Health providers' stand could invite other execution methods

By JULIE WATSON, Associated Press

SAN DIEGO (AP) — With the American Pharmacists Association taking a stance this week, the medical community is now united in its opposition to playing any role in capital punishment killings.

That could make it increasingly difficult for corrections departments to obtain the already scarce drugs for lethal injections and prompt death penalty states to return to previously shunned methods like firing squads, gas chambers and electric chairs, people on both sides of the issue said Tuesday.

"What happens in the course of an execution can be extremely ugly and excruciatingly painful," said Cheryl Pilate, a Kansas City, Missouri, attorney who has represented two inmates in that state who were executed and another whose death sentence is on hold pending appeals.

"Alternative methods tend to make more plain what is actually happening when an execution occurs: It extinguishes a human life," she said. "Frankly, there is no pretty way to do it."

The pharmacists' association on Monday adopted a resolution saying participation in executions goes against its members' core values as health care providers.

That echoes ethics codes adopted by associations for doctors, nurses and anesthesiologists on the issue. The decision came a week after the International Academy of Compounding Pharmacists adopted a similar policy for its 4,000 members.

Officials in the death penalty states of Texas and Oklahoma declined to comment on the potential impact of the health community's stance.

While not legally binding, the policies likely will decrease the number of businesses willing to sell such lethal injection drugs to prison departments.

States already have been scrambling to find suppliers since major drugmakers stopped selling to corrections agencies. Many have been turning to compounded pharmacies, which make made-to-order drugs for clients and are less regulated than the large manufacturers.

Georgia's Department of Corrections spokeswoman Joan Heath said only time will tell what the fallout will be.

"It is simply too soon to predict if this will cause concern," she said when asked whether the pharmacy group's decision could affect the state's ability to get lethal injection drugs.

Some say the pressure mounting on businesses to not partake in executions could simply drive more of them underground, with states offering to protect their identities. Judges have said such laws are unconstitutional.

Attorney Pilate said Missouri closely guards information about its executions and where it is getting the drugs, leaving unanswered questions.

"It makes you wonder if the drug is coming from an unsavory origin or some dark corner of the Internet," she said.

An execution scheduled for March 2 in Georgia, which also does not release such information, was halted at the last minute after corrections officials said the execution drug — compounded pentobarbital — appeared cloudy. The state has suspended all executions while officials analyze the cloudy drug.

Death penalty supporter Kent Scheidegger of the Criminal Justice Legal Foundation said the increasing challenges might spell the end for lethal injections — but not for capital punishment.

The medical community's involvement has made legal injections appear as a medical procedure and not as a punishment, he added.

"The whole business of involving the medical profession and pharmacies is unnecessary," Scheidegger said. "We'd be better off without it."

Some death penalty states are preparing for that.

Tennessee passed a law last year to reinstate the electric chair if it can't get lethal drugs, and Utah has reinstated the firing squad as a backup method.

Republican Rep. Paul Ray, who sponsored the Utah bill, said he knew the announcement from the pharmacists association was coming, which contributed to his urgency in getting a backup plan in place.

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Study Casts Doubt on Acetaminophen for Low Back Pain, Arthritis

By Robert Preidt, HealthDay Reporter

TUESDAY, March 31, 2015 (HealthDay News) -- Acetaminophen -- best known as Tylenol in the United States -- does not appear to help ease lower back pain and offers little relief for the most common form of arthritis, according to a new report.

The review of data from 13 studies could challenge existing recommendations on pain relief, experts say.

"These results support the reconsideration of recommendations to use [acetaminophen] for patients" with these conditions, concluded a team led by Gustavo Machado of The George Institute for Global Health at the University of Sydney in Australia.

The researchers analyzed 10 studies that examined the use of acetaminophen to treat osteoarthritis of the hip or knee, and three studies that assessed the use of the painkiller for lower back pain.

Osteoarthritis -- the most common form of arthritis -- and back pain are among the leading causes of disability worldwide, the researchers said. Current clinical guidelines recommend acetaminophen as the first-line drug treatment for both conditions.

However, doubts about the effectiveness of the drug in treating the conditions, and concerns about the safety of the recommended full dose (up to 4,000 milligrams a day), have made those guidelines controversial, Machado's team said.

Looking at the pooled data, the investigators found that for people with lower back pain, acetaminophen was ineffective in either reducing patient disability or enhancing quality of life.

In people with osteoarthritis of the hip or knee, acetaminophen provided only a small, not clinically important benefit in the reduction of pain and disability, the study found.

McNeil Consumer Healthcare, the maker of Tylenol, countered that acetaminophen has a long history of effectiveness.

In a statement, the company said that before clinical guidelines are changed, "it is important to comprehensively look at the body of evidence . . . The safety and efficacy profile of acetaminophen is supported by more than 150 studies over the past 50 years."

And one U.S. expert also urged caution.

"Part of the problem of comparing many trials is the benefit to an individual patient is lost," said Dr. Houman Danesh, director of integrative pain management at Mount Sinai School of Medicine in New York City.

"Back pain is a multifactorial process -- if the patient has musculoskeletal imbalances which cause the pain, the treatment differs than if they have arthritis, or improper shoe support, or back pain that is caused from a herniated disc," Danesh explained. "Lumping these and other diagnoses into an all-inclusive label of 'back pain' is not recommended in treating the patient."

Dr. Allyson Shrikande is a physiatrist -- an expert in physical rehabilitation -- at Lenox Hill Hospital in New York City. She said that there are also non-drug options for treating pain.

"Strengthening exercises have been shown to decrease pain in knee osteoarthritis," Shrikande noted. "Physicians often prescribe Tylenol or other oral medications as first-line treatment, but perhaps an individually tailored physical therapy program should be tried prior to the use of Tylenol or other oral pain medications."

Danesh agreed that pills are not always necessary. In fact, "this [new] study does suggest that other methods -- such as acupuncture, smoking cessation, weight loss, physical activity and proper ergonomics at our work stations -- may have an equal role to [acetaminophen] in treating back pain," he said.

Safety issues may also come into play. In an accompanying journal editorial, Christian Mallen and Elaine Hay of Keele University in England, wrote that the study "reopens the debate" about the effectiveness and safety of acetaminophen.

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Steer Clear of Raw Milk, Researchers Warn

By Robert Preidt, HealthDay Reporter

TUESDAY, March 31, 2015 (HealthDay News) -- Raw milk causes more than half of all milk-related foodborne illnesses in the United States, even though only about 3.5 percent of Americans drink raw milk, according to a new report.

The researchers warned that people are nearly 100 times more likely to get a foodborne illness from raw (unpasteurized) milk than from pasteurized milk.

While some claim that raw milk is healthier and tastes better than pasteurized milk, the report authors said their findings show that raw milk carries significant health risks. People should not drink it, they said.

The team at the Johns Hopkins Center for a Livable Future reviewed 81 published journal articles about raw cow's milk. They found it was often contaminated with Salmonella, Campylobacter, Listeria and a dangerous type of E. coli. These bacteria can cause foodborne illness leading to diarrhea, vomiting, cramping, fever and even kidney failure or death.

The report was recently prepared for Maryland lawmakers as they consider lifting a ban on the sale of raw milk.

"Ultimately, the scientific literature showed that the risk of foodborne illness from raw milk is over 100 times greater than the risk of foodborne illness from pasteurized milk," lead author Benjamin Davis, a doctoral candidate in the Johns Hopkins Bloomberg School of Public Health's Department of Environmental Health Sciences, said in a school news release.

"Although potential benefits related to the consumption of raw milk would benefit from further investigation, we believe that from a public health perspective it is a far safer choice to discourage the consumption of raw milk," he added.

Co-author Cissy Li, also a doctoral candidate in the Department of Environmental Health Sciences, said the risks of consuming raw milk instead of pasteurized milk are "well established in the scientific literature." In some cases, the consequences are severe or fatal, she said in the news release.

"Based on our findings, we discourage the consumption of raw milk, especially among vulnerable populations such as the elderly, people with impaired immune systems, pregnant women, and children," Li added.

More information

The U.S. Centers for Disease Control and Prevention has more about raw milk.

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Heart Groups Issue Updated Blood Pressure Guidelines

By Steven Reinberg

HealthDay Reporter

TUESDAY, March 31, 2015 (HealthDay News) -- Three leading groups of heart experts have issued updated guidelines that set blood pressure goals for people with heart disease.

