- Dermatologists Accept Millions from Pharmaceutical Companies: Study
- Exercise May Lower Risk of UTIs and Other Infections
- You Asked: What High-Fat Foods Should I Be Eating?
- Exclusive: 4 Breakthrough Uterus Transplants Performed in the U.S.
- There’s Even More Evidence That Fitness Trackers Don’t Work
Posted: 05 Oct 2016 08:35 AM PDT
Dermatologists received more than $34 million from industry in 2014, and most of that money came from pharmaceutical companies, according to a new study published in JAMA Dermatology.
Researchers in the study mined the Centers for Medicare and Medicaid Services Sunshine Act Open Payment database, which lists payments that dermatologists receive from companies making products that are reimbursed by a government-run health program. In 2014, the database’s first full year of financial data, 8,333 dermatologists received more than 208,000 payments. The top 10% of dermatologists received 90% of the total payments.
“At the center of all this is [the patient’s] concern about dishonesty and selfishness,” says says Dr. Hao Feng, the study’s first author and a dermatology resident at NYU Langone Medical Center.
Most of the payments were for food and beverage, but that’s not where the big money was spent. Speaker fees, consulting fees and payments for research represented 70% of the total money spent. The top 15 companies were all pharmaceutical manufacturers. Studies on other branches of medicine reveal that receiving industry payments and meals was linked to increased prescribing of brand-name medications, the authors write.
“Recently there has been an increased amount of scrutiny on industry and physician interaction and an increased emphasis on the disclosures of these interactions,” says Dr. Hao Feng, the study’s first author and a dermatology resident at NYU Langone Medical Center.
“Previous studies have shown that when a physician does consulting for a company, the patients may view these physicians as being a prominent leader in the industry,” Feng says. But it change their mind negatively, too—especially when it comes to food and beverage payments. Past research suggests that these types of industry ties can affect how a patient sees his or her doctor.
The payment amounts are likely even higher, since many devices and medications aren’t compensated through government programs and therefore wouldn’t be subject to disclosure. More research is needed to find out exactly how these payments are affecting patient care.
Posted: 05 Oct 2016 08:28 AM PDT
Anyone who’s had a urinary tract infection knows how annoying they can be. But here’s another prevention method you might want to add to your arsenal: exercise. New research suggests that regular physical activity, even at low levels, may be protective against bacterial infections—and the findings were especially promising when it came to UTIs.
The study, published in the journal Medicine and Science in Sports and Exercise, followed nearly 19,000 people in Denmark for one year. Previously, the participants had been asked to rank their leisure-time physical activity on a scale of 1 (“regular hard physical training and competitive sports several times per week”) to 4 (“reading, watching television, or other sedentary behaviors”). This divided them into three physical-activity groups—vigorous, moderate, and low—as well as a sedentary group. (Anyone who was sedentary because of a history of cancer, diabetes, heart disease, or lung disease was not included in the study.)
Over the course of the year, researchers from Aalborg University in Denmark used national pharmacy data to see which people filled prescriptions for antibiotics. About 22% of men and 34% of women were given at least one antibiotic—indicating that they’d been diagnosed with a bacterial infection—in that time.
Health.com: 7 Things Every Woman Should Know About UTIs
When they controlled for factors such as age, body mass index, smoking status, and alcohol consumption, the researchers found that people in the low physical-activity group were10% less likely to have had an infection than those in the sedentary group. Low physical activity was defined as strolling, riding a bicycle, light gardening, or other light physical activity for at least 4 hours a week.
The link was especially strong when they looked at people who’d had drugs prescribed specifically for UTIs. Volunteers in the low- and moderate-activity groups had a 21% and 32% lower risk, respectively, compared to sedentary people.
This could be an important finding, since more than half of women (and yes, some men) will get a UTI in their lifetime. In the United States, the illness—characterized by an intense need to urinate and a burning sensation while doing so—results in more than 8 million doctor’s visits each year.
