that poor sleep and susceptibility to colds go hand in hand, and scientists think it could be a reflection of the role sleep plays in maintaining the body’s defenses.

In a recent study for The Archives of Internal Medicine, scientists followed 153 men and women for two weeks, keeping track of their quality and duration of sleep. Then, during a five-day period, they quarantined the subjects and exposed them to cold viruses. Those who slept an average of fewer than seven hours a night, it turned out, were three times as likely to get sick as those who averaged at least eight hours.

Sleep and immunity, it seems, are tightly linked. Studies have found that mammals that require the most sleep also produce greater levels of disease-fighting white blood cells — but not red blood cells, even though both are produced in bone marrow and stem from the same precursor. And researchers at the Max Planck Institute for Evolutionary Anthropology have shown that species that sleep more have greater resistance against pathogens.

“Species that have evolved longer sleep durations,” the Planck scientists wrote, “appear to be able to increase investment in their immune systems and be better protected.”

THE BOTTOM LINE: Research suggests that poor sleep can increase susceptibility to colds."

When Doing Nothing Is the Best Medicine

When Doing Nothing Is the Best Medicine - WSJ.com:

"What cures colds, flu, sore throats, sore muscles, headaches, stomach aches, diarrhea, menstrual cramps, hangovers, back pain, jaw pain, tennis elbow, blisters, acne and colic, costs nothing, has no weird side effects and doesn't require a prescription?

Plain old-fashioned time. But it's often the hardest medicine for patients to take.

"Most people's bodies and immune systems are wonderful in terms of handling things—if people can be patient," says Ted Epperly, a family physician in Boise, Idaho, and president of the American Academy of Family Physicians.

"I have a mantra: You can do more for yourself than I can do for you," says Raymond Scalettar, a Washington, D.C., rheumatologist and former chairman of the American Medical Association. But, he says, "some patients are very medicine-oriented, and when you tell them they aren't good candidates for a drug they've heard about on TV, they don't come back."

An estimated one-third to one-half of the $2.2 trillion Americans spend annually on health care in the U.S. is spent on unnecessary tests, treatments and doctor visits. Much of that merely buys time for the body to heal itself.

And while temporary relief from symptoms is nothing to sneeze at, it adds up to a considerable amount of spending: $5.4 billion annually on cough and cold remedies, $2.7 billion on headache remedies and $411 million on chest rubs and other analgesics, according to Nielsen Co. Americans also spend an estimated $1 billion on unnecessary antibiotics that don't even relieve the symptoms of viral infections, and contribute to antibiotic resistance. But some patients are so insistent on getting antibiotics that doctors give in.

"I have colleagues who say, 'You can take this pill and get better in two days, or do nothing and get over it in 48 hours,' " says Dr. Scalettar.

Even H1N1, or swine flu, for all the uproar, almost always resolves in a few days with no treatment. The Centers for Disease Control and Prevention is urging physicians to use Tamiflu, an antiviral medication, sparingly to prevent shortages and avoid antiviral resistance. Only people who are hospitalized or at high risk for complications should get Tamiflu, according to the CDC.

The list of "self limiting" maladies—those that require no outside treatment—range from minor annoyances to what might appear to be more serious musculoskeletal problems. "Muscle aches and pain, minor traumas, sprains and strains typically do not need to be seen by a doctor," says Dr. Epperly, who recommends his organization's Web site, www.FamilyDoctor.org, as a resource to look up symptoms and health concerns. "Nausea, vomiting and diarrhea are typically time-limited. People will start to see improvement in two or three days—just watch that you're not throwing up blood," he says. If so, call your doctor.

Almost all viral infections resolve on their own, unless you have a compromised immune system. As a rule of thumb, Dr. Epperly says, infections in the nose, throat, stomach and upper respiratory tract tend to be viral. Infections elsewhere in the body are likely to be caused by bacteria, and those can get worse without antibiotics. About 80% of urinary-tract infections resolve on their own, for example, but about 20% develop into more serious kidney or blood infections. And even if they don't, the symptoms can be very uncomfortable.

Parents are often extremely eager to "do something" for children who complain of sniffles, stomach aches, scrapes and fevers. Yet kids are generally very resilient, writes Lara Zibners, an emergency pediatrician, in her book, "If Your Kid Eats This Book, Everything Will Still Be Okay." (For a fever, she advises calling the doctor if the patient is a baby younger than three months and has a fever over 100.4 degrees. For kids older than that, other symptoms are more important than the thermometer—especially if a child is listless, irritable, unusually sleepy, refusing to eat or drink, or having trouble breathing.)

Some chronic maladies follow predictable courses, according to many medical experts ,whether or not they are treated.

Colic is almost always gone in four months. Some 70% of acne is gone three to four years after it first appears. "Frozen shoulder"—a painful restriction of the shoulder joint—is typically painful for three to six months and stiff for the next four to six months, and resolves completely after one to three more months. Temporomandibular joint (TMJ) pain tends to go away by itself in 18 months. Sciatica resolves on its own in three weeks in 75% of cases.

For all the misery it causes, 80% to 90% of back pain resolves with only "conservative measures" (which include anti-inflammatory drugs, rest, heat, physical therapy and chiropractic treatments). "Sometimes it take days to weeks, sometimes it takes weeks to months, but pain lasts more than three months in only about 10% of cases," says Michael J. Yaszemski, chief of orthopedic spine surgery at the Mayo Clinic in Rochester, Minn.

Whether to operate even in those remaining cases is controversial, he says. With acute lumbar disc herniation, studies have found that two and five years later, there's little difference between patients who had surgery and those who did not. But surgery can sometimes provide relief faster.

"There are those patients who feel they just can't wait—like Joe Montana," says Dr. Yaszemski of the former San Francisco 49ers quarterback, who made headlines when he returned to playing football just eight weeks after spinal surgery in 1986.

Many patients are relieved to hear that they don't need to take medicine, have a blood test or undergo surgery for what ails them. But some feel embarrassed to have taken the doctor's time or frustrated because they think the doctor isn't taking their situation seriously. ("Much depends on the way you tell them," says Dr. Scalettar. "There are some arrogant doctors.")

And some patients resent paying for a visit when all the doctor provides is reassurance that they'll get better with time. "If a patient says, 'You mean, I'm paying $100 for you to tell me there's nothing wrong?' I say, 'There is something wrong—a virus,' " says Dr. Epperly. " 'But more importantly, I can tell you what's not wrong: it's not meningitis or cancer or a brain tumor or some other life-threatening illness. And if the pain doesn't go away in a few days, please, please tell me, and we'll investigate further.' "

"The longer you've known someone, the easier that conversation is," Dr. Epperly adds.

