Are You Eating Enough ‘Powerhouse’ Vegetables?

By Dennis Thompson

HealthDay Reporter

THURSDAY, June 5, 2014 (HealthDay News) — Watercress, Chinese cabbage, chard and beet greens are among the most nutrient-dense “powerhouse” vegetables, packing a huge dose of vitamins and minerals into every calorie, a new study reports.

At the same time, don’t expect to receive huge amounts of nutrition from raspberries, tangerines, garlic or onions, the findings suggest.

National nutrition guidelines emphasize consumption of powerhouse fruits and vegetables, which are strongly associated with reduced risk of chronic disease.

But until now, the study author noted, nutritional value of veggies hasn’t been ranked in a way that would show which best qualify as nutrient-dense powerhouse foods.

For the report, Jennifer Di Noia, an associate professor of sociology at William Paterson University in Wayne, N.J., crafted a list based on the nutritional density of fruits and vegetables, using data from the U.S. Department of Agriculture.

“Higher-ranking foods provide more nutrients per calories,” Di Noia said. “The scores may help focus consumers on their daily energy needs, and how best to get the most nutrients from their foods. The rankings provide clarity on the nutrient quality of the different foods and may aid in the selection of more nutrient-dense items within the powerhouse group.”

Di Noia calculated the nutrition contained in 47 fruits and veggies, finding that all but six met the criteria as a powerhouse food.

Cruciferous and dark green leafy vegetables dominate the top 10. They are, in order, watercress, Chinese cabbage, chard and beet greens, followed by spinach, chicory, leaf lettuce, parsley, romaine lettuce and collard greens.

All the top vegetables contain high levels of B vitamins, vitamin C, vitamin K, iron, riboflavin, niacin and folate — nutrients that help protect people against cancer and heart disease, the researcher noted.

These leafy vegetables taking the top powerhouse spots “makes sense,” said Lauri Wright, a spokeswoman for the Academy of Nutrition and Dietetics.

“They have a lot of the B-vitamins and a lot of fiber in the leaves,” said Wright. “If you think about plants, that’s where they store their nutrients. Those green leafy vegetables have a lot of minerals and vitamins and fiber in those leaves, and very few calories.”

People who chop off the leafy part of vegetables such as celery, carrots or beets are “actually cutting away some very good nutrients,” said Wright, an assistant professor at the University of South Florida College of Public Health in Tampa.

The six fruits and vegetables that didn’t make the list as powerhouse foods are raspberries, tangerines, cranberries, garlic, onions and blueberries. While all contain vitamins and minerals, they are not densely packed with important nutrients, the study said.

The full list is published June 5 in the journal Preventing Chronic Disease.

Folks will get good nutrition from the powerhouse veggies whether they eat them raw or cook them, as long as they don’t boil them, Wright said.

“Fresh, you have 100 percent of the vitamins and minerals,” she said. “When you cook it, you might lose a small percentage, but it’s not significant.”

Boiling, however, can drain veggies of B-vitamins, vitamin C and other nutrients, Di Noia and Wright said.

Cooks who choose to boil spinach or collard greens should save the nutrient-rich water, either including a little with each serving or re-using the water in sauces or soups, Di Noia said.

Wright agreed. “We encourage you to use the liquid. If you have a bowl of green beans, have some of the liquid with your serving of beans,” she said.

More information

The U.S. Department of Agriculture has more about good nutrition.

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CPAP Mask Success May Depend on Family Support, Study Finds

THURSDAY, June 5, 2014 (HealthDay News) — People struggling with sleep apnea who turn to the CPAP mask for help may do better if they get support from partners and family members, a new study shows.

“Having healthy relationships with family members can create an environment that supports the patient’s use of CPAP,” study lead author Faith Luyster, a research assistant professor in the School of Nursing at the University of Pittsburgh, said in an American Academy of Sleep Medicine news release.

Millions of Americans experience the snoring and interrupted nighttime breathing of sleep apnea. Continuous positive airway pressure (CPAP) therapy helps keep a person’s airway open by providing a stream of air through a mask that is worn during sleep. Many patients find the mask uncomfortable, however, affecting treatment adherence rates.

In the new study, Luyster’s team tracked 253 patients with obstructive sleep apnea who were prescribed CPAP therapy. These individuals were monitored for three months to determine if they used the mask device nightly.

