Don’t forget to secure your health insurance as you go to college

Are you among the 400,000 freshmen in California — or 2.9 million nationwide — who have just started college, or are about to? As you buy your books, ponder the best meal plan or wonder whether you will get along with your roommate, don’t forget about health insurance.

Whether you’re an undergrad or graduate student, your options will depend on where you go to college, if you already have coverage through a family or individual health plan, and how much money you make.

It might surprise you to know you could qualify for no-cost Medicaid, the public health insurance program for people with low incomes.

“The good news is there are a few good options,” says Paul Rooney, vice president of carrier relations at eHealth, an online health insurance broker based in Santa Clara, Calif.

Since health plans vary from region to region and state to state, your first call might be to an insurance agent in the market where your college is located to discuss your options. The help is free. In California, you can find certified insurance agents on the “Find Help” tab of the website of California’s Obamacare marketplace, Covered California: www.coveredca.com


Sometimes, staying on your family’s plan is the best option — and you can do so up to age 26.SIGN UP

If you are on your family’s plan, or you have your own insurance, call the customer service number on your insurance card to ask about the level of coverage, if any, it will provide if you attend college in another region or state.

If your family health plan is a preferred provider organization (PPO) with a national insurance company — Cigna, Aetna or UnitedHealthcare, for example — you often can get full medical services at in-network prices in other regions of the country where your insurer operates.

But it also has to work financially. Parents, ask your employer or your insurer if taking your child off the family PPO will lower your premium. If the answer is no, and he will have full network coverage while away at college, it makes sense to keep him on the plan.

If the answer is yes, do the math.

Keith Wakeman, CEO of a Chicago-based mental health app startup called SuperBetter, learned he would save $1,900 this year by taking his son Jack off the family’s Blue Cross PPO and buying him the student plan offered by Purdue University, where he is a freshman.

“The plan is much better for Jack in terms of deductibles and copays — and also includes vision and dental,” Wakeman says. “It was a no-brainer for us.”

It probably also makes sense to take your student off the family plan if it is a health maintenance organization (HMO) or an exclusive provider organization, both of which restrict their networks more than PPOs.

There are exceptions: Some insurers allow HMO enrollees to get full medical services at no extra cost in other regions or states where they operate. Ask your health plan if that’s possible.

If it’s not, the health plan offered by your college could be a good option.

Student health plans have improved in recent years, in part because they almost always comply with the Affordable Care Act’s coverage requirements. That means most offer a comprehensive range of medical services at a high level of coverage, says Stephen Beckley, a senior partner with Fort Collins, Colo.-based Hodgkins Beckley Consulting, which works with colleges on student health programs.

The University of California system’s health plan is “exceptional,” Beckley says, “because of its highly favorable cost and the addition of vision and dental benefits.”

Nationally, costs vary widely from college to college, and some are very high, Beckley says.

The cost of this year’s UC undergraduate student health insurance plan, which includes all campuses except Berkeley, ranges from $1,773 to $3,537 for 12 months of coverage, according to Zina Slaughter, the plan’s director. Stanford University, by contrast, charges $5,592 for undergraduate and graduate students.

Beware: Many universities, the UC system and Stanford included, will enroll you in their health plan automatically, and you must obtain a waiver — by proving you have other acceptable coverage — to avoid the charges.

“We tell people that you should make sure you’re not being opted into services you won’t use,” says Erin Hemlin, director of health and policy advocacy for Young Invincibles, which promotes the interests of young adults.

If your family plan doesn’t work for you anymore and your college plan is too expensive, check to see if you qualify for no-cost Medicaid, which goes by the name Medi-Cal in California and insures one-third of the state’s residents.

This goes for students at private universities and public schools, including the 481,000 students at the 23 campuses of the California State University system and the 2 million-plus who attend one of the state’s 115 community colleges.

In the more than 30 states that have expanded Medicaid, including California, individuals who make up to about $17,200 annually are eligible for the program. It helps if your parents do not claim you as a dependent on their tax returns; otherwise, you must report their income.

Check with the health department in your county to see if you qualify. Find a list of California county offices at www.dhcs.ca.gov.

If your income is too high for Medicaid, you might still qualify for a subsidy to buy a health plan through your state’s Obamacare insurance exchange. In California, log onto the Covered California website or call 800-300-1506 to research options.

Enrollment in 2020 Obamacare exchange plans starts Oct. 15 for Covered California and Nov. 1 in most of the rest of the country.

Experts say a viable option for some students who are on their family’s plan is to stay on it, getting emergency care at a local hospital if necessary and basic primary care at the on-campus clinic (access is often included in student fees). They can wait to get physical checkups and other non-urgent care until they visit home.

Giorgia Winters, a resident of Long Beach, Calif., says that’s the decision she and her husband made for their son Matthew, 18, who just entered Embry-Riddle Aeronautical University in Prescott, Ariz. They don’t worry about his health: He had to pass a Federal Aviation Administration fitness test to pursue his pilot’s license at the school.

“He’ll come fairly often, because Prescott is an hour or so away by airplane,” Winters says. “I don’t know how much better it is financially, but it was more comfortable for us.

source: usa.inquirer.net

New study suggests 2.5 hours exercise a week can slow decline in Parkinson’s disease

A new study has found Parkinson’s patients who do 2.5 hours, or 150 minutes, of exercise a week can slow down the effects of the condition.

Parkinson’s disease (PD) is a progressive condition that often results in impaired mobility, a decrease in health-related quality of life (HRQL), and death.

Previous research has also provided evidence that physical activity can delay this progressive decline.

The new study, carried out by Northwestern University and Rehabilitation Institute of Chicago, looked at 3,408 participants who had provided data over a two-year period, with information collected during at least three clinic visits.

At each visit the team measured physical activity by patients’ self-reports on how many hours of exercise they did each week.

The results showed that those with Parkinson’s disease who partook in 150 minutes of exercise each week had a smaller decline in quality of life and mobility over the two years compared to those who didn’t exercise or exercised less.

In addition, declines in HRQL and mobility were significantly slower not only for those who exercised regularly at the start of the study, but also for those who started to exercise later, after their first study-related visit.

“The most important part of the study is that it suggests that people who are not currently achieving recommended levels of exercise could start to exercise today to lessen the declines in quality of life and mobility that can occur with this progressive disease,” added lead investigator Miriam R. Rafferty.

The team also found that increasing exercise by 30 minutes per week was associated with even slower declines in HRQL in those with advanced PD. The team now believe that these findings could have significant implications for making exercise and physical activity more accessible to people with more severe disability, as the mobility impairments of those with advanced PD may limit their access to regular exercise in community and group exercise programs.

Although the study did not look at which type of physical activity is best, it does suggest that any form of exercise is better than no exercise as long as it is done in a “dose” of at least 150 minutes per week.

“People with PD should feel empowered to find the type of exercise they enjoy, even those with more advanced symptoms,” added Dr. Rafferty.

