Wednesday, November 30, 2016

Grown-ups can also be picky eaters

I once knew a kid who would not eat mushrooms because of the word "mush" in there. My own daughter won't touch a pea, and since an unfortunate food poisoning incident as a toddler, won't eat rice.

Do most people outgrow these little quirks?

Well, says Nancy Zucker, a psychologist and director of the Duke Center for Eating Disorders--as quoted in a piece in the NYT--many adult food dislikes (veggies #1) start in childhood.

How many is many? No stats--adults tend to keep these things on the down low.

One said--there is not a lot of empathy for picky eaters.

Researchers at Duke and the University of Pittsburgh did an online questionnaire of 40,000 adults.

Still, the causes of adult picky eating are not well understood:

--A childhood scare with choking or vomiting

--A lingering fear of certain foods

--A different way of tasting--foods contain hundreds of compounds that determine taste and smell--individuals may perceive these differently.

--Texture--okra, canned spinach--can also play a role. Someone else did not like to cut into tomatoes and "watch the guts spill out."

You can learn to like something or a way of preparing something, of course, My kid would not eat a pea, but she would eat artichoke leaves in sauce when a year old.

Some people come to Duke to relearn eating of certain foods.

Oh--and if you know a picky eater...don't force them to eat one bite.

They don't want to--and you can't make them.

Tuesday, November 29, 2016

Californians to meet mall robot

Yeah, that's him.
Mike Murphy, in Nextgov, Nov 23, 2016, says the bots are coming to spread holiday cheer.

The Japanese telecom SoftBank will bring a personal robot named Pepper to two shopping centers in California (Westfield San Francisco Center and Westfield Valley Fair in Santa Clara).

No, this eager fellow won't argue with you over returns or pick out a scarf to go with that jacket. Pepper can, however, say Hello in six languages, take photos of customers from its chest, play games with customers and start up dance parties with its built-in tunes.

Customers can also provide feedback on their experiences in the mall to Pepper. Maybe they can say they didn't come there for a dance party.

Other less chummy robots are already coming to shopping--touchscreens instead of cashiers,  security bots that cruise around and sometimes run over customers.

So Pepper is just the beginning...He may be an automated selfie machine now...but wait...

Personally, I preferred Rosie on the Jetsons. She was no Roomba.

Monday, November 28, 2016

Should medical research take in gender and sex?

Wait a hot one--aren't sex and gender the same thing? No, according to Cara Tannenbaum of the University of Montreal and Janine Austin Clayton, NIH.

These two have written a Viewpoint article in JAMA making a case for dividing research into sex and gender.

By their definitions, sex refers to biology, anatomy and sex hormones. Gender, they say, encompasses social, behavioral, and cultural interactions and the roles between men and women.

Too often, they say sex and gender-specific results are missing in evaluating therapies--because scientists trained last century learned to conduct research mostly in men, believing these results would also apply to women.

But now we know women metabolize drugs differently than men. Sick women may also be pregnant--not segregating results may mean not treating women safely.

Reasons to separate results by sex and gender:

--These results may be hidden in combined results.

--To provide raw material for meta-analyses, a way of combining results to see if results are the same or different across diverse populations of men and women.

--To avoid the need to repeat a trial to check for gender-specific matters that arise.

This brings us to dosage--same for men and women? The FDA is already recommending lower doses of some drugs for women, so no, this probably needs to change.

Also, Addyi, a drug to boost sexual desire in women, was tested for compatibility with alcohol on 23 men and two women--even though it was FOR women. Even in men, the drug increased the likelihood of fainting, dizziness and low BP.  The risk was probably greater for women.

When will the research be 50/50 men and women? Stay tuned--some journals have already adopted guidelines in this direction.

About time! Stay tuned. And stay skeptical.

Wednesday, November 23, 2016

Dementia decreasing--let us give thanks

According to findings of a team at the University of Michigan (JAMA Internal Medicine), despite the rise of diabetes, high blood pressure, and obesity, which are thought to contribute to dementia, the percentage of Americans with these various memory disorders has dropped 3%.

Interestingly, they also found that those with the most years of education had the lowest chances of developing dementia. (Today's seniors are more likely to have a HS diploma than a decade ago.)

However, the number of seniors is going up (Boomers) so the overall burden of dementia is still rising.

