Thursday, December 15, 2011

Regaining Weight After Losing It Might Harm Menopausal Women

According to a study recently published in the American Journal of Clinical Nutrition, older women who lose weight but do not maintain the loss might suffer some negative consequences in their overall health. The National Institute on Aging sponsored the investigation.

Investigators at Wake Forest Baptist Medical Center, demonstrated that within a year, some older women gain a considerable amount of weight back after losing it.

Barbara Nicklas, Ph.D., a gerontologist at the J. Paul Sticht Center on Aging and Rehabilitation at Wake Forest Baptist and lead researcher for the investigation, explained:

"The body composition of some of the women was worse than before their weight loss. When older women lose weight, they also lose lean mass. Most women will gain a lot of the weight back, but the majority of the weight regained is fat."

78 postmenopausal women were analyzed in the study, one year after losing 12% of their body weight by dieting in a completely separate studey. Participants averaged 58 years of age. The team recorded their body composition, including change in body weight, fat and muscle, immediately before and after initial weight loss, and then again 6 and 12 months later. During the first year after initial weight loss no weight loss intervention occurred.

Their was to find out if the composition of body weight regained following intentional weight loss is comparable to the composition of body weight lost.

At the six-month follow-up after the study ended, 53 of 78 (68%) of women regained some weight, while 52 of 68 (76%) of women regained some weight at the 12-month follow-up. 16 women (24%) continues to lose weight after the program, while 11 women (16%) weighed more than they did at baseline at the 12-month follow-up.

75% of women who regained weight gained over 4.4 pounds at the 6-month follow-up. At 12-month follow-up this number increased to 84%. The researchers examined whether lost lean mass from intentional weight loss was recovered in women who regained more weight.

The team discovered that the fat mass in these women was rising to a higher level than was lean mass during the post-intervention period.

During the diet program, 67% of weight loss was fat while 33% was muscle. 81% of the entire weight regained during 12 months of follow up was fat, while 19% was muscle. On average, 26% of fat lost was regained by 12-months after the diet program, while only 6% of muscle lost was gained back.

Nicklas explains:

"Most people will regain their weight after they lose it. Young people tend to regain weight in the proportion that they lost it. But the older women in our study did not appear to be regaining the muscle they lost during initial weight loss in the same way."

Although researchers are unsure what the long term effects of losing muscle mass in middle age and older women are, combined with loss of bone density which is known to occur as individuals age, the loss of muscle may increase their risk of falling, as well as other things.

Nicklas said:

"There are certainly a lot of health benefits to weight loss, if you can keep the weight off. For older women who lose weight, however, it is particularly important that they keep the weight off and continue to eat protein and stay physically active so that, if the weight does come back, it will be regained as muscle instead of fat."

Nicklas warns that study results were restricted to sedentary, abdominally obese, postmenopausal women, and the among younger populations or men the discoveries may differ. "Future studies of weight cycling are needed to determine its effects on muscle strength, quality, and function and body composition in older adults after all weight lost is regained", she said.

The investigators explain:

"Many health complications associated with overweight and obesity are improved with weight loss. However, negative consequences (such as loss of muscle mass and bone density) are also associated with weight loss and are detrimental for older adults, which results in a reluctance to recommend international weight loss in this population. Because lean mass loss in older adults may be associated with the development of adverse health events and disability, it is important to examine whether the benefits of weight loss outweigh the risks in this population."

Written by Grace Rattue

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Starch Intake May Influence Risk For Breast Cancer Recurrence

Researchers have linked increased starch intake to a greater risk for breast cancer recurrence, according to results presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011.

"The results show that it's not just overall carbohydrates, but particularly starch," said Jennifer A. Emond, M.S., a public health doctoral student at the University of California, San Diego. "Women who increased their starch intake over one year were at a much likelier risk for recurring."

Researchers conducted a subset analysis of 2,651 women who participated in the Women's Healthy Eating and Living (WHEL) Dietary Intervention Trial, a plant-based intervention trial that enrolled about 3,088 survivors of breast cancer. WHEL researchers studied breast cancer recurrence and followed the participants for an average of seven years.

The subset analysis involved an examination of how changes in carbohydrate intake influenced breast cancer recurrence. "The WHEL dietary trial, even though it focused on fruits and vegetables, fiber and fat, didn't really have a specific carbohydrate goal," Emond said.

She and her colleagues obtained carbohydrate intake information from multiple 24-hour dietary recalls at baseline and at one year. In an annual phone interview, participants reported everything they had eaten during the last 24 hours.

At baseline, carbohydrate intake was 233 grams per day. Results showed that women whose cancer recurred had a mean increase in carbohydrate intake of 2.3 grams per day during the first year, while women whose cancer did not recur reported a mean decrease of 2.7 grams per day during the first year.

Starches were particularly important, Emond said. Changes in starch intake accounted for 48 percent of the change in carbohydrate intake. Mean change in starch intake during the first year was 0.1 grams per day among women whose cancer recurred vs. 0.7 grams per day among women whose cancer did not recur.

When change in starch intake during one year was grouped into quartiles of change, the rate of an additional breast cancer event was 9.7 percent among women who decreased their starch intake the most during one year, compared with an event rate of 14.2 percent among women who increased their starch intake the most during one year.

The change in starch intake was "independent of dietary changes that happened in the intervention arm," Emond said. "It is independent of more global changes in diet quality."

After stratifying patients by tumor grade, Emond and colleagues found that the increased risk was limited to women with lower-grade tumors.

These results indicate a need for more research on dietary recommendations that consider limited starch intake among women with breast cancer.

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Stop-Start Low-Carb Diets More Effective Than Standard Dieting

Recent findings presented by researchers at Genesis Prevention Center at University Hospital in South Manchester, England, at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, have demonstrated that an intermittent, low-carbohydrate diet is preferable to a standard and daily calorie-restricted diet to reduce weight and lower blood levels of insulin. High levels of insulin are linked to a greater risk of developing cancer.

The study, funded by the Genesis Breast Cancer Prevention Appeal, revealed that reducing carbohydrates for two days per week is superior for preventing breast cancer and other diseases compared with a standard, daily calorie-restricted diet, but researchers added that further study is required.

Michelle Harvie, Ph.D., SRD, a research dietician at the Genesis Prevention Center, who presented the study said:

"Weight loss and reduced insulin levels are required for breast cancer prevention, but [these levels] are difficult to achieve and maintain with conventional dietary approaches."

Harvie and her team decided to compare three different diets over 4-months to assess the effects on weight loss and blood markers of breast cancer risk in 115 women who had a family history of breast cancer. The researchers randomly assigned patients with either a calorie-restricted, low-carbohydrate diet or an "ad lib" low-carbohydrate diet whereby patients were allowed to consume unlimited proteins and healthy fats, like lean meats, olives and nuts for 2 days per week, or a standard, calorie-restricted daily Mediterranean diet for seven days per week.