The researchers also looked specifically at bacterial respiratory tract infections, such as sinusitis and pneumonia. Previous studies have suggested that exercise can protect against these types of illnesses, but no significant association was found in this analysis.
When the researchers applied their analysis to just the men in the study, they found that results were not statistically significant—possibly because the strongest association came from UTIs, of which men had far fewer. However, the findings did suggest a “J-shaped tendency,” the authors wrote, in which low and moderate levels of physical activity were associated with a decrease in antibiotic use (compared to sedentary behavior), but vigorous activity was associated with an increase.
These findings are similar to those of previous studies, done on athletes, that suggest that exhaustive, high-intensity exercise may actually lower immunity and increase the risk of viral infections. (In other words, it is possible to get too much of a good thing.)
The results for women didn’t show an increased risk for vigorous exercisers: All levels of physical activity appeared to lower the risk of infection compared to sedentary behavior, although adjusted results were only significant for the low-activity group.
Of course, the study couldn’t definitively prove that participants had these infections, based on antibiotic prescriptions alone—or that exercise habits played a direct role in their susceptibility for them. And the authors admit that one question about leisure-time exercise certainly doesn’t tell the whole story.
But their findings do show a “significant protective effect” of low physical activity on the risk of suspected bacterial infection, they wrote, and of low and moderate activity on the risk of UTIs specifically. “These results indicate that practitioners should be aware of physical activity as a potential preventive factor for bacterial infections in the work of disease prevention and health promotion,” they concluded.
Posted: 05 Oct 2016 05:00 AM PDT
By now you’ve probably gotten the message: dietary fat is not the enemy. When you reach for low-fat salad dressing or fat-free snack foods, you’re not doing your health or waistline any favors. “We’ve focused on fat reduction for 40 years, and it’s sent us in exactly the wrong direction in terms of obesity and diabetes,” says Dr. David Ludwig, a professor of nutrition at Harvard School of Public Health.
So which high-fat foods should be packing your plate? Start with nuts and vegetable oils, says Dr. Lydia Bazzano, a professor of nutrition at Tulane University.
Bazzano has coauthored several studies that found ditching carbs—rather than fat—is a healthier way to control appetite, lose weight and improve risk factors for heart disease. She says there’s still not a ton of good research looking at the health impacts of specific fat-rich foods.
But thanks to the PREDIMED study, which examined the impact of a Mediterranean diet on heart disease risks, nuts like walnuts and almonds and vegetable oils like extra virgin olive oil and sunflower oil are now well-established health champs. The monounsaturated fats in these foods appear to lower levels of bad cholesterol, which may explain their health benefits, Bazzano says.
Add fish and seeds to your shopping list, says Fumiaki Imamura, a nutritional epidemiologist at the University of Cambridge in the UK. Imamura’s research suggests the polyunsaturated fatty acids in these two food groups are protective against oxidative stress and unhealthy blood sugar adaptations, and therefore may lower your risk for diabetes—among other diseases.
All the foods mentioned above are great. But don’t get too caught up in all the talk about monounsaturated or polyunsaturated fatty acids, warns Dr. Dariush Mozaffarian, chair of nutrition at Tufts University’s Friedman School of Nutrition Science and Policy. “It’s about all the other nutrients and compounds a food source contains, not just its fatty acids,” he says.
The health benefits associated with olive oil, for example, may have a lot to do with the olive skin’s healthful bioactive compounds, not just its monounsaturated fat content, Mozaffarian explains. Also, some of the health perks linked to cheese or Greek yogurt may have more to do with the healthy bacteria that come from the fermenting process, not each of these food’s levels of fat.
Speaking of cheese and yogurt, should we all be eating butter, milk and other dairy foods? The answer is murky. Mozaffarian says there’s some evidence—but nothing conclusive—that the medium-chain and branch-chain amino acids found in dairy fat may be good for you. “Things like butter are probably neutral,” he adds. “So probably not worth either emphasizing or avoiding in your diet.”
