Health in Review Now: December 2010

Low-Sugar Cereals Help Kids Eat Healthier

Dec. 13, 2010 -- Children are more likely to eat a nutritious, balanced breakfast if they are served low-sugar cereals, even if they add a little table sugar to their bowls, a new study says.

Although children may favor cereal that’s high in sugar, they’re more likely to eat fruit at breakfast when served a cereal containing less sugar, researchers say.

The study observed what 91 children aged 5 to 12 at a summer day camp ate when served either high-sugar or low-sugar cereals.

Cereal, Fruit, and Added Sugar

In the study, children were divided into two groups. One group had a choice of three high-sugar cereals and the other group had a choice of three low-sugar ones. Milk, orange juice, cut-up bananas and strawberries, and small packets of table sugar were available to both groups.

All the children reported after breakfast that they either liked or loved the cereal they’d eaten, whether it was high or low in sugar content.

But kids in the high-sugar group ate about two servings, nearly twice as much refined sugar, or 24.4 grams, as the children in the low-sugar group, who ate a little over one serving on average, with 12.5 grams of refined sugar, according to the researchers.

And this was true even though the kids who ate low-sugar cereals added significantly more table sugar to their bowls.

The children who ate low-sugar cereal ate similar amounts of milk and total calories, and were more likely to put fresh fruit on their cereal than the kids who ate high-sugar cereals.

The researchers say their study shows that kids will eat low-sugar cereals and like their breakfasts, even though they think the brands higher in sugar taste better.

So the take-home message, they say, is for parents to serve low-sugar cereals, but spice the servings up psychologically by also offering fresh fruit and table sugar.

Such a strategy, the researchers say, could reduce the amount of added sugar in children’s diets.

A Little Psychology With Breakfast Can Help

Children who were offered low-sugar cereals (Cheerios, Rice Krispies, Corn Flakes) were “significantly more likely to put fresh fruit on their cereal, compared with children” offered high-sugar cereal choices (Froot Loops, Cocoa Pebbles, Frosted Flakes), the researchers say.

According to the study, 54% of kids who ate low-sugar cereal added fresh fruit, but just 8% of those served high-sugar cereal did.

Children did not add more sugar to the low-sugar cereals than was already contained in the high-sugar cereals.

The study supports the notion that children will eat more refined sugar when served high-sugar cereals, even when they are allowed to add sugar to low-sugar cereals.

“This result suggests that a parent who is concerned that a child will not eat enough of a low-sugar cereal in the morning could provide a small amount of table sugar as well as fresh fruit for the child to add to the cereal,” the authors write. “This strategy would be preferable to purchasing a pre-sweetened high-sugar cereal that typically contains 2.5 or three teaspoons of sugar per serving.”

U.S. Failing to Meet Goals for Women's Health: Report - US News and World Report

THURSDAY, Dec. 9 (HealthDay News) -- The United States has failed to reach almost every goal set for women's health, a new report says.

Conducted by the National Women's Law Center and Oregon Health Sciences University (OHSU), the report -- based largely on federal objectives drawn from the U.S. Department of Health and Human Services' Healthy People 2010 agenda -- is the fifth in a 10-year look at the status of women's health in this country. In this latest analysis, a satisfactory rating was only handed out on three of 26 measures of good health for women.

"If you look at the nation overall, the nation hasn't done that well," Dr. Michelle Berlin, vice chair of the report and associate director of the OHSU Center for Women's Health, said during a news conference on Wednesday.

The three goals that have been met throughout the country are the number of women receiving mammograms, the number of women getting screened for colorectal cancer and the number of women going for annual dental visits, Berlin said.

Since 2000, there has been some progress in reducing deaths from heart disease, stroke and breast and lung cancer. And, fewer women are smoking, the report found.

However, more women are obese and more suffer from high blood pressure and diabetes. Also, fewer women are getting Pap tests for cervical cancer, and the incidence of Chlamydia and binge drinking are on the increase, the report showed.

