Archive for the 'Health' Category

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Doctors Break Down Which Pregnancy ‘Tips’ Really Matter

 

By Matt Brennan of The Beacon-News

While the lists of pregnancy do’s and don’ts can be extensive, there is one thing women should not lose track of as they go through the process, and that’s enjoying it.

That’s the advice of Dr. Susan Acuna, obstetrician/gynecologist on staff with Central DuPage and Delnor Community hospitals.

Women should remember to enjoy the experience of having a child moving around inside them, she said. While they experience that thrill, there are things they can be doing to keep themselves and the baby healthy.

There is a lot of information out there. It can be overwhelming. Some of the information and ideas have a stronger medical basis than others. It is best to follow the recommendations that have a stronger basis in medicine and science, she said.

“Many women come in and say, ‘I heard I should avoid lunch meat and peanut butter,’” Acuna said. “Those are not based on any factual information.”

The concern about peanuts or peanut butter is that eating them would increase the baby’s chance of picking up the allergies. It’s not based on enough science, she said. With lunch meat, she said to just make sure that it is reasonably fresh.

The most important thing for women to do during pregnancy is to take a prenatal vitamin, Acuna said.

“It’s shown to prevent birth defects,” she said. “That’s an important thing that women may or may not know.”

Provena Mercy Medical Center nutritionist Melissa Gash said that making sure calorie intake is correct for the patient’s height and weight is important.

“You really only need about 300 extra calories a day,” she said. “It’s really minimal what you have to increase.”

To put it in perspective, the extra calories can be achieved with a glass of milk and an apple, she said. The normal recommended weight gain during a pregnancy is about 25 to 30 pounds. Many women gain much more than that, she said.

“They wonder why they can’t lose that weight after the baby’s out,” she said.

Yoga, Pilates and prenatal water aerobics have all increased in popularity recently, said Dr. Natalie Roche of Fox Valley Women and Children’s Health Partners. The exercises can help to alleviate some of the pain associated with pregnancy, she said.

There are some exercises that should be avoided during pregnancy, such as biking, roller skating and jumping on a trampoline, Acuna said.

“I recommend they avoid any activity that would put them at risk of falling,” she said.

Running, biking on a stationary bike and working out on an elliptical machine are all safer forms of exercise, she said.

Gash is on her third pregnancy, she said. She also runs a nutrition seminar for pregnancy at Provena Mercy called “From Pickles to Ice Cream.” Cravings are legitimate, she said. Many pregnant women have them. But, “a lot of women use them as an excuse,” she said.

Morning sickness and nausea are fairly common, especially during the first 12 weeks of pregnancy, she said.

“Sometimes you’re just not going to feel that good those first couple weeks,” she said.

Sex, drugs more common in hyper-texting teens

This article from MIKE STOBBE of AP

Teens who text 120 times a day or more — and there seems to be a lot of them — are more likely to have had sex or used alcohol and drugs than kids who don’t send as many messages, according to provocative new research.

The study’s authors aren’t suggesting that “hyper-texting” leads to sex, drinking or drugs, but say it’s startling to see an apparent link between excessive messaging and that kind of risky behavior.

The study concludes that a significant number of teens are very susceptible to peer pressure and also have permissive or absent parents, said Dr. Scott Frank, the study’s lead author.

“If parents are monitoring their kids’ texting and social networking, they’re probably monitoring other activities as well,” said Frank, an associate professor of epidemiology and biostatistics at Case Western Reserve University School of Medicine.

Frank was scheduled to present the study Tuesday at a meeting of the American Public Health Association in Denver.

The study was done at 20 public high schools in the Cleveland area last year, and is based on confidential paper surveys of more than 4,200 students.

It found that about one in five students were hyper-texters and about one in nine are hyper-networkers — those who spend three or more hours a day on Facebook and other social networking websites.

About one in 25 fall into both categories.

Hyper-texting and hyper-networking were more common among girls, minorities, kids whose parents have less education and students from a single-mother household, the study found.

Frank’s study is billed as one of the first studies to look at texting and social networking and whether they are linked to actual sexual intercourse or to other risky behaviors.

“This study demonstrates that it’s a legitimate question to explore,” said Douglas Gentile, who runs the Media Research Lab at Iowa State University.

