On June 11, the Dr. Margaret Chan, director-general of the World Health Organization announced the H1N1 flu was officially a 2009 pandemic—a worldwide outbreak. At this time, the outbreak is considered moderate, in that most people recover from the infection without the need for hospitalization or medical care; overall national levels of severe illness from influenza (H1N1) are similar to levels of seasonal flu; and hospitals and health care systems in most countries have been able to meet the demand of patients seeking treatment. Thorough and frequent hand washing and proper coughing and sneezing techniques are two of the best methods to prevent contracting the flu and similar respiratory illnesses.
Mosquitoes in St. Louis County test positive for West Nile virus
Through testing, health officials have discovered West Nile Virus-carrying mosquitoes throughout St. Louis County. Positive results have been reported in mosquitoes in Florissant, St. John, Hanley Hills, Bel-Nor, Pagedale, Frontenac, Lemay, Sunset Hills and Jefferson Barracks County Park and in Mehlville.
Although no human cases have been reported, residents can minimize opportunities for mosquitoes to flourish by draining objects that can collect water at least once a week, keeping gutters cleaned out, repairing tears in door or window screens. People can avoid mosquito bites by wearing long-sleeved shirts, long pants and light-colored clothing outdoors and by spraying clothing with repellants containing DEET or picaridin. For more information on mosquito prevention, call the County Vector Control office at 314-727-3097 or go online at www.stlouisco.com/doh.
Where you carry fat predicts disease risk than weight
A mouse study indicates that overeating, rather than the obesity it causes, is the trigger for developing metabolic syndrome, a collection of heath risk factors that increases an individual’s chances of developing insulin resistance, fatty liver, heart disease and type 2 diabetes.
How and where the body stores excess, unused calories appears to matter most when determining a person’s risk of developing metabolic syndrome, researchers at UT Southwestern Medical Center suggest.
“Most people today think that obesity itself causes metabolic syndrome,” said Dr. Roger Unger, professor of internal medicine at UT Southwestern Medical Center and senior author of the study. “We’re ingrained to think obesity is the cause of all health problems, when in fact it is the spillover of fat into organs other than fat cells that damages these organs, such as the heart and the liver. Depositing fatty molecules in fat cells where they belong actually delays that harmful spillover.”
The study appears in the Proceedings of the National Academy of Sciences, and is among the first to suggest that weight gain is an early symptom of pre-metabolic syndrome, rather than a direct cause.
Is childhood obesity, asthma linked?
A new study indicates there may be yet another reason to reduce childhood obesity – it may help prevent allergies. The study published in the May issue of the Journal of Allergy and Clinical Immunology showed that obese children and adolescents are at increased risk of having some kind of allergy, especially to a food.
“We found a positive association between obesity and allergies,” said Dr. Darryl Zeldin, acting clinical director at NIEHS and senior author on the paper. Researchers analyzed data on children and young adults ages 2 to 19 from the National Health and Nutrition Examination Survey –NHANES, new national dataset designed to obtain information about allergies and asthma.
Researchers analyzed data from 4,111 children and young adults. They looked at total and allergen-specific immunoglobulin E (IgE) or antibody levels to a large panel of indoor, outdoor and food allergens, body weight, and responses to a questionnaire about diagnoses of hay fever, eczema, and allergies. The researchers found the IgE levels were higher among children who were obese or overweight. Obese children were about 26 percent more likely to have allergies than children of normal weight.
“The signal for allergies seemed to be coming mostly from food allergies. The rate of having a food allergy was 59 percent higher for obese children,” said NIEHS researcher Stephanie London, M.D., a co-author on the study.
“Seeing a possible link between obesity and allergies provides additional motivation for undertaking the challenge of reducing childhood obesity,” Linda Birnbaum, Ph.D., NIEHS director, said.
Weight loss improves fatty liver disease
Saint Louis University researchers found that weight loss of at least 9 percent helped patients reverse a type of liver disease known as nonalcoholic steatohepatitis (NASH), a finding that will allow doctors to give patients specific weight-loss goals that are likely to improve their livers. The finding comes from a study of the diet drug orlistat (also known as Xenical and Alli), which did not itself improve liver disease.
Brent Neuschwander-Tetri, M.D., a hepatologist at Saint Louis University Liver Center and study researcher said, “It’s a helpful study because we can now give patients a benchmark, a line they need to cross to see improvement.”
The study looked at patients with NASH, which is a type of liver disease characterized by excessive fat, causing inflammation and damage in the liver. Researchers set out to see if orlistat, which limits fat absorption, along with calorie restriction would lead to weight loss and improve liver disease in overweight patients with NASH, which was determined by a liver biopsy.
Fifty patients participated in the study, with all instructed to consume a 1,400 calorie diet and vitamin E, and half also receiving orlistat for 36 weeks, at which time liver biopsies were repeated.