Indeed, applying what some call "a tincture of time" requires time on the doctor's part as well. Explaining why a medication or CT scan or MRI isn't necessary, or what signs to look for if an ailment isn't getting better, often takes more time than writing a quick prescription.

Of course, there are symptoms that people should never ignore, since they could signal a serious illness or a condition that could get worse, not better, with time. Contact your doctor immediately if you experience any of the following:

• Crushing chest pains—the classic signs of a possible heart attack.
• Sudden numbness or weakness on one side of the body, confusion, trouble speaking or severe headache—which could indicate a stroke.
• Sudden, severe headaches.
• Any major injury, especially involving loss of consciousness.
• Coughing up, throwing up or excreting blood.
• Suicidal or homicidal urges.
• Flashing lights in your vision—which could be a detached retina.
• Inability to breath—which could be a severe allergic reaction.
• Recurrent tooth pain. "You can typically give a tooth ache 24 hours," says Dr. Epperly. "If it's an abscess that would require a root canal, it won't get better by itself."

The bottom line: Don't hesitate to call your doctor if you have persistent pain or a loss of function or anything unusual for you. It's worthwhile to rule out something serious that does need medical attention. But if the doctor says you will get better on your own, that's a powerful prescription itself."

Mama wasn't always right: 9 updated health rules - CNN.com

Mama wasn't always right: 9 updated health rules - CNN.com:

"Now that you have kids, you've probably realized that there was actually some sense behind all that advice your mother gave you.

There is a lot of sense behind some of mama's advice, but other adages are not quite right.

Maybe you can thank her for your perfect posture (even though it took 4,567 reminders to stand up straight) or for insisting on all those family dinners. Then again, some things need not be passed down to yet another generation. Take a look.

Mama always said: Eat more! Kids are starving!

That's true, but probably not in your house. The clean-plate club isn't where it's at anymore. It's important to give kids the chance to stop eating based on appetite, instead of external cues like an empty bowl, says Marilyn Tanner-Blasiar, a pediatric dietitian at Washington University School of Medicine. It helps them stay attuned to their feelings of satiety.

When they lose that connection, the risk of becoming overweight goes up. But moms wouldn't be moms if they didn't worry about their kids' food. It's never going to be easy to let go, but if you give them healthy options and allow them to eat when they're hungry and stop when they're full, the rest will take care of itself.

Mama always said: Don't sit so close to the TV -- you'll ruin your eyes

Actually, you won't, and neither will your kids. According to the American Optometric Association, children can't harm their eyes by sitting with their noses practically pressed against the flat-screen. Watching close-up, however, may cause eyestrain, which can lead to headaches, says Dr. Vincent Iannelli, a Dallas, Texas, pediatrician.

Eyestrain doesn't worsen vision, but it's not comfortable, either. For healthier viewing, remind your children not to watch in total darkness -- the sharp contrast between the room and the TV can worsen strain -- and have them plop down about ten feet away. But if you have a child who's always sitting really close, she may be having a hard time seeing. Ask her to scooch to a more normal distance, and if she can't see the screen clearly, get her eyes checked.

Mama always said: Don't read in the dark

Smart thinking. Just as watching TV in a black void can cause eyestrain, so it goes with reading in low light, says Cathy Doty, a pediatric optometrist in New Bern, North Carolina. And if kids keep it up for long periods (like your voracious reader, who sneaks in extra chapters with a flashlight under the covers), it can lead to intermittent blurred vision and headaches.

All of these symptoms resolve with rest, but this behavior can speed the onset of nearsightedness in kids who are genetically predisposed, says Doty. To protect their peepers, make sure kids have at least 60 watts of light to read under and encourage them to keep books (and computer screens) at arm's length and to take frequent breaks. Parenting.com: Moms' dirty little secrets

Mama always said: Don't frown, you'll get wrinkles

Yep, you might. Furrowing your brow millions of times over your life can leave a line or two eventually. So can laughing. There's no way to avoid it, nor any reason to try.

Our facial muscles move to express emotion. And without those muscles, we couldn't eat, drink, smile, or kiss. The best way to help protect your kids' future faces and skin from head to toe? Load them up with SPF and keep on encouraging all the healthy stuff you already do: Try a vegetable. Run outside and play. And most of all, have fun! Parenting.com: 12 parenting rules you can break

Mama always said: Sit up straight

Good one, Nana. Slumping over puts major pressure on the neck, shoulders, and back, not to mention that it keeps the lungs from completely filling. But constantly scolding kids to correct their posture is frustrating. Instead, try to keep your kids active, says Patrice Winter, a physical therapist and assistant professor at George Mason University. It will give their muscles the strength needed to maintain alignment -- without nagging!

Mama always said: That music is too loud

It probably is. If you have a kid who goes nowhere without her iPod, there's a good chance she's rocking her way to some hearing loss later, says Dr. Craig Derkay, professor of otolaryngology and pediatrics at Eastern Virginia Medical School. If she likes her tunes loud, ask her to take a break every 20 minutes or so. You can also consider springing for noise-canceling headphones: They drown out background sounds, so she'll be less tempted to turn it up.

Mama always said: We're having dinner together because that's what families do

She was onto something. Kids are more likely to eat a balanced meal when the family dines together, says Kathleen Burklow, a clinical psychologist in Cincinnati, Ohio. And it's an all-around great way to connect. Don't stress if you can't do it every night (who can?); instead, make the most of the time you have. Parenting.com: 7 snacks that won't spoil dinner

If you always get the same one-word responses, have the kids ask you questions about your day. Or come up with a few very specific questions for everyone to answer, like what made you laugh today? What was the nicest thing someone did for you today? What was the nicest thing you did? You might be surprised at how much you actually hear.

Mama always said: Eat your breakfast

Pass it down. There is no doubt that breakfast is the most important meal of the day. Studies have proven that children who eat an a.m. meal perform better in school. Plus, many breakfast foods are excellent sources of calcium, iron, and fiber, all of which tend to be lacking in many children's diets. If your kids are picky breakfast eaters, have them grab a handful of raisins, some dry cereal, or even some leftover pizza to nibble on when they're ready. Parenting.com: 13 rise & shine breakfast ideas

Mama always said: Put on a coat, you'll catch a cold

The only thing your kid is likely to get from being outside in the cold is... cold. "When I was growing up, my grandmother insisted I bundle up in even slightly cold weather because 'getting cold could make you sick,'" says Sue Stevens of Arlington, Texas. "I knew from my school health class that she was wrong and that germs make you sick. I let my own son play in the rain, sleep under a ceiling fan, and play soccer in short pants in freezing weather. He never had colds afterward!" That's because only cold and flu viruses cause those illnesses.

There is some research that suggests that prolonged exposure to chilly temps may dampen the immune system because it puts a strain on the body. But that's not the same as making you sick. So if your kid wants to tough out the chilly season in his skimpy but oh-so-hip hoodie, save yourself the fight. Let him!"