The study found those who text at least 120 times a day are nearly three-and-a-half times more likely to have had sex than their peers who don’t text that much. Hyper-texters were also more likely to have been in a physical fight, binge drink, use illegal drugs or take medication without a prescription.

Compared to the heavy texters, the hyper-networkers were not as likely to have had sex, but more likely to have been involved in other risky behaviors like drinking or fighting.

A Kaiser Family Foundation study found that about half of children ages 8 to 18 send text messages on a cell phone in a typical day. The texters estimated they average 118 texts per day. That study also found that only 14 percent of kids said their parents set rules limiting texting.

Other studies have tied teen texting to risky or lewd behavior. A Pew Research Center study found that about one-third of 16- and 17-year-olds send texts while driving. And an Associated Press-MTV poll found that about one-quarter of teenagers have “sexted” — shared sexually explicit photos, videos and chat by cell phone or online.

The latest survey did not ask what students texted or what they discussed on social networks.

One suburban Cleveland student said her texts involve non-sexual small talk with friends, homework assignments and student council bake sales.

“I text with my mother about what time I need picked up,” said Tiara Freeman-Sargeant, a 14-year-old Shaker Heights High School freshman. She said she sends and receives about 250 texts a day.

Talking on the phone just isn’t appealing to some teens, said her classmate, Ivanna Storms-Thompson.

“Your arm gets tired, your ear gets sweaty,” said Ivanna, who also doesn’t like the awkward silences.

Like her friend, Ivanna said she mostly gets A’s. Whether kids who text do well in school or behave in a crazy, risky way is coincidental, she said.

“It depends on who you’re talking to and whether they have their priorities straight,” she said.

Online:

Conference: http://www.apha.org/meetings/

Pregnancy Problems Could Be From Antibacterial Agent

Dr. Margaret James, professor and chair of the department of medicinal chemistry at the University of Florida, is seen here in a photo taken Oct. 26, 2010. James has found that tricolsan, an ingredient found in some of the most popular brands of antibacterial soaps, toothpaste and other household products, may disrupt an enzyme important during pregnancy. (Jesse S. Jones/University of Florida)

A chemical found in everything from antibacterial soaps and lotions to socks and toothpaste may disrupt an enzyme that plays an important role in pregnancy, University of Florida researchers say.

Thought to be harmless, triclosan gives many soaps and lotions their antibacterial oomph and is found in hundreds of popular products. But a team of UF researchers led by Margaret O. James has discovered that the chemical hinders an enzyme linked to the metabolism of estrogen. The researchers’ findings are reported in the November print issue of the journal Environment International.

In pregnancy, this enzyme, called estrogen sulfotransferase, helps metabolize estrogen and move it through the placenta into the developing fetus. There, the estrogen plays a crucial role in brain development and the regulation of genes.

“We suspect that makes this substance dangerous in pregnancy if enough of the triclosan gets through to the placenta to affect the enzyme,” said James, a professor and chairwoman of medicinal chemistry in the UF College of Pharmacy. “We know for sure it is a very potent inhibitor. What we don’t know is the kinds of levels you would have to be exposed to to see a negative effect.

“We know it is a problem, but we don’t know how much of a problem. We need to move forward and do additional studies.”

In pregnancy, the placenta basically serves as a developing baby’s in-womb survival kit. Almost everything the fetus gets from its mother — namely food and oxygen — comes through the placenta. It also creates important hormones, such as progesterone and estrogen.

Aside from the role it plays in the fetus, estrogen also affects how much oxygen the baby gets from the mother, said Charles Wood, a professor and chairman of physiology and functional genomics in the UF College of Medicine and a co-author of the study. All of the oxygen a baby gets from its mother flows through the mother’s uterine artery. Without enough estrogen, this artery can constrict, decreasing blood flow.

“If you don’t make enough estrogen you can, we think, starve the baby of enough oxygen,” Wood said.

Estrogen is also involved in signaling the uterus to contract during labor. But maintaining the right levels of the hormone during pregnancy is a delicate balance, Wood says. Too much estrogen could send the mother’s body into premature labor. Too little could hinder the flow of oxygen. Both instances could affect how the baby’s brain develops.

This is one of the reasons scientists are concerned about the pregnancy-related effects of chemicals such as triclosan.