Specifically, the guidelines reinforce a target blood pressure of less than 140/90 mm Hg for those at risk for heart attack and stroke. The guidelines also set a goal of 130/80 mm Hg for those with heart disease who have already had a heart attack, stroke or a ministroke, or who have had a narrowing of their leg arteries or an abdominal aortic aneurysm.

However, the new guidelines are intended to be more flexible than ones crafted in 2007, said Dr. Clive Rosendorff, chairman of the committee that wrote the updated guidelines. Ultimately, the blood pressure goal any individual patient tries to achieve should be left to the discretion of the doctor and the patient.

For example, the lower goal may not be appropriate for older, frail patients who might experience dizziness if their blood pressure drops too much.

"Guidelines are simply that, guidelines, they are not inflexible rules," Rosendorff said.

The updated guidelines, from the American Heart Association, the American College of Cardiology and the American Society of Hypertension, were published March 31 in the journal Hypertension.

"In patients with heart disease, untreated high blood pressure is a major risk for heart attack and stroke," said Rosendorff, who is also a professor of medicine at the Icahn School of Medicine at Mount Sinai Medical Center in New York City.

Rosendorff said these guidelines are for patients with heart disease. New blood pressure guidelines for people who have high blood pressure but do not have heart disease are in the works, but those won't be released for some time, he said.

High blood pressure has become a growing problem in the United States during the past decade, according to a recent report from the U.S. Centers for Disease Control and Prevention. The overall death rate from high blood pressure has increased 23 percent since 2000, even as the death rate from all other causes has dropped 21 percent. That spike was seen in both genders and was most marked among those aged 45 to 64 and those over 85.

According to Rosendorff, one change in the updated guidelines is a concise statement about which drugs should be used to lower blood pressure in patients with heart disease.

"There are three drugs which have been shown to improve outcomes," he said. These include beta-blockers that slow the heart rate and reduce the force of cardiac contraction and also increase blood flow to the heart, Rosendorff said.

The guidelines also recommend angiotensin II receptor blockers (ARBs) and angiotensin-converting-enzyme inhibitors (ACE inhibitors), which increase the size of blood vessels, thus lowering blood pressure, and diuretics that lower blood pressure by reducing the amount of fluid in the body.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said men and women with high blood pressure and heart disease may benefit from more cohesive management strategies that target both conditions.

"As large numbers of men and women have not achieved optimal control of their blood pressure and are having major cardiovascular events which could have been prevented, more needs to be done to ensure implementation of these recommendations into routine clinical practice," Fonarow said.

Dr. Harlan Krumholz, a professor of cardiology at the Yale School of Medicine, views the updated guidelines as part of an ongoing debate among experts as to what blood pressure goals should be.

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Benefits of Iron Supplements Unclear for Pregnant Women, Young Children

By Tara Haelle

HealthDay Reporter

TUESDAY, March 31, 2015 (HealthDay News) -- Taking iron supplements during pregnancy doesn't appear to significantly change any health outcomes for mom or baby, a new review shows.

A second review -- this one on infants and toddlers -- found no evidence that iron supplements improved growth or development.

Both conclusions come from a U.S. Preventive Services Task Force (USPSTF) review of the latest research on iron supplementation and screening for pregnant women, babies and young children.

The USPSTF determined that there isn't enough evidence to recommend that pregnant women or infants and children receive iron supplements or be screened for iron deficiencies. But, they also noted there isn't enough evidence to recommend against either practice.

The recommendations regarding prenatal supplements are an unchanged update from those in 2006. What's new is that this study also finds no evidence to support routine screening.

"There is not enough research to demonstrate that women need to be routinely screened for iron-deficiency anemia or that they should routinely take iron supplements in the absence of symptoms," said Dr. Amy Cantor, lead author of the prenatal study.

"It is not particularly harmful to take an iron supplement, but it may not be necessary," added Cantor, who is an assistant professor of obstetrics and gynecology and family medicine at Oregon Health & Science University in Portland.

Generally, a healthy pregnant woman who does not have symptoms of low iron does not need any more than the 27 milligrams per day of iron that the Institute of Medicine recommends, Cantor said.

Her team analyzed the evidence from 11 trials on pregnant women routinely taking iron supplements. It found that supplements didn't affect women's quality of life or rates of C-sections, underweight newborns, preterm birth or infant death.

The researchers did find that women's iron levels improved with supplements. But, whether or not there is a benefit from this change is unclear, according to the investigators.

The researchers didn't find any studies looking at the benefits of screening for iron deficiency.

Not everyone was on board with the USPSTF recommendations.

Iron helps blood carry oxygen and nutrients throughout the body, so low iron levels can cause problems during pregnancy, said Dr. Andre Hall, an obstetrician and gynecologist at Birth and Women's Care in Fayetteville, N.C.

"In addition, if a mother is anemic, she has less reserve in cases of bleeding during delivery," he said.

According to Dr. Jill Rabin, co-chief of the division of ambulatory care at Women's Health Programs-PCAP Services in the North Shore-LIJ Health System of New Hyde Park, N.Y., doctors may still recommend that women take iron supplements and continue to screen for iron deficiency at the beginning of prenatal care and late in the third trimester.

"We still continue to recommend supplements and screening because we know iron helps carry the blood to the mom and the baby," said Rabin. "There are no major harms, and the benefits may be enormous, so we should just keep doing what we're doing and keep doing more research," she said.

The most common problems associated with taking iron supplements were nausea, constipation and diarrhea that went away on their own, study author Cantor said. Women can get iron through a diet rich in dark green leafy vegetables, various meats and seafood, beans, dried fruit and iron-fortified cereals, breads and pasta, she said.

The findings in infants and toddlers were similar to those for pregnant women, according to Marian McDonagh, a professor of epidemiology at Oregon Health & Science University in Portland, and lead author of that study.

McDonagh's team reviewed 10 trials they identified that measured effects of iron supplements in children aged 6 months to 2 years.

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Eat Right to Protect Your Sight

By Robert Preidt, HealthDay Reporter

TUESDAY, March 31, 2015 (HealthDay News) -- A number of nutrients can help keep your eyes healthy, and some may even improve your eyesight, an eye doctor says.

It's particularly important to eat a variety of fresh fruits and vegetables, said Dr. James McDonnell, a pediatric ophthalmologist at Loyola University Health System in Maywood, Ill.

"Make a colorful plate, especially with greens, blues and reds. Certain foods have distinct benefits for the eyes in addition to overall health, including many of the trendy superfoods such as kale, broccoli and sweet potatoes," he said in a Loyola news release.

McDonnell said healthy eating might help protect you from cataracts, macular degeneration -- a leading cause of vision loss in older Americans -- and even blindness.

He listed several nutrients that are especially good for your eyes.

Astaxanthin. "This supernutrient protects eyes from developing cataracts, macular degeneration and blindness," McDonnell said. "Seaweed and wild, rather than farmed, salmon are excellent choices high in astaxanthin. It also aids in so many aspects of wellness that astaxanthin is my top recommendation for incorporation into your diet."

Omega-3. This fatty acid contained in fish protects against dry eye and age-related macular degeneration, he said.

"Studies show that individuals who ate oily fish such as tuna, sardines, herring and salmon at least once a week were 50 percent less likely to develop neovascular [wet] macular degeneration than those who ate fish less than once per week," McDonnell said.

Anthocyanins. "Blueberries, bilberries and especially black currants contain high amounts of anthocyanins and help to maintain the health of the cornea and blood vessels in every part of the eye," McDonnell said. "They also help reduce the risk of cataracts and macular degeneration as well as decrease inflammatory eye disease and diabetic retinopathy."

Vitamin D. "Safe sun exposure, fish oils, fatty fish and, to a lesser extent, beef liver, cheese, egg yolks and certain mushrooms contain this master hormone, which acts on more than 4,000 genes," McDonnell said. He added that vitamin D3 supplementation has been shown to help prevent age-related macular degeneration, reduce retinal inflammation and improve vision.

Zeaxanthin. This nutrient, which McConnell said reduces the risk of age-related macular degeneration, is found in dark green vegetables such as kale, broccoli, collards, raw spinach and romaine lettuce. "Lightly cooking these vegetables increases your body's ability to absorb these nutrients," McDonnell said.