Berlin noted that these data also vary state-to-state, so that although some goals have been met nationally, individual states may be falling behind. "The range is pretty concerning," she said.

In fact, no state was given a overall satisfactory grade for women's health and only two states, Vermont and Massachusetts, got the next highest grade of "satisfactory minus." Thirty-seven states received an unsatisfactory grade, and 12 were given an F.

States ranking at the bottom include Alabama, Arkansas, Louisiana, Mississippi, Oklahoma and West Virginia.

In addition to health goals, the report looked at 68 federal health policies. Medicaid coverage for breast and cervical cancer treatment and participation in the Food Stamp Nutrition and Education Program were the only of these goals that were met.

Nine states met a majority of the goals, with California, Massachusetts, New Jersey and New York meeting the most. The four states that met the fewest were Alabama, Idaho, Mississippi and South Dakota, according to the report.

The hope is that provisions of the Affordable Care Act, signed into law by President Barack Obama in March, will slowly improve the grade nationally and within each state, the report said.

For example, four of the Medicaid eligibility and enrollment goals will be met when new Medicaid eligibility rules take effect in 2014. In addition, coverage of preventive services by private insurers, such as Pap smears, mammograms and osteoporosis screenings, have been met by mandating the coverage of such services with no cost-sharing, which became effective in September, the report noted.

Other findings in the report include:

One in five women between the ages of 18 and 64 is uninsured, the highest rate since the U.S. Census Bureau began reporting such data.
No state met the Healthy People 2010 goal of 100 percent of women having health insurance.
Almost 50 percent of all pregnancies are unintended, missing the goal of reducing unintended pregnancies to 30 percent or less.
Only seven states require that prenatal care services be covered in all individual and group health plans.
Only eight states require private insurers to cover contraceptives.
Nineteen states restrict private insurers' coverage of abortion services.
The District of Columbia has the highest heart disease death rate at 174.8 deaths per 100,000.
Hawaii has the lowest heart disease death rate at 60.9 per 100,000.
More than 33 percent of women in Mississippi are obese, the highest rate in the nation, compared with 19 percent in Colorado, the lowest.
Nearly 13 percent of women in West Virginia have diabetes, the highest rate in the nation, compared with 5 percent in Alaska, the lowest.

Dr. Olveen Carrasquillo, chief of the division of general internal medicine at the University of Miami Miller School of Medicine, said she was "not surprised by the report."

"The reductions in the biggest killers of women, cardiovascular disease and some cancers, are probably the biggest victories we have had in health in the last 20 years," he said. "But clearly there are a ways to go."

Alzheimer's: Planning for the holidays - MayoClinic.com

Holidays can be bittersweet for families affected by Alzheimer's. Consider simple tips to make the holidays enjoyable for everyone.

By Mayo Clinic staff

Alzheimer's disease affects both family and community life. Holiday observances are no exception. Holiday memories from before your loved one developed Alzheimer's may darken an otherwise joyful season — and worries about how your loved one's condition may disrupt your family's plans can overshadow the simple pleasure of being together. Rather than dwell on how much things have changed or worry about what might go wrong, focus on making the holidays as enjoyable as possible.

Keep it simple at home

If you're caring for a loved one who has Alzheimer's at home:

Make preparations together. If you bake, your loved one may be able to participate by measuring flour, stirring batter or rolling dough. You may find it meaningful to open holiday cards or wrap gifts together. Remember to concentrate on the process, rather than the result.
Tone down your decorations. Blinking lights and large decorative displays can cause disorientation. Avoid lighted candles and other safety hazards, as well as decorations that could be mistaken for edible treats — such as artificial fruits.
Host quiet, slow-paced gatherings. Music, conversation and meal preparation all add to the noise and stimulation of an event. Yet for a person who has Alzheimer's, a calm, quiet environment usually is best. Keep daily routines in place as much as possible and, as needed, provide your loved one a place to rest during family get-togethers.

