Is Tau the ‘How’ Behind Alzheimer’s?


By Dennis Thompson

HealthDay Reporter


FRIDAY, Oct. 31, 2014 (HealthDay News) — Malfunction of a key brain protein called tau is the likely culprit behind Alzheimer’s disease and other forms of dementia, a new study in mice concludes.


Neurons — highly specialized nerve cells in the brain — appear to die when tau malfunctions and fails to clear the cells of unwanted and toxic proteins, explained Charbel Moussa, head of the Laboratory for Dementia and Parkinsonism at Georgetown University School of Medicine, in Washington, D.C.


This means drugs that replace the function of tau in these brain cells are likely to slow the progression of Alzheimer’s, he said.


“A strategy like this will give us hope that we can delay or stabilize the disease progression,” Moussa said.


Tau has long been a prime suspect in the search for the cause of Alzheimer’s disease. The brains of Alzheimer’s patients wind up clogged with twisted protein threads made of tau, particularly in regions important to memory.


But researchers have been at a loss to explain why tau might cause Alzheimer’s, and whether the tangles of tau are more important than another hallmark of Alzheimer’s, plaques made of a protein called amyloid beta that fill the spaces between the brain’s nerve cells.


Moussa said his experiments with mice have shown that tau works to keep neurons naturally free of amyloid beta and other toxic proteins.


When tau malfunctions, the neurons begin to spit amyloid beta out into the space between the brain cells, where the protein sticks together and forms plaques, he said.


“When tau does not function, the cell cannot remove the garbage,” Moussa said. The result is cell death, he explained.


Tests on the brain cells of mice revealed that removing all tau impaired the neurons’ ability to clear out amyloid beta, according to findings published Oct. 31 in the journal Molecular Neurodegeneration. But if researchers reintroduced tau into brain cells, the neurons were better able to remove accumulated amyloid beta from the cells.


Moussa said his study suggests the remaining amyloid beta inside the neuron destroys the cells, not the plaques that build up outside. The mouse experiments also showed that fewer plaques accumulate outside the cell when tau is functioning.


Malfunctioning tau can occur as part of the aging process or due to genetic changes. As people grow older, some tau can malfunction while enough normal tau remains to help clear the garbage and keep neurons alive. “That explains the confusing clinical observations of older people who have plaque buildup, but no dementia,” Moussa explained in a Georgetown University news release.


In this study, Moussa also explored the possible use of a cancer drug called nilotinib to force neurons to keep themselves free of garbage, with the help of some remaining functional tau.


“This drug can work if there is a higher percentage of good to bad tau in the cell,” added Moussa, whose work was funded in part by a grant from Merck & Co., the pharmaceutical company.


Heather Snyder, director of medical and scientific operations for the Alzheimer’s Association, said Moussa’s findings are interesting but not conclusive.


“They’re saying that tau may have an earlier role than we currently know. That’s as far as I would go,” Snyder said. “We still don’t know how all the pieces come together.”


Snyder said new imaging technology that allows doctors to track tau buildup in a person’s brain over time may help solve this question in the future.


Also, experts say, results of animal experiments don’t necessarily apply to humans.


But Dr. Ronald Petersen, director of the Mayo Clinic Alzheimer’s Disease Research Center, said the new study adds to the growing evidence that “the role of tau is fundamental in the disease process.”


“Developing therapeutics for tau is a high priority,” Petersen said. “Not easy, not simple, but it could be very fruitful.”


More information


For more on Alzheimer’s disease, visit the U.S. National Institute on Aging.














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Child’s Appendix More Likely to Rupture in Regions Short of Surgeons


FRIDAY, Oct. 31, 2014 (HealthDay News) — Children and teens with poor access to general surgeons are at increased risk of suffering a ruptured appendix, and the risk is particularly high among young children, a new study finds.


If an infected appendix isn’t removed quickly enough, it can burst or rupture, leading to a serious, sometimes fatal infection, according to background information from the study.


Researchers analyzed data from nearly 7,000 children younger than 18 who were diagnosed with appendicitis at surgical centers in North Carolina between 2007 and 2009. Nearly one in four of the youngsters later suffered a ruptured appendix.


The risk of ruptured appendix was 1.7 times higher among patients who were transferred to another hospital, and 1.4 times higher among those who came from areas with a severe shortage of general surgeons, fewer than three for every 100,000 people.