Ludwig agrees, saying there’s no “nutritional requirement” for dairy. But if you decide to eat dairy, “the existing epidemiological evidence suggests full-fat dairy is associated with healthier outcomes than low-fat dairy,” he says. (Keep this in mind the next time you’re ordering a “skinny” skim-milk latte.)
If you’re looking for the simplest rule of thumb, follow Mozaffarian’s golden rule: “Eat foods that give rise to life.” Nuts, nut butters, seeds, seed oils, olives, olive oil and avocados all fit the bill.
“It’s also crucial to point out that the benefits come from replacing carbs with healthy fats,” he adds. Think fewer crackers and bagels, and more olive oil-drenched salads sprinkled with seeds and nuts.
Posted: 05 Oct 2016 02:00 AM PDT
Four American women have received womb transplants from living donors at Baylor University Medical Center at Dallas, TIME learned exclusively. This is the first time living-donor womb transplants have been performed in the United States.
The four surgeries took place between Sept. 14 and Sept. 22, and three of the womb transplants were removed after tests determined the organs were not receiving normal blood flow. One woman still has her transplanted uterus and has shown no signs of rejection so far.
Uterus transplants with live donors have a precedent for success. In Sweden, where the surgery was pioneered, five of nine womb transplant recipients have given birth to healthy babies and one woman is pregnant for the second time.
Dr. Giuliano Testa, the lead surgeon and surgical chief of abdominal transplantation at Baylor, acknowledges that these results so far, while disappointing, still show tremendous progress. “If you look at this from the science [perspective], it’s something we’ve learned a lot from, and we have a patient who is doing well,” he says. “This is the beginning of hopefully a great history for medicine. ”
All four of the women have a condition called Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and were born without a uterus. About one in 4,500 women in the U.S. are estimated to have MRKH. Baylor plans to perform a total of 10 womb transplants before the end of 2016. “You cannot discount the desire of a woman to have a normal pregnancy, bear her own child, and deliver,” says Testa. “This is part of human nature.”
Baylor says the women received their transplants from so-called altruistic donors, meaning the donor women are not related to the recipients and do not know who they are. The women who received the transplants are between ages 20 to 35, and the donors are between ages of 35 to 60. Around 50 women volunteered to donate their womb. “I am totally amazed by that,” says Testa. “They told us, ‘We had our chance to become mothers, and now we have this uterus and it’s not doing anything for us. We can put this uterus to use for people who really need it.’ That struck me as a physician. These women are phenomenal.” Baylor has not identified any of the women.
The donors and the recipients declined to speak with TIME, requesting privacy.
This is the second time a hospital in the U.S. has attempted womb transplants. In February, the Cleveland Clinic performed the first uterus transplant in the U.S.; the organ was from a deceased donor. Less than two weeks after the transplant, the recipient, Lindsey McFarland, acquired an infection and the transplant had to be removed. The Cleveland Clinic then put its program on pause. You can read TIME’s interview with McFarland, here (for subscribers). Uterus transplants are estimated to cost from $150,000 to over $500,000, and since they are still experimental, they are not usually covered by insurance.
At Baylor, it took about five hours for the wombs to be removed from the donors, and another five to transplant. The surgical team included four Baylor University Medical Center surgeons, two Swedish surgeons with womb transplant experience, two anesthesiologists, and seven operating room nurses.
The two Swedish doctors are from Sahlgrenska University Hospital in Gothenburg and are part of the first surgical team in the world to perform successful womb transplants. “We have to collaborate with other teams around the world and share our knowledge,” says Dr. Liza Johannesson, one of the doctors from Sahlgrenska University Hospital who assisted Baylor with their surgeries. “If no one can repeat it, it’s not worth anything. We owe it to the patients to be open.” Johannesson says her team will continue to assist Baylor with further womb transplant procedures.
