A report from the RAND Corp. concludes that obesity is an expensive condition in terms of health care costs. This analysis of two national health surveys finds that obese people spend 36 percent more for health services, and 77 percent more for medications than the average American.1 This is roughly twice as much as the costs incurred by smoking.The author says that differences between the health costs and condition of an average obese individual and a person of optimum weight could be compared to the average 50-year-old versus a 30-year-old.
1. Health Affairs, March 12, 2002.
Blood Pressure Diagnosis
For many years, the upper blood pressure number (systolic) was considered the more important component of a patient's reading. Then, the diastolic measurement was deemed more significant, and has been for many years. A new study of 4,700 men suggests that maybe we were right the first time. This study found a doubled risk of cardiovascular death when systolic readings were 160 or higher. However, in those with elevated diastolic readings, but not significantly high systolic pressures, there was no such correlation. The findings apply particularly to elderly persons, whose high systolic pressures are often ignored if the diastolic readings are within normal limits.2
2. Archives of Internal Medicine, March 11, 2002.
Insulin Not Preventive
The theory that small injections of insulin might help prevent the development of type-1 (juvenile onset) diabetes was bolstered by a couple of small pilot studies in the recent past. In fact, many doctors, believing in this treatment, have been prescribing these injections to patients considered at high risk. Unfortunately, a new, more scientifically sound study reveals that these injections may be useless. The research, sponsored by the National Institutes of Health, evaluated 339 children identified as high-risk for type-1 diabetes. Two groups were formed: one that received the insulin injections, and one that was simply monitored. There was no significant difference in outcome between the two groups; both developed diabetes at similar rates.3
3. NEJM, May 30, 2002.
Painkillers Slow Healing
New research reinforces what many of us were taught in college decades ago: deadening pain resulting from an injury appears to interfere with healing. Research at the University of Medicine and Dentistry of New Jersey found that NSAIDs appeared to slow or modify bone healing after a fracture. Researchers administered Celebrex or Vioxx to rats with broken legs, and noted that most fractures had not fully healed after two months. When new bone formation did occur, it was often weak and superficial. The significant component appears to be the cox-2 enzyme (associated with inflammation and pain) blocked by these drugs. Researchers are starting to realize that the enzyme (and maybe the inflammation itself) plays an important role in healing.4
4. Journal of Bone and Mineral Research, May 2002.
Salt for Preemies
Because premature infants lose more sodium through their urine than full-term babies, many physicians prescribe salt supplements during the first two weeks after birth. A new study by London physicians concludes that this is probably a good practice. The researchers monitored the mental and physical development of prematurely born children for up to 13 years, and found significant improvements in mental abilities of those given the supplements. IQ tests were 10 percent better, with memory and language skills also showing higher scores.5
5. Archives of Disease in Childhood, Fetal and Neonatal Edition, March 2002.
Beer to Fight Cancer
Japanese researchers report that they have a novel preventive measure for persons concerned about colon cancer: drink more beer. Laboratory rats were given a potent carcinogen, then fed a diet that included water, beer, or beer-related products such as malt. About 90 percent of the water-drinking rats developed tumors, but only two-thirds as many of the beer-consumers did so. The researchers believe that nonalcoholic ingredients, such as vitamins and amino acids, were responsible for the results. The researchers also note that they had no trouble convincing the rats to drink their beer.6
6. OTC, April 7, 2002, reporting on the annual meeting of the American Association for Cancer Research in San Francisco.
Hong Kong researchers report that babies who live in households with two or more smokers are 30 percent more likely to be hospitalized than those from smoke-free homes. The study looked at 8,300 babies born in 1997, for the first 18 months of their lives. The hospitalizations were typically for respiratory problems. The authors of the study estimate that health costs due to smoking during the first year amount to about 10 percent of all health care costs for this age group.7 For households with only one smoker, the hospitalization rate was about seven percent higher than normal.
7. Reuters, March 7, 2002.
Therapy Better than Drugs
A study8 from Vanderbilt University in Nashville suggests that cognitive therapy treatment may be a better way to manage depression than pharmaceuticals. The costs and effectiveness for both types of treatment were about the same over a four-month period, but the cognitive therapy appears to have a more permanent effect, with relapses occurring much less often. In the long term, cognitive therapy (which is somewhat slower to show results initially) appears to be much more effective, both clinically and economically. The conclusions of this study are expected to come as a big surprise to many psychiatric professionals who have strong faith in the drugs they prescribe.
8. Reuters, May 24, 2002.
Breastfeeding against SIDS
Swedish researchers studying Sudden Infant Death Syndrome report that breastfeeding appears to offer some protection from the problem. Babies breastfed for less than eight weeks, they say, were three-to-five times more likely to die of SIDS than those nursed for four months or longer.9 The researchers do not have a solid explanation for the results, but suggest that it may be related to the more frequent feedings or closeness of the parent-child relationship.
9. Archives of Disease in Childhood, May 2002.
Breastfeeding to Stay Slim
Scottish researchers report in The Lancet10 that breastfed babies tend to put on less excess weight in their first few years, which may have implications adulthood. A study involving 32,000 children, found up to a 30 percent lower incidence of obesity in those who had been nursed as infants, as measured by their body mass index. The researchers feel that these results may carry over into adulthood, as there have been a number of associations between childhood obesity and subsequent excess weight as an adult.
10. The Lancet, June 8, 2002.
Vitamin D and Colon Cancer
Research from the University of Texas-Southwestern in Dallas is shedding some light on how vitamin D is involved in protection against colon cancer. The vitamin, it appears, is instrumental in detoxifying lithocholic acid, one of the more powerful toxins created by the body as a by-product of digestion. Lithocholic acid, a bile acid used in the digestion of fats, has been shown to induce DNA changes, even cancers, when introduced directly into the intestines of laboratory animals. These cancers don't develop when vitamin D is present at the same time, according to this report.11 Lithocholic acid toxicity may also explain why many studies suggest a link between dietary fat and colorectal cancer.
11. Reuters, May 16, 2002.
A report in the New England Journal of Medicine12 warns that persons with allergies to nuts should be wary of one more source of exposure: kisses. Researchers noticed a large number of their nut-allergy patients reporting reactions after being kissed by someone who had eaten nuts as many as six hours beforehand. One trip to the emergency room was triggered by a kiss on the cheek. The reactions detailed by the authors ranged from mild itching and swelling at the area of contact within a minute or so, to reactions severe enough to cause wheezing. About one third of the reactions were experienced by teenagers and young adults while dating.
12. NEJM, June 6, 2002.
Colorado Springs, Colorado
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