Quarterdeck

The feasting season (Thanksgiving and Christmas) is just around the corner. Let’s take some time to update on weight gain and obesity.

Obesity causes 100,000 U.S. cancer cases
Obesity can cause cancer, according to researchers. As estimated 100,000 cases of cancer related to obesity are reported in the US each year and the numbers are expected to rise as the obesity problems worsen. The types of cancer caused by excessive fat include endometrial and esophageal cancer.

Some obese people perceive body size as OK, dismiss need to lose weight
Can we judge our weight properly? It seems that people who are overweight tend to perceive their body size wrongly – thus, leading to the belief that losing weight is not necessary. This was according to a research presented at the research presented at the American Heart Association’s (AHA) Scientific Sessions 2009 in Orlando, Florida. I will discuss the report more in detail in an upcoming post.

At last, a chocolate that makes you LOSE weight (if you don’t mind the green tinge)
It looks like chocolate with a greenish tinge and it’s yummy like chocolate but it’s not fattening like chocolate. It is called Lola, manufactured by the Spanish food maker Cocoa Bio and it supposedly helps you lose weight. The manufacturers claim that they have specially added amino acids into the chocolates that stimulate production of hormones which suppresses appetites. By simply popping one or two of these goodies in your mouth about an hour meal mealtime, you will feel pleasantly full. Truly good news for chocoholics, except for the steep price – £5 for a box of 5. Oh, and the green tinge? It’s from the algae Spirulina added as dietary supplement.

Secondhand smoke exposure worse for toddlers, obese children
We know that secondhand smoke is bad for the health. The latest findings, however, indicate that some are more endangered than others. In this study presented at the AHA’s Scientific Sessions 2009, researchers report that exposure to secondhand smoke has the greatest impact on those who are young and those who are obese.

Relation between socioeconomic status and body mass index: evidence of an indirect path via television use
German researchers investigated how body mass index (BMI) is related to socioeconomic status and television (TV) and video game use. They conducted the investigations in German and American children. The results showed that low socioeconomic status is related to high BMI. This in turn is related to media, particular TV use. Children of low socioeconomic status tend to watch more TV and have higher BMI. The presence of TV in the children’s bedrooms is especially an important contributing factor whereas video game use is not.

Total Artificial Heart Recipient to Celebrate 2nd Anniversary with Donor Heart By Riding with Team SynCardia in El Tour de Tucson
This is the 2^nd anniversary of the day when she a new heart. And on this day, 30-year old Vanessa Cirillo will celebrate her new life and her new heart by participating in the 2009 El Tour de Tucson cycling race. Cirillo had a heart attack in 2000 which weakened her heart towards cardiomyopathy. She received an artificial heart called SynCardia temporary CardioWest™ Total Artificial Heart which bought her time until she got a donor heart on November 24, 2007. Cirillo will be cycling for Team SynCardia. Cirillo explains her way of celebrating this anniversary:

“I think the bike race is a great way to celebrate my new beginning. You need to go through struggles and learn lessons to become a better person. Once you have that strength, you can give more to others. This race and helping raise awareness about organ donation allows me to do that.”

Wall Street Journal writer honored for medical reporting excellence
For his work in reporting about heart disease and stroke, Thomas M. Burton medical reporter for the Wall Street Journal was awarded the 2009 American Heart Association Howard L. Lewis Achievement Award for excellence in medical and science journalism. The award recognizes a career of distinction in reporting about heart disease and stroke.
Burton was honored “for his engaging and creative reporting on the practice of medicine and the pharmaceutical and medical-device industries,” the award citation noted. “In particular, his unique mix of investigative and story-telling skills, along with a true passion for his work, result in enterprising reporting that has made a real difference in the ongoing fight against heart disease and stroke.”

FDA Announces New Warning on Plavix: Avoid Use with Prilosec/Prilosec OTC
The US FDA has issued a warning in relation to the use of the anti-clotting drug Plavix (clopidogrel) in relation to the use of Prilosec (omeprazole), a proton pump inhibitor that is available over the counter (OTC). The FDA has data that suggests that interaction between omeprazole and clopidogrel will result in reducing the activity of the anti-clotting drug by half.
Clopidogrel is widely used as an anti-clotting agent in patients at risk for heart attack and stroke. Omeprazole is common used as antacid.
According to Mary Ross Southworth of the Division of Cardiovascular and Renal Products in the FDA’s Center for Drug Evaluation and Research:

“Both of these drugs, when used properly, provide significant benefits to patients. However, patients at risk for heart attacks or strokes who use Plavix to prevent platelet aggregation will not get the full effect of this medicine if they are also taking Prilosec.”

