China's National Population and Family Planning Commission Minister Zhang Weiqing on Monday said the country would not change its one-child-per-family policy for at least 10 years, the Wall Street Journal reports (Chao, Wall Street Journal, 3/11). Speculation arose in recent weeks that officials were considering significantly changing the policy after Zhao Baige, a vice minister in the national family planning commission, was quoted as saying that China was studying how it could move away from the one-child policy. Zhang said that such changes would cause "serious problems," as well as strain economic and social growth in the country. "Given such a large population base, there would be major fluctuations in population growth if we abandoned the one-child rule now," Zhang said.
The policy limits most urban couples to one child and most rural couples to two children, the New York Times reports. According to the Times, critics of the policy say it has led to "numerous abuses," including forced abortions. The policy also is considered to have contributed to China's gender imbalance. China is currently the most populous country, with 1.3 billion people. The China Daily reported that the population is growing at 17 million people a year. Government officials have said that the one-child policy has prevented about 400 million births, although some independent scholars have placed the level at closer to 250 million (Yardley, New York Times, 3/11).
Zhang said the one-child limit is strictly enforced among only 35.9% of the population living in large cities. He added that the 52.9% of the population living in rural areas can have two children if their first child is a girl and that 11% of the population, mostly ethnic minorities, can have two or more children (York, Globe and Mail, 3/11). Zhang said that officials might consider a change in the policy "if there is need" after an anticipated "birth peak" over the next decade, when 200 million people in the country are expected to enter childbearing years.
According to the AP/Boston Herald, the total fertility rate in China is 1.8 children per couple, below the replacement level of 2.1 children per couple (AP/Boston Herald, 3/10).
Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
Wednesday, March 19, 2008
China Will Not Consider Changes To One-Child Policy For At Least 10 Years, Official Says
What Is Life Like For Teens With Allergies?
A study into teenagers with food allergies will investigate what life is like for them in an attempt to improve their quality of life and curb the number of allergy-related deaths.
Scientists at the University of Portsmouth have created a quality of life questionnaire which asks teenagers what it is like for them to live with a food allergy. They are inviting young people with food allergies to come forward to take part in the study.
A previous UK study which examined all deaths from food-related allergies between 1992-2001 suggested that 35 per cent of deaths occurred in youngsters aged from 10-19.
Children aged 10-14 years accounted for 10 per cent of food allergy deaths and those aged 15-19 accounted for 25 per cent.
Heather Mackenzie, from the University's School of Health Sciences and Social Work said: "Although deaths from food allergy are rare, teenagers are overrepresented in these figures. This indicates that they find food allergies the most difficult to deal with."
In order to develop a draft questionnaire she has interviewed youngsters and discovered that their attitudes to food allergies vary and that the severity of the condition doesn't always dictate the way they feel about it and the way they manage it. She said:
"Some teenagers have relatively mild food hypersensitivity but it has a drastic affect on their quality of life, and vice versa. Teenagers are especially vulnerable because they are learning to take responsibility for their food allergy, which is challenging in itself, whilst also trying to be a normal teenager. Those with serious allergies carry around pre-loaded injection kits containing adrenaline and some see it as a nuisance but it's vital that they understand that it can save their lives and that thousands of others are in the same boat."
The aim of the new study is to provide doctors and other healthcare professionals with a tool to assess teenagers' quality of life by finding out how they feel about their allergy. It will help doctors give them advice on how to manage their allergy and sources of further help.
Mackenzie says she wants more volunteers to complete the questionnaire in order to ensure that it accurately reflects teenagers' concerns. She wants to hear from teenagers who would like to help people to understand more about what living with a food allergy is like for them.
The Anaphylaxis Campaign, a national charity for people with potentially life-threatening allergies (www.anaphylaxis.org.uk), will be helping the study by sending questionnaires to some of its teenage members.
David Reading, director of the Anaphylaxis Campaign, said: "Food allergy can occasionally be serious, but we are convinced that teenagers who are affected can learn how to protect themselves. We would hope that this study will lead to a greater understanding of the problem that allergic teenagers face and better medical advice for them."
Young people aged 13-18 who would like to take part can go to www.port.ac.uk/foodallergysurvey or contact Heather Mackenzie on 023 9284 4441 or heather.mackenzie@port.ac.uk. They will be asked to complete a short questionnaire about how having food allergies affects their life and will be entered into a prize draw to win an iPod.
For more information visit the following link.
Food allergies affect approximately 2.3% of teenagers and approximately 1.4-1.8% of the UK adult population as a whole
The most common allergies are to peanuts and other nuts and they frequently severe but other foods which can be triggers include egg, milk, fish, shellfish, soya, sesame and wheat.
Any allergic reaction, including the most extreme form, anaphylactic shock, occurs because the body's immune system reacts inappropriately in response to the presence of a substance that it wrongly perceives as a threat.
From 1992 - 2002 the UK the youngest person to die from a fatal reaction to peanut was 13 years old and the median age was 21 years.
6 children aged between 10-14 years died in the years between 1992-2001 in the UK and 15 teenagers aged 15-19 years died (25%).
Doctors Should Ask About Cocaine Use When Younger Patients Present With Chest Pains
In a bid to improve management of patients who present with chest pain and other heart attack symptoms, the American Heart Association (AHA) has issued a scientific statement recommending doctors ask about cocaine use when they examine younger patients with chest pains and who have no obvious risk factors for heart disease.
The statement is published as a paper in an early online issue of Circulation, the journal of the AHA, and is authored by Dr James McCord, chair of the statement writing committee and cardiology director of the chest pain unit for the Henry Ford Medical System in Detroit, Michigan, and colleagues.
McCord explained that if doctors suspect a heart attack, then they should rule out cocaine use early on because cocaine exposure changes what is safe and what is not. The statement emphasizes in particular that:
- Clot-busters and beta-blockers are dangerous for patients who have been exposed to cocaine.