Young appendicitis patients with limited access to general surgeons likely have to wait longer to be transferred and start receiving care, according to the authors of the study presented this week at an American College of Surgeons meeting in San Francisco.


Compared to children older than 12, the risk of ruptured appendix was 5.6 times higher among kids age 5 and younger, and 1.3 times higher for those ages 5 to 12.


“Transfers from other hospitals tend to be younger children. Rural surgeons may feel comfortable treating a 12- or 13-year-old, but if the child is 1 month or 5 years old, they will usually be transferred,” study lead author Dr. Michael Phillips, a surgery resident at the University of North Carolina at Chapel Hill, said in a College of Surgeons news release.


Such transfers can take a couple of hours, he noted.


Another reason why younger children with appendicitis are more likely to suffer a ruptured appendix is that they can’t explain what’s wrong with them, which could delay diagnosis, according to the release.


“In some cases, the child will have signs of appendicitis, like eating less and a fever, but parents will think it’s something else. Then they send the child to a pediatrician, wait for lab tests to come back, then have an imaging study. This process can take a while,” Phillips said.


Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.


More information


The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about appendicitis.














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Spinal Surgery Varies by Region in U.S.: Study


FRIDAY, Oct. 31, 2014 (HealthDay News) — Surgery for low back pain caused by spinal stenosis varies depending on where in the United States you live, a new report says.


“Nearly 80 percent of Americans will experience low back pain at some point in their lives, and about 30 million people a year receive professional medical care for a spine problem,” co-author Brook Martin, of the Dartmouth Institute of Health Policy & Clinical Practice, said in a college news release.


In spinal stenosis, thickening of tissue surrounding the spine affects the spinal nerves, resulting in pain, according to background information in the study. Treatments include surgery, medication, physical therapy and steroid injections, the study said.


The two types of surgery for spinal stenosis are spinal decompression and spinal fusion, according to the researchers, who explain that in spinal decompression, doctors remove the tissue compressing the spinal nerves. In spinal fusion, surgeons join two or more vertebrae to stabilize the spine.


Spinal fusion has a higher risk of infection and readmission to the hospital, and there is no evidence that it provides greater benefit to patients, according to the news release. Even so, its use increased 67 percent among Medicare patients from 2001 to 2011 and it’s now more common than spinal decompression, the researchers said.


The study’s analysis of Medicare data revealed that rates of spinal decompression varied eightfold across the United States, from about 25 procedures per 100,000 patients in Bronx, N.Y., to nearly 217 procedures per 100,000 patients in Mason City, Iowa. In general, rates of spinal decompression were highest in the Pacific Northwest and northern Mountain states.


Rates of spinal fusion varied more than 14-fold nationally, from about 9 procedures per 100,000 patients in Bangor, Maine, to about 127 procedures per 100,000 patients in Bradenton, Fla., according to the Dartmouth Atlas Project report.


“It is critical that we fully inform patients of the risks as well as potential benefits through a collaborative process between patients and physicians of shared decision making,” Martin said.


Surgery is irreversible, Martin said. “Using shared decision-making encourages the exchange of information so as to optimize results,” he said.


More information


The American College of Rheumatology has more about spinal stenosis.














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Sleep Apnea May Steal Some of Your Memory: Study


FRIDAY, Oct. 31, 2014 (HealthDay News) — Sleep apnea may make it hard for you to remember simple things, such as where you parked your car or left your house keys, a small study suggests.


Tests on 18 people with severe sleep apnea showed that this ability — called spatial memory — was impaired when sleep apnea disrupted rapid eye movement (REM) sleep, even when other stages of sleep weren’t affected. REM sleep is the deepest level of sleep, during which dreams typically occur.


“We’ve shown for the first time that sleep apnea, an increasingly common medical condition, might negatively impact formation of certain memories, even when the apnea is limited to REM sleep,” study leader Dr. Andrew Varga, a clinical instructor of medicine in the division of pulmonary, critical care and sleep medicine at the NYU Langone Medical Center in New York City, said in an NYU news release.


“Our findings suggest memory loss might be an additional symptom for clinicians to screen for in their patients with sleep apnea,” added Varga, who is also an attending physician in NYU’s Sleep Disorders Center.