Baylor estimates it will take the women about three months to get back to normal daily activity. In six to 12 months, a woman with a successful uterus transplant can attempt in vitro fertilization (IVF). (Since the women’s ovaries are not connected to their wombs, IVF is required if she wants to get pregnant.) Because all organ transplants require recipients to take potent and sometimes toxic anti-rejection medication, typically, the uterus is removed after they’ve had two children.
The Baylor team is assessing the results from the first four surgeries before moving forward with the other six. “This is the way we advance,” says Testa. “I am not ashamed of being the one who will be remembered as the guy who did four [transplants] in the beginning and three failed. I am going to make this work. I believe from an ethical and clinical and research point of view, we have our heart in the right place.”
Posted: 04 Oct 2016 03:30 PM PDT
Fitness trackers are ubiquitous, on the wrists and in the Happy Meals of thousands of Americans. But the latest evidence suggests that they don’t do much to motivate people to move more.
Turns out, it’s really hard to persuade people to exercise—even when they have access to how many steps they’ve taken, and even when they get paid for it.
In the new yearlong study, published in The Lancet Diabetes & Endocrinology, researchers randomized 800 people in Singapore who had a full-time job into four groups. Some wore a Fitbit Zip and were paid a small amount of money to get moving—which they were instructed either to keep or to donate to charity—while others didn’t wear Fitbits. Researchers measured their physical activity, weight, blood pressure, the body’s ability to use oxygen (called cardiorespiratory fitness) and their self-reported quality of life.
For the last six months of the study, all incentives were dropped, and people could choose whether or not to continue wearing their fitness trackers. (About 40% of people had stopped wearing it in the first six months anyway.)
The cash seemed to work at first. Those who were rewarded with cash did an extra 13 minutes of moderate-to-vigorous physical activity each week and added 570 steps to their daily counts. Raising money for charity had no effect. But once the monetary rewards stopped, so did the improvements.
By the end of the study, just 10% of people were still wearing the trackers. And only the Fitbit group had improved from where they started, getting 16 extra minutes of moderate-to-vigorous physical activity per week.
That small boost didn’t translate into any differences in the health outcomes the researchers measured. In fact, no group improved on those measures at either six or 12 months.
This isn’t the first scientific blow to wearables; a study in September found that when people were put on a weight loss program and told to either wear a device or not, those who wore one lost less weight, not more. John Jakicic, the author of that study and a physical activity researcher at the University of Pittsburgh, was not involved in the new Lancet papers, but he says the findings gel with his own.
Simply spitting out your stats and comparing them to what you should be doing isn’t motivating, research is showing. “We found that just giving people a device doesn’t necessarily mean it’s going to result in something you think it’s going to result in,” Jakicic says. “These activity trackers really don’t engage people in strategies that really make a difference in terms of long-term lifestyle change.”
For trackers to work, the interface and the feedback people receive need to get more sophisticated and refined, he says.
Even when wearables do help improve physical activity—every little bit counts, and an extra 16 minutes a week isn’t nothing, after all—it often isn’t enough to get the health benefits of exercise. “You get an improvement in the activity, but the threshold’s just not there,” Jakicic says. “I’m sure that there are some health outcomes that will benefit from an additional 16 minutes per week, but obviously it’s something that they haven’t looked at.”
For his part, Jakicic thinks that fitness trackers have promise as a fitness intervention. He even wears one—but more to geek out over things like step intensity and heart rate than to motivate himself to exercise. “The vast majority of people who purchase these things probably are fitness people,” he says. “I think the challenge is, how do we build these for people who are not into it, to help them to become more active? This data suggests that we need to do more than just give them an activity tracker. “
|You are subscribed to email updates from Health – TIME. |
To stop receiving these emails, you may unsubscribe now.
|Email delivery powered by Google|
|Google Inc., 1600 Amphitheatre Parkway, Mountain View, CA 94043, United States|