People who were married or living with a partner were more likely to use CPAP regularly than those who were single, the team found. Patients with better family relationships also had better CPAP adherence than those with poor family relationships.

“This is the first study to explore the role of family factors in CPAP adherence,” Luyster said.

Based on the results, she believes that interventions that involve the patient’s family in sticking with the CPAP device “may help patients who would benefit from family support during the initial treatment period.”

The study was published online recently in the journal Sleep and was also scheduled for presentation at this week’s annual meeting of the Associated Professional Sleep Societies in Minneapolis.

More information

The U.S. National Heart, Lung, and Blood Institute has more about CPAP.

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To Run or Not to Run? DNFs and When to Quit a Race

Nowhere is the saying “life is what happens to you when you’re busy making other plans” more true than in endurance sports. For a race like a half-marathon or marathon, you often need to sign up several months in advance just to secure your spot.

• Ultrarunning: Are We Meant to Go the Distance?


• 10 Ways You’re Sabotaging Your Workout


• The 5 Keys to a Perfect Warm-Up

Over those next few months of training (oh, and that little thing called life), myriad obstacles can get in your way, from big projects at work to injury. But figuring out when you should take a DNS (did not start), or even a DNF (did not finish) — and when you should grit your teeth and bear it — can be a tough call to make. When emotions ride high and intuition goes out the window, hear what our running experts have to say on whether you should — or shouldn’t — toe the line.

If You’re Injured

Runners are notorious for being a little creaky around the edges from the miles of wear and tear they put on their body. It’s not uncommon to experience some degree of pain or soreness through the course of a training cycle. “But if the pain is increasing as you run or if it’s at a moderate to severe level before you begin the run,” says Michael Conlon, the owner of Finish Line Physical Therapy, “then it’s worth paying attention to.” He recommends choosing a pain-free form of cross-training, such as biking or swimming, or running on an Alter-G Anti-Gravity Treadmill if you have access to one.

If you’re training for a longer race, like a half-marathon or marathon, you should be even more wary about pushing through injury. “I’m overly cautious and would recommend a runner not run the race if an injury is casting doubt on their ability to finish, run without pain, or otherwise have an enjoyable experience,” says Jason Fitzgerald, a USA Track & Field certified coach and the founder of Strength Running.

You can look to see if your race offers options to defer until the next year or transfer your bib to someone else. If you still have friends or family competing in the race, you may want to go cheer them on — which is fine if that’s what you’re really there to do. “If you’re just there to torture yourself,” says licensed clinical and sports psychologist Bhrett McCabe, PhD, then don’t do it. “It’s nice to see a race from the other perspective, so make sure you have a purpose if you’re going.”

If You Need to Take a DNF

A DNF is always a very tough decision, says Fitzgerald, “especially as most runners love finishing races for the pride, camaraderie and potentially a nice medal. But it’s a good idea to stop and quit the race if a pain surfaces or persists that is sharp, stabbing, or otherwise very intense.” It’s likely you could cause additional damage by pushing through, further aggravating the injury, or creating new ones.

Michele Gonzalez made the call during the Staten Island Half Marathon last year that she’d need to drop out. Her calf had cramped up at mile nine, and her stride changed in order for her to keep running. For her, “Finishing a tune-up race was not the goal,” she says. “It was to get 13.1 miles of hard, fast running and to practice pushing when things got tough.” She decided to drop out because she believes no race is worth a serious injury.

She also took a DNF at the New Jersey Marathon last year, due to issues with nerves, fueling and hydration. It was a goal race for Gonzalez, who dropped out when she realized she wouldn’t hit the time she was aiming for. Making the call wasn’t clear-cut, though. “You need to differentiate between hitting the wall and having something actually hurt,” she says. “My calves were cramping, but it was more fatigue than injury. I still regret today that I dropped out.”

If You’re Undertrained

Of course, sometimes the problems present themselves much earlier than race day. It happens: You’re signed up for the marathon, but it’s just not in the cards. Life somehow got in the way, and there’s no chance you can run 26.2 miles in one shot. But if you’re lucky, your event might have other options like a half-marathon, 10-mile race or 5K.

“Some athletes might decide to drop down to a shorter race,” says Dr. Amanda Visek, a sports psychologist at George Washington University. If you’ve made this decision far enough out, you can reduce your mileage and adjust your training for the new distance. She also recommends accepting and embracing the new race goal and then doing whatever is necessary in terms of mental or physical preparation to meet your goal.