Bioflavonoids. Found in tea, red wine, citrus fruits and cherries, bioflavonoids may lower the risk of cataracts and macular degeneration, he said. And beta-carotene, contained in carrots, sweet potatoes, spinach, kale and butternut squash, protects you against night blindness and dry eyes, the eye doctor noted.

Lutein. This nutrient is also good for your eyes. "The best source is from organic eggs laid by pastured organic hens. You can also take supplements made from marigold flowers," McDonnell said.

More information

The U.S. National Eye Institute has more about healthy eyes.

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New Stroke Prevention Efforts May Be Paying Off

By Dennis Thompson

HealthDay Reporter

TUESDAY, March 31, 2015 (HealthDay News) -- Fewer people are being treated in U.S. emergency rooms for strokes caused by blood clots in the brain, which experts read as a sign that current stroke prevention methods are working.

The rate of emergency department visits for either a stroke or a mini-stroke (transient ischemic attack) -- a temporary blockage of blood flow to the brain -- decreased dramatically between 2001 and 2011, according to a new U.S. Centers for Disease Control and Prevention report.

Such ER visits declined 35 percent for adults 18 and older, and 51 percent for those 55 to 74, said the report from the CDC's National Center for Health Statistics (NCHS).

The statistics mirror a "dramatic reduction in stroke fatality in the country, which we believe is likely due to better control of risk factors," said Dr. Larry Goldstein, chief of the division of stroke and vascular neurology and director of the Duke Stroke Center at Duke University Medical Center in Durham, N.C.

People are preventing strokes by taking cholesterol-lowering statin drugs and medications to control high blood pressure, Goldstein said. In addition, fewer people are smoking, which is a leading risk factor for stroke, and indoor air laws are limiting nonsmokers' exposure to secondhand smoke.

The CDC report, published in the March NCHS Data Brief, also contained evidence that doctors are providing more comprehensive care for stroke victims, experts said.

For example, doctors more frequently used MRIs or CT scans to evaluate a patient who came to the emergency room with signs of a blood-clot stroke, the CDC report found.

The percentage of ER stroke visits that involved an MRI or CT scan increased 39 percent between 2001 and 2011, researchers said.

Such scans are important prior to giving patients powerful clot-busting medications that can quickly treat a stroke and prevent further brain damage, said lead report author Anjali Talwalkar, a medical officer with the NCHS.

"If it's a stroke that is a bleed in the brain, you don't want to give certain types of medication," such as clot-busting drugs, since they could cause the bleeding to increase, Talwalkar said. "These scans are definitely a critical piece of care for a stroke."

Experts also found it encouraging that more patients are being admitted into a hospital or transferred to another facility after showing up in an ER for stroke. The number of admissions or transfers increased 10 percent between 2001 and 2011, according to the report.

"That reflects the growing importance of more aggressive stroke treatments," said Dr. Richard Libman, vice chair of neurology for North Shore-LIJ Health System in Manhasset, N.Y.

These aggressive treatments can include what's called "drip and ship," in which patients are given clot-busting drugs at local hospitals and then transferred to stroke centers that can provide more comprehensive care, Libman said.

These stroke centers also have been pioneering ways to clear blood clots by snaking a catheter into a person's head and removing the clot manually, he added.

Not all the news from the CDC report was positive, however.

The researchers also found that fewer people are arriving at the ER by ambulance after suffering stroke symptoms.

The percentage of ambulance-transported stroke patients younger than 75 decreased 41 percent between 2004 and 2011, the report found.

This decrease happened despite public health campaigns aimed at getting people who may be suffering a stroke to call 911 immediately, Libman said.

"Data and studies have shown that if you have a stroke and you get to the hospital early by ambulance, you have a higher chance of being treated with clot-busting drugs than if you arrive by any other mode of transportation," he said.

Clot-busting drugs are only effective when given soon after onset of stroke, and doctors may choose not to use them if hours have passed, Libman said.

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Clues to 'Brain Fog' in Chronic Fatigue Patients Found in Spinal Fluid

By Amy Norton

HealthDay Reporter

TUESDAY, March 31, 2015 (HealthDay News) -- People with chronic fatigue syndrome show a distinct pattern of immune system proteins in their spinal fluid -- a finding that could shed light on the "brain fog" that marks the condition, researchers say.

The new study found that, compared with healthy people, those with chronic fatigue syndrome had lower levels of certain immune-system proteins called cytokines in the fluid that bathes the spinal cord and brain.

The exception was one particular cytokine, which was elevated in not only people with chronic fatigue, but also those with multiple sclerosis.

The finding could offer clues as to why people with chronic fatigue syndrome typically have problems with memory, concentration and thinking, said lead researcher Dr. Mady Hornig, a professor at Columbia University's Mailman School of Public Health in New York City.

The study also bolsters evidence that some type of immune dysfunction underlies the puzzling disorder, Hornig said.

Chronic fatigue syndrome is known medically as myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS. In the United States, it affects up to 2.5 million people, according to the Institute of Medicine, a scientific panel that advises the federal government.

In February, the IOM released a report affirming that chronic fatigue syndrome is a legitimate medical condition that many health professionals still misunderstand -- or even dismiss as a figment of patients' imagination.

The term "chronic fatigue syndrome" was coined back in 1988, and in hindsight, it was a "lousy" choice, said Suzanne Vernon, a virologist and scientific director of the Solve ME/CFS Initiative, based in Los Angeles.

"People hear it and think, 'Oh, you're tired. I'm tired, too,'" said Vernon, who was not involved in the study. "But this is debilitating fatigue. It's like having a case of the flu that never goes away."

Plus, symptoms go beyond fatigue, and include what's been dubbed "brain fog" -- a collection of thinking-related problems such as confusion and difficulty with concentration and short-term memory.

For the new study, reported March 31 in the journal Molecular Psychiatry, Hornig's team studied spinal-fluid samples from 32 people with chronic fatigue syndrome, 40 with multiple sclerosis, and 19 healthy people.

Overall, the researchers found reduced levels of most cytokines in chronic fatigue syndrome patients' spinal fluid, versus the two other groups. But one cytokine, eotaxin, was elevated in people with chronic fatigue syndrome and those with multiple sclerosis.

The significance of that finding is not clear yet, Hornig said. But she said eotaxin is involved in allergy-like immune responses.

To Vernon, the findings offer "additional evidence of clear [biological] markers in ME/CFS."

"These biomarkers are indications of some kind of disease process," Vernon said. In other words, she added, chronic fatigue syndrome is "not made up."

Why did the study include people with multiple sclerosis? There are some similarities between MS and chronic fatigue syndrome, Hornig explained. MS patients suffer fatigue, and the disease is believed to be caused by an abnormal immune reaction -- in this case, against the body's own nerve tissue.

The precise cause of chronic fatigue syndrome is far from clear, but in general, it's thought to involve some type of immune system dysfunction, Hornig explained.

In a recent study, her team found that in people who've had chronic fatigue syndrome for a relatively short time -- fewer than three years -- cytokine levels in the blood were actually elevated. They dropped again, though, in people who'd had the disease for a longer time.

People in the current study had had chronic fatigue syndrome for about seven years. So the relatively low cytokine levels in their spinal fluid "parallel" what was seen in the earlier study, Hornig said.

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Scientists Find More Evidence of Breast Milk's Goodness

By Alan Mozes, HealthDay Reporter

TUESDAY, March 31, 2015 (HealthDay News) -- A high-tech comparison of the breast milk of humans and their close primate relatives is revealing just how nutritious the human variety is.

The research was led by Danielle Lemay, a nutritional biologist at the University of California, Davis' Genome Center. Her team used a new technique for identifying proteins found in breast milk.

The researchers found that human breast milk has far more protein content than the breast milk of one of humans' closest primate relatives, the rhesus macaque monkey.

"The higher levels of these proteins in human milk are consistent with the well-established perspective that human babies, compared to other primate infants, are born at a slightly earlier stage of development and require higher levels of specific proteins that will nurture them as they mature," Lemay said in a university news release.

In other words, human breast milk might be even more protein-rich because human babies rely on its nutritional benefits to a larger degree than other primates.

