Agave: Calories, Nutrition Facts, and More

By Kathleen M. Zelman, MPH, RD, LD
And Jenn Horton
WebMD Feature

Reviewed by Kathleen M. Zelman, MPH, RD, LD

You've seen agave syrup in your grocery store or in products sweetened with its nectar. It's about 1.5 times sweeter than sugar and comes from the same plant that's used to make tequila.

Should you reach for it instead of sugar, honey, or maple syrup? What if you're working on losing weight or have diabetes?

The answer may be more about your personal taste than about health. If you were hoping that you could use as much agave as you like, that's unfortunately not the case.

What Is Agave?

The agave plant grows from the southwestern U.S. through the northern part of South America. It’s the same plant used to make tequila.

Most agave sweeteners come from the blue agave plant. You don't get its raw nectar. Much like high-fructose corn syrup, it's highly processed before you can add it to your tea, top your pancakes with it, or get it in an energy drink, bar, or other product.

Agave has about 60 calories per tablespoon, compared to 40 calories for the same amount of table sugar. So to save on calories, you'd need to use less, which should be possible, since agave is sweeter.

Agave and Diabetes

Have you heard that agave is a better sweetener for people with diabetes? In theory, it's high in fructose and low on the glycemic index, making it a better option than refined sugar. But there's not a lot of research to back that up, and one of the studies was done in lab animals, not people.

The American Diabetes Association lists agave as a sweetener to limit, along with regular table sugar, brown sugar, honey, maple syrup, and all other sugars.

Liz Applegate, director of sports nutrition at the University of California, Davis, agrees. She says your body doesn’t know where the fructose or glucose comes from, be it fruit, agave, or high-fructose corn syrup; so if you eat too much of it, that's a problem.

Applegate's advice: It's better to choose naturally sweetened items that have some nutritional benefit, like fruit or even a little bit of honey, which is a mite richer in antioxidants than sugar is.

Less Is More With All Added Sweeteners

Just like most other added sugars, agave offers no miraculous health benefits, Applegate says. It simply adds sweetness.

If you want to switch from one sweetener to another, Applegate suggests instead looking at the overall amount of added sugars already in your day. Some of them are in foods you might not expect. Check food labels, write down everything you eat for a week, and see how much sugar you're already getting.

The American Heart Association recommends limiting sweeteners to no more than 6 teaspoons for women and 9 teaspoons for men per day, on average. That includes all sources, whether it's agave, sugar, high-fructose corn syrup, or anything else.

source : Agave: Calories, Nutrition Facts, and More

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Help! My Kid Is a Jerk!

By Lisa O'Neill Hill
WebMD Feature

Reviewed by Roy Benaroch, MD

Your kid is a great kid -- good sport, lots of good deeds -- but he has obnoxious moments. And those moments threaten your sanity.

Sometimes he doesn't listen to you. He won't take no for an answer. He's mean to his sister. You start to ask yourself, "Is my kid a jerk?"

Some ages are naturally harder on kids -- and parents.  But how can you tell what's normal? What can you do about it? And when should you get help?

"All of those behaviors are typically one of two things: A cry for help or attention," says Christine Carter, PhD, author of Raising Happiness: 10 Simple Steps for More Joyful Kids and Happier Parents. "I see these things as flags, maybe not red flags, but certainly yellow or orange."

They dish out sassy or back talk, yell, or have angry outbursts.

Why they do it: Disappointment, anger, or frustration

What you can do: Point out the difference between what your child feels and how she acts. Feelings are always OK. Tell your child you understand her feelings, but help her take the heat out of the moment.

"The most appropriate response [when you feel] angry is to do something to calm yourself down so you can be effective," Carter says. Suggest your kid take 10 deep breaths or write a letter that she never sends. After a few minutes, she can come back and try again to talk calmly.

They disobey or ignore you.

Why they do it: She's testing her limits. She probably wants more freedom but might feel too controlled."Sometimes ... parents don't adjust their expectations for the kid, so they may still be treating the kid like he or she is 8 or 9," when she's older, Kenefick says. Kids, especially teenagers, need a bit of freedom. "When parents don't give kids this opportunity, that's when they see a lot of conflict."

What you can do: Let them make choices that are right for their age. "Their lives are so structured and they're just trying to carve out a place for themselves," Carter says. But they also need limits. "If they don't feel like they have boundaries, they will start disobeying you a lot to test you," she says. So it's important to follow through when they break the rules -- each and every time.

They beg or won't take no for an answer.

Why they do it: They're upset you didn't say yes.

What you can do: Negotiation between parents and kids is normal. But it's different than whining and begging. If you say "no" to your kid's request, he should learn how to deal with his disappointment. Carter suggests that parents be firm when something isn't open to discussion. How do you do that? Tell your child not to ask again. "You have the ability to say 'no' and not negotiate," Carter says. 

source : Help! My Kid Is a Jerk!

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Diet Changes Can Alter Gut Bacteria, Study Says

Researchers monitored stool samples of two people for a year

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

FRIDAY, July 25, 2014 (HealthDay News) -- Dietary changes can dramatically alter the balance of bacteria in the gut on a daily basis, according to a new study.

These fluctuations could lead to monitoring systems that might help detect and ease flare-ups for people with certain chronic illnesses, such as inflammatory bowel disease (ulcerative colitis and Crohn's disease), the researchers said.

Trillions of bacteria live in the digestive tract, but their effect on human health isn't well understood, the Massachusetts Institute of Technology (MIT) scientists noted.

To better understand the role of bacteria in the body, the research team monitored changes in the bacteria of two people over the course of one year. Stool samples were collected daily to monitor the amount and types of bacteria present.

The participants also used an iPhone app that tracked lifestyle factors -- such as diet, sleep, mood and exercise -- that could have an impact on their gut bacteria.

Both people experienced an event during the study period that had a significant impact on their gut microbiome, or the number and types of bacteria in their digestive tract.

One developed diarrhea while on a two-week trip to a developing nation. This person had significant changes in the balance of gut bacteria. After returning home to the United States, however, the gut bacteria returned to normal, according to the study published in the July 25 issue of Genome Biology.

