Monthly Archives: December 2016

Should You Know If Live Long and Be Positive

Patients with coronary heart disease who have positive expectations about recovery, expressing beliefs such as “I can still live a long and healthy life,” had greater long-term survival, researchers reported.

Among a cohort of almost 3,000 patients undergoing coronary angiography, those with the highest expectations for outcomes actually had the best outcomes, Dr. John C. Barefoot, and colleagues from Duke University Medical Center in Durham, N.C.

“Patients differ widely in terms of their psychological reactions to major illnesses such as coronary heart disease,” Barefoot’s group explained online in the Archives of Internal Medicine.

Related: Should I Have an Angiogram?

To explore the specific potential influence of recovery expectations, rather than overall optimistic personality traits, the investigators enrolled 2,818 patients with clinically significant disease and followed them for about 15 years.

Recovery expectations were assessed on the Expectations for Coping Scale, in which patients agreed or disagreed with statements such as “I doubt that I will ever fully recover from my heart problems” and “My heart condition will have little or no effect on my ability to do work.”

Patients were stratified into quartiles according to their expectation scores.

After adjustment for multiple variables, the mortality rate in the highest quartile — the most optimistic group — was 32 per 100 versus 46 per 100, respectively, “illustrating a substantial magnitude of this effect even after taking multiple covariates into account,” Barefoot and colleagues observed.

“These observations add to a compelling body of evidence that endorsing optimistic expectations for one’s future heart health is associated with clinically important benefits to cardiovascular outcomes,” Dr. Robert Gramling, and Dr. Ronald Epstein, of the University of Rochester in New York, wrote in a commentary accompanying the study.

“The degrees of evidence observed in these studies suggest that optimism is a powerful ‘drug’ that compares favorably with highly effective medical therapies,” they wrote.

Other experts advised caution, however.

“Like all observational studies, unmeasured patient characteristics may have contributed to the better outcomes,” observed Dr. Steven E. Nissen, of the Cleveland Clinic.

“Patients with a ‘positive’ attitude may simply be healthier than patients with a negative attitude. In fact, their ‘attitude’ may reflect their health status,” Nissen wrote to MedPage Today and ABC News in an e-mail.

Two “plausible” hypotheses can help explain the study findings, according to Barefoot and colleagues.

First, patients who are optimistic may use more effective strategies to cope with recovery from illness, by addressing the problem and reducing risk factors.

Second, patients whose outlook is more negative may experience worse stress that in turn could have harmful cardiac effects.

Limitations of the study, according to the investigators, included the possibility of confounders and selection bias.

“These findings argue for expanded efforts to understand the influence of recovery expectations and the potential benefits of attempts to modify them,” Barefoot’s group concluded.

However, the potential efficacy of such efforts is uncertain, according to Dr. James Kirkpatrick, of the University of Pennsylvania in Philadelphia.

“Whether a patient’s outlook can be changed (or patients can change their outlook) and improve results, and whether there are other factors which might make these patients do better, is unknown. One of those factors might be that cardiovascular providers give better care to patients with a positive outlook — perhaps spending more time with them or being more conscientious,” wrote Kirkpatrick in an email to MedPage Today and ABC News.

“Future studies will need to take this possible mechanism into account,” wrote Kirkpatrick.

The study was supported by the National Heart, Lung, and Blood Institute and the National Institute on Aging.

One author has a patent pending on an allele as a marker of cardiovascular disease and stress, and is a founder and major stockholder in Williams LifeSkills Inc.

Editorialist Gramling is funded by the National Palliative Care Research Center and the Greenwall Foundation.

Beer’s Health Benefits

Your favorite pint may be healthier than you realize. When it comes to good-for-you happy hour beverages, we tend to think mainly of red wine and its heart-friendly antioxidants. Recent research, however, reveals that beer may also help what ales you, from reducing the risk of osteoporosis to beating brain fog.