Lemay and her colleagues published the findings online this month in the Journal of Proteome Research.

The new research relies on a new means of molecular analysis that enabled the team to spot more than 1,600 distinct proteins in human milk, of which more than 500 were spotted for the first time.

This compared with just over 500 proteins found in rhesus macaque milk.

The breast milk of humans and rhesus monkeys also share 88 proteins in common, the team noted. However, 93 percent of those shared proteins were still found in higher quantities in human milk.

Some of those proteins aid in the digestion of fats, Lemay's team said, while others boost babies' ability to absorb iron and vitamins B-12 and D.

Current recommendations from the American Academy of Pediatrics urge women to breast-feed their baby exclusively for the first six months of life, and then combine breast milk and other foods until at least 12 months.

Going forward, Lemay suggested that "proteins that appear to have neurodevelopmental significance for human babies will be key targets for future research focused on enhancing infant formula."

More information

There's more on breast milk at the U.S. National Institute of Child Health and Human Development.

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Face Scans Show How Fast a Person Is Aging

By Dennis Thompson

HealthDay Reporter

TUESDAY, March 31, 2015 (HealthDay News) -- Every face tells a story, and that story apparently includes hints of how quickly a person is aging, a new study contends.

Facial features have proven even more reliable than blood tests in spotting those for whom time is taking a heavier toll, a Chinese research team reports in the March 31 issue of the journal Cell Research.

A computerized 3-D facial imaging process uncovered a number of "tells" that show if a person is aging more rapidly, including a widening mouth, bulging nose, sagging upper lip, shrinking gums and drooping eye corners, the researchers said.

"This suggests not only that youth is 'skin deep,' but also that health is 'written' on the face," the study authors concluded, suggesting that facial scanning could more accurately assess a person's general health than a routine physical exam.

This sort of facial imaging is part of a cutting-edge technology aimed at estimating life expectancy and assessing health risk factors simply by taking a scan of your face, said Jay Olshansky, a professor at the University of Illinois at Chicago's School of Public Health and a board member of the American Federation for Aging Research.

"A lot of your risk factor for disease shows up in your face," Olshansky said. "You can identify the precise places on the face where these risk factors show up."

In fact, Olshansky predicts that insurance companies eventually could turn to such technology to improve underwriting of life insurance, predicting a person's future health with a simple face scan rather than a complex panel of blood tests.

"All of that blood chemistry, all of the money spent on it, is mostly a waste of money and time," he said. "You can get at these risks a much simpler way through a combination of facial analytics and asking the right questions."

In the new study, researchers at the Chinese Academy of Sciences collected 3-D facial images of 332 people of Chinese descent between the ages of 17 and 77.

Based on this data, the researchers constructed a model for predicting age, generating a map of the aging human face that recognized certain patterns of aging based on specific facial features.

They found that up to age 40, people of the same chronological age could differ by up to six years in facial age. Those older than 40 showed even wider variation in facial age.

"In aging science, we know people who look young for their age are aging more slowly," Olshansky said. "They look younger because they probably are younger. One year of clock time is matched by something less than one year of biological time. It's real. We can see it."

The researchers compared the results of their facial scans to routine blood tests they took from the participants, and found that age estimates based on facial features were more accurate than blood screenings for cholesterol, uric acid or the blood protein albumin.

The findings track with what doctors already know about how age can affect a person's face, said Dr. Anne Taylor, chairwoman of the American Society of Plastic Surgeons' Public Education Committee.

"Our lips are shrinking, and the distance between the nose and the mouth increases as we age," Taylor said. "And there's a reason for the saying, 'Long in the tooth.' Your gums are shrinking as you age, so more of your teeth are showing."

Olshansky added that facial features also reveal evidence of behaviors that can affect your health.

Smokers tend to develop wrinkles around the mouth, caused by constant pursing of the lips to suck on a cigarette, he said. Drinkers develop a "W.C. Fields" nose, red and bulbous at the tip.

Researchers currently are exploring the ways in which diabetes, obesity, drug use and other detrimental personal behaviors affect the aging of the face, Olshansky noted.

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E-Cigs Tied to Drinking, Other Risky Teen Behaviors

By Robert Preidt, HealthDay Reporter

TUESDAY, March 31, 2015 (HealthDay News) -- Electronic cigarettes are used by both smoking and nonsmoking teens, and are associated with drinking and other risky behaviors, a new study finds.

"We found that e-cigarette access is strongly related to alcohol use in teenagers," said study author Karen Hughes. She is a professor of behavioral epidemiology at Liverpool John Moores University in England.

"Those who drink are more likely to have accessed e-cigarettes than nondrinkers regardless of whether they smoke normal cigarettes or not, and those who drink frequently, binge drink, drink to get drunk, drink strong alcohol products, and show signs of unsupervised alcohol consumption are most likely to have accessed e-cigarettes," said Hughes in a news release from BMC Public Health.

The study was published in the journal on March 30.

The researchers from the university surveyed more than 16,000 students, aged 14 to 17, in England and found that 20 percent of them had used e-cigarettes.

Of those who had tried e-cigarettes, 16 percent had never smoked, 23 percent had tried smoking but didn't like it, nearly 36 percent were regular smokers, nearly 12 percent only smoked when drinking, and nearly 14 percent were ex-smokers.

Students who drank alcohol were much more likely to use e-cigarettes than nondrinkers, and those who regularly binge drank were four times more likely to use e-cigarettes than those who didn't drink, according to the study.

Among those who drank, e-cigarette use was associated with binge drinking and violence after drinking, regardless of whether they smoked. These findings suggest that teens who use e-cigarettes are at risk for other types of substance use and risk-taking, according to the researchers.

Fellow study author Mark Bellis said, "Our research suggests that we should be very concerned about teenagers accessing e-cigarettes. While debate on e-cigarettes has focused largely on whether or not they act as a gateway to tobacco cigarette use, e-cigarettes themselves contain a highly addictive drug that may have more serious and longer lasting impacts on children because their brains are still developing."

More information

The U.S. National Institute on Drug Abuse has more about e-cigarettes.

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Letting Kids Sip Alcohol May 'Send Wrong Message'

By Robert Preidt, HealthDay Reporter

TUESDAY, March 31, 2015 (HealthDay News) -- Children who are allowed occasional sips of alcohol are more likely to start drinking by the time they're in high school, a new study suggests.

Researchers followed 561 middle school students in Rhode Island for about three years. At the start of sixth grade (about age 11), nearly 30 percent of the students said they'd had at least one sip of alcohol.

In most cases, those sips were provided by parents, often at parties or special occasions.

By ninth grade, 26 percent of those who'd had sips of alcohol at a younger age said they'd had at least one full alcoholic drink, compared with less than 6 percent of those who didn't get sips of alcohol when younger.

The researchers also found that 9 percent of the sippers had gotten drunk or engaged in binge drinking by ninth grade, compared with just under 2 percent of the non-sippers.

The study was published March 31 in the Journal of Studies on Alcohol and Drugs.

The findings don't prove that sips of alcohol at an early age are to blame for teen drinking, said lead researcher Kristina Jackson, of Brown University's Center for Alcohol and Addiction Studies, in Providence, R.I.

"We're not trying to say whether it's 'OK' or 'not OK' for parents to allow this," Jackson said in a journal news release.

She noted that some parents believe that introducing children to alcohol at home teaches them about responsible drinking and reduces the appeal of alcohol.

"Our study provides evidence to the contrary," Jackson said.

Giving sips of alcohol to young children may send them a "mixed message," she suggested.

"At that age, some kids may have difficulty understanding the difference between a sip of wine and having a full beer," Jackson said.

More information

The U.S. Substance Abuse and Mental Health Services Administration discusses how to prevent your child from drinking.

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New Research Tightens Childhood Paralysis-Enterovirus D68 Link

By Randy Dotinga, HealthDay Reporter

MONDAY, March 30, 2015 (HealthDay News) -- New research strengthens the suspected connection between a virus called enterovirus D68 and the sudden development of paralysis in children in California and Colorado between 2012 and 2014.

The researchers found the genetic signature of a specific type of enterovirus D68, called B1, in half of youngsters who developed acute flaccid myelitis. This complication causes sudden muscle weakness and paralysis. The researchers didn't find any other infectious agent that was capable of causing the children's symptoms.