Be practical away from home

If your loved one lives in a nursing home or other facility:

Celebrate in the most familiar setting. For many people who have Alzheimer's, a change of environment — even a visit home — causes anxiety. Instead of creating that disruption, consider holding a small family celebration at the facility. You might also participate in holiday activities planned for the residents.
Minimize visitor traffic. Arrange for a few family members to drop in on different days. Even if your loved one isn't sure who's who, two or three familiar faces are likely to be welcome, while nine or 10 may be overwhelming.
Schedule visits at your loved one's best time of day. People who have Alzheimer's tire easily, especially as the disease progresses. Your loved one may appreciate morning and lunchtime visitors more than those in the afternoon or evening.

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Difference Between Cold & Allergy Symptoms

What Are Colds and Allergies?

Colds are caused by hundreds of different viruses. When one of these viruses gets into your body, your immune system attacks. Some of the effects of this immune response are the classic symptoms of a cold, such as congestion and coughing.

The germs that cause colds are contagious. You can pick them up when an infected person sneezes, coughs, or shakes hands with you. After a couple of weeks, at the most, your immune system fights off the virus and you stop having symptoms.

Allergies are caused by an overactive immune system. For some reason, your body mistakes harmless substances -- such as mold or pollen -- for germs and attacks them. Your body releases chemicals such as histamine, just as it does when fighting a cold. This can cause swelling in your nasal passages, a runny nose, coughing, and sneezing. Allergies are not contagious, although some people may inherit a tendency to develop them.

Differences Between Colds and Allergies

Characteristic	Cold	Allergy
Duration	three-14 days	Days to months -- as long as you are exposed to the allergen
Time of Year	Most often in the winter, but possible at any time	Any time of the year -- although the appearance of some allergens are seasonal
Onset of symptoms	Symptoms take a few days to appear after infection with the virus.	Symptoms can begin immediately after exposure to the allergen
Symptom	Cold	Allergy
Cough	Often	Sometimes
Aches	Sometimes	Never
Fatigue	Sometimes	Sometimes
Fever	Rarely	Never
Itchy, watery eyes	Rarely	Often
Sore throat	Often	Sometimes
Runny or stuffy nose	Often; usually yellow mucus	Often; usually clear mucus

Although there are some differences, cold and allergy symptoms overlap quite a bit. The most important difference is that colds don't last longer than 14 days. If you still have symptoms after two weeks, these may be allergy symptoms.

Prevention and Treatment of Colds and Allergies

Because the causes of cold and allergy symptoms are quite different, preventing them requires different strategies.

To prevent allergy symptoms, avoid substances you're allergic to, called allergens. So if you're allergic to pollen, for instance, avoid going outside on days when the pollen count is high. Here are common allergens:

Pollen
Mold
Animal dander
Dust mites
Cockroaches

To prevent cold symptoms, stop the cold-causing virus from getting into your system. Keep your distance from people who have colds. Wash your hands often. To protect others, always cover your mouth and nose (with a tissue or your sleeve, rather than your hands) when sneezing or coughing.