- Bare metal stents rather than drug-eluting stents should be used in long-term cocaine users.
- Most cocaine-associated chest pain is not a heart attack.
- Patients who have been exposed to cocaine should be placed under observation for 9 to 12 hours.
Research shows that chest pain that is associated with cocaine use tends to appear within three hours of taking the drug, but the chemical residue stays in the body for a minimum of 18 hours and can continue to present problems, said McCord. Also, doctors have more difficulty diagnosing heart attacks using electrocardiographs of younger patients, he explained.
Cocaine-associated emergency department visits went up by 47 per cent between 1999 and 2002, said the authors, which means that the number of cocaine users that doctors are likely to come across as a result of such admissions will probably increase.
A common method for diagnosing and treating heart attacks is to take the patient into the catheterization lab (the "cath lab"), which has the equipment that allows the doctor to insert a thin tube or catheter into a heart artery and then use imaging techniques to see where the blockage might be, and then inflate a small balloon to open the the artery.
Where a cath lab is not available, a doctor may give a patient who appears to have had a heart attack a clot busting drug instead. However, if the patient is a recent cocaine user there is an added risk of bleeding into the brain because of the higher blood pressure induced by the cocaine. So this procedure should only be used if the doctor is absolutely certain the patient has indeed had a heart attack, said the authors.
Beta-blockers are used to reduce blood pressure without causing narrowing of the arteries. But in patients who have recently been using cocaine and who present with chest pain, beta-blockers may actually produce the opposite effect: they could increase blood pressure and make the arteries already narrowed by cocaine even narrower. This has been shown to have potential fatal consequences in studies using animals, said McCord.
Drug eluting or bare metal stents are used to restore blood flow to the heart where there is no arterial blockage. Studies have shown that long term cocaine users fitted with stents have a tendency to lapses in taking the regular medication needed to stop drug-eluting stents becoming blocked, and that is why the statement recommends such patients be fitted with bare metal ones only.
Cocaine can worsen the effects of a heart attack, said the authors, because it increases the heart's need for oxygen, elevating heart rate, blood pressure and contraction power at each beat. But at the same time the drug also constricts blood vessels and makes it harder for the heart to get the oxygen it needs. This increases risk of clotting and manifests as angina, which is felt as chest pain.
The statement draws attention to other conditions that can develop alongside chest pain and heart attacks with cocaine users, and it is important that these are also looked for as they can be crucial to the treatment that is followed. For instance, one condition that can accompany cocaine use is aortic dissection (a tear in a blood vessel that can be fatal), another is bleeding into the lung ("crack lung").
Other symptoms that patients who use cocaine also report having alongside chest pains are shortness of breath, palpitations, feelings of anxiety, nausea, dizziness and sweating profusely. These are very similar to heart attack.
Very Premature Children At Higher Risk For Increased Disability
Children born of very premature births can have levels of brain and motor impairment that increase as the term of gestation decreases in time. According to an article published in the March 8, 2008 issue of The Lancet, this means that preventing learning disabilities in these children is an important goal for future research.
A very preterm birth is defined as a gestation period less than 33 weeks, while a full term of gestation is generally considered to be 40 weeks. In Europe, between 1.1% and 1.6% of livebirths fit this very premature category. The number of children who survive very preterm birth has increased gradually because of advances in therapies and quality of care. However, this increasing survival rate has raised issues about increases in presentation of adverse developmental outcomes.
To learn more about this, Dr. Beatrice Larroque and Dr Pierre-Yves Ancel, of the INSERM Research Unit on Perinatal Health and Women's Health, Villejuif, France, and Universite Pierre et Marie-Curie-Paris, Paris, France, and colleagues did the EPIPAGE study, which examined 2,901 livebirths occurring between 24 and 32 complete weeks of gestation in nine regions of France. These children were compared to a reference 667 children from the same geographical regions born at 39-40 weeks of gestation. At five years of age, the children were examined medically and assessed for cognitive function using the Kaufman assessment battery for children (K-ABC), recording scores on the mental processing composite (MPC) scale. Medical healthcare history was also collected from the parents.
The children were categorized according to levels of disability. A severe disability was defined as one or more of the following: non-ambulatory cerebral palsy, MPC score less than 55, or severe visual or hearing deficiency. Moderate disability was defined as cerebral palsy allowing walking with aid or an MPC score of 55-69. Minor disability was classified as cerebral palsy involving walking without aid, MPC score of 70-84, or visual deficit.
Of the 2357 surviving children born very prematurely, 1817 (77%) had a medical assessment at the five year follow up point. Of the 664 in the reference group, 396 (60%) were also evaluated. In the very preterm group, 5% had severe disability, 9% moderate disability and 25% minor disability. In the reference group, 0.3%, 3%, and 8% of the children were in these categories respectively. Disability levels were highest in children born between 24 and 28 weeks of gestation. Additionally, special healthcare resources were used more by very preterm children: 42% of children born between 24 and 28 weeks, 31% between 29-32 weeks needed these services; only 16% of the children between 39 and 40 weeks did.
The authors conclude with suggestions for further directions of research: "These results raise questions about health and provision of rehabilitation services, and the cost of these services to families and society. Further work is needed to identify the best and most effective early developmental interventions to improve the functional prognosis of motor disabilities. As they grow older, children with cognitive deficits will have difficulties at school and will need help or special education. No conclusive results about the enhancement of cognitive outcome in the long term have yet been established, and studies investigating such interventions are needed.
Dr Mary Jane Platt, Division of Public Health, University of Liverpool, UK, contributed an accompanying Comment in which she reiterates the need for care after a very preterm birth: "The EPIPAGE study reminds us that children born before 33 weeks need care and support that lasts far beyond discharge from the neonatal care unit."
Monday, March 3, 2008
Ayurvedic Management of HIV/AIDS
At present, there is no scientifically proved cure for HIV /AIDS. Globally, the number of infected HIV /AIDS patients is increasing at an alarming rate; with a current estimate of 33.2 million people who are living with HIV 1. Hence, there is a dire need to search for a safe, effective and economical treatment for HIV /AIDS.