But before you go on a beer binge, remember that moderation is key to reap its health perks. That means no more than two 12-ounce beers a day for men and one for women. “If you overdo it, alcohol can take a toll on your health, contributing to liver damage, certain cancers, heart problems, and more,” says Andrea Giancoli, RD, spokesperson for the American Dietetic Association. People with certain health conditions — including gout, high triglycerides, or breast cancer, for example — should avoid drinking beer or other alcohol because it can exacerbate those health problems, according to Joy Bauer, RD, nutrition and health expert for Everyday Health and The Today Show.

Too much alcohol can also cause weight gain. After multiple rounds, calories can add up quickly (a 12-ounce regular beer can pack up to 150 calories, while a light beer has around 100).

But for most of us, here are five healthy reasons to toast your next beer:

Beer Boost No. 1: A Stronger Skeleton

Make no bones about it: Beer in moderation may protect bone health thanks to its high silicon content. Participants who sipped one or two beers a day had greater bone mineral density than those who drank more or fewer beers, found a 2009 study published in the American Journal of Clinical Nutrition. “Silicon helps stimulate bone-building cells, and the estrogenic effect of alcohol also has a protective quality for bones,” says study author Katherine Tucker, PhD, professor of nutritional epidemiology at Northeastern University in Boston. Which brew boasts the most silicon? Try an India Pale Ale. A 2010 University of California Davis study found that IPAs had the highest levels of the mineral.

Beer Boost No. 2: A More Powerful Ticker

A beer a day may keep heart disease away. “Alcohol raises levels of ‘good’ HDL cholesterol,” says Arthur Klatsky, MD, senior consultant in cardiology at the Kaiser Permanente Division of Research in Oakland, Calif. “It also has anti-clotting effects, which keeps blood vessels clear and healthy.” In fact, Israeli researchers found that people who drank one beer daily had lower levels of fibrinogen, a protein that helps promote blood clotting, than those who abstained from drinking. (Blood clots can cause heart attack and stroke.) Study participants drank Maccabee beer, but researchers believe that any type of beer could have similar heart-healthy effects.

Beer Boost No. 3: Healthier Kidneys

Finnish researchers found that men who drank beer had a 40 percent lower risk of kidney stones compared to those who drank other types of alcohol. The benefit may be due to beer’s high water content. Dehydration can increase the risk of kidney stones, which are little deposits of salt and minerals such as calcium that can form in your kidneys. Beer’s hops (a kind of flower that gives beer its bitter flavor and acts as a preservative) may also help prevent kidney stones by slowing the release of calcium from bones.

Beer Boost No. 4: Better Brain Power

While excessive alcohol intake can cause irreparable brain damage, moderate daily consumption actually safeguards a sharp mind, research shows. One classic New England Journal of Medicine study, which analyzed the drinking habits of about 11,000 women over more than 15 years, found that those who had up to one drink a day had a 20 percent lower risk of brain function decline (as measured by memory and other cognition tests) than nondrinkers. Alcohol intake may protect blood vessels in the brain and also lower stroke risk, say researchers.

Beer Boost No. 5: Lower Cancer Risk

Beer’s health benefits aren’t limited to those who drink it: Marinating steak in your favorite brew could eliminate up to 88 percent of the carcinogens that form as a result of pan-frying meat, according to a Portuguese study. Cooking meat at high temperatures creates cancer-causing compounds known as heterocyclic amines (HCAs). Researchers think that the sugars in beer help prevent HCA formation.

The Facts Of Radiation Exposure

Japan’s ongoing nuclear crisis understandably has people around the world worried about radiation exposure and the potential health risks it may pose. According to the latest reports, radiation from Japan was detected in Southern California late this week, but experts are quick to point out that the levels are far from dangerous. The readings were “about a billion times beneath levels that would be health threatening,” a diplomat with access to United Nations’ radiation tracking told the Associated Press.

Nor is it unexpected. “Whenever radioactive particles get in the atmosphere, they have the potential to spread around the world,” says James Thrall, MD, president of the American College of Radiology. “But they get diluted as they travel, so they’re unlikely to pose any real health problem.”