Health Library

• MayoClinic.com: Childhood obesity -- make weight loss a family affair
• MayoClinic.com: Children's illness -- top 5 causes of missed school
• MayoClinic.com: Children and TV -- Limiting your child's screen time

Two-thirds of our calories now come from just four crops: rice, soy, wheat and corn

Nicholas Kristof - Food for the Soul - NYTimes.com:

"Michael Pollan, the food writer, notes that monocultures in the field result in monocultures in our diets. Two-thirds of our calories, he says, now come from just four crops: rice, soy, wheat and corn. Fast-food culture and obesity are linked, he argues, to the transformation from family farms to industrial farming."

List of the most nutritious nuts

David H. Murdock: The "Nut" In Nutritious:

"In my first blog post, I wrote about the benefits of thirty-three of the healthiest fruit and vegetables on earth, describing the nutrition benefits of each. The post garnered over 100,000 readers, and generated nearly 400 reader comments, many of which asked for more information. People asked: "What about nuts? What about beans? What about fish? Aren't they healthy, too?" My answer is: "Yes, of course!"

Therefore, my next ten posts will be devoted to covering ALL the areas crucial to longevity.... Though I'm not a scientist, everything my Dole Nutrition Institute publishes is based on scientific research. So this second post will provide information readers requested on nuts - and why you should include them in your diet.

ALMONDS: My favorite - especially when covered in dark chocolate! Top nut source of vitamin E, to protect the heart, slow aging, and bolster immunity.

WALNUTS: Top nut in heart-healthy, brain-boosting omega-3 oils. The omega-3 oils in walnuts could help calm and moisten dry, irritated skin. Walnuts also contain a unique form of vitamin E thought to suppress prostate and lung cancer cell division.

PECANS: Top nut in antioxidants. This means they can help neutralize the free radicals that can accelerate aging and cause DNA damage. Pecans may also lower cholesterol.

PEANUTS: Though not strictly a nut (they are in fact a legume), peanuts contain more protein than tree nuts. They also contain the potent antioxidant resveratrol -- famously found in red wine.

PISTACHIOS: Top nut in potassium, needed to maintain healthy blood pressure. Also top nut in phytosterols (plant compounds that inhibit cholesterol absorption).

CASHEWS: Top nut in zinc, a mineral needed to support vision and immunity.

PINE NUTS: Top nut in manganese, essential for bone health and wound healing.

BRAZIL NUTS: Top nut in selenium, a mineral needed for proper thyroid and immune health. Selenium may also protect against cancers of the prostate, liver and lungs. Don't eat more than four a day.

MACADAMIA NUTS: Often shunned because they have more saturated fat than other nuts. However, researchers have found that a handful of macadamia nuts a day reduced total cholesterol by about 9%.

These are the kinds of things we are studying at our North Carolina Research Campus. It is the only campus in the world encompassing eight universities all working together for the benefit of health and longevity. These include Duke University, UNC Chapel Hill, NC State University, UNC Charlotte, North Carolina Central University, NC A&T State University, UNC Greensboro and Appalachian State University. Our Dole Nutrition Institute publishes articles, brochures, videos and our Dole Nutrition News, which you can receive by signing up at www.dolenutrition.com.

Stay tuned for my next post on Brain Fitness: What mental exercises and daily activities help keep your mind sharp and focuses, at any age."

Every seven years you shed about half your friendships and acquire new ones

The other seven-year itch - THE WEEK:

June 19, 2009

"The other seven-year itch

Every seven years, a new study finds, you shed about half your friendships and acquire new ones. Though your best friend may seem like your permanent confidant, there’s only a 30 percent chance that you will be that close to the same person seven years from now. As for the rest of your friends, only 48 percent will still be a regular part of your life in 2016. It’s not that most of us are fickle or disloyal, says Dutch sociologist Gerald Mollenhorst, who conducted the study of more than 1,000 people over seven years. It’s simply that people come together in “friendship networks” mostly out of circumstance and context; when they move away, switch jobs, and experience other major life changes, bonds become attenuated and often dissolve. At the same time, new contexts and new people lead to new friendships. We’d all like to believe we’ve chosen friends and mates because of some inherent affinity, Mollenhorst tells ScienceDaily.com, but the reality is that happenstance and sheer proximity play a big role."

Why people blush

Why people blush - THE WEEK:

June 19, 2009

"Why people blush

When some fair-skinned people feel embarrassment, they blush. When they blush, they get more embarrassed, because they feel that it’s a sign of weakness—visible proof that they can’t keep their cool. Stop worrying, says new research: Blushing is actually good for your social reputation. When researchers asked a group of volunteers to judge people’s personalities based on photos, people who were pictured with a pink flush were more likely to be seen as sympathetic characters. In another study, scientists found that blushing can hasten bonding in a fraternity-like setting. “It was a subtle effect, but we found that the frequency of blushing predicted how well these guys were getting along at the end,” psychologist Dacher Keltner tells The New York Times. Blushing signals to others that you have a heart and are sensitive to what other people think of you. It’s therefore endearing. “A blush comes online in two or three seconds,” Keltner says, “and says, ‘I care.’”"

Why tots shouldn’t watch TV

Why tots shouldn’t watch TV - THE WEEK:

Friday, June 19, 2009

"Why tots shouldn’t watch TV

If you have a baby or a toddler, turn off that TV. A new study finds that when children are exposed to a lot of TV before the age of 2, they are deprived of interaction with adults, which can lead to delays in brain and language development. University of Washington researchers found that for every hour the TV set was on, even if it was just in the background, adults spoke from 500 to 1,000 fewer words to children. When the distraction of the boob tube was present, children spoke less, too, and there were fewer conversations between the adults and the children. This was true whether the show was a kid’s program or an adult show that parents were watching in the child’s presence. Speaking directly to a child, previous research has shown, is critical to brain development. In surveys, 30 percent of Americans admit to having the TV on all day long, whether anyone is watching or not. Television, researcher Dimitri Christakis tells LiveScience.com, “is a poor caregiver substitute. My recommendation is that children under the age of 2 be discouraged from watching television.”"

A Recipe For Longevity: 33 Of The Healthiest Foods On Earth

David H. Murdock: A Recipe For Longevity: 33 Of The Healthiest Foods On Earth:

"David H. Murdock
May 20, 2009

A Recipe For Longevity: 33 Of The Healthiest Foods On Earth"

"Is it possible to live to 125 or maybe 150? It's certainly a possibility, as discussed on Oprah Winfrey's recent show on longevity. She visited me at my farm to learn how, at 86, I am enjoying the robust health, energy, and mental creativity of someone many decades younger. My secret: large quantities of fruit and vegetables, plus an hour of daily exercise.