Older U.S. women stick to hormone pills: study | Reuters

(Reuters) - Prescriptions for hormone replacement therapy have fallen more than 50 percent in the United States since 2001, but doctors are still inexplicably giving women high-dose pills linked to strokes and cancer, researchers reported on Thursday.
The U.S. Food and Drug Administration and other groups do not say women should avoid hormone replacement therapy, or HRT, but they recommend taking the lowest possible dose for the shortest period of time.
"We're disappointed," Dr. Randall Stafford of Stanford University in California, who led the study, said in a statement.
"Yes, there was an increase in the use of low-dose preparations, but it was not sizeable."
Hormone replacement therapy is used by women who are going through or who have gone through menopause to relieve symptoms that range from hot flashes, low energy, sleeplessness and vaginal dryness to bone loss.
Doctors once believed HRT also prevented heart disease and cancer, but the Women's Health Initiative found in 2002 that women who took estrogen plus progesterone pills for five years had higher rates of ovarian cancer, breast cancer, strokes and other health problems.
Sales of U.S. market leader Wyeth's combined estrogen plus progesterone pill Prempro have fallen by about 50 percent since 2001 to around $1 billion a year. Wyeth is now owned by Pfizer.
Many makers of HRT have reformulated their products, offering much lower doses of hormone, often as patches, creams or vaginal delivery products.
Stafford and colleagues looked at data from 340,820 patient visits to hospitals, clinics and doctor's offices, as well as information from telephone calls.
They found that use of HRT fell by 52 percent from 2001 to 2009, from 17.5 million users to 8.3 million users. But the women using HRT were often still getting relatively high doses of hormones in the pills.
"Despite reduced use, standard-dose oral (HRT) remains the dominant formulation, yet lower dose transdermal and vaginal preparations may yield less harm," they wrote in Menopause: The Journal of the North American Menopause Society.
"We thought that over time there might be greater tailoring of therapy based on characteristics of the individual woman," Stafford said. "The bottom line is that over time we didn't see the level of refinement in clinical practice that we expected."
Many experts believe that lower-dose formulations and skin patches may be a safer way to deliver HRT. The patches, in particular, may reduce the amount of hormones reaching vulnerable organs.
In 2001, more than 16 million women took some form of HRT pill, but by 2009, 6 million did, the survey found.
Lower-dose product use increased modestly, from 700,000 in 2001 to 1.3 million in 2009, they found.
In October, researchers reported that women who took hormone replacement pills had more advanced breast cancers and were more likely to die from them than women who took a dummy pill. [ID:nN19153576] In June, a different team found that women using low-dose patches were less likely to have strokes than women taking pills [ID:nN03253698].

Guidelines Call for Increase in Vitamin D

Nov. 30, 2010 -- New guidelines for vitamin D call for increasing the recommended dietary allowance (RDA) of vitamin D to 600 international units (IU) for everyone aged 1-70, and raising it to 800 IU for adults older than 70 to optimize bone health.

The guidelines, released by the Institute of Medicine (IOM), also raised daily calcium RDAs.

The new guidelines call for a recommended dietary allowance of 700 milligrams of calcium per day for children aged 1 through 3, 1,000 milligrams daily for almost all children aged 4 through 8, 1,300 milligrams of calcium per day for adolescents aged 9 through 18, and 1,000 milligrams for all adults aged 19 through 50 and men until age 71. Women starting at age 51 and men and women aged 71 and older need 1,200 milligrams of calcium per day.

The majority of Americans and Canadians are getting sufficient vitamin D and calcium, the new guidelines state. Some adolescent girls aged 9-18 may fall below the daily recommended level of calcium intake, and some elderly people may have an inadequate intake of calcium and vitamin D.

The older vitamin D guidelines call for a recommended dietary allowance of 200 IU a day for people up to age 50, 400 IU a day for those ages 51 to 70, and 600 IU a day for those older than age 70.

Vitamin D helps the intestines better absorb calcium and plays an important role in bone health. It is often called the "sunshine vitamin" because our bodies make it when exposed to sunlight. It is often added to milk.

Growing numbers of studies link vitamin D deficiency to diseases such as heart disease, certain cancers, and diabetes. The studies show associations that indicate further investigation is needed and do not necessarily prove that vitamin D deficiency has a causative role. Many scientists were hoping that the new dietary intake levels would go even higher to reflect the findings of these studies.

But “we don’t think more is better,” says committee member Clifford J. Rosen, MD, a senior scientist at the Maine Medical Center Research Institute in Scarborough. “We believe that taking in amounts larger than 600 to 800 IU a day has no extra benefit for bones.”

Upper Levels of Daily Vitamin D and Calcium

The new vitamin D recommendations also increased the daily upper level intakes of vitamin D. These levels represent the upper safe boundary.

The upper level intakes for vitamin D are:

1,000 IU per day for infants up to 6 months
1,500 IU per day for infants 6 to 12 months
2,500 IU per day for children ages 1 through 3
3,000 IU daily for children 4 through 8 years old
4,000 IU daily for all others

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