If You’re Not Ready to Race

We know, we know — the Type A part of you doesn’t want to hear this. But if you can still comfortably finish the distance, just not at a racing pace, you can always turn it into a more relaxed run. And sometimes, says McCabe, you will surprise yourself and run better than you could have hoped for.

“Expectations are entitlements, so they raise pressure and limit the ability to compete naturally,” McCabe says. “They force you to read into each experience and evaluate how you are performing compared to your desires.” Instead, he encourages his athletes to make “demands” of themselves during the race, such as “I know today will be difficult, but I am going to work to stay in the moment rather than worry about the future.”

There’s also the option of shifting your focus to help others. If you have a friend who’s doing the race, maybe that means pacing them to a PR (if their fast pace is a more comfortable pace for you), an experience that can be nearly as rewarding as hitting your own personal best. Or, if you’re really dead-set on just running for fun, turn the race into a game. How many pictures can you take? How many high fives can you get?

Find Your Next Goal Race

Whether you’ve skipped the race altogether or dropped down in distance or pace, you might be itching for your next adventure.

“As soon as someone drops out of a race, they can immediately begin to adjust their goal or begin a new goal for a different race,” says Visek. “Take into consideration all of the variables at that moment — your training, conditioning, your next race — and begin to formulate a plan,” says Visek.

But don’t rush in prematurely. McCabe suggests waiting several days so that you’re not registering based on an emotional reaction. Take some time to process what happened leading up to your dropping out or down.

However, if you’re avoiding racing out of fear, it’s important to get back out there sooner rather than later. “We know from anxiety research that the more we avoid [something], the stronger the fear is,” McCabe says. “The longer you try to steer clear of this adversity, the worse the fear will become, so face it head on.”

You’ll know from your physical and mental training when you’re ready for your next race.

Life by DailyBurn is dedicated to helping you live a healthier, happier and more active lifestyle. Whether your goal is to lose weight, gain strength or de-stress, a better you is well within reach. Get more health and fitness tips at Life by DailyBurn.

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No Drop in Smokeless Tobacco Use Among U.S. Workers: CDC

By Margaret Steele

HealthDay Reporter

THURSDAY, June 5, 2014 (HealthDay News) — Cigarette smoking continues to decline among Americans who work, but use of smokeless tobacco — a known cause of cancer — has held steady since 2005, U.S. health officials reported Thursday.

Certain types of jobs — construction and mining, especially — are hotbeds of smokeless tobacco use, according to a study conducted by the U.S. National Institute for Occupational Safety and Health.

Looking at tobacco use over five years, the researchers found a decline in cigarette smoking among working adults — from about 22 percent in 2005 to 19 percent in 2010. But use of smokeless tobacco products such as chewing tobacco and snuff inched up slightly — from 2.7 percent in 2005 to 3 percent in 2010.

“These findings can help health professionals direct assistance to working men and women to stop using smokeless tobacco, a known cause of oral, esophageal and pancreatic cancer,” the researchers from the U.S. Centers for Disease Control and Prevention reported.

The CDC called on employers to try to snuff out all forms of tobacco use.

New smokeless tobacco products such as snus (finely ground moist snuff) and candy-flavored dissolvable tobacco, combined with increased marketing, might explain smokeless tobacco’s steady use, the CDC authors said. However, snus and some other products weren’t included in the questionnaire so it’s possible smokeless tobacco use is underestimated, study author Dr. Jacek Mazurek, of the division of respiratory disease studies, and colleagues noted.

Chewing tobacco and snuff aren’t safe, research has shown. These products may contain more nicotine than cigarettes, according to the U.S. National Institutes of Health. Nicotine is highly addictive, which is why it’s so hard to quit smoking.

For the report, researchers analyzed data from the National Health Interview Survey.

About 19 percent of mining workers acknowledged use of smokeless tobacco, the survey found.

Adults involved in oil and gas extraction also reported heavy use of smokeless tobacco, with about 11 percent using the products, according to the study published in the June 6 issue of the CDC’s Morbidity and Mortality Weekly Report.

The percentage of cigarette smokers who also use smokeless tobacco was relatively unchanged during the study period — about 4 percent, the researchers said.

