Entries for September 2009

Being overweight in middle age reduces your likelihood of gliding into your 70s without any health problems like diabetes, heart disease, or cancer. It also reduces your odds of being able to walk up a flight of stairs or get through your day without crying. Obese women have it toughest, finds a new study published today in the British Medical Journal. They're nearly 80 percent less likely to experience "healthy survival" when they reach age 70, compared with women who gained fewer than 9 pounds since age 18.

Are the researchers showing that thin women who maintain their weight over the years actually live longer? Well, no, but they do indicate that these women live better, not just avoiding chronic diseases but also sidestepping mental and physical health problems that prevent women from enjoying the leisure time of their senior years—say, Mediterranean cruises or romps in the park with the grandkids.

What's more, the study showed that it's truly tough to be a "healthy survivor," free of any sort of chronic physical or emotional pain or health condition at age 70. Only 10 percent of the 17,000 nurses in the study were, and this group included those who didn't gain any weight as well as those who gained quite a bit. (Those who lost weight were excluded from the study because it might indicate disease.) But weight mattered; about 16 percent of the women whose weight didn't deviate by more than 9 pounds when they reached middle-age could call themselves healthy survivors, compared with 11 percent of those who gained between 9 and 22 pounds by midlife. The percentages dropped further with more weight gain; just 3 percent of healthy survivors were obese in middle age.

A vaccine that protects against the cervical-cancer-causing human papillomavirus is making headlines today after a 14-year-old British girl, Natalie Morton, died Monday, hours after being injected. No, it's not the Gardasil vaccine used in the United States, but Cervarix, which may become available here in the next few months. (A Food and Drug Administration advisory committee voted a few weeks ago to recommend Cervarix—the HPV vaccine of choice in Britain—for approval.)

Awaiting the results of Morton's autopsy, British health officials are stressing today that they don't yet know whether the vaccine is linked to her death. One health official said it was "unlikely" that the girl's death was caused by Cervarix and says parents should still get their daughters immunized. Yet at the same time, the school where the girl's vaccine was administered has been ordered by the government to halt its program, at least temporarily, and certain batches of the vaccine have been recalled.

In these tough economic times, women are reporting that they've put off having a baby or have decided not to have any more children, according to a survey released today by the Guttmacher Institute, a nonprofit organization focusing on reproductive health issues. The survey of 947 women ages 18 to 34 with annual household incomes of less than $75,000 was conducted this past summer, and the findings confirm the results of similar surveys conducted earlier in the year:

• Nearly half of women in the new survey said that they want to reduce or delay childbearing because of the economy.

I sent my 11-year-old son to school today with a stuffy nose and mild cough, as I've done countless times in the past. Now, though, I'm wondering whether I should have kept him home. How do I know it's really a garden-variety cold and not the swine flu?

"That's a great question," says Richard Wenzel, a swine flu expert and former president of the Infectious Diseases Society of America. "You really have no way of knowing if it's the flu or just a cold." Given that we're in the middle of an H1N1 epidemic, he estimates that my son's chances of having this flu are considerable, since some of his friends have had confirmed cases—maybe even as high as 50/50. Even though he doesn't have fever? I press. "At the beginning of the outbreak in Mexico, only 30 percent of patients hospitalized with the infection had fever initially," he tells me, "and 15 percent of patients never developed a fever at all." What usually sent them to the hospital was shortness of breath or chest pain. In Chile, he adds, about half of those with confirmed H1N1 had no fever; many just had a headache and runny nose.

Senate Finance Committee Chairman Max Baucus today released a new version of a healthcare reform bill, and—not surprisingly—abortion coverage is again a sticking point. None of the Republican committee members have signed on to support the bill, and ranking member Chuck Grassley from Iowa noted that "there are still some serious outstanding issues that have yet to be resolved, like preventing taxpayer funding of abortion services."

