Physical activity or medical treatment

Moral of the story: Which do we target in health campaigns? Why not both?

Source: BMJ

(1) What's more important in the obesity battle – physical activity or medical treatment?
(Head to Head: Should health policy focus on physical activity rather than obesity?)
Yes: http://www.bmj.com/cgi/content/extract/340/may25_1/c2603 No: http://www.bmj.com/cgi/content/extract/340/may25_1/c2602
Experts disagree on bmj.com today about the best way to tackle the obesity crisis. While Professor Louise Baur and colleagues from the Children's Hospital at Westmead and the University of Sydney in Australia acknowledge that "physical inactivity is a major contributor to the global burden of disease," they says that it would be wrong to only focus on this and ignore the problem of obesity.
Baur and colleagues argue that physical inactivity is just one marker and that there is substantial evidence that unhealthy diets low in fibre and high in sugar and large portion size are also responsible for obesity and the diseases associated with it.
However, Dr Richard Weiler, a specialist registrar in sport and exercise medicine at Imperial College Healthcare NHS Trust and general practitioner, and colleagues believe that inadequate cardio-respiratory fitness causes disease more than excess body fat, waist size and body mass index.
Weiler and colleagues maintain that "physical inactivity is one of the greatest health threats facing developed nations today" and they are concerned that 95% of the populations in England and the United States do not meet the recommended guidelines of doing 30 minutes moderate to vigorous physical activity on at least five days a week or equivalent.
They say this is alarming given that physical inactivity rather than obesity per se is an actual cause for many illnesses including obesity, heart disease, type 2 diabetes, mental health problems, high blood pressure and dementia.
Spending huge amounts on treating obesity is not the right way forward, they argue. Weight loss drugs and surgery are risky and the long-term benefits are limited and they certainly do not have the associated health benefits linked to physical activity. They conclude that it is time for health policy and healthcare professionals to focus on fighting physical inactivity, a "chronic disease that has an adult population prevalence of 95%."
Professor Baur, on the other hand, believes that "on its own, improving physical activity will have little impact on reducing overall levels of already established obesity."
She believes that obese people need access to high quality treatment provided by well-trained professionals to deal with their weight and any linked health problems.
In conclusion, Professor Baur and colleagues advocate tackling obesity with a range of strategies, for example, increasing physical activity, improving diet and lifestyles. They say urban planning should be developed to encourage people to use their car less and cycle more and public transport should be made more accessible and affordable.
Contacts:
Louise Baur, The Children's Hospital at Westmead, Sydney, NSW, Australia
Email: louiseb3@chw.edu.au Richard Weiler, Specialist Registrar in Sport and Exercise Medicine, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK and General Practitioner, Hertfordshire Email: c/- cassie.zachariou@imperial.nhs.uk

Pill for female sex drive

Moral of the story: a possibly unnecessary an dangerous drug that targets female arousal.

Source: AMA Morning Rounds 5/24/2010

FDA advisory committee to consider approving pill designed to boost women's sex lives.
The Washington Post (5/24, Stein) reports, "A panel of federal advisers will soon" consider "endorsing the first pill designed to do for women what Viagra [sildenafil] did for men: boost their sex lives." The drug known as "flibanserin," which was developed by Germany's Boehringer Ingelheim, may become "the first prescription medication to tap what some have estimated could be a $2 billion market in the United States alone." But, "even before the FDA's Reproductive Health Drugs Advisory Committee meets June 18 to consider the request, the prospect of the drug's approval has triggered debate over whether the medication, like others in the pipeline, represents a long-sought step toward equity for women's health or the latest example of the pharmaceutical industry fabricating a questionable disorder to sell unnecessary -- and potentially dangerous -- drugs."
The creator of a new documentary on "female sexuality" stumbled upon the issue while researching her film, Newsweek (5/23, Kantrowitz, Wingert) reported. Liz Canner "was bewildered by the purported disease" that some refer to as "female sexual dysfunction." Noting that Vivus executives told her that "43 percent of women had this disorder," Canner asked, "How could that be true if I had never heard of it before?" After "a cross-country quest that included visits with scientists, experts in erotica, and individual women," Canner "ultimately concluded that the catch-all female sexual dysfunction is essentially a phony disease made up by pharmaceutical companies."



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Processed meat may be linked to increased risk of heart disease, diabetes

Moral of the story: Processed meat may the real culprit and unprocessed red meat may be less unhealthy than previously thought. maybe.

Source: AMA Morning Rounds 5/18/2010

Processed meat may be linked to increased risk of heart disease, diabetes.