No pills, not even aspirin, and certainly no supplements ever enter my mouth -- everything I need comes from my fish-vegetarian diet, which incorporates 30-40 different kinds of fruit and vegetables every week. Even though I am Chairman and Owner of Dole Food Company, I do most of my own grocery shopping, and even took Oprah on an impromptu trip to Costco, in a day that included bike riding, exercise in the gym, and juicing vegetables in the kitchen. Oprah marveled at how much I eat, and yet never gain a pound. In fact, I expend a lot of energy in my 50-60 minutes of cardio and strength training every day. Plus there's the fact that fruit and vegetables tend to be lower in calories, but higher in filling fiber and other nutrients that help you feel satisfied.

By eating many fruits and vegetables in place of fast food and junk food, people could avoid obesity. Obesity accelerates aging even faster than smoking, according to scientific research.

We created the North Carolina Research Campus to study the health benefits of fruits and vegetables. It is the only campus in the world encompassing eight universities all working together for the benefit of health and longevity. These include Duke University, UNC Chapel Hill, NC State University, UNC Charlotte, North Carolina Central University, NC A&T State University, UNC Greensboro and Appalachian State University. We've gathered a comprehensive array of famous scientists and scientific equipment under one roof, including a two-story, 950 megahertz, 8-ton superconducting magnet. It is the largest and most powerful magnet in the world and will help us look at both plant and human cells at the most minute level. We are constantly doing research on all fruit and vegetables, including the ones listed below, which are the mainstay of my diet.

The Healthiest Foods on Earth

Pineapple	Speeds post-surgery	Promotes joint health	Reduces asthma inflammation
Blueberries	Restore antioxidant levels	Reverse age-related brain decline	Prevent urinary tract infection
Spinach	Helps maintain mental sharpness	Reduces the risk of cancers of the liver, ovaries, colon and prostate	Top nutrient density
Red Bell Pepper	Reduces risk of lung, prostate, ovarian and cervical cancer	Protects against sunburn	Promotes heart health
Broccoli	Reduces diabetic damage	Lowers risk of prostate, bladder, colon, pancreatic, gastric and breast cancer	Protects the brain in event of injury
Tomato	Reduces inflammation	Lowers risk of developing esophageal, stomach, colorectal, lung and pancreatic cancer	Reduces cardiovascular disease risk
Apple	Supports immunity	Fights lung and prostate cancer	Lowers Alzheimer’s risk
Artichoke	Helps blood clotting	Antioxidant Superfood	Lowers “bad” cholesterol
Arugula	Lowers birth defect risk	Reduces fracture risk	Protects eye health
Asparagus	Nourishes good gut bacteria	Protects against birth defects	Promotes heart health
Avocado	Limits liver damage	Reduces oral cancer risk	Lowers cholesterol levels
Blackberries	Build bone density	Suppress appetite	Enhance fat burning
Butternut Squash	Supports night vision	Combats wrinkles	Promotes heart health
Cantaloupe	Bolsters immunity	Protects skin against sunburn	Reduces inflammation
Carrot	Antioxidants defend DNA	Fights cataracts	Protects against some cancers
Cauliflower	Stimulates detoxification	Suppresses breast cancer cell growth	Defends against prostate cancer
Cherries	Alleviate arthritic pain and gout	Lower “bad” cholesterol	Reduce inflammation
Cranberries	Alleviate prostate pain	Fight lung, colon and leukemia cancer cells	Prevent urinary tract infection
Green Cabbage	Promotes healthy blood clotting	Reduces risk of prostate, colon, breast and ovarian cancers	Activates the body’s natural detoxification systems
Kale	Counters harmful estrogens that can feed cancer	Protects eyes against sun damage and cataracts	Increases bone density
Kiwi	Combats wrinkles	Lowers blood clot risk and reduces blood lipids	Counters constipation
Mango	Supports immunity	Lowers “bad” cholesterol	Regulates homocysteine to protect arteries
Mushrooms	Promote natural detoxification	Reduce the risk of colon and prostate cancer	Lower blood pressure
Orange	Reduces levels of “bad” cholesterol	Lowers risk of cancers of the mouth, throat, breast and stomach, and childhood leukemia	Pectin suppresses appetite
Papaya	Enzymes aid digestion	Reduces risk of lung cancer	Enhances fat burning
Plums & Prunes	Counter constipation	Antioxidants defend against DNA damage	Protects against post-menopausal bone loss
Pomegranate	Enhances sunscreen protection	Lowers “bad” cholesterol	Fights prostate cancer
Pumpkin	Protects joints against polyarthritis	Lowers lung and prostate cancer risk	Reduces inflammation
Raspberries	Inhibit growth of oral, breast, colon and prostate cancers	Antioxidant DNA defense	Lower “bad” cholesterol levels
Strawberries	Protect against Alzheimer’s	Reduce “bad” cholesterol	Suppress growth of colon, prostate and oral cancer
Sweet Potato	Reduces stroke risk	Lowers cancer risk	Protect against blindness
Watermelon	Supports male fertility	Reduces risk of several cancers: prostate, ovarian, cervical, oral and pharyngeal	Protects skin against sunburn
Banana	Increases Fat Burning	Lowers risk of colorectal and kidney cancer, leukemia	Reduces asthmas symptoms in children

One of my missions in life is to share this kind of knowledge with others, so they can live more vital, active, satisfying lives. Since acquiring major interests in Dole 26 years ago, educating the public on proper diet has constituted the agenda of my Dole Nutrition Institute. We publish the Dole Nutrition News -- enjoyed by 2.5 million subscribers (sign up at www.dolenutrition.com). We create cooking and nutrition videos, cookbooks, brochures, and other educational collateral, like the chart above. We also provide educational support to teachers, parents and kids through www.dolesuperkids.com."

* David H. Murdock is Chairman and owner of Dole Food Company, Inc., the world's largest producer and marketer of fresh fruit, fresh vegetables, packaged and frozen foods. He is also Chairman, CEO and owner of Castle & Cooke, Inc., a leader in real estate development. Mr. Murdock advocates healthy eating to promote longevity. His Dole Nutrition Institute is dedicated to nutrition education through an award-winning monthly newsletter, health brochures, cookbooks, videos and the Dole Nutrition website. He recently dedicated the David H. Murdock Core Laboratory Building, the UNC Nutrition Research Building and the NC State Fruit and Vegetable Science Institute Building at the newly opened North Carolina Research Campus, representing a historic partnership with leading universities to advance knowledge about nutrition and disease prevention.

Fight Disease With Soap and Water - Wash your hands

Fight Disease With Soap and Water - WSJ.com:

"Wall Street Journal, May 12, 2009

Put Up Your Dukes: Fighting Disease With Soap and Water

Fear of swine flu is fading, but there are still plenty of reasons to wash your hands frequently.