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Heart failure is a condition wherein the heart gets weakened by disease that it can no longer pump blood effectively. Most often, patients with heart failure have other chronic diseases that include atherosclerosis, arrhythmia, kidney failure, and diabetes.

According to a recent research study, more than half a million Medicare recipients in US older than 65 are hospitalized for heart failure every year. Of these patients, 23% are back at the hospital within 30 days of initial discharge. This rate of rehospitalization is much higher than what is normally observed in other developed countries. It is not clear how this figure compares with rate of hospitalizations among Americans with health insurance coverage.

According to lead author Dr. Joseph S. Ross of Mount Sinai School of Medicine in New York.

“I was hoping for improvement and was disappointed to find that was not the case. Despite the increased focus on the need to reduce readmissions, about a quarter of patients are back into the hospital within 30 days.”

The results of the study indicate a great need for improving health care.

So what are the possible reasons behind this high rate of hospitalization?

• According to the report, the current fee system in the US pays doctors for treating and hospitalizing patients but not for preventive strategies and measures.
• There is a lack of communications between doctors in the hospital and the primary care physicians who help patients manage chronic diseases.

The more specific reasons, however, need to be identified in future studies.

The recommended course of action for hospitals before discharging heart failure patients is that patients should receive written information about the following:

• Eating a proper diet;
• Engaging in appropriate physical activity;
• Taking medicines correctly;
• Monitoring their weight; and
• Knowing what to do if their symptoms worsen.

Previous studies however, have shown that this line of communication between hospitals and primary care clinicians do not work effectively. Efforts are being made to step up with electronic health records which hopefully can overcome this problem.

Dr. Ross continues

“Coming back and forth into the hospital isn’t good for patients, and it isn’t good for the healthcare system. This is a tremendous challenge… Patients should use this information to vet hospitals, to look at the quality of care delivered there and ask questions about the care they receive. Hospitals should consider the rehospitalization rate a grade which, from these findings, needs improvement.”

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What do retired professional athletes and sportspersons do in their “old age”? They take it easy, they enjoy life, they coach, or they write a book and tell all.

This is what Andrei Agassi just did in his autobiography entitled “Open.” I have never read it and I doubt if I ever will as I am not a big fan of tennis. However, what makes Agassi’s book so controversial is because the title has a double meaning. It is not only about his game or his personal life. It is about his honesty and his admitting to taking the recreational drug crystal meth during his professional years.

About crystal meth

Crystal meth (source: chemistry.about.com) is officially called methamphetamine or metamfetamin. It is usually used in crystalline form, thus the name. So what does crystal meth do? It has some positive and negative effects. On the upside, it can

• change moods and cause elation
• enhance energy and performance
• lead to weight loss
• increase sexual drive

The downsides are

• addiction
• loss of appetite
• sleeping problems
• mood swings, even psychosis
• potential for overdose

Crystal meth is not the only recreational drug used by athletes. The most common performance-enhancing drugs used by professional athletes are:

• Anabolic steroids
• Androstenedione  
• Creatine
•  Stimulants
• Diuretics

Why take drugs?

Agassi is not the first professional athlete to use forbidden drugs nor will he be the last. He joins the likes of star sprinter Marion Jones, cyclist Jan Ulrich and fellow tennis pro Martina Hingis. But the big difference is that the aforementioned athletes got caught; Agassi didn’t. According to his autobiography, he tested positive for drugs but lied before the governing body of ATP and got away with it.

So why do athletes take drugs?

Agassi wrote that he started taking the drug when his career was in crisis. Clearly, drugs can enhance performance. According to this Australian report, here are some of the reasons why athletes take performance-enhancing drugs:

• winning can attract lucrative sponsorship deals and endorsements;
• society places great emphasis on success in sport, which puts more pressure on an athlete to win;
• some banned drugs can speed recovery from injury, which means athletes can be back training and competing more quickly;
• some athletes believe their competitors are using drugs and that to be competitive, they need to take drugs as well;
• some athletes’ desire to win is so great that they are willing to use any means, including cheating, to gain success; and
• some coaches may push drug use to enhance their athletes’ chances of winning, which boosts their profile as a successful coach.

Coming up next: the health effects of performance-enhancing drugs.

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To remove or not to remove a healthy breast. That is a very difficult decision many women have to face when diagnosed with breast cancer.

Why remove a healthy breast?