This strain of enterovirus D68 first appeared about four years ago, according to the study authors. The researchers also found signs that this strain of enterovirus doesn't always lead to complications. In a pair of siblings infected by the strain, only one developed acute flaccid myelitis.

"This suggests that it's not only the virus, but also patients' individual biology that determines what disease they may present with," said Dr. Charles Chiu, associate professor of laboratory medicine and director of the University of California, San Francisco-Abbott Viral Diagnostics and Discovery Center.

"Given that none of the children have fully recovered, we urgently need to continue investigating this new strain ... and its potential to cause acute flaccid myelitis," he said in a university news release.

The study was published in the March 30 issue of The Lancet Infectious Diseases.

More information

For more about enterovirus D68, visit the U.S. Centers for Disease Control and Prevention.

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Scientists Sniff Out Origins of Body Odor

By Robert Preidt, HealthDay Reporter

MONDAY, March 30, 2015 (HealthDay News) -- There's new hope for people plagued by body odor, with researchers pinpointing bacterial genes that play a major role in the malodorous scent.

The findings might someday lead to new ways to control the problem, the researchers suggested.

As the researchers explained, body odor occurs when bacteria on the skin break down molecules in sweat. In the new study, the researchers found the DNA in Staphylococcus hominis bacteria that produce the proteins that break down sweat molecules.

These proteins are responsible for breaking the sweat molecules into compounds that play a major role in body odor, the researchers said. These compounds are pungent in tiny amounts -- as little as one part per trillion.

One of the genes found in S. hominis was also found in two other species of staph bacteria linked to body odor, according to the study.

The new research was to be presented Monday at the Society for General Microbiology's annual meeting in Birmingham, England. Findings presented at meetings are generally considered preliminary until they've been published in a peer-reviewed journal.

"This work has significantly advanced our understanding of the specific biochemical processes involved in body odor production. It was surprising that this particular body odor pathway is governed by only a small number of the many bacterial species residing in the underarm," study leader Dan Bawdon, from the University of York in the United Kingdom, said in a society news release.

He added that these findings could lead to better ways to control body odor.

Traditional deodorants and antiperspirants work by killing all types of underarm bacteria or by blocking the sweat glands, respectively. This research could lead to new compounds that specifically target the offending compounds, he said.

More information

The U.S. National Library of Medicine has more about sweat.

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Equal Numbers of Males, Females Are Conceived: Study

By Randy Dotinga

HealthDay Reporter

MONDAY, March 30, 2015 (HealthDay News) -- Many scientists believe human conception produces more male than female embryos, with male embryos less likely to survive.

But, a new study suggests that equal numbers of males and females are conceived and female embryos are less likely to survive.

"It looks like more females die during pregnancy than males," said Steven Orzack, a senior research scientist with the Fresh Pond Research Institute in Cambridge, Mass. "People have long thought the opposite was true. An important fact that people thought was reasonably well-demonstrated is probably incorrect."

The findings aren't definitive, and a researcher not involved with the study who has focused on the subject believes this new hypothesis is wrong. But Orzack said he and his colleagues are on solid ground with statistics that challenge long-held assumptions about human development.

According to Orzack, many scientists have believed that more males are conceived than females. Slightly more males are born than females, he said, and then females begin to outnumber males as people grow older because men die at younger ages. By the time people are seniors, women significantly outnumber men.

"It's important to study male-female differences in the womb because they underlie, in part, the profound differences we see between males and females at birth and thereafter," Orzack said.

In the new study, researchers looked at the records of more than 30 million embryos, fetuses and babies that survived past childbirth. Almost all the records were from census records of live births. But the researchers also examined tens of thousands of records of the genders of embryos and fetuses that were the product of fertility treatments, underwent testing during pregnancy or were aborted.

The researchers found evidence that approximately equal numbers of males and females are conceived, but female embryos are more likely to die than male embryos during the first trimester. Males are more likely to die during the third trimester, the researchers said.

Could modern obstetrics be affecting the ratio of boys to girls? The statistics for the new study go back for decades, even to the 1930s, so it's hard to know for sure, Orzack said. It's possible, he said, that some parents learn of their unborn child's gender and prefer to abort if the child isn't a boy. Still, "I don't think that has a huge effect on the ratio we're talking about," he added.

William James, a longtime researcher into gender ratios in the womb and an honorary research fellow at University College London, dismissed the new study as "largely invalid because much of the data they [the study authors] cite is not of healthy women."

Study author Orzack responded that "there's no reason to think" that the health of the women has anything to do with the ratio of males to females. As for the health of the women in the study, he said it includes census data on almost all live births and fetal deaths plus numbers from other women (such as those who underwent fertility treatments and abortions) who may be in good health. "This is the best kind of data that we can get," he said, although "it's not perfect."

What's next? "We'd like to pursue research that would help us understand why it appears that more females are dying than males" earlier in pregnancy but then reverses later, Orzack said.

The study appears in the March 30 issue of the Proceedings of the National Academy of Sciences.

More information

For more about pregnancy, visit the U.S. National Library of Medicine.

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Report Shows Progress in America's War on Cancer

By Dennis Thompson

HealthDay Reporter

MONDAY, March 30, 2015 (HealthDay News) -- America is making slow but steady progress against cancer, with a continuing decline in cancer deaths, according to a new report.

The overall cancer death rate fell an average 1.5 percent per year between 2002 and 2011, representing improved survival for men, women and children, the report found.

The rate of new cancer cases also declined an average 0.5 percent a year during that period.

Experts say the promising figures reflect success in both treating and heading off cancer in the body's four most vulnerable sites -- the lungs, colon, breasts and prostate.

"These numbers reflect a combination of factors that include prevention, early detection and improved treatment," said report co-author Ahmedin Jemal, vice president of surveillance research for the American Cancer Society.

However, the new report also found that cancer rates are rising for some rarer forms of cancer, including cancer of the liver, mouth and throat, thyroid, and kidneys.

The annual report was published in the March 30 issue of the Journal of the National Cancer Institute. The report was co-authored by experts from the North American Association of Central Cancer Registries, the American Cancer Society, the U.S. Centers for Disease Control and Prevention, and the U.S. National Cancer Institute.

Combining resources, the four groups concluded that cancer deaths fell 1.8 percent a year among men between 2002 and 2011, 1.4 percent a year for women and just over 2 percent a year for children.

New cancer cases fell slightly for men during that decade, while remaining level for women, according to the report. The incidence rate for new cancers in children 19 and younger increased, but by less than 1 percent a year, the report stated.

Those two trends indicate that cancer is being effectively prevented and, if it occurs, successfully treated, said Recinda Sherman, report co-author and program manager of data use and research for the North American Association of Central Cancer Registries.

Advances in lung cancer are tied directly to fewer people smoking, while the decline in colon and breast cancers also are tied to prevention efforts, Sherman said.

For example, colon cancer is preventable through screening, with doctors able to detect and remove dangerous pre-cancerous polyps through a colonoscopy.

"The early polyps are being removed even before they turn into cancer," said Dr. Lynne Penberthy, senior author of the annual report and associate director of the Surveillance Research Program at the U.S. National Cancer Institute.

Prostate cancer rates also are declining, but experts are not exactly sure why that is occurring. Prostate cancer screening is no longer recommended, Jemal said, which could lead to a decline in detected new cases.

Rarer cancers are on the rise for various reasons. Liver cancer, for instance, has increased due to long-lasting hepatitis C infections that occurred in drug-using baby boomers in the 1970s and early 1980s, Sherman said.

Penberthy agreed, adding that obesity and alcohol abuse also have played a factor in rising liver cancer cases and deaths. "There are potential interventions that would reduce the risk of this cancer," she said.

Mouth and throat cancers also have been increasing among men, even though they are considered a tobacco-related type of cancer, Sherman said.

This increase in cancer likely is due to human papillomavirus infection, or HPV, the sexually transmitted disease that also is the leading cause of cervical cancer in the United States, she said.

A vaccine has been developed for HPV and is currently recommended for both boys and girls. "These numbers show there's definitely a reason to promote that vaccine for both genders," Sherman said.

Other increases in rare cancers remain a mystery. For example, no one is sure exactly why thyroid and kidney cancers are rising among men and women, Sherman said.