Employers can step up efforts to curb smokeless tobacco use, the CDC suggested.

Making workplaces tobacco-free, offering information on the health risks of tobacco and the benefits of quitting can help reduce these destructive habits. Promoting work-based tobacco-cessation services, including health insurance that covers treatment for tobacco dependence, is another valuable aid, the CDC report said.

The finding that 3 percent of working adults used smokeless tobacco in 2010 indicates that much work is needed to meet the Healthy People 2020 target of 0.3 percent or less for U.S. adults.

More information

The U.S. National Library of Medicine has more about smokeless tobacco.

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People Under 65 Hard Hit by Flu This Year

By Steven Reinberg

HealthDay Reporter

THURSDAY, June 5, 2014 (HealthDay News) — H1N1 flu was the most common influenza strain in the United States this year, according to the latest report from the U.S. Centers for Disease Control and Prevention.

As in previous years, H1N1 disproportionately affected younger people — nearly 60 percent of the 9,635 confirmed flu-related hospitalizations occurred in people between the ages of 18 and 64 years. And, people between the ages of 50 and 64 years had the highest rates of flu-related hospitalizations this year compared to the past four flu seasons, the CDC said.

These latest figures are from the June 6 issue of the CDC’s journal Morbidity and Mortality Weekly Report.

Things could’ve been much worse, though. The predominant virus didn’t cause a pandemic this year because of prior widespread exposure to H1N1, and also because of its inclusion in this year’s flu vaccine, the CDC said.

The agency is recommending inclusion of the H1N1 virus in next year’s flu vaccine as well.

“This year, not only do we have a vaccine that works well, but millions of people have already been exposed to the H1N1 virus,” Dr. Michael Jhung, a medical officer in the U.S. Centers for Disease Control and Prevention’s influenza division, told HealthDay. Although H1N1 flu has circulated since 2009, “this is the first season since then we have seen it dominate,” he added.

The timing was different, too. “We had a bit of an early peak to the flu season,” Jhung said. “We typically see the highest activity in January/February, but it happened this season about a month early.”

Even though H1N1 was the most common flu strain, a “herd immunity” kept it from becoming a pandemic again, Jhung said.

For a virus to become pandemic, it must pass easily from person to person and have never circulated before so that people don’t build immunity to it.

“The theory of herd immunity is that if you vaccinate enough people, not everyone has to be immune in order to stop the disease spreading through a community,” he said.

For instance, infants under 6 months of age cannot be vaccinated for flu, but if the people around them are vaccinated, the odds of the infant getting the flu are greatly reduced, Jhung noted.

Also, the makeup of the current flu vaccine made it more effective than the vaccines of the last couple of years, Jhung said. “We have a preliminary estimate for vaccine effectiveness that’s quite good — 62 percent,” he said.

That means the likelihood of getting the flu if you were vaccinated was cut by 62 percent. “In the previous two years, vaccine effectiveness was between 47 and 49 percent,” Jhung said.

This year’s flu vaccine protected people from H1N1 and other flu types, including H3N2 and a type of influenza B virus. Some formulations of the vaccine had an additional B strain, protecting people against four types of flu, Jhung said.

The CDC relies on hospital data to estimate adult deaths at the end of the flu season, and it’s too soon to obtain those figures, Jhung said. Adult flu deaths in the United States usually range from 35,000 to 40,000 a year.

The agency does have up-to-date records for children, however. So far this season, 96 children have died from flu. In 2009, when H1N1 first surfaced, 348 children died from influenza, according to the CDC.

The best way to protect yourself from the flu is by getting a flu shot, the CDC advises. The agency recommends everyone 6 months old and up to get a flu vaccine every year. This year, about 40 percent to 45 percent of those who should get a flu shot did — about the same as last year, Jhung said.

Although the peak of flu has passed, flu activity continues throughout the summer, according to the CDC.

More information

For more information on flu, visit the U.S. Centers for Disease Control and Prevention.

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More Americans Kept Awake by Fido, Fluffy

THURSDAY, June 5, 2014 (HealthDay News) — Dogs whimpering that they need to “go outside,” cats with medical needs, even pets that snore — it’s all adding up to sleepless nights for many Americans, a new report finds.

Overall, the percentage of people reporting sleep-time trouble with their pets rose from 1 percent in 2002 to 10 percent by 2013, according to a small study by Mayo Clinic researchers in Phoenix.