In a retrospective study in 55 patients, Ayurvedic treatment has proved to be very promising in the management of HIV/AIDS. Fifty-Five adult patients were given Ayurvedic treatment for HIV/AIDS, during the period from April 1999 to November 2004.Each patient had tested positive for HIV/AIDS on at least 2 different occasions. No patient was taking anti-retroviral drugs at the time of commencing Ayurvedic treatment. All patients were started on treatment after written, informed consent.
The Ayurvedic Herbal Combination ( AHC ) comprises of eleven different herbs in different dosage strengths, based upon their respective potencies, reported anti-viral and immunomodulatory properties, and their traditional usage according to Ayurvedic principles of medicine 2 -4 .The constituents of AHC with their respective dosages are as follows:-Terminalia arjuna: 250 mg. ;Zinziber officinale: 250 mg. ;Phyllanthus niruri :1 gm ;Glycyrrhiza glabra:1gm. ;Withania somnifera:1gm. ;Eclipta alba: 250mg. ;Centella asiatica: 250mg. ;Boerhavia diffusa: 250mg. ;Emblica officinalis: 250mg. ;Tinospora cordifolia: 250mg. ;Rubia cordifolia: 250mg. This AHC was dispensed in a combined dose of 5 gms. t.i.d., to be taken with water after meals. Aqueous herbal extracts of all the medicines were used, in tablet form.
All patients were advised to eat a well-balanced, nutritious diet. Therapeutic counseling sessions were conducted regularly to help the patients achieve mind relaxation, to modify their risk behavior , and to increase adherence and compliance to therapy.
All patients were followed up at monthly intervals. Detailed clinical examination was done at each visit and significant findings were recorded. In addition, in affording and willing patients, investigations like CBC, Hb, Liver and Renal functions, X-Ray of chest, Western Blot, CD4 count and Viral Load were done wherever possible. Other investigations were done, if required, for Opportunistic Infections (O.I.).All O.I. were promptly and aggressively treated with modern medicines. A close watch was kept for adverse reactions of the drugs.
Therapeutic outcome was assessed by overall clinical examination, change in Karnofsky score (assessment for overall well-being of patients), change in weight, occurrence and response to O.I., and change in CD4 and Viral Load values. Maximum number of patients was in the age ranging from 20 - 39 years (80 %). Of the total number of 55 patients, 39 were male (71 % ) and 16 were female (29 %), with the male: female ratio being 2.4: 1. There were 7 couples who took treatment together.
Of the 55 patients, 5 patients died, 42 patients took treatment for varying periods and then stopped treatment, while 8 patients continued treatment till the end of the study period. The 5 patients who died were critically ill at the time of presentation, and died mostly within the first two months of starting Ayurvedic treatment. The cause of death varied ; 1 patient died from cirrhosis of the liver, 3 died of extensive Pulmonary Tuberculosis (multi-drug resistant) and 1 died of a combination of Pulmonary Tuberculosis and demyelination disease of the brain.
In the 50 patients who were alive till the time of their last follow-up , there was an average weight-gain of 2.3 kgs.(range = - 4 to + 7.5 kgs), usually within the first 3 months. In those patients who took continuous treatment for more than 3 months, the Karnofsky score increased from an average of 75.9 at the commencement of treatment to 87.4 at the last follow-up. Almost all the patients had 1-3 O.I. at the time of presentation. Other than Tuberculosis, all the O.I. cleared up rapidly within the first 2 months of treatment.
Long-term administration of Ayurvedic medicines (upto 30 months) did not seem to have any major adverse effects. In fact, in a few patients, the tests for liver and renal function appeared to normalize further, with treatment. Haemoglobin readings gradually improved in those patients taking regular, prolonged treatment.The most striking effect of the Ayurvedic medicines was on the Viral Load and CD4 counts. Because of financial constraints, only 15 patients (27 % ) agreed to do either the Viral Load or the CD4 count, or both. In most patients, there was a definite and steady decrease in the Viral Load, and an increase in the CD4 cell counts.
Antiretroviral medicines are the mainstay in the modern treatment of HIV/AIDS. However, a plethora of side-effects, development of resistance to drugs and escalating treatment costs are serious concerns. In the absence of a definite cure for HIV/AIDS, Ayurvedic medicines may provide a useful alternative for long-term management of patients, since these medicines are economical and devoid of serious side-effects. However, scientific research is necessary to determine efficacy of these medicines. This retrospective study is one such effort to assess long-term therapeutic effects of an Ayurvedic Herbal Combination in the management of HIV /AIDS.
In this study, 4 patients died within the first 2 months of commencing treatment. Onset of therapeutic effect is slow with Ayurvedic medicines, and these patients probably could not benefit from Ayurvedic treatment. This emphasizes the need to start treatment as early as possible in immuno-compromised patients. The causes of death indicate that Tuberculosis and CNS involvement are major killers in HIV patients. Multi-drug resistance to Tuberculosis is also a major concern.
16 patients ( 29% ) did not come back after just one ( 11% ) or two ( 18% ) visits. The reasons cited were, a complete inability to pay for treatment, or a search for a ‘better’ or a ‘guarenteed cure’. Fortunately, perceptions have changed in the last few years. Even illiterate patients from the lower socio-economic strata are no longer asking for a ‘guarantee’ or a ‘cure’. ‘Long-term management with minimum expenses’ is a mantra being readily accepted by the HIV positive patient of today.
All the patients who took medicines regularly, had a high-protein diet and kept themselves busy, improved very well and put on weight. Even 2 to 3 years after stopping Ayurvedic treatment, most of the patients are doing very well, some inspite of very low CD4 counts. This is probably one of the biggest long-term advantages of taking Ayurvedic medicines for HIV /AIDS. However, patients with socio-economic difficulties and a lot of psychological pressure who could not have access to regular treatment, started losing weight after initially improving with treatment. A comprehensive management of each patient thus needs to address several issues relevant to each individual patient.