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Breast Cancer Is Not One Disease, Experts Say

By Robert Preidt, HealthDay Reporter

MONDAY, March 30, 2015 (HealthDay News) -- Breast cancer isn't the same for every woman, even at the cellular level, according to a new statement from four major medical groups focused on the disease.

The report was issued Monday by the American Cancer Society, the U.S. Centers for Disease Control and Prevention, the U.S. National Cancer Institute, and the North American Association of Central Cancer Registries. They say that classifying breast cancers according to tumor subtypes could help improve treatment of the disease.

The report "assesses breast cancer as four molecularly defined subtypes, not as a single disease," National Cancer Institute director Dr. Harold Varmus said in an institute news release. "This is a welcome step, [resulting from] medically important information that already guides therapeutic strategies for these subtypes," he said.

The four major molecular subtypes are categorized according to their hormone receptor (HR) status, meaning a chemical receptor lying on breast cancer cells that reacts to hormones such as estrogen. Categorization is also dependent on a tumor cell's activity around the HER2 gene. Both factors can affect how a tumor acts and might be treated, experts say.

The four tumor types are: Luminal A (HR+/HER2-), Luminal B (HR+/HER2+), HER2-enriched (HR-/HER2+), and triple negative (HR-/HER2-).

Experts have long known that the four subtypes respond differently to treatment and have different survival rates, according to the report published March 30 in the Journal of the National Cancer Institute.

Cancer registries across the United States are now recording these breast cancer subtypes, the groups noted, and this new data will help researchers more accurately rank breast cancer by risk. It should also help patients better understand each subtype's impact on their health, the authors said.

Some differences in breast cancer rates and deaths between racial and ethnic groups are also tied to differences in the rates of different breast cancer subtypes emerging in those groups, the report suggests.

It said there were unique racial/ethnic group patterns by age, poverty level, geography and specific tumor characteristics. For example, rates of HR+/HER2- breast cancer -- the least aggressive subtype -- were highest among white women.

Blacks had higher rates of the most aggressive breast cancer subtype -- triple negative -- than other racial/ethnic groups, and also had the highest rates of late-stage disease. Blacks have the highest rates of breast cancer deaths, the report noted.

Varmus called the move towards more categorization, "a harbinger of the more rigorous classification of cancers based on their molecular features that is now being aggressively pursued under the President's Precision Medicine Initiative. The new diagnostic categories now being defined will increasingly support our ability to prevent and treat breast and many other kinds of cancer, as well as monitor their incidence and outcomes more rigorously over time."

Two breast cancer experts applauded the move.

"The breaking apart of breast cancer into subgroups highlights the fact that not all breast cancers are equal," said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City. "These cancers are treated differently by medical oncologists already, but the new classification will help patients have a better understanding of survival rates that are more specific to a particular subtype of breast cancer."

Dr. Charles Shapiro is director of Translational Breast Cancer Research at the Tisch Cancer Institute at Mount Sinai in New York City. He agreed that "the biology of these subtypes is of critical importance to selecting the most effective treatments for breast cancer.

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5 Common Preventable Medical Errors

Lots of Leafy Greens Might Shield Aging Brains, Study Finds

By Alan Mozes

HealthDay Reporter

MONDAY, March 30, 2015 (HealthDay News) -- A single serving of leafy green vegetables each day may help keep dementia away, new research suggests.

Researchers evaluated the eating habits and mental ability of more than 950 older adults for an average of five years.

Those who consumed one or two servings of foods such as spinach, kale, mustard greens and/or collards daily experienced slower mental deterioration than those who ate no leafy greens at all, the study found.

The brain benefits associated with dark leafy greens likely stem from several key nutrients, particularly vitamin K, said study lead author Martha Clare Morris of Rush University Medical Center in Chicago.

The researchers "observed a protective benefit from just one serving per day of green leafy vegetables," which are known to be rich in vitamin K, added Morris, a nutritional epidemiologist at the Rush Alzheimer's Disease Center.

Morris was scheduled to present her team's findings Monday at the annual meeting of the American Society for Nutrition in Boston. Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.

The study cannot actually prove that leafy greens preserve clarity of thinking.

But another expert, Dr. Yvette Sheline, said the finding is both "interesting and in some ways surprising."

"It makes sense that leafy green vegetables would have an effect on mental health," said Sheline, a professor of psychiatry and neurology at the University of Pennsylvania Perelman School of Medicine.

"We know generally that what you eat, or don't eat, can affect your risk for high blood pressure and vascular disease, which can both then worsen the course of dementia," she said.

But exactly how leafy greens may alter dementia risk remains a mystery, Sheline said.

"But while it's still being worked out, I'd say go to your local grocery and pick up some kale. There's certainly no harm done," she added.

For the study, funded by the U.S. National Institutes of Health, researchers focused on 954 men and women enrolled in Rush's Memory and Aging Project. Participants were 81 on average at the start, and three-quarters were women.

Every year for almost five years on average, participants completed a 144-item food and beverage questionnaire and underwent 19 mental skill tests.

In the end, each individual's nutrient intake was calculated based on the type and quantity of food consumed on a daily basis.

The team determined that those who routinely consumed one or two servings of leafy greens every day demonstrated the mental capacity of someone more than a decade younger, compared with those who never ate leafy greens.

The findings held up even after accounting for gender, age, education, smoking history, exercise, and any heightened Alzheimer's risk (such as a family history).

Might vitamin K supplements work as well?

Morris took a cautionary stance, noting that the study focused solely on food sources of vitamin K. She also suggested that the mental health benefit found in food sources might ultimately be associated with a constellation of nutrients found alongside vitamin K, rather than vitamin K alone.

"It is very difficult to tease apart the specific association of vitamin K from other nutrients," she said. Leafy greens also contain beneficial lutein, folate and beta-carotene, Morris added.

If you're not a fan of kale and spinach, such nutrients can also be found in a range of bright fruits and vegetables, the researchers pointed out.

More information

For tips on preventing Alzheimer's disease, visit the U.S. National Institute on Aging.

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Gestational Diabetes Drug Might Raise Babies' Complication Risk

By Steven Reinberg

HealthDay Reporter

MONDAY, March 30, 2015 (HealthDay News) -- When used to treat diabetes that develops during pregnancy (gestational diabetes), the drug glyburide has been linked to a number of complications in the baby, according to a new study.

In fact, infants born to mothers given glyburide (DiaBeta) during pregnancy had a higher risk of respiratory distress, needing intensive care, having low blood sugar, being too large at birth, and birth injury when compared to babies born to mothers treated with insulin.

There has been widespread and rapid uptake in the use of glyburide in mothers with gestational diabetes in the last 10 years, according to the report.

"Doctors and patients need to be aware that although glyburide is easier to use than insulin, not all women may be good candidates for management with this medication," said lead researcher Michele Jonsson Funk, an assistant professor of epidemiology at the University of North Carolina at Chapel Hill. "We need to better understand which women can be treated effectively with glyburide, considering not only the short-term but also the long-term effects that these treatments may have on the health of their newborns," she said.

It's important to note, however, that while this study found an association between the use of glyburide and an increased risk of complications, the study wasn't designed to show a cause-and-effect relationship.

And Funk added that exactly why the drug is linked with these complications isn't clear.

But these findings are especially concerning since, according to Funk, the number of women who develop gestational diabetes in the United States has more than doubled during the last 20 years.

The report was published March 30 in JAMA Pediatrics.

"Glyburide has been used increasingly in pregnancy over the last 10 years. Although the initial trial data suggested it was safe, large studies including this one have raised concerns about the safety of its use," said Dr. Richard Holt, author of an accompanying editorial in the journal, and a professor of diabetes and endocrinology at the University of Southampton in England.

Using a nationwide, employer-based insurance database, Funk and her colleagues collected data on more than 110,000 women with gestational diabetes. Women with type 1 or type 2 diabetes were excluded from this study. The researchers also excluded women under 15 or over 45 years, as well as women pregnant with multiples.

About 8 percent of women with gestational diabetes were treated with glyburide or insulin, according to the study. During the study period -- 2000 to 2011 -- the use of glyburide increased from 8.5 percent to 64 percent, the researchers found.

The study reported a 3 percent difference in the number of babies who needed neonatal intensive care admission, with babies born to mothers on glyburide more likely to end up in the NICU than babies born to mothers taking insulin.