According to their findings, both intermittent low-carbohydrate diets were superior to the standard daily Mediterranean diet for weight loss, reduction of body fat and insulin resistance. The average loss in weight and body fat was about 4 kg (about 9 pounds) for the calorie-restricted, low-carb diet and the "ad lib" low-carb diet compared to 2.4 kilograms (about 5 pounds) with the standard dietary approach. The restricted low-carbohydrate diet reduced patients' insulin resistance by 22%, with a reduction of 14% with the "ad lib" low-carbohydrate diet, compared with 4% for those who did the standard Mediterranean diet.

Harvie commented:

"It is interesting that the diet that only restricts carbohydrates but allows protein and fats is as effective as the calorie-restricted, low-carbohydrate diet."

Harvie and her team are planning on studying carbohydrate intake and breast cancer.

Written by: Grace Rattue

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Caffeine Study Shows Sport Performance Increase

Caffeine combined with carbohydrate could be used to help athletes perform better on the field, according to new research by a sport nutrition expert.

Mayur Ranchordas, a senior lecturer and performance nutritionist at Sheffield Hallam University, carried out studies on footballers using caffeine and carbohydrates combined in a drink. Along with improvements in endurance caused by ingesting carbohydrate, the athletes' skill level improved after taking caffeine and carbohydrate together.

Mayur said: "There is already plenty of research that shows that caffeine and carbohydrate improve endurance, but this study shows that there is also a positive effect on skill and performance.

"We carried out three different soccer-specific match simulations of 90 minutes each two 45 minute sessions that tested agility, dribbling, heading and kicking accuracy. The test was designed to mimic a football game where the participants had to carry out multiple repeated sprints, dribble the ball around cones and shoot accurately.

"We found that the combination of carbohydrate and caffeine allowed players to sustain higher work intensity for the sprints, as well as improving shooting accuracy and dribbling during simulated soccer activity.

"These findings suggest that, for athletes competing in team sports where endurance and skill are important factors, ingesting a carbohydrate and caffeine drink, as opposed to just a carbohydrate drink, may significantly enhance performance. Our findings suggest that soccer players should choose a carbohydrate caffeine drink over a carbohydrate drink to consume before kick off and at half-time."

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Saturday, December 10, 2011

Vitamin D & Incontinence

Vitamin D deficiency is higher among certain demographic segments, including women, the elderly, and the obese. All three groups also share an increased risk of pelvic floor problems, including urinary incontinence. Could there be a connection? Perhaps so, according to recent research.

A study published in Obstetrics & Gynecology compared vitamin D levels with incidence of various forms of pelvic floor disorder among 1,881 women, average age 48. Those with low levels of vitamin D (characterized as less than 30 nanograms per milliliter, or ng/ml) had a 170% increased risk of urinary incontinence, compared to those with higher blood levels. Why might this be? As a hormone, vitamin D supports a myriad of bodily functions, including maintenance of muscle and bone. As a result, deficiency could undermine the muscular infrastructure of the pelvis needed for urinary control.

Related research suggests that losing weight could result in as much as a 47% decrease in episodes of incontinence, perhaps by reducing the pressure that excess adipose tissue places on the pelvis -- and by increasing levels of vitamin D: Maintaining levels of vitamin D may lower your risk of other ailments, including fractures, tooth loss, depression, chronic pain, and even certain cancers. Winter's shorter, colder days make it harder to get enough vitamin D from the sun -- but our Portobello Mushroom Powder provides a whole food, vegan, natural alternative, with 150% of your vitamin D needs in each teaspoon.

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Thursday, December 8, 2011

HCG Diet Products Illegal, FDA Warns Seven Companies

It is illegal to sell unapproved diet products that make unsupported claims, the FDA (Food and Drug Administration) has warned seven companies which are selling "homeopathic HCG weight-loss drugs.

The marketers of these products tell users to follow an extremely restricted and potentially dangerous diet. The FDA is advising consumers not to use the illegal HCG weight-loss products because of the potential danger there might be in following these diets. If they have not been tested scientifically in clinical trials, it is impossible to know how safe and effective they are.

The weight-loss drugs claim to contain HCG - human chorionic gonadotropin - a hormone. They can be bought on the internet and at some retail outlets in the form of sprays, pellets or oral drops.

The following companies have received warning letters:
  • HCG Diet Direct, LLC
    Product name - HCG Diet Homeopathic Drops
  • HCG 1234 LLC (The hCG Drops LLC)
    Product name - Homeopathic HCG
  • HCG Platinum, LLC
    Product names - HCG Platinum, HCG Platinum X-30, HCG Platinum X-14
    Product name - HCG Extra Weight Loss Homeoapthic Drops
  • Natural Medical Supply, LLC DBA HCG Complete Diet
    Product name - HCG Extra Weight Loss Homeoapthic Drops
  • Nutri Fusion Systems, Inc
    Product names - HCG Fusion 30, HCG Fusion 43
    Product name - Homeopathic Original HCG, Homeoapthic HCG
The FDA says HCG Diet Products Are Illegal

What is HCG?

HCG stands for human chorionic gonadotropin. It is a hormone that the human placenta produces and can be detected in the urine of pregnant females.

HCG has been approved for usage in some cases of female infertility and male hormone treatment.

Approved HCG products are only available through a doctor's prescription, and in injection form.

There are no FDA-approved HCG products for weight-loss treatment on the market.

Why is the FDA concerned?

For a start, there are no FDA-approved drugs containing HCG for the treatment of weight loss. HCG has not been scientifically demonstrated to be effective and safe in obesity treatment. There is no compelling evidence that HCG accelerates weight loss.

The "homeopathic" HCG products tell purchasers to follow a very low calorie diet (VLCD). A VLCD should only be undertaken when supervised by a properly qualified medical professional. VLCD, if not done under proper supervision, raises the risk of developing gallstones, electrolyte imbalance and irregular heartbeats.

Written by Christian Nordqvist

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Women On Rotating Night-Shifts At Increased Risk Of Type 2 Diabetes, Weight Gain

In women, there is a positive association between rotating night shift work and the risk of developing type 2 diabetes and, furthermore, long duration of shift work may be associated with greater weight gain. These findings from a study by Frank Hu and colleagues from Harvard School of Public Health in Boston, USA, published in this week's PLoS Medicine, are of potential public health significance as a large proportion of the working population is involved in some kind of permanent night and rotating night shift work.

The authors used data from the Nurses' Health Study I (NHS I - established in 1976, and which included 121704 women) and the Nurses' Health Study II (NHS II - established in 1989, and which included 116677 women), and found that in NHS I, 6,165 women developed type 2 diabetes and in NHS II 3,961 women developed type 2 diabetes. Using statistical models, the authors found that the duration of rotating night shift work was strongly associated with an increased risk of type 2 diabetes in both cohorts and that the risks of women developing type 2 diabetes, increased with the numbers of years working rotating shifts. However, these associations were slightly weaker after the authors took other factors into consideration.

Although these findings need to be confirmed in men and other ethnic groups, these findings show that additional preventative strategies in rotating night shift workers should therefore be considered.

The authors say: "Recognizing that rotating night shift workers are at a higher risk of type 2 diabetes should prompt additional research into preventive strategies in this group."

