How Your Zzzs Can Ward Off Disease

January 13, 2009 1:46 PM

By DAN CHILDS, ABC News Medical Unit

Call it another reason to turn in early. Researchers at Carnegie Mellon University released a study Tuesday showing that people who get less than seven hours of sleep per night were three times as likely as their well-rested counterparts to come down with a cold.

The new study, published in the Archives of Internal Medicine, is not the first time research has suggested a link between sleep and immune function. Evidence of such a connection goes back at least as far as 2002, to a small study published in the Journal of the American Medical Association. In this study, researchers found that young adult subjects who had received insufficient sleep for four days straight got less immune protection from a flu shot than the subjects who got more sleep.

Dr. Akram Khan, a sleep disorders expert at Oregon Health and Science University, said research has hinted at such a connection for quite some time.

“Your mother was probably right when she told you that you need to get enough sleep,” Khan said, noting that animal studies have added more to the base of evidence supporting the link between sleep and immune function.

“Animals, when they get sick, tend to sleep a lot, and those that get sleep are more likely to recover,” he said. “If you deprive rats of their ability to sleep, eventually they will die of a bacterial infection.”

What’s more interesting, Khan said, is the possibility that an effect similar to that seen in the Carnegie Mellon study may be seen in infections other than the garden-variety cold. In short, could sleep help stave off a viral pandemic?

“Maybe people are also less likely to get infected with bird flu if they slept adequately,” Khan offered. “This could have humongous public health implications.”

And the best part may be that the remedy, in this case, is available without a prescription.

“It doesn’t cost a thing; all you have to do is sleep an extra hour or two,” Khan said.

January 13, 2009 | Permalink | User Comments (12)

Alzheimer's Drug Death Risk Means Tough Questions for Families

January 10, 2009 10:00 AM

By AUDREY GRAYSON, ABC News Medical Unit

When an elderly patient with dementia enters into nursing home care, his or her family is often faced with a difficult choice. On the one hand, they can put their loved one on an antipsychotic medication that will temper his or her aggression -- at the cost of perhaps increasing the risk of early death. Or they can face the possibility that their loved one could be kicked out of the nursing home due to his or her aggressive behavior.

Despite the fact that antipsychotic drugs for Alzheimer’s disease now carry a warning that they are linked to increased death risk in elderly patients, these medications still are often used in the nursing home setting to help manage aggression in elderly patients with dementia -- particularly if an entering patient poses a risk of harming him- or herself or others.

But this needn’t always be the case. Alzheimer’s experts say it is important that family members of elderly patients with dementia understand that there are ways of managing aggressive behavior in these patients without resorting to drug treatment.

William Thies, chief medical officer of the Alzheimer’s Association, suggested that families first look into non-pharmacological treatments for aggressive behavior in elderly demented patients, which can be as effective as antipsychotic medications.

“Non-pharmacological treatments are things like changing the environment of the patient, changing the way the patient is addressed, and eliminating certain triggering events that may cause deteriorations in patient behavior,” Thies explained.

And now that a new study published in the journal Lancet Neurology finds that the death risk for elderly demented patients taking antipsychotic medication is even bigger than previously thought, understanding the alternatives to drug treatment is more important than ever.

Researchers from King's College London studied 128 patients who were given either an antipsychotic drug or a placebo. After one year, they found that 70 percent of those taking the antipsychotic medication were still alive, compared to 77 percent of those on a placebo.

More startlingly, they found that this gap widened over time. By three years, only 30 percent of those on the drugs were alive compared to 59 percent in the placebo group.

In order to encourage families to make the best decisions for their loved ones, dementia experts say these families must consider a number of factors before turning to antipsychotic medications.

“My advice to families is to agree that the symptoms are bad enough to warrant exposing their loved ones to risk -- and mortality is not the only risk,” said Dr. Thomas Finucane, professor of medicine at Johns Hopkins University. “If yes, to agree explicitly on what the meaningful goals of treatment are, and to stop the medicine unless a meaningful goals are met.”

January 10, 2009 | Permalink | User Comments (13)

Are We More Racist Than We Think?

