Category: blog

Categories
blog

Top Reasons Not to Quit Coffee

Many studies have found that coffee has numerous components — many of them antioxidants — that can be good for your health. Although too much caffeine can be dehydrating, drinking at least one cup of coffee a day, according to a recent Japanese study, can cut your risk for bleeding in the brain.

Keep coffee drinking as healthy as possible by drinking it black or with a little bit of skim milk. Adding whole milk, half and half or cream, and sugar only adds calories.

The good news for coffee drinkers who’d rather do without the caffeine is that decaffeinated coffee provides some of the same health benefits as the caffeinated version.

So, drink to your health! Coffee, that is.

Categories
blog

Time Vs. Intensity: What Matters Most in a Workout

When it comes to working out, slow and steady may be the way to go.

Longer periods of slower, less-intense exercise — or simply moving more throughout the day — might be better for you than the short, high-intensity interval workouts that have garnered praise in recent years, a new study published in PLOS One finds.

When normal-weight participants burned a similar amount of calories through either short, intense workouts or longer periods of standing and walking, the group that stood and walked more had improved cholesterol levels and insulin response compared to the vigorous exercisers. Not that this effect was easy to come by: The group that completed longer periods of low-intensity exercise substituted six hours of sitting with four hours of walking and two hours of standing every day.

Previous studies have found that short bursts of intense interval training are more effective for fat loss than longer, steady state cardio. This new study doesn’t mean than getting your heart rate up and adding strength training to your day isn’t important — it’s just the latest evidence that simply baking more activity into your day in addition to regular trips to the gym can have a big benefit. (Another recent study found that standing more reduces your risk of type 2 diabetes.)

Researchers call this the “use it, or lose it” effect, noting that just standing up provides a kind of wake-up call for your body that boosts physiological system functioning.

Taking walking meetings at the office can help you fit in fitness and also clear your mind while you work. You can also squeeze in push-ups, squats, and other fast body-weight exercises on your lunch break, when you wake up in the morning, and just before bed. If you take public transportation, always stand on the train or bus and get off a stop or two earlier to squeeze in extra steps. If you drive, park farther away from your destination, or see if you can swap your car for a bike a day or two a week.

The most important thing you can do is make standing up and moving around part of your to-do list like you would any other task — giving yourself a specific time and place for movement.

When you move more, your body and mind will thank you.

Categories
blog

Vitamins for Women: What to Take and When

 

More than half of all American adults take multivitamins or other dietary supplements, according to the U.S. Centers for Disease Control and Prevention. Women in particular have been quick to jump on the supplement bandwagon, despite past research that challenged the effectiveness of multivitamins in the prevention of cancer and heart disease. Recent studies have found other benefits of vitamins, including a boost in brainpower as you age. Though experts say food is still your most important source of nutrients, they also say meeting daily dietary needs is vital to long-term health. Supplements can help you fill in nutritional gaps.

“When it comes to preventing certain diseases, vitamins may not be a panacea,” says Heidi Skolnik, MS, a nutrition consultant and nationally recognized writer, editor, and lecturer. “That said, women typically diet, and so there are often gaping holes in their nutrition. Most experts like myself prefer to recommend food as the prominent source of vitamins because the body may use food-sourced vitamins more efficiently than supplements.”

Vitamins for Women: What You Need

Our bodies are like fine cars. You can’t put regular gas in a Porsche and expect it to run well. For that reason, you should consider adding the following nutrients to your diet:

  • Calcium. As you age, your bone mass decreases and you need more calcium to lower your risk of osteoporosis. You typically need 1,000 to 1,500 milligrams of calcium daily, depending on how old you are. You can reach this daily requirement by consuming dairy products (preferably fat-free), drinking pure orange juice that has been fortified with calcium, or taking calcium supplements.
  • Vitamin D. As you get older, you lose some of your ability to convert sunlight into vitamin D, and without vitamin D, your body can’t use calcium. Also, using sunscreen to protect yourself from skin cancer means shutting out some of the vitamin D you’d get from just being outside in the sun. To compensate for this loss, older women might consider taking a multivitamin containing both vitamin D and calcium. To help you understand how much vitamin D you need each day, consider this: A glass of milk provides about 100 international units (IU) of vitamin D. If you’re over 50, you should be getting 400 IU daily; over 70, you need 600 IU.
  • Iron. If you’re still menstruating, you need to be sure you’re getting an adequate amount of iron in order to prevent anemia. “Food sources are a good starting point, but you may need supplements,” says Skolnik. You’ll find iron in meat, poultry, beans, eggs, and tofu. “It’s important to pair your iron-rich meals with foods that contain vitamin C, like orange juice or citrus fruits, because vitamin C helps increase iron absorption,” Skolnik says. If you are a woman past menopause you need less iron, so unless your doctor recommends an iron supplement, you should look for a multivitamin without iron.
  • Folic acid. Women who are pregnant or trying to become pregnant need to get more folic acid; it has been shown that low levels of this B vitamin can lead to birth defects in the baby affecting the brain and spinal cord. In addition to supplements, folic acid can be found in orange juice, beans, and green vegetables, and in foods such as breads and flour that have been fortified with it.
  • Beta-carotene. Skolnik says that antioxidants — cancer-fighting substances like beta-carotene and vitamin C — help defend your body against cell damage. “Food sources are best for beta-carotene, and they include carrots, apricots, papaya, cantaloupe, pumpkin, sweet potatoes, and mangoes.” In other words, look for the color orange when you’re in the produce aisle.
  • B6 and B12. Like vitamin D, vitamin B12 is not processed as well by older women and may be one vitamin to consider taking in supplement form, perhaps through a multivitamin. Both B vitamins are very important as you grow older. “Vitamin B6 helps with red-blood cell formation and vitamin B12 helps with nerve-cell and red-blood cell development,” Skolnick says. These vitamins can be found in a wide variety of healthful foods; following basic food pyramid recommendations is a good way to make sure you get enough of each. As an example, Skolnick says “you can get a day’s supply of vitamin B12 by eating one chicken breast, one hard-boiled egg, a cup of plain low-fat yogurt or one cup of milk, plus one cup of raisin bran.”
  • Omega-3 fatty acids. These acids have been shown to act like natural anti-inflammatory substances in the body. They may also be important in helping to keep your heart healthy. As a woman gets older, her levels of estrogen decline, and that puts her at greater risk for heart disease, Skolnik says. Fatty fish, like salmon and tuna, is a great source of omega-3 fats, and pure orange juice is often fortified with omega-3s. Or, she adds, “Taking fish oil capsules is an excellent way to make sure you target these important fats.”

Although most nutritional needs can be met through a healthy, well-balanced diet, many women, especially older women, can benefit from a good multivitamin.

If you are an older woman, ask your doctor or pharmacist to make sure you’re getting enough calcium and vitamins B12 and D from your multivitamin, and not too much iron.

Generally speaking, most experts believe that taking multivitamins is a good idea. “Clearly when it comes to calcium and vitamin D we all need additional supplementation. We can only eat so much dairy or fortified foods in a day. For the rest, a multivitamin may help to fill in the gaps that your diet does not provide,”

Categories
blog

Brisk Walking May Equal Running for Heart Health

 

Brisk walking is as good as running for reducing blood pressure, cholesterol and diabetes risk — three key players in the development of heart disease, a new study finds.

It’s a matter of how far you walk or run, not how long, said Paul Williams, a staff scientist at the Lawrence Berkeley National Laboratory in Berkeley, Calif.

“Both of these activities reduce risk factors, and if you expend the same amount of energy you get the same benefit,” Williams said. The key was the more people walked or ran each week, the more their health improved, he said.

The findings suggest “there is now some choice in the exercise you want to do,” he said. Some people find running more convenient, others prefer walking, especially people just starting to exercise, he noted.