While the study found an association between sleep apnea and impaired memory, it did not prove a direct cause-and-effect link between the two.


The study was published online Oct. 29 in the Journal of Neuroscience.


People with sleep apnea experience periods of disrupted breathing during the night. Sleep apnea can occur at any stage of sleep, but is often worst during REM sleep. Some people have sleep apnea only during REM sleep, the researchers noted.


Sleep apnea affects 4 percent of Americans overall, and as many as one in four middle-aged men.


More information


The American Academy of Family Physicians has more about sleep apnea.














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Study Shows How Toddlers Adjust to Adult Anger


By Tara Haelle

HealthDay Reporter


FRIDAY, Oct. 31, 2014 (HealthDay News) — Toddlers can both sense adult anger and alter their behavior in response to it, new research reveals.


“Babies are like sponges,” said study co-author Andrew Meltzoff, co-director of the University of Washington Institute for Learning & Brain Sciences, in Seattle. “They learn not only from their own direct social experiences but from watching the social interactions between two other people.”


He said he was most surprised at how emotionally “sophisticated” the babies were at such a young age.


“This study shows that even 15-month-olds have their emotional antennae up and are scanning the social environment to understand and predict other people’s emotional reactions,” he said. “Young children have a kind of emotional radar that is quite striking.”


Meltzoff’s team conducted an experiment in which 150 toddlers, all aged 15 months, sat on their parents’ laps and watched an experimenter show them how to use several toys that made different sounds.


During this demonstration, another person came in the room, sat down and began complaining about the experimenter’s actions with the toys.


Then the children had an opportunity to play with the toys. When the complaining person was out of the room or had her back turned, the children quickly picked up the toys and copied the experimenter’s actions.


If the complainer watched the child with a neutral expression or looked at a magazine, however, the toddlers usually waited an average of four seconds before they picked up any of the toys. They were also less likely to do the same actions they had seen the experimenter do.


“Interestingly, the infants treat this previously angry person as anger prone — someone who might get angry at them even though she shows no signs of being angry right now,” Meltzoff said. “They remember the emotional history of a person.”


The findings were published in the October/November issue of the journal Cognitive Development.


The researchers also compared the children’s impulsivity based on questionnaires from the parents. Children with higher ratings of impulsivity, based on the parents’ answers, were more likely to do what the experimenter had done even if the complainer was watching them.


“We found great variation among the toddlers,” Meltzoff said. “Some had excellent self-control, and some were a little more impulsive and could not control themselves.”


It was the toddlers who had more advanced self-control who surprised Meltzoff the most, he said. The more impulsive ones, meanwhile, “just plow forward seemingly unable to control their desire to imitate the interesting action,” even if doing so risks making the complainer upset, he said.


This finding is particularly important because of what is known about children’s long-term development if they have difficulties with self-regulation early on, said Julie Poehlmann-Tynan, a professor of human development at the University of Wisconsin-Madison.


“For example, self-control predicts school readiness, academic achievement and social competence, among other things,” she said. It’s exciting, she added, that even 15-month-olds have already learned to combine emotional cues with visual or other perceptual cues of an adult they don’t know and then use that to guide their behavior.


“This study suggests that parents need to consider how their toddlers are learning from what is occurring in the social world around them,” she said. “It also suggests that toddlers who seem to be impulsive may need more assistance learning how to inhibit behaviors than observation alone.”


One weakness of the study was that the researchers did not gather information about what conflict the children may have been exposed to, whether in the home, from media or elsewhere.


Meltzoff said it’s natural for parents to experience and show a variety of emotions in front of their children, but if a parent constantly shows anger, then a child may learn that people are generally angry and perhaps that the world in general is an angry, hostile place.


“Children who grow up surrounded by perpetual anger may develop a tendency to predict that everyone around them will react in an angry and hostile fashion,” Meltzoff said. “If kids predict or interpret other people’s behavior as being hostile, then they tend to heighten their own aggressive behaviors,” prompting an unhealthy vicious cycle, he said.


His team is planning a follow-up study to see whether the children’s behavior at 15 months of age predicts their self-control when they are school-aged.


The study was funded by the U.S. National Institutes of Health.


More information


Visit the U.S. National Library of Medicine for more on toddler social development.