“Some of these (chemicals) can go and combine with estrogen receptors and mimic estrogen or keep estrogen off its receptors or change the metabolism of estrogen, which is what we are looking at with triclosan,” Wood said.

In April 2010, the Food and Drug Administration decided to take a closer look at triclosan after several studies found links to problems with hormone regulation and other possible negative health effects. Other studies have shown that the chemical, which cannot be broken down by bacteria, stays in the environment long after it is used.

“Triclosan is a material that is present in the environment and everyone has low levels. If you use products with triclosan, you will likely have higher levels,” said Bruce Hammock, a professor of entomology at the University of California-Davis who studies triclosan. “It has some real benefits but it is certainly not risk-free.”

More studies are needed before researchers can conclude what effects triclosan really has on human health, James said.

“The triclosan is incorporated into household products because it inhibits bacterial growth,” James said. “But the bad thing is it has this unexpected side effect of inhibiting this important enzyme in the body. At this point we don’t know if the levels people are exposed to are high enough to cause an adverse effect.”

Source: April Frawley Birdwell, http://www.physorg.com/news/2010-11-pregnancy-problems-antibacterial-agent.html, Provided by University of Florida

Genetics May Play A Part In A Woman’s Chance For Nausea During Pregnancy

Researchers found that women were more likely to experience a serious form of morning sickness if their mothers or sisters did as well.

Looking specifically at a very severe form of nausea known as hyperemesis gravidarum (HG), the authors found that women with sisters who had HG were 17 times more likely to also develop HG. Women with this condition have unrelenting, excessive nausea and vomiting that puts them at risk of malnutrition, dehydration and significant weight loss.

Study author Dr. Marlena Fejzo of the University of Southern California-Los Angeles told Reuters Health she wasn’t surprised by the findings, since previous research has shown that severe morning sickness is more likely to affect both members of identical twin pairs, hinting at a heritable element.

However, in the new study, she added, “the degree of heredity is very exciting because it suggests genes are involved, and when we find those genes, we may finally understand the cause of severe nausea in pregnancy and be able to make new treatments that are designed to treat the cause rather than the symptoms.”

Most pregnant women – an estimated 75 percent – experience some morning sickness, according to the American Pregnancy Association, but 1 percent suffer the extreme HG form of illness that can require hospitalization.

It’s unclear why some women become nauseous while pregnant and others don’t. Even animals such as dogs and monkeys appear to experience a form of morning sickness, Fejzo noted. “There are even reports of snakes avoiding food during pregnancy,” she said in an e-mail.

To investigate whether severe forms of nausea might have genetic roots, Fejzo and her team reviewed information collected from 207 women who experienced HG during pregnancy and had at least one sister who had also been pregnant. They compared their responses to 110 of the patients’ female friends who had relatively nausea-free pregnancies, serving as controls.

The researchers found that 14 percent of women who experienced HG during pregnancy had sisters who also had HG, versus less than 1 percent of women who did not have HG.

When combining HG with other severe forms of morning sickness – persistent nausea that was not bad enough to require IV fluids or nutrition – a family history also appeared to put women at higher risk. Specifically, 34 percent of women with HG also had an affected sister, versus 8 percent of women who were never diagnosed with HG.

Among 469 women with HG and 216 of their female friends, 33 percent of those with HG had a mother with severe nausea or HG as well, versus only 8 percent of their friends.

“There can be variation in nausea and vomiting from one pregnancy to the next, which suggests that not only genes are involved but also other factors,” Fejzo noted. “For example, some studies suggest a female fetus or carrying multiple fetuses results in more nausea. So I would speculate that the level of nausea in pregnancy is a combination of both genetic factors and non-genetic factors.”

One concern about these findings, noted Dr. Andrej Grjibovski at the Norwegian Institute of Public Health, who did not participate in the study, is that women with HG might have been more likely to volunteer to participate in the study if they had relatives who were also affected. And since these women recruited the controls themselves, they “may not be representative of the general population,” he cautioned.

Still, Grjibovski said in an e-mail that he was “not at all” surprised by the findings, since other research has suggested both maternal and paternal genes may play a role in HG. A recent analysis of more than 2 million birth records showed that women whose mothers suffered from a serious type of morning sickness were at triple the risk of the condition themselves.