The procedure is called prophylactic mastectomy, which is the removal of a noncancerous breast. This is considered to be an aggressive preventive measure in order to reduce the risk of developing cancer, and can also involve removal of the ovaries (oophorectomy).

What are the reasons for removal?

Women diagnosed with cancer in one breast can opt for removal of the non-cancerous breast as well.

Women with a strong family history of breast cancer.

Women who tested positive for mutations in the breast cancer genes BRCA1 and BRCA2.

How prevalent is prophylactic mastectomy?

Historically, the number of women opting for prophylactic mastectomy is low. However, a recent report by researchers from the New York State indicates that the number is increasing. The report looked at female New York residents from 1995 to 2005. 6,275 women underwent prophylactic mastectomy. 81% of these women have been diagnosed with cancer in one breast but not the other. The rest had no personal history of breast cancer. During the study period of more than a decade, the rate of prophylactic mastectomy doubled. The increase is mostly due to women who had cancer and opted for removal of healthy one.

According to study leader Dr. Stephen Edge of the Roswell Park Cancer Institute

“These data from New York are the only data on a large population of women that examine the use of bilateral prophylactic mastectomy. These data demonstrate that prophylactic mastectomy is an uncommon procedure that is performed most commonly on women with a personal history of breast cancer. Although the total number of prophylactic mastectomies performed per year was small, it appears that the use of the surgery is increasing.’ In addition …women with breast cancer should have careful counseling regarding benefits and risks before proceeding with prophylactic mastectomy of the other breast.”

Is prophylactic mastectomy necessary?

Current state of evidence does not support the belief that removal of a non-cancerous breast would lower the risk or prevent the development of cancer, even among those in high-risk groups.

According to Dr. Marissa Weiss at Breastcancer.org:

“Simply having a proven gene abnormality does not necessarily mean that a woman will develop breast cancer, or that her cancer will be any worse than cancer that does not stem from an inherited genetic flaw.”

The take home message is that women should think twice and weigh the risks and benefits of having a noncancerous breast removed.

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Life expectancy is better than ever, at least in developed countries, according to the most recent statistics from the World Health Organization (WHO) from 2007

Japan tops the list in terms of life expectancy at birth with 79 years for men, 86 years for women, and an overall life expectancy of 83 years in 2007. Not far behind are Italy, Switzerland and San Marino with an overall life expectancy of 82 years. Below is a list of countries whose population is expected live up to 80 or older:

• Japan – 83 years
• Andorra, Australia, Italy, Iceland, Switzerland and San Marino – 82 years
• Canada, France, Monaco, New Zealand, Norway, Singapore, Spain, Sweden and Israel – 81 years
• Cyprus, Belgium, Austria, Germany, Greece, Ireland, Luxemburg, the Netherlands, the United Kingdom, and Malta – 80 years

The United States did not make it to the top 25, with a life expectancy at birth of 78 years.

On the other end of the spectrum are the following countries:

• Sierra Leone – 41 years
• Afghanistan – 42 years
• Lesotho and Zimbabwe – 45 years
• Chad and Zambia – 46 years
• Central African Republic, Guinea-Bissau, Mozambique, Swaziland, and Uganda –  48 years
• Burkina Faso, Burundi, Mali, and Nigeria – 49 years

The two lists above clearly show that life expectancy is highest in highly developed countries. A person born in Japan is most likely going to live twice as long as somebody born in Sierra Leone. Another trend to be seen in the figures is that life expectancy is increasing in high income countries but not in the low income countries.

German and Danish researchers report that 75% of children born in those countries with high life expectancy (e.g. 80+ years) will live up to the age of 75 if the health conditions stay as it is now. If health conditions improve and life expectancy continues to rise, children born since 2000 in rich countries can live up to 100.

This means that in rich countries, despite problems with obesity, heart disease, diabetes, cancer, and other chronic illnesses, people are living longer.

So why are people in rich countries living longer? The answer lies in better health care and advances in medical treatments.

This may sound great, especially for us who live in rich countries because it seems like we are finally winning the battle against aging and diseases. However, there are some downsides to this good news.

 According to the study authors:

“Increasing numbers of people at old and very old ages will pose major challenges for health-care systems. Present evidence, however, suggests that people are not only living longer than they did previously, but also they are living longer with less disability and fewer functional limitations.”

According to Richard Suzman, an aging expert at the U.S. National Institute on Aging:

“We are within five to 10 years of a watershed event where there will be more people on Earth over 65 than there under five. Those extra years need to be financed somehow and we need to start thinking about it now.”

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