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Make the Most of This Weekend’s Time Change


FRIDAY, Oct. 31, 2014 (HealthDay News) — A few simple steps can help make this weekend’s time change easier to cope with, a sleep expert says.


“Adjusting to the end of Daylight Saving Time in the fall is a bit easier than handling the time change in the spring. The main reason is because we gain an hour of sleep for the fall time change,” Dr. Praveen Rudraraju, director of the Center for Sleep Medicine at Northern Westchester Hospital in Mount Kisco, N.Y., said in a hospital news release.


The many Americans who are sleep-deprived should go to bed at their regular time so they can take advantage of the hour of sleep they’ll gain when the clocks slide back one hour in the wee hours of Sunday morning, he said.


The first few days after the time change can be difficult because the sun sets close to 5 p.m., which means it will be dark when many people leave work. Try to take advantage of the early sun in the morning to boost your mood, Rudraraju suggested.


Those most likely to have difficulty adjusting to the time change are short sleepers and early risers, because they’re less likely to be able to take advantage of the extra hour of sleep this weekend.


If you’re one of these people, delay your bed time by an hour so that you’ll wake up at your regular time, Rudraraju advised.


Some people make take up to one week to get used to the time change, he noted.


If you have a young child who wakes up at 6 a.m., try to put the youngster to bed 15 minutes later each day starting a few days before the time change. If you don’t make this gradual adjustment, the child is likely to wake up at 5 a.m. when the clock changes, Rudraraju noted.


More information


The U.S. National Institute of Neurological Disorders and Stroke has more about sleep.














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Halloween at the ER Is No Treat


FRIDAY, Oct. 31, 2014 (HealthDay News) — Carving pumpkins and trick-or-treating may seem like harmless fun, but Halloween injuries send many children to emergency rooms in the United States every year, experts say.


Out of eight holidays, Halloween had the fifth highest number of ER visits involving children aged 18 years and younger, according to 2007-2013 data from the National Electronic Injury Surveillance System.


Nearly one in five Halloween injuries involved the head, noted the American Academy of Orthopaedic Surgeons and the Pediatric Orthopaedic Society of North America. Lacerations were also common, the groups noted. The study showed that one-quarter of all hand and finger injuries were lacerations.


Children younger than 5 and kids between 10 and 14 sustained the greatest proportion of injuries.


“Costumes, candy and scary monsters tend to be top-of-mind for kids during Halloween, not falls and fractures,” said Dr. John Gaffney, pediatric orthopedic surgeon and academy spokesman. “It’s important for parents to establish clear boundaries with their kids and teach them safety tips to ensure they have a positive experience, rather than having to visit the emergency room.”


Experts from both associations provided the following safety tips to parents and their children during Halloween:


For trick-or-treaters:



  • Make sure children walk on sidewalks. Remind them not to cut across people’s yards or through their driveways.

  • Buy or make flame-resistant costumes and make sure they fit properly. Masks, hats or other accessories that are too big can obstruct children’s vision. Costumes that are too large can cause kids to trip and fall.

  • Choose bright colors. Costumes with noticeable colors will ensure that kids can be seen in the dark. Add reflective tape to costumes and treat bags as an additional safety measure to make sure children are visible.

  • Wear comfortable shoes. Regardless of the costumes children choose, their shoes should be sturdy, comfortable and slip-resistant to prevent falls.

  • Remind children to avoid houses that are not well-lit.

  • Use flashlights. Children and parents should carry flashlights so they can see properly and others can see them. Teach kids that pointing a flashlight above chest level could block the vision of other trick-or-treaters.

  • Be wary of pets. Pets may be threatened when strangers approach their homes.

  • Bring a cellphone. If there’s an emergency, a cellphone will allow trick-or-treaters to call for help.


For pumpkin carvers:



  • Use a pumpkin carving kit, or knives designed for carving. These tools are less likely to get stuck in a pumpkin while carving.

  • In the event of a pumpkin carving injury, elevate the injured body part above the heart and apply direct pressure to the wound with a clean towel. If bleeding doesn’t stop after 15 minutes, or if the cut is very deep, go to the emergency room.

  • Pumpkin carving always requires adult supervision. Rather than using a knife to carve, children can scoop out pumpkin seeds or decorate the pumpkin.

  • Don’t carve a pumpkin if you are under the influence of alcohol or another substance.