In an accompanying Perspective article, Mika Kivimäki from University College London, David Batty from the University of Edinburgh, and Christer Hublin from the Finnish Institute of Occupational Health in Helsinki, Finland (uninvolved in the research study) say: "We are increasingly residing in a '24/7' society, thus the option to eradicate shift working is not realistic. If the observed association between rotating shift work and [type 2 diabetes] is causal, as it may be, additional efforts to prevent [type 2 diabetes] among shift workers through promotion of healthy life styles, weight control and early identification and treatment of prediabetic and diabetic employees are needed."

These authors continue: "Some modifications to shift work itself might also be feasible. Rotating shift work comprises a range of alternative schedule patterns, such as backward- and forward-rotating shift systems, and the proportion of night and early morning shifts varies. Future studies should address these variations and identify patterns that minimize [type 2 diabetes] risk, ideally through large-scale randomized trials that would provide insights into causality."

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Wednesday, December 7, 2011

Endurance Exercise Linked To Right Ventricle Of The Heart Damage Risk

According to a study published online today in the European Heart Journal, investigators have discovered initial evidence that some athletes who participate in extreme endurance exercises, such as endurance triathlons, alpine cycling, ultra triathlons or marathons might damage the right ventricles of their hearts - 1 of the 4 chambers in the heart that helps pump blood around the body.

The study discovered that even though the damage in the majority of the 40 athletes examined in the investigation was reversed within a week of a competitive event, magnetic resonance imaging (MRI) showed more permanent damage - scarring of the heart muscle (fibrosis) in 13% (5 athletes). The 5 athletes who developed fibrosis competed in endurance sports for longer periods than those who did not show fibrosis.

Dr André La Gerche, a postdoctoral research fellow at St Vincent's Hospital, University of Melbourne, Australia, who at present, is based at the University Hospitals Leuven, Belgium, explained:

"It is most important that our findings are not over-extrapolated to infer that endurance exercise is unhealthy. Our data do not support this premise."

Although, André explained that the discoveries did indicate that there may be a few athletes who might have been born with a susceptibility damage as a result of long-term endurance exercise.

André, stated:

"Virtually all of the changes in the athletes' hearts had resolved one week after having taken part in a competitive event. In most athletes, a combination of sensible training and adequate recovery should cause an improvement in heart muscle function; that is, the heart rebuilds in a manner such that it is more capable of sustaining a similar exercise stimulus in the future. This positive training response can be over months rather than weeks.

The question from our research is whether there are some athletes in whom extreme exercise may cause injury from which the heart does not recover completely. If this occurs, affected athletes may be at risk of reduced performance - a cardiac "over-training" syndrome - of it may cause arrhythmias. If this occurs, it is likely to affect only a minority of athletes, particularly those in whom more intense training fails to result in further improvements in their performance."

Dr La Gerche and his colleagues in Australia and Belgium enrolled 40 elite athletes in Australia to participate in the study. The athletes were planning to compete in 1 of the 4 endurance events. The participants had no known heart problems, were already well trained (training intensely for over 10 hours per week), and performing well (finishing within the first 25% of the field in a recent event).

The athletes were examined using MRI, echocardiography, and had blood samples taken at three intervals; the first 2-3 weeks before the race, the second within one hour of completing the race, and the third 6-11 days after the race.
Results demonstrated that within 1 hour of completing the race the athletes' hearts had changed shape, volume increased, while the function of the ventricle decreased. Levels of a chemical called B-type natriuretic peptide (BNP) increased. BNP is secreted by the ventricles in response to over-stretched heart muscle cells. Although after one week, right ventricle function recovered in the majority of the athletes, MRI detected signs of fibrosis in 5 athletes who had been training and competing for longer than the other participants. Furthermore, they discovered that post-race changes to the function of the right ventricle increased with the duration of the race.

Results revealed that the left ventricle, which, to date has been examined the most in athletes, showed no alterations. Dr La Gerche, explained:

"Our study identifies the right ventricle as being most susceptible to exercise-induced injury and suggests that the right ventricle should be a focus of attention as we try to determine the clinical significance of these results. Large, prospective, multi-centre trials are required to elucidate whether extreme exercise may promote arrhythmias in some athletes. To draw an analogy, some tennis players develop tennis elbow. This does not mean that tennis is bad for you; rather it identifies an area of susceptibility on which to focus treatment and preventative measures."

Dr. La Gerche, concluded:

"It is important to note that this is one component of an evolving understanding of how the right ventricle is the "Achilles heel" of heart function during exercise. We previously studied heart function during intense exercise and demonstrated that the load on the right ventricle (stress, work and oxygen demand) increases to a greater extent than in any of the other heart chambers.

Professor Hein Heidbuchel, who I work with, has shown that the source of ventricle arrhythmias in affected athletes is almost always the right ventricle. Finally, it has been shown that intense exercise in rates causes inflammation, fibrosis and arrhythmias in the right but not the left ventricle. Hence, there are consistent messages, all implicating the right ventricle and yet it has been neglected in the vast majority of studies regarding cardiac changes in athletes. Now there is sufficient evidence to invest in the long-term prospective studies that are required."

In an associated report, Professor Sanjay Sharma, of St George's University London (UK), medical director of the London Marathon, explains that even though the investigation is small, "the results provide food for thought and the data should be embraced to galvanize more detailed and longitudinal assessment of large groups of endurance athletes. The potential for such projects is enormous considering the colossal increase in participation rates in endurance events such as the marathon. The long-term conclusions of the authors may appear preposterous to some, but could prove to be the retrospective 'elephant in the room'.

In a comment for this press release, Prof. Sharma, explained:

"My personal feeling is that extreme endurance exercise probably does cause damage to the heart in some athletes. I don't believe that the human body is designed to exercise at full stretch for as long as 11 hours a day, so damage to the heart is not implausible. It is too early to say that taking part in endurance sports causes long-term damage to the right ventricle, but this study is an indication that it might cause a problem in some endurance athletes with a predisposition and, therefore, it should be studied further."

Written by Grace Rattue .

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Some Children's Cereals Have More Sugar Than Twinkies And Cookies

Parents wishing to give their kids a good start to the day have good reason to be concerned about the amount of sugar in children's breakfast cereals, says the Environmental Working Group (EWG), in its recent review of 84 popular brands sold in the United States. According to EWG's analysis, the worst offender is Kellogg's Honey Smacks, which comprises nearly 56% sugar by weight; in fact, a one-cup serving of this cereal contains 20 grams of sugar, which is more than you will find in a Hostess Twinkie snack cake. And one cup of any of another 44 cereals, including the popular Cap'n Crunch and Honey Nut Cheerios, contains more sugar than three Chips Ahoy! cookies, or about three teaspoons.

EWG's Senior Vice President of Research, Jane Houlihan, said:

"As a mom of two, I was stunned to discover just how much sugar comes in a box of children's cereal."

She said the bottom line message of the EWG report is "most parents would never serve dessert for breakfast, but many children's cereals have just as much sugar, or more".