The list of infections that can spread via unwashed hands reads like the Biblical plagues, including staph, strep, salmonella, E. coli, hepatitis, MRSA (methicillin-resistant Staphylococcus aureus), colds, flu and norovirus -- the infamous cruise-ship bug.

The importance of hand washing has been known since 1847, when a doctor named Ignaz Semmelweis suspected that maternity patients were dying in his Vienna hospital because med students treated them right after working on cadavers. When he instituted hand-cleaning, the deaths fell sharply.

The Centers for Disease Control and Prevention says hand washing is the most effective way to stay healthy. But many people don't do it often enough, or long enough, to be effective. Here's a guide:

The swine flu headlines have brought attention to the importance of hand-washing. Health columnist Melinda Beck describes the best way to wash off germs and protect against sickness.

When to do it. Wash your hands every time you use the bathroom. Every surface presents an opportunity for germs to hitchhike out. "Who thinks to clean the latch on the inside of the stall door? Try nobody," says Jim Mann, executive director of the Handwashing for Life Institute, which advises food-service providers around the world on best hand-hygiene practices.

Also wash your hands whenever you change a diaper, pick up animal waste, sneeze, cough or blow your nose; when you take public transportation, insert or remove contact lenses, prepare food, handle garbage and before eating. Few people are as conscientious as they should be. Mr. Mann recalls being in meetings to discuss hand hygiene: "Everybody shakes hands. You finish the talk, and everybody runs for the food line. Nobody washes their hands."

How to do it. Soap and water is the gold standard. In a recent study in the journal Clinical Infectious Diseases, researchers in Australia doused the hands of 20 health-care workers with human H1N1 flu virus. Soap and water removed slightly more virus than three alcohol-based hand rubs. When volunteers didn't clean their hands, most of the virus was still present an hour after exposure.

It's the mechanical process of washing that's so effective. Soap molecules surround and lift the germs, friction from rubbing your hands loosens them, and water rinses them down the drain.

Experts recommend using warm water -- mainly for comfort, so you'll wash longer. Use liquid soap if possible. Bar soaps can harbor germs, though they'll likely rinse off with water.

Use enough soap to build a lather. Lace your fingers together to cover all the surfaces. Rub the fingertips of one hand into the palm of the other, then reverse. Keep rubbing for as long as it takes to sing "Happy Birthday" twice. (Some experts prefer "Row, Row, Row Your Boat." But any tune will do as long as it lasts at least 15 seconds.)

"The typical 'splash and dash' that most people do doesn't do anything," says Mr. Mann.

Rinse thoroughly. Residual soap can make hands sore. Leave the water on while you grab a paper towel and use it to shut off the faucet. Take it with you to use on the door handle as well.

Drying lessons. Many hand-hygiene experts are down on hand dryers -- chiefly because few people have the patience to dry completely and end up wiping their hands on their clothes. "That's fine -- unless your pants have been down around your ankles in the stall," Mr. Mann says.

Air dryers can also blow remaining germs as far as six feet away.

Antibacterial soap? In 2005, a Food and Drug Administration panel voted 11-to-1 that antibacterial soaps are no more effective at keeping people healthy than regular soap. There may be some downside too. Some antibacterial ingredients like triclosan leave a residue on the skin that continues killing some bacteria. Critics worry that the remaining bacteria could become resistant, not only to soap but also to antibiotics. "To our knowledge, it's not happened, but it's theoretically possible," says Elaine Larson, a professor in the schools of nursing and public health at Columbia University. Another problem with antibacterial soap, she says, is that it gives people a false sense of security. "People think, 'Ah -- it's antibacterial. So the germs are gone.' That's a false perception," Dr. Larson says.

Hand sanitizers. It's not often that a personal-care product gets a presidential endorsement. Some drug stores sold out after Barack Obama echoed the CDC's recommendation that people use alcohol-based hand sanitizers when soap and water aren't available to help stop the spread of swine flu.

Experts say they must be at least 60% alcohol to kill germs. "Alcohol ruptures their cell membranes -- it causes them to explode," says Dr. Larson, although she notes that if your hands are visibly dirty, soap and water is much preferable.

Curiously, the FDA does not allow over-the-counter hand sanitizers to claim they kill viruses. The CDC's recommendations are based on information published since the FDA ruling, showing that alcohol-based sanitizers are effective at killing viruses, specifically the H1N1 strain, says Nicole Coffin, a CDC spokeswoman.

Can you overdo handwashing? Yes. "Try to strike a balance between being obsessive-compulsive and being reasonable," says Dr. Larson. "And if there is some kind of outbreak like with the flu or SARS, then there is reason for more caution.""

Do Everybody a Favor - Take a Sick Day

Cases - Do Everybody a Favor - Take a Sick Day - NYTimes.com:

"New York Times, May 12, 2009

Do Everybody a Favor: Take a Sick Day

By ANNE MARIE VALINOTI, M.D.

My patient was a 25-year-old man. He sat on the examination table, the picture of misery, coughing, red-eyed and shivering. His fever was 103. An interview and an examination suggested influenza (the rapid diagnostic test for flu wasn’t available at that time), but there was little I could offer him, other than ibuprofen and some homespun advice.

“Go home and get to bed,” I told him.

He looked at me. “Bed? I’ve got to get back to work.” He put on his jacket and power tie and headed back to Wall Street.

I was appalled. Work in that condition? How could he even think straight with that fever? Whom else would he infect along the way?

Still, a tiny part of me was filled with admiration. Here was a tough guy. No reason to let minor delirium keep him from doing his job.

I had recently finished my residency, three years immersed in the culture of house officer training. Of all the sins an intern or resident could commit, the worst was to call in sick, for it meant somebody else would have to do your work — extra patients to admit, phone calls to make, IVs to insert, emergencies to deal with.

As a resident, my greatest pride was in never having missed a day for illness. I’d drag myself in and sniffle and cough through the day. Once, I’m embarrassed to admit, I trudged up York Avenue to the hospital making use of my own personal motion sickness bag every few blocks while horrified pedestrians looked on.

Now, though, I see the foolishness of this bravura. And I confront it almost daily in my primary care practice. No one can miss a day — a minute, even — of work, carpooling, volunteering, vacation, anything. “I don’t have time to be sick!” my patients wail. Everyone must soldier on, leaving sick days to those with less important things to do.

And many patients aren’t satisfied with sympathy and friendly advice. They have come to the office for that little piece of blue paper, the antibiotic prescription. “I would never ask for this under normal circumstances,” I’m told — except (pick one) I’m getting married tomorrow; leaving for a month in the Amazon; having 25 houseguests for the weekend.

Never mind that antibiotics are useless in treating colds and viral illnesses, and that they have their own dangers and side effects. Some doctors will write the prescription just to get on with their day.