HG hospitalizes more than 59,000 women every year in the U.S. A recent review of 27 large studies concluded that there is no reliable treatment for nausea in early pregnancy. Still, options include dietary changes (such as eating small meals and avoiding spicy foods), alternative therapies such as acupressure and hypnosis, and some prescription anti-nausea medications.

Fejzo said her team is currently planning a study to compare the genes of 1,000 women with HG to those of 1,000 of their unaffected friends. “With this approach, we should be able to identify the genetic variants that predispose to HG and then hopefully create new, more effective medications that are designed to correct the cause of the disease as opposed to the current medicines which are used to treat the symptoms.”

Source: American Journal of Obstetrics & Gynecology, online October 25, 2010.

Hopkins Looks Into Fitness Guidelines For Pregnant Women

This article by Meredith Cohn, The Baltimore Sun

Study to see how much exercise is healthy for mom, baby.

Her Asics laced up and her water bottle at her side, Meredith Dobrosielski stepped onto the treadmill for a robust half-hour walk.

For the Towson runner, this wasn’t just any trip to the gym. The session took place in a lab at Johns Hopkins Bayview Medical Center in Baltimore. And each step offered information on the impact of exercise on her fetus. Dobrosielski is about 8 months pregnant.

Doctors expect the information collected to fill in some gaps in the data on how much pounding is OK for a developing baby. Eventually, they hope to be able to develop personalized workout schedules for women in different states of fitness.

“We do know that not only can exercise be done, it should be done,” said Dr. Andrew J. Satin, professor and vice chairman of the department of gynecology and obstetrics for the Hopkins School of Medicine. “But the level of fitness should impact the individual’s prescription.”

Not too long ago doctors used to tell all women not to exercise when they became pregnant, but that advice has changed, said Satin and Dr. Linda Szymanski, a fellow in maternal fetal medicine helping conduct the research. But there still is little data about what’s too much for the elite athlete verses the couch potato and those in between. Satin said much is based on “opinion and common sense.”

They believe research is limited because doctors fear testing pregnant women. But nine months into the study, there have been no adverse reactions. As a precaution, the hospital’s labor and delivery area is close by.

About 60 women in their third trimester of pregnancy take turns on the treadmill. Some are regular runners and others are sedentary. Everyone takes a moderate walk, and the regular runners also run until they hit their peak capacity but don’t linger there. Several measurements are taken over the sessions from fetal heart rate and blood flow to the womb to fetal movement and amniotic fluid levels. The fetuses are examined by ultrasound before and after treadmill work.

Over time, the doctors plan to measure the impact on fetuses; partner with biomedical engineers to develop new ways to monitor the fetus, perhaps wirelessly during exercise; and collect long-term data on the pregnancy outcomes. The treadmill tests are the first step and some solid data should be available in a couple of months.

Doctors and groups such as the American College of Obstetricians and Gynecologists and the American Pregnancy Association now give blanket advice to pregnant women to get 30 minutes of exercise a day.

Potential benefits include improvement in general health and a decreased chance of gestational diabetes and hypertension, among others. Also, these groups say, that labor, delivery and recovery can be easier.

But the advice is based on recommendations from government and groups such as the American College of Sports Medicine that non-pregnant people get such exercise. And it’s filled with notes of caution for those who are just starting and those with certain conditions. The college suggests seeing a doctor first, starting slow and stopping when there’s pain or bleeding — advice Satin doesn’t dispute.

He added that doctors do know driving up a heart rate and maintaining it there for too long can cut off blood flow to the fetus. Getting overheated and dehydrated are also problems. Joints also can become lax and balance may be off, so some exercises should be avoided, such as street biking late in pregnancy. Contact sports, horseback riding and downhill skiing also may cause injury from blows or falls.

But he and others say not everyone has gotten the message that exercise is beneficial.

It was a big change in 2008 when physical guidelines were published for Americans, including pregnant women, said James Pivarnik, who works with the sports medicine college and is professor kinesiology and epidemiology and director of the Center for Physical Activity and Health at Michigan State University.

He said the guidelines do indicate “that the elite runner can continue doing what she is doing for a bit, provided her health care provider is in the loop, and that she has no warning signs or other issues.” But he said “boutique” recommendations are hard with so many possible circumstances.

