Health News You Need to Know

15 health news stories from the past 12 months that you can’t afford to miss
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A newer, safer hormone therapy

Conventional HT-a combination of estrogen and progestin-is an extremely effective treatment for severe hot flashes and other menopausal symptoms. But this pharmaceutical blend is believed to increase a woman’s chances of developing breast cancer. And estrogen therapy by itself (without progestin) is linked to uterine cancer. Now researchers are optimistic that they have found a safer kind of hormone therapy-one that replaces progestin with a type of drug known as a selective estrogen receptor modulator (SERM). You have probably heard of two SERMs already: tamoxifen, which is used in the treatment and prevention of breast cancer, and raloxifene, which is typically prescribed as a bone builder to combat osteoporosis. Now two new studies suggest that SERMs plus estrogen can relieve menopausal symptoms in women while also reducing their risk for both breast cancer and uterine cancer: When researchers at Yale University treated breast and uterine cancer cells with estrogen plus a new SERM called bazedoxifene, they found that the combina-tion appeared to avoid the problematic cell-proliferating effect of conventional HT. In another recent study, from the journal Fertility and Sterility, researchers found that the combination greatly reduced hot flashes and vaginal atrophy. The estrogen-bazedoxifene combo is being tested in large clinical trials. "The FDA may approve it in the next couple of years," says Hugh Taylor, MD, one of the Yale researchers. Estrogens combined with available SERMs, such as raloxifene, may also improve symptoms, but more research is needed.
Illustrated by August Heffner

The risky pill women pop

About half of American women ages 40 and over take some kind of dietary supplement. But recent studies have questioned the effectiveness of one type of pill, the multivitamin, in heading off major problems like heart disease. Now there’s a suggestion that multis may actually cause harm: They’ve been associated with an increased risk of breast cancer. In a 10-year Swedish study of 35,329 women ages 49 and up, participants who reported using multivitamins every day were 19 percent more likely to develop the disease, a finding that held up after researchers adjusted for various risk factors. One theory is that a component of multivitamins-possibly folic acid, which another study recently linked to breast cancer in a small minority of women-might play a role, says author Susanna Larsson, PhD, of the Karolinska Institute in Stockholm. To be clear: This observational study did not definitively establish that multivitamins contribute to the development of breast cancer. But the research does underscore the idea that it’s generally safer (and more effective) to "get as many nutrients as we can from food instead of pills," says Andrea Giancoli, RD, MPH, spokeswoman for the American Dietetic Association.
Holly Lindem

The walking rate that gets results

Experts recommend working out at a moderate intensity to reap the cardiovascular benefits of exercise. But how do you know if you’re working hard enough? Researchers at San Diego State University sought a simple way for walkers to gauge metabolic intensity (referred to as metabolic equivalent units or METs), a measurement based on oxygen intake. When the scientists monitored treadmill walkers, they found that women tended to reach MET 3, the minimum level of oxygen intake for moderate physical activity, at about 100 steps a minute. To keep the best pace, wear a pedometer and a watch, says lead study author Simon Marshall, PhD. And aim for 3,000 steps in 30 minutes.
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Happy music, healthy heart

Protect your ticker with cheerful tunes. Scientists at the University of Maryland School of Medicine found that when people listened to music they found joyful, their blood vessels widened by 26 percent. Such expansion means that the protective chemical nitric oxide has been released, which reduces the risk of blood clots and hardened arteries, says researcher Michael Miller, MD. On the other hand, hearing music that listeners described as anxiety-causing narrowed blood vessels by six percent and produced artery harming chemicals. The Rx: Listen to music that boosts your mood at least three times a week.
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The smart way to pay your medical bills