The results of the study can be found published in the Journal of Parkinson’s Disease. JB

source: lifestyle.inquirer.net

Four great reasons to add high intensity intervals to your workout

From HIIT and CrossFit to spinning and functional training, here are four good reasons to jump onboard the latest trend for high-intensity interval-based workouts that combine short, intense bursts of activity with low-intensity active recovery.

Get great results, fast!

Military-inspired interval training sessions, combining short 30-second bursts of intense activity with short recovery periods, can change the shape of your body in record time by burning fat.

CrossFit combines elements of weight lifting (lifting, throwing, moving objects), classic gym exercises (push-ups, pull-ups, rings) and cardio training (running, rowing, cycling).

Some HIIT (High Intensity Interval Training) programs use body weight rather than equipment, boosting metabolism with a workout based on a series of standard exercises (squats, wall sits, lunges, planks, jumps, etc.) that work all muscle groups. This type of exercise can burn up to 800 calories in 30 minutes.

Circuit-based functional training programs are also popular at the moment. Some use equipment (resistance bands, gym balls, BOSU balls, kettlebells, TRX straps, etc.) while others don’t. Some are held outdoors, making use of benches, tree trunks, railings, etc.

Slow down aging

A study, published last March 7 about Cell Metabolism, found that using HIIT training techniques in aerobic, endurance-based activities like cycling and walking could slow down aging at cellular level. This involves adding short bursts of higher-intensity activity to a regular workout, like a 30-second sprint in the middle of a slower-paced jog, for example. This was found to boost the action of cell powerhouses called mitochondria, whose ability to generate energy declines with age.

Save time

These short but intense exercise sessions can fit easily into busy daily schedules. High Intensity Interval Training or functional training sessions usually last around 30 minutes. CrossFit sessions usually last up to an hour and high-intensity spin classes are 45 to 60 minutes in length. Classes can now be booked online at a growing number of gyms, making last-minute sessions more feasible.

Get tips and motivation from a coach

In this type of class, there’s usually at least one coach for around 12 participants. The trainer sets the program of exercises for each session with a “workout of the day.” They are also on hand to offer personalized tips and advice tailored to individual levels or goals. Exercising in a group can also prove more motivating than slogging it out alone with a screen or an MP3 for company. JB

source: lifestyle.inquirer.net

New fitness trend ‘Rage Yoga’ lets students drink beer, swear and listen to rock music

Yogis, prepare yourselves for a different kind of ‘Zen’.

A female resident of Calgary in Canada has introduced a new variation to the globally popular exercise, which was dubbed as ‘Rage Yoga’.

Citing reports from the Huffington Post, the unlikely trend combines yoga poses with pints of beer, screamed profanity, and Metallica and Black Sabbath.

Canadian Lindsay-Marie Istace, who added a new twist to the traditional work-out, encourages her students to yell, swear and even burp during sessions, while a variety of heavy metal songs play in the background.

If the stretching is a bit too much, yogis may also take “hydration breaks” or grab a sip of beer or wine before continuing.

Laughter is also heavily encouraged for students finding themselves falling during a tricky pose.

“I think there are a lot of people intimidated by the usual yoga culture”, said Istace.

“Yoga studios are intimidating for people who are just getting into yoga, and for people who are very experienced in yoga they just want something that is a little less serious,” the former contortionist and fire-eater added.

Rage Yoga sessions are only available every Monday and Wednesday in Dickens Pub in Calgary Canada, but Istace is looking to bring ‘Rage Yoga’ to more subscribers online in the near future.

More information about the new exercise-craze is available in Intace’s personal website, rageyoga.com. Khristian Ibarrola, INQUIRER.NET

source: lifestyle.inquirer.net

Sleep-deprived kids are more tempted by food

Children who don’t get enough sleep might be more tempted by food, a new study suggests.

Five-year-olds who slept less than 11 hours a night were more eager to eat at the sight or reminder of a favorite snack, compared to those who slept longer, researchers reported in the International Journal of Obesity.

The children who slept less than 11 hours at night also had a higher body mass index – a measure of weight in relation to height – than those who slept 11 hours or more. The Centers for Disease Control and Prevention recommends 11 to 12 hours of sleep for pre-school children.


“There is now accumulating evidence in both children and adults to suggest that short or insufficient sleep increases reward-driven ('hedonic') eating,” said Laura McDonald, the study’s lead author and a researcher at University College London, in email to Reuters Health.

“This is, of course, a concern,” she added, “given that we live in a modern ‘obesogenic’ environment” where tasty, high-calorie foods “are widely available and cheap to consume.”

Previous studies have shown that too little sleep significantly increases the chances that a child will be overweight or obese, McDonald and her team point out. But less was known about how sleep affects daily calorie intake.

“Some studies using brain imaging in adults have shown that sleep restriction increases responsiveness in reward centers of the brain in response to images of palatable food . . . however, no studies in children have examined whether sleep changes food responsiveness,” noted McDonald.

The new study involved 1,008 five-year-olds born in 2007 in England and Wales. The researchers had mothers answer a questionnaire about their youngsters’ responsiveness to food cues and their behavior toward food when they were presumably full, soon after eating.

The average sleep duration for the children in the study was 11.48 hours.

Among kids who slept less than 11 hours a night, food responsiveness was 2.53 on a scale of 1 to 5, compared to 2.36 for those who slept 11 to 12 hours, and 2.35 for those who got at least 12 hours of sleep a night.

“In children who do not get enough sleep at night, limiting exposure to palatable food cues in the home might be helpful at preventing overconsumption,” McDonald said.

The study found no link between sleep duration and whether kids were still willing to eat when they were full.

While the study can’t prove that less sleep causes more eating, McDonald said another possibility is that the reverse might be true. “It is definitely a possibility that food responsiveness might impact sleep behavior,” she said. “For example, it could be that children who are more food responsive are also more difficult to settle at night (when adults or older children might be eating).”

Emerson Wickwire, director of the Insomnia Program at the University of Maryland School of Medicine, told Reuters Health by email that the study adds a new twist to research showing sleep is a risk factor for obesity.

“The current study suggests a new potential explanation (hedonic eating) for weight gain among children who sleep less . . . in other words, kids in the study who slept less were more susceptible to unhealthy food cues in the environment,” said Wickwire, who was not involved in the study.

Wickwire said the study also showed the importance of sleep for children.

“We know that parents have a huge influence on the sleep patterns of five-year-olds. So really, it’s incumbent on parents to make sure their kids are getting enough sleep,” said Wickwire, a board-certified sleep specialist. —Reuters

Vigorous exercise helps people live longer – study

MIAMI, United States - Vigorous exercise, the kind that makes you sweat, get red in the face and breathe hard, may be better than moderate exercise when it comes to living longer, researchers said Monday.

The study by Australian researchers is based on more than 200,000 adults over age 45, and is published in the Journal of the American Medical Association (JAMA) Internal Medicine.

The study participants were followed for more than six years.