“While the majority of patients did not view their pets intolerably disturbing their sleep, a higher percentage of patients experienced irritation [and] this may be related to the larger number of households with multiple pets,” study lead author Dr. Lois Krahn, a Mayo Clinic psychiatrist, said in a clinic news release.

“One patient owned a parrot who consistently squawked at 6 a.m.,” Krahn noted. “He must have thought he was a rooster.”

The study, slated for presentation at this week’s annual meeting of the Associated Professional Sleep Societies in Seattle, involved 110 patients treated at the Mayo Clinic Center for Sleep Medicine in Arizona between August and December 2013.

The patients answered questions about their pets and how they behaved at night. The patients also provided specific information on the number of pets they had, the types of pets they owned and where the animals slept at night.

The researchers found that 46 percent of the patients had pets. Of these people, 42 percent had more than one animal. Most of the study participants had dogs, cats or birds.

Among the pet behaviors that caused the patients to be disturbed during the night:

• snoring,


• whimpering,


• wandering,


• wanting to “go outside”, and


• having medical needs.

“When people have these kinds of sleep problems, sleep specialists should ask about companion animals and help patients think about ways to optimize their sleep,” Krahn said.

More information

The U.S. National Heart, Lung and Blood Institute provides more information on the health effects of poor sleep.

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Yoga May Not Help Ease Asthma, Study Suggests

THURSDAY, June 5, 2014 (HealthDay News) — Although yoga is believed to boost physical and mental health, it does not seem to help ease symptoms of asthma, a new study finds.

Even so, experts from the American College of Allergy, Asthma and Immunology (ACAAI) noted that if it makes people with asthma feel better they should continue to practice it.

“Many asthma sufferers look to complementary therapies, such as yoga, to help relieve their symptoms,” Dr. Michael Foggs, an allergist and ACAAI president, explained in a news release from the organization. “If yoga helps them to feel better and breathe better, patients should by all means practice it. At the same time, we don’t advise that yoga be recommended to asthma sufferers as a treatment.”

The researchers analyzed 14 previous studies involving 824 adults from North America, Europe, Asia, Africa and Australia, to find out if yoga could help treat symptoms of asthma and improve the lung function and quality of life for people with the respiratory condition.

“We reviewed the available data to see if it made a difference and found only weak evidence that it does,” study author Holger Cramer, director of yoga research at the University of Duisburg-Essen in Germany, said in the news release. “Yoga can’t be considered a routine intervention [treatment] for patients with asthma at this time. But it can be considered an alternative to breathing exercises for asthma patients interested in complementary interventions.”

Experts point out that prevention strategies are key to managing asthma. People with the condition should work with their allergist to identify their asthma triggers and avoid them. Possible asthma triggers include allergens, respiratory infections and cold temperatures.

For those with unpredictable asthma that flares up at least twice a week, there are medications that can be taken long-term to keep the condition under control. Allergic asthma can also be treated with allergy shots if the allergens can’t be avoided.

The findings were published in the June issue of Annals of Allergy, Asthma & Immunology.

More information

The U.S. National Heart, Lung, and Blood Institute provides more information on asthma.

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Broken Bones, Concussions Most Common Injuries in Youth Hockey

THURSDAY, June 5, 2014 (HealthDay News) — Broken bones and concussions are the most common injuries that children who play ice hockey suffer, a new study reveals.

Researchers from the Mayo Clinic in Rochester, Minn., found many of the kids with these injuries needed to be hospitalized or undergo surgery. Since ice hockey is gaining popularity in the United States, they noted that children should be reminded to wear all necessary protective equipment and to have respect for opposing players.

“Ice hockey is one of the most popular sports in Minnesota and is rapidly growing in popularity throughout the United States. Due to the fast, hard-hitting nature of the game, people often ask, ‘What kinds of injuries might happen to my children?’ ” study author Dr. Michael Ishitani, a pediatric surgeon at Mayo Clinic Children’s Center, said in a Mayo Clinic news release.

The study involved patients who were examined in a pediatric trauma center after being injured while playing ice hockey. The injuries occurred over a period of 16 years.

The researchers found the children’s age and gender played a role in the types of injuries they had.

“Most injuries occurred in boys and older children, though approximately 20 percent occurred in girls, which is higher than previously reported,” Ishitani said.