Just three pages of the 223-page proposal deal with abortion coverage, and, at first blush, the provisions seem pretty innocuous. The law would not supersede state laws regarding the procedure, nor would it negate conscience protections for doctors who don't wish to perform it, nor abortion-related antidiscrimination laws. The law would also ensure that abortion can't be mandated as part of a minimum benefits package except in cases where federal funds are already permitted to be used, that is, in cases of rape or incest or to save the life of the mother.

A new study released yesterday sounds pretty shocking: Fewer than 10 percent of Americans qualify as being at low risk for heart disease. Just 7.5 percent of us (to be exact) have none of the following risk factors that put our hearts in danger: being overweight (a body mass index above 25), being a smoker, having high cholesterol (above 200 mg/dL) or high blood pressure (above 120 mm Hg/80 mm Hg), or having diabetes, according to the study, which was published in the journal Circulation. That's a decrease from 15 years ago, when 10.5 percent of us fell into the low-risk category. So the news here is that we're going backward despite the fact that experts know a lot more today about preventing heart disease than they did a decade or two ago.

Starting in the late 1970s, when quitting smoking first came into fashion, an increasing number of us fell into the low-risk category. Blame the backsliding on our ever expanding waistlines. "Increasing adiposity is likely to be a major driver," write Harvard Medical School researchers in an editorial that accompanied the study. This is just the tip of the iceberg, they warn. As the growing number of overweight kids reach adulthood, "low-risk" Americans will become an endangered species. And, yes, this will certainly drive up healthcare costs and the price tag of reform.

In an effort to contain swine flu, the French Health Ministry this week called for citizens to avoid "all direct contacts between people and particularly with sick people," which means no kissing or shaking hands. Quelle horreur, one might think, but the French seem ready to banish their tradition, called la bise, of bestowing pecks multiple times on both cheeks. Some businesses are instituting bise bans, and schools are instructing students to greet one another by raising a hand, like American Indians. Here in the United States, our own Centers for Disease Control and Prevention issued a guidance for college students last month instructing them to partake in "self -isolation" if they're suspected of being infected with the H1N1 virus that causes swine flu. The agency goes on to say:

If close contact with others cannot be avoided, the ill student should be asked to wear a surgical mask during the period of contact. Examples of close contact include kissing, sharing eating or drinking utensils, or having any other contact between persons likely to result in exposure to respiratory droplets.

R&B singer Chris Brown, who recently pleaded guilty to felony assault for an attack on his girlfriend, Rihanna, is now launching a verbal attack against none other than Oprah Winfrey in the new issue of People magazine. He is upset that Winfrey aired a show about domestic violence that she dedicated to "all the Rihannas of the world." Brown tells People:

"I commend Oprah on being like, 'This is a problem,' but it was a slap in my face. I did a lot of stuff for her, like going to Africa and performing for her school. She could've been more helpful, like, 'OK, I'm going to help both of these people out.' "

Winfrey's rep responded by telling TMZ, "Oprah is very appreciative that Chris Brown performed at her school, but she takes domestic abuse very seriously. She hopes he gets the counseling he needs."

New research out this week from the American Institute for Cancer Research adds to the growing body of knowledge about actions women can take to lower their breast cancer risk. The new report is an update of previous research, adding results of 81 new studies to the findings of more than 800 that have followed women in the United States and around the world to see who develops breast cancer and who doesn't. The study authors contend that some 70,000 cases of breast cancer—representing 40 percent of new U.S. cases—could be prevented every year if women followed these measures.

I'm always a little hesitant to report about research that lowers your cancer risk. Leading breast surgeon Susan Love, author of Dr. Susan Love's Breast Book, has told me time and time again that the vast majority of breast cancers—the ones not triggered by an inherited gene mutation—have no known cause. And it's tough to tease out particular lifestyle habits that protect us from cancer since women who, say, exercise a lot may be more health conscious in general, eating better and seeing their doctor more often than those who don't. What's more, I think such research inadvertently conveys the message that people are somehow to blame for their cancers. With the exception of smoking and lung cancer, that's simply not the case. (And there are plenty of folks who develop lung cancer and never smoked a day in their life.)