Those who did jogging, aerobics or competitive tennis -- vigorous exercise for 30 percent of their weekly workouts -- had a mortality rate that was nine to 13 percent lower than those who did moderate exercise, like swimming, social tennis, or household chores.

"The benefits of vigorous activity applied to men and women of all ages, and were independent of the total amount of time spent being active," said lead author Klaus Gebel from James Cook University's Centre for Chronic Disease Prevention.

"The results indicate that whether or not you are obese, and whether or not you have heart disease or diabetes, if you can manage some vigorous activity it could offer significant benefits for longevity."

Currently, the World Health Organization urges adults to do at least 150 minutes of moderate activity or 75 minutes of vigorous activity per week.

But the current research suggests that given the choice, people should opt for some higher intensity exercise if they can, and if their doctor agrees, the study authors said.

"Our research indicates that even small amounts of vigorous activity could help reduce your risk of early death," Gebel said.

"For those with medical conditions, for older people in general, and for those who have never done any vigorous activity or exercise before, it's always important to talk to a doctor first." — Agence France-Presse

source: gmanetwork.com

Walking may help overweight people curb sugar cravings

Walking for 15 minutes may help overweight people at least temporarily reduce cravings for high-calorie, sugary snacks, a small study suggests.

"This study showed that brisk walking can be used as a strategy to reduce momentary food craving," said Adrian Meule, a psychologist at Ruhr University Bochum in Germany who wasn't involved in the research.

Exercise may provide some cognitive stimulation that interferes with thoughts about the craved food, and the discipline to regularly take walks to circumvent cravings might also improve the ability to follow through with healthy food choices, Meule said in an email.

Globally, almost 2 billion adults are overweight or obese, according to the World Health Organization. This increases their risk of premature death, breathing difficulties, cardiovascular disease, diabetes, hypertension, fractures and mental health issues.

The study, by Larissa Ledochowski at the University of Innsbruck in Austria and colleagues, examined the impact of a 15-minute treadmill walk on sugar cravings in a group of 47 overweight people who were on average about 28 years old.

To elevate sugary snack cravings, participants were asked to abstain from eating any sweets for three days at the start of the study. They were also asked to fast, drink nothing but water, and avoid any exercise for two hours prior to each assessment of cravings.

Then, in an exercise session, some participants warmed up for two minutes slowly on a treadmill then walked for 15 minutes at a pace fast enough to catch a bus, but not to the point of breathlessness.

For comparison, other participants, instead of exercise, were told to sit passively for 15 minutes without doing anything.

After exercising or sitting still, all of the participants sat quietly for five minutes. Then, they did a computerized test designed to boost physiological arousal and stress. Next, they were asked to unwrap a piece of candy and hold it without eating it.

Throughout the process, participants were questioned seven different times about their food cravings and their feelings of arousal or stress.

Those who exercised reported significantly lower cravings for sweets mid-way through the experiment and at the end than the participants who didn't get on the treadmill.

Even when people unwrapped candy and held it in their hands, people who exercised first had fewer cravings than those who didn't.

The study is small, and its limitations include relying on people to tell the truth about abstaining from sweets before the start of the experiment and a lack of measurements to track how much exertion was required by each participant to walk on the treadmill.

They were also exercising at a fairly low intensity, said Margaret Schneider, a researcher at the University of California, Irvine.

"The study only looks at the short-term impact, so we really shouldn't draw any conclusions about how one 15-minute exercise bout would impact eating behavior throughout the day," Schneider, who wasn't involved in the study, said in an email.

Even so, exercise does have the ability to improve mood, and it's possible that this could result in reduced cravings among individuals who eat for emotional reasons, she said. At the same time, mild exercise can also trigger metabolic processes that make more blood sugar available to the brain, reducing the craving for sugary foods.

And the study offers a reason to consider working at a treadmill desk, also known as walking work stations, Schneider said. "Presumably, remaining active at a low intensity throughout the day will result in less snacking and enhanced mood among the overweight."

Keeping healthy snacks on hand will also help exercise have the intended effect on food choices, Meule said. "Otherwise, temporarily reducing food craving by brisk walking will be ineffective. Even if people successfully manage to control their food cravings, they still have to eat something." — Reuters

Air pollution may be tied to anxiety

Women who live in areas with higher air pollution may also have higher anxiety, according to a new analysis.

“It’s a really interesting finding and definitely suggests that air pollution may be related to mental health,” said lead author Melinda C. Power of Johns Hopkins University in Baltimore.

“If this is truly causal this is going to have a huge effect on the population because everyone is exposed, but we need more research to build this body of evidence,” Power added.

The researchers used data on more than 70,000 women in the Nurses’ Health Study who filled out an eight-question anxiety survey between ages 57 and 85.

Overall, about 15 percent of the women had high anxiety symptoms.

Using their previous home addresses from before they filled out the anxiety questionnaire, the researchers were able to estimate the women’s exposure to so-called particulate matter in the air during the past 15 years, based on factors like distance to major roadways, population density, local sources of emissions and wind speeds.

The researchers found no link between anxiety levels and large air pollution particles, but exposure to fine particles was tied to increasing anxiety levels, according to results in BMJ. The more recent the exposure, the higher the level of anxiety tended to be.

For example, women who were exposed to the most small particles in the air one month before their anxiety test were about 12 percent more likely to have high anxiety symptoms, compared to those estimated to be exposed to the least particles one month previously.

Fine particulates come from combustion sources, including cars and power plants, Power told Reuters Health by phone. The smaller the particle, the deeper it may travel into the lungs.

“Our study can only comment on the population level, on average people who were more highly exposed had a higher level of anxiety,” she said. It did not assess distance to pollution sources or the amount of air pollution an individual would need to experience to have increased anxiety.

Since it was an observational study, it does not necessarily indicate that pollution causes anxiety, she said. Women living in more polluted areas may experience other sources of stress that would be linked to anxiety as well.

The authors suspect that fine particulate pollution may be linked to certain subtle conditions, like inflammation, which may increase the risk of anxiety. Further research will need to explore this possibility, and to look for a similar link among men and people of a younger age, Power said.

It is too soon to think about intervening or giving individuals recommendations based on this result, she said.

However, there is substantial evidence that lowering air pollution would improve cardiovascular health and respiratory health and reduce the risk of stroke, she said. Short-term exposure to particulate pollution is tied to an increase in stroke risk according to an analysis of all published research on the subject, which appears in the same issue of BMJ.

The relationship between atmospheric pollution and risk of heart attack and heart failure had already been established, and this new paper, supported by the British Heart Foundation, adds stroke risk to that category, said lead author Dr. Anoop Shah of the University of Edinburgh in the U.K.

There’s not much an individual can do to decrease their exposure to air pollution as it's ubiquitous, Shah told Reuters Health by phone. But policymakers do have the power to improve public transport systems in urban areas and reduce the number of vehicles on the roads, which are the major source of damaging pollution, he said.