This study also brought forth some interesting results. One patient who subsequently died, had severe demyelinating disease of the brain (as diagnosed in a major hospital), and had lost most of his motor control and sensory senses, since several months. After being given Ayurvedic treatment for about 1 ½ months he became alert, and could speak clearly, albeit temporarily, for 1 week. Another patient with Nephrotic syndrome resulting in long-standing generalized oedema (2 years ) had complete regression of the oedema after 2 months of Ayurvedic treatment without any other treatment. One HIV positive patient with suspected malignancy of lung in the right upper lobe was steadily losing weight. After starting Ayurvedic treatment, he started putting on weight. Another patient with history suggestive of HIV Encephalopathy was semi-conscious at presentation. He was passively fed on liquid diet and a combination of both modern drugs and Ayurvedic treatment. This patient be!
came ambulatory within 2 weeks, and after 2 months of treatment he was faring well, even with a CD4 count of just 6.The above 4 instances indicate that the Ayurvedic medicines may have multi-faceted properties and need further evaluation.
Thus,the retrospective study of 55 HIV positive adult patients treated with an Ayurvedic Herbal combination from April 1999 to November 2004 proved the Ayurvedic medicines to be highly effective as anti-viral and immuno-stimulant,and safe on long-term use. A nutritious diet, Ayurvedic baseline therapy, timely allopathic treatment of Opportunistic Infections and regular counseling support appears to be an ideal combination in the management of HIV/ AIDS patients.
America's Children Are Dying To Lose Weight
Wasting away, Katie died weighing only 58 pounds. And she was sixteen. That just doesn't seem possible to me when I look at my seven-year-old daughter who weighs in at about 55 pounds. Anorexia is a medical enigma. Although there is little concrete evidence of what actually causes anorexia, most experts agree that there are several contributing risk factors. We believe that awareness of these risk factors can reduce the odds that they will be triggered so we are hopeful that this information will save lives. If you're a parent or a teacher, you need to read on…
Word has it around town that Katie had been told by a high school teacher that "she needed to go on a diet." So she did. Certainly this one comment didn't cause this young lady to spin out of control with dieting but it might have been the straw that broke the camel's back. Negative comments about body type and size from authority figures, teachers, coaches and parents, can have a big impact on an adolescent child's self-esteem and are implicated as possible triggers in studies on anorexia. Never underestimate the power of the spoken word to heal… or kill…
Eating disorders (bulimia and anorexia) have historically been considered a girl problem but the pendulum is swinging. Anorexia is being diagnosed more frequently in boys, too. Young boys are becoming more body image conscious than in previous generations. Case in point: my nine-year-old son has come home from school upset on several occasions because kids have called him fat. He is far from fat; in fact, he has cystic fibrosis so we are grateful for any extra padding he has and work very hard to keep his weight as high as possible. His diet is exactly the opposite of what everyone else is eating, filled with high fat, high calorie foods. Jacob understands the importance of complying with his dietary requirements but it can be hard for him to go against the norm.
With the emphasis on childhood obesity and diabetes, children are thankfully becoming more aware of the necessity of good nutrition and weight control. But I wonder if there is a price to be paid by children who are predisposed to eating disorders. With the media, parents, doctors, schools and peers emphasizing being thin and high achieving, it will be unfortunate if the numbers of children diagnosed with anorexia accelerates.
The difficulty lies in knowing which children are predisposed to eating disorders. As our society addresses the obesity issue, are we unknowingly putting some children at risk for eating disorders? How can we address the very real, very troublesome problems associated with the alarmingly increasing body mass index of our young children without triggering other children's potential for becoming anorexic?
This is a problem every parent of every child should consider. Research shows that about 6% of young people suffer from an eating disorder and this figure is thought to be low. The next time you are at a school assembly, look around. There are likely to be at least 10 kids there who have an eating disorder. One of them may even be your own. It is thought that the "anorexic mentality" is in place long before there is physical evidence of the disease. Has your thirteen -year-old been on a diet lately? Stats say that there is an 80% likelihood that she has been. Dieting at a young age puts children at risk for anorexia.
The cause of an eating disorder in any one child is unclear because multiple factors appear to play a role. Genetic factors, family interaction patterns, and the individual's own character and personality have all been implicated. But to summarize the problem in a single sentence, it appears that the illness is a response to coping with stress in genetically predisposed children who are filled with denial about their feelings and weight. There! Quick, short, concise, and anything but simple. This single sentence has many implications for parents and parenting. Let's take a brief look at each of these contributing factors individually and provide parenting responses that might be helpful in combating eating disorders.
1. The Genetic Factor in Eating Disorders
Eating disorders, like many other behavioral illnesses, appear to run in families. Not only does the illness itself run in families but the predisposing temperament seems to as well. The one good thing about illnesses that run in families is the fact that children can be prepared to recognize warning factors prior to the onset of the problem. When children are forewarned, they are forearmed. This forewarning is best carried out in a heart-to-heart discussion about possible future problems. A loving parent, relative, or counselor can initiate dialogue before the child is an adolescent, in an informative, non-hand-wringing and factual manner that indicates a hopeful outlook for a healthy future.
2. Anorexia and Bulimia as a Way of Coping with Stress
Food and emotions are closely linked. Over- and under-eating change brain chemicals that affect anxiety and depression. They are both often unhappy and ineffective ways of coping with stress. An authority on anorexia recently noted that a child's inherent vulnerabilities "load the gun," and environmental stresses "pull the trigger." So, assuming inherent vulnerabilities like genetics are unchangeable, how can we avoid pulling the trigger? Is it possible that we can use parenting techniques that will reduce the odds of pulling the trigger?