As health care costs jump, money-saving flexible spending accounts offer more savings. This employee benefit lets you use pretax income to pay for out-of-pocket health care expenses. The catch: Unspent funds don’t carry over into the next year. Dental and vision expenses tend to be predictable, but how do you estimate the right amount to put aside for medical costs? Here’s a formula that can help. Deductibles: Count on at least $200 for in-network fees and about $100 more than your 2009 out-of-network deductible. {plus} 6 to 12 co-pays: Half are for doctor visits, the rest cover drugs. "Plan on a physical and two sick visits-plus two follow-ups," says Dale Block, MD, who has managed claims for insurance companies. Figure you’ll get one to three Rx’s per sick visit, and add a few co-pays for unexpected trips to specialists. {plus} A year’s worth of pricey OTCs, like 30+ SPF: Check out drugstore.com’s FSA tracker. {plus} If you have a chronic issue: Consider what you need to manage symptoms, such as acupuncture for pain or PMS. And don’t forget therapy, dietary counseling and exercise. Fees related to a diagnosed symptom, such as hot flashes, may be eligible with a doctor’s note. For more information, go to more.com/fsa
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Sweat away side effects

If you’re taking antidepressants for hot flashes, make sure you exercise regularly. Using the drugs for more than two years may raise your chances of developing type 2 diabetes, says a new study published in the American Journal of Psychiatry. When researchers studied the records of over 150,000 people, they found that a moderate to high daily dose of components found in many of the drugs (particularly in the serotonin-reuptake inhibitor Paxil, and the tricyclic antidepressant Elavil) was linked to an 84 percent increase in diabetes risk. The connection may be related to a potential side effect of these drugs: weight gain, which is a type 2 diabetes trigger. Working out regularly not only helps weight control, it can also boost your mood and quell hot flashes and other menopausal symptoms.
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An OTC brain drain

Having trouble sleeping? Don’t always reach for the Benadryl. Yes, it causes drowsiness, but a review in the Journal of Clinical Interventions in Aging found that, when taken nightly, Benadryl (diphenhydramine) temporarily reduces mental sharpness by blocking a brain receptor crucial to memory function. The effect worsens with age, since we lose receptors over time, but anyone who takes the drug nightly will notice impairment, says study coauthor Malaz Boustani, MD. OTCs with "PM" in their names may have similar effects.
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The newfound power of popcorn

Need a guilt-free, nutrient-packed snack? If you’re not in the mood for carrot sticks (and, really, who is?), reach for plain popcorn or whole wheat crackers. According to a recent study, many whole grain foods are as rich as fruits and vegetables in health-promoting polyphenols, a type of antioxidant. This is news because until now researchers had not thought to measure the polyphenols hidden in the fiber that’s in whole grain foods, says Joe Vinson, PhD, a chemistry professor at the University of Scranton and lead author of the study. His team found that whole grain products are sometimes even richer in these nutrients than fruits and vegetables are. "The average serving of fruit contains six milligrams of polyphenols per gram," Vinson says. An average serving of whole grain flour provides eight to 15 milligrams per gram. Cereals made with whole wheat or whole corn contain high levels of the antioxidant, and you get a serious dose of polyphenols when extras like dried fruits, nuts, cinnamon and raisins are added into the package. In fact, raisin bran scored higher than any other food tested; popcorn ranked highest in the snack category. To keep calories in check, get your polyphenols by sprinkling a handful of cereal on nonfat yogurt and opting for plain over buttered popcorn.
Nino Andonis

What your hot flashes may be telling you

Feeling flushed? Your bones could be at risk. A new study by researchers at UCLA found that women who experience hot flashes are more likely to have lower bone density than other women. What’s the connection? One theory: Stress hormones, which have been linked to bone weakening, could play a role in the development of both problems, says study author Carolyn J. Crandall, MD. But hot flash sufferers shouldn’t panic, she notes. Those who participated in the study had not yet developed osteoporosis, which means you may have a chance to prevent the disease. "Women with hot flashes should be [especially conscientious] about meeting the daily requirements for calcium and vitamin D," Crandall says. For women over 50, that’s 1,200 milligrams of calcium and between 800 IU and 1,000 IU of vitamin D; most women under 50 need 1,000 milligrams of calcium and between 400 IU and 800 IU of vitamin D. Crandall also endorses the other recommendations issued by the National Osteoporosis Foundation: 30 minutes of weight-bearing, impact exercise (such as jogging) most days of the week, in addition to resistance exercise (like lifting weights) two to three times a week. For additional workout tips, go to nof.org/prevention/exercise.htm.
Illustrated by Shout

Want to live longer?