While orlistat itself was not linked directly to improved liver health, weight loss was. Researchers were also able to pin-point the percentage of weight loss needed to improve liver damage. Patients who lost five percent or more of body weight over nine months showed improvement in insulin resistance and fat accumulation in the liver, and those who lost at least nine percent showed reversal of their liver damage.
“The bottom line is that weight loss can help improve fatty liver disease,” said Neuschwander-Tetri, who is a professor of internal medicine at Saint Louis University. “Now we know how much weight loss is needed for improvement, and we can give patients specific goals as they work to improve their health.”
The findings were published in the January edition of Hepatology, the study was conducted at SLU and Brooke Army Medical Center and was funded by Roche Pharmaceuticals, the maker of orlistat.
Losing weight can cure obstructive sleep apnea in overweight patients
For sufferers of obstructive sleep apnea (OSA), a new study shows that losing weight is perhaps the single most effective way to reduce OSA symptoms and associated disorders, according to a new study in the American Journal of Respiratory and Critical Care Medicine.
Weight loss may not be a new miracle pill or a fancy high-tech treatment, but it is an exciting therapy for sufferers of OSA both because of its short- and long-term effectiveness and for its relatively modest price tag.
“Very low calorie diet (VLCD) combined with active lifestyle counseling resulting in marked weight reduction is a feasible and effective treatment for the majority of patients with mild OSA, and the achieved beneficial outcomes are maintained at one-year follow-up,” wrote Dr. Henri P.I. Tuomilehto, of the department of Otorhinolaryngology at the Kuopio University Hospital in Finland.
The prospective, randomized trial found that, in 81 patients with mild OSA, the 40 patients who were in the intervention arm underwent a diet that strictly limited caloric intake combined with lifestyle counseling lost more than 20 pounds on average in a year—and kept it off, resulting in markedly lower symptoms of OSA. The 41 patients in the control arm, who only received lifestyle counseling and lost on average less than 6 pounds, and were much less likely to see improvements in their OSA.
And not only does sustained weight loss improve OSA, it also improves the many other independently linked co-morbidities such as hypertension, high cholesterol, and diabetes.
Furthermore, Dr. Tuomilehto observed, “The greater the change in body weight or waist circumference, the greater was the improvement in OSA.” In fact, mild OSA was objectively cured in 88 percent of the patients who lost more than 33 pounds, a statistic that declined with the amount of weight lost.
Black female breast cancer survivors needed by UMSL’s College of Nursing
The Black Women Breast Cancer Survivor Project at the University of Missouri-St. Louis College of Nursing is seeking black women breast cancer survivors to participate in the Long Term Quality of Life in Black Women Breast Cancer Survivors Research Project.
This Susan G. Komen for the Cure funded project asks participants to complete a series of questionnaires focusing on their life experiences before and after their cancer diagnosis. This is a non-invasive research project that pays participants a stipend upon completion.
The information gathered from the surveys will be used to help nurses and other health care professionals provide culturally-competent care to the growing diverse patient population. Margaret Barton-Burke, the Mary Ann Lee Endowed Professor of Oncology Nursing at UMSL, is overseeing the project.
Although black women experience a lower incidence of breast cancer, the death rate is higher.
“Current care is based on what we have learned from white women,” Barton-Burke said. “If we could get survivors from the African-American community to tell us what their experiences have been, we could better understand the nature and impact of breast cancer on different aspects of African-American women’s lives.”
Black women who were diagnosed with and treated for stage one, two or three breast cancer, have completed treatment, and would like to participate, should call Ebony Smith, M.P.H., project coordinator at 314-516-6074.
African-Americans want doctor’s help to lose weight
The conversation on weight management isn’t taking place between patient and physician – and when it does, many patients don’t like what they’re hearing, according to a new study at Temple University School of Medicine, released in the May issue of The Journal of Internal General Medicine. Researchers there say many patients feel their physicians are not initiating or addressing their weight concerns at all. And when they do, some doctors say patients aren’t doing enough to lose weight.
“Patients expect their doctors to initiate the discussion and not ignore their weight issues,” says lead researcher Dr. Stephanie Ward M.P.H., assistant professor of medicine and public health at the School of Medicine. “They also feel doctors have the knowledge, but don’t take the time to give concrete advice on how to lose weight.”
Ward conducted focus groups on 43 obese patients, all African-Americans recruited through the general internal medicine practices at Temple. While obesity does not discriminate, national data shows it disproportionately affects African-Americans, which leads to severe health complications and even death. The patients were asked a number of preset questions on how their primary care physicians address weight management.
“We were surprised by their desire for a degree of specific information which they wanted from their doctor.
Study participants overwhelmingly disliked the word obese and insisted it should be used only in reference to zoo animals.
A majority found doctors who were open and encouraging and acknowledged their efforts were beneficial, whereas doctors who ignored a patient’s weight or blamed all the patient’s ills on obesity were viewed more negatively. Scare tactics evoked a mixed reaction; some participants felt motivated, while others did not respond well to an ultimatum of “diet or die.”