I have done this and know plenty of other physicians who have — much as we may resent being bullied and feel we’ve failed in our duty to “first, do no harm.” In fact, we may very well be doing harm. Beyond the possible side effects and allergic reactions, the nonchalant use of antibiotics in the community has helped lead to the rise of the drug-resistant bacteria known as superbugs.

“Clearly, the overprescribing of antibiotics in doctors’ offices, clinics and other community settings contributes to the problem of antibacterial drug resistance,” Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Disease, told me in an e-mail message. “Because most bacteria multiply rapidly, they can quickly evolve and develop resistance to antimicrobial drugs. Overusing or misusing antibiotics can make resistance develop even faster.”

If the swine flu epidemic ever swings into full gear, I will be prepared for the onslaught of ill patients. I will educate them about the appropriate use of antibiotics. I will provide symptomatic relief when I can. And I will let them know it’s O.K. to be sick. It’s O.K. to stay home from work, pull up the covers and drink gallons of hot tea all day. Maybe for an entire week.

And believe me: if you show up to work sick these days, you are not going to earn anyone’s admiration."

Anne Marie Valinoti is an internist in northern New Jersey.

What Are Friends for? A Longer Life

Well - What Are Friends for? A Longer Life - NYTimes.com:

"In the quest for better health, many people turn to doctors, self-help books or herbal supplements. But they overlook a powerful weapon that could help them fight illness and depression, speed recovery, slow aging and prolong life: their friends.

Researchers are only now starting to pay attention to the importance of friendship and social networks in overall health. A 10-year Australian study found that older people with a large circle of friends were 22 percent less likely to die during the study period than those with fewer friends. A large 2007 study showed an increase of nearly 60 percent in the risk for obesity among people whose friends gained weight. And last year, Harvard researchers reported that strong social ties could promote brain health as we age.... in many studies, friendship has an even greater effect on health than a spouse or family member."

Why a Big Meal Makes You Hungry

Why a Big Meal Makes You Hungry - WSJ.com:

"Every few months, a new study purports to prove that a calorie is a calorie is a calorie, and that the only way to lose weight is to burn more than you take in.

But veteran dieters know something that some researchers apparently don't: Certain foods seem to fuel the appetite like pouring gasoline on a fire. Some people find that once they start eating bread, cookies, chocolate, potato chips -- or leftover Easter candy -- they lose all sense of fullness and find it difficult to stop.

That's the concept behind "The Skinny," a new book by Louis J. Aronne, longtime director of the Comprehensive Weight Loss Program at NewYork Presbyterian Hospital/Weill Cornell Medical Center. He makes the best case yet why what you eat and when you eat it can make a big difference in appetite, satiety and how much willpower it takes to cut down. "It's true that a calorie is a calorie," Dr. Aronne says. "But what that doesn't take into account is how some calories affect what people eat later on."

Appetite Stokers

Some foods make it harder to stop eating:

• Bread
• Sweets
• Juice
• Pasta
• Wine or beer before dinner
• Artificial sweeteners

*Source: "The Skinny" by Louis J. Aronne

After 23 years of treating patients -- some of it espousing liquid diets -- Dr. Aronne has concluded that refined carbohydrates and foods with high sugar and fat content promote what he calls "fullness resistance." They interfere with the complex hormonal messages the body usually sends to the brain to signal that it's time to stop eating. People feel hungrier instead.

This happens in part because refined carbohydrates raise blood-sugar levels, setting up an insulin surge that drives blood sugar down again, causing rebound hunger. That insulin spike also interferes with leptin, the hormone secreted by fat cells that should tell the body to stop eating. Obese people have loads of leptin, but it either doesn't get to the brain, or the brain becomes resistant to it. "This is not a failure of willpower, it's a physical mechanism," Dr. Aronne writes. The body also becomes resistant to insulin, setting the stage for diabetes.

Other researchers have described similar phenomena. An article in this month's Medical Hypothesis argues that for some people, refined foods with high sugar and carbohydrate content can be just as addictive as tobacco and alcohol.

Eating foods high in protein, vegetables, fiber and water have the opposite effect, Dr. Aronne says. His plan recommends revising what you eat, one meal at a time, to restore your sense of fullness:

Breakfast: Loading up on lean protein -- ideally from egg whites or a protein shake -- in the morning reduces hunger all day long. Eating muffins, bread, sweetened cereal and juice does the opposite. A study of 30 overweight women at Saint Louis University School of Medicine found that those who ate eggs for breakfast consumed 140 fewer calories at lunch, and ate less for the next 36 hours, compared with women who ate bagels in the morning.

Some people argue that they aren't hungry in the morning, but Dr. Aronne notes that ghrelin, the hormone that typically signals hunger, adjusts to habitual meal patterns. After a few days of eating breakfast, you should find that you are hungry in the morning, and are eating less the night before, he writes.

Lunch: Some dieters try to cut calories by skipping this meal. But going more than five hours without food causes hunger hormones to rise and fullness hormones to drop, and sends more of the calories consumed at dinner straight to fat cells. Dr. Aronne recommends starting lunch with a salad -- at least two cups of lettuce -- then more vegetables, and then lean protein. Skip the cheese, croutons, bacon and creamy dressings, he advises. Using vinegar alone will cut your appetite and slow the rise in blood sugar.

Dinner: The end of the day is fraught with temptation. Obese people consume significantly more calories at dinner than slimmer people. Here, too, load up first on salads, clear soups, or high-protein appetizers like shrimp cocktail, then have a lean protein main course. Unlike some other diet plans, Dr. Aronne's program allows a half-cup of grains or a small dessert at the end of the meal, but only if you're still hungry.

Eating bread before dinner makes people lose their sense of fullness and eat more, Dr. Aronne warns. Alcohol makes it worse by lowering your resistance and promoting fat storage.

Snacks: Like many other weight-loss experts, Dr. Aronne believes that midmorning and midafternoon snacks can act as mini appetite suppressants, preventing blood sugar from dropping too low. But the same principals apply: high-sugar, high-starch, high-fat snacks -- including those little 100-calorie cookie packs -- start a vicious cycle of more cravings, whereas fruit, nuts, vegetables and clear soups can halt them.

Beverages: It should go without saying that juice and sweet soda can add hundreds of extra calories a day. A few studies have shown that even artificially sweetened beverages can prompt people to crave real sweets during the day. Cut back on all sources of liquid calories, Dr. Aronne advises; stick with water.

To be sure, if you eat as Dr. Aronne suggests, you'll consume fewer calories overall. The point is, eating protein early in the day may make it much easier to cut down. "It definitely does make a difference," says Ned Sadaka, a New York investment manager who consulted Dr. Aronne to drop 30 pounds that had crept up on him in recent years. He's lost 21 pounds and 5 inches off his waist since January.