More information


The U.S. Centers for Disease Control and Prevention provides more Halloween health and safety tips.














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Generic Drugs May Help Breast Cancer Patients Stick to Therapy


FRIDAY, Oct. 31, 2014 (HealthDay News) — Access to generic hormone therapy medicines improves the chances that breast cancer patients will stick with their drug treatment, a new study found.


“We know that hormone therapy for women with hormone receptor-positive breast cancer can reduce recurrence by up to 50 percent,” study leader Dr. Dawn Hershman, an associate professor of epidemiology at Columbia University Medical Center in New York City, said in a hospital news release.


“However, work by our group and others has shown that a substantial number of women discontinue treatment before the recommended five years or do not take the prescribed dose,” she added.


“Our findings suggest that more effort should be made to reduce out-of-pocket costs for these potentially life-saving medications. This is especially important given the rapid increase of expensive oral cancer therapies,” explained Hershman, who is also an associate professor of medicine at Columbia’s College of Physicians and Surgeons.


The study included more than 5,500 women. All were 50 years of age or older. And, all of the women had early stage breast cancer that was hormone receptor-positive. That means the cancer is fueled by the hormone estrogen, according to the American Cancer Society (ACS).


The women in the study all had surgery to remove their breast cancer. After surgery, they were prescribed drugs called aromatase inhibitors, a common type of therapy for hormone receptor-positive cancers. Aromatase inhibitors work by blocking the conversion of other hormones into estrogen. In women who’ve gone through menopause, these drugs can lower the amount of estrogen in the body, according to the ACS.


Even though hormone therapy significantly reduces the risk of disease recurrence in patients with this type of breast cancer, many women don’t take their medications as directed, the researchers said.


The patients in the study were followed for two years. The investigators found that women who took generic aromatase inhibitors were 50 percent more likely to adhere to their drug therapy than those who took brand-name aromatase inhibitors, which are much more expensive.


“This is increasingly important because we are starting to learn that even longer therapy — up to 10 years — may be beneficial. It’s critical that we understand why people do not take their medication and what we can do to improve adherence,” concluded Hershman, leader of the Breast Cancer Program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Medical Center.


Several factors may contribute to breast cancer patients’ failure to adhere to drug therapy, the study authors suggested.


“Cost is not the only reason. But it can intensify other factors such as side effects. Up to 40 percent of women taking [aromatase inhibitors] experience joint stiffness. If you add a high co-payment to the mix, that’s often enough to make them discontinue therapy,” Hershman said in the news release.


The study was published online Oct. 27 in the Journal of the National Cancer Institute.


More information


The American Cancer Society has more about aromatase inhibitors.














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Study Confirms Obesity-Breast Cancer Link for Blacks, Hispanics


FRIDAY, Oct. 31, 2014 (HealthDay News) — Obesity increases the risk of certain types of breast cancer in postmenopausal black and Hispanic women, two new U.S. studies show.


One study of more than 3,200 Hispanic women found being overweight or obese increased the risk for estrogen receptor-negative and progesterone receptor-positive breast tumors among postmenopausal women.


“We’ve known this for a long time for white women, but now we are seeing this also in Hispanic women,” study author Esther John, a senior research scientist at the Cancer Prevention Institute of California, said in an American Institute for Cancer Research news release.


The study was presented Thursday at the research institute’s annual meeting in Washington, D.C., and published Oct. 30 in the journal Cancer Epidemiology, Biomarkers & Prevention.


“Breast cancer appears to have different risk factors in younger versus older women but by far, breast cancer is more common among postmenopausal women,” John said.


“This has huge implications for not just Hispanics but all women. We cannot change genetics or family history, but we can do something about obesity,” she said. “You can eat less, choose healthier foods and do more physical activity. It may not be that easy but it’s possible. And it’s important for not just lowering breast cancer risk but for many other diseases.”


The other study included more than 15,000 black women and found that being overweight or obese increased postmenopausal women’s risk of ER-positive breast cancer by 31 percent. It also found that the risk was nearly double among black women who were lean as young adults and gained weight in adulthood.


The study was also released at the cancer research meeting.


