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Medical News & Health :: Someone just found a cure for the common cold? Need to know how to look for a top specialist in a certain field? Post the article, or ask the question here. Medical News & Health is a wonderful Forum to keep informed about the latest happenings in the World of Medicine.
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| Will Sugar Substitutes Lead to Weight Gain? |
Posted by Miller on May, 16. :: 0 Comments
Sugar Substitutes Linked to Weight Gain
Tracy Hampton, PhD
JAMA. 2008;299(18):2137-2138.
Although low-calorie sweeteners are a dietary staple for many individuals trying to maintain or lose weight, an emerging body of evidence suggests these substances offer little help to dieters and may even help promote weight gain.
A 2007 review found that laboratory, epidemiological, and clinical studies examining effects of low-calorie sweeteners presented an unclear picture of their usefulness (Bellisle F and Drewnowski A. Eur J Clin Nutr. 2007;61[6]:691-700). Because the scientific findings are mixed, there is currently no official recommendation about using artificial sweeteners as a tool for weight control.
Recent studies reveal that consuming artificial sweeteners may not help, and may even thwart, efforts to lose weight.
However, some studies have suggested that low-calorie sweeteners may actually increase appetite for sweet foods, promote overeating, and lead to weight gain. Recent findings lend further support to this theory, demonstrating that artificial sweeteners blunt the body's energy expenditure mechanisms and activate taste pathways differently than sucrose—findings that might prompt dieters to rethink their weight-loss strategies.
HOW SWEET IT IS
According to the Calorie Control Council, the number of US residents who consume products containing sugar-free sweeteners grew from fewer than 70 million in 1987 to about 160 million in 2000 (http://www.caloriecontrol.org). National survey data indicate that the incidence of obesity increased over that time from approximately 15% to 30% (Flegal KM. Physiol Behav. 2005;86[5]:599-602).
Scientists agree that while intensely sweet low-calorie sugar substitutes help lower the energy density of beverages and foods, these products also uncouple sweetness and energy, which may disrupt the body's ability to accurately assess caloric intake.
Investigators at Purdue University in West Lafayette, Ind, recently showed that rats fed saccharin-containing food took in more calories and gained more weight than rats fed sugar-sweetened food (Swithers SE and Davidson TL. Behav Neurosci. 2008;122[1]:161-173). The findings add to their previous discovery that rats fed low-calorie artificial sweeteners fail to predict the caloric consequences of eating sugar-sweetened food later on. In other words, rats fed low-calorie sweeteners did not reduce their intake of sugar-sweetened food in a subsequent feeding, unlike rats originally fed sugar-sweetened food (Davidson TL and Swithers SE. Int J Obes Relat Metab Disord. 2004;28[7]:933-935).
"Sweet things usually are predictive of high calories, and the taste generates a lot of responses that help the animal utilize calories efficiently," explained principal investigator Terry Davidson, PhD, of Purdue's Department of Psychological Sciences. "If we start giving sweet tastes that don't have calories with them, then those responses aren't going to be as strong, and they’ll get extinguished," he added.
The researchers also noted in the new study that, compared with sugar-fed rats, saccharine-fed animals had a smaller rise in core body temperature following consumption of a naturally sweetened high-calorie food. This blunted thermic response caused the animals to eat more and to burn calories less efficiently.
This research suggests that individuals trying to lose weight "may just not be able to switch from their caloric sweeteners to noncaloric sweeteners and have everything magically get better," said first author Susan Swithers, PhD, also of Purdue's Department of Psychological Sciences.
Additional research is needed to determine whether the Purdue findings apply to humans who consume artificial sweeteners. "We hope that this model represents the key features of humans, but the control of feeding behavior is probably a lot more complex in humans than in rats," said Davidson.
TASTE AND THE BRAIN
Another recent study, in humans, revealed that sugar is more potent than low-calorie sweeteners in stimulating brain areas related to expectation and satisfaction, thereby turning off the desire for more sweetness (Frank GK et al. Neuroimage. 2008;39[4]:1559-1569). "We thought that sugar and artificial sweeteners, which both activate sweet receptors in the tongue, would both activate the same pathways in the brain," said principal investigator Walter Kaye, MD, of the University of Pittsburgh's Department of Psychiatry. "They turned out to not be the same," he added.
The researchers used functional magnetic resonance imaging to compare brain activity in women eating sugar with those eating the artificial sweetener sucralose. Their studies found that compared with sucralose, sucrose elicits a stronger brain response in the anterior insula, frontal operculum, striatum, and anterior cingulate and that only sucrose stimulation engages the dopaminergic midbrain areas that respond to food rewards.
"Thus, brain response distinguishes the caloric from the non-caloric sweetener, although the conscious mind could not," the authors wrote. "This could have important implications on how effective artificial sweeteners are in their ability to substitute sugar intake," they added.
The investigators propose that because sucralose does not provide calories that act as a natural feedback mechanism that results in satiety, other means—such as additional eating—will likely be needed to provide satiety. Their findings also indicate that certain regions of the brain, such as the anterior insula, may be attractive targets for modulating food-reward sensations.
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| Spirivia use |
Posted by lazydaize on May, 15. :: 2 Comments
My doc just told me that if my lung function was under 40 percent that spiriva doesn't do any good. I thought it was suppose to help maintain what lung function I had left. Am I just wasting my money to buy this expensive drug for nothing. Anyone know anything about it.