The study also revealed that older boys were more likely to have an extremity injury. Meanwhile, symptoms of a concussion more often affected girls and younger children.

The researchers pointed out there were few life-threatening injuries.

“Most kids aren’t going to be the next Wayne Gretzky,” Ishitani concluded. “I encourage parents and coaches to remember that kids are out there to develop their skills, be a part of a team and develop into mature young men and women.”

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about children and sports injuries.

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Study Supports Durability of Parkinson’s Treatment

THURSDAY, June 5, 2014 (HealthDay News) — Therapeutic, transplanted brain cells producing the brain chemical dopamine remain viable in Parkinson’s disease patients for many years, a new study reveals.

The findings “suggest that transplanted dopamine neurons can remain healthy and functional for decades,” study co-author Ole Isacson, of Harvard University and McLean Hospital in Boston, said in a news release from the journal Cell Reports. The study was published in the journal on June 5.

As explained by the study authors, the tremors and other symptoms experienced by Parkinson’s disease patients are caused by the loss of dopamine-producing neurons (brain cells). Healthy dopamine-producing neurons can be transplanted into patients’ brains, but there were questions about how long the transplanted cells would remain healthy.

This study included five Parkinson’s patients who had received transplants of fetal tissue-derived dopamine-producing neurons four to 14 years ago. Their transplanted dopamine neurons appeared healthy and showed no signs of Parkinson’s disease-associated deterioration.

The findings provide further support for stem cells as a source for transplant-ready dopamine neurons, the study authors said. Isacson noted that neuronal transplant has proven to be a durable treatment for many Parkinson’s patients, with some improving for years without any need for standard medications.

However, he added that the therapy is still not common, with access so far limited to patients participating in certain clinical trials.

Isacson called the new finding “extremely encouraging,” adding that the long life of the transplanted neurons bodes well “for advancing [the technique] as a restoration therapy for Parkinson’s disease.”

More information

There’s more on the illness at the National Parkinson’s Foundation.

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Pot Use Might Be Linked to Abnormal Sperm

THURSDAY, June 5, 2014 (HealthDay News) — Marijuana use might affect the size and shape of a young man’s sperm, possibly impairing his fertility, a new study claims.

“Our data suggests that cannabis users might be advised to stop using the drug if they are planning to try and start a family,” study author Dr. Allan Pacey, a senior lecturer at the University of Sheffield in England, said in a university news release.

“Our knowledge of factors that influence sperm size and shape is very limited, yet faced with a diagnosis of poor sperm [size and shape], many men are concerned to try and identify any factors in their lifestyle that could be causing this,” said Pacey.

The study, published June 5 in the journal Human Reproduction, doesn’t prove that pot use impairs male fertility; it only suggests an association between the two.

The research included nearly 2,000 men who visited one of 14 fertility clinics and answered questions about their medical history and their lifestyle.

Of that group of men, 318 had sperm that was considered “abnormal.” Less than 4 percent of their sperm was the correct size and shape, the researchers said. The information collected on these men was compared to data from the remaining 1,652 men who had sperm that was considered “normal.”

The researchers examined how certain lifestyle choices affected the size and shape of the men’s sperm and found “very few identifiable risks,” Pacey said.

Although cigarettes and alcohol had little effect, the study revealed that sperm size and shape was negatively affected if the men were younger than age 30 and had smoked marijuana within three months.

Sperm samples produced during the summer were also nearly twice as likely to be considered “abnormal,” the study showed.

The study authors noted that sperm size and shape may be linked to other factors that were not measured, such as the quality of a man’s DNA.

Previous research has suggested sperm need to be of good size and shape to work their way through a woman’s body after sex and fertilize an egg.

Men exposed to paint strippers and lead are also at risk of having sperm with poor shape and size, Nicola Cherry, an epidemiologist and professor formerly of the University of Manchester in England, said in the news release.

More information

The U.S. National Institute on Drug Abuse provides more information on the health effects of marijuana use.

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Weight Gain From Antidepressants Is Minimal, Study Suggests

By Alan Mozes

HealthDay Reporter

THURSDAY, June 5, 2014 (HealthDay News) — While it has long been known that some antidepressants can help spur weight gain, a new study finds that the actual amount gained is usually small.