The researchers also found that 1.1 percent more babies of mothers on glyburide had respiratory distress than babies born to mothers on insulin. The difference in the number of babies born too large for their gestational age was 1.4 percent more for babies exposed to glyburide compared to babies exposed to insulin.

The study authors suggested a possible reason for the differences in birth complications may be that women on glyburide don't have adequate control of blood sugar levels.

Holt said more research is needed, and that doctors should "look for alternatives to glyburide until more safety data are available."

Dr. Jonathan Blau, the associate director of neonatology at Staten Island University Hospital in New York City, said, "It is very concerning that a drug that is routinely used to manage gestational diabetes apparently results in adverse outcomes."

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U.S. Kids Getting Fewer Daily Calories From Fast Food

By Randy Dotinga

HealthDay Reporter

MONDAY, March 30, 2015 (HealthDay News) -- American children are getting fewer calories a day from fast food restaurants, but one-third still eat ready-to-go pizza, chicken and burgers on a daily basis, a new study finds.

Among kids aged 4 to 19, national health and nutrition surveys showed that average daily calorie consumption from fast food restaurants fell by 110 calories between 2003 and 2010, said study author Colin Rehm. Also, the percentage of kids consuming fast food on a given day dropped from nearly 39 percent to about 33 percent in the period, the McDonald's-funded study found.

"It is good news with a few important qualifiers," said Rehm, who worked on the research while at the University of Washington. "We need to make sure that the decrease in calories hasn't been paralleled by a drop in nutrients or food groups."

The findings suggest young people are consuming fewer high-calorie foods and beverages at burger restaurants during their visits, Rehm said, while making fewer visits to pizza places and eating smaller portions of pizza when they do. (The percentage of kids who got food at pizza joints fell from 12 percent to 6 percent, the study said.)

"We observed a decrease in calories for burger, pizza and chicken restaurants," said Rehm, now a nutrition scientist at Tufts University in Boston. "We did not observe any changes for sandwich or Mexican restaurants."

Kids' eating habits are of concern because in the past three decades obesity has more than doubled in children and quadrupled in adolescents, according to the U.S. Centers for Disease Control and Prevention.

Rehm believes the results suggest that fast-food restaurants are serving healthier options.

Another expert said parents may also be getting the message that fast food is generally unhealthy.

"Studies that have looked at the nutrition quality of fast food have shown that most of the options available are poor quality," said Kelly Purtell, an assistant professor of human sciences at Ohio State University.

"Fast food meals are often deficient in important nutrients and contain high levels of added sugars and fats, so reductions in overall caloric intake are likely a good sign," she said.

"The proliferation of alternative restaurants with relatively fast service are also potentially contributing to the reductions," Purtell said.

Does the study point to a healthier trend? Purtell thinks so, although she acknowledged that kids could be eating fewer calories and less nutritious food.

"It is also important to note that over 30 percent of kids report eating fast food in a given day. This is still incredibly high," Purtell added.

She said the new study is important because it helps researchers understand trends in fast food consumption among kids.

"We have known that kids eat a lot of fast food, but this provides new information," she said.

The reported decline in calories from fast food parallels research on U.S. adults that showed that overall calories from fast food fell from 13 percent in 2007-2008 to 11 percent in 2009-2010, according to background notes with the study.

For kids, the statistics suggest that total calories consumed fell by about 205 calories a day from 2003-2010, Rehm said. "About half of this drop was due to decreases in calories from fast food, he said.

The findings appear in a research letter published March 30 in JAMA Pediatrics.

The study authors launched their research to gain understanding of how fast food consumption by kids might be changing. "We also wanted to examine, for the first time, trends in fast food consumption by type of fast food restaurant," Rehm said.

He noted that the surveys should have picked up visits to newly popular "fast casual" restaurants like Chipotle and Panera Bread because they qualify as fast food restaurants.

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Could an Apple a Day Help Keep the Pharmacist Away?

By Robert Preidt, HealthDay Reporter

MONDAY, March 30, 2015 (HealthDay News) -- Munching each day on a McIntosh, Granny Smith or other apple might not keep the doctor at bay, but a new study finds apple eaters are less likely to need a prescription medicine.

The study, funded by the U.S. National Institutes of Health, looked at data from nearly 8,400 people who took part in federal health surveys between 2007 and 2010.

Of those participants, 753 (9 percent) were apple eaters -- at least one small apple per day -- and the rest were non-apple eaters.

Apple eaters were slightly less likely to use prescription medications, reported a team led by Matthew Davis, of the University of Michigan School of Nursing in Ann Arbor.

But apple consumption was not linked to other health markers -- things such as the number of annual doctor visits a person made, frequency of overnight hospital stays, or visits to a mental health professional.

And the study wasn't designed to find that apple consumption caused any uptick in health. Davis and colleagues found that people who ate at least one apple each day also tended to have higher levels of education and were less likely to smoke.

Overall, the findings "suggest that the promotion of apple consumption may have limited benefit in reducing national health care spending," the study authors concluded.

One expert agreed that eating apples might be at least a signal of a healthier lifestyle, however.

"This study does leave open the possibility that apple lovers do have healthier lifestyles in general, which could explain the association between apple-eaters and fewer prescription medications," said Erin Keane, an outpatient dietitian at Lenox Hill Hospital in New York City.

She also pointed to the apple's nutritional goodness.

"Apples are a good source of soluble fiber, vitamin C and certain flavonoids, as are many fruits and vegetables," Keane said. "For these reasons, apples help decrease our [bad] LDL cholesterol, boost our immune system, and provide us with anti-cancer compounds," she added.

"We should take advantage of this sweet treat and use it in place of dessert or as part of a snack with some nuts or low-fat cheese to get us on the right path towards health," she believes.

The study was published online March 30 in the journal JAMA Internal Medicine.

More information

The U.S. Centers for Disease Control and Prevention has more about fruits and vegetables.

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U.S. Pediatricians Remain Opposed to Random Drug Tests in Schools

By Amy Norton

HealthDay Reporter

MONDAY, March 30, 2015 (HealthDay News) -- Random drug testing in schools may sound like a good way to keep kids off drugs, but there is little evidence it works, the American Academy of Pediatrics says.

In a new report, the nation's leading group of pediatricians reaffirms its stance against random drug testing in schools. The group suggests schools redirect their limited resources toward helping students avoid or overcome drug problems.

Teen alcohol and drug use is a big problem, the group says, and subjecting kids to random drug tests might sound like a strong deterrent. But scientific research shows otherwise.

"The evidence is just really weak," said Dr. Sharon Levy, a co-author of the report published online March 30 in Pediatrics.

For one thing, Levy said, the tests are unlikely to catch kids who use drugs sporadically, rather than heavily.

"And with kids, it's mainly sporadic use that you're trying to detect," said Levy, director of the adolescent substance abuse program at Boston Children's Hospital.

Daniel Romer is a researcher and director of the Adolescent Communication Institute at the University of Pennsylvania's Annenberg Public Policy Center. He was not involved with the report, but agreed that random drug testing is largely ineffective.

In a recent study of U.S. high school students, Romer found that kids in schools with random drug testing were no less likely to experiment with alcohol or marijuana.

Around 20 percent of U.S. high schools had started a drug testing program by 2006, according to the U.S. Centers for Disease Control and Prevention. And the number of schools doing so is rising, Romer said -- with even some middle schools considering the tactic.

Testing usually involves a urine test that looks for drugs like marijuana, cocaine and amphetamines. Legally, random testing can target only kids going out for sports or other extracurricular activities.

And that means they miss many students -- including some of those most at risk of drug abuse, Romer said.

Other issues include the risk of false-positive results. Some medications, such as ADHD drugs, or even certain foods can generate a positive result, Levy said.

And then there's cost. Levy's team said a single drug test is about $24. But since random testing catches so few students on drugs, it costs around $3,000 to get one positive test result.

Plus, Romer said, "random drug testing has no impact on kids' beliefs about drugs."

Students determined to use drugs will likely figure out how to get around the tests -- for example, by switching to a drug that is not detected by their school's test panel. "Then it becomes like a cat-and-mouse game for them," Romer said.

"The idea of drug testing sounds good," he added. "The reality is different."