In fact, as reported by Reuters today, Beijing has introduced measures to limit the number of motorists on heavily polluted days. It's the latest move by authorities there to battle the choking smog that has blanketed the city in recent years. — Reuters

Diabetics can avoid problems with attention to heart risks

Even if they haven't been diagnosed with heart disease, diabetics with classical heart-risk factors like smoking and elevated “bad” cholesterol are at heightened risk of serious heart-related “events” and death, according to a new study.

Among people with diabetes but not heart disease, researchers linked more than a third of cardiovascular “events”—such as heart attack and stroke—and 7 percent of deaths to inadequate control of heart risk factors.

That means those cardiac events and deaths might have been avoided with better control of the known risk factors, the study team writes in Diabetes Care.

“The take home message from this study is that adults with diabetes can reduce their risk of cardiovascular events, and patients should work together with their provider to set a care plan including goals and strategies to reduce modifiable risk factors,” said lead author Gabriela Vazquez-Benitez, a research investigator at HealthPartners Institute for Education and Research in Minneapolis, Minnesota.

“This can include regular care visits, screening, laboratory, weight, and blood pressure,” she told Reuter’s Health in an email.

The risk factors for cardiovascular problems in diabetes are well known and include high blood pressure, smoking and poor control of blood sugar. If more attention were paid to these risk factors, the rate of cardiovascular problems and death could be substantially reduced, the study team argues.

There are nearly 25 million Americans with diabetes and if current trends continue, more than one in three adults are projected to develop the disease.

Stroke and coronary heart disease are the major causes of complications, deaths and healthcare costs in adults with diabetes, they write.

The authors point out that medical advances have improved the health of people with diabetes, especially when it comes to cardiovascular problems. But for people with diabetes as a group, the burden of cardiovascular problems remains very high.

In their study, Vazquez-Benitez and her team analyzed data on nearly 860,000 adults with diabetes.

They looked at rates of major cardiovascular complications such as heart attacks and heart failure, as well as deaths from all causes, plus four risk factors: blood pressure, levels of LDL cholesterol, smoking and blood sugar levels over the months.

The authors emphasize that overall rates of major cardiovascular complications and deaths were “substantially higher” in people with diabetes who already had heart disease, compared to those without it.

But delaying diabetes complications is possible, Vazquez-Benitez said, not only for cardiovascular events but for problems like nerve damage and kidney disease.

“Although there is a genetic component of diabetes, there are modifiable risk factors that can reduce risk of heart attack, stroke and death,” said Deborah Greenwood, a registered nurse and president of the American Association of Diabetes Educators. Lowering blood sugar, LDL cholesterol and blood pressure, as well as quitting smoking can greatly reduce risk, she said.

All adults over 45 should be screened for diabetes so it can be diagnosed and treated early, said Greenwood, who was not involved in the study. For most people with so-called pre-diabetes, she pointed out, losing 5 to 7 percent of body weight and doing 150 minutes of physical activity per week could avert progression to full-blown diabetes.

She also emphasized the importance of participating in diabetes self-management education and partnering with a credentialed diabetes educator to change behaviors and improve modifiable risk factors. “A diabetes educator will work with you to develop a plan specifically tailored to your individual needs, preferences and lifestyle to ensure success,” Greenwood said. — Reuters

Large breakfast, small dinner tied to better diabetes blood sugar

Big breakfasts and small dinners might be a healthier way to eat for people with type 2 diabetes, according to a small new study.

Diabetics in the study who ate big breakfasts and small dinners had fewer episodes of high blood sugar than those who ate small breakfasts and large dinners, researchers found.

Blood sugar—also known as blood glucose—is controlled by the body’s internal clock, with larger blood sugar peaks after evening meals, Dr. Daniela Jakubowicz told Reuters Health in an email.

People with type 2 diabetes often time their meals in opposition to their internal clock, said Jakubowicz, a researcher at Tel Aviv University’s Wolfson Medical Center in Israel.

“They frequently skip breakfast while eating a high-calorie dinner,” she said, adding that skipping breakfast is linked to obesity and poor blood sugar control.

The new study involved eight men and ten women with type 2 diabetes, ages 30 to 70, who were being treated with either the diabetes drug metformin and dietary advice or diet advice alone.

Type 2 is the most common form of diabetes and is often linked to obesity. In type 2 diabetes, the body's cells are resistant to the hormone insulin, or the body doesn't make enough of it. Insulin gives blood sugar access to the body's cells to be used as fuel.

The participants were randomly assigned to follow a meal plan that consisted of either a 700-calorie breakfast and 200-calorie dinner or a 200-calorie breakfast and a 700-calorie dinner. Both diets included a 600-calorie lunch.

After following the assigned meal plans for six days at home, the participants spent a day at the clinic, where blood tests were taken. They repeated the experiment two weeks later with the other diet plan.

The study team found that post-meal glucose levels were 20 percent lower, and levels of insulin were 20 percent higher, when the participants consumed the large breakfasts and small dinners, according to the results in Diabetologia.

“Our study demonstrated that a large breakfast and reduced dinner is a beneficial alternative for the management of glucose balance during the day and should be considered as a therapeutic strategy in type 2 diabetes,” Jakubowicz said.

Jakubowicz said longer studies are needed to see if the benefits would continue over time.

The new results support the advice to eat like a king at breakfast, a prince at lunch and a pauper at dinner, said Anna Taylor in an email to Reuters Health.

“Select your calories with care, however; what you eat, how you eat, and when you eat all play an important role in your nutrition as well as your health,” said Taylor, a registered dietitian at the Cleveland Clinic in Ohio. She wasn’t involved in the study.

She added that it’s important for people to keep in mind that the study’s participants took few medications and had no major complications.

The results might therefore not apply to other groups with diabetes, Taylor said.

She said that people with diabetes who take insulin should speak to their endocrinologists before experimenting with drastic dietary adjustments. — Reuters

Drinking coffee may lower risk of multiple sclerosis

WASHINGTON - People who drink four to six cups of coffee daily may be less likely to get multiple sclerosis, according to international research out Thursday.

"Caffeine intake has been associated with a reduced risk of Parkinson's and Alzheimer's diseases," said lead author Ellen Mowry of the Johns Hopkins University School of Medicine in Baltimore, Maryland.

"Our study shows that coffee intake may also protect against MS, supporting the idea that the drug may have protective effects for the brain," she added.

The findings of a US and Swedish study—released ahead of the American Academy of Neurology annual meeting in Washington—each compared more than 1,000 MS patients to a similar number of healthy people.

Researchers tracked how much coffee the subjects drank in the one, five and 10 years before symptoms began for those afflicted with MS.

After accounting for other factors such as age, sex, smoking, body mass index and sun exposure, the Swedish study found that "compared to people who drank at least six cups of coffee per day during the year before symptoms appeared, those who did not drink coffee had about a one and a half times increased risk of developing MS."

Similar protective effects were seen among those who drank lots of coffee five to 10 years before symptoms appeared.