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| Banning CFC's - How Asthma Patients are Affected |
Posted by cjhsa on May, 15. :: 6 Comments
http://www.nytimes.com/2008/05/13/health/13asth.html?ei=5087&em=&en=3e5c6ec25f8b73b0&ex=1210996800&adxnnl=1&adxnnlx=1210864832-7gDYtnDIJ5B8gcRKcVszSg
Millions of people with asthma and other lung diseases will have to switch inhalers by the end of the year. And for many, the transition will not be smooth.
The change — mandated by the federal government in 2005, to go into effect next Jan. 1 — is to comply with the 1987 treaty to protect the earth’s ozone layer. It bans most uses of chlorofluorocarbons, or CFCs, which are used as propellants in many inhalers.
CFC-free inhalers have been available for more than a decade. But four million to five million users have yet to switch, according to the consumer advocacy group Allergy and Asthma Network Mothers of Asthmatics.
For one thing, the old inhalers cost much less — an average of $13.50, or one-third the price of a CFC-free inhaler, which uses propellants called HFAs, for hydrofluoroalkanes. (CFC inhalers are generic; HFA inhalers are brand-name.) People with asthma use an average of three or four inhalers a year, but some patients use one a month.
Moreover, the new and old inhalers differ in feel, force and taste, and how they are primed and cleaned. Advocates for people with asthma say doctors and patients have not been educated about the changes.
“What the government failed to do is to mandate anyone to tell patients and physicians this transition was happening,” said Nancy Sander, president of the asthma group. “There is no education, no monitoring of patients, no financial assistance to patients who have to pay higher prices for the new drugs.”
As a result, she and others say, there have been unnecessary fears about the newer inhalers, preventable trips to the emergency room and even some hoarding of CFC inhalers.
Callers to a hot line run by Ms. Sander’s group have complained that when they were switched to the new inhalers, the differences between the two types were never explained. Many thought that their device was broken or that their symptoms were not being relieved by the new inhalers.
The Food and Drug Administration says that since January 2007 it has received 415 complaints about HFA inhalers’ costing too much or not working properly. After a public meeting last month in which doctors and patients said most people were unaware of the transition, the agency has been stepping up educational efforts, with several public service announcements expected by the end of this month, said Deborah Henderson, an official at the Center for Drug Evaluation and Research.
Both types of inhalers use albuterol, a short-acting medication that can prevent an asthma attack when used preventively — before exercising, for example — or at the first sign of breathing trouble.
But the cost difference has meant huge gains for drug companies. As people switched to HFA inhalers in 2006 and 2007, sales of all albuterol inhalers jumped from about $500 million to $1.1 billion, according to I.M.S. Health, a health care information company. Of the 40.5 million prescriptions written for albuterol inhalers last year, it said, about half were CFC and half were HFA inhalers.
And even though there are important differences between the four brands of HFA inhalers, some insurers cover only one of the four. Advocates say the higher cost may keep patients from buying inhalers or force them to cut back on other medications or switch to a less effective over-the-counter inhaler that uses epinephrine.
Several members of Congress are asking the Bush administration to require insurers, including the Medicare and Medicaid programs, to cover the new inhalers equally. Representative Steve Kagen, a Wisconsin Democrat who is also an allergy and asthma physician, said it was important “to make sure there’s as little co-pay as possible.”
The four HFA inhalers are Ventolin by GlaxoSmithKline, ProAir by Teva, Proventil by Schering-Plough and Xopenex by Sepracor. (Xopenex uses a different chemical, levalbuterol.) All companies have give-away programs for those in need and are providing free samples that doctors give to their patients. There is also financial assistance available through the Partnership for Prescription Assistance (1-888-477-2669).
Studies show that HFA inhalers are as effective as CFC inhalers and have the same rate of side effects. But if they are not used properly, patients will not get adequate doses. There are three critical differences.
HFA inhalers must be pumped four times to prime them — a number that was not so critical with the more forgiving CFC inhalers, said Dr. Leslie Hendeles, professor of pharmacy and pediatrics at the University of Florida. And each brand of the newer inhaler requires a different frequency of priming.
HFA inhalers have a weaker spray. “It’s very soft so people think it’s not working,” Dr. Stoloff said. Where CFC inhalers deliver a powerful force that feels as if the airway is being pushed open, the newer ones provide a warm, soft mist that also has a distinct taste.
They also require a slower inhale. “You have to take a nice slow, deep breath and hold it,” Ms. Sander said. If people worry that it’s not working, they may not take the second puff, may fail to wait the necessary 30 seconds between puffs or may take too many puffs. ,And their anxiety may rise, further constricting their airways.
HFA inhalers need to be washed with warm water and air dried once a week. The medication is stickier and will clog the hole, reducing the amount of medication the spray delivers.
There are also important differences among the brands, though some doctors simply write Albuterol HFA on the prescription, leaving the pharmacist to choose the brand. Only one, Ventalin, has a dose counter, which helps users keep track of how much medication is left. ProAir appears to be on many insurance companies’ lists of approved medications, but it has the softest spray, Dr. Stoloff said.
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| Tension Headache |
Posted by Montana on May, 13. :: 33 Comments
Has anyone ever had a tension headache that lasted several weeks?
I had a head cold which started several weeks ago (around 5-6 weeks) and the headache started in the front working it's way to the back of my head. Now it's been stuck there for about a month now and it just won't go away.
I've been majorly stressed lately and it feels just like a tension headache, but I've never had a headache last so long.
Just wondering if tension headaches can last this long.
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| Boiling Water |
Posted by cello on May, 13. :: 14 Comments
Someone told me that one should not re-boil tap water that has been boiled, but could not remember the reason why (someone else told him).
Why would it be so?
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