The Wall Street Journal (5/18, Winslow) reports that processed meat may be linked to increased risk of heart disease and diabetes, according to a study published online in the journal Circulation.

        The Boston Globe (5/17, Cooney) "White Coat Notes" blog reported that investigators looked at data from "20 studies involving more than 1.2 million participants from 10 countries who were followed for up to 18 years." After "pooling the study results, the researchers found that eating unprocessed red meat was not associated with heart disease or diabetes." However, "people who ate at least one serving a day of processed red meat -- one hot dog or two deli slices -- had a 42 percent higher risk of heart disease and a 19 percent higher risk of diabetes than people who did not eat processed red meat."

Hookahs not safer than cigarettes

Moral of the story: Hookahs may actually be worse than cigarettes in exposing people to more heavy metals and nicotine.  Stay away from both, they are bad.

Source: AMA Morning Rounds 5/18/2010

Hookahs, other water pipes mistakenly believed by many to be safer than cigarettes.

The New York Times (5/18, D6, Rabin) reports that after mailing "questionnaires in 2007 and 2008 to 1,208 people ages 18 to 24," researchers in Canada found that "many young people seem to believe that hookahs and other water pipes are safer than cigarettes." According to the authors of the Pediatrics paper, one myth involved young adults thinking that "because the texture is smoother, it is less toxic" and believing that "the water filters out the toxins." But, "that is not at all true," investigator Jennifer O'Loughlin asserted. "In fact, she said, the pipes may expose smokers to higher amounts of nicotine and heavy metals than cigarettes."

New fathers may suffer from depression

Moral of the story: Be aware of this possibility when you have a kid and address the issue if you see it arising.  Depression is a treatable condition and is perfectly normal to have arise with a new kid.

Source: AMA Morning Rounds 5/19/2010

New fathers may suffer from depression.

ABC World News (5/18, story 12, 1:15, Sawyer) reported, "We've all become a lot more sensitive to the problems of postpartum depression (PPD) in new moms." Now, however, "it turns out now that...new fathers may be suffering, too."

        USA Today (5/19, Szabo) reports that, according to a study published May 19 in the Journal of the American Medical Association, "14% of American men develop depression, either during their partner's pregnancies or in the first year after delivery." In other countries, "approximately 8% of fathers...develop the problem, according to the analysis, which included 43 studies of 28,000 people."

        The study "found that 10.4% of men experienced serious depression at some point between his partner's first trimester and one year after childbirth, more than double the depression rate for men in general," the Los Angeles Times (5/19, Roan) reports. Unfortunately, "paternal depression symptoms are much less likely to be recognized than maternal depression," because men do not become weepy or sad, and instead may display anger, irritability, or detachment from their families.

        On the front of its Personal Journal section, the Wall Street Journal (5/19, D1, Wang) reports that reasons for depression in men bear similarities to those for women, and may result from being deprived of sleep and stress between partners.

        Bloomberg News (5/19, Ostrow) reports that depression "may also occur because of changes in perceived role in life, financial stress, isolation from friends and social activities." Paternal "depression was highest in the three to six months following the baby's arrival," possibly "because family leave ends about that time, particularly in the US," the study authors from the Eastern Virginia Medical School theorized.

        According to CNN (5/19, Landau), "depression in fathers has potential negative implications for the family, and for the child's development and behavioral and emotional health," lead author James Paulson, PhD, "said. Paulson's study also found that fathers' depression tended to have an association with mothers' depression -- so when moms were more depressed, so were dads." Still, further research "is needed to determine how the two are related, as one parent's moods have not been proven to cause the other's."

Some advocacy groups concerned about endocrine-disrupting chemicals in sunscreens.

Source: AMA Morning Rounds 5/15/2010

Some advocacy groups concerned about endocrine-disrupting chemicals in sunscreens.
The Chicago Tribune (5/13, Deardorff) reported that "there's growing concern by advocacy groups, parents, and some doctors that some of the chemicals in" sunscreens "are endocrine disruptors and may pose risks to children." The Environmental Working Group currently "recommends against using any product containing the ingredient oxybenzone." Dr. Alan Greene, the author of "Raising Baby Green: The Earth-Friendly Guide to Pregnancy, Childbirth and Baby Care," is concerned that "the tests evaluating oxybenzone have been done on healthy adults in the middle of life. 'Permanent changes of puberty happen with one drop of sex hormones,' he said. 'We don't know the impact of kids and babies who get at least three times the concentration as adults.'"


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