“This study was motivated in the first place by the number of patients who have asked me if their medicine is going to make them gain weight,” said study co-author Dr. Roy Perlis, director of Massachusetts General Hospital’s Center for Experimental Drugs and Diagnostics, in Boston.

“It’s the most common question I get when prescribing any medication, frankly,” he said. “But most antidepressant studies have been short term, looking at just a few months of treatment. So I wanted to look at it for a longer period of time,” Perlis explained.

“I think our findings should be reassuring to patients. Yes, antidepressants can lead in some cases to small amounts of weight gain, that’s true. And we need to pay attention to it, and do a much better job of making people aware of the issue,” he said.

“But we also found these are drugs that all do their intended job very well, and that the amount of weight gain that they can bring about is very, very modest, and occurs at very similar levels across medications,” added Perlis, who is also an associate professor of psychiatry at Harvard Medical School.

The study, funded by the U.S. National Institute of Mental Health, appears in the June 4 online issue of JAMA Psychiatry.

According to the researchers, more than 10 percent of Americans are prescribed antidepressant medications at some point in their lives.

To explore how these drugs might affect weight gain, the research team conducted an electronic health records analysis to track weight gain among more than 19,000 adults suffering from depression.

These patients had been treated with at least one of 11 different antidepressants for at least three months between 1990 and 2011. The list included: amitriptyline (Elavil), bupropion (Wellbutrin), citalopram hydrobromide (Celexa), duloxetine (Cymbalta), escitalopram oxalate, fluoxetine hydrochloride, mirtazapine, nortriptyline (Sensoval), paroxetine hydrochloride, venlafaxine, or sertraline hydrochloride.

Roughly 3,400 additional patients were also included in the analysis, although none had been diagnosed with depression. All had been treated for other issues with a range of non-antidepressant medications, including asthma and anti-obesity prescriptions.

Weight fluctuation among all the patients was followed for one year.

Perlis and colleagues found that being younger and/or male increased the risk for gaining weight, as did starting treatment with a relatively low body mass index (BMI, a measurement based on weight and height).

When honing in on specific antidepressants, the researchers found that Celexa seemed to promote more weight gain than other popular antidepressants. Celexa is from a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), which also includes Paxil, Prozac and Zoloft.

Sensoval, Elavil (which is no longer available in the United States), and Wellbutrin all prompted “significantly” less weight gain than Celexa, the research showed.

However, Perlis stressed that the range in weight gain between the various drugs was very narrow, with very little practical difference seen in the actual pounds gained by patients on different meds.

“Really, these antidepressants are very similar in their potential to cause a small amount of weight gain,” he said. “We’re talking, on average, of a gain of about one to two pounds over the course of a year. So it’s not huge amounts. And I really don’t think that our findings would automatically push me to choose one medication over another based on their impact on weight gain. Not unless a patient was very, very concerned about it.”

And, Perlis added, antidepressants can at times actually promote weight loss, particularly among depressed patients who may have gained some weight prior to beginning treatment.

“So, rather than being scared off because they’ve gained weight, I would hope people will be reassured that treatment might actually help in that department,” he noted. “The aim is to help people be more comfortable getting treatment for these very treatable illnesses, whether with medications or talk therapy or both.”

Also touching on the topic of weight gain, another JAMA Psychiatry study looked at how a subgroup of depression patients appear to be particularly vulnerable to weight gain as a result of the condition itself, rather than its pharmaceutical treatment.

In this case, a team of Swiss researchers, led by Dr. Aurelie Lasserre from Lausanne University Hospital, focused on patients diagnosed with a condition referred to as “major depressive disorder with atypical features.” Such patients tend to experience mood elevations in reaction to positive events.

Such men and women, the investigators found, face a particularly high risk for developing obesity, and for retaining the extra weight even after recovering from their depressive condition.

The finding, said Lasserre’s team, suggests that doctors should be particularly careful when prescribing appetite-stimulating medications to such patients.

More information

For more about antidepressants, visit the U.S. National Library of Medicine.

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Could the ‘Ulcer Bug’ Guard Against Obesity?

By Amy Norton

HealthDay Reporter

THURSDAY, June 5, 2014 (HealthDay News) — Countries with low rates of the ulcer-causing bacterium H. pylori tend to have high rates of obesity, a finding that researchers say they see as more than a chance correlation.

