Tuesday, March 24, 2009

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."

Tuesday, March 10, 2009

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...."

Wednesday, March 04, 2009

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."