So if you have someone at the Thanksgiving table with this condition, Rebecca Aline, LCSW, supervisory clinical social worker at Houston Methodist's Nantz National Alzheimer Center, recommends creating new traditions, instead of insisting on old (such as Grandma doing the cooking).

--Keep celebrations simple. Engage the senses--cookie baking, decorations, church.

--Communicate beforehand to explain how the person may have changed from a year ago.

--Realize the person has changed, so the holiday celebration may be a little different, too.

--Focus on new memories.Grieve for old times, but try to create new times.

--Be sure to follow doctor's orders and get the person their meds on time, provide rest periods, and reduce stress.

When Mom was at the holiday table, sometimes someone would say, "Mom? Remember when..." And then stop. Not a great phrase in these circumstances.

Just let the warmth and love come through. This people never forget.

Tuesday, November 22, 2016

350 slices of pizza a second

Yup--that is how much Americans consume. For 15% of the country, this is the top comfort food.

In the November issue of Food Technology, assoc editor Melanie Zanoza Bartelme outlines eight things about pizza:

--58% of US pizza eaters say they would buy more frozen pizza if it had more gourmet ingredients.

--76% of consumers have eaten at a pizza restaurant in the past year.

--Pizzas are trending toward thinner crusts--but hand tossed is Number One is restaurants.

--Gluten-free trust is also trending. Launches of gluten-free pies increased 58% between 2012 and 2015.

--Tomato-based red sauce remains the most common topping, but ranch, alfredo, and white sauce are gaining.

--Mozzarella is the most common cheese, ricotta and Parmesan a distant second. But also look for comers like gorgonzola, fontina, goat, Romano, asiago, provolone, feta and pepper jack. Even gouda is popping up. (Or being popped on top.)

--Sausage and pepperoni are still the top meats--but bacon is also widely available now as is chicken breast. Other meats include prosciutto (up 27% since 2010), meatballs, salami, and anchovies.

--Onions, tomato, mushroom and peppers are on 73% of restaurant menus.

We like artichokes and of course, I invented Black Pizza--anchovies and black olives. Some people at your table may recoil.

Monday, November 21, 2016

Arguing with teens over food this T-Day

For many reasons, teenagers start responding to messages about obesity and the environment and embark on diets that don't just limit intake, but eliminate entire food groups.

This can lead to "discussions" and confusion at big gatherings.

C.S. Mott Children's Hospital did a survey of 910 parents with at least one child between 13 and 18.

--One in six said their teen had tried a diet that is vegetarian. Six percent said, gluten-free. Four percent said vegan and two percent said paleo.

Half of these parents said this had caused trouble at holiday and family meals.

And it wasn't just Aunt Emma getting hurt because the kid would not eat her famous Mac 'n' Cheese.

Families also had trouble finding a restaurant all could enjoy (61%). Fifty-five percent spent extra time finding and preparing special dishes. Stress was a factor--with this stressing 54% of those surveyed. And the special foods represented an extra expense for half.

Parents, the researchers said, could ask the teens to prepare his or her own meals or find good substitutions.

But why did the kids come up with these requirements?

--A third said their kid's rationale was health-related.

--29% said another family member was on the same diet.

--A friend's suggestion (17%)

--The diet's environmental impact (14%)

Half of the parents also said they looked into the teen's diet and suggested vitamins or supplements.

But just 17% took the kid to a doctor to discuss the regimen.

So how do the teens fare on these diets?

--Half the parents said it made the teen feel healthier

--41% said no difference

--7% said the teen's health was impacted negatively

Well, kids--you know... They won't stay on anything too restrictive too long--unless, of course, it leads to an eating disorder. Then shunning turkey will be the least of the problems.

Friday, November 18, 2016

Just try ringing for a nurse

Sophie Quinn, author of Help Wanted: Why Willing Workers Aren't Filling Open Jobs, writing at Stateline (Pew Charitable Trusts), takes on the nursing situation.

What's the most in-demand worker in Houston? A nurse.

A fourth to a third of all nurses are set to retire in coming years, even though many nurses are postponing their retirement. And even now, nurses with certain skills are great demand. Hiring a nurse in Houston can take 55 workdays.

Couldn't we just graduate more nurses? We are--but hospitals, nursing homes, home care agencies, doctor's offices--all have specific requirements. They may want, for example, experience as an operating room nurse and not be able to afford a nurse with that.

So many new nurses find that their degree is not a ticket to ride. Many employers are beefing up their internships and in-house training. New York City even has a program to help new nurses find work.

Most nurses are RNs--Registered Nurses. These are the nurses who hand out medicine, monitor vital signs, and help patients manage their situation when they go home. Licensed practical nurses provide more basic care, such as helping patients dress and changing beds.

But--as the tide of new nurses continues to rise, employers are raising the ante. For one thing, an associate's degree will be bottom rung--the Institute of Medicine recommends that by 2020, a bachelor's will be required.

Even now, in Houston, nurses with an associate's degree have trouble getting an interview at the big hospitals.

So, the next time you are in the hospital and need a nurse, you may need to take a Chill Pill.

I love nurses...they can make or break a hospital stay. But salaries will have to go up to fix this problem--and medical care is too expensive as it is.

Thursday, November 17, 2016

Teething pains

Every parent has been through it or soon will be--the eruption of relentlessly emerging teeth through tender gums.

Most babies get their first tooth at around six months of age. Some start as early as three months--or those teeth could not sprout until eight or nine months.

First up--usually the bottom middles. On top, the front teeth come in first, then the molars, and then the eyeteeth (pointy canines). The gums may also be swollen and red.

This process is uncomfortable--we can't remember--it may even hurt! Babies react by crying and fussing and/or chewing on anything they can get.

Besides red gums, the baby may be irritable, have trouble sleeping, drool a lot, and not seem hungry.

And, of course, with chewing on everything--they may pick up a bacteria or virus.

Is there anything you can do?

--If the baby is fussy, give it a plain, solid teething ring. Some parents chill it--but don't freeze it, which creates more problems. The baby can decide how much pressure to put on the sore spot.

--Offer cold yogurt or applesauce.

--Do not jump for the pain relievers--they probably are not necessary. Forget teething gel--it contains benzocaine, which should not be swallowed, as it will be if on the gums. Also--"teething tablets" have been warned about by the FDA.

A child will get 20 baby teeth. About age 3, it's time for a trip to the dentist. Yes, the baby teeth need to be kept cavity-free. Even though they will fall out, baby teeth are placeholders for the permanent teeth and help those come in correctly.

Use a soft pediatric brush and plain water on those adorable baby whites.

Wednesday, November 16, 2016

How to prevent heartburn

Holiday festivities provide many delicious opportunities to get heartburn. Yick.

About a fifth of the American people get this--which in doctorspeak is called gastroesophageal reflux disease (GERD).

You may know the sensation--a burning in the throat and chest and a bitter taste. This usually comes after overeating and affects overweight people more often.

Actually it has nothing to do with the heart, though the symptoms can mimic a heart attack.

Losing even five pounds can help it...

Some other tips:

Skip the after-dinner mints. Peppermint may feel like it's clearing the aftertaste, but it relaxes the muscles between the stomach and the esophagus, which allows stomach acid to flow back into the esophagus.

Other triggers? Tomato-based products, citrus fruits and juices, spicy food, high-fat foods, chocolate, alcohol, and caffeinated beverages (including soda).

Chewing gum can help if you are prone to heartburn. This stimulates acid-neutralizing saliva.

Try "Rest and Digest." Stress is "Fight or Flight." Rest and Digest is eating slowly, chewing thoroughly, and savoring. Use s smaller plate--overeating is big culprit.

Taking a short walk after meals instead of flopping in the recliner allows gastric juices to flow in the right direction. Wait two hours before lying down.

The first time I experienced heartburn was when I was eight months pregnant--my partner was astonished--I had never had it before? And now, when everything else in my innards seems to be wacky, I don't get heartburn often--but I do know people who do.

And it's no picnic.And the frequent bathing of the esophagus in acid can lead to more serious problems.

Tuesday, November 15, 2016

Sunshine, you make me happy

Positive thinker Norman Vincent Peale used to recommend that if you feel sad, just think of the sun...Not go out and bask--just think of it.

Now--researchers at Brigham Young say the time between sunrise and sunset is the period that matters most for mental and emotional health. This goes for everyone, not just people with seasonal affective disorder.

And within that period, sunshine keeps the level of emotional distress stable.

Forget hot or cold temps, air pollution, and maybe even threatening rainclouds--these won't get you down, but lack of sunlight will.

Winter has fewer sun hours--and thus is a busier time for therapists, the researchers said (J of Affective Disorders).

Mark Beecher, clinical prof and licensed psychologist at BYU, and Lawrence Reed, a physics prof there combined forces. Rees had weather data for Provo, Utah--Beecher had emotional health data for the same area.

They analyzed several variables such as wind chill, rainfall, solar radiance, wind speed, temperature, and more. The weather data could be analyzed down to the minute in the exact area where the psychological clients lived. And they used a mental health treatment outcome measure, rather than suicide attempts or online diaries, to analyze psychological distress.

Amount of sun was the determining factor in lack of distress.

I live in the Sonoran Desert, where it is sunny most days--and you may be heard, this makes it HOT. But even on the hottest day, it's all about the sun to me--a clinical sample of one.

Monday, November 14, 2016

For some, sad times lie ahead

In my Blue Cross/Blue Shield newsletter, they talked about how to cope with grief during the holidays. Since the holidays are usually a time of family closeness, a missing member can hit hard. So many memories of when that person was there.

Grieving people ask:

--Should I act like everything is OK?

--Is it OK to skip some traditions if they are too much for me?

--Should I change rituals?

First, you need to accept your feelings. Don't feel guilty if you are not into the holidays--or if you find yourself enjoying moments despite everything.

Don't judge yourself...and others should not judge you either.

Just do what feels right.

Have an exit strategy if you go to a party or event you shared with the loved one.

Take a friend to events.

Or--create a new tradition:

--Donate to a charity the person loved.

--Volunteer or donate food.

--Plant a tree or sponsor a plaque or bench somewhere.

Many people add new people and new activities each holiday--you can, too.

My sister married a guy whose son, 4, had died at Christmas--they never had a family dinner, he would not come to my house for one, they didn't decorate. It had been decades. It made me sad.

But I guess not as sad as he still was.

Friday, November 11, 2016

How to burn calories--do the holidays

Not a mess--a calorie burning
opportunity...
We think of holiday time as eating time, but there are also chances to burn off a few cals. By a few, I mean a few...

Gift shopping: 95 cals

Standing in line: 47

Food shopping (pushing a cart): 13

Baking cookies: 95

Changing beds for guests: 40

Housecleaning: 191 (wow, we have a winner, wait, it's housecleaning, never mind)

Caroling: 140 in an hour, singing while standing
                   204 walking between houses at 2 mph

A nice big piece of pie is what...250-400 calories? That's a lot of bed changing.

Still--you may also be sightseeing with guests, going up and down stairs more, shoveling walks, making snowmen with all the kids, and otherwise getting off your routine--every little bit helps.

Thursday, November 10, 2016

Skin care varies by age

First some general skin care advice, much of which you have probably heard...

--Select products geared to your skin type--sensitive, dry, oily or a combo.

--Protect your skin from the sun, that big nuclear reactor in the sky.

--Use a retinoid unless it dries or irritates.

Now for the ages:

TWENTIES. It's never too early to start thinking about your skin. Young women need a simple regimen. Wash your face twice a day with a gentle cleanser and use SPF 30 every morning. You can also add a retinoid at this age if it agrees with you. Remember--sun damage is cumulative--you need to start early to keep it from building up. Also women in their twenties may still have acne. There are many treatments--ask your dermatologist.

THIRTIES: The dark spots may be showing up--sun damage. This can happen even through glass...so SPF 30 everyday. In addition, a retinoid and topical Vitamin C may help and help prevent more. Wrinkles may also be making an appearance. But beware of heavy-duty wrinkle treatments aimed at older women--they can cause acne or milia (small cysts where dead skin cells get trapped under the surface). This means retinoids. Women in their 30s should also use a light anti-oxidant serum and if you are worried about wrinkles, maybe botox or hyaluronic acid. Spider veins can also be a problem in this age group.  See if you can afford treatment for those.

FORTIES: The skin begins to lose collagen and elastin and sag. There are non-invasive treatments such as microfocused ultrasound and radiofrequency microneedling. Fillers may also help. At this age, you may also lose fat in the face and hands (my problem--the hands). There are treatments for this. You may also want to address unwanted body fat in the torso and legs (not subject to exercise). Again, focused ultrasound, thermal energy treatment, and cryolipolyisis are something to ask about.

Ooops--the advice ends in the forties. I guess if you're older, your rmoney is gone or you are beyond saving.

Darn.

Wednesday, November 09, 2016

Nearly half of clinical trials never published

Yes, we argue over whether a clinical trial really shows this or that, but apparently almost half are so inconclusive or ambiguous, they just slide off the radar.

This info comes from the University of Oxford.

Between 2004-2014, 11,714 trials out of 25,927 on Clinical Trials.gov has not been published within two yrs of being completed.

This encompassed 8.7 million patients who gave their time and hope to the research.

The problem is this--if  negative, non-significant results or no results are not reported, and positive results are, this overstates the effectiveness of treatments.

According to BuzzFeed News, the worst offender in this respect is Sanofi, a French pharmco. It published only 285 of 435 trials.

Novartis came in second, with 201 unpublished trials.

One company, Ranbaxy (Indian) published none of its trials.

On the flip side, Shire, an Ireland-based company, published all 96 of its trials.

When trials are not published, so-called evidence-based medicine is not possible or is skewed.

The researchers also said not publishing betrayed the participants, who had undergone a lot of inconvenience or pain to benefit patients like them.

The pressure is there to publish only high-impact results, as one researcher put it.

Novartis did fight back, saying their results were published on their own website.


Tuesday, November 08, 2016

Uh-oh, zombies could overtake Chicago in 2 months

Researchers at the Argonne National Lab used a computational model designed to study the spread of MRSA and Ebola to game plan a zombie invasion. You know those scientists--pretty playful.

It would only take 60 days for 2 million Chicagoans to be zombified.

While there seemed to be little resistance in place to the walking dead--strategies such as training ordinary people to kill zombies and communications from city officials that tell people how to avoid them did make a difference.

This experiment draws attention to the model for strategizing public health issues.

This ChiSIM model can simulate the complex behavior of millions of "agents"--in this case, Chicagoans, moving through 2 million locations in the city.

Recently the model was used to identify a "hub" for MRSA--the Cook County Jail.

Where is Glenn when you need him?

Monday, November 07, 2016

Do you get "stuck tune"?

Almost all of us do--you know, when a song gets in your head and repeats and repeats a phrase or two all day, like a "private screensaver," as one researcher put it.

The Germans call this an "ohr wurm"--ear worm.

What makes a song so "sticky"? Dr Kelly Jakubowski from the music dept at Durham University has made a large-scale study of this.

Sticky songs are usually faster with an easy-to-remember melody and some unique intervals.

Viz: Bad Romance (Lady Gaga), Don't Stop Believing (Journey), and Can't You Out of My Head (Kylie Minogue).

Tunes that stick also tend to have "common global melodic contours."

Country songs tend to have a simple "contour"---the first phrase rises in pitch, the second falls. As in Twinkle Twinkle Little Star.

My Sharona (Knack) and In The Mood (Glenn Miller) both had unusual interval structure--which makes them sticky.

How often the song is on the radio or high on the charts is also a major factor.

Ninety percent of us, the scientists say, get a tune stuck at leas once a week.

How can you shake an ear worm?

--Listen to the song all the way through.

--Distract yourself with a new song.

--Or wait for it to fade. It will...but another may take its place.

Friday, November 04, 2016

Thinking of becoming a sperm donor?

Many men think of donating sperm as a quick buck--like selling their blood.

But Tamar Lewin, NYT, Nov 3, 2016, says your odds of getting into Harvard or Stanford are higher than being accepted at any of the major sperm banks.

California Cryobank and Fairfax Cryobank, the two largest, take only one in 1,000 applicants.

White men under 5'9" need not apply. Some ethnic groups can be shorter.

You must keep your sperm count high--meaning 2-3 days of abstinence before donating.  And donors must produce a good specimen once or twice a week.

Don't count on quick money. To prevent the spread of of HIV and other diseases, the FDA requires that sperm be frozen for six months and the donor retested before it can be used--and the donor can be paid.

Lots of forms--lots of tests.