The US study found that "people who didn't drink coffee were also about one and a half times more likely to develop the disease than those who drank four or more cups of coffee per day in the year before symptoms started to develop."

More research is needed to determine if caffeine in coffee has any impact on relapse or long-term disability due to MS, an incurable disease of the central nervous system that affects 2.3 million people worldwide.

The study was funded by the Swedish Medical Research Council, the US National Institute of Neurological Disorders and Stroke, the National Institute of Environmental Health Sciences and the National Institute on Aging. — Agence France-Presse

source: gmanetwork.com

Eating placentas? US moms swear by health benefits

WASHINGTON - Health trends come and go, but one post-birth fad is gaining a foothold in the United States among some new mothers who extol the benefits of eating their own placentas.

Convinced it helps to boost energy, produce healthy milk and ward off postpartum depression, the practice is catching on among mothers who shun modern medicine for natural care, or Hollywood celebrities eager to adopt new-age trends.

It is called "placentophagy," and entails eating the iron-rich afterbirth in any form: liquid, solid or packed into a pill.

The bloody, spongy organ provides the fetus with nutrients, oxygen and hormones via the umbilical cord during the 40-week gestation period.

Some midwives promote its nourishing virtues for mothers too.

"Placenta helps to restore your body with vitamins, minerals and hormones," midwife Claudia Booker told AFP.

"Not rejuvenate you so you can go to parties... just restore you when you feel like a used machine," she said, speaking over her kitchen sink in Washington where she prepares placenta pills.

For $270, Booker, a 65-year-old with cropped hair and tattooed ears, processes and prepares the vascular organ into a course of capsules lasting several weeks.

The process of turning placenta into pills is perhaps more familiar to cooks than scientists: she cleans it, presses the blood from it and steams it before placing it in a dehydrator overnight.

The dried placenta is then cut into strips and put in a coffee grinder to turn into a powder she puts inside small capsules, a technique she learned from a Chinese acupuncturist.

Placenta smoothie

There are no scientific studies on the number of new moms partaking in the practice and few on its effects, but that has not prevented the trend from taking hold in some circles, including among A-listers.

"Clueless" star Alicia Silverstone has tried it and swears by it. And "Mad Men" vixen January Jones tried it too, earning her the nickname "Mad Mom" in some American media.

The trend has even spawned cookbooks and a devoted army of recipe testers on mommy blogs who write about placenta lasagnas, tacos or chocolate truffles.

Mother of seven Catherine said wanted to try it after giving birth to her last child. She chopped her placenta into cubes and blended it with almond milk, honey and blueberries for an afterbirth smoothie.

She opted for a pureed version to "disguise the taste," she said, adding that she froze leftovers to be enjoyed later.

Placenta being a rare item, some mothers want to make sure none goes to waste.

For others, packing placenta nutrients into edible treats like chocolate truffles is preferable to taking vitamins.    

"It seemed to be a good idea because I tend to forget to take my vitamins but I don't forget that I'm in the mood for chocolate!" mother-of-three Melissa told AFP.

Emotional benefits

Booker maintains that the benefits of eating the placenta are also psychological, helping mothers to stave off postpartum depression that affects up to 19 percent of women in the United States, according to the Centers for Disease Control and Prevention.

"It is one of the pieces of the puzzle that helps you to decrease the emotional roller coaster of the early postpartum period," Booker said, the pungent scent of cooked blood wafting through her house.

It is also believed to ease fatigue and anxiety in the tumultuous post-birth period, she added.

But researchers are only starting to conduct comprehensive studies on the practice, which first emerged in the United States in the 1970s, according to Daniel Benyshek, a medical anthropologist at the University of Nevada.

Americans are believed to be among the first to eat their own afterbirth, he said, though dried placenta has been long used in Chinese medicine, prized by healers for its curative qualities.

Others have examined the effect in mammals, most of which eat afterbirth.

Psychologist Mark Kristal from the University at Buffalo found that mice experience less pain in the post-birth period if they eat their placenta.

But most studies about human benefits do not meet acceptable scientific standards, Benyshek said. Instead, most evidence is anecdotal.

"There is a lot of positive feedback from women, including women who experienced postpartum depression," he said.

Based on a survey of 189 women in 2013 conducted by Benyshek, 98 percent reported the effects of eating their own placenta as "positive."

He is planning to release a full study this summer based on research from 30 women.

'Night-and-day difference'

Scientifically proven or not, many are embracing placentophagy as an essential post-birth ritual.

"The reason that I chose to do that it is that there is a history of depression and one of the purported benefits of course is that it helps bounce my hormones," said Melissa.

Fellow mother Laura Ransom from Las Vegas, Nevada, said she wished she had tried it earlier.

She took placenta pills after the birth of her third child and said it helped her manage a hectic schedule.

"I did not do this with my first two pregnancies and I can't express the night-and-day difference of my emotional and physical recovery," she said.

"The pills gave me energy, curbed my mood swings, actually made me really happy, and helped me to handle things in the midst of adding number three to our family after a move and my husband starting a job." — AFP


source: gmanetwork.com

Certain diabetics more likely to benefit from blood pressure meds

People with type 2 diabetes who get treatment for high blood pressure live longer and have a lower risk of heart disease, according to a new review.

But to the researchers’ surprise, diabetics with only slightly high blood pressure - higher than the healthy range but not quite in the hypertension range - didn’t get as much benefit from treatment.

“Everything else being equal,” the patients with type 2 diabetes most likely to benefit from blood pressure lowering are those whose blood pressure is higher, said coauthor Professor Kazem Rahimi of The George Institute United Kingdom and The University of Oxford, in email to Reuters Health.

The review included 40 trials from 1966 to 2014 on blood pressure lowering treatments in more than 100,000 people with type 2 diabetes. The treatments included diuretics (sometimes called “water pills”), ACE inhibitors, and other drugs.

A healthy blood pressure reading is 120/80 millimeters (mm) of Mercury (Hg).

Readings above 120/80 but below 140/90 indicate “pre-hypertension.” Blood pressure above 140/90 mm Hg can be diagnosed as hypertension.

According to the new review, with every decrease of 10 mm Hg in the first number – the systolic blood pressure - the risk of dying during the study decreased by about 10 percent, and the risk of an acute heart problem, heart disease, stroke and diabetic retinopathy also went down.

Lowering blood pressure appeared to carry the most benefit for people whose initial systolic readings were higher than 140 mm Hg, the authors write in JAMA.

“The study calls for more individualized treatment decisions when it comes to controlling blood pressure in people with type 2 diabetes, in particular for diabetics with lower baseline blood pressure levels,” Rahimi said.

Blood pressure medications did decrease the risk of other problems like stroke, diabetic eye disease and excess protein in the urine, even for people with relatively lower blood pressures, he said.

But diuretics can cause an increase in blood sugar for people with diabetes. Other side effects of blood pressure medications include impotence, potassium deficiency, skin rash or kidney damage.