“Pretty much the aerobic recs are the same as for anyone,” he said.

Pivarnik agreed more research is needed, such as Satin’s. He’s now looking at how much weight lifting is good for pregnant women.

Szymanski said the incomplete data has only confused the message. “[Pregnant] women express frustration because a number of doctors give different advice. Some still tell them not to exercise, especially if they haven’t been exercising.”

Outdated information and myths perpetuated by the Internet still mean many women who had been exercising — up to a quarter by some accounts — stop because they fear they will harm their babies, the doctors said.

Satin said it’s actually a really good time to suggest starting an exercise program. Women are more apt to take care of themselves when they are pregnant. They’ll quit smoking, eat better and exercise for the sake of the developing baby and then carry over the good habits, he said.

As long as jogging is comfortable, runners can keep at it. Stationary bikes and running in a pool also are good exercises, Satin said. And walking is safe for nearly everyone. The fetuses are not “flipping and flopping,” he said. In fact, the entire uterus is moving with the exercise motion, buoying the fetus.

Satin said his interest in pregnant athletes grew out of his work with women in the military who wanted to stay physically fit. He was formerly a professor and chair of the Uniformed Services University F. Edward Hebert School of Medicine in the obstetrics and gynecology department. Szymanski also is an exercise physiologist and collegiate athlete.

Dobrosielski, who is about to have her second child, said she decided to participate in the study because she wanted to help other women. She’s been running “forever” and played field hockey in high school and college. An ankle injury stopped her from running after 4 months, but everyday she runs in a pool, or does yoga, lifts weights or rides a stationary bike.

She knows she won’t lose as much of her fitness and will be able to return to running, even racing, quickly. Others should be able to find out what’s good for them, she said.

“It’s a special population and there’s so little time for study,” she said of pregnant women. “I felt comfortable exercising and I knew when I needed to stop. I think it’s important for all women to exercise and maybe this research will convince them to do that.”

Exercising while pregnant

Several medical organizations recommend 30 minutes of exercising a day for pregnant women.

•If you’re just beginning or have a condition, consult your doctor. Start slow and stop if you have pain or bleeding.

•Don’t get overheated, stay hydrated and take breaks.

•Your joints may be lax and your balance off, particularly in later months, so avoid unstable ground or consider a stationary bike or running in a pool.

•No contact sports, but some weight training is OK. Avoid lying on your back after the first trimester.

2 Studies Present New Data On Effects Of Alcohol During Pregnancy

 

These new studies have recently been reported.

Scientific data continue to indicate that higher intake of alcohol during pregnancy adversely affects the fetus, and could lead to very severe developmental or other problems in the child. However, most recent publications show little or no effects of occasional or light drinking by the mother during pregnancy. The studies also demonstrate how socio-economic, education, and other lifestyle factors of the mother may have large effects on the health of the fetus and child; these must be considered when evaluating the potential effects of alcohol during pregnancy.

A very large population-based observational study from the UK found that at the age of 5 years, the children of women who reported light (no more than 1-2 units of alcohol per week or per occasion) drinking did not show any evidence of impairment on testing for behavioral and emotional problems or cognitive ability. There was a tendency for the male children of women reporting “heavy/binge” drinking during pregnancy (7 or more units per week or 6 or more units per occasion) to have poorer behavioural scores, but the effects were less clear among female offspring.

A second study, published in Pediatrics, based on a population in Western Australia examined the associations between dose, pattern, and timing of prenatal alcohol exposure (PAE) and birth defects and found similar results, that there was no association between low or moderate prenatal alcohol exposure and birth defects.

Data from a randomly selected, population-based cohort of non- indigenous women who gave birth to a live infant in Western Australia (WA) between 1995 and 1997 (4714 participants) were linked to WA Midwives Notification System and WA Birth Defects Registry data. Information about maternal alcohol consumption was collected 3 months after birth for the 3 month period before pregnancy and for each trimester separately.

Low alcohol consumption was defined as less then 7 standard drinks (10g) a week, and no more than 2 drinks on any one day. Women who consumed more than 70g per week were classified as heavy drinkers and women consuming more than 140g were classified as very heavy drinkers.

Overall, current scientific data indicate that while drinking during pregnancy should not be encouraged, there is little evidence to suggest that an occasional drink or light drinking by the mother is associated with harm. Heavy drinking, however, is associated with serious developmental defects in the fetus.