Meanwhile, the other participant developed food poisoning from salmonella. As a result, gut salmonella jumped from 10 percent to nearly 30 percent. Moreover, populations of helpful bacteria nearly disappeared. After the person recovered from food poisoning, the beneficial bacteria rebounded to about 40 percent of the total microbiome. But the researchers pointed out that most of the strains were different from those originally present.

"On any given day, the amount of one species could change manyfold, but after a year, that species would still be at the same median level. To a large extent, the main factor we found that explained a lot of that variance was the diet," study senior author Eric Alm, an associate professor of biological and environmental engineering, said in an MIT news release.

Looking ahead, the researchers said they plan to explore why gut bacteria tend to return to their normal levels after fluctuating widely.

source : Diet Changes Can Alter Gut Bacteria, Study Says

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Study Links Shift Work to Risk for Type 2 Diabetes

Researchers cite many possible reasons for the effect, including hormonal changes

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

THURSDAY, July 24, 2014 (HealthDay News) -- Shift workers, especially men, may be at higher risk for type 2 diabetes compared to people not on such schedules, a new study suggests.

Also at special risk are shift workers who don't work on a set schedule, with shifts moving around at various times of the day.

The findings are "not at all surprising," said one expert, Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City.

"Physicians have long known that working shifts disrupts many key body chemicals, creating a ripple effect that can lead to ailments such as gastrointestinal disorders, cardiovascular disease and even

In the new review, researchers analyzed data from 12 international studies involving more than 226,500 people.

The study, led by Zuxun Lu of Huazhong University of Science and Technology in Wuhan, China, took several factors into account, such as workers' shift schedules, their body mass index (BMI, a calculation of height and weight), family history of diabetes and their level of physical activity.

Although the findings weren't able to show a direct cause-and-effect relationship, the researchers found that any amount of shift work was linked to a 9 percent greater risk for developing diabetes. Gender also played a role -- for men engaged in shift work, the risk jumped to 37 percent.

Although the reason why men are at greater risk than women isn't clear, the researchers believe that testosterone levels may play a role. Prior studies have pointed to an association between low testosterone levels and insulin resistance and diabetes, the researchers noted.

Daytime levels of this male hormone are regulated by the internal body clock, Lu's team explained.

Those whose shifts moved around through different periods of the day were especially likely to develop type 2 diabetes than those who worked normal "office hours." The study found rotating shift work to be linked to a 42 percent greater risk for diabetes.

According to Lu's team, erratic working schedules make it more difficult for the body to establish a sleep-wake cycle, and poor sleep may worsen insulin resistance, a precursor to diabetes.

Previous studies have also linked shift work to weight gain and obesity, a big risk factor for type 2 diabetes. And the researchers note that shift work can also affect cholesterol levels and blood pressure.

Another expert said other factors may be at play as well.

"Growth hormone, known to elevate blood glucose when present in excess, peaks at 1 a.m.," noted Dr. Gerald Bernstein, director of the Diabetes Management Program at Friedman Diabetes Institute at the Beth Israel Medical Center in New York City. "Shift work also often makes it more difficult to schedule regular meals and exercise."

Still, Bernstein said that "even with a strong risk for diabetes I would not discourage someone from taking a job that is based on shifts."

Instead, he said "it would be better to screen shift workers regularly for pre-diabetes and intervene to slow the progression to full-blown diabetes."

Manevitz agreed. "Those who must do shift work would be wise to consult their doctor, who can monitor cholesterol levels, blood pressure and insulin levels to detect if blood sugar levels are creeping up dangerously," he said. "Doctors may also be able to prescribe sleep aids to help shift workers get the proper amount of sleep, even if that sleep comes during odd hours."

The study was published recently in Occupational & Environmental Medicine.

source : Study Links Shift Work to Risk for Type 2 Diabetes

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Is Coffee Aggravating Your Hot Flashes?

Researchers suggest women skip caffeine if they're bothered by menopausal symptoms

WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

THURSDAY, July 24, 2014 (HealthDay News) -- Drinking caffeine may worsen the hot flashes and night sweats that affect roughly two-thirds of women as they go through menopause, new survey data suggests.

"While these findings are preliminary, our study suggests that limiting caffeine intake may be useful for those postmenopausal women who have bothersome hot flashes and night sweats," said researcher Dr. Stephanie Faubion, director of the Women's Health Clinic at the Mayo Clinic in Rochester, Minn.

But caffeine -- a stimulant found in coffee and colas -- appears to have a different effect on women beginning the transition into menopause (known as perimenopause). In their case, caffeine might boost their mood, memory and concentration, the survey suggested.

The findings, published online July 23 in the journal Menopause, stem from a Mayo Clinic poll of more than 1,800 menopausal women conducted between 2005 and 2011. Symptoms were compared between caffeine users and nonusers.

"Menopause symptoms can be challenging, but there are many management strategies to try," Faubion said. One way to gain some control over bothersome symptoms is to be careful about what one eats, she added.

That means generally forgoing spicy food and hot beverages, as well as caffeine, alcohol and tobacco, she said in a Mayo news release.

Given that about 85 percent of Americans drink caffeine in some form on a daily basis, Faubion and her colleagues tried to ascertain to what degree the stimulant might affect the severity of hot flashes and night sweats.

Prior research on the question has offered mixed results. But responses to the current survey suggested that caffeine intake does appear to aggravate and worsen such symptoms, they found.

Avoiding caffeine, maintaining a healthy weight, staying active and adopting meditative techniques can help, Faubion said. She also advocated dressing in removable layers, and sleeping with moisture-control bedding as additional means to limit the discomfort menopausal symptoms can sometimes bring about.

A woman generally reaches menopause -- the time when her periods stop -- after age 45.

source : Is Coffee Aggravating Your Hot Flashes?

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5 Best Stretches for New Moms

By Karen Asp
WebMD Feature

Reviewed by David T. Derrer, MD

After having a baby, it’s perfectly normal to feel like your body is a little off. "Your back, shoulders, and hips are likely to feel tight,” says Erica Ziel, a personal trainer in Newport Beach, CA.

These five moves will soothe common sore spots and help ease you back into a fitness program. “When you do these stretches, use your core muscles to deepen the stretch and get your core strength back,” Ziel says.