We believe the answer is yes. We can easily use parenting techniques that excel at raising children who effectively learn to cope with stress in healthy ways. Such techniques include guiding children to solve their own problems rather than solving them for them, allowing children to experience the consequences of their decisions, and responding to children's mistakes with empathy and understanding rather than anger, frustration, and criticism. These are great immunizations against the use of food as a dysfunctional coping response. The experience of coping and overcoming difficulties with good problem-solving skills leads to the ability to confront feelings and issues in a healthy manner, rather than displacing them with changes in food intake. Also, the child's history of successfully coping with painful outcomes of poor choices makes denial much less likely. And, when a child's mistakes are met with empathy and understanding rather than anger and frustration, a child feels!
supported and understood rather than criticized, demeaned and alone.
3. Psychological Factors in Eating Disorders
Two personality factors have often been reported to be present in eating disorders: perfectionism and high, unrealistic expectations of self. Even when anorexic adults have achieved success, deep down they report feeling insecure and inadequate. There is a tendency to see things only in extremes without shades of gray:
"I'm good or I'm bad."
"I'm pretty or I'm ugly."
"I'm successful or a complete failure."
"I'm perfect or defective."
"I'm fat or I'm thin."
Healthy parenting techniques discourage this type of thinking. Parents: don't over-reassure your children. Over-reassurance actually validates the child's negative thinking and may lead to unhealthy "either/or" black-and-white thinking. Responding with, "Gee, honey, I see it differently, but tell me how you are no good," allows for less manipulation, more acceptance of responsibility, and a child's far more accurate self-examination. Using encouragement rather than praise is also an important parenting technique to increase children's self-awareness. Encouragement gives them experience in viewing themselves, their responses, and their creations realistically, rather than simply trying to please an authority figure. With this simple tool, parents can easily help children learn how to feel good from the inside out rather than looking for approval and self-worth from authority figures.
4. The Role of the Family
There are a number of family factors that are thought to play a role in eating disorders. As we look at some of these interaction factors, it is safe to say that while healthy parenting patterns certainly will not cause or aggravate the problem, they may not be able to alleviate the problem either. Loving, effective parents are known to have had children suffering depression, suicide, and eating disorders. Also, this discussion on parenting styles should not be used as a source of parental guilt but instead provide motivation for change if change is needed. Parents do the best they can, under the circumstances they experience, to raise their children with the love they are able to show. The problem in examining family patterns lies with the fact that all sorts of dysfunctional patterns have been reported. These form a long list:
- Smothering and over-protective families
- Controlling and critical parents
- A chronic feeling of being abandoned and misunderstood
- Having parents or a family that overemphasize appearance and achievement
- Having rigid parents who don't model good conflict resolution skills
The effect of unintentional, yet unhealthy, parental responses cannot be ignored. Again, good parenting techniques do not guarantee success, but at least they are unlikely to contribute to the problem. So rather than focusing on what is speculatively wrong, it is more effective to focus on doing what is right by using healthy parenting skills rather than the unhealthy ones that contribute to dysfunctional family patterns. Whether or not an eating disorder is present, or may be present in the future, it will never hurt for parents to show healthy responses and good parenting techniques.
5. Societal Influences
Finally, there are possible societal factors that influence eating disorders. Big drinks and big burgers have enticed the population into a diabetic frenzy. While most of the population is downright overweight, the females that populate the media (those who model prettiness and good looks) are generally thin to the point of appearing anorexic themselves. Talk about image confusion! On the male side of the equation, we have the same issue with buff men cavorting playfully with thin, pretty women.
With so much emphasis in our culture on athletic performance and good looks, it is not too surprising that some predisposed children take things too far. And, although on the surface it seems reasonable enough to blame society for the self-destructive choices of an individual, this is ultimately self-defeating when dealing with individual situations. Blaming society or others simply removes individual responsibility and accountability and actually increases the likelihood of the negative behavior.
In conclusion, when all is said and done, nobody, at this point, can say with any certainty the exact cause of an eating disorder in any one particular child. But we can say with absolute certainty that all the speculation, studies, reports, and conjecture do not implicate the healthy family interaction patterns taught by Love and Logic. It would appear the personality of the anorexic person is not that of children who have grown up in a home advocating honest acceptance of personal responsibility and where children are:
- Lovingly supported by parents who view mistakes as learning experiences,
- Allowed to make choices and share control,
- And encouraged to cope with the stresses of life in healthy ways.
An ounce of prevention is worth a pound of cure particularly where eating disorders are concerned. At this time, there is no cure for anorexia. And America's children are dying to lose weight.
About Essential Fatty Acids and Fish Oil
What are essential fatty acids?
Essential fatty acids are unsaturated fats typically found in the oils of vegetables, certain nuts and seeds and some fish. They’re said to benefit health more than the saturated fats found in meat and dairy products and may even have a positive impact on cholesterol and triglyceride levels in the blood. Essential fatty acids are referred to as "essential" because they must be obtained through diet and are essential to the normal growth and function of muscles, nerves, cells and organs in humans. There are two families of essential fatty acids, omega-3 fatty acids and omega-6 fatty acids.
Omega-3 fatty acids – the fatty acids found in fish oil
Omega-3 fatty acids are a type of polyunsaturated fat present in many coldwater fish including trout, salmon, sardines, anchovies, herring, mackerel, tuna and cod. The two most potent forms of omega-3 fatty acids are eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA), both known as "good fats" – unlike saturated fats, which when consumed in excess can lead to cardiovascular problems, neural and brain disorders.
EPA helps to produce the prostaglandins (hormone-like substances) which help control blood-clotting and arterial functions. EPAs may also help to lower serum triglyceride levels.
DHA is a major component of human brain and retinal tissue and aids the transmission of nerve impulses.
The term "omega-3 essential fatty acid" has become synonymous with "fish oil" in modern American marketing literature.