The advantage of running is you can cover twice as much ground in the same amount of time as you would walking, Williams pointed out.

Williams is referring to brisk walking, however. “Walking for exercise. It’s not a mosey kind of thing, but actually walking for exercise,” he explained.

For the study, published online April 4 in Arteriosclerosis, Thrombosis and Vascular Biology, Williams and Dr. Paul Thompson, a cardiologist at Hartford Hospital in Connecticut, collected data from the National Runners’ Health Study and the National Walkers’ Health Study. More than 33,000 runners and nearly 16,000 walkers were involved.

The runners and walkers were 18 to 80 years old, but mostly in their 40s and 50s, the study authors noted.

Over six years, both running and walking led to similar reductions in risk for high blood pressure, high cholesterol and diabetes, and perhaps even heart disease, the researchers found.

Specifically, Williams and Thompson found:

  • Running reduced the risk of high blood pressure 4.2 percent and walking reduced the risk 7.2 percent.
  • Running reduced the risk for high cholesterol 4.3 percent and walking lowered the risk 7 percent.
  • Running lowered the risk for diabetes 12.1 percent and walking reduced the risk 12.3 percent.
  • Running decreased the risk of heart disease 4.5 percent and walking reduced the risk 9.3 percent.

Dr. Gregg Fonarow, a spokesman for the American Heart Association and professor of cardiology at the University of California, Los Angeles, said engaging in regular physical activity is well-established to maintain cardiovascular health and reduce the risk of cardiovascular events, stroke, and premature death.

The American Heart Association and other organizations highly recommend regular physical activity for the primary and secondary prevention of heart disease and stroke, he added.

“These findings suggest similar benefit for similar energy expenditures with exercise regardless of intensity,” Fonarow said. “However, for those who are capable of engaging in more vigorous exercise, this may be the more time-efficient strategy.”

Other research using data from the walkers’ and runners’ studies found that for weight loss, running beats walking. That study appears in the April issue of Medicine & Science in Sports & Exercise

Categories
blog

Diabetes Prevention Research: A Small Sliver of a Big Pie

 
Most diabetes research focuses on treating the disease with medications rather than preventing it, according to a new analysis from researchers at Duke University. Their research also uncovered the fact that few trials specifically target seniors and children, groups that may require specially tailored diabetes prevention and treatment approaches.
 
Experts project that more than 550 million people worldwide will have diabetes by 2030, and nearly 400 million more may be living with prediabetes by that time, according to the International Diabetes Federation (IDF). Identifying successful prevention approaches through research could help slow the global epidemic.
 
The Duke analysis, published today in Diabetologia, included nearly 2,500 diabetes trials conducted worldwide between 2007 and 2010, taken from the ClinicalTrials.gov study registry. Only 10 percent of the trials focused on prevention efforts, while the vast majority — 75 percent — assessed treatments for people who already have the disease. The remaining 15 percent of studies examined diabetes screening and diagnostic procedures, supportive care, and other topics.
 
The analysis also showed nearly two-thirds of all diabetes trials investigated medications, primarily for treatment rather than prevention. A much smaller proportion — 12 percent — focused on behavioral strategies, such as lifestyle change programs, education, and counseling.
 
“I don’t think anybody knows what the optimal percentage of diabetes trials being dedicated to prevention really is,” said Jennifer Green, MD, the senior author of the study.
 
However, said Dr. Green, research to identify successful prevention strategies and methods for translating those efforts into the real world could have substantial benefits.
 
“If we can prevent the development of diabetes in a significant number of individuals, that should theoretically reduce healthcare costs and minimize the likelihood that those people develop diabetes-related complications in the future,” Green said. Health organizations like the IDF and the American Diabetes Association have also emphasized the need for more prevention research.
 
The high proportion of trials testing drug treatments is partly a reflection of funding, according to Sue Kirkman, MD, an endocrinologist at the University of North Carolina School of Medicine who was not involved in the new study. “Many of the studies received funding from pharmaceutical companies and that’s part of the reason there were so many drug studies,” she said.
 