“We know that breast cancer has several subtypes and there is growing evidence that these subtypes have different risk factors,” study author Dr. Elisa Bandera, of Rutgers Cancer Institute of New Jersey, said in the news release. “The distribution of these subtypes and risk factors are different for African Americans and Hispanics compared to white women.”


One study is not enough, said Bandera. “We need to know more about what African American women can do to prevent and survive breast cancers of all types, which are often aggressive and deadly.”


More than one in two black women and nearly one in two Hispanic women in the United States are obese.


More information


The U.S. National Cancer Institute has more about breast cancer.














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Kids: An Rx for Menopause’s Hot Flashes?


By Amy Norton

HealthDay Reporter


FRIDAY, Oct. 31, 2014 (HealthDay News) — Women who live with young children may be less likely to suffer hot flashes after going through surgical menopause, a new study suggests.


The finding, published recently in the journal Menopause, followed a small group of women who had their ovaries removed because they were at high genetic risk of ovarian cancer. Most of the women had already gone through menopause, but 48 had not — which meant the surgery caused an abrupt menopause.


In that group of women, those with a young child at home tended to have less severe hot flashes and night sweats, according to the study.


“This is a very interesting study that raises some important questions,” said Dr. Jill Rabin, an obstetrician/gynecologist who was not involved in the research.


One of those questions is whether the hormone oxytocin offers some protection from hot flashes, according to Rabin, co-chief of ambulatory care at North Shore-LIJ Health System in New Hyde Park, N.Y.


Oxytocin is commonly known as the “bonding hormone,” because it’s released during certain types of human connection — including when mothers breast-feed or care for young children.


But, like other hormones, oxytocin is “not just a one-job molecule,” said study co-author Virginia Vitzthum, a professor of anthropology at Indiana University, in Bloomington.


She explained that oxytocin also helps regulate the body’s core temperature — which, in theory, could be one reason why the women in the study who lived with children tended to have fewer hot flashes.


But this study doesn’t prove oxytocin deserves the credit.


“It just hints at that,” Vitzthum said.


Women who live with young kids might have other factors in their lives that help protect against more severe hot flashes, according to Vitzthum.


To name a few, differences in exercise, diet, job activities or stress levels could be at work, she said. And her team was not able to account for racial or ethnic differences, since most women in the study were white.


Vitzthum said the idea for the study stemmed, in part, from research on cultural differences in menopausal symptoms.


Women in some non-industrialized societies report far fewer hot flashes, versus those in industrialized countries. There could be any number of reasons, but one possibility is that family structure plays a role, Vitzthum said.


“Inter-generational living is very common in those cultures,” she said. Grandmothers or aunts are often under the same roof as young children, and share the responsibility for caring for them.


In the United States, Vitzthum noted, the “nuclear family” is now the norm. “But certainly through most of human history, the extended family was very common,” she said.


According to Vitzthum, it’s possible that humans evolved so that it’s not only children who benefit from those family relationships — but older family members, as well.


The current study included 117 women, all from the Seattle area, who had surgery to remove their ovaries because they carried gene mutations that raised their cancer risk. Sixty-nine women had already gone through menopause, while the remainder had not.


About half of the women had a child at home — either their own or a grandchild.


In general, the study found that women who were pre-menopausal before surgery tended to report less severe hot flashes after surgery if they lived with a child younger than 13.


Rabin agreed that oxytocin is only a theoretical explanation for the finding: “One issue is that [the researchers] didn’t actually measure the women’s oxytocin levels,” she said.


But Rabin said the possible connection is worth further research — including studies that follow women as they go through natural menopause.


According to Vitzthum, that research could take many directions. “For example, we don’t think the young child would have to be genetically related to you,” she said.


It’s possible, she speculated, that being around young kids — through volunteering, or helping to care for friends’ children or grandchildren — could help soothe hot flashes.


Another question is whether other types of relationships could affect hot flash severity, Vitzthum said.


Physical contact, including hugs, helps release oxytocin. And in some of those cultures where hot flashes are less common, older women are not shy about physical contact with each other, Vitzthum said.


“They hug each other, lean on each other, put a head on someone else’s shoulder,” she noted. Whether that helps cool hot flashes is unknown — but, Vitzthum said, “cuddling is just good.”


More information


Learn more about menopause symptoms and treatments from the U.S. Office on Women’s Health.