Sources of omega-3 essential fatty acids other than fish oil include, but are not limited to:
• Avocadoes (whole or oil)
• Brazil nuts
• Flaxseed
• Flaxseed oil
• Fortified milk products
• Hempseeds
• Hempseed oil
• Omega-3 eggs
• Pumpkin seeds
• Sesame seed
• Soybean oil
• Walnuts
• Wheat germ oil
Omega-6 fatty acids – not found in fish oil
Omega-6 EFAs are found in animal products such as dairy and meat and are common in cooking oils such as safflower, olive, sunflower, hemp, soybean, pumpkin, sesame, walnut and flaxseed oils. Too many omega-6 EFAs, say nutritionists, can throw off the balance of prostaglandins and lead to health problems. Experts recommend a ratio of three parts omega-3 essential fatty acids to every one part omega-6 fatty acid in the diet. Research indicates that Americans consume far more omega-6 fatty acids than omega-3 as a result of overindulging in fried foods, red meat and cheese.
Omega-6 fatty acids are dependent on interactions with omega-3 essential fatty acids in order to benefit good health, which is why a balance of the two is crucial in the diet. The American Heart Association cautions against a high dietary intake of omega-6 fatty acids as it can lead to the development of gallstones and promote tumors.
Prostaglandins
Prostaglandins encompass a number of hormone-like substances found in every cell in the body. They’re critical to the dilation and constriction of blood vessels, the contraction and relaxation of muscles, the regulation of blood pressure and the modulation of inflammation. Prostaglandins are needed for overall good health and maintenance and must be replenished constantly. It’s easy to understand why having a good balance of prostaglandins in the body is essential to well-being.
Where does fish oil come from?
Most fish oil is extracted from the fatty flesh of the fish, unless a product specifically states otherwise, as is the case with cod liver oil or shark liver oil – extracted from fish liver. Nutritious fish oil is usually derived from deep, coldwater fish and those swimming in the wild (wild fish eat other fish and marine animals and vegetation to survive, whereas farm-raised fish are typically fed some type of less nutritious, less expensive, commercial-grade pellet). Some experts say the best fish comes from the deep Atlantic of Norway and other Scandinavian countries: the deeper and colder the water, say experts, the less chance of toxins such as mercury, lead, dioxins, furans and PCBs occurring in the fish oil. Fish from eastern Pacific waters is known to contain elevated levels of mercury.
Fish oil supplements – good ones / bad ones
"Product disclosure" is the operable phrase when seeking out nutritious fish oil supplements. From what kind of fish is the oil extracted and from where is it extracted naturally through pressing or with a centrifuge; or are petrochemical solvents such as hexane used to extract the oil from the source? How is the fish oil refined? Is it molecularly distilled, which to date is the most reliable form of fish oil purification, or does the label read something like "extra-distilled" or "super-distilled?" Such terms have no bearing on quality or safety. Because the hundreds of thousands of fish oil supplements on the market remain unregulated by the FDA, the safety, consistency, efficacy and strength of these products varies immensely among brands.
When reading fish oil supplement labels:
• Make sure the type of fish from which the fish oil is extracted is listed.
• Look for terms "coldwater," "deep water" and "wild" as opposed to "farm-raised."
• In what ocean or hemisphere was the fish caught? North Atlantic, deep, coldwater is said to be the most nutritious.
• Make sure the fish oil is molecularly distilled, which better ensures the absence of PCBs, heavy metals and other contaminants.
• What parts of the fish were used? Fish oils extracted from fish liver may be higher in heavy metals and contaminants.
• What fish oil extraction method was used? Cold or modified expeller pressing means that the oil was produced without damaging temperatures or unnecessary pressure.
Marketing claims that have no defined meaning in relation to fish oil supplements, and which often mislead consumers, include:
• Ultra-pure
• Professional grade
• Pharmaceutical grade
• High-potency
• Super-distilled
• Natural
• Extra-distilled
• Best
• Finest
• Highest quality
• Pure
• Purest
• Purified
Essential fatty acid health benefits and risks
Few argue the benefits of fish oil and essential fatty acids in the diet. Clinical studies have demonstrated that the omega-3 fatty acids can benefit cardiovascular health and that "good unsaturated fats" derived from vegetables and fish are far more nutritious than "bad saturated fats" which come from red meat, animal products and dairy. The cardiovascular benefits to balancing omega-3 and omega-6 fatty acids in the diet include lowered serum cholesterol, decreased serum trigylcerides and reduced platelet aggregation. Although many fish oil supplement companies claim that fish oil supplementation may aid brain function and strengthen the immune system, a complete body of evidence has yet to be produced.
Along with the health benefits of fish oil come some risks, most associated with taking too high doses of fish oil or having dangerously high levels of omega-3 and omega-6 essential fatty acids in the blood. Some of these risks can include:
• Thinning of the blood and reduced ability of the blood to clot.
• Increased risk of bleeding.
• Too large doses can increase glucose levels in persons with already elevated blood sugar levels.
• In excess, fish oil may suppress the immune system.
• Increase the occurrence of nosebleeds and easy bruising.
• Upset stomach, nausea, diarrhea and belching.
• Poisoning from heavy metals, PCBs, dioxins and pesticides.
Experts and nutritionists are convinced that the health benefits of fish oil far outweigh the risks. However, many warn that fish oil shouldn’t be taken with blood-thinning medication such as warfarin or aspirin and shouldn’t be taken by anyone with bleeding disorders or uncontrolled hypertension. It is highly advisable to consult a physician before supplementing a diet with fish oil.
EPAs, DHAs, efficacy and the FDA
In September of 2004, the FDA announced they would allow a qualified health claim for reduced risk of coronary heart disease for conventional foods that contain EPA and DHA omega-3 fatty acids as outlined in FDA’s "Interim Procedures for Qualified Health Claims in the Labeling of Conventional Human Food and Human Dietary Supplements." Notwithstanding inconclusive research at the time of release, the FDA said it would exercise its enforcement discretion with respect to the following qualified health claim:
"Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease. One serving of [name of food] provides [x] grams of EPA and DHA omega-3 fatty acids. [See nutrition information for total fat, saturated fat and cholesterol content.]"