One in 10 Americans has diabetes today, most often type 2, the adult-onset kind, according to the Centers for Disease Control and Prevention. Two out of three people with diabetes have high blood pressure or take medication to lower it, according to the American Diabetes Association.

“People with a blood pressure of 140 or higher are likely to enjoy the greatest benefit from blood pressure lowering, and for most, the benefits of taking blood pressure medication are likely to outweigh the potential side effects,” Rahimi said. “In people with systolic blood pressure below 140 mm Hg, treatment recommendation requires more careful assessment of the patient’s likely absolute net benefit.”

Based on one U.S. trial in 2010, blood pressure goals have been relaxed for people with diabetes, which may have been an overreaction, according to Dr. Bryan Williams of University College London, who wrote an accompanying editorial in the journal.

Before that trial, most guidelines recommended that people with diabetes keep their blood pressure below 130/80 mm Hg. Afterward, some guidelines were relaxed to 140/90 mm Hg.

Rahimi’s study “shows that the current BP goals are not low enough to optimally reduce the risk of stroke, for example,” Williams told Reuters Health by email.

“Certainly BP should be lowered to below 140/90 mm Hg and I would suggest it would be appropriate to go lower than 130/80 if the patient will tolerate it and this is more likely to be tolerated better in younger people,” he said.

“There is no magical threshold above which blood pressure suddenly becomes harmful and below which it becomes benign,” Williams said. “The thresholds are designed to simplify trials and guidance but in reality the risk relationship is continuous with no obvious threshold.” — Reuters

What are ovarian cysts?

Dolores, a 35-year-old high school teacher, came to see me at the clinic one day looking very worried. She was clutching a pelvic ultrasound report which said she had an “ovarian cyst.” Immediately fear assailed her, and many questions came up: Did she need surgery? Was the cyst malignant and life-threatening? What will happen to her three small children if she got sick? How did she get it? 

When we looked at the ultrasound results closely however, it said that the ovarian cyst was at the right side, about 3 cm. in its widest diameter, thin-walled, and was signed out as a follicular cyst. I assured her this was one of the functional or physiologic cysts of the ovary. It was benign, and there was no need for any surgery; we would simply repeat the ultrasound after three to six months and see.

The ovaries are two structures (right and left) attached to the fallopian tubes and the uterus at the lower abdomen. Each month, from among the many unripe eggs inside it, one egg (the primary follicle) matures and is extruded out during ovulation. Sometimes the egg does not come out, and after a time the follicle becomes filled with fluid, and becomes a follicular cyst. These are benign growths that most of the time disappears spontaneously. The area from which the egg comes out is called the corpus luteum, and sometimes fluid also fills this area after ovulation and this becomes a corpus luteum cyst, another benign condition.

Many other non-malignant cysts can occur in the ovaries, like the dermoid cyst, which can grow to large sizes, carrying inside it skin, hair, neural tissues and sometimes even teeth and muscles; or, the so-called chocolate (endometrial) cyst, containing dark brown fluid. Many times too, numerous, very small (less than 1 cm) cysts grow at the edges of the ovaries, and the ovaries are considered polycystic.

We do not exactly know why ovarian cysts form. They occur very commonly in women during their reproductive age, probably because at this time the ovaries are actively involved in the menstrual cycle. Mature eggs come out every month, and hormones are produced in a recurring fashion. This is also a reason why ovarian cysts in post-menopausic women should be regarded with more caution, especially when there is sudden enlargement.

Symptoms

When cysts are small they are usually asymptomatic. This is when an accidental finding of an ovarian cyst surprises the woman the most. The request for a pelvic ultrasound (or sometimes, a whole abdomen ultrasound) for another ailment could provide a surprise finding.

However, the usual symptoms include dull abdominal pain, many times described simply as heaviness; or something vague like low back pains. Doctors agree that cysts are worrisome when they grow to more than 6 cm. in size; some would call growths that are less than this as simply “cystic ovaries.”  When these cysts grow large they could even be felt by the woman herself, or her partner.

When the ovarian growth is large enough it could cause pressure on the bladder, so the woman urinates more frequently. Painful sexual intercourse too, could occur. At times there will be menstrual changes, or, dysmenorrhea. This usually occurs in endometrial cysts, where the endometrial glands inside the ovaries also bleed and the cysts grow every time the woman menstruates.

Dresses and pants too could become tighter as the cyst grows. Because of the space that the cyst occupies, nausea and vomiting occur, as the woman feels full easily after eating.

Complications

Ovarian cysts sometimes have pedicles (or long, thin attachments) and these could twist. The blood supply and nerves are affected by this torsion, and can cause severe pain. The ovarian cyst itself could also become infected, and the contents become an abscess, again, leading to pain and other signs of infection.

When the intra-cystic pressure increases to such an extent that the walls could no longer hold, there could be rupture, spilling out the contents of the cyst into the peritoneum. Again, pain ensues, and with time, infection (peritonitis) follows.

Hemorrhage too, is another feared sequel of an unattended ovarian cyst. Needless to say, there will be pain, and loss of blood inside the abdomen.

Treatment

As mentioned in Dolores’ case, when the ovarian cyst is deemed physiologic and small, there is room for observation, and watchful waiting. These functional cysts could resorb by themselves, or sometimes spill out their small contents, collapse and disappear.

Larger and symptomatic cysts (regardless of size) are managed by surgery. Many gynecologic surgeons now employ laparoscopy, which entails passing a thin, lighted instrument through the abdominal wall to remove the cyst. This is the best management for cysts that are free (no adhesions), and when ovarian cancer has been ruled out. Many times the surgeon will opt to do a laparotomy, which means opening up the abdomen to remove a large and adherent cyst.

Some gynecologists too, while observing an ovarian cyst over several cycles, will prescribe an oral contraceptive to prevent further ovulation while observing the existing growth.

Fear of malignancy

Dolores’ worry about malignancy then could be allayed, as hers was a functional cyst. Clinically though we could suspect malignancy in ovarian growths when the following occurs: sudden enlargement of the cyst, plus constitutional signs of malignancy that includes weight loss, anemia, and loss of appetite. There are ultrasound findings too that could make us suspect that the cyst is no longer benign: fluid in the abdomen (called ascitis), or seeing both cystic and solid structures in the same ovarian growth. In this case, a gynaecologic oncologist would need to do surgery for a debulking procedure (removal as much malignant tissue), sample the lymph nodes, and decide post-surgery therapies. We do not know why ovarian cancer develops. But studies show that this disease is associated with: age, obesity, smoking, infertility (and the taking of ovulation medications), and a positive family history of ovarian, breast, or colon cancer.

For Dolores, she went home that day relieved and at peace, finding resolution for her many questions and worries. — BM, GMA News

source: gmanetwork.com




 

Post-traumatic stress doubles diabetes risk in women

MIAMI - Women who suffer from post-traumatic stress are almost twice as likely to develop type 2 diabetes as women not affected by the disorder known as PTSD, a US study said Wednesday.