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7 Natural Swaps for Refined Sugar

Photo: Kristin Duvall Getty; Courtesy Hungry Girl

Photo: Kristin Duvall Getty; Courtesy Hungry Girl




Lots of people are cutting back on refined sugar these days—are you one of them? If so, here are a few ways to do it…


Calorie-Free Sugar Substitutes


Stevia

Stevia has become a pretty popular all-natural calorie-free sweetener, popping up in little green packets and even some soft drinks. I really like Truvia, but PureVia and Stevia In The Raw are also great. Stevia In The Raw even comes in a variety that measures cup-for-cup like granulated sugar. Vitaminwater Zero is sweetened with stevia, and soda sippers looking for a natural alternative should check out Blue Sky Zero.


Monk fruit

Also known as luo han guo, this very sweet fruit is being used to make natural sweeteners that are calorie-free. Monk Fruit In The Raw comes in packets as well as bakers’ bags. And monk fruit extract can be found in certain varieties of popular food products…maybe more of them than you realize. Some Vitalicious products (including most of my beloved chocolatey VitaTops), some cereals by Kashi, all of the Chobani 100.


Fruit-based fixes


Fruit is a great option when it comes to naturally satisfying your sweet tooth. Plus, fruit packs healthy fiber, which will help to keep you feeling full. Check out these recipe ideas!


Apple pie in a mug

In a microwave-safe mug sprayed with nonstick spray, mix 1 cup chopped apple, ½ tsp. cinnamon, ⅛ tsp. lemon juice, and 1 no-calorie sweetener packet (like the kinds mentioned above). Mix well, cover, and microwave for 2 minutes, or until softened. The result is a dessert-y treat with under 100 calories and not a bit of refined sugar. This one’s a favorite in The Hungry Girl Diet!


Creamy coconut raspberry smoothie

Traditional smoothies often have loads of excess sugar. In this recipe, the combo of juicy raspberries and no-calorie sweetener results in sweet indulgence you can feel good about sipping. Only 106 calories, plus 7.5g fiber!


Other Natural Alternatives, Plus an Important Heads-Up


These sugar substitutes are natural (though they often undergo some processing), but they generally contain as many calories and grams of sugar as the real thing—sometimes more. Try combining them with the calorie-free stuff to keep those numbers in check!


Honey

There are many honey varieties on shelves; these can be good in hot drinks and for baking. Each teaspoon has about 20 calories.


Agave nectar

This syrup is made from the agave plant. It’s not as thick as honey, yet it’s more intensely sweet. It’s also vegan friendly. A teaspoon has around 20 calories.


Coconut sugar

If you need something granulated, this is a good option. The flavor’s a little more like brown sugar than regular white sugar, but it’s nice. Each teaspoon has about 15 calories, similar to traditional sugar.


‘Til next time… Chew the right thing!










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Almost 1 in 5 Americans Plagued by Constant Pain, Survey Suggests


By Alan Mozes

HealthDay Reporter


THURSDAY, Oct. 30, 2014 (HealthDay News) — Almost one-fifth of Americans do daily battle with crippling, chronic pain, a large new survey reveals, with the elderly and women struggling the most.


The poll of roughly 35,000 American households provides the first snapshot of the pain landscape in the United States, the survey authors said.


The bottom line: Significant and debilitating pain that endures for three months or more is now a common feature in the lives of an estimated 39 million Americans.


“I wasn’t particularly surprised by our findings,” said study author Jae Kennedy, a professor of health policy and administration at Washington State University in Spokane. “But I found it sobering that so many American adults are grappling with persistent pain.”


“Going forward, it will be important to track changes in rates of persistent pain within the U.S., and compare these rates to other countries with different health care systems,” Kennedy said.


Kennedy and his colleagues report their findings in the October issue of the Journal of Pain.


To get a sense of the scale of the Americans’ experience with pain, the study authors analyzed responses to a 2010 National Center for Health Statistics survey.


Those who said they had experienced serious continual pain during the prior three months were the focus of the poll, rather than participants who said they had experienced short-term pain or pain that was intermittent or moderate in nature.


The result: Overall, 19 percent of the adults polled were deemed to have experienced “chronic” and severe daily pain.


That grouping did not, for the most part, include adults who said they struggled with arthritis or back and joint pain, as those people tended to say their pain was not constant and persistent, the study authors noted.


That said, the chronic pain figure exceeded 19 percent among specific groups of respondents, including those between the ages of 60 and 69, women, those who said their health was fair or poor, those who were obese or overweight, and those who had been hospitalized in the prior year.


And among those with chronic pain, more than two-thirds said their pain was “constantly present,” while more than half said their pain was at times “unbearable and excruciating.”


That level of physical pain can prompt psychic pain, Kennedy noted.


“Being in pain is depressing,” he said in a statement. “Being in pain all the time is tiring. Being in pain all the time is anxiety-provoking. So it’s plausible that pain is triggering other kinds of more psychological distress.”


Kennedy suggested that for those experiencing chronic, crippling pain there are a variety of potential interventions, including physical and occupational therapy, exercise, dietary changes, weight loss, massage and psychotherapy, alongside alternative interventions such as acupuncture, yoga and chiropractic services.


Medicines, including narcotic painkillers like hydrocodone, oxycodone and morphine, can also be helpful, but only if long-term use is avoided, Kennedy said.


“We are clearly overusing opioids [narcotics],” he noted. “The U.S. consumes about 80 percent of the world’s opioid supply, and 99 percent of the hydrocodone supply. These medications are effective in the short term, [such as] for managing postoperative pain, but long-term use often leads to dependency or addiction.”


Bob Twillman, director of policy and advocacy for the American Academy of Pain Management, agreed, noting that the kind of crippling pain that can make it impossible for people to work tends to have many different sources, not all of which are best addressed with narcotic painkillers.


“If it was just one thing causing pain, we might have one treatment that would work for most people,” he said. “But, given that we have millions of people with dozens, or perhaps even hundreds of causes for their pain, we can’t use a cookie-cutter approach to treating pain.”


And that means, Twillman added, that medications may not always be the best answer for every patient.


“Those medications are wonderful when they work, but on average, they only relieve about a third or less of the chronic pain people experience, and may be completely ineffective in treating some kinds of chronic pain,” Twillman said. Also, the drugs don’t do anything to tackle the emotional, mental and behavioral aspects of pain management, he added.


“If we’re going to do the best job possible of caring for people with chronic pain, we need to look at all of these aspects of the pain experience, and try to address them all,” Twillman said. “When we are able to do that, we’ll be successful in addressing the chronic pain that millions of Americans live with every day.”


More information


Visit the U.S. National Institute of Neurological Disorders and Stroke for more on chronic pain.














from Health News / Tips & Trends / Celebrity Health http://ift.tt/105yEwu

Cronut Calories: How Dunkin’ Donuts’ Version Compares to the Original

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Photo: Dunkin’ Donuts



By now you’ve probably heard the buzz surrounding all that is the delicious cronut—a buttery, flaky fusion of donut and croissant, created by the famed chef Dominique Ansel. The treat still commands lines outside his bakery and just recently Ansel revealed his recipe, an epic 2,300-word long, 3-day process with so many steps it’s enough to make your head spin.


Getting in on the trend, Dunkin’ Donuts announced this week that they’ll be launching their own (ahem, copycat) version of the confection in 7,900 stores for a limited time starting on November 3. They describe the $2.49 croissant donut as “24 layers of buttery dough…covered in the same sweet distinctive glaze used on our Glazed Donuts.”


Sounds like a total calorie bomb, but it’s not quite as bad as you’d think. The Croissant Donut isn’t currently listed in the company’s nutrition catalog, but according to Dunkin’ Donuts, each one has 300 calories, 14g of fat (8g saturated), 39g of carbohydrates.


Ansel’s recipe is way more of a Halloween scare. We did a nutritional analysis to find out just how many calories are in one of his famed cronuts—specifically the one with chocolate-champagne ganache, orange sugar, and champagne-chocolate glaze. Read at your own risk.


Dominique Ansel’s Cronut


Calories: 675*

Total fat: 38g

Saturated fat: 23g

Sodium: 823mg

Carbohydrate: 80g

Fiber: 3g

Protein: 7g


*That’s nearly 150 calories more than a McDonald’s Big Mac!


RELATED: 10 High-Protein Breakfast Recipes








from Health News / Tips & Trends / Celebrity Health http://news.health.com/2014/10/30/calories-in-cronut-dunkin-donuts-croissant-donut/

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