In 2000, the FDA announced a similar qualified health claim for dietary supplements containing EPA and DHA omega-3 fatty acids and the reduced risk of coronary heart disease (CHD). The FDA recommends that consumers not exceed more than a total of three grams per day of EPA and DHA omega-3 fatty acids, with no more than two grams per day from a dietary supplement.
Monday, February 25, 2008
The Changing Face of AIDS
The rapidly mutating virus developed resistance to the drugs that were used to suppress it. In the mid 1990’s drug “cocktails,” multi drug combinations of antiretroviral drugs were able to provide barriers to mutation. The number of deaths for AIDS patients dropped dramatically and long term aspects of the disease changed. Victims could expect longer life spans though they would require medication the rest of their lives.
The longer life expectancy of AIDS patients presented another set of problems. AIDS patients are living longer, but they are aging faster. Those in the 50 to 60 age group who suffer from AIDS, have the health issues that most people do not experience until they are a decade older.
The number of AIDS sufferers over the age of 50 has increased by 77% from 2001 to 2005, and now more than a quarter of the approximately one million active AIDS cases in this country are advanced in age. Of 5,049 patients who began AIDS therapy between 1995 and 2004, 997 were over the age of 50, 1,834 were 40-49 and the rest were between 18-39 years of age. AIDS presented new challenges to the medical community in the 70’s and 80’s and now the problems presented in the aging AIDS population is again challenging the medical community.
There is presently no data that specifically compares the onset of geriatric diseases between AIDS and non AIDS patients, but the medical community says that people in their mid-50’s, without AIDS, usually do not have heart disease or diabetes associated with lipodystrophy or oesteoporosis without additional risk factors.
Lipodystrophy is a side effect of the drugs that keeps HIV in check. It rearranges fat in the body and can lead to the sunken eyes and cheeks usually associated with advanced age. It can lead to insulin resistance and raise triglyceride levels. Individuals on AIDS therapy treatment are usually treated with corticosteroids to protect against other opportunistic infections that prey on HIV weakened immune systems. This can lead to a bone disease, vascular necrosis, and the necessity for hip replacement surgery. Other aging problems with HIV are the development of memory deficits and liver and kidney disease.
In a Jan 6, 2008 article in the International Herald Tribune, Jane Gross quotes Dr. Tom Barrett, medical director of Howard Brown, “All we can do right now is to make inferences from thing to thing to thing. They might have gotten some of these diseases anyway. But the rates and the timing, and the association with certain drugs, makes everyone feel that this is a different problem.”
Why is this happening? There haven’t been any studies to provide sound statistics of what problems are related to AIDS. Only recently have there been enough aging AIDS patients to study. The initial assumptions are that those who have survived with the AIDS infection, have immune systems and organs that first took a beating from the disease, and then were further damaged by the toxicity of the antiretroviral drugs which they took to survive the disease.
With lack of research, patient care suffers. Barrett says the incidence of osteoporosis warrants routine screening. However, in the United States, Medicare, Medicaid and most private insurers will not cover bone density tests for middle aged men.
The New York-based AIDS Community Research Initiative of America, in trying to provide help and assistance to older individuals with AIDS, found that depression, which is common to the elderly, is even higher among longtime AIDS survivors. They often grow despondent because of health issues and the deaths of friends and associates.
Mary Engel, writing in the Los Angeles Times on February 5, 2008 quotes Los Angeles resident and long time survivor Thomas Woolsey, 59, “Everybody I knew died in the late ‘80’s or early ‘90’s. It sounds like I’m the lucky one, but I don’t really think so. What good is a life without any friends?”
Healthy Holiday Eating Tips
Clearly, the holidays are not a time to diet. But you can take steps to lessen the impact on your waistline.
Never go to a holiday event on an empty stomach. Fasting ahead of time to leave room for that BIG MEAL or extra trips to the buffet is a no-no. Be sure to eat a snack or light meal before leaving home; foods like chicken or cottage cheese which are high in protein help you eat less later.
Offer to bring a dish to holiday parties. Make it a low-calorie version of a favorite, insuring at least one safe choice. Don’t stand near the buffet where you might be tempted to fill your plate again, and again.
If the event is at your house, do yourself and your guests a favor by including healthier items such as salad, fruit and vegetables on the menu. Provide low-calorie and fat-free salad dressings, dips and condiments. When preparing dishes, look for healthy ingredient substitutions such as low-fat or skim milk instead of whole milk and swap applesauce for oil in baked goods. The dishes can be just as tasty without all the added fat and calories.
Watch your portion sizes. This becomes especially important at a buffet, where there are so many choices, each looking so inviting. You can still have a large variety of food; just eat a small portion of each.
Slow down. Don’t eat as if you’re at an eating competition. Choose your food carefully and then eat slowly, savoring the flavor of each bite. Most people eat so quickly, their stomach is full long before the signal reaches their brain; which usually leads to overeating and that bloated, miserable feeling.
Do your best to stick with an exercise program. Exercise not only helps keep away the pounds but also helps to reduce the stress which often accompanies family get-togethers and social events. After the meal, take the socializing outdoors for a nice walk around the neighborhood or to a nearby park.
Don’t fall into the fast food trap. The holiday season can be hectic and leave you with little time to prepare healthy meals. Plan ahead; prepare meals ahead of time and freeze them so they are handy when you need them.
Be realistic. Holidays are a time for fun and you will want to join in. Instead of dieting, try aiming for maintaining your present weight by making smart eating choices and staying active. Pat yourself on the back for all of your efforts!
Traditional Chinese Medicine may reduce the side-effects of chemotherapy
Traditional Chinese Medicine (TCM) may help in reducing the side-effects for breast cancer patients undergoing chemotherapy, according to a recent study conducted by the Cochran Collaboration. The Cochran Library is an independent evidence based research group that provides evidence to inform healthcare decision-making.