On the other hand, researchers testing lifestyle change and other non-medication treatments may have a more difficult time securing funding, Green speculated.
Minimal Diabetes Research in Older Adults and Children 
 
The analysis also revealed that very few studies focused on older adults, a group at especially high risk for developing type 2 diabetes. Nearly 20 percent of adults aged 65 and older worldwide have diabetes, yet only 1 percent of trials specifically targeted this population, and 31 percent excluded this age group.
 
“I think the exclusion of older people from so many of these studies is a huge problem,” said Dr. Kirkman. “The population that’s going to be disproportionately needing these treatments is being excluded from the studies of treatments. That just really struck me as unwise.”
 
“People aged 65 and older need to use the same kinds of medications as younger individuals to treat their diabetes, but it may be that their responses are different,” said Green. “They probably have different needs and care considerations that would benefit from future study.”
 
Only 4 percent of diabetes trials specifically looked at children aged 18 and under. Experts said this number may be appropriate, given the very small proportion of children who have diabetes relative to adults, but the youngest patients, like the oldest, may need different care.
 
“The kinds of treatments that we routinely used for adults may not work as well in children, and that is certainly something we should try to better understand,” Green said.
 
The researchers also found that some areas of the world with high rates of diabetes have not been actively involved in diabetes research. For example, six of the 10 countries with the highest diabetes rates are located in the Middle East, yet few trials have been conducted in this region.
 
“This is something that people who are designing and executing trials going forward might want to consider so we can include high-risk groups,” according to Green. “It seems wise and only fair for these treatments to be tested in diverse populations before they are prescribed.”
The Future of Diabetes Research 
 
This study provides a snapshot of recent diabetes research efforts, but experts are most interested in seeing how these trends change over time.
 
“I do think we need more trials on prevention, more trials in children, and definitely more trials in older people with or at risk for diabetes,” said Kirkman. “I would be interested in seeing the same analysis in 2015 to see if things have changed. I think the real issue is seeing if things are going to get better.”
 
“This study is an interesting starting point,” Green commented. “We’re hoping that this stimulates conversation and might be helpful in determining what kinds of research efforts are funded in the future.”
Categories
blog

Why Is It So Hard to Exercise?

 

You know you should do it. And you know why: Exercising — simply put, moving instead of sitting — is critical for safeguarding your health and setting a good example for your kids. So why does it seem so hard to get yourself moving?

The truth is: You can. But knowing how and why to exercise isn’t enough. You need to develop the right mind-set to get and stay motivated.

“Change is hard!” says certified health behavior coach Shelly Hoefs, fitness supervisor at the Mutch Women’s Center for Health Enrichment in Sioux Falls, S.D. “When we try to start exercising, we think of all the excuses for not doing it and all the things that have gotten in the way before. Getting fit starts to seem overwhelming. And that makes it feel stressful. Before long, we don’t want to do it anymore.”

Here are five steps to get you moving in the right direction — and keep you going.
1. Find Personal Motivation to Exercise

What you need to get you up off the couch is a reason that’s important to you. At first, that may be some external factor, says Cal Hanson, director of the Sanford Wellness Center in Sioux Falls, S.D. It could be a number on the scale that surprises you or your doctor’s recommendation that you need to move more to stay healthy.

There are all kinds of benefits to getting fit. Which matters most to you? Something as simple as taking a walk after dinner every night helps to:
control your weight
strengthen your bones
enhance your muscles
reduce your risk for heart disease, type 2 diabetes, and some types of cancer

Plus, by becoming active, you’re being a good role model for your children.

These benefits may get you started, but they may not cut it when it comes to keeping you moving day after day, Hanson says. To keep up your motivation to exercise over time, you also need to find your internal motivators. Maybe taking a yoga class leaves you feeling more energized or less stressed. Maybe a run or walk every day helps you let go of stress. Hanson says these are the kind of rewards that are meaningful to you on a personal level and that can help keep you motivated.