Not everyone agrees that consuming more protein cuts appetite. Harvard School of Public Health's Frank Sacks led a study recently published in the New England Journal of Medicine that compared 811 overweight adults on four diets with varying levels of protein, fat and carbohydrate. "We found absolutely no difference in their satiety and hunger levels," Dr. Sacks says. All the groups lost similar amounts of weight.

Other weight-loss experts say that's not surprising, since there were only modest differences in their fat, protein and carbohydrate intakes, and many participants didn't stick to their plans."

Trying to lose weight? Watch what you drink

Trying to lose weight? Watch what you drink - CNN.com:

"75 percent of U.S. adults are projected to be overweight or obese by 2015, according to researchers. Americans consume anywhere from 150 to 300 more calories than they did three decades ago and half of those calories come from liquid. A new study out of John Hopkins Bloomberg School of Public Health finds that reducing liquid calories, especially from sugar-sweetened drinks such as punches, fruit juices and sodas, helps people lose weight and keep it off.

Question: Why the emphasis on liquid calories?

Americans consume more liquid calories now than they ever have before. But unlike calories from solid food, it's much harder for people to track how many calories they consume from drinking. The human body's systems for regulating hunger and food intake are complex. But scientists do know that the lack of physiological and environmental cues associated with drinking, like not having to chew or prepare a drink like you prepare a meal, play a role. For these reasons, liquid calories don't keep a person full and they are not as satisfying as solid food. They are usually "empty calories" as well because they generally lack any nutritional value."

Video Watch more on the dangers of sweetened drinks »

Want to live longer? Cut back on red meat

Want to live longer? Cut back on red meat - CNN.com:

"Burger lovers beware: People who eat red meat every day have a higher risk of dying over a 10-year period -- mostly because of cardiovascular disease or cancer --than their peers who eat less red or processed meat, according to a new study of about half a million people.

"This is the biggest and highest quality study like this," says Barry M. Popkin, Ph.D., from the University of North Carolina, who wrote an editorial accompanying the study, which was published Monday in Archives of Internal Medicine. "They collected the diet data very carefully, and it's saying to people, 'You don't have to eat red meat every day.'"

In the study, a research team led by Rashmi Sinha, Ph.D., from the National Cancer Institute in Rockville, Maryland, looked at more than 500,000 people who were aged 50 to 71 when they enrolled in the National Institutes of Health-AARP Diet and Health study.

Over a 10-year period, people who ate the most red meat every day (about 62.5 grams per 1,000 calories per day, equivalent to a quarter-pound burger or small steak per day) had about a 30 percent greater risk of dying compared with those who consumed the least amount of red meat (a median of 9.8 grams per 1,000 calories per day). The excess mortality was mostly the result of cardiovascular disease and cancer."

18 and Under - Distractions May Shift, but Sleep Needs Don’t

18 and Under - Distractions May Shift, but Sleep Needs Don’t - NYTimes.com:

"“The literature really strongly suggests the average early to mid-adolescent needs 9 to 9.25 hours a night,” said Dr. Judith Owens, an associate professor of pediatrics at the Alpert Medical School of Brown University, who directs the Pediatric Sleep Disorders Clinic at Hasbro Children’s Hospital.

She quickly headed off my question about children — or adults — who don’t need that much sleep. “It’s a bell-shaped curve,” she said, with just 2.5 percent of the population needing significantly less sleep than average.

“The problem,” she went on, “is that 95 percent of us think we’re in that 2.5 percent. You should assume until proven otherwise that your kid needs that much sleep.”

What is the bedtime recommendation for an 8- or 9-year-old? The experts sensibly suggest that you work backward from wake-up time, trying for 10 hours of sleep, and testing your routine by checking whether the child wakes spontaneously, alert and cheerful and ready for the day....

As children move into middle school, Dr. Owens said, they still need plenty of sleep, but it gets harder for them to follow the schedule that the world demands.

“Sleep needs don’t change all that dramatically from late elementary through middle school into high school,” she said. “What changes is the circadian rhythm of sleep and wake, and typically as you go into and through puberty your sleep and wake time shifts by as much as two hours. They simply can’t fall asleep as early as they did when they were 7 or 8 years old.” That is why many experts say the high school day should start later....

Even as we’ve come to understand more and more about the importance of sleep, for brain function and learning, for mental and physical health, the world has gotten to be a harder and harder place for a child to go to sleep. The basic advice pediatricians give to parents of young children about bedtime routines — turn off the television, take her on your lap, read a book — is important for older children, too: spend time together, wind down, turn off electronic devices, read a book...."

Asking Tough Questions of Doctors

Asking Tough Questions of Doctors - WSJ.com:

""The culture around medicine is changing very quickly as patients begin to understand the full impact of medical errors and see that quality health care is not a given," says Bruce Siegel, a professor in the department of health policy at George Washington University who runs the Aligning Forces for Quality program. Many physicians are trained "to think of ourselves as little gods" and resist patients who question their authority, Dr. Siegel says. But "the more enlightened physicians are beginning to realize this could be a positive thing for health care."

The Pennsylvania Patient Safety Authority, which tracks medical errors and recommends preventive measures, says research conducted in the state shows patients are increasingly willing to ask certain questions of their doctor. It says patients will seek a better explanation of something they don't understand or question the reason for a procedure or unfamiliar drug.

But patients are most reluctant to ask anything that might be viewed as confrontational, such as requesting that health-care providers confirm a patient's identity before a procedure or asking practitioners to wash their hands, the group says. Hand washing is considered the most important preventive measure against the spread of potentially deadly infections....

Many hospitals make use of the 'Speak Up' campaign launched in 2002 by the Joint Commission, the nonprofit group that accredits hospitals. The program provides free brochures and posters to hospitals urging patients to take a role in preventing medication errors, infections and wrong-patient procedures. The brochures, available at www.jointcommission.org, provide lists of questions to ask medical practitioners, urging patients, for instance, to make sure doctors and nurses check their wristband and ask their name before administering medicine."

Doctors have long resisted having science guide their practice

Why Doctors Hate Science | Sharon Begley | Newsweek.com:

"Doctors have long resisted having science guide their practice. That's obvious from the disparity in clinical practices from one region of the U.S. to another, as The Dartmouth Atlas of Health Care has been finding since the early 1990s. Rates of coronary-bypass surgery among Medicare patients in McAllen, Texas, are five times those in Pueblo, Colo. Rates of back surgery in Casper, Wyo., are six times those in Honolulu and the Bronx. From one city to another, the frequency of visits to specialists varies more than fivefold. Yet elderly people in Casper don't have worse back pain than those in the Bronx, and those in Texas aren't suffering occluded arteries at higher rates than those in Colorado. Instead, the enormous disparity in how doctors in different regions treat the same condition reflects medical culture, not medical science."