Try the Mediterranean diet, which just got simpler to follow. For years, research has linked lower mortality rates to this style of eating: plenty of vegetables, fruits, nuts, legumes, cereals, fish and seafood, olive oil and other healthy fats, and easy on meat and dairy products. Now a new study conducted at the University of Athens Medical School, which followed more than 23,000 Greeks for nearly a decade, has dissected the diet, looking at its components and their relative contributions. The findings: Eating lots of fish and limiting dairy weren’t key to improving longevity. The moral of the story is, as long as your weight is stable, lattes are fine, and you can skip the scrod if you feel like it.
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Keep belly fat at bay

A year after they had lost an average of 24 pounds, women who exercised for two 40-minute sessions a week-either with aerobics or resistance strength training-maintained the fat loss in their middles, while non-exercisers regained 33 percent of their fat, according to a small study published in the journal Obesity. Don’t have 40 minutes to spare? Twenty minutes of exercise, four times a week, may also fend off the regain, the researchers believe. Find more exercise and diet strategies for beating belly fat at more.com/whittle.
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The break mistake doctor’s make

Spine or other non-hip fractures can signal osteoporosis, but many doctors miss the connection, says a study in the Journal of Bone and Joint Surgery. When researchers looked at the records of women over age 50 in Korea, they discovered that those with wrist fractures were far less likely to be offered bone mineral testing and treatment for osteoporosis than those with breaks in the hip or spine. That’s a problem, because the Korean system-like the American one-depends on the physicians who treat fractures to initiate bone disease evaluation. The oversight is a missed opportunity, say the researchers, because women with wrist fractures have an increased susceptibility to breaks.
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Straight talk on stroke risk

A recent study suggests SSRIs (selective serotonin reuptake inhibitors) increase the risk of stroke in menopausal women. Does that mean you should stop taking them? Not necessarily. The study, which was published in the Archives of Internal Medicine, followed 136,000 postmenopausal women enrolled in the Women’s Health Initiative and found that women taking SSRIs like Zoloft, Paxil and Lexapro had a marginally higher chance of experiencing a hemorrhagic stroke, in which a blood vessel in the brain bleeds. "That makes some sense because SSRIs have a slight aspirin-like anticlotting effect," says Jordan W. Smoller, MD, assistant vice chair of psychiatry at Massachusetts General Hospital, in Boston, and the lead author of the study. But the danger, he says, is very small. "We’re talking a 0.4 percent risk of stroke for women taking SSRIs versus a 0.3 percent risk for those not taking them. So for the individual person, the risk is likely to be low." Women shouldn’t stop taking their medication based on this one study, Smoller adds. Talk to your doctor about any concerns.
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Retire happy

Ease out of employment: Retirees who keep working part time experience fewer health problems than those who go from 40 hours a week to zero hours, according to a University of Michigan study that followed 12,189 retirees. Working reduced hours, known as bridge employment, helps maintain structure in life and provides a social outlet and a financial cushion, the authors say. These important factors are all known to boost physical and mental health. For tips on finding bridge work, go to more.com/part-time.
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Is Dr. Right a robot?

Robotic surgery, which takes the scalpel out of a doctor’s hands and puts it in the metallic grasp of a $1.5 million machine, has become an almost fashionable way for women to be treated for pelvic diseases like fibroids and endometriosis. The big selling points: Computer-assisted surgery is highly accurate, is performed with minimal incisions and can be directed from a console by a doctor. But many physicians feel that this technology, which may not be covered in full by insurance, has been overhyped, and at this point there are no hard data showing that the outcomes of robotic gynecological operations are any better than the results of laparoscopic (minimally invasive) or traditional surgery. "The maker of surgical robots has done a brilliant job selling its product to hospitals, which then use it to promote their cutting-edge image," says Barbara Levy, MD, a Seattle-based gynecologist. Ask about your options before you jump on the robotics bandwagon. An honest physician will recommend what benefits you most at the least expense rather than push the technology du jour.
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First Published Mon, 2010-07-26 11:57

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