2. Set Realistic Goals to Get Fit

CDC guidelines call for adults to do 2 1/2 hours of moderate-intensity aerobic exercise a week. That’s a 30-minute walk five days a week. If you kick it up a notch — jogging or running, for example – it can be 15 minutes a day, five days a week.

You can aim for these exercise guidelines, but don’t try to meet them at the start. “People lose their motivation to exercise when they try to do too much too soon,” says Hanson.

So instead of walking for 30 minutes a day right off the bat, start out doing 15 minutes a day, two or three days a week.

Set weekly goals, gradually adding more time and intensity. At the end of each week, take a look at how you did. If you reached your goal, celebrate! “And if you didn’t reach your goal,” Hanson says, “think about what went wrong and how you’re going to respond differently next time.”
3. Stop Thinking of It as Exercise — Do Something You Enjoy

You don’t have to go to the gym to get a good workout. It’s all about moving more — however you do it. For some people, going to the gym provides structure that helps them focus and a sense of accomplishment when they’re done. For others, it’s a chore — one they wind up avoiding as often as they can.

What else can you do? Almost anything that gets you — and your family — moving:
Walk the dog, or walk a neighbor’s dog. They’ll be grateful for the help!
Have dance contests with the kids instead of watching TV.
Go to the park and play hide-and-seek.
Shoot hoops with the kids.
Walk or bike to the store instead of driving, or park far away from the entrance.
Get off the train a stop early and walk the rest of the way to your office.

If you think about it, you’re surrounded by opportunities to get more active. Find the ones that you get excited about. You’re more likely to keep doing them if you’re having fun.
4. Plan How to Fit Exercise Into a Hectic Schedule

For busy parents, a major obstacle to getting fit is lack of time. If you wait for time to open up, chances are you won’t be able to squeeze in a walk or a dance class very often. To avoid getting sidetracked by the daily demands of life, try these tips:
“Sit down with your schedule and really carve out blocks of time,” says psychologist Susan Bartell, PsyD, author of Dr. Susan’s Fit and Fun Family Action Plan. Put it in your calendar like any other appointment.
Add physical activity to things you already do. For example, pedal a stationary bike while reading or watching TV. Or take a walk with a friend to catch up instead of calling each other on the phone.
Plan activities you can do with your kids, such as going for bike rides or skating. Not only will you find more time for fitness, you’ll help inspire your kids to move more.

If you plan ahead for potholes on the road to fitness, you’re more likely to stay on course, Bartell says. “When you think through solutions to problems in advance, you’re less likely to give up when a pothole comes along.”

5. Bounce Back From Setbacks

You’ve set a reasonable fitness goal. You’ve prepared for potential problems. Yet somehow you still didn’t make it to the gym today as you had planned. Don’t let that be your downfall.

“For many people, this is a slippery slope,” Hanson says. “It reminds them of times when they failed before, and they begin to think of themselves as exercise failures.”

When this happens, it’s time for an attitude adjustment so you don’t completely lose your motivation to exercise. If you miss the gym on Monday, that doesn’t mean your whole week is shot, Hanson says. It simply means you need to hit the gym on Tuesday or take the dog for an extra-long walk tonight.

Knowing how to exercise isn’t just a matter of learning how to use your body to hold a yoga pose or swing a racquet. It also involves learning how to use your mind to propel yourself into action and stick with a fitness routine.

“Start thinking of yourself as someone who exercises,” says Hoefs. “Eventually, that will become your identity.”

Categories
blog

Overcoming Barriers

 

A barrier is something that keeps you from doing something else.

If you’re not active, it’s likely that you have at least one reason why. Perhaps you’ve never been very active. Maybe you’re afraid you’ll get low blood glucose. Think about what’s keeping you from being active and then check out some of our solutions to the most common barriers to physical activity.

Barrier Solution
I don’t have time to exercise for 30 minutes a day. Think about your day – do you have available time slots?