1. Hip Rolls

What they do: Open up your lower back and hips.

How to do them: Lie on your back with your knees bent, feet shoulder-width apart, and arms along your sides. Press your lower back and heels into floor as you tilt your pelvis up. Slowly raise your hips off the floor until they are as high as you can lift them.

With your hips raised, bring your knees together and turn your toes toward each other. Slowly roll yourself down to the floor, one vertebra at a time, drawing in your ribs and keeping your knees pressed together.

Repeat five to eight times.

2. Downward-Facing Dog

What it does: Lengthens your lower back.

How to do it: Position yourself on the floor on all fours. Keep your wrists in line with your shoulders and your knees in line with your hips.

Slowly straighten your legs and lift your hips until your body forms a V-shape. “Be sure to relax your shoulders away from your ears,” Ziel says.

Work up to holding the pose for 10 to 20 seconds. Release into child’s pose. To do that, sit back on your heels, knees apart, and bend forward touching your forehead to your knees or the floor, with your arms extended in front of you.

3. Pigeon Pose

What it does: Opens up your hips.

How to do it: Get on the floor on all fours. Move your right knee toward your right hand, then place your right leg on the floor in front of you with your right foot pointing toward your left hip.

Straighten your left leg behind you.

Sit up tall.

Then slowly lower your upper body, leaning forward only as far as it feels good for your hips to stretch.

Hold for a minute, and then switch sides.

“Don’t force the stretch,” Ziel says.

Or do this instead: If pigeon isn’t working for you, sit tall in a chair and place your right foot over your left thigh, just above the left knee. Hold for a minute, and then switch sides.

4. Mermaid Stretch

What it does: Opens the front of the body, especially your chest and hips.

source : 5 Best Stretches for New Moms

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Routine Pulse Check May Prevent Second Stroke, Study Says

Patients, relatives can get reliable results, researchers find

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

WEDNESDAY, July 23, 2014 (HealthDay News) -- Regularly checking the pulse of a stroke survivor may help prevent another stroke, researchers report.

"Screening pulse is the method of choice for checking for irregular heartbeat for people over age 65 who have never had a stroke. Our study shows it may be a safe, effective, noninvasive and easy way to identify people who might need more thorough monitoring to prevent a second stroke," said study author Dr. Bernd Kallmunzer, of Erlangen University in Germany.

The study included more than 250 people who survived an ischemic stroke (blocked blood flow to the brain). Either the patients or their relatives were taught how to monitor the pulse to detect an irregular heartbeat.

Pulse checks taken by patients and relatives were nearly as accurate as those taken by health care workers, according to the study published online July 23 in the journal Neurology.

The pulse readings taken by the participants and health care professionals were compared to readings of electrical activity in the heart, which showed that 57 of the patients had irregular heartbeats.

Pulse measurements taken by relatives had a sensitivity of 77 percent and a specificity of 93 percent, compared with about 97 percent and 94 percent, respectively, for health care workers.

Sensitivity is the percentage of positive findings that are correctly identified. Specificity is the percentage of negative findings that are correctly identified.

Among patients who did their own pulse checks, 89 percent provided reliable results, with a sensitivity of 54 percent and specificity of 96 percent. False positives occurred in six patients and false negatives in 17 patients.

"The low rate of false positives in this study shows that health care professionals, caregivers and patients can be guided to use this simple tool as a first step in helping to prevent a second stroke," Kallmunzer said in a journal news release.

source : Routine Pulse Check May Prevent Second Stroke, Study Says

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New HIV Guidelines Released by WHO

By Pam Harrison
Medscape Medical News

July 23, 2014 (MELBOURNE, Australia) -- Five groups of people are driving the global HIV epidemic, the World Health Organization (WHO) says in its new guidelines.

Men who have sex with men, sex workers, injection-drug users, transgender people, and people in prisons are among the groups targeted for prevention and treatment efforts.

HIV rates are "going down all over the world, with the exception of key affected populations," Fabio Mesquita, MD, said during a news conference at the 20th International AIDS Conference. Mesquita is the director of the HIV and viral hepatitis program at the Ministry of Health in Sao Paulo, Brazil.

"If we don't address key affected populations, we won't reach our goal of controlling the epidemic by the year 2030," he said.

Recent statistics indicate that men who have sex with men are up to 19 times more likely than people in the general population to be infected with HIV. Female sex workers are up to 14 times more likely to be infected. Transgender women are almost 50 times more likely to be infected.

"In all parts of the world, these populations have compromised access to good [HIV-related] services," said Gottfried Hirnschall, MD, director of the WHO Department of HIV/AIDS.

'Hostile Environment' for People at High Risk

Laws that stigmatize people and penalize sexual orientation drive risky behavior underground, making it hard, if not impossible, for people at high risk for HIV to access HIV prevention and care services, speakers at the news conference explained.

As a consequence of this hostile environment, rates of new HIV infections are increasing in all these groups, but especially in men who have sex with men, a group in which "explosive epidemics" of HIV are occurring in many parts of the world, Hirnschall said.

It's estimated that up to 50% of all new HIV infections occur in these groups, according to the Joint United Nations Programme on HIV/AIDS.

Guideline Recommendations

One of the major recommendations in the guidelines is that an HIV-prevention method called pre-exposure prophylaxis, or PrEP, be part of prevention efforts for men who have sex with men. PrEP involves taking a daily pill containing two medicines, and it can help protect an uninfected person against HIV -- although it's not 100% effective.

"There is strong evidence for this recommendation," said guideline chair Chris Beyrer, MD. He's the director of the Johns Hopkins Center for Public Health and Human Rights in Baltimore, and president-elect of the International AIDS Society.

Beyrer stressed, though, that PrEP treatment is not recommended for all men who have sex with men -- only those who want the treatment and who are at risk for HIV. He explained that PrEP must be used with other prevention methods, such as condoms, condom-appropriate lubricant, and education.

source : New HIV Guidelines Released by WHO

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Will 3-D Printing Revolutionize Medicine?