Drinking More Milk And Less Soda Helps To Build Strong Bones

This article by Elena Conis, at the Los Angeles Times

Want strong bones? Eat foods high in calcium and vitamin D, get plenty of exercise — and maybe steer clear of soda.

In recent decades, as consumption of the beverage has steadily displaced the consumption of others —particularly milk — studies have consistently linked soda consumption with weaker bones. Now scientists are trying to figure out how and why, precisely, drinking soda may affect skeletons.

One theory is that a component in cola may cause bone to deteriorate; another is that people who drink soda simply drink (and eat) fewer nutritious foods.

In the 1990s, several studies suggested soft-drink consumption might be linked to lower bone mass and reduced bone accretion — the process by which bone is built up — in children, especially teens.

In a study of 127 teens that was published in the Journal of Adolescent Health in 1994, teenage girls who drank carbonated beverages were three times as likely to suffer bone fractures compared with girls who didn’t drink soda. A study by the same author published in the Archives of Pediatric Adolescent Medicine in 2000 showed the same effect — and an even stronger one for girls who drank cola beverages, who were five times as likely to suffer bone fractures.

Researchers surmised at the time that soda took its toll on bones because children who drank soda did so in place of milk. Soda drinking was also seen as a marker for a generally unhealthful diet lacking items that help foster strong bones.

It does seem to be true that soda drinkers have worse diets overall. In a study published this month in the Journal of the American Dietetic Assn., for example, among 170 girls followed from age 5 to 15, those who drank soda at age 5 were less likely to drink milk throughout childhood than 5-year-olds who did not drink soda. And they were more likely to consume diets lacking in calcium, fiber, vitamin D, protein, magnesium, phosphorus and potassium.

Such findings are significant because as much as 90% of bone mass is acquired in youth, particularly from age 16 to 25, says Dr. Jeri Nieves, director of bone density testing at Helen Hayes Hospital in West Haverstraw, N.Y.

Children who fail to get enough bone-building nutrients and bone-thickening exercise in their youth end up with increased risk of osteoporosis and fracture as they get older, adds Dr. Robert Murray, director of the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital in Columbus, Ohio.

But there is also evidence that drinking sodas — specifically, colas — may take a direct toll on the skeleton, says Dr. Katherine Tucker, professor of health sciences at Northeastern University in Boston.

In a large, well-designed study published by Tucker and colleagues in the American Journal of Clinical Nutrition in 2006, women enrolled in the ongoing Framingham Osteoporosis Study who drank just three or more colas a week had a 3.7% to 5.4% lower bone mineral density in their hip bones when compared with women who didn’t drink the beverage.

The study also showed what scientists call a dose response: The more soda participants drank, the lower their bone mineral density.

The effect was seen only with colas — non-cola soft drinks, such as ginger ale and orange soda, had no effect on bone density. That finding led Tucker and colleagues to suggest that the phosphoric acid in cola is behind its bone-weakening effects.

Phosphoric acid is added to colas for its tangy flavor. It’s not normally found in the food chain, Tucker says. When ingested, it causes the acidity of the blood to increase; to adjust the blood’s pH, the body draws calcium out of bones and into the bloodstream.

These proposed effects of phosphoric acid on bone are largely theoretical, but they are supported by animal studies and some human research. A Danish study published in the journal Osteoporosis International in 2005 measured the blood levels of bone minerals in a group of men after they consumed a low-calcium diet and 2.5 liters of soda daily for 10 days, and then again after they consumed a normal diet and 2.5 liters of skim milk for 10 days.

During the cola-drinking period, the men had higher blood levels of the bone mineral phosphate, the bone turnover protein osteocalcin and a substance called CTX — results that indicated minerals were being removed from bone, and not replaced, during the soda-drinking period.

Scientists are continuing to test the theory that phosphoric acid in soda harms bones. But even if it turns out that phosphoric acids cause only small or temporary changes in bone composition, these can add up over time, Tucker says.

In the meantime, Nieves suggests, it’s probably wise to limit your intake of soda.

“It’s not like alcohol, where one drink a day is OK,” she says. “Because bone mass is constantly changing throughout life, soda can cause bone loss at any stage.”