Do as much as you can. Every step counts. If you’re just starting out, start with 10 minutes a day and add more little by little. Work up to 10 minutes at a time, three times a day. You can also try for 15-minute spurts twice a day.

Make physical activity part of your daily routine. For example, walk or bike to work or to the store, exercise while you watch TV, take the stairs instead of the elevator, or do something active with your family to spend time together.
I’ve never been active. Don’t discount your everyday activities. You may do more than you realize, such as housekeeping or mowing the lawn. Being active is more than just “exercise”.

Talk to your doctor about what exercise is safe for you and discuss how you can start.

Starting slowly is important and so is choosing activities that you enjoy. Over time, activity will get easier. You will find that you can increase the amount/intensity of physical activity you do.
I’m too tired after work. Find a time when your energy is highest. You could plan to do something active before work or during the day. For example, you could try walking for 30 minutes during your lunch break a few days each week.

Remember that increasing the amount of physical activity you do will actually increase your energy.
I don’t have the right clothes. Wear anything that’s comfortable as long as you have shoes that fit well and socks that don’t irritate your skin.
I’m too shy to exercise in a group. Choose an activity you can do on your own, such as following along with an aerobics class on TV or going for a walk.

Remember that every-day activities you do on your own like gardening and household chores get you moving and help burn calories.
I don’t want to have sore muscles. Exercise shouldn’t hurt if you go slowly at first. Choose something you can do without getting sore.

Learn how to warm up and cool down.

Stretch before and after you do something active.
I’m afraid I’ll get low blood glucose. If you’re taking a medication that could cause low blood glucose, talk to your health care provider about ways to exercise safely.
Walking hurts my knees. Try chair exercises, swimming, biking, or an elliptical machine. These and other low-impact exercises may be less painful.
It’s too hot outside. If it’s too hot, too cold, or too humid, walk inside a school or a shopping center.

Think of some other activities that are always available regardless of the weather like using a stationary bike, indoor aerobics classes, yoga videos at home, indoor swimming, stair climbing, calisthenics, or dancing.
It’s not safe to walk in my neighborhood. Find an indoor activity, such as an exercise class at a community center.

Think of activities you can do in the safety of your home.
I’m afraid I’ll make my condition worse. Get a checkup before planning your fitness routine. Learn what’s safe for you to do.
I can’t afford to join a fitness center or buy equipment. Do something that doesn’t require fancy equipment, such as walking, jogging, calisthenics, or using cans of food for weights.

Jumping rope and resistance band exercises are other activities that only require one piece of inexpensive equipment.

Look for inexpensive resources in your community like community education programs, park and recreation programs, walking trails, school running tracks, or worksite wellness programs.
Exercise is boring. Find something you enjoy doing.

Mix it up. Try different activities on different days.

Exercise with someone else to keep you company.

If you can, try exercising while listening to music or watching television.
I don’t really know how to exercise. Select activities that require few skills, like climbing stairs, walking, or jogging.

Take a class and develop new skills.
I don’t have the motivation to exercise. Invite a family member or friend to exercise with you on a regular basis. You can also join an exercise group or class in your community.

Remember all of the benefits that come with being physically active.

Make a plan so you decide when you will do each type of activity. Be sure to set realistic goals and make a plan so you know what you are working toward.

 

Categories
blog

Certain Contraceptive May Pose Risk of Type 2 Diabetes for Obese Women

A first-of-its-kind study by researchers at the Keck School of Medicine of the University of Southern California (USC) indicates that healthy, obese, reproductive-age women who use long-acting reversible contraception (LARC) containing the hormone progestin have a slightly increased risk for developing type 2 diabetes when compared to those who use non-hormonal contraception. 

The research concludes that progestin-releasing LARC appears to be safe for use by such women but needs further investigation.

Nicole M. Bender, assistant professor of clinical obstetrics and gynecology at the Keck School, was the principal investigator for the study “Effects of progestin-only long-acting contraception on metabolic markers in obese women,” which recently appeared online in the journal Contraception. 