By Sonya Collins
WebMD Health News

Reviewed by Brunilda Nazario, MD

July 23, 2014 -- Sydney Kendall lost her right arm below the elbow in a boating accident when she was 6 years old. Now 13, Sydney has used several prosthetic arms. But none is as practical -- nor as cool, she’d argue -- as her pink, plastic, 3-D-printed robotic arm.

The arm was custom-designed for her this spring, in pink at her request, by engineering students at Washington University in St. Louis through a partnership with Shriners Hospital. They printed it while Sydney and her parents watched. 

“It took about 7 minutes to do each finger,” says Sydney’s mother, Beth Kendall. “We were all blown away.”

When Sydney wore her new arm to her school outside St. Louis, her classmates were blown away, too. “They were like, ‘Sydney, you’re so cool! You’re going to be famous!'” Sydney recalls.

The robotic arm, with its opposable thumb, helps Sydney grip a baseball, maneuver a mouse, and pick up a paper coffee cup.

The cost? About $200. Traditional robotic limbs can run $50,000 to $70,000, and they need to be replaced as children grow.

“Kids don’t usually get to have robotic arms because they are so expensive,” Beth Kendall says.  

Robotic arms like Sydney’s are just one example of how 3-D printing is ushering in a new era in personalized medicine.

From prosthetics to teeth to heart valves, it’s bringing made-to-order, custom solutions into operating rooms and doctors’ offices. Experts say dozens of hospitals are experimenting with 3-D printers now, while researchers work on more futuristic applications of the technology: printing human tissue and organs. To foster even more research, the National Institutes of Health in June launched a 3-D Print Exchange that allows users to share and download files.

“3-D printing is a potential game-changer for medical research,” said NIH Director Francis Collins, MD, PhD, in announcing the exchange. “At NIH, we have seen an incredible return on investment; pennies’ worth of plastic have helped investigators address important scientific questions while saving time and money.”

As one of the leading researchers in the field, Anthony Atala, MD, director of the Wake Forest Institute of Regenerative Medicine, understands its promise firsthand. The institute has already created miniature livers that live in petri dishes as a step toward creating organs. “3-D printing has the potential to revolutionize medicine,” he says.

What Is 3-D Printing?

Imagine an ink jet printer that, rather than spraying out ink in the shape of letters, sprays out a plastic or metal gel or powder in the shape of a tooth, finger, or a hip joint. A typical printer receives a document to print, while 3-D printers take their commands from an MRI or a CT scan of a body part. Also known as “additive manufacturing,” 3-D printing produces an object, layer by layer, from the ground up.

source : Will 3-D Printing Revolutionize Medicine?

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HIV Meds May Also Help Control Hepatitis C, Study Finds

For people infected with both viruses, early treatment is critical, researchers report

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

WEDNESDAY, July 23, 2014 (HealthDay News) -- For patients infected with both HIV and hepatitis C, HIV antiretroviral therapy may help control both viruses, a small study suggests.

Researchers said doctors could use their findings to improve treatment strategies for people with the two diseases.

"The findings suggest that HIV suppression with antiretroviral medications plays an important role in the management of individuals with [hepatitis C] and HIV infection," said study leader Dr. Kenneth Sherman, a professor of medicine at the University of Cincinnati College of Medicine. "It supports the concept that in those with HCV/HIV infection, early and uninterrupted HIV therapy is a critical part of preventing liver disease."

The researchers conducted the study to address concerns that treating patients who have HIV -- the AIDS-causing virus -- and hepatitis C with HIV antiretroviral therapy would damage the liver and cause more harm than good.

To put this theory to the test, they closely examined 17 patients infected with both viruses for two years. The patients received approved HIV antiretroviral drugs. They were also examined frequently, and their blood was routinely tested to track any changes in the viruses and their immune response.

The findings were published July 23 in the journal Science Translational Medicine.

Some patients experienced an initial increase in a blood test that shows changes in liver injury, hepatitis C or both in the first 16 weeks of the study.

Over 18 months, however, the study revealed that "viral loads" for hepatitis C dropped back down to levels expected for a patient infected with only hepatitis C and not HIV.

"The drop in [hepatitis C] viral levels was a big surprise, and not what we necessarily expected," said Sherman in a university news release. "There is a complex interaction of biological effects when patients are infected with both HIV and the hepatitis C virus." He explained that initially HIV treatment results in a transient increase in hepatitis C viral replication and evidence of liver injury. However, over time, HIV suppression leads to reduced hepatitis C viral replication.

In the United States, up to 300,000 people are infected with both hepatitis C and HIV. Globally, that number increases to between 4 million and 8 million, the researchers said.

Drug makers Bristol-Myers Squibb and Gilead Sciences supplied the antiretroviral medications used in the study at no charge. One of the scientists involved in the research, Dr. Judith Feinberg, a professor of infectious diseases at the University of Cincinnati, is a Bristol-Myers Squibb investigator and speaker.

source : HIV Meds May Also Help Control Hepatitis C, Study Finds

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Cystic Fibrosis Drug Combo May Be Less Effective Than Hoped

One medication seems to partly counteract the other, suggests study on human cells

WebMD News from HealthDay

By Randy Dotinga

HealthDay Reporter

WEDNESDAY, July 23, 2014 (HealthDay News) -- A powerful drug combo may not be as effective against cystic fibrosis as previously thought. New lab-based research on human cells suggests that one of the medications might stop the other from working properly.

However, this study's findings aren't definitive, and there's still hope for the medications known as ivacaftor (brand name Kalydeco) and lumacaftor, according to the study's senior author.

"The development of drugs like ivacaftor and lumacaftor is undoubtedly a step forward, but our study suggests that more work will need to be done before we can realize the full potential of these drugs," said Martina Gentzsch, an assistant professor with the department of cell biology and physiology at the University of North Carolina, Chapel Hill.

"Fortunately, we now have a better understanding of some of the potential pitfalls to these drug combinations and a means to test alternative strategies to make these drugs more effective," said Gentzsch.

For its part, the Vertex pharmaceutical company, which produces both medications, recently released the results of a phase 3 clinical trial on the drug combo, involving patients with cystic fibrosis. The findings, based on use of the drug combination by more than 1,100 patients, "showed consistent and statistically significant improvements in lung function and other measures of the disease," Vertex said in a statement.