In fact, we’re probably exposed to significantly more radiation every day than the miniscule fallout arriving from Japan. Here’s a quick tutorial on radiation to put our collective anxiety in perspective:

What Is Radiation?

Radiation is a form of energy in waves. It exists on a spectrum, with low-frequency radiation (from radio waves and microwaves) on the low end and high-frequency radiation (from gamma rays and x-rays) on the high end. All radiation affects the cells in our bodies to some extent, but the lower the frequency of the waves and the lower the exposure, the less dangerous it is.

To understand the risks of high-frequency radiation — the kind we’re talking about in this article — think back to high school physics: These waves have enough energy to knock electrons off molecules, which can cause damage to cell DNA that can ultimately lead to cancer.

How Are We Exposed to Radiation?

We encounter radiation each day from a variety of sources. The average American is exposed to about 6 millisieverts (mSv) of radiation annually, according to the United States Nuclear Regulatory Commission (USNRC). Half of this typically comes from background radiation that occurs naturally in the environment, and half comes from medical tests, such as X-rays, mammograms, and CT scans.

According to Kelly Classic, MS, spokesperson for the Health Physics Society, sources of environmental radiation include:

Radioactive compounds in soil and building materials like concrete, brick, and stone
Radiation from outer space that your encounter when you fly on airplanes or visit high-altitude places
The mineral potassium in your own body (a small fraction of potassium, which our bodies need to function, is radioactive)
Radon gas in the home, which accounts for about 2 mSv of exposure each year, and is the largest contributor of background radiation
Finally, there’s the kind of radiation released during nuclear reactions, such as what’s disseminating from Japan’s Fukushima Daiichi plant.

Here’s a look at various sources of radiation exposure (dose of radiation in millisieverts (mSv)), according to data from the Health Physics Society and the U.S. Environmental Protection Agency (EPA). By way of comparison, a single dose of radiation below 0.01 mSv is considered negligible by the National Council on Radiation Protection and Measurements.

Banana: 0.0001
Dental X-ray: 0.005
Living within 50 miles of a nuclear power plant: 0.01 (per year)
A flight from New York to Los Angeles: 0.04
Smoking 1 ½ packs of cigarettes: 0.08
Chest X-ray: 0.1
Living at sea level: 0.25 (per year)
Mammogram: 0.3
Living in Denver: 0.5 (per year)
Abdominal CT scan: 14
Measures between reactors No. 3 and No. 4 during the March 15 explosion at the Fukushima plant: As high as 400 per hour
What Level of Radiation Exposure Is Safe?

It’s well-established that exposure to large amounts of radiation at once can cause acute sickness and even cancer. (A 1,000 mSv-dose can trigger acute radiation sickness, causing symptoms such as nausea and vomiting; 3,000 mSV can be lethal, according to Thrall.)

But there’s no good data on the long-term risks of the low levels of radiation to which we’re continually exposed.

According to the World Nuclear Association, annual exposure to 100 mSv or greater carries a measurable, though small, increase in cancer risk. Below that level, it’s believed that your body’s cells are able to heal themselves from radiation. “There are enzyme systems in the body that repair damage from these low levels of background radiation,” says Thrall.

But even small levels of radiation exposure may impact cancer risks later in life.

This has been of particular concern in the medical community, where some experts worry that increasing use of diagnostic CT scans (which has skyrocketed from 3 million annual scans nationwide in 1980 to 70 million in 2007, according to MedPage Today) will impact future cancer rates. For example, in one 2009 study, National Cancer Institute researchers estimated that one in 270 women and one in 595 men who had a heart CT at age 40 would eventually develop cancer related to the test.

While the health benefits of necessary diagnostic imaging usually outweigh the small risks of secondary cancers, it’s always a good idea to talk to your doctor before any procedure involving radiation to understand exactly what you’re getting, why you need it, and what the potential health risks may be.

Bottom line: Americans are exposed to far more radiation in their daily lives — and especially from certain medical tests — than from dispersed particles traveling across the Pacific. “With what we know now about the situation in Japan, there are no personal or public health risks apparent for people in the United States,” Thrall says.