“Contraceptive studies often only look at normal-weight women,” said Penina Segall-Gutierrez, co-investigator of the study and an assistant professor of clinical obstetrics and gynecology and family medicine at the Keck School. “Studies such as this are necessary because, today, one-third of women in the U.S. are overweight and one-third are obese. All women, including overweight and obese women, need to have access to safe and effective contraception.” 

Obese women are at increased risk for pregnancy-related complications and are sometimes warned by their doctors not to use contraceptives containing estrogen, such as the pill, patch and vaginal ring. 

“[Those choices] raise the risk for blood clots,” Segall-Gutierrez said. “So they need other, viable alternatives. The implanted LARC devices last three to 10 years, are easily reversible, and women don’t have to remember to do anything with them, in contrast to the birth-control pill.”

The six-month study observed the metabolic markers in three groups of obese women: a control group using non-hormonal birth control methods, including condoms, the copper IUD, and female or male sterilization; a second group with a progestin-releasing LARC device implanted in the uterus (IUD); and a third group with a progestin-releasing LARC device implanted under the skin.

“All three methods were found to be safe and effective, and they did not create changes in blood pressure, weight, or cholesterol,” Segall-Gutierrez said. “However, there was a 10 percent increase in fasting blood-glucose levels among the skin implant users, compared to a 5 percent increase among the IUD users and a 2 percent decrease among those using non-hormonal methods. The effects on sensitivity to insulin showed a similar trend. It is unknown if these effects would continue if the devices were used and studied for a longer period of time.”

Segall-Gutierrez and her Keck research partners have studied the metabolic effects of other birth-control methods as well. In 2012, they reported findings that obese women receiving a progestin birth-control shot every three months may be at increased risk for developing type 2 diabetes. 

“Overall, we’re finding that methods such as the progestin injection and the progestin skin implant, which both have higher circulating progestin, may have an increased risk for metabolic changes compared to methods like the IUD, which only has a local effect ─ in the uterus,” she said. 

Segall-Gutierrez added that the progestin-releasing IUD has other benefits. It is approved by the U.S. Food and Drug Administration for treatment of heavy menstrual bleeding, which often affects obese women. The IUD also protects against endometrial cancer, which disproportionately affects obese women.

“Choosing a birth-control method requires consideration of many factors, including the patient’s lifestyle and willingness to use the method, desire for future fertility, and risk for a host of diseases ─ diabetes and endometrial cancer being two of them for obese women,” she said. “We would like to expand our most recent study by looking at more participants over a longer period of time to see if the metabolic effects we observed in the progestin-releasing implants persist or are only temporary.”

Categories
blog

High Blood Pressure During Pregnancy May Signal Later Diabetes, Heart and Kidney Disease Risk

 

High blood pressure during pregnancy — even once or twice during routine medical care — can signal substantially higher risks of heart and kidney disease and diabetes, according to new research in the American Heart Association journal Circulation.

“All of the later life risks were similar in pregnant women who could otherwise be considered low-risk — those who were young, normal weight, non-smokers, with no diabetes during pregnancy,” said Tuija Männistö, M.D., Ph.D., lead author of the study and a postdoctoral fellow at the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development in Rockville, Md. 

Studies have shown higher heart and kidney disease risk in women with preeclampsia, a serious pregnancy-related disease marked with high blood pressure and measurable protein in the urine.

In the new study, researchers looked at less serious forms of high blood pressure that are much more common in pregnant women. For 40 years, they followed Finnish women who had babies in 1966. They calculated the risk of heart or kidney disease or diabetes in later life among women with high blood pressure during pregnancy, comparing them to women with normal blood pressure during pregnancy.