Alan Smyth, a professor of child health and division head at the University of Nottingham in England, agreed that initial research in people, not on cells in the laboratory, was more promising. The drug combo seems to work, he said, and newer drugs of a similar type may help scientists improve on their performance.

However, Smyth cautioned that the phase 3 trial data from Vertex has not yet gone through the peer-review process typically required to give physicians confidence in the results.

An earlier, phase 2 trial -- also with positive results for patients -- was published online in the peer-reviewed journal The Lancet Respiratory Medicine in June.

Cystic fibrosis affects an estimated 30,000 people in the United States, according to the Cystic Fibrosis Foundation. It's an inherited disease that disrupts cells in the lungs and the pancreas, causing mucus to become thick and sticky. The mucus builds up, causing breathing and digestion problems.

"Existing medications target only the symptoms of cystic fibrosis but not the cause of the disease," Gentzsch said. "As a result, they may lead to improvement but do not prevent the overall slow progression of lung disease over time. In addition, many current therapies are time-consuming and can be more difficult to use in young children."

A newer drug known by the brand name Kalydeco targets a protein that doesn't work properly in certain people with cystic fibrosis. Researchers have praised the medication, but it only works in an estimated 5 percent of patients who have a specific genetic variation.

source : Cystic Fibrosis Drug Combo May Be Less Effective Than Hoped

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Is Butter Back? The Truth About Saturated Fats

By Amy Paturel
WebMD Feature

Reviewed by Elizabeth Klodas, MD, FACC

For decades we’ve been warned that eating saturated fat, the type found in meat, cheese, and other dairy foods, can lead to heart disease. Instead, we've been told to choose healthy fats from nuts, seeds, fish, and vegetable oils.

New research questions that belief. A recent review of 72 studies found no link between saturated fat and heart disease. The review also showed that monounsaturated fats like those in olive oil, nuts, and avocados don't protect against heart disease.

This isn’t the first study to question the idea that saturated fats are bad for your heart. Five years ago, another research review also found no link between saturated fat and heart disease.

Still, these studies aren't the final word. Right now, not everyone agrees that saturated fats are harmless.

Major health groups like the American Heart Association say getting a lot of saturated fat raises your chances of getting heart disease -- and they aren’t changing their guidelines.

What Should You Eat?

Until science figures out the answer, what should you eat?

Don’t view the study as a green light to load up on butter, steak, and cheese. Be smart about the saturated fats in your diet.

“Countless studies show that if you replace saturated fat with polyunsaturated fat, you do get a reduction in heart disease risk,” says Alice Lichtenstein, professor of nutrition science and policy at Tufts University in Boston. Polyunsaturated fats, often called omega-3 and omega-6 fatty acids, come from vegetable oils -- soybean, corn, and canola -- and fatty fish like salmon, mackerel, herring, and trout. They are also found in most nuts, especially walnuts, pine nuts, pecans, and brazil nuts.

The best way to prevent heart disease may be to eat more whole, unprocessed foods. So eat fish, beans, fruits, vegetables, brown rice, nuts, seeds, vegetable oils and olive oils, and even some animal products like yogurt and high-quality meat and cheese. The Mediterranean diet, which draws about 45% of calories from fat -- including small amounts of saturated fat -- is a good choice.

And remember: Diet isn’t the only reason people get or don’t get heart disease. Your genes and lifestyle habits (like smoking, exercise, and stress) also play a part.

source : Is Butter Back? The Truth About Saturated Fats

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Appeals Courts Rule Differently on ACA Provision

By Julie Rovner

Tue, Jul 22 2014

Updated at 12:45 p.m.

A three-judge panel at the U.S. Appeals Court for the D.C. Circuit threw the fate of an important part of the Affordable Care Act into doubt Tuesday. In a 2-1 decision in Halbig v. Burwell, the judges ruled that the Internal Revenue Service lacked the authority to allow subsidies to be provided in exchanges not run by the states. That could put at immediate risk the millions of people who bought insurance in the 36 states where these online insurance marketplaces are run by the federal government.

“Because we conclude that the ACA unambiguously restricts the section 36B subsidy to insurance purchased on the Exchanges ‘established by the state,’ we reverse the district court and vacate the IRS’s regulation,” said the decision by Judge Thomas Griffith.

Meanwhile, just an hour later, another three-judge panel on the 4th Circuit Court of Appeals in Richmond, Va., came to the opposite conclusion – upholding the federal subsidies.

“It is therefore clear that widely available tax credits are essential to fulfilling the Act’s primary goals and that Congress was aware of their importance when drafting the bill,” said the decision written by Judge Roger Gregory.

The Obama administration said it will appeal the Halbig decision. The Justice Department will ask the entire appeals court panel to review the decision, and that panel is dominated by judges appointed by Democrats, 7-4. The issue is also in other courts around the country.

White House spokesman Josh Earnest said: “There's a lot of high-minded case law that's applied here. There's also an element of common sense that should be applied as well, which is that you don't need a fancy legal degree to understand that Congress intended for every eligible American to have access to tax credits that would lower their health care costs, regardless of whether it was state officials or federal officials who were running the marketplace.”

‘’We believe that this decision is incorrect, inconsistent with Congressional intent, different from previous rulings, and at odds with the goal of the law: to make health care affordable no matter where people live.  The government will therefore immediately seek further review of the court’s decision,” said a statement from the Justice Department.

Meanwhile, Elizabeth Wydra, chief counsel for the Constitutional Accountability Center said the ruling wouldn’t take effect right away. “The court’s rules are that it doesn’t happen for 45 days,” to give the government time to ask for a full en banc hearing, “or 7 days after the en banc hearing has been denied.”

Should the decision eventually stand, however, it could mean at least five million Americans would face an average premium increase of 76 percent, according to a projection done by the consulting firm Avalere Health.

The court said that the wording of the health law “plainly makes subsidies available only on Exchanges established by states,” and that the legislative history of the bill “provides little indication one way or the other of congressional intent.”

But Judge Harry T. Edwards offered a strong dissent. “It makes little sense to think that Congress would have imposed so substantial a condition in such an oblique and circuitous manner.”

The case could end up in the Supreme Court. 