The research in the journal JAMA Psychiatry was led by public health scientists at Columbia University and Harvard University, and provides the "strongest evidence to date of a causal relationship between PTSD and type 2 diabetes," the journal said in a statement.

The data was based on surveys given to nearly 50,000 US women from 1989 to 2011.

Researchers found that about half the increased risk for diabetes was attributable to the use of antidepressants (34 percent) and overeating, as measured by elevated body mass index (14 percent).

But the other half of the heightened risk could not be explained, and researchers ruled out potential links to smoking, diet, alcohol intake or exercise.

The study also found that the more symptoms of PTSD a woman had, the higher her risk of developing type 2 diabetes.

About one in nine women experience PTSD at some point, which is twice the rate among men, according to background information in the article.

"Not only is PTSD devastating to mental health, but it affects physical health too, raising risk for cardiovascular disease, diabetes, and obesity," said senior author Karestan Koenen, professor in the Department of Epidemiology at the Mailman School at Columbia University.

Researchers urged healthcare professionals to be on the lookout for signs of diabetes in women who have endured traumatic events.

"As fewer than half of Americans with PTSD receive treatment, our study adds urgency to the effort to improve access to mental health care to address factors that contribute to diabetes and other chronic diseases," said first author Andrea Roberts, research associate in the Department of Social and Behavioral Sciences at Harvard School of Public Health. — Agence France-Presse

source: gmanetwork.com

Yoga may benefit heart health as much as aerobics

Those sun salutations and downward dogs could be as good for the heart as cycling or brisk walking, and easier to tolerate for older people and those with health challenges, according to a new review of existing research.

Based on 37 clinical trials, researchers found that doing yoga lowered blood pressure, cholesterol, heart rate and other cardiovascular risk factors in increments comparable to those seen with aerobic exercise.

“Taken together, these improvements could facilitate and complement a regimen toward better cardiovascular health,” said Paula Chu, a doctoral candidate in health policy at Harvard University in Cambridge, Massachusetts, who led the study.

She and her co-authors caution in the European Journal of Preventive Cardiology, however, that larger studies are needed to understand how yoga improves health, how much of it is ideal and if there are differences in benefits from various types of yoga before the practice becomes a standard prescription for heart disease.

Nonetheless, yoga’s benefits have been long suspected, said Dr. Larry Phillips, a cardiologist at NYU Langone Medical Center in New York.

“I think what we’ve seen is with yoga and the relaxation and behavior modification that goes along with it, there is a benefit to all patients, but especially those with heart disease,” said Phillips, who was not involved in the new analysis.

“Here we are able to see there are more measurable benefits than we’ve seen before,” he told Reuters Health.

Yoga originated in India more than 5,000 years ago, and has become a popular mind-body therapy in the West. Yoga’s breath control and body postures are believed to help nourish self-awareness, control stress and develop physical strength and balance.

The more traditional Hatha style of yoga is the most widely practiced in the U.S. But many specialized yoga “products,” such as hot yoga, power yoga and yoga retreats are part of a billion-dollar yoga industry.

One study estimates that 15 million Americans have practiced yoga at least once, according to Chu and her co-authors.

They focused on yoga’s effects on cardiovascular disease, as well as risk factors including high blood pressure, high blood sugar, excess abdominal fat and abnormal cholesterol levels that make up a profile—known as metabolic syndrome—that often leads to heart disease and diabetes.

The study team analyzed 37 randomized, controlled trials involving 2,768 people through December 2013. The trials either looked at yoga compared to no exercise or to aerobic exercises. Participants’ average age was 50 and they were followed for anywhere from 12 weeks to one year.

Those who did yoga had significant improvements in a range of risk factors. Systolic blood pressure (the top number) dropped by an average of 5.21 mm Hg, and diastolic pressure (the bottom number) dropped 4.9 mm HG. LDL “bad” cholesterol fell by an average 12.14 mg/dl and HDL “good” cholesterol rose by an average 3.20 mg/dl. Average heart rate was lower by a little over 5 beats per minute and weight loss averaged a bit over 5 pounds.

These changes were similar to the improvements seen among people who did aerobic exercise instead.

There were no changes, though, in fasting glucose levels or A1C, a measure of long-term blood sugar control in diabetics.

Chu and her colleagues note that one weakness of the results is that the analyzed trials included various types of yoga that were practiced for different amounts of time. These included Silver yoga (for seniors), Iyengar yoga (a form of Hatha that emphasizes correct postures), Viniyoga (which includes chanting) and Vinyasa (breath-synchronized movements.)

There were also a wide range of populations, from the young and healthy to older people with histories of heart disease, Chu told Reuters Health.

“We are not recommending anyone ditch their medicines or established medical or physical practices,” she said. “Individuals can talk to their doctors about whether yoga is a viable option for them.”

Yoga classes may be offered at health clubs, spas, senior centers and in other settings. Individual classes at stand-alone yoga centers tend to range from $15 to $30.

Phillips said he encourages his patients to develop a healthy lifestyle and exercise regimen, which could include yoga. He urges people to find a class that is appropriate for their comfort level and ability.

“I think the effects of relaxation do decrease stress levels and have a benefit to the heart,” said Phillips, adding that he had found doing yoga boosted his own mood and energy level. — Reuters

Exercise tied to prostate cancer survival

Among men with prostate cancer, those who lead active lifestyles have better survival rates than those who don’t, a new study suggests.

There are many benefits to being physically active, but the new results suggest there are “specific effects also on the survival among prostate cancer patients,” said the study's lead author Stephanie Bonn of the Stephanie Bonn.

“There is great potential for men diagnosed with prostate cancer to improve their own survival by being physically active,” she wrote in an email to Reuters Health.

In the US alone, about 210,000 men are diagnosed with prostate cancer every year and about 28,000 die of it, according to the Centers for Disease Control and Prevention (CDC).

Previous studies have found links between physical activity and survival in cancer patients, but few looked at prostate cancer, Bonn and her colleagues write in Cancer Epidemiology, Biomarkers and Prevention.

For the new study, they analyzed data on 4,623 men from Sweden diagnosed with early-stage prostate cancer between 1997 and 2002. The information included details on the men's physical activity levels and general health until 2012.

Overall, the men who walked or biked daily for at least 20 minutes after their diagnosis had a 39 percent decreased risk of dying from prostate cancer and a 30 percent decreased risk of dying from any cause, compared to those who were less active.

For example, each year, among every 1,000 men who walked or biked at least 20 minutes a day, there were about 23 deaths from any cause, compared to about 38 deaths among every 1,000 men who exercised less.

Additionally, for every 1,000 men who exercised for an hour or more per week, there were about 21 deaths from any cause per year, compared to about 34 deaths among every 1,000 of those who exercised less.

The results were consistent regardless of the type of treatment the men received for their prostate cancer, Bonn said.

“However, our results apply to men diagnosed with localized prostate cancer and only those men who were still alive a number of years after their diagnosis were included in the study,” she said, adding that it most likely excludes men with more aggressive prostate cancers.