January 08, 2009 6:19 PM

By JOSEPH BROWNSTEIN, ABC News Medical Unit

Earlier this week, "What Would You Do?" aired a segment that examined whether people respond to overt racism, concluding that we often don't speak up when confronted with  it.

Today, a new study in the journal Science shows our tolerance for racism may be even greater than we believed. The authors say that people don't respond, or even get upset, when they see racism directed at someone else.

"When they’re put in that situation, they are not upset at all, and they don’t punish or censor the racism at all," said psychologist Kerry Kawakami of York University in Toronto and one of the study's authors.

But the new study is more  an indictment of the failure to stand up to racism when it would have been easy to do so.

In Kawakami's study, 120 subjects -- none of whom were black -- were randomly divided into two groups.

Half the subjects were put in a room with a black person and a white person (both actors) and told they would be doing an experiment with a partner. The black actor would leave the room, grazing the knee of the white person on his way out.

After the black actor left the room, the white actor would respond in one of three ways: He'd say either  nothing, or "Typical. I hate it when black people do that," or use a racial slur.

Shortly after, a  black actor would return with the researcher to begin the puzzles, and the subject was asked to choose either the black or the white partner.

The second group of subjects was presented with the same scenario, but hypothetically, and were asked how upset they would be and whom they would choose as a partner.

While the subjects presented with  the hypothetical situation said they would  be upset and choose the black person as a partner, those who had witnessed the actual situation did the opposite. More than 60 percent of the those who had witnessed the racist comment  chose the white partner, while less than 30 percent of the subjects in the  hypothetical situation  said they'd  do that.

It seems most won't put their foot down when confronted with racism.

"It’s not even standing up to racism, it’s not even as costly as it was on your program,” said Kawakami, referring to ABC News' "What Would You Do" segment.

While the situation set up by ABC required someone to speak up in a crowded area, the people in the study only had to speak up in a small group, or avoid a racist partner when that was all the information they had in making their choice.

And even when  they were alone in a room with a racist, the people in the study said nothing.

“Nobody in our study said anything to the white person,” said Kawakami.

Additionally, Kawakami said, the people in the study who had witnessed racism apparently did not experience any distress because of it.

Many see the election of Barack Obama as a sign that racism has ended in the United States, but experiments like these signal it has not vanished entirely.

Kawakami said racism might persist partly because there is not enough said to people who make racist comments.

“Racist behavior is not censored, is not punished in our society, and that could be one reason why it’s still so prevalent,” she said.

January 8, 2009 | Permalink | User Comments (7)

A Note From the FDA: There Are Beetles in Your Juice

January 07, 2009 11:33 AM

By KIRK FERNANDES, ABC News Medical Unit

So, you know all those ground-up bugs you’ve been drinking and eating? Ooh … awkward moment. You didn’t know you were gulping down ground-up bugs, did you?

Well, it turns out that one of the best ways to make a “natural” red food coloring is to crush the dried bodies of the female Dactylopius coccus -- a cactus-eating insect from the Americas.

The resulting scarlet hue brightens some of our popular juices, candies, yogurts and ice creams. And the same coloring can be used in makeup including lipstick.

Earlier this week the Food and Drug Administration issued a rule requiring manufacturers using the dye -- known as carmine, or cochineal extract -- to label it as such in foods and cosmetics.

But not because of the gross factor. Instead, the FDA is doing so to help prevent dangerous anaphylactic reactions in people who are allergic to the insects and are unknowingly ingesting and/or rubbing the colorful bug powder on their faces.

The labeling of "these color additives in all foods and cosmetics is necessary to ensure their safe use," stated the FDA report issued Monday.

The new requirement was, in part, a response to a citizen petition about the allergic reactions, first launched in 1998 by the Center for Science in the Public Interest, according to the FDA report. But the final rule doesn’t go as far as the center had wanted: an overall ban of the ingredient or a required label to explain that carmine is "insect-derived."

"We wanted people to know that it comes from an insect," said Michael Jacobson, the center's executive director. "Vegetarians, Jews, anybody else who has concerns about eating animal products should know that."