This story was corrected to say that Judge Harry T. Edwards offered the dissent. Earlier versions incorrectly said  Judge A. Raymond Randolph offered the dissent.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

source : Appeals Courts Rule Differently on ACA Provision

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Caffeine Powder: FAQ

By Emily Newman
WebMD Health News

Reviewed by Michael W. Smith, MD

The story of an 18-year-old prom king, who according to reports died from an irregular heartbeat and seizures brought on by a caffeine overdose, has raised questions about caffeine -- particularly the powdered type used by the teen. Here’s what you need to know.

What is caffeine powder?

It's caffeine in powder form.

Caffeine is naturally in more than 60 plants, like coffee beans, tea leaves, and cacao, the FDA says. But man-made caffeine is also added to energy drinks and sold as powder or capsule supplements. 

For about $10, you can buy 100,000 milligrams of caffeine powder online. That’s more than 1,000 Red Bulls’ worth of caffeine in one package. The powder can be used for inexpensive homemade caffeinated drinks and foods, as well as for pre-workout shakes. One online customer claims they made a caffeinated corn chowder.

Customer reviews on sales sites are quick to warn of how easy it is to mistakenly use too much of the powder. The serving size is 1/16 of a teaspoon, which requires mini-measuring spoons and a scale to measure. Simply mixing two regular spoonfuls of the powder into a drink is the same as drinking 70 Red Bulls at once, which could kill you. Some people use caffeine powder that comes in pre-measured capsules, each with 200 milligrams of caffeine.

“The public does not realize the caffeine content present in these products and the risk associated with ingestion of even small quantities,” says Chris Holstege, MD, director of toxicology and assistant professor at the University of Virginia School of Medicine.

Is caffeine powder regulated by the FDA?

The FDA regulates dietary supplements, such as caffeine powder, differently than "conventional" foods and drug products. The FDA ensures that claims on supplement labels are factual -- but dietary supplements don't need approval from the agency before they're marketed to the public.

Experts are calling for tougher regulation of supplements and larger warning labels on caffeine powder that highlight the deadly consequences of overdose.

How much caffeine is too much?

Experts agree that you should avoid having more than 600 milligrams of caffeine in one day. To put that in perspective, one grande Starbucks coffee (16 ounces) has about 330 milligrams of caffeine. A 12-ounce Diet Coke has 45 milligrams.

Because caffeine is a drug, though, its effects can vary from person to person depending on weight, medications, and overall health, Holstege says.

Can you overdose on caffeine?

Deaths caused by caffeine overdose are rare, but they do happen, says Steven Meredith, PhD. 

Five-thousand milligrams to 10,000 milligrams of caffeine is considered the lethal amount. That looks like a large number, but 5,000 milligrams is just one small teaspoon of caffeine. A grande Starbucks coffee, by comparison, has less than 1/10 of a teaspoon.

Makers of caffeine powder “should do a better job of educating [their] customers by labeling their products appropriately with warnings" about the risks of using too much, Meredith says.

An overdose of caffeine can lead to heart problems and seizures that can be lethal. So, keep track of how much caffeine you have, and avoid giving children caffeine.

source : Caffeine Powder: FAQ

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Blood Test Might Help Predict Survival With Lou Gehrig's Disease

Study findings may also help researchers test new ALS drugs, researchers suggest

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

TUESDAY, July 22, 2014 (HealthDay News) -- Simple blood tests may one day help predict survival and the course of the disease in people with amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, Italian researchers report.

The components in the blood that might yield clues to how fast ALS is progressing are called albumin and creatinine. These components are normally tested to follow kidney and liver health, according to the U.S. National Library of Medicine.

But now it appears that these substances may be helpful for gauging the health of people with ALS, the new study suggests.

"The assessment of albumin and creatinine in the blood can reliably predict the prognosis of ALS at the time of diagnosis," said lead researcher Dr. Adriano Chio, a professor of neurology in the Rita Levi Montalcini department of neuroscience at the University of Torino.

The average survival of ALS patients is just one to three years after the diagnosis, according to background information in the study. Finding a simple way to predict progression of the disease might help doctors treat patients and help researchers evaluate new drugs, the study authors suggested.

"Currently, clinical trials rely on two main outcomes: survival, which is considered too rough and is largely biased by the different clinical practice of ALS centers; and the ALS functional scale, which has several limitations and is at least partly subjective. Researchers are actively looking for more objective [ways to predict] progression," Chio said.

Levels of albumin and creatinine might become a neurologist's tool for predicting patients' prognosis early in the disease, he said.

"In the research arena, albumin and creatinine could be used as [a way to track] disease progression in clinical trials for the discovery of new effective drugs for ALS," Chio added.

The report was published online July 21 in JAMA Neurology.

Dr. Ronald Kanner is chair of neurology at North Shore University Hospital and Long Island Jewish Medical Center in Manhasset, N.Y. He said the course of the disease is extremely variable. "Some patients succumb within a year and others progress very slowly, with 5 percent still alive after 20 years," Kanner said.

This great variability makes it difficult to judge the effectiveness of treatments aimed at slowing progression, he said. "The current study identified easily measurable substances in the blood that can give a clue to the severity of the disease and the impact of treatment," he added.

Kanner added: "ALS is a devastating disease that affects the nerve cells that control muscles. It causes progressive weakness and wasting of muscles and eventually leads to the inability to swallow or breathe."

For the study, Chio and colleagues looked at blood levels of albumin, creatinine, white blood cells, sugar, cholesterol and thyroid hormones in more than 600 people with ALS. They said they later validated their findings by duplicating the study in an additional 122 people with ALS.

Only levels of albumin and creatinine were related to survival in both men and women, according to the study findings. Lower levels of these substances were related to worse survival and muscle function.

Lower creatinine was related to a loss of muscle mass. And, lower levels of albumin were linked to increased inflammation, the investigators found.

The researchers suggest that longer-term studies following the levels of creatinine and albumin throughout the course of the disease would help better define their relationship to ALS symptoms and the progression of the disease.

source : Blood Test Might Help Predict Survival With Lou Gehrig's Disease

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Fruit Recalled for Possible Listeria Contamination

WebMD News from HealthDay

July 22, 2014 -- Packaged fresh fruit sold at Costco, BJ's, Trader Joe's and other retailers has been recalled because of concerns of possible contamination with the life-threatening bacteria listeria, according to published reports.