The new study can’t prove that more exercise extended the men's lives, but Bonn said it would be interesting to conduct a trial to measure the long-term and short-term effects of physical activity on prostate cancer.

The researchers say the association between exercise and prostate cancer could be related to hormones, fat tissue or inflammation. They plan to further investigate the exact mechanisms.

“At the moment we are working with a large study where men have donated both biological samples, and responded to a lifestyle questionnaire where physical activity was assessed in detail,” Bonn said. “We will study how different types of physical activity and also body weight may impact both the risk of prostate cancer as well as survival.” — Reuters

Obesity can be deemed a disability at work – EU court

BRUSSELS - Europe's top court ruled on Thursday that obese people can be considered as disabled, meaning that they can be covered by an EU law barring discrimination at work.

The decision followed a question from a Danish court, which was reviewing a complaint of unfair dismissal brought by Karsten Kaltoft, a child-minder, against a Danish local authority.

Kaltoft, who never weighed less than 352 pounds during his employment, argued that his obesity was one of the reasons he lost his job and that this amounted to unlawful discrimination, an allegation the council denied.

The Court of Justice of the European Union was asked to rule on whether EU law forbids discrimination on the grounds of obesity or whether obesity could be considered a disability.

The Luxembourg-based court ruled that EU employment law did not specifically prohibit discrimination on the grounds of obesity, and that the law should not be extended to cover it.

However, the court said that if an employee's obesity hindered "full and effective participation of that person in professional life on an equal basis with other workers" then it could be considered a disability.

This, in turn, is covered by anti-discrimination legislation.

According to statistics from the World Health Organization, based on 2008 estimates, roughly 23 percent of European women and 20 percent of European men were obese. — Reuters

Review finds best exercises to prevent women’s knee injuries

Some training methods are better than others at preventing knee ligament injuries in young women, researchers advise.

Based on 14 previous studies, the researchers say training programs that focus on strengthening the legs and hips and stabilizing the abdomen are the most effective for preventing injury to the anterior cruciate ligament (ACL), and doing more than one type of exercise is also important.

“We know neuromuscular training can reduce ACL injury in female athletes, but we were not sure what exercises are the best to attain the maximal prophylactic effects,” said Dai Sugimoto of The Micheli Center for Sports Injury Prevention and the Boston Children’s Hospital Orthopaedics and Sports Medicine department, in Massachusetts.

The ACL is the key stabilizing ligament in the knee, and is most often injured during sports that involve quick turns or pivoting movements.

ACL injuries are very serious and can take a long time to heal, the researchers write in the British Journal of Sports Medicine. College athletes with ACL injuries lose more time on the field than athletes with ankle or traumatic head injuries, according to the researchers.

Young women facing the greatest risk are those who play sports involving a lot of pivoting, such as soccer, basketball, lacrosse and handball, according to Sugimoto. He added that the most common age for women to be injured is around 14 to 17 years.

Grethe Mykelburst, who outlined the risks involved with ACL injury in an email, said, “it takes you out of your sport for 6-12 months, and some don’t succeed to return to their previous level.” She added that the risk of getting osteoarthritis, a degenerative condition, in the knee is high after injury.

Mykelburst, a sports physical therapist and associate professor at the Oslo Sport Trauma Research Center in Oslo, Norway, was not involved in the review.

Sugimoto’s team analyzed 14 studies of exercise intervention programs, looking specifically at four different exercise approaches including balance, jump training, abdomen stabilizing exercises and strengthening of the legs and hips.

Training programs that aimed to build strength in the back of the legs and in the hips significantly reduced the number of ACL injuries when compared with programs that did not. That was also true of programs that focused on strengthening and developing more control of the abdomen.

Programs that included more than one type of exercise were significantly more effective than those using only one type. “Neuromuscular training has to incorporate many exercise modes,” Sugimoto told Reuters Health. “Performing only one exercise mode seems ineffective.”

The researchers note that while balance and jumping exercises were somewhat helpful in reducing injury, they were not effective unless combined with other exercises.

The study lists a number of specific helpful exercises, including Russian hamstring curls, sit-ups, pushups and bench press. Sugimoto emphasized the hamstring curls in particular, as they work both to strengthen the legs and hips and require abdomen control.

“With inclusion of these exercises as well as a variety of exercise modes, athletes can attain the fullest benefit from neuromuscular training and prevent ACL injury,” Sugimoto said.

Every year 350,000 people seek ACL reconstruction surgery in the United States, the authors point out.

Sugimoto said that although surgery is the best available treatment, 24 to 30 percent of high school athletes who undergo the surgery tear their ACL again within the next several years.

“That’s why we need to prevent ACL injury in first place to avoid subsequent ACL injury and preserve a healthy knee joint,” Sugimoto said.

“The evidence is strong that neuromuscular training works,” Mykelburst agreed. “As an athlete or a coach, you can’t afford not using the prevention program and exercises that exist,” she added. — Reuters

Carbs more harmful than saturated fats – study

WASHINGTON - Long-derided saturated fats—associated with an array of health problems such as heart disease—caught a break Friday when research revealed their intake could be doubled or even nearly tripled without driving up their level in a person's blood.

Carbohydrates, meanwhile, are associated with heightened levels of a fatty acid linked to increased risk for diabetes and heart disease, the same study showed.

"The point is you don't necessarily save the saturated fat that you eat, and the primary regulator of what you save in terms of fat is the carbohydrate in your diet," senior author Jeff Volek of Ohio State University, said in the report.

To conduct the study, which appeared in the journal PLOS ONE, scientists put 16 participants on a strict dietary regime that lasted four and a half months.


Every three weeks their diets were changed to adjust carbohydrate and total fat and saturated fat levels.

The scientists found that when carbs were reduced and saturated fat was increased, total saturated fat in the blood did not increase, and even went down in most people.

The fatty acid called palmitoleic acid, which is associated with "unhealthy metabolism of carbohydrates that can promote disease," went down with low-carb diets and gradually increased as carbs were re-introduced, the study said.

An increase in this fatty acid indicates that a growing proportion of carbohydrates is being converted into fat instead of being burned by the body, the researchers said.

"When you consume a very low-carb diet your body preferentially burns saturated fat," Volek said.

"We had people eat two times more saturated fat than they had been eating before entering the study, yet when we measured saturated fat in their blood, it went down in the majority of people," he said.

The finding "challenges the conventional wisdom that has demonized saturated fat and extends our knowledge of why dietary saturated fat doesn't correlate with disease," Volek added.

By the end of the trial, participants saw "significant improvements" in blood glucose, insulin and blood pressure and lost an average of 22 pounds (10 kilograms).

"There is widespread misunderstanding about saturated fat. In population studies, there's clearly no association of dietary saturated fat and heart disease, yet dietary guidelines continue to advocate restriction of saturated fat. That's not scientific and not smart," Volek said. — Agence France-Presse

source: gmanetwork.com