It should be noted that cochineal allergies appear to be rare. The FDA collected 14 reports of adverse reactions during a 10-year period. And the agency is not considering it a "major food allergen" like other foods such as shellfish and tree nuts, which are covered by the Food Allergen Labeling and Consumer Protection Act of 2004.

A quick scan of the medical literature turned up a few reports of people with occupational asthma linked to carmine, including two workers at a carmine factory and two butchers who used the coloring in their sausages (both in Spain).

Manufacturers don’t have to start adding the “carmine” or “cochineal extract” labels until 2011, but you can find many products from familiar brands that are already noting the special ingredient.

Image of D. coccus cortesy of Peter J. Bryant, University of California, Irvine.

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January 7, 2009 | Permalink | User Comments (53)

Jett Travolta’s Death: Beyond the Media Coverage

January 07, 2009 10:01 AM

By DAN CHILDS, ABC News Medical Unit

At 2 p.m. Tuesday, a Google search revealed 5,971 results for news stories featuring the term “Travolta.” This was little surprise, considering the intense news media spotlight on the death of 16-year-old Jett Travolta in the Bahamas Friday.

Since the news was announced, the ABC News Medical Unit has spoken to experts in a variety of medical specialties for comments on what could have caused the boy’s death.

We heard back from several of these experts, but one response that stood out was from Dr. Nancy Minshew, a professor of psychiatry and neurology at the University of Pittsburgh. While we initially expected that Minshew’s expertise in the area of autism research would be a boon to our reporting, it was her experience as a parent who had lost a child that resonated with us.

Here are excepts from Minshew’s message, reprinted here with her permission:

“I don’t know what anyone can say about this death, except that it is every parent's worst nightmare and it is just the beginning. Who cares what caused it?

“The phone call from out of nowhere -- the police or the hospital call to ask: ‘Are you the parents of...’ It happens suddenly. It happened to me. My son died in a car wreck six years ago, and I got a call at 4 a.m. You suddenly become a member of a not-so-small club you can never resign from, and that will grieve you until you die. It will cause you to question your most fundamental beliefs.

“I would like to say these parents will feel better soon, but they won’t. Maybe in two years or three they will feel better, but not this year or next year. And not before they question every thing they did or did not do. ... Every invasion of their privacy with speculation about cause will cause pain. Empathy would help. That is all I can say about that.”

What do you think?

January 7, 2009 | Permalink | User Comments (19)

Can Weight Loss Surgery Save Our Children From Themselves?

December 30, 2008 8:56 AM

By DAN CHILDS, ABC News Medical Unit

ABC News' Lisa Stark reported today in a World News report and in a story on ABCNews.com that new research suggests severely obese teens with Type 2 diabetes may be able to benefit from weight loss surgery. The study unleashed a torrent of reactions from both the public in general and the medical community, and the ABC News Medical Unit received many comments from experts in baratric surgery and diabetes. Below is some of what they had to say.

A number of doctors told the Medical Unit that performing the operation on teens is a desperate measure for desperate times -- particularly as obesity rates in those age 12 to 19 approaches 18 percent, according to the Centers for Disease Control and Prevention. Study co-author Dr. Anita Courcoulas, chief of bariatric surgery at the University of Pittsburgh Medical Center, is concerned about the teen obesity problem:

“When we find that younger patients are experiencing what we used to think of as adult-type problems, it brings up the question of whether we can apply adult-type treatments,” Courcoulas said. “These are all children with a BMI over 50. These are really big, sick kids.”

New Jersey-based laparoscopic surgeon Dr. Alexander Abkin agreed:

“I, myself, offer teens both gastric bypass and gastric banding; it works great and it does reverse or cure Type 2 diabetes. ... If kids are denied care now, they will grow to be disillusioned about their future as adults, sick with medical problems, socially inadequate because of discrimination and so on. Surgery is one of the avenues to offer that hope.”