The voluntary recall includes peaches, plums, nectarines and pluots -- apricot-plum hybrids -- packaged between June 1 and July 12 by Wawona Packing Co. of California, WPIX-TV in New York City reported.

"Because we do not know the locations of the companies that purchased the products from our direct customers, the company is issuing a nationwide recall," Wawona said in a news release Sunday.

Wawona said internal testing discovered traces of the virulent bacteria, but no illnesses have been reported.

Since the discovery, the company said it has retrofitted and cleaned packing lines and equipment connected with the possible contamination. It also said subsequent daily testing has been negative, according to the news report.

The items affected by the recall include peaches, nectarines, plums and pluots sold in clamshell-type packages of six. If you bought the fruit, throw it away immediately. Consumers with questions can call Wawona Packing at 1-888-232-9912 or check http://ift.tt/1yNO7O7.

Listeriosis -- the illness caused by L. monocytogenes bacteria -- causes fever and chills, headache, upset stomach and vomiting, according to the U.S. National Institutes of Health. It is most likely to affect pregnant women and unborn babies, older adults, and people with weakened immune systems. Treatment is with antibiotics.

source : Fruit Recalled for Possible Listeria Contamination

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HIV Diagnoses Down in U.S., Except for Young Gay Males: CDC

Messages about safe sex may be falling on deaf ears, researcher notes

WebMD News from HealthDay

By Randy Dotinga

HealthDay Reporter

SATURDAY, July 19, 2014 (HealthDay News) -- A new report offers good and bad news about the AIDS epidemic in the United States: The annual diagnosis rate of HIV, the virus that causes the disease, has dropped by one-third in the general population but has climbed among young gay and bisexual males.

Significantly fewer heterosexuals, drug users and women were diagnosed each year with HIV, according to the report from the U.S. Centers for Disease Control and Prevention. However, the annual diagnosis rate more than doubled for young gay and bisexual males.

The push for safer sex may be falling on deaf ears in a generation too young to have seen the ravages of AIDS, said report co-author Amy Lansky, deputy director for surveillance, epidemiology and laboratory sciences at the CDC's Division of HIV/AIDS Prevention.

"It's been more than 30 years since the first cases were reported," she said. "It's harder to maintain that sense of urgency."

The report only looked at people diagnosed with HIV, and health officials think many more are infected with the virus but don't know it. The statistics also don't say anything about when these people were infected, making it hard to pinpoint trends in efforts to prevent transmission of the virus.

Still, "we're making significant progress and seeing declines overall," said Lansky. However, she added, the rising numbers of diagnoses among young men who have sex with other men are "a considerable problem."

The AIDS epidemic began more than 30 years ago. While the last two decades have brought great advances in drugs that prevent AIDS from developing in HIV-positive people, an estimated 1.1 million people are still living with HIV in the United States, Lansky said. Officials believe about 16 percent of those people -- or about 176,000 -- don't know they're infected, she said.

In the new report, published in the July 23/30 issue of the Journal of the American Medical Association, researchers examined HIV diagnoses in the United States from 2002 to 2011 in people aged 13 and older.

Although almost 500,000 people were diagnosed with HIV during that time, the annual rate of diagnoses fell from 24 out of every 100,000 people to 16 -- a decline of 33 percent.

Many groups experienced significant declines in infection.

Among women, diagnosis rates dropped by about half, and among men by more than one-quarter. For blacks and Hispanics, the rates of diagnosis declined 37 percent and 41 percent, respectively.

The report estimates that HIV infections due to injection drug use fell by roughly 70 percent and from heterosexual contact by more than one-third for men and women.

Distribution of sterile needles, increased HIV testing and drug-treatment programs could explain some of the downward trend, Lansky said.

source : HIV Diagnoses Down in U.S., Except for Young Gay Males: CDC

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Many Young Adults Misinformed About Hookahs' Harms

More than half surveyed said the water pipes weren't dangerous

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

SATURDAY, July 19, 2014 (HealthDay News) -- Many young adults don't realize that using hookahs can harm their health, a new study reveals.

Hookah smoking can be just as dangerous as cigarettes, according to the U.S. Centers for Disease Control and Prevention. However, this study found that many young adults believe the water pipes are a safe alternative to cigarettes.

Researchers asked patrons, aged 18 to 30, at three Southern California hookah lounges if they thought that hookah use could be harmful. More than half said they did not believe that it would harm their health.

When asked why they believed hookahs were not a health threat, 47 percent said they thought the smoke gets filtered through the water. More than one-third thought the fruit used to flavor the tobacco detoxifies harmful chemicals, and 16 percent said the tobacco used in hookahs doesn't contain nicotine and isn't addictive.

None of those beliefs is true, said the authors of the study in the July/August issue of the journal Nursing Research.

"With hookah smoking on the rise, particularly among young adults, our goal was to identify factors influencing perceptions, attitudes and preferences toward hookah smoking," lead researcher Mary Rezk-Hanna, a nursing doctoral student at the University of California, Los Angeles, said in a university news release.

Previous research has shown that while cigarette use continues to fall, hookah smoking is on the rise, especially among college students. Sixty percent of the participants in the UCLA study said hookah smoking is a trendy way of socializing.

"This study underscores the urgent importance of more research and campaigns to increase public knowledge on the dangers of hookah smoking, especially among young adults," Rezk-Hanna said.

Understanding the basis of these perceptions and beliefs can help health care professionals design effective prevention and intervention strategies, she added.

source : Many Young Adults Misinformed About Hookahs' Harms

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HPV Test Beats Pap Smear in Gauging Cervical Cancer Risk, Study Finds

Study of over 1 million women suggests it could be stand-alone screening method

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

FRIDAY, July 18, 2014 (HealthDay News) -- A new study involving data on more than 1 million women finds the HPV test outperforming the standard Pap test in assessing cervical cancer risk.

Researchers at the U.S. National Cancer Institute (NCI) conclude that a negative test for HPV (human papillomavirus) infection is associated with an extremely low risk for cervical cancer and provides greater assurance of low cervical cancer risk than a negative Pap test.