Based on percentage sugar by weight, the EWG analysis finds that the 10 worst children's cereals are:
  1. Kellogg's Honey Smacks (55.6% sugar by weight).
  2. Post Golden Crisp (51.9%)
  3. Kellogg's Froot Loops Marshmallow (48.3%)
  4. Quaker Oats Cap'n Crunch's OOPS! All Berries (46.9%)
  5. Quaker Oats Cap'n Crunch Original (44.4%)
  6. Quaker Oats Oh!s (44.4%)
  7. Kellogg's Smorz (43.3%)
  8. Kellogg's Apple Jacks (42.9%)
  9. Quaker Oats Cap'n Crunch's Crunch Berries (42.3%)
  10. Kellogg's Froot Loops Original (41.4%)
Only one in four of the cereals the EWG reviewed meets the government's recommended guideline of no more than 26% added sugar by weight. The guideline comes from the federal Interagency Working Group on Food Marketed to Children, which proposed standards to Congress to curb marketing of children's food with too much sugar, salt and fat as a response to the growing obesity crisis.

The EWG wants the guideline, which is unenforceable, it is up to cereal producers to take it up voluntarily, to be even tighter than 26%.

NYU nutrition professor Marion Nestle said cereal companies spend a fortune convincing parents that kids should have cereal for breakfast, and that sugary cereals are fun, and all kids like them. It is an interesting fact that the cereals at the top of the EWG highest-sugar list also happen to make the most profit for their producers, who invest upwards of £20 million a year in advertising those brands.

"No public health agency has anywhere near the education budget equivalent to that spent on a single cereal. Kids should not be eating sugar for breakfast. They should be eating real food," said Nestle.

Health expert Dr Andrew Weil remembers when he went to medical school in the 60s, the view was that sugar was a fairly harmless food item that gave "empty calories" but no vitamins or minerals or fiber.

"But 50 years of nutrition research has confirmed that sugar is actually the single most health-destructive component of the standard American diet. The fact that a children's breakfast cereal is 56% sugar by weight - and many others are not far behind - should cause national outrage," said Weil.

Research shows that compared to kids who eat breakfast with less sugar, kids who eat high sugar breakfasts have a harder time at school: they experience higher levels of frustration and find it more difficult to work independently. Also, by lunchtime, they are hungrier, have less energy, find it harder to pay attention and concentrate, and they make more mistakes.

Add to this the fact that the rate of childhood obesity has tripled in the US in the last three decades, to the point where now, according to the Centers for Disease Control and Prevention, one in five children is obese, and rates of type 2 diabetes in children are also rising rapidly, and we may well be facing the unprecedented scenario that the children of today will have a shorter lifespan that their parents.

If you want to buy cereal for your children, but are not sure how to choose the right one, then you would do well to pay more attention to the back of the packet than the front. Nestle recommends that you look for:
  • Cereals with a short ingredient list (added vitamins and minerals are okay),
  • Cereals high in fiber, and
  • Cereals with little or no added sugars. Added sugar includes: honey, molasses, fruit juice concentrate, brown sugar, corn sweetener, sucrose, lactose, glucose, high-fructose corn syrup and malt syrup.
Nestle says that one of the best and easy breakfasts you can make for your children is fresh fruit with high-fiber, lower-sugar cereal. For an even more nutritious breakfast, take out the cereal and put in homemade oatmeal.

Click here to download a PDF of the full EWG report: "Sugar in Children's Cereals".

Written by Catharine Paddock PhD

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Physical Fitness More Important Than Body Weight In Reducing Death Risks

If you maintain or improve your fitness level -- even if your body weight has not changed or increased -- you can reduce your risk of death, according to research reported in Circulation: Journal of the American Heart Association.

In a study of 14,345 adult men, mostly white and middle or upper class, researchers found that:
  • Maintaining or improving fitness was associated with a lower death risk even after controlling for Body Mass Index (BMI) change.
  • Every unit of increased fitness (measured as MET, metabolic equivalent of task) over six years was associated with a 19 percent lower risk of heart disease and stroke-related deaths and a 15 percent lower risk of death from any cause.
  • Becoming less fit was linked to higher death risk, regardless of BMI changes.
  • BMI change was not associated with death risks.
BMI is a measurement based on weight and height (kg/m2). MET measures the intensity of aerobic exercise - specifically, the ratio of metabolic rate during a specific physical activity to a reference rate of metabolic rate at rest.

"This is good news for people who are physically active but can't seem to lose weight," said Duck-chul Lee, Ph.D., the study's lead researcher and physical activity epidemiologist in the Department of Exercise Science at the University of South Carolina's Arnold School of Public Health in Columbia. "You can worry less about your weight as long as you continue to maintain or increase your fitness levels."

Results of the study underscore the importance of physical inactivity as a risk factor for death from heart disease and stroke, said researchers. Researchers also found no association between changes in body fat percentage or body weight and death risk.

Participants, who were an average 44 years old, were part of the long-term, large-scale Aerobics Center Longitudinal Study. They underwent at least two comprehensive medical exams.

Researchers used maximal treadmill tests to estimate physical fitness (maximal METs), and height and weight measurements to calculate BMI. They recorded changes in BMI and physical fitness over six years. After more than 11 years of follow-up, researchers determined the relative risks of dying among men who lost, maintained or gained fitness over six years. They accounted for other factors that can affect outcomes, including BMI change, age, family history of heart disease, beginning fitness level, changes in lifestyle factors such as smoking and physical activity, and medical conditions such as high blood pressure or diabetes.

One possible explanation for these results: about 90 percent of the men were either normal weight or overweight at the beginning of the study. Among obese people, changes in BMI might have a significant effect on death risks. So it's unclear whether these results would apply to severely obese people, Lee said.

A BMI score under 25 is considered healthy, 25 to less than 30 is overweight, and 30 or greater is obese.

Because the study was mostly done in white middle and upper class men, it's difficult to know whether the results apply to other racial and socioeconomic groups. Women would likely have similar results as the men in the study, Lee said.

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Changes In Sleep-Wake Cycles And Level Of Daily Activity Can Increase Chances Of Dementia

Older women with weaker circadian rhythms, who are less physically active or are more active later in the day are more likely to develop dementia or mild cognitive impairment than women who have a more robust circadian rhythm or are more physically active earlier in the day. That's the finding of a new study in the latest issue of the Annals of Neurology.

"We've known for some time that circadian rhythms, what people often refer to as the "body clock", can have an impact on our brain and our ability to function normally," says Greg Tranah, PhD., a scientist at the California Pacific Medical Center Research Institute - part of the Sutter Health network - and the lead author of the study. "What our findings suggest is that future interventions such as increased physical activity or using light exposure interventions to influence circadian rhythms, could help influence cognitive outcomes in older women."

The researchers collected data on activity and circadian rhythm from 1,282 healthy women, all over the age of 75, who were taking part in the Study of Osteoporotic Fractures. All the women underwent a series of neuropsychological tests to ensure they had no evidence of cognitive or brain problems. At the end of five years 15 percent of the women had developed dementia and 24 percent had some form of mild cognitive impairment (MCI). Those women who had weaker circadian rhythm activity, lower levels of activity, or whose peak level of activity was later in the day, were at highest risk of developing dementia or MCI.

"This was not a small difference, but a rather sizable, statistically significant one," says Tranah. "Those who had the later wake times, whose activity was later in the day, were 80 percent more likely to develop MCI or dementia compared to women who had earlier wake times and earlier activity."

Circadian rhythms play an important role in the control of sleep-wake cycles and there is considerable evidence to show they also play a role in regulating certain brain functions, such as alertness, learning and memory. As people get older the activity level of those rhythms - how strong they are - often change, bringing with it changes in sleep patterns and levels of physical activity.

"To our knowledge this is the first study to show such a strong connection between circadian activity rhythm and the subsequent development of dementia or MCI," says Tranah. "The reasons why this is so are not yet clear. The changes in circadian rhythm may directly influence the onset of dementia or MCI, or the decrease in activity may be a consequence, a warning sign if you like, that changes are already taking place in the brain. Identifying what the reason is could help us develop therapies to delay, or slow down, the development of brain problems in the elderly."

In an accompanying commentary in the journal, Andrew Lim and Clifford Saper of the Department of Neurology at Harvard Medical School, say the study "represents a significant advance" in understanding the connection between circadian rhythm activity and dementia. "By showing that variations in rest-activity patterns precede the development of cognitive impairment and dementia, Tranah and colleagues have identified both a novel predictor of and a potential therapeutic target for incident cognitive deterioration and dementia."

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Diabetes And Obesity Increase Risk For Breast Cancer Development

Having diabetes or being obese after age 60 significantly increases the risk for developing breast cancer, a Swedish study has revealed. Data also showed that high blood lipids were less common in patients when diagnosed with breast cancer, while low blood lipids were associated with an increased risk.

Researchers of the study, reported at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011, also looked at overall cancer incidence and discovered that use of one diabetes drug was associated with a lower rate of any cancer, while another was associated with an increased risk.

Researchers evaluated health care data from a region of 1.5 million people living in Southwestern Sweden to provide a comprehensive picture of cancer risk.

"We are looking at everybody, and we found that diabetes in adult women and obesity in women aged 60 and older significantly increased breast cancer risk," said Håkan Olsson, M.D., professor in the departments of oncology and cancer epidemiology at Lund University. "This is useful information for women who want to know their risk and who can take steps to lower it."

He and his colleagues examined records of 2,724 patients up to 10 years before they developed cancer and 20,542 patients who never developed the disease.

They found that obesity in women after age 60 increased risk for developing breast cancer by 55 percent. "At the most, 15 out of 100 obese women would get breast cancer compared with slightly less than 10 out of 100 in the general population," Olsson said.

Women with diabetes had a 37 percent increased risk for developing breast cancer if their diabetes had been diagnosed up to four years before cancer was diagnosed.

Women with abnormally low levels of blood lipids (mostly cholesterol) had a 25 percent greater risk for developing breast cancer, while high levels of blood lipids appeared to be associated with a lower risk for breast cancer. The mechanisms behind these effects are unclear, and the finding needs to be replicated in a different population-based study, Olsson said.

Researchers also looked at the national drug prescription registry to examine the link between risk for all cancers and use of two diabetes drugs, glargine and metformin. In this study, investigators found that glargine use, which had been associated with increased cancer development in previous European studies, almost doubled the risk for development of any cancer, while metformin was linked to an 8 percent lower risk for cancer in patients with diabetes.

Olsson said more research is needed to clarify the specific cancers at increased risk. The number of patients in this study who developed breast cancer using these medications was too small to make any link to breast cancer risk, specifically, he said.

The study was funded by Sweden's Southern Health Care Region.

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Link Between Low Vitamin D Levels And Higher Degrees Of Insulin Resistance

A recent study of obese and non-obese children found that low vitamin D levels are significantly more prevalent in obese children and are associated with risk factors for type 2 diabetes. This study was accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

High rates of vitamin D deficiency have been found in obese populations and past studies have linked low vitamin D levels to cardiovascular disease and type 2 diabetes. The mechanisms by which obesity and its comorbidities are related to vitamin D deficiency are not fully known. This new study examined associations between vitamin D levels and dietary habits in obese children, and tested whether there were correlations between vitamin D levels and markers of abnormal glucose metabolism and blood pressure.

"Our study found that obese children with lower vitamin D levels had higher degrees of insulin resistance," said Micah Olson, MD, of The University of Texas Southwestern Medical Center in Dallas and lead author of the study. "Although our study cannot prove causation, it does suggest that low vitamin D levels may play a role in the development of type 2 diabetes."

In this study, researchers measured vitamin D levels, blood sugar levels, serum insulin, BMI and blood pressure in 411 obese subjects and 87 control non-overweight subjects. Study participants were also asked to provide dietary information including daily intake of soda, juice and milk, average daily fruit and vegetable intake, and whether or not they routinely skipped breakfast.

"Poor dietary habits such as skipping breakfast and increased soda and juice intake were associated with the lower vitamin D levels seen in obese children," said Olson. "Future studies are needed to determine the clinical significance of lower vitamin D levels in obese children, the amount and duration of treatment necessary to replenish vitamin D levels in these children and whether treatment with vitamin D can improve primary clinical endpoints such as insulin resistance."

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Arsenic Exposure Via Rice

A study just published by a Dartmouth team of scientists in the Proceedings of the National Academy of Sciences (PNAS) advances our understanding of the sources of human exposure to arsenic and focuses attention on the potential for consuming harmful levels of arsenic via rice.

Arsenic occurs naturally in the environment and in elevated concentrations it can be harmful to human health. Common in groundwater, the World Health Organization set guideline limits for Arsenic levels in drinking water (currently 10 micrograms per liter). Concerns about arsenic exposure are now extending beyond water to rice, as underscored in the new PNAS publication. Rice is susceptible to arsenic contamination due to its ability to extract arsenic from the environment into the rice plant.

"Arsenic exposure during pregnancy is a public health concern due to potential health risks to the fetus," says Margaret Karagas, professor of community and family medicine at Dartmouth Medical School and senior author of the paper.

Karagas, director of the Children's Environmental Health and Disease Prevention Center at Dartmouth, and her colleagues have been active in the area of arsenic and human health for over 15 years, including work linking arsenic and bladder cancer and other conditions. She notes that research elsewhere has related arsenic at very high levels to infant mortality, reduced birth weight, hampered immune function, and increased mortality from lung cancer later in life.

"The study presented in the PNAS paper is based upon a sample of 229 pregnant New Hampshire women whose urine was tested for arsenic concentration," says Diane Gilbert-Diamond, a postdoctoral fellow and co-lead author on the paper. The women in the study were divided into two groups based on whether or not they had eaten rice in the two days before urine collection. The tap water in their homes also was tested for arsenic concentration.

"This enabled our team to separate the potential for exposure to arsenic from drinking water from that of rice," says Gilbert-Diamond. The urinary arsenic analyses were performed at the University of Arizona by co-author Professor A. Jay Gandolfi and colleagues and water testing was performed at Dartmouth's Trace Element Analysis Facility by co-author Brian Jackson, PhD.

According to the U.S. Department of Agriculture, Americans consume an average of a half-cup of rice per day, but this varies by ethnic group. Asian Americans, for example, consume an average of more than two cups per day.

Urinary arsenic concentrations for the 73 study subjects who ate rice showed a median of 5.27 micrograms per liter, while the median for the 156 non-rice eaters showed 3.38 micrograms per liter, a statistically significant difference between the two groups.

The authors conclude that their findings highlight the need to monitor arsenic in food, noting that China already has statutory limits on arsenic content in rice (0.15 micrograms of inorganic arsenic per kilogram of food) but the U.S. and the E.U. do not. Rice concentrations vary widely throughout the world and between species and growing conditions. Karagas emphasizes, "While this study reveals the potential for exposure to arsenic from rice, much additional research is needed before we can determine if there are actual health impacts from this source of exposure." Tracy Punshon, research assistant professor of biological sciences and co-author says, "Rice is a nutritious food source worldwide. Ultimately any health risks, if found, would then need to be weighed against the obvious nutritional benefits of rice consumption."

The authors also conclude that the results of the study reinforce the concern that private well water in New Hampshire is a potential source of arsenic exposure. In this study, over 10 percent of the women consumed water containing arsenic concentrations currently above the World Health Organization (WHO) guideline and U.S. Environmental Protection Agency standard for public water systems.

"We strongly recommend that all homeowners who use a private well have their water tested regularly for arsenic," says Kathryn Cottingham, co-lead author and professor of biological sciences. "Although health risks of rice consumption are not yet clear, the risks posed by contaminated water are well established."

The work was supported by the National Institute for Environmental Health Sciences (NIEHS) and the U.S. Environmental Protection Agency (EPA), both of which support the Children's Environmental Health and Disease Prevention Center at Dartmouth. Funding also was provided by NIEHS's Superfund Research Program to Dartmouth's Toxic Metals Superfund Research Program.

"The NIEHS and EPA programs supporting this research seek not only to advance the science in which we are engaged but, at the same time, be relevant to society," says Dartmouth Provost Carol Folt, the Dartmouth Professor of Biological Sciences, associate director of the center and a co-author of the PNAS paper. "Our results are highly consistent with both goals, and the team effort needed to successfully implement such work is a hallmark of Dartmouth's research programs."

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Eating Fish With Omega 3 Fatty Acids Could Reduce Heart Disease Risk In Young Women

Young women may reduce their risk of developing cardiovascular disease simply by eating more fish rich in omega-3 fatty acids, researchers reported in Hypertension: Journal of the American Heart Association.

In the first population-based study in women of childbearing age, those who rarely or never ate fish had 50 percent more cardiovascular problems over eight years than those who ate fish regularly.

Compared to women who ate fish high in omega-3 weekly, the risk was 90 percent higher for those who rarely or never ate fish.

Researchers used a Danish nationwide population based pregnancy cohort to examine whether or not eating more fish might reduce cardiovascular disease risk in the young women.

About 49,000 women, 15-49 years old, median age of just under 30 years in early pregnancy - were interviewed by telephone or answered food frequency questionnaires about how much, what types and how often they ate fish, as well as lifestyle and family history questions.

Researchers recorded 577 cardiovascular events during the eight-year period, including five cardiovascular deaths in women without any prior diagnosis of the disease. In all, 328 events were due to hypertensive disease, 146 from cerebrovascular disease, and 103 from ischemic heart disease.

Inpatient and outpatient admission for cardiovascular disease was much more common among women who reported eating little or no fish. In three different assessments over a 30-week period, women who never ate fish had a three-fold higher disease risk compared to women who ate fish every week.

"To our knowledge this is the first study of this size to focus exclusively on women of childbearing age," said Marin Strøm, Ph.D., lead researcher and post doctoral fellow at the Centre for Fetal Programming, at Statens Serum Institut in Copenhagen, Denmark. "The biggest challenge in getting health messages like this across to younger populations is that usually the benefits may not be evident for 30 or 40 years, but our study shows this is not the case. We saw a strong association with cardiovascular disease in the women who were still in their late 30's."

Fish oil contains long chain omega-3 polyunsaturated fatty acids, which are believed to protect against heart and vascular disease. Few women in the study took fish oil supplements, so these were excluded from the analyses and the results were based on the dietary intake of omega-3 fatty acids, not intake from supplements.

Most previous studies that found cardiovascular benefits of omega-3 fatty acids have focused on men, according to Strøm.

"Men and women share many cardiovascular risk factors, but some studies have shown that there might also be gender differences. For example, inflammation, cholesterol, and triglyceride levels may have a more negative influence among women," Strom said.

Even women who ate fish only a couple of times a month benefitted. "Women who eat fish should find the results encouraging, but it is important to emphasize that to obtain the greatest benefit from fish and fish oils, women should follow the dietary recommendations to eat fish as a main meal at least twice a week," she said.

The most common fish consumed by women in the study were cod, salmon, herring, and mackerel.

"Our study shows that for younger women, eating fish is very important for overall health, and even though we found cardio-protective effects at relatively modest dietary levels, higher levels may yield additional benefits," Strøm said.

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Preventing Childhood Obesity

Targeting children aged six to 12 with school-based programmes that encourage healthy eating, physical activity and positive attitudes to body image are among a range of interventions that can help reduce levels of obesity, according to a new review of the evidence. While some people argue against taking action because they worry that the action could itself do harm, evidence of harm due to the interventions themselves was not found across the studies. "There is now compelling evidence that strategies can be implemented to halt the growing rates of obesity in children. We know that doing nothing is likely to result in increases of overweight and obesity, particularly in countries where the prevalence continues to rise", says the lead researcher of this study, Prof Elizabeth Waters, who works at the McCaughey Centre at the University of Melbourne, Australia. The research is published in The Cochrane Library.

Childhood obesity can cause social, psychological and health problems, and is linked to obesity later in life and poor adult health.

An international team of researchers have updated a previous Cochrane Review by searching for new evidence from existing studies to see which forms of intervention could have maximum effect in helping children to avoid becoming obese. They found that since 2005 the number of trials had increased from 22 to 55. With this increased pool of information they could make a more thorough assessment of the various approaches people had taken.

Becoming obese is strongly linked to inappropriate nutrition and low levels of physical activity, so unsurprisingly many of the programmes aimed to improve either or both of these behaviours.

The studies varied in terms of what programmes they evaluated for preventing obesity and the degree of benefit they identified. Nevertheless, taken together the review indicates that the interventions had a positive impact on average bodyweight. "Our findings show that obesity prevention is worth investing in. Given the range of programmes included in this review, it is hard to say exactly which components are the best, but we think the strategies to focus on are those that seek to change environments, rather than just the behaviour of individuals," says Waters. The evidence identifies a number of promising policies and strategies that could be considered for implementation. These include:

Including healthy eating, physical activity and body image in school curricula.
  • Increasing the number of opportunities for physical activity and the development of fundamental movement skills during the school week.
  • Improving the nutritional quality of food supplied in schools.
  • Creating environments and cultural practices within schools that support children eating healthier foods and being active throughout each day.
  • Professional development and capacity building activities which help to support teachers and other staff as they implement health promotion strategies and activities.
  • Giving more attention to parent support and home activities that encourage children to be more active, eat more nutritious foods and spend less time in screen-based activities.
"Research that aims to reduce childhood obesity must now concentrate on finding ways of embedding effective interventions in health, education and care systems, so that we can make population-wide, long term impacts on the levels of obesity," says Waters.

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Have A Healthy Merry Christmas

As we enter the festive season of celebration, partying, eating and drinking, for many of us, mixed in with that Yuletide spirit is an uneasy sense that all this overdoing it can be damaging to health, which is tempting to dismiss with the excuse that it only happens once a year, so where's the harm? But perhaps, there are some things we should consider, such as how to avoid weight gain, how to avoid food poisoning, and how to be sensible about drinking and alcohol, without spoiling the cheer, so we can look forward to a Healthy Merry Christmas.

Avoiding Weight Gain

According to the British Dietetic Association, the average person in the UK consumes around 6,000 calories on Christmas day, which is three times the daily guideline amount for women, more than twice that for men. However, as well as this, over the festive period, which seems to start earlier every year, the average person consumes an extra 500 calories a day, equating to a weight gain of about 5 lbs (2 kg) by New Year's Day.

Holly Hull, a researcher from the Department of Health and Exercise Science at the University of Oklahoma in the USA, says that Thanksgiving is the start of a high risk season for people who are already overweight. Nowadays, the holiday season is not just one day of overeating:

"You have this period that extends through the new year where there's more alcohol, more snacks, more finger foods and appetizers that are energy dense," says Hull in an article in the New York Times.

When you look across the various studies that have been done on how much weight people put on over the Christmas period it ranges from around 1 pound on average to about 5 pounds (about 2 kg). But while researchers may disagree on the exact figure, they all agree that the problem isn't so much the amount of gain itself, but the fact that once gained, it is hard to shift, so as the years go by, our body weight creeps up.

So perhaps the message we should focus on, is treat Christmas as any other time of year when you have a party or go out to dinner, and be mindful of a few things that are not too difficult to do, but when you add them all up, they create a shift in mindset and behavior that makes a significant difference to helping you keep a trim waistline.

With that in mind, here are some "small step" tips to help you avoid putting on those pounds over the festive period, and indeed, at any other time of year:

  • Go for a brisk walk if you have over-eaten. Not a jog or a run, as this could give you indigestion, but instead of flopping on the sofa and reaching for those chocolates or nibbles, slip into your trainers or stout walking shoes and take a brisk 15-minute walk round the block.
  • Don't eat in front of the TV: prepare your meal thoughtfully, sit at the table and focus on savouring the food.
  • Become aware of the triggers that encourage you to keep on eating when you are not really hungry: practise Mindful Eating, a topic we covered last year in our article on how to have yourself a mindful merry Christmas.
  • Don't eat just because the food is there: either take it away or move yourself away. Learn to listen to your hunger and appetite signals: there is a difference between feeling "peckish" because you can see something tempting, and feeling hunger pains. (And don't stand next to the food at parties!)
  • Eat slowly: remember, there can be a 15-minute delay before the stomach tells the brain it is full. If you eat too quickly, you will be over-full. So, slow down, savour every bite, and when you have finished what is on your plate, tell yourself: if you are still hungry in 20 minutes, then you can have some more, and even then, only a bit more.
  • Don't starve yourself to compensate for over-eating: respect your appetite. Keep to a normal eating pattern of meals. Starving confuses your appetite rhythm and you may find yourself trapped in a vicious cycle of crash diets and over-eating binges.
  • Going to a dinner party? Eat something before you go so you are not tempted by second and third helpings. Don't be afraid to say "no" if pressed to eat more, prepare a nice compliment for your host "that was delicious and just the right amount, any more and it will spoil it, thank you!"
  • When eating in restaurants, have a larger starter and skip the main course, or share courses. If tempted to have a dessert, then ask for one dessert and several spoons and share it. You don't have to finish every dish: tell yourself the main reason you are there is for the company, the atmosphere, the food is secondary, so don't gorge until you are full.
  • Avoid eating when you are bored or depressed: become aware of the reason, then "switch" the trigger to an alternative activity, like getting on with that hobby, play a game, or go for a walk.
  • Beware of tempting buffets at parties, especially those canapés: they pack a lot of fat per mouthful. Choose the non-creamy, non-pastry varieties, take one or two, and then politely refuse. If you must stack your plate, make it mostly salads and crudités, and go easy on the sauces and dips.
  • Plan a realistic Christmas (or any other time) exercise regime: half-hour brisk walks around the block can burn off 200 calories at a time, and might be easier to fit into your schedule than over-ambitious three-hour sessions at the gym. Or do one trip to the gym and two walks.
  • Research shows that doing vigorous exercise in short bursts, even five or ten minutes at a time, is as beneficial as a continuous long session. So, go up the stairs instead of the lift or elevator, park the car at the other end of the car park and walk briskly to the mall entrance, get off the bus two stops early and walk the rest. With these small, achievable strategies, you may find that even on a really busy day, you can can fit in the equivalent of a half-hour work-out with the same health and calorie-burning benefits.
  • Get onto the dance floor at those parties, or even at home, get up and move and shake to your favourite dance CDs. Not only will you burn calories, and hopefully have some fun, it is difficult to eat when you are dancing!
  • Don't shop when you are hungry! This will also help you keep your money under control. Plan what to buy and stick to the list. Many people shop with a "siege" mentality at Christmas, as if the shops are going to be shut for weeks.
  • Don't be tempted to eat the leftovers after a meal. If having friends round for dinner, offer them the leftovers. Have plenty of containers and food bags ready, so you can pack the leftovers straight away, either for friends or for the freezer.
  • Balance rich, energy-dense foods with healthy options: the average mince pie contains about 250 calories (that takes 40 minutes of cycling to burn off, or 25 minutes of swimming, or half an hour of jogging, or 25 minutes on a Stairmaster!), so when offering mince pies, offer some fresh or dried fruit and nuts: a plate of mince pies with a bowl of satsumas, for instance. Or instead of reaching for two mince pies, reach for one plus a satsuma or a handful of nuts. Some people remove the pastry "lid" and eat an "open" mince pie as a way to cut down some of the calories.

Cooking the Turkey and Avoiding Food Poisoning

Christmas turkey coming out of oven
Christmas is one of the few times of the year people find themselves preparing to cook a large turkey or other bird, and many have little idea of the health risks.

Strangely enough, many Christmas cooks actually wash their turkey before preparing it. This is not just a waste of time (since running water will not rid the bird of the bacteria that cause food poisoning, only high temperature can do that), but actually increases the risk of spreading any germs to other parts of the kitchen, for instance by splashing them onto surfaces, worktops, chopping boards and utensils. Germs that cause food poisoning can also linger on surfaces for days.

In 2007 the UK's Food Standards Agency (FSA) surveyed over 2,000 people and found 80% of them wash their turkeys before cooking them, thereby raising "significantly the risk of food poisoning". Apparently, women over 45 were the most likely offenders.

Judith Hilton, Head of Microbiological Safety at the FSA, said "it's not possible to wash off the germs that cause food poisoning with water. They're killed by heat. By washing your raw turkey, you're actually more likely to spread the germs than get rid of them."

The FSA says 20% of all food poisoning outbreaks are related to poultry, and they receive more reports in December than any other month.

Around a quarter of turkeys eaten at Christmas in the UK will have been bought frozen, yet many people don't thaw the bird correctly, allowing salmonella and campylobacter to survive the cooking process.

The agency says one in three cooks also puts the stuffing inside the bird, but they recommend you don't do that. The safest way is to cook the stuffing separately, outside the bird, in its own roasting tin, because cooking it inside the bird raises the risk that the poultry meat might not cook through fully.

The FSA says to make sure your turkey is cooked properly:
  • Check it's piping hot all the way through,
  • Cut into the thickest part to check that none of the meat is pink, and
  • If the juices run out, they should be clear.
NHS Choices has a comprehensive webpage on how to defrost, prepare and cook the perfect Christmas turkey or other poultry, including goose, duck and chicken. There is also useful advice on how to handle leftovers, which should be refrigerated and never stored at room temperature.

Drinking and Alcohol

Pint of lager with Christmas hat
Christmas is a special time of year as we catch up with family and friends and celebrate, and for many, the spirit of the season is accompanied by the ready flow and consumption of that other spirit, alcohol. But as the festive period now extends into weeks, it can be rough on your health, and may well cause you to feel physically and mentally worn out.

How much harm does regularly drinking too much at Christmas, or indeed at any other time, do to your liver? And what about your health in general?

Chris Day, professor of liver medicine at Newcastle University in the UK, says you run the risk of developing "fatty liver" if you regularly drink more than 8 units a day if you are a man or over 5 units a day if you are a woman, for two or three weeks. So if you are regularly drinking three or four pints of beer a day, or several glasses of wine, or three or four double whiskies, you are likely to be running that risk, because one unit of alcohol is 10ml or 8g of pure alcohol, which is the amount of alcohol in one 25ml single measure of whisky (ABV 40%), a third of a pint of beer (ABV 5-6%) or half a standard (175ml) glass of red wine (ABV 12%).

In an article on the website of the independent charity Drinkaware, Day explains how alcohol affects the liver:

"Our liver turns glucose into fat which it sends round the body to store for use when we need it. Alcohol stops this happening, so your liver cells just get stuffed full of fat. Your liver gets larger."

When this happens, you can feel vaguely uncomfortable in the abdomen, as your liver is swollen. You can also feel nauseous and lose your appetite.

However, the liver is a remarkable organ that is wonderful at repairing itself, and the chances are, if you are not a regular heavy drinker, then your liver will recover from a bout of heavy drinking. But, says Day, if you continue to drink alcohol on a regular basis, above 2-3 units a day for women, and 3-4 units a day for men, that fatty liver will persist and become inflamed, raising the risk of developing hepatitis, and then eventually, cirrhosis, which is scarring of the liver from continuous hepatitis.

Unfortunately, the problem is people can be completely unaware of the damage being done to their liver. You can spend 20 years damaging your liver and feel fine until the damage is serious, says Day who warns that "two or three heavy sessions a week for a year will increase the chance of liver damage".

But the liver is not the only part of your body you need to take care of where alcohol is concerned. Heavy drinking sessions have other consequences, such as causing irregular heart rhythms and raising the risk of developing a heart attack. There is a term for this, the so-called "Holiday Heart Syndrome", where people feel they are having a heart attack. Jonathan Chick, a consultant psychiatrist specialising in alcohol dependence, says people who have 15 units of alcohol or more in one session are vulnerable to Holiday Heart Syndrome, which can lead to sudden death.

Other problems that result from heavy drinking sessions are damage to the stomach lining, which can lead to vomiting and diarrhea; feeling shaky and anxious, as your brain reacts to alcohol withdrawal; and changes in mood, skin, weight and sleep.

Returning to a healthier lifestyle usually addresses all these consequences, but if you drink too much on a regular basis, you are more likely to develop diabetes, liver and mouth cancer, chronic pancreatitis and mental health problems.

Drinkaware suggest if you are planning to drink this Christmas, then stay within the daily unit guidelines. In the UK the government advises men should not regularly drink more than 3-4 units of alcohol a day, and women should not regularly drink more than 2-3 units a day.

Day also suggests you give your liver a break, and have days when you don't drink alcohol at all over the Christmas period:

"There's no doubt that the liver does much better when you give it a break."

Another fact that may not occur to people out to have a "good time" at Christmas, is that when you are drunk you are very vulnerable. According to Thames Valley Police in the UK, one third of rapes happen when the victim is drunk, almost half of all violent crime is alcohol-related, as are 80% of pedestrian deaths on a Friday or Saturday night. Their message is it is fine to have fun and go out and enjoy yourself, but plan ahead, drink sensibly and "look out for one another".

They offer tips like plan in advance how you will get home, save the number of a cab firm in your mobile or cellphone, don't accept drinks from strangers, never leave your drink unattended, stay clear of any trouble you see, and avoid walking alone through dark or unsafe areas (men as well as women).

And of course, don't drink and drive, and remember, you can still have alcohol in your system the day after a big night out: enough to be over the legal limit.

Finally, here are some more tips from Drinkaware to help you keep your alcohol intake in check:
  • If you want to cut down, do it gradually rather than go "cold turkey" and you are more likely to stay committed.
  • Keep track of your drinking: count your units and see how the pattern develops over time.
  • Know what you are buying: check how much alcohol is in different drinks, eg it's not uncommon for some wines to be nearly 15% ABV (alcohol by volume), which means you would be over your daily limit if you drank more than one glass. Fortunately more and more wines at 10% ABV are starting to appear, so check the labels.
  • Smaller measures: an easy way to cut down is to use smaller glasses. For example, go for 125ml wine glasses rather than the larger 250ml ones. You will get six glasses out of a standard 750ml bottle with the smaller glasses, rather than just three as you would with the larger ones.
  • If you like your spirits, get an alcohol measure for home use and make it easier to keep track of your units.
  • Confine your drinking to dinner time only, rather than treat the whole evening as drinking time.
  • Don't feel tempted to finish off the bottle because there is still some left: get a good bottle stop, or get inventive with what you can do with leftover wine, for instance in cooking.
  • When you are out, beware of "rounds". This is more of a British tradition, but it can be dangerous not only for your wallet but for your health if you feel forced to keep up with the heaviest drinker in the group just when you are trying to cut down. Duck out of a round, or choose a smaller drink, or a soft drink.
  • Track your drinks as you go along, go for smaller drinks, and sip soft drinks in between alcoholic ones, to help you cut down the rate of your drinking when you are out. If out clubbing, take a bottle of water with you on the dance floor, so you are not tempted to quench your thirst with alcohol (and also increase your dehydration).
Written by Catharine Paddock PhD

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