Calorie Counters Have It Right, Diet Study Says

Calorie Counters Have It Right, Diet Study Says - WSJ.com:

"You aren't what you eat. You're how much.

That's the message from a two-year National Institutes of Health-funded study that assigned 811 overweight people to one of four reduced-calorie diets and found that all trimmed pounds just the same. It didn't matter what foods participants ate, but rather how many calories they consumed.

An intense debate has long raged over which dieting regimen is best. Low carb? High protein? Low fat? But the federal study, one of the longest of its kind, "really goes against the idea that certain foods are the key to weight loss," says Frank Sacks, principal investigator and a professor of cardiovascular-disease prevention at Harvard School of Public Health. "This is a pretty positive message. It gives people a lot of choices to find a diet they can stick with.""

Watching a lot of TV during adolescence can change a normal brain to a depressive one

Health scare of the week: Does TV damage teen brains? - Subscriber Only - THE WEEK:

"Watching a lot of TV during adolescence, an alarming new study has found, can change a normal brain to a depressive one. The study, which tracked more than 4,000 adolescents as they grew up, found that for every extra hour a teen spends watching TV or playing videogames on an average day, he or she is 8 percent more likely to develop depression as an adult. Study author Dr. Brian Primack says that teens’ experiences help shape their developing brains, and that being parked in front of a screen often replaces positive social, academic, and athletic activities that give kids a sense of mastery and self-respect. Instead, he tells the Los Angeles Times, TV teaches kids to be passive, and to judge themselves against fictional characters whose looks and accomplishments seem out of reach."

Vitamin Pills - A False Hope?

Well - Vitamin Pills - A False Hope? - NYTimes.com:

"Ever since the Nobel Prize-winning biochemist Linus Pauling first promoted “megadoses” of essential nutrients 40 years ago, Americans have been devoted to their vitamins. Today about half of all adults use some form of dietary supplement, at a cost of $23 billion a year.

But are vitamins worth it? In the past few years, several high-quality studies have failed to show that extra vitamins, at least in pill form, help prevent chronic disease or prolong life.

The latest news came last week after researchers in the Women’s Health Initiative study tracked eight years of multivitamin use among more than 161,000 older women. Despite earlier findings suggesting that multivitamins might lower the risk for heart disease and certain cancers, the study, published in The Archives of Internal Medicine, found no such benefit...

“I’m puzzled why the public in general ignores the results of well-done trials,” said Dr. Eric Klein, national study coordinator for the prostate cancer trial and chairman of the Cleveland Clinic’s Glickman Urological and Kidney Institute. “The public’s belief in the benefits of vitamins and nutrients is not supported by the available scientific data.”"

List of Top 100 foods to improve productivity

Top 100 Foods to Improve Productivity

Here is a list of healthy foods that should be an essential part of a good diet:

Babies Know - A Little Dirt Is Good for You

Personal Health - Babies Know - A Little Dirt Is Good for You - NYTimes.com:

"In studies of what is called the hygiene hypothesis, researchers are concluding that organisms like the millions of bacteria, viruses and especially worms that enter the body along with “dirt” spur the development of a healthy immune system. Several continuing studies suggest that worms may help to redirect an immune system that has gone awry and resulted in autoimmune disorders, allergies and asthma.

These studies, along with epidemiological observations, seem to explain why immune system disorders like multiple sclerosis, Type 1 diabetes, inflammatory bowel disease, asthma and allergies have risen significantly in the United States and other developed countries.

Training the Immune System

“What a child is doing when he puts things in his mouth is allowing his immune response to explore his environment,” Mary Ruebush, a microbiology and immunology instructor, wrote in her new book, “Why Dirt Is Good” (Kaplan). “Not only does this allow for ‘practice’ of immune responses, which will be necessary for protection, but it also plays a critical role in teaching the immature immune response what is best ignored.”

One leading researcher, Dr. Joel V. Weinstock, the director of gastroenterology and hepatology at Tufts Medical Center in Boston, said in an interview that the immune system at birth “is like an unprogrammed computer. It needs instruction.”

He said that public health measures like cleaning up contaminated water and food have saved the lives of countless children, but they “also eliminated exposure to many organisms that are probably good for us.”

“Children raised in an ultraclean environment,” he added, “are not being exposed to organisms that help them develop appropriate immune regulatory circuits.”"

The simple choices that we make in our lifestyle can be as powerful as drugs and surgery

Deepak Chopra et. al.: 'Alternative' Medicine Is Mainstream - WSJ.com:

By Deepak Chopra, Dean Ornish, Rustum Roy and Andrew Weil

"...if we want to make affordable health care available to the 45 million Americans who do not have health insurance, then we need to address the fundamental causes of health and illness, and provide incentives for healthy ways of living rather than reimbursing only drugs and surgery.

Heart disease, diabetes, prostate cancer, breast cancer and obesity account for 75% of health-care costs, and yet these are largely preventable and even reversible by changing diet and lifestyle....

The latest scientific studies show that our bodies have a remarkable capacity to begin healing, and much more quickly than we had once realized, if we address the lifestyle factors that often cause these chronic diseases. These studies show that integrative medicine can make a powerful difference in our health and well-being, how quickly these changes may occur, and how dynamic these mechanisms can be.

Many people tend to think of breakthroughs in medicine as a new drug, laser or high-tech surgical procedure. They often have a hard time believing that the simple choices that we make in our lifestyle -- what we eat, how we respond to stress, whether or not we smoke cigarettes, how much exercise we get, and the quality of our relationships and social support -- can be as powerful as drugs and surgery. But they often are. And in many instances, they're even more powerful....

Our "health-care system" is primarily a disease-care system. Last year, $2.1 trillion was spent in the U.S. on medical care, or 16.5% of the gross national product. Of these trillions, 95 cents of every dollar was spent to treat disease after it had already occurred. At least 75% of these costs were spent on treating chronic diseases, such as heart disease and diabetes, that are preventable or even reversible....

The disease that accounts for more premature deaths and costs Americans more than any other illness is almost completely preventable simply by changing diet and lifestyle. And the same lifestyle changes that can prevent or even reverse heart disease also help prevent or reverse many other chronic diseases as well....

It's time to move past the debate of alternative medicine versus traditional medicine, and to focus on what works, what doesn't, for whom, and under which circumstances...."

Dr. Chopra, the author of more than 50 books on the mind, body and spirit, is guest faculty at Beth Israel Hospital/Harvard Medical School. Dr. Ornish is clinical professor of medicine at the University of California, San Francisco. Mr. Roy is professor emeritus of materials science at Pennsylvania State University. Dr. Weil is director of the University of Arizona Center for Integrative Medicine.