Sexually transmitted HPV infection is thought to cause the majority of cervical cancers.

The findings support current guidelines that advise that both tests be used in cervical cancer screening, study lead author Julia Gage, a research fellow in the NCI's division of cancer epidemiology and genetics, said in an institute news release.

She believes the findings also bolster support for use of the HPV test alone "as another alternative for cervical screening."

As the experts explained it, certain types of HPV cause nearly all cervical cancers. A Pap test detects abnormal cell changes associated with cervical cancer, and both the Pap and the HPV test involve the use of cells collected from the cervix.

The new study included women aged 30 to 64 in California who underwent HPV and Pap testing between 2003 and 2012.

The risk of developing cervical cancer within three years after a negative HPV test was about half the already low risk seen after a negative Pap test, the study found.

The number of women who developed cervical cancer within three years was 11 per 100,000 after a negative HPV test compared to 20 per 100,000 after a negative Pap test, the investigators found.

One expert welcomed the new study.

Dr. Jill Maura Rabin works in Women's Health Programs-PCAP Services at North Shore-LIJ Health System in New Hyde Park, N.Y. She said the finding "provides greater assurance regarding future risk of cervical cancer."

She believes that "the annual well-woman visit remains an excellent venue to re-assess your health and risk status, to evaluate your complete health as well as to address any concerns you may have."

However, a negative HPV test does not mean that a woman is risk-free for life, Rabin stressed. "The risk of HPV and other sexually transmitted infections remains a factor should your risk status change -- for example, a new partner, or any illness which suppresses your immune system," she said.

The study was published online July 18 in the Journal of the National Cancer Institute.

The U.S. Preventive Services Task Force, an influential advisory group, currently recommends Pap testing every three years between the ages 21 to 65, or co-testing every five years between the ages 30 to 65 for women with normal screening results.

source : HPV Test Beats Pap Smear in Gauging Cervical Cancer Risk, Study Finds

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EPA Unveils New Bug Repellant Labeling

Should work much like sunscreen SPF labels, telling users how much protection they will get, agency says

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

FRIDAY, July 18, 2014 (HealthDay News) -- A new graphic for insect repellant labels will show consumers how many hours the product will protect them from mosquitoes and/or ticks, the U.S. Environmental Protection Agency says.

"We are working to create a system that does for bug repellents what SPF [sun-protection factor] labeling did for sunscreens," Jim Jones, assistant administrator of the EPA's Office of Chemical Safety and Pollution Prevention, said in an agency news release.

Use of the graphic is voluntary and insect repellant makers who want to use it must submit an application that includes test results proving how long their product works. The graphic is limited to products applied directly to the skin and could start appearing on insect repellants early next year.

Current labels on skin-applied insect repellants do a poor job of informing consumers about which insects a product protects against and how long it works, according to the EPA. Officials say the new graphic will make it easier for people to select an appropriate insect repellant.

"By providing vital information to consumers, this new graphic will help parents, hikers and the general public better protect themselves and their families from serious health threats caused by mosquitoes and ticks," Jones said. "We are encouraging manufacturers to submit applications so they can add the graphic to their registered repellent products."

The EPA and the U.S. Centers for Disease Control and Prevention urge people to use insect repellants and take other measures to protect themselves from biting insects that carry serious diseases.

Mosquitoes can transmit West Nile virus and St. Louis encephalitis. Ticks can transmit Rocky Mountain spotted fever, ehrlichiosis and Lyme disease. There are about 300,000 cases of tick-transmitted Lyme disease in the United States each year, according to the CDC.

source : EPA Unveils New Bug Repellant Labeling

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'Rockford Files' Star Dies

The Zone Diets, Here's what's trending on Twitter this week.         Desi Anwar @desianwar "@HuffingtonPost: James Garner, star of the long-running TV shows 'The Rockford Files' and 'Maverick,' dies huff.to/1yKELTm" RIP 😔 20 Jul 'Rockford Files' Star Dies LOS ANGELES, July 20 (Reuters) - Actor James Garner, best known for his prime-time television roles as the wisecracking frontier gambler on "Maverick" and as an ex-con turned private eye on "The... F.C. Internazionale @InterOfficialID #Inter dan @dcunited akan menggelar sesi latihan bersama pada 31 Juli. bit.ly/1nLgvYR #InterforUS #FCIM pic.twitter.com/EX8YNpFLcC 20 Jul OfficialAFC_ID @OfficialAFC_ID #Arsenal memulai pra musim dengan kemenangan 2-0 atas Boreham Wood. Laporan laganya: po.st/aUrp2b #BWFCvAFC pic.twitter.com/leCMjJ9cLQ 19 Jul simPATI @simPATI Simak berita seputar Pilpres di NewsLoop. Download Gratis: goo.gl/5q2xjE [2/2] 20 Jul NewsLoop NewsLoop brings together the best of local and international content from over 600 publishers in 30 news and lifestyle categories in Singapore, Malaysia, Indonesia, Thailand, Australia and Philippi... Verrell Bramasta @BramastaVerrell 🙏 pic.twitter.com/g6ksbfj1V1 20 Jul 1 Retweet Kimberly Ryder @kimbrlyryder Thanks @optikseis for my new Tiffany&Co. aviators! pic.twitter.com/UUH0Q6mKJn 20 Jul 1 Retweet Satria Garuda BIMA-X @bsatriagaruda Welcoming new member Ricca of @officialJKT48 @Tata_JKT48 pic.twitter.com/HSvLhmPyUA 19 Jul 1 Retweet Mochammad Dimas @dimaz_Joe18 On this day, one year ago @HaryyAfandy @ManukLiverbird @OfficialLFC_ID @BIGREDS_IOLSC #LFC IndonesiaTour2013 pic.twitter.com/ZJ8iFIqPaE 20 Jul 1 Retweet Don't miss out. Stay up to date on what's happening. Go to Twitter Forgot your Twitter password? Get instructions on how to reset it. You can also change your email digest frequency or unsubscribe from these emails. Need help? If you received this message in error and did not sign up for Twitter, click not my account. Twitter, Inc. 1355 Market St., Suite 900 San Francisco, CA 94103

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