They found: 

• One-third of the women had at least one high blood pressure measurement during pregnancy. 
• Women who had any high blood pressure during pregnancy had 14 percent to over 100 percent higher risk of cardiovascular diseases later in life, compared to women with normal blood pressure during pregnancy. 
• Women who had any high blood pressure during pregnancy were 2 to 5 times more likely to die from heart attacks than women with normal blood pressure during pregnancy. 
• Women who had high blood pressure during pregnancy and healthy blood pressure levels after pregnancy had a 1.6- to 2.5-fold higher risk of having high blood pressure requiring medication or hospitalization later in life. 
• Women who had high blood pressure during pregnancy had a 1.4- to 2.2-fold higher risk of having diabetes in later life. 
• Women who had transient high blood pressure with and without measurable protein in the urine had a 1.9- to 2.8-fold higher risk of kidney disease in later life, compared to women with normal blood pressure during pregnancy. Transient high blood pressure is temporary high blood pressure that later returns to normal.

“According to our findings, women who have had high blood pressure during pregnancy or who are diagnosed with high blood pressure in pregnancy for the first time might benefit from comprehensive heart disease risk factor checks by their physicians, to decrease their long-term risk of heart diseases,” Männistö said. 

Future research should estimate how lifestyle changes during pregnancy, such as diet, affect the risk of developing high blood pressure during pregnancy, Männistö said. Studies also should focus on how lifestyle changes and clinical follow-up after pregnancy could change these women’s long-term health. 

Because the study was limited to non-Hispanic Caucasian Finnish women, researchers said they aren’t sure if results would be the same for other racial and ethnic groups.

Categories
blog

Possible Link Between Diabetes and Increased Risk of Heart Attack Death

Having diabetes doubles a person’s risk of dying after a heart attack, but the reason for the increased risk is not clear. A new University of Iowa study suggests the link may lie in the over-activation of an important heart enzyme, which leads to death of pacemaker cells in the heart, abnormal heart rhythm, and increased risk of sudden death in diabetic mice following a heart attack. 

“Many studies have shown that patients with diabetes are at especially high risk for dying from a myocardial infarction (heart attack). Our study provides new evidence that this excess mortality could involve a pathway where oxidized CaMKII enzyme plays a central role,” says Mark Anderson, M.D., Ph.D., UI professor and chair and executive office of internal medicine, and senior author ofthe study recently published in the Journal of Clinical Investigation. 

Diabetes affects more than 8 percent of the U.S. population, and heart attack is the most common cause of death in people with diabetes. Diabetes also causes increased oxidative stress – a rise in the level of so-called reactive oxygen species (ROS) that can be damaging to cells. 

In 2008, Anderson’s lab showed that CaMKII (calcium/calmodulin-dependent protein kinase II) is activated by oxidation. The new study links oxidative stress caused by diabetes to increased death risk after a heart attack through the oxidation-based activation of the CaMKII enzyme.

“Our findings suggest that oxidized CaMKII may be a ‘diabetic factor’ that is responsible for the increased risk of death among patients with diabetes following a heart attack,” says lead study author Min Luo, D.O., Ph.D., a cardiology fellow in the UI Department of Internal Medicine.

Luo and her colleagues used a mouse model of diabetes to probe the link between the disease and an increased risk of death from heart attack.

The study showed that heart rates in the diabetic mice slowed dramatically and, like humans with diabetes, the mice had double the death rate after a heart attack compared to non-diabetic mice.

Evidence from the diabetic mice suggested that the excess deaths following heart attack was due to heart rhythm abnormalities, prompting the team to investigate the heart’s pacemaker cells, which control heart rate.

Looking at the diabetic mice, the team found that pacemaker cells had elevated levels of oxidized CaMKII enzyme and more cell death than pacemaker cells in non-diabetic mice. The levels of oxidation and cell death were further increased in the diabetic mice following a heart attack.

When the team blocked oxidation-based activation of the enzyme, fewer pacemaker cells died, and the diabetic mice maintained normal heart rates and were protected from the increased death risk following a heart attack.

The findings suggest that preventing or reducing activation of the CaMKII enzyme in specific heart cells may represent a new approach for reducing the risk of death due to heart attack in patients with diabetes.