Although chemotherapy is still considered the best treatment for breast cancer, the side effects can be very unpleasant. Side-effects include nausea and vomiting, decrease in bone marrow density, mouth soreness, lower resistance to infections, hair loss, and weakness and fatigue. More than half of the women that undergo chemotherapy suffer from one or more of these side-effects.
The purpose of the review was to evaluate the safety and effectiveness of using traditional Chinese Medicinal Herbs to reduce the side effects of chemotherapy. The study followed 542 women with breast cancer undergoing chemotherapy, and concluded while there was no statistical evidence to suggest that Chinese Medicinal Herbs could be harmful, the use of Medicinal Herbs may offer some benefit to those breast cancer patients undergoing chemotherapy in terms of bone marrow improvement and quality of life. There are approximately 50 fundamental herbs used in Chinese medicine and combinations of these herbs make up herbal remedies. For this study, six common herbal remedies were tested.
Despite widespread use of alternative medicine, such as Traditional Chinese Medicine, historically, there have been very few clinical trials to measure the health outcomes from their use. The Cochran study is a welcomed step forward in this direction. The authors admit that more well designed trials are required and that the evidence in this study it too limited to provide confident conclusions.
Consumers: Beware of Counterfeit Colgate Toothpaste
In the initial recall announcement, the importer, MS USA Trading, Inc. of North Bergen, N.J., said the toothpaste may contain diethylene glycol, a chemical found in antifreeze. The trading company said the problem was discovered in routine testing by the Food and Drug Administration.
Colgate-Palmolive assures customers that “counterfeit toothpaste is not manufactured or distributed by Colgate and has no connection with the company whatsoever”. They also add that diethylene glycol is not now and has never been an ingredient in Colgate toothpaste anywhere in the world.
According to a Colgate-Palmolive news release, the counterfeit products were found in several ‘dollar-type discount stores’ in Maryland, New Jersey, New York, and Pennsylvania. Updated information also includes small discount retailers in Canada.
Colgate-Palmolive, in cooperation with government health and law enforcement authorities, continues to remove counterfeit toothpaste from the shelves of retail stores. Here are some indicators to look for to identify the counterfeit product:
• The counterfeit toothpaste is labeled as a five ounce or 100 ml tube, a size not made or sold by Colgate in the United States.
• Includes regular, gel, triple and herbal versions.
• There are words on the package, “Manufactured by: COLGATE-PALMOLIVE (PTV) LTD., SOUTH AFRICA-52 Commissioner Street, Boksburg, 1460”
• There may be several misspelled words on the product carton including: “isclinically”, “SOUTH AFRLCA” and “South African Dental Assoxiation”.
Colgate products are sold in a wide variety of retail outlets including supermarkets, pharmacies, general merchandise stores, large dollar stores and club stores. To help you identify genuine Colgate toothpaste made for sale in the United States, look for:
• The words “Distr. by Colgate-Palmolive, New York, NY 10022” appear in the lower right-hand corner of the panel on the box.
• In the white box that contains the UPC bar code genuine Colgate products for sale in the U.S. begin with the code number 35000.
Colgate says it is working closely with the FDA to help identify those responsible for the counterfeit product.
If you suspect that you have counterfeit product, do not use it. Visit the FDA’s web site (www.fda.gov) for more information or call Colgate’s customer service line (1-800-468-6502)
Thursday, February 21, 2008
Key To Long Life
A study has shown that men who exercise, are the right weight and do not smoke during retirement increase their chances of living for another 25 years, reported The Daily Telegraph. The Guardian also covered the story and said the chances of reaching 90 were surprisingly dependent on behaviour from age 70 onwards.
Both newspapers gave a list of adverse factors and their estimated effect on the odds of a 70 year old man reaching 90. These included high blood pressure, lack of exercise, smoking, obesity, diabetes, and a sedentary lifestyle.
This study adds to the body of knowledge on what contributes to exceptional longevity in this age group: that smoking is bad and exercise and a healthy weight are good. However, the study did not look at all the factors that can affect lifespan. Also, the study was carried out in mainly white, middle class men in the US so the findings may not apply to all 70 year olds.
What were the results of the study?
The researchers found that of the 2,357 men aged around 70 when they enrolled in the study, 970 (41%) men survived to age 90.
Those men who did not have high blood pressure, were not sedentary, did not smoke, and were not obese or diabetic at the start of the study had a 54% chance of living to 90 years old.
Men who smoked at the start of the study had only a 25% chance of living to 90 years old. Having a combination of different adverse effects at enrolment reduced the probability of survival even further, e.g. someone who was sedentary, with high blood pressure and diabetes had a 19% chance of surviving to 90 years old, while someone with all five risk factors had only a 4% chance of still being alive 20 years later.
This was a large study and there were other relevant findings: smoking or being overweight was associated with worse physical ability, while moderate, vigorous exercise was associated with better physical ability. Not surprisingly, the men who lived to 90 or older were less likely to have cancer, heart disease, or other diseases associated with high mortality.
Blood test detects ovarian cancer early
Researchers have developed what they believe is the first blood test that accurately detects ovarian cancer at an early stage.“The ability to recognize almost 100% of new tumours will have a major impact on the high death rates of this cancer,” senior author Dr. Gil Mor, from Yale University School of Medicine in New Haven, Connecticut, said in a statement. “We hope this test will become the standard of care for women having routine examinations.”
In 2005, Mor’s team first described a panel of biomarkers that can detect stage I and II ovarian cancer.
In the present trial, reported in the medical journal Clinical Cancer Research, the researchers expanded the panel from four proteins to six, and used a sophisticated assay system to measure protein levels in 362 healthy women and 156 patients newly diagnosed with ovarian cancer.
Alone, none of the biomarkers could distinguish the cancer patients from the healthy comparison group, the researchers report. When all six biomarkers were measured, however, the test identified 95 percent of the cancer patients.
A larger evaluation of the biomarker assay is currently underway.