On the other side of the debate, physicians, like New York bariatric surgeon Dr. Mitch Roslin, warned that surgery may not be the magic bullet for which many have hoped:

“Having done this for 15 years, if there is weight regain -- and there is in many [gastric bypass] patients -- the diabetes can return. ... I think it is reasonable to aggressively treat young [diabetes] patients, since their internal or vascular age is greater than gestational age. [But] I am becoming more skeptical than many of my colleagues that [gastric bypass surgery] is [the] best operation.”

Dr. Francine Kaufman, head of the Center for Diabetes and Endocrinology at the Children’s Hospital in Los Angeles, concurred:

“This should not be viewed as license for any bariatric center to start looking at this procedure in teens; the procedure should be viewed still as experimental. The take-home message is one of caution. We have no long-term data, no idea what will happen with a dramatic permanent procedure such as gastric bypass ... that has to last 70 to 80 years or more.”

And Dr. Charles Clark, a professor at the Indiana University School of Medicine, said that prevention is the only sure-fire answer to the problem:

“I view with great concern the approach to the problem in the cited article. ... The expense and morbidity of the procedure makes it an unreasonable solution. The only solution to the childhood obesity epidemic will be more successful approaches to its prevention and treatment.”

December 30, 2008 | Permalink | User Comments (6)

Drink to Your Health? Nutrition Experts Scrutinize Diet Coke Plus Claims

December 24, 2008 3:30 PM

By DAN CHILDS, ABC News Medical Unit

While diet sodas have long been touted as a less unhealthy alternative to their full-calorie counterparts, they have never been passed off as nutritious.

But now, soft drink giant Coca-Cola’s new marketing push for Diet Coke Plus may be an effort to stake a sweet claim in the health food realm.

The labeling of the no-calorie soft drink, which contains niacin, vitamins B6 and B12, zinc and magnesium, has already raised the ire of the Food and Drug Administration, specifically for the use of the word “Plus.”

“Based on our review, we have concluded that this product is in violation of the Federal Food, Drug, and Cosmetic Act,” reads a letter from the FDA to Coca-Cola. “Your Diet Coke Plus product is misbranded ... because the product makes a nutrient content claim but does not meet the criteria to make the claim.”

Neither do nutrition experts appear to be buying into what they say appears to be an effort to slap a healthy label on a beverage of questionable nutritive value. Here’s what Dr. David Katz, director and co-founder of the Yale Prevention Research Center, had to say in an e-mail to the ABC News Medical Unit:

“To the extent of my familiarity with the FDA regulations, I believe that Coca-Cola is 'technically' correct: they have stated their product contains added vitamins and minerals, and indeed, it does. And I'm not sure FDA regulations extend to the use of 'plus' in a product name, without any specific health claim.”

But Katz adds that the move by Coca-Cola may reveal an unfortunate marketing trend:

“What makes this interesting is that FDA is invoking regulations that may or may not directly fit this scenario to address what is clearly a concerning trend: nutrient-fortified everything. I fully agree with the FDA's position on this. ... Adding some nutrients to an otherwise questionable food -- and soda is VERY questionable food -- does not change its basic character.”

Alice Lichtenstein, senior scientist and director of the Cardiovascular Nutrition Laboratory at Tufts University, adds in her own e-mail that consumers may do best to get their nutrients the old-fashioned way -- through the foods that naturally contain them.

“With the exception of unusual circumstances, we are best served if we get nutrients from foods, not supplements, even if the supplements are dissolved in a beverage. Foods have fiber, phytonutrients and other compounds that are associated with decreased risk of chronic diseases. The supplements, regardless of form (pill or beverage), do not contain these compounds.”

December 24, 2008 | Permalink | User Comments (19)

Do Winter Babies Really Have Less Fun?

December 24, 2008 11:00 AM

By JOANNA SCHAFFHAUSEN, ABC News Medical Unit

As every good astrologer knows, people love to find hidden meaning in their birth dates. In my immediate family, there are five of us born under the sign of Aquarius, between late January and early February.  This makes us all winter babies, which is bad news according to a report today in USA Today.