Looking at 49 studies from Australia, Europe, Japan and the United States, the review authors found that in several countries such as Italy, Japan, Portugal and Spain, the majority of the population carried H. pylori. And those countries had relatively low rates of obesity, ranging from 3 percent in Japan to about 15 percent in Spain.

That was in contrast to the United States, for example, where about one-third of adults are obese and around the same percentage carry H. pylori.

None of that, however, proves cause and effect, cautioned an obesity expert who was not involved in the study.

“This study found a simple correlation, at the population level,” said Christopher Ochner, an assistant professor of pediatrics at the Mount Sinai Icahn School of Medicine in New York City.

“This does not mean H. pylori is your friend, and will keep you slim,” he stressed.

And even if the bug does have some direct effect on weight, it would likely be small — and no reason to refuse antibiotics if you have an H. pylori-related ulcer, Ochner added.

“Would you hang on to something that’s doing you harm, so you can lose a pound or two?” he asked.

Dr. Gerald Holtmann, the senior researcher on the review, agreed. “This study does not question the established indications for H. pylori eradication,” said Holtmann, of the University of Queensland in Brisbane, Australia.

There are, though, reasons to believe that the bug can affect weight, Holtmann’s team reported recently in the journal Alimentary Pharmacology and Therapeutics.

Although H. pylori is a major cause of stomach ulcers, most people who harbor the infection — at least half the world’s population — do not develop ulcers. And some researchers have speculated that H. pylori has benefits as well as costs.

Holtmann pointed to a couple studies showing that after people take antibiotics to get rid of H. pylori, they have more weight gain than those with untreated infections. And some animal and human research suggests that the bacteria can affect appetite-regulating hormones.

But whether H. pylori makes a real difference in the battle of the bulge is hard to pin down, according to Holtmann.

For example, the gut is home to trillions of bacteria that are thought to affect digestion, immune function and possibly weight control. And people with and without H. pylori may have a generally different gut-bacteria makeup, Holtmann’s team pointed out.

“The data suggests that either H. pylori itself or other infectious factors linked with H. pylori are significant,” Holtmann said.

Ochner called the new findings “very interesting,” and he agreed that it’s plausible the ulcer bug could have some positive effect on weight.

But he doubted that it could make a big difference on anyone’s bathroom scale.

“Body weight is incredibly complex,” Ochner said. “It involves so many factors. And in my opinion, this will not turn out to be one of the big ones.”

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on H. pylori.

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Short ‘Birth Spacing’ Linked to Preterm Delivery

THURSDAY, June 5, 2014 (HealthDay News) — Women who wait less than 18 months after having a child to get pregnant again are more likely to have a shorter pregnancy and a preterm birth, according to a new U.S. study.

The study authors recommended that women be educated about the importance of “birth spacing” to help reduce rates of premature births and the associated health problems.

“This study has potential clinical impact on reducing the overall rate of preterm births across the world through counseling women on the importance of adequate birth spacing, especially focusing on women known to be at inherently high risk for preterm birth,” said study co-author Emily DeFranco, an assistant professor of maternal-fetal medicine at the University of Cincinnati College of Medicine.

For the study, the researchers examined Ohio Department of Health records for nearly 455,000 births to see how birth spacing — the amount of time between giving birth to one child before becoming pregnant again — affected the duration of pregnancy.

The women in the study had two or more pregnancies within six years. Those with a short amount of time between birth and another pregnancy were divided into two groups: those who waited less than 12 months before becoming pregnant again and those who waited 12 to 18 months. These women were then compared to women who waited 18 months or more between pregnancies.

The study found that women with shorter times between pregnancies were more likely to give birth before reaching 39 weeks’ gestation than women who waited longer. Overall, women who waited at least 18 months between pregnancies had the lowest rates of premature birth.

Of the women who had less than 12 months between pregnancies, just over 53 percent delivered before 39 weeks’ gestation. These women were also more than twice as likely as women who waited 18 months or more between pregnancies to deliver before 37 weeks’ gestation.

The study authors said they also found that black women more often had shorter intervals between pregnancies than other women. Premature deliveries were also more common among black women who waited less than 12 months between pregnancies. However, overall, black women had higher rates of premature deliveries — even when there was 18 months or more between pregnancies. The researchers concluded that a woman’s race might be a predictor of premature birth, regardless of birth spacing.

The study was published June 4 in BJOG: An International Journal of Obstetrics and Gynaecