by Carole Jackson>, Bottom Line Health

Have you ever bought a prescription medication online? If you have, you’re in good company. A recent FDA survey showed that almost one-quarter of Internet users have. The majority of these respondents used an online service associated with their health insurance.

It’s easy to see why many people go online—it’s convenient. You press a few buttons on your computer, and without having to leave your home, your prescription is delivered to your doorstep.

But if you’re thinking about purchasing prescription medications from an online source that isn’t affiliated with your health insurance or a local pharmacy, there are many unregulated, fraudulent, illegal companies that want you to think that they are legitimate, legal pharmacies—and they may even have Web sites that look very professional. But if you use one, you may not receive what you paid for. There’s no way to know for sure whether the product that you receive contains the right amount (or any) of the active ingredient. Plus, the medicine could be contaminated or expired. So I spoke to an expert for tips on how to safely buy prescription medications online…

RED FLAGS

Many people don’t realize how important it is to research an online pharmacy before using it. For example, the FDA survey showed that 15% of the respondents said that they would consider buying medication from an online pharmacy based outside the US. But the FDA doesn’t regulate pharmacies that are located outside the US. So the first rule of thumb is to make sure that an online pharmacy is licensed in the US state where it is operating, said Connie Jung, RPh, PhD, acting associate director for policy and communication at the FDA in the Office of Drug Security, Integrity and Recalls, who analyzed the survey results. This ensures that the pharmacy will be held to following state laws. To find out whether your Internet pharmacy is licensed by the state that it’s operating in, don’t just go by a statement on the site (because that could be fake). Check with your state’s licensing organization by clicking here.

Here are more questions to ask yourself before you commit to using a particular online pharmacy, from Dr. Jung…

• Does the pharmacy require that you send in your prescription? If it doesn’t, don’t use the pharmacy. Any legit pharmacy will require a prescription. Depending on the pharmacy, the pharmacist will either ask you to mail in the prescription or he or she might contact your doctor directly.
• Does the pharmacy send you spam? If you start getting spam or weird e-mails from the pharmacy that offer deep discounts and push you hard to buy medications, don’t use the pharmacy. That’s a sign that the “pharmacy” and its Web site may be a sham.
• Does the pharmacy offer prices that are too good to be true? There’s no way to know exactly what’s “too good to be true,” but if, say, one pharmacy typically charges $32 for a bottle of a brand-name (nongeneric) medication, and another charges $30, but an online pharmacy is charging just $5, that’s suspicious.
• Does the pharmacy have pharmacists who are available to talk to you? If the store doesn’t allow you to speak with any pharmacists over the phone, don’t use it. It may be an indication that real pharmacists aren’t running the pharmacy.

Source: Connie T. Jung, RPh, PhD, acting associate director for policy and communication, Office of Drug Security, Integrity and Recalls, Office of Compliance, Center for Drug Evaluation and Research, US Food and Drug Administration, Rockville, Maryland.

by Carole Jackson>, Bottom Line Health

Here’s an unusual New Year’s resolution that you probably have never made.

Become more flexible this year—literally!

For anyone who wants to have a fit, healthy body, building more endurance and strength are common goals, but you rarely hear someone say, “By the end of the year, I want to be able to touch my toes with the palms of my hands while standing—and do it smiling!”

But improving and/or maintaining flexibility is key to your health, because being loose and limber makes it easier to build strength and endurance…it makes everyday activities, such as tying your shoes or reaching behind the driver’s seat in a car, less painful…and it makes you less prone to injury.

And it just feels great.

So, how flexible are you?

Take our quick quiz to find out…and then, if you discover that you’re not exactly like Gumby, don’t worry—I’ll provide you with some easy tips from an expert that’ll make you flexible in no time.

YOUR QUICK FLEXIBILITY TEST

To get an idea of how limber you are (or aren’t), take this simple test created by Diana Zotos, a physical therapist and yoga instructor at the Hospital for Special Surgery in New York City.

Shoulder Stretch. Standing, place your right forearm behind your waist and then raise your hand as far up as you comfortably can. Repeat this move with your left forearm. Can you…

a. Reach your shoulder blades with your fingertips?

b. Reach your middle back?

c. Reach your lower back?

Trunk Rotation. Sit up straight in a chair with your arms crossed lightly across your chest, hands touching opposite shoulders. Stare straight ahead. When you gently twist your upper body and head from side to side, can you…

a. Turn your torso to about the 3:00 position on your right side and 9:00 on your left?

b. Turn not quite as far—only to 2:00 and 10:00?

c. Turn only to 1:00 and 11:00, or not much further than your starting position?

Leg Reach. Stand up straight with feet hip-distance apart. When you bend forward and simultaneously slide both of your hands as far as you can down your legs (with your right hand on your right leg and your left hand on your left leg), can you…

a. Reach below the knee?

b. Reach the knee?

c. Reach mid-thigh?

Toe Touch. Sit on the floor with your back straight and your legs extended straight in front of you. When you bend over, can you…

a. Touch your toes?

b. Reach your ankles but no further?

c. Get only as far as your shins?

If you answered mostly As, good job—you’re lithe and limber. Just keep stretching a couple of times a week. If you fall into the B range, you’re getting a bit stiff and could benefit from stretching more often, three to five times a week. If you answered primarily Cs, watch out! You may not be moving around as much as you should, and as a result, you’re losing a lot of flexibility—but it’s never too late to reclaim it! Doing the following stretches can help you open up your muscles and start to see improvement in your flexibility in as little as one to two weeks.

LIMBER UP!

Marla Altberg, a certified personal trainer and Pilates mat instructor in New York City, assured me that even if you have spent the holidays (or longer) on the couch, you can easily loosen up again by performing this 10- to 15-minute stretching routine…

ON YOUR BACK: To perform the following stretches, lie on your back with your knees bent, feet slightly apart and flat on the floor and arms by your sides with palms facing downward.

Triangle Stretch (For hamstrings, quads, inner thighs and hips):

1. Make a triangle by crossing your left foot over your right knee.

2. Grasp your right leg behind your thigh, and inhale as you bring it in toward your chest.

3. Take your left elbow and press it gently against your left knee.

4. Breathe naturally as you hold the stretch for 20 seconds.

5. Return to your starting position and repeat on the other side.

Leg Raise (For hamstrings, quads and back):

1. Leaving your left leg where it is, bring your right knee to your chest as you inhale, and then slowly raise your right foot straight up to the ceiling as you exhale.

2. Using both hands, grab hold of your right leg behind your thigh, and climb up your leg, hand over hand, as far as you can toward your foot.

3. Keeping your hands as close as possible to your right foot, pull your right leg toward you, keeping it as straight as possible while your knee moves toward your face, gently but carefully—never to the point of pain. At the same time, push the leg against your hands in the opposite direction. Hold this pose for a count of 10, if possible.

4. Walk your hands back down, and repeat on the other side.

“T” Stretch (For back and side abdominals):

1. Join your knees together and tilt them both over to the left side until they touch the floor (or come as close to the floor as possible).

2. Spread your arms out to your sides, so your body forms the letter “T,” and turn your head and torso to the right.

3. Hold for 20 seconds, breathing naturally and deeply into the stretch. Repeat on the opposite side.

ON YOUR TUMMY: To perform the next set of stretches, roll over onto your stomach.

Ab Contraction (For abs and back):

1. Make a pillow with your hands, rest your forehead on it and position your feet hip-width apart.

2. Inhale deeply, and then exhale as you draw your abdominal muscles in and up. Hold for 5 to 10 seconds and release. Pause for just a few seconds and then repeat twice.

3. Next, make the same muscle contraction but, as you do so, slightly raise your head (keeping your forehead glued to your hands) and chest off the floor. Hold for five seconds and release. Pause for just a few seconds and then repeat twice.

Fly Like Superman (For back, abs, butt and shoulders):

1. Still lying on your stomach, extend your arms above your head, shoulder-width apart, with the palms of your hands facing downward.

2. Inhale deeply. Exhaling, contract your abs and raise your right arm and left leg slightly off the floor simultaneously.

3. Hold for a count of 3 to 5 and then release. Repeat on the other side, and then do one more set.

Cat Stretch (For back and abs):

1. Get on your hands and knees.

2. Inhaling, pull your stomach in, tip your pelvis forward and arch your back like a cat. Hold for 3 to 5 seconds.

3. Exhaling, gradually relax back into your original position. Pause for just a few seconds and then repeat twice.

Note: If you have a health issue such as a bad back, joint problems or heart disease, consult your primary care provider before beginning any new exercise program.

Sources: Diana Zotos, physical therapist and advanced clinician, rehabilitation department, Hospital for Special Surgery, New York City. Marla Altberg, certified personal trainer and Pilates mat instructor, New York City.

by Carole Jackson>, Bottom Line Health

Ever step inside a hotel room and know instantly that someone recently smoked in it?

Or hop into a rental car and need to roll down the windows immediately to air out the stench of cigarettes?

Or maybe you occasionally get a “tobacco-y” whiff from the clothes or hair of a smoker who lives below you or in the condo next door.

So-called “thirdhand” smoke is the contamination that remains after a cigarette has been extinguished. And I’m sorry to tell you that it’s also dangerous, just like firsthand smoking and secondhand smoke—and why you need to avoid it…

OF MICE AND MEN

Believe it or not, the quintessential experiment proving the hazards of thirdhand smoke was published in Cancer Research way back in 1953. Researchers at the (then-called) Sloan-Kettering Institute of the Memorial Center for Cancer and Allied Diseases in New York collected cigarette smoke in a beaker and then gathered the residue that clung to the glass. They mixed the residue with a solvent and painted it on the backs of some mice…on other mice (the control group), they painted solvent alone. Researchers found that 59% of the mice exposed to tobacco residue developed skin lesions, and most of those mice went on to develop cancer. In contrast, none of the control mice developed skin lesions or cancer.

Now fast-forward to today. Sure, we’re living in a time when smoking is banned from most public places in the US, but, unfortunately, many homes, apartment buildings, hotel rooms and cars are still heavily contaminated, I learned recently from Jonathan Winickoff, MD, MPH, a pediatrician and professor of pediatrics at Harvard Medical School in Boston and one of the country’s top researchers on tobacco and health.

Some of these spaces are being smoked in still…others used to be smoked in…and all can hurt your health.

HOW WE’RE EXPOSED

Thirdhand cigarette smoke adheres to all surfaces and remains there even after a butt is stubbed out. “It’s surprisingly dangerous because it reacts with other compounds in the environment and with itself to create new tobacco-specific nitrosamines, compounds that are highly carcinogenic,” said Dr. Winickoff.

This thirdhand smoke is, unfortunately, almost impossible to clean off most surfaces, though you’ll have more luck with glass surfaces than with porous ones, such as wallboard. Usually, it just sticks around until someone comes into contact with it.

There are three ways that humans can come into contact with thirdhand smoke…

• Through breathing. The compounds can be reemitted into the air, so it’s possible to inhale them into your lungs.
• Through touch. Compounds can enter the body through the skin—just by touching a wall or lamp or using an armrest, for example.
• Through ingestion. The microscopic compounds can settle on everything from dishware to food, making it possible for us to unknowingly eat them.

HEALTH CONSEQUENCES OF TOBACCO TOXINS

People of any age can suffer various health consequences from any amount of exposure to thirdhand smoke, though children, in particular, are more likely to come into contact with the toxins and are more likely to be negatively affected by them.

Children breathe at faster rates than adults, so when thirdhand smoke is present, the little ones’ respiratory exposure is much higher. Also, they tend to touch everything and move around surfaces like mops, which increases their skin exposure. Plus, they ingest twice the amount of house dust as the average adult, said Dr. Winickoff.

Since a child usually weighs less than what an adult weighs, exposure will impact a kid’s body more. And because their bodies and brains are still developing, the exposure can have measurable effects. Studies have found that children exposed to thirdhand smoke have much higher blood levels of cotinine, which is a breakdown product of nicotine, compared with children who are not exposed to contaminated environments. “High cotinine levels have been associated with developmental delays and lower reading and math scores,” said Dr. Winickoff. “Plus tobacco smoke exposure—it can be hard to tease out the effects of secondhand and thirdhand smoke—is now a leading cause of Sudden Infant Death Syndrome.”

SMOKE-FREE LIVING

So if you or someone around you still smokes, this is obviously another good reason to quit—and another good reminder that smoking doesn’t just harm the person who has the cigarette in his or her mouth. For more information on how to quit, click here.

If you’re not a smoker, do everything you can to avoid thirdhand smoke. Try to live in a building that is smoke-free, because even if there is just one smoker around—even in another apartment—smoke moves freely in the air through ductwork or out one window and into another and can affect everyone. Reject a stinky-smelling hotel room or rental car, and ask the company for a replacement. And if a smoker (even one who is not smoking at the moment) steps into an elevator with you, step out of the elevator and take the next one. Is this inconvenient? Sure, but your good health is worth the extra hassle.

Source: Jonathan Winickoff, MD, MPH, pediatrician and associate professor, department of pediatrics, Harvard Medical School, Boston, and immediate past chair of the American Academy of Pediatrics Tobacco Consortium. He has drafted tobacco control policies for the American Medical Association and other organizations.

by Carole Jackson>, Bottom Line Health

It’s January, which means that it’s time for warm gloves, furry coats and…antibiotics.

Yep, antibiotics.

A new study shows that adults in the US are prescribed antibiotics most often right now, during the first three months of the year.

Now, you might argue, Well, that’s because more people get bacterial infections during the winter.

But check out what else these researchers found, and you’ll see that there may be another reason for it…and, frankly, it’s a reason that outrages me—the findings suggest that many doctors may be behaving badly and putting people at risk.

DOCS PRESCRIBE AT THEIR DISCRETION

Scientists examined the national Medicare records of about 1 million seniors annually over three years. They tracked antibiotic prescriptions month by month to see when the most antibiotics were prescribed. They also analyzed the prevalence of the following conditions…

• Category 1: Bacterial pneumonia. This disease almost always requires antibiotics, according to the study authors.
• Category 2: Acute nasopharyngitis (the common cold) and nonspecific upper respiratory tract infections. These diseases are usually viral infections, so antibiotics are almost never necessary, according to the study authors.
• Category 3: Sinusitis, pharyngitis, tonsillitis and bronchitis. These diseases sometimes require antibiotics, but often they don’t, according to the study authors.

In addition, they compared disease prevalence and antibiotic prescription rates in the four main US regions—the Northeast, South, Midwest and West.

Results: As I mentioned earlier, antibiotics were prescribed most often during the first three months of the year. And the rate of bacterial pneumonia (category one), which almost always requires antibiotics, also spiked during those months. So upon first glance, you might think that solely explains the spike in antibiotic prescriptions.

But take a close look at this next finding. When the researchers compared the four regions, they found that the areas that had the highest prevalence of bacterial pneumonia, on average, did not have the highest rate of antibiotic prescriptions, on average, as you would expect. For example, the Northeast had the highest prevalence of bacterial pneumonia, but it didn’t have the highest antibiotic prescription rate—it had the second lowest, after the South and the Midwest. Very peculiar, isn’t it?

In addition, the rates of the diseases that fell into categories two and three (which don’t usually require antibiotics) also spiked during the first three months of the year—not just bacterial pneumonia. “These findings imply that it’s likely that some antibiotics were prescribed inappropriately to older adults to treat diseases that don’t typically require those drugs,” explained lead study author Yuting Zhang, PhD.

A QUESTIONING ATTITUDE

You, of course, know that overusing antibiotics can cause bacteria to become drug-resistant, leading to disease strains that can’t be wiped out with standard antibiotics. And taking antibiotics can be pretty hard on your body, too. This knowledge, coupled with the finding above, means that you may want to be extra inquisitive if and when you visit a doctor—especially in the winter.

If your doctor prescribes an antibiotic, should you automatically accept it? That’s a personal decision, but if you ask me, I make sure that my doctor has a darn good reason to give me one before I take it.

In fact, you may want to consider the following advice from regular Daily Health Newscontributor Andrew Rubman, ND, founder and medical director of the Southbury Clinic for Traditional Medicines in Southbury, Connecticut. He told me that when your doctor prescribes an antibiotic, always ask, “How confident are you that bacteria are causing my illness?” Physicians can rarely be 100% certain that bacteria are the root cause of health problems, Dr, Rubman said—but you should expect at least a fair degree of confidence from your doctor before swallowing antibiotics. Here are more of Dr. Rubman’s tips, below…

• If bacteria are definitely the cause…Ask these two follow-up questions—are antibiotics absolutely necessary? And what do recent studies show about the effectiveness of the antibiotic you’re suggesting?Some bacterial diseases, such as bacterial pneumonia, which was mentioned earlier, almost always require an antibiotic. But others, such as the diseases in categories two and three above, can often be resolved with over-the-counter remedies. “The OTC antihistamine drug diphenhydramine (Benadryl) is a good decongestant for occasional use, and your naturopath may consider prescribing you natural treatments such as nettle, echinacea, horehound, cajaput seed oil and/or henbane to shorten the duration and symptom intensity of your condition,” said Dr. Rubman. So find out from your doctor whether you can try an OTC product first. Keep in mind that all supplements have potential side effects and contraindications based on certain medical conditions that you may have and drugs that you may take, so take them under a doctor’s care.

  If your doctor insists that an antibiotic is necessary and explains that there is scientific evidence that it’s shown to be effective in relieving or curing your particular health problem, then ask whether you need a “broad-spectrum” type or whether a “narrow-spectrum” type will do, because a broad-spectrum type may be overkill for the problem at hand.

• If your doctor isn’t sure whether the cause is bacterial or viral…You’re faced with a more difficult decision. Ask what your options are besides antibiotics and how likely they are to help, and then, after weighing all the benefits and risks with your doctor, make a judgment call.

• If a virus is definitely the cause…Skip the antibiotics and ask your doctor what sort of treatment might help. If you’re interested in using a natural treatment, specifically, it’s best to consult a naturopathic doctor. Supplements containing the herbs lobelia (Indian tobacco), Ligusticum porteri (called osha by Native Americans) or larch tree bark (Larix occidentalis) can help clear mucus from the respiratory tract, for instance, if you have a respiratory infection.

Now, your doctor may say, “the cause of the illness is viral, but I want to give you an antibiotic to prevent any secondary bacterial infections.” Dr. Rubman said that in this type of situation, it’s best to consult a naturopathic doctor for a second opinion. And if you do eventually get a secondary infection, first ask your doctor to try to confirm that it’s bacterial through symptom examination and/or lab tests before considering an antibiotic.

Sources: Yuting Zhang, PhD, associate professor, health economics, and director, Pharmaceutical Economics Research Group, University of Pittsburgh. Her study was published in Archives of Internal Medicine.

Andrew Rubman, ND, founder and medical director of Southbury Clinic for Traditional Medicines, Southbury, Connecticut. He is contributing medical editor to Daily Health News. www.SouthburyClinic.com

by Carole Jackson>, Bottom Line Health

Let’s say that I asked you this question: Are senior citizens at greatest risk of dying from a car-related injury while walking, riding in the passenger seat of a car or driving?

If you’re like me, then your guess would be driving. It’s just part of being human—as we age, our eyesight and reflexes (and maybe even our mental focus) all diminish…and those are all vital for something as risky and difficult as driving.

Well, a new British study found that seniors are actually in most danger while walking.

How is that possible? I spoke with the researcher to find out…

PEDESTRIAN PERILS

A research team lead by Jonathan J. Rolison, PhD, analyzed all fatal injuries reported by police in Britain between 1989 and 2009 that were classified as “road traffic fatalities.” Meanwhile, the UK National Travel Survey had estimated the number of excursions—whether as a driver, passenger or pedestrian—made each year by individuals age 21 and up. When the researchers combined these two sets of data, they were able to calculate the risk that an individual would be fatally injured for each excursion. Here’s what they found…

When it came to both driver and passenger fatality rates, people age 70 and older had a higher rate than people who were considered “middle-aged” (between 30 and 69). But the rate of the older set was about equal to that of the youngest set—people between ages 21 and 29.

When it came to the pedestrian fatality rate, however, seniors were far more likely to die than people in any other age group—and they were far more likely to die as pedestrians than while driving or sitting in a passenger seat.

“In other words, seniors shouldn’t just be cautious about driving and riding in passenger seats in cars—they should also be cautious while walking,” said Rolison. “Walking is riskier than they might think.”

SAFEGUARDING SENIORS

Anyone who is elderly should be extra careful while walking on or near roads. Seniors typically walk more slowly than younger individuals, and they more often misjudge the speed of approaching vehicles—often due to declining hearing and/or sight. “These things compromise their ability to safely cross streets,” said Dr. Rolison. And because they are usually more frail and susceptible to injury than younger people, they should cross streets only at designated crossing areas, ideally when no cars are in sight. It’s best for them to choose crossing areas that have timers if their neighborhood has any, because those will ensure that seniors have a particular amount of time to safely cross.

Source: Jonathan J. Rolison, PhD, a psychology lecturer at Queen’s University, Belfast, Ireland. His study was published in Journal of the American Geriatrics Society.

by Carole Jackson>, Bottom Line Health

People with multiple sclerosis (MS) want to do everything possible to prevent the autoimmune disease’s uncomfortable and disabling consequences, including weakness, numbness, blurred vision and bladder problems.

What’s wonderful is that recent research has found that consuming more of a certain nutrient found in foods and supplements might slow the progression of the disease.

I talked to the study’s lead author, Ellen Mowry, MD, to find out more about this vitamin and how much of it exactly might help my readers who are living with MS…

“D-CIPHERING” THE RESEARCH

The nutrient in question is vitamin D.

Dr. Mowry and her colleagues analyzed people with MS during a five-year period. They gauged their blood levels of vitamin D from all sources—sunlight, foods and/or supplements. (Patients weren’t told to consume specific amounts of vitamin D.) Researchers used MRI scans on the patients to look for two particular types of lesions in the brain—new T2 lesions and gadolinium-enhancing lesions. These lesions indicate that MS is advancing—the development of lesions in MS patients is associated with long-term disability.

Dr. Mowry and her team found an intriguing association—the higher the level of vitamin D in the blood, the lower the number of both types of lesions. Each increase of 10 nanograms per milliliter of vitamin D in the blood was linked to a 15% lower risk for new T2 lesions and a 32% lower risk for gadolinium-enhancing lesions.

Researchers also tracked the progression of disability in patients and found that the higher the levels of vitamin D, the less disability a person would subsequently have.

This doesn’t mean that consuming more vitamin D will definitely prevent MS from progressing (this study did not show cause and effect—only an association with blood levels), but there’s a chance that it could.

THE BEST DOSE OF D

Curious to know how much of the vitamin MS patients may want to take, I asked Dr. Mowry and Daily Health News regular contributor Andrew Rubman, ND, founder and medical director of the Southbury Clinic for Traditional Medicines in Connecticut, to address this question.

They both said that beyond getting vitamin D through foods and sunlight, people with MS often need to take an additional 2000 IU to 4000 IU of the vitamin each day in supplement form. (Keep in mind that not all experts agree yet on what is optimal. Plus, vitamin D may interact negatively with certain drugs and exacerbate certain health conditions. So check with your doctor before taking any vitamin D.)

Both also advised having your blood levels of vitamin D measured by your doctor before starting supplementation. This way, if you have MS, you can see whether your measurement falls between the 40 and 60 nanograms per milliliter that Dr. Mowry counsels her MS patients to shoot for. You can then adjust your vitamin D dosage to reach that range.

Sources: Ellen Mowry, MD, assistant professor of neurology, Johns Hopkins University School of Medicine, Baltimore. Andrew L. Rubman, ND, founder and medical director, Southbury Clinic for Traditional Medicines, Southbury, Connecticut.www.SouthburyClinic.com

by Carole Jackson>, Bottom Line Health

If you’re a man, then there’s a good chance that you take your health for granted. Now hold on a second, I don’t mean to insult you — you are probably great at many things, but odds are that going to the doctor isn’t one of them. A new study from the H. Lee Moffitt Cancer Center & Research Institute in Tampa, Florida, shows that men are much less likely to get screened for cancer than women — and that’s a major cause for concern, because men have higher cancer death rates than women.

According to the most recent statistics from the CDC, three of the top five most commonly diagnosed cancers in men are prostate, colorectal and skin. And they’re all ones that the American Cancer Society (ACS) says that men should be screened for. For most men, colorectal and prostate screenings should start at age 50 and skin exams at age 20, but the ACS suggests talking to your doctor about your personal risk factors to determine the most appropriate age. How many have you been screened for recently?

To discuss the startling Moffitt finding in more detail, I called study coauthor Jenna L. Davis, MPH, research coordinator in the department of health outcomes and behavior at the center. The study results were published on November 8, 2011 in American Journal of Men’s Health.

WHY MEN FALL BEHIND

Researchers examined data from a large-scale, random phone survey of approximately 1,150 adults in New York City, Baltimore and San Juan, Puerto Rico. The selected cities provided wide geographic, racial and ethnic representation, Davis explained. Most participants were between the ages of 30 and 59, and 35% were men.

In their analysis of answers, Davis and her team found that…

• Roughly the same percentage of men (67%) and women (66%) believed that cancer screenings successfully detected cancer all or most of the time.
• Even though they had the same faith in screening, 41% of men said that they had never had any type of cancer screening — compared with just 5% of women. This may sound hard to believe, since PSA tests (prostate screenings) and occult blood stool testing for colorectal cancer are typically included in a man’s annual physical. Davis said that these results could be due to the fact that men have had cancer screenings but simply didn’t realize that the tests were being performed — or, perhaps more likely, it’s because many men simply skip annual physicals.
• When asked about their willingness to undergo screening for the following cancers — skin, lung, oral, stomach, colorectal, liver and blood (leukemia) — men’s responses indicated that they were less willing than women when the question was put in a general way. But, interestingly, when given specific details about the screening process, they became slightly more willing than women. Of course, you can’t judge willingness just by what people say, so it could have been that men wanted to appear willing — which is a far cry from actually getting yourself to the doctor for a test!

MAKING SENSE OF THE RESULTS

I asked Davis about why men aren’t getting screened as much as women are. She speculated that there are numerous reasons for this. Besides the fact that prior research has shown that men are less likely to go to the doctor than women, there’s an awareness problem. Media coverage tends to focus more on women’s cancers than men’s cancers. Even national government agencies promote greater cancer awareness among women — Davis noted that the National Institutes of Health has long had an Office of Research on Women’s Health, but it’s still working on one for men.

But what’s even more intriguing is Davis’s hopeful secondary finding — the silver lining is that once men learn some specifics about cancer screenings, they say that they’re more willing to go get screened than when they have only general information about the screening. So men — listen up! According to Davis, here’s how to be more informed, so you’re more motivated…

• Go to the doctor at least once a year. The more regularly you see your primary care physician, the less likely you’ll fall behind on screenings and the more questions you can ask to ease any fears.
• Learn more about cancer screening. Check out ACS’s cancer screening guidelines, which include recommendations for men of all ages, so you know when to get tested for what.
• Advocate for your health. If your doctor does not perform certain screenings that the guidelines above recommend, speak up and ask why.

Source:

Jenna L. Davis, MPH, research coordinator, department of health outcomes and behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.

by Carole Jackson>, Bottom Line Health

When we think about making sure that we have the healthiest hearts possible, the first thing that comes to mind is what not to eat. Bye-bye, ice cream sundaes, big steaks and fried chicken! But a new study suggests that what we add to our diets — not what we eliminate — may be even more important.

To find out what our hearts (if not our minds) really want us to eat, I spoke to Joseph Carlson, PhD, RD, director of the division of sports and cardiovascular nutrition at Michigan State University’s College of Osteopathic Medicine in East Lansing and the lead author of the study. His research was published in the November 2011 issue of Journal of the American Dietetic Association.

IT WASN’T THE FAT

Dr. Carlson told me that he and his colleagues chose to study teens, in particular, because of the dramatic increase over the past few decades in the number of adolescents with cardiovascular risk factors. And his findings echo what other studies have discovered in terms of adult heart health. They evaluated data from a large federal survey on the health and nutritional status of adults and children. During one part of the survey, 2,100 participants ages 12 to 19 were asked to list everything that they had eaten and drunk in the 24 hours before having a physical exam. Based on their answers, the researchers calculated how many grams of fiber and saturated (“bad”) fat and how many milligrams of cholesterol the youngsters had eaten per 1,000 calories. Then, during the physicals, their cardiac risk factors were assessed.

The results: Compared with those who consumed the most fiber, those who consumed the least fiber were three times more likely to have what’s called metabolic syndrome, which means having at least three of these cardiovascular risk factors — excess abdominal fat… high blood pressure… elevated blood sugar… high amount of triglycerides (blood fats)… and low HDL (“good”) cholesterol. What was even more interesting: Eating less of what we all tend to think of as “bad” foods filled with saturated fat and cholesterol was not associated with a lower risk for metabolic syndrome.

Wait a minute… does that mean that you can throw as much cheese on your omelet as you want — as long as you eat it with whole-grain toast? Unfortunately, no, said Dr. Carlson. Consuming saturated fats and cholesterol can raise your LDL “bad” cholesterol, increase inflammation and hurt your circulation. But these were not components used to evaluate metabolic syndrome in this study. In other words, this research did not show that overdoing saturated fat and cholesterol hurts your cardiovascular health — but we already know that it can. What the study did show, however, is that consuming foods rich in fiber is very powerful for maintaining heart health.

WHY FIBER IS A DIET “MUST”

There are many reasons that adding fiber to your meals may lead to better heart health, Dr. Carlson noted. For one thing, he said, it’s very filling — when you eat more of it, you tend to eat less overall, so you are less likely to be overweight. High-fiber diets, he continued, may also improve glycemic response (the effect of food on blood sugar) and dyslipidemia (an abnormal concentration of cholesterol or triglycerides in the blood). Minerals that may reduce the risk for metabolic syndrome, such as potassium and magnesium, are plentiful in a fiber-rich, plant-based diet, he said. And plant-based foods tend to be high in antioxidants, which may offset oxidative stress and inflammation that are elevated in people with metabolic syndrome.

I know it isn’t news to you that fiber is good for you — but really, before reading this, did you appreciate just how important fiber is? Dr. Carlson told me that Americans’ average fiber intake is less than 15 grams a day, well below the recommendation of 25 grams and 37 grams for females and males, respectively. But this goal can be reached by choosing a variety of fiber-rich foods daily, including fruits, vegetables, whole grains, beans, nuts and seeds. Remember, as a bonus, high-fiber foods fill you up, making you less likely to reach for fatty foods — a win-win for your heart.

Source:
Joseph Carlson, PhD, RD, associate professor and director, division of sports and cardiovascular nutrition, College of Osteopathic Medicine, Michigan State University, East Lansing.

by Carole Jackson Bottom Line Health

Want to find out if a doctor is any good?

Sure, you can Google his/her name to find out where he trained or what medical awards he has won…or ask friends and relatives for their opinions.

But what about asking if he excelled at playing a team sport in his younger years?

It may seem like a strange question, but a recent study suggests that it’s not, well, completely out of left field.

Researchers in the department of otolaryngology–head and neck surgery at Washington University School of Medicine in St. Louis found that prior excellence in a team sport was a better predictor of overall performance as a doctor in their residency program than the more standard criteria of medical school grades, standardized test scores and letters of recommendation.

SPORTS TRUMP SCORES

Who would have thought that joining, say, a soccer team would boost medical skills more than cramming for an exam?

For the study, researchers asked faculty members to rate 46 recent graduates of the residency program with regard to their overall quality as clinicians. The faculty members rated the graduates using a five-point scale, with 1 meaning “should not have graduated” and 5 meaning “outstanding—I would choose him/her as my doctor.”

The researchers then reviewed each graduate’s residency application, looking at factors such as medical school grades, standardized test scores and letters of recommendation, which all are standard criteria used to judge an applicant’s likelihood of success in a residency program.

They also sent the graduates a simple questionnaire regarding their pre-residency experience in both athletics and music.

Questions included…

• Do you have established excellence in a team sport? (The researchers made judgment calls in terms of what was considered a “team sport.” If the individual was on a track team, for example, being on a relay team would count, but throwing a javelin would not. The person had to have worked with others in order to win. )
• Do you have established excellence in an orchestra, band or choir?

Results: Researchers found that there was no correlation between medical school grades, standardized test scores or letters of recommendation and the faculty assessments of who ended up being a good doctor. However, there was a significant correlation between achievement in a team sport and a graduate’s faculty rating. (There was a slight correlation between achievement in music and faculty ratings, but it wasn’t statistically significant.)

To learn more about the study and its findings, I spoke to lead author Richard A. Chole, MD, PhD.

One limitation to the study worth noting is that the particular residency program that was studied is highly competitive. In other words, all the doctors were extremely bright, so there wasn’t an extremely wide range of grades or test scores. “In a residency program where there’s a greater spectrum of grades and test scores, the correlation may not be as strong,” said Dr. Chole. Nevertheless, the findings point to a very intriguing link.

MEDICINE IS A TEAM SPORT

The study shows that there’s a lot more to being a good doctor than being an “A” student, Dr. Chole told me. “What our findings illustrate is that the best doctors tend to be the ones who are good at participating with their colleagues as part of a team, and playing a team sport is great preparation for that,” he said.

So instead of asking our doctors for their diplomas, perhaps we should be asking them for their high school and college yearbooks, so we can see whether they were on basketball, baseball, football, soccer, lacrosse or other sports teams!

Source: Richard A. Chole, MD, PhD, chairman of the department of otolaryngology-head and neck surgery at Washington University School of Medicine in St. Louis. The study was published in Archives of Otolaryngology-Head & Neck Surgery.

by Carole Jackson Bottom Line Health

According to the latest statistics on the topic, there’s a good chance that you’ve been seeing a specialist for primary care problems.

For example, maybe you’ve been seeing your ear, nose and throat physician any time that you get a sore throat.

Or you might be the kind of person who goes to an orthopedist every time your back hurts.

But let me ask you this—is that what’s best for your health?

A new study reports that it probably isn’t.

WE’RE SEEING THE WRONG DOCTORS

Just how often are we Americans seeing specialists for primary care?

The study reports that over 40% of doctor visits for primary care in the US occur in the offices of specialists. These include both preventive exams and appointments that deal with common symptoms and diseases, such as fever, nasal congestion, anemia and asthma. The research found that all kinds of specialists were treating primary care problems, such as ob/gyns, cardiologists, gastroenterologists and nephrologists.

While the study didn’t delve into why patients were taking primary care concerns to specialists, lead researcher Minal S. Kale, MD, said that one reason may be the growing shortage of primary care doctors.

The number of medical students choosing to go into primary care started falling in the late 1990s. Based on a supply-and-demand analysis done by the Association of American Medical Colleges, in 2010, there were 9,000 fewer primary care doctors than were needed nationwide. And the association predicts that this shortage will grow to 65,800 by 2025—assuming that the Patient Protection and Affordable Care Act (aka “Obamacare”) is fully implemented so that formerly uninsured people can begin seeking medical care. The doctor shortage is worst in rural areas, said Dr. Kale.

Another reason patients go to specialists for routine care—patients may believe that specialists are better qualified to treat them. But past research shows that the opposite is actually true.

DOCTORING “THE WHOLE YOU”

Dr. Kale acknowledged that there are certain situations in which it is appropriate to see a specialist. For example, a person in the midst of chemotherapy should certainly see his oncologist, rather than his primary care physician, if he develops a rash…and a person with chronic heart failure should see his cardiologist if he develops chest congestion. But these are symptoms that almost everyone else should discuss with a primary care physician.

“Primary care physicians usually have long-standing relationships with patients, so they tend to have a full understanding of the totality of their medical conditions,” Dr. Kale said. A specialist might look at a patient with a specialist’s eye—in other words, a gastroenterologist may be specifically on the lookout for stomach and intestinal problems if a patient comes in with abdominal pain. He or she might be alert to common causes such as indigestion, constipation, food poisoning, ulcers, gallstones or kidney stones. But a gastroenterologist might not notice that the problem is stemming from another part of the body entirely, such as from a migraine headache or psychological stress. Since primary care doctors deliver preventive health care and treat lots of different conditions on a routine basis, they have more expertise in treating the whole you.

And there’s science that supports Dr. Kale’s point. Other national research from the Primary Care Institute at University of Rochester School of Medicine and Dentistry in New York found that people who used primary care physicians, rather than specialists, as their regular source of health care were more likely to report fewer medical diagnoses and had a lower mortality rate, on average.

SAVE THE SPECIALIST FOR SPECIAL PROBLEMS

So if you’re scheduling your annual, preventive physical or if you’re planning to see a doctor about a common symptom, such as a nagging cough, the message is—call your primary care physician. If you don’t have one, take the time to find one—get suggestions from friends and family members and/or search your insurer’s Web site for in-network doctors. You can always see a specialist later if you need to—but you generally won’t!

Source: Minal Kale, MD, research associate, general internal medicine, The Mount Sinai Hospital, New York City. She is coauthor of a research letter published in Archives of Internal Medicine.