The story reads in part: “A large body of research suggests that, on average, winter babies grow up to be less educated, less intelligent, less healthy and lower paid than people born in the spring, summer or fall.”  But it’s all mom’s fault, new research says.  A study from two University of Notre Dame researchers says that winter babies’ lack of success can be blamed on the increased odds that their mother will be poor and uneducated.

There is no question that children of parents with limited education and lower economic status have a host of disadvantages.  They typically do not receive the best health care, nutrition or schooling.  The new research can’t answer the next question, which is why poor and uneducated women would be more likely to give birth in the winter months.  We’ll have to wait to see if that result is confirmed through other studies.

But does the medical literature show such dire results for winter babies?  The answer is no, not really.  There are indeed studies linking a winter birth date with poorer health or lower intelligence, but other studies find just the opposite.

For example, a study tracking more than 12,000 children in Scotland found that late winter babies born in February scored among the highest on intelligence tests.  Fall babies had the lowest scores in this this report.

A Danish researcher named Gabriele Doblhammer has repeatedly demonstrated that late fall and early winter babies live longer than spring or summer babies, though debate continues as to why this might be.

Another study finds women born in the summer months tend to have fewer children. And research from Harvard on more than 22,000 children found those born in the winter months were generally taller, heavier and had superior mental abilities to those born in the summer months.

So which group of studies is right?  The unfortunate truth about scientific research is that all the studies may be correct, meaning there is no ultimate truth to be found.  Results likely depend on the people in the study, the questions asked and the way that researchers interpret the results.

But one truth is certain from all the research: The birth month does not determine the outcome for any one baby.  There will be summer babies who succeed and those who do not; winter babies who live to a ripe old age and those who die too soon.

Trying to determine a child’s future from his or her birth date is like reading the horoscope to find out the day’s events ahead of time.  The information can’t possibly be true for everyone with the same birth month, or it’s so vague it could apply to the entire human population.  Today my horoscope says I may have overstepped my bounds and need to apologize.  Perhaps I should make amends to my husband for leaving Christmas wrapping all over our living room… except his birthday is just four days before mine, so it’s his horoscope too.

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December 24, 2008 | Permalink | User Comments (10)

Flight of the Aggravator: Expert Tips On Stress Relief During Airport Delays

December 23, 2008 7:53 AM

By KIRK FERNANDES, ABC News Medical Unit

Like many other Americans, I'm planning to travel for the holidays. I'm also planning to get stuck at the airport.

With the way the weather is working, things aren't looking good for a smooth flight to the middle of snow country -- Michigan, in my case.

But there are things you can do -- no matter where you're going -- to help relieve the stress you know is coming. For example, several stress reduction experts say simple things, such as making sure you get enough sleep the night before your flight, could improve your stress response the next day in the midst of a delay.

"At holiday travel time, expectations should be realistic, which often means lower," says Kim Lebowitz, director of cardiac behavioral medicine at Northwestern Memorial Hospital in Chicago, Ill. "Expect to arrive late and try to save the rest of the arrival day for something low-key, something that won't be too upsetting if it gets eliminated from the vacation because of travel delays."

We asked some of the experts from the ABCNews.com OnCall+ Stress sections for their stress relief tips for airport delays. Here are some of their suggestions you might consider:

TIP #1 -- Plan on getting delayed: Anticipating the challenges that may develop when you're facing a major negative event will help organize your response, explains Jeffrey Janata, a psychologist at University Hospitals Case Medical Center in Cleveland, Ohio.

Some experts suggest bringing enough books to read, making sure the laptop is charged, distracting the kids with a portable video game, or staying in touch with family and friends via cell phone.

"When somebody is in a stressful situation, if they can feel they're in control of some of the parameters of the situation, it greatly reduces their stress," says Phillip Levendusky, associate professor of psychology at Harvard Medical School.

TIP #2 -- Expand your toolbox of coping skills: Some people appear less stressed because they have better coping skills, says Katherine Muller, director of the cognitive behavior therapy program at Montefiore Medical Center in the Bronx, N.Y. Muller offers several coping tips in the OnCall+ Stress section.

In addition, several experts we talked to recommend using headphones (even noise-canceling headphones) to reduce noise stress.