So what does keep kids from using and abusing drugs? That's not clear, Levy and Romer said.

Studies have found the most famous anti-drug effort used in U.S. schools -- the D.A.R.E. education program -- ineffective (though, Romer noted, it has recently been revamped). D.A.R.E. stands for Drug Abuse Resistance Education.

In his own recent study, Romer found that kids in high schools with a "positive climate" were less likely than students at other schools to use marijuana or alcohol.

A positive climate means that kids feel safe and have a good relationship with their teachers, and the school has fewer problems with nondrug issues, like bullying.

"The question remains, how do you create a positive climate?" Romer said.

He thinks that if school officials feel they have a drug problem, it would be wise to look at the overall climate.

"How good are the relationships between students and adults at the school? Is there a problem with bullying?" Romer said. "It's unlikely that drugs are the only problem."

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Milliliter-Only Dosing Recommended for Kids' Meds

By Tara Haelle

HealthDay Reporter

MONDAY, March 30, 2015 (HealthDay News) -- Time to toss out the teaspoon and tablespoon when it comes to sick kids: The best way to measure liquid medications for children is in metric milliliters, a leading group of U.S. pediatricians says.

"Metric dosing is the most precise way to dose medications and prevent overdoses," said Dr. Ian Paul, lead author of a new policy statement from the American Academy of Pediatrics.

Accidental medication overdoses send more than 70,000 children to U.S. emergency rooms each year, according to background information with the statement, which is published online March 30 in the journal Pediatrics.

Two common ways these overdoses occur are incorrect measurement of the medicine and using the wrong device to measure it out -- giving a tablespoon instead of a teaspoon, for instance.

"There are increasing data that suggest that some dosing errors and overdoses occur when parents use spoons to dose medications," said Paul, chief of academic general pediatrics at Penn State College of Medicine in Hershey.

"In fact, the 1975 American Academy of Pediatrics policy statement cited in the current report suggested that oral syringes were the best and most precise way to deliver accurate medication doses," he added

This new policy statement goes further, recommending exclusive use of the metric system, specifically milliliters with the abbreviation mL.

"By the whole health care system adopting a single approach, the consistency will be of further benefit and more similar to how medications are dosed around the world, where metric dosing has been routine and standard," Paul explained.

The switch, Paul said, is "based upon newer evidence suggesting this is both more accurate and less likely to cause large dosing errors." He said most doctors are already familiar with metric dosing, but patients, parents and caregivers may need some instruction.

The biggest advantage to using only metric dosing is consistency and clarity, said Dr. Roy Benaroch, an assistant adjunct professor of pediatrics at Emory University in Atlanta.

"Medications and doctor visits with sick children can be confusing, and we ought to do what we can to make sure that instructions are clear, using consistent units that are the same on the label and the device used to measure," Benaroch said.

Using only milliliters "eliminates at least some significant sources of dosing confusion and errors," he added.

Currently, some over-the-counter medications include metric dosing instructions along with a measuring device marked in teaspoons, the academy noted.

Previous research has found that parents who use only milliliters when giving kids medicine make fewer errors than parents who use teaspoons or tablespoons, the statement said.

The statement outlined specific recommendations aimed at reducing errors that can result in an overdose.

In addition to using only milliliters, the academy recommends that units are dosed to the nearest 0.1, 0.5 or 1 mL and that no other abbreviation is used except mL. It also recommends that zeroes come before a decimal, such as 0.5, but that no zeroes come after the last number of a decimal. Both recommendations are designed to prevent caregivers from accidentally measuring out 10 times the prescribed dose.

The medication's concentration should be clearly labeled on prescriptions along with non-abbreviated instructions on how frequently the medication should be given, the academy advises.

Parents may be less familiar with the metric system, so doctors should review the dosing with families when the medications are recommended, and pharmacies, hospitals and health centers should only print prescription labels with metric dosing and include an appropriate measuring device.

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Health Tip: Develop Healthy Habits for Contact Lenses

Health Tip: Are Wisdom Teeth Causing Problems?

By Diana Kohnle, HealthDay Reporter

(HealthDay News) -- Wisdom teeth typically emerge in a person's late teens or early 20s, and may cause big problems.

The Mouthhealthy.org website recommends having wisdom teeth removed if you develop:

• Pain in the back of the mouth.


• Decaying wisdom teeth that cannot be remedied.


• Mouth infections tied to wisdom teeth.


• Tumors or cysts forming near wisdom teeth.


• Gum disease near wisdom teeth.


• Damage to nearby teeth.

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Spring Allergies Have Arrived

By Robert Preidt, HealthDay Reporter

SUNDAY, March 29, 2015 (HealthDay News) -- It may not feel like it in some parts of the United States, but spring has arrived and that means it's allergy season.

About 50 million Americans have seasonal allergies -- also called hay fever -- and suffer symptoms such as sneezing, stuffy or runny noses, and itchy eyes, nose and throat, according to the American College of Allergy, Asthma and Immunology.

"Even with snow still on the ground, trees have started budding and are the first to produce pollen, creating major problems for people with allergies," Dr. David Rosenstreich, chief of the division of allergy and immunology at Montefiore Medical Center in New York City, said in a hospital news release.

"The symptoms people experience often resemble a common cold, but, if it happens every year at this time, it's most likely to be allergies," he explained.

Over-the-counter and prescription medications can help reduce allergy symptoms.

"By taking medicine early, you can prevent the symptoms before they begin," Rosenstreich said. "If you start after the symptoms are in full swing, it's much harder to stop the allergic reaction than to prevent it from the beginning."

There are a number of other things you can do to control allergy symptoms, such as limiting your time outdoors on days with high pollen counts, and keeping your house and car windows closed to keep pollen out.

It's also a good idea to use an air conditioner, which filters the outside air before it enters your home. Don't mow your lawn or rake leaves, because this stirs up pollens and molds. Wash your hair after you've been outdoors, and don't hang sheets or clothes outside to dry.

"There's no reason for people with allergies to suffer. As long as you take the proper precautions, you should be able to enjoy the outdoors and make the most of the warm weather," Rosenstreich said.

More information

The U.S. National Library of Medicine has more about hay fever.

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Processed Foods the Biggest Chunk of Calories in U.S. Grocery Bags: Study

By Robert Preidt, HealthDay Reporter

SUNDAY, March 29, 2015 (HealthDay News) -- Highly processed foods account for more than 60 percent of the calories in products Americans routinely buy in grocery stores, a new study finds.

These foods tend to have more fat, sugar and salt than less-processed foods, the researchers said.

"Overall, we found that not only are highly processed foods a dominant, stable part of U.S. purchasing patterns, but also that the highly processed foods that households are purchasing are higher in fat, sugar and salt, on average, compared to the less-processed foods that they buy," study author Jennifer Poti, a research assistant professor at the University of North Carolina at Chapel Hill, said in a news release from the American Society for Nutrition.

Poti's team analyzed at least one year of grocery store purchases by more than 157,000 households between 2000 and 2012. The participants took part in the study for an average of four years and collectively bought 1.2 million items.

Highly processed foods include items such as prepared meals, white bread, cookies, chips, soda and candy. Unprocessed or minimally processed foods include fresh or frozen vegetables, fresh meat, milk, eggs and dried beans.

From 2000 to 2012, the proportion of calories bought in highly processed foods remained stable at 61 percent to 62.5 percent. There was a significant increase in the proportion of calories bought in ready-to-heat foods (such as frozen meals), reaching more than 15 percent in 2012, the investigators found.

The findings were scheduled for presentation Saturday at the Federation of American Societies for Experimental Biology annual meeting, in Boston. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.

"Many Americans have strongly held opinions and beliefs about processed foods," Poti said in the news release.

"Some consider processed foods to be tasty, convenient and affordable choices while others contend that the combination of sugar, fat, salt and flavoring in these foods promotes overeating and contributes to obesity. But until now, we didn't really have the evidence needed to settle this debate," she explained.

Poti said there is a need to distinguish between processed and highly processed foods.

"It is important that when we discuss processed foods, we acknowledge that many processed foods, such as canned vegetables or whole-grain breakfast cereals, are important contributors to nutrition and food security. However, it is the highly processed foods . . . that might potentially be related to obesity," Poti said.

More information

The U.S. Centers for Disease Control and Prevention has more about nutrition.

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