There will be many questions about your sexual history, drug use, travel, hobbies, etc. You will undergo physical, personality, and STD screening.

You may be asked for a childhood or adult photo and write an essay or make a tape for users. There will also be genetic testing.

The pay is also variable based on how many vials your specimens fill. You could make $1,500 a month if accepted.

You can't wait for the mood to strike--donations are made during business hours and some banks have short hours.  You will agree to donate at least once a week for six months to a year--to justify the $2,000 they spend screening you.

How many babies can you create? The biggest sperm banks have rules that limit on donor to 25-30 family units. Some people prefer the same donor for 2-3 children. It is not unusual for one donor to father dozens.

But you may not get to meet these offspring. Some donors join the Donor Sibling Registry to see how many they have fathered, but sperm donors can remain anonymous. Still, even anonymous donors are being identified by curious children.

So--sound like something you'd like to get into?

Full disclosure--I started out to conceive with donor sperm and have been through this process, but along the way, I met a guy, he "donated" to me, and my daughter ended up being his--not #234's--the Irish guy with musical ability.

Thursday, November 03, 2016

What's up in the world of fitness

Even though some studies show wearing a FitBit does not result in the pounds sliding off, wearable technology still tops the list of the American College of Sports Medicine's annual fitness trend survey.

Technology is a must have in our daily lives, chirps the lead author of the survey.

The ASCM surveys more than 1,800 health and fitness pros to get these trends.

1. Wearable technology. Activity trackers, smart watches, heart rate monitors, and GPS tracking devices.

2. Body weight training. You use your body weight in pushups and pullups and the like rather than a lot of equipment.

3. High intensity interval training (HIIT). Short bursts of activity followed by a short recovery period. All done in under 30 mins.

4. Educated and experiences professionals. Many places "certify" people--be sure the certification program is certified by the National Commission for Certifying Agencies. Of course, they think ASCM is the best.

5. Strength training. Still a staple of many health clubs.

6. Group training. Self-explanatory.

7. Exercise as medicine. Doctors recommend physical activity.

8. Yoga. Includes Power Yoga, Yogalates, Bikram, Astanga, Vinyasa, Kripalu, Anurara, Sivandan, and others. (I did Sivananda for yrs.)

9. Personal training. This means training to be a trainer.

10. Exercise for weight loss.

So what's trending in your life? Is trending a word?

Wednesday, November 02, 2016

Ads for toddler food may be misleading

Milk, formula, or a "milkshake"?
Jennifer L. Harris of the Rudd Center for Food Policy and Obesity at the University of Connecticut analyzed the content of ads for infant formula and toddler foods.

Often, she found, the messages promoted manufactured alternatives as better than breastfeeding or homemade food.

This contradicts the beliefs of many health professionals.

Yet, in 2015, companies spent $77 million to advertise these foods and bevs to parents.

Nearly 60% of this advertising promoted oroducts not recommended by doctors--notably "toddler milks," which were pushed as being "formula, poor toddler snacks, and a child's liquid nutrition supplement.

In fact, ads for toddler milk are displacing ads for actual formula and are aimed largely at Hispanic parents.

Toddler milks contain added sugar. and are less expensive than formula, so parents buy them.

Maybe not if they read this. Pass it on.

Tuesday, November 01, 2016

Medical clothes--what's your take?

At the University of Rhode Island's biomedical engineering dept, professors and students are working on ways doctors can better prescribe for Parkinson's patients--based on their symptoms.

The approach is to transform gloves, socks, clothes, and shoes into high tech items.

Smart textiles are the focus--wearable items embedded with sensors, electronics, and software that can collect data from patients and deliver it to doctors.

They already came up with a wristband that monitors tremors of people with Parkinson's and sends that info to doctors.

Now--the emphasis is on textiles. Gloves can monitor tremors, too.

They are also working on high-tech socks for people who have suffered strokes. These socks gauge the walking stride and gait.

In the works--smartwatch tech for patients with psychiatric illnesses and autism.  These will measure daily activities.

Incidentally, the URI students are also working on a smart dog collar to scare away coyotes. How do the collars know there is a coyote around? Good question! says the prof. Well...how do they?

As for the human electronic wearables--my question is: What doctor would have time to look at all this messaging...You can hardly get a prescription refilled without six calls or a trek to the office.