TIP #3 -- Seek out comfortable seating: Stuffy heat and too many strangers nearby could activate stress responses in your body, says Dr. Charles Raison of the Emory University School of Medicine in Atlanta, Ga. "If you are going to have to wait for a long time try to find an area that is not hot and overly crowded."

TIP #4 -- Get moving: Exercise is "one of the best things people can do to reduce the physiological response to stress," says Janata. While that's typically true "over the long haul," according to Janata, you may benefit from periodically walking up and down the concourse or just moving around.

TIP #5 -- Make an escape: Raison recommends leaving the airport during long delays: "If you have the financial means and are going to be stuck for more than a day, try to get out of the airport and hang out in town. This is the ultimate way to beat airport stress and can sometimes turn a trip-wrecker into a novel vacation."

TIP #6 -- Get a massage: Those airport massage stations are there for a reason ... and a growing amount of scientific evidence confirms what you probably already know -- massage reduces the body's stress response, says Raison.

TIP #7 -- Beware the bar: Lower levels of alcohol can be a relaxant, but if you stay too long at the bar, you're likely to create more problems. "Refrain from overdoing alcohol because it actually is likely to make things worse, not better," said Janata.

So, what are your tips for stress relief during airport delays?

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December 23, 2008 | Permalink | User Comments (9)

Nuts Over Nuts: Column on Allergy Sparks Debate

December 22, 2008 5:22 AM

By LARA SALAHI, ABC News Medical Unit

Parents of children with food allergies are not happy with a recent write-up in the British Medical Journal that decries so-called "Draconian measures" to prevent nut allergy reactions in schools.

The surge in schools that are going nut-free may be fueling anxiety and “overreaction" in parents, Dr. Nicholas Christakis, an internist and professor at Harvard Medical School, writes in the column.

Christakis makes the argument that while 3.3 million Americans are allergic to nuts, "only 150 people [children and adults] die each year from all food allergies combined." The response to nut allergies is more extreme than reactions to other more statistically dangerous things such as traumatic injuries caused by sports, writes Christakis.

Christakis equates the nut crackdown to symptoms of a mass psychogenic illness, or epidemic hysteria -- in which an otherwise healthy individual experiences a wave of extreme anxiety. (Christakis is known most recently for publishing research on social networks, including findings on how obesity, smoking and happiness may spread among friends and family.)

“It does indeed provoke anxiety to imagine a hidden deadly danger in so innocent a thing as having a snack in kindergarten,” writes Christakis. “And being around others who are anxious heightens one’s own anxiety."

However, some parents of children with nut allergies, including Maria Hardy of Loudoun, Va. -- whose daughter has extreme sensitivities to peanuts -- say Christakis may be underestimating the severity of the nut allergy problem.

“This doctor is not an authority in this subject,” says Hardy. “He is an internal medicine practitioner, not a pediatric allergist who would know all the facts.”

While Hardy is one of many parents who believe in nut bans to protect their nut-allergic children, some participants in local allergy groups do not think a mandatory ban of nuts is always the best approach.

Gina Clowes, who created the allergy blog AllergyMoms.com, is not a proponent of schoolwide nut bans, but she says she feels parents should be working closely with school officials to best minimize the risk to their kids.

“In my experience, most parents do a very good job of advocating for their food-allergic children while gradually teaching their children to take over this important task [of taking care of their food allergies],” says Clowes.

Some parents who have written a response directly to Christakis say he's writing back to them. "So he's heard our concerns and is open to speaking with us," says Clowes.

The ABC Medical Unit asked Christakis if he had anything further to say about the parents' responses and he referred us to his original column.

The ABCNews.com OnCall+ Allergy center features a roundtable of mothers who discuss the everyday challenges of dealing with severe allergies in children. Some of their stories offer a personal look into the anxiety and issues they face.

Said one mother taking part in the roundtable: "I know what's safe for my son. I know what I need to do and I'm going to do it. If people think I'm crazy; they think I've over the top, I don't care. My focus is on keeping my son safe."

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December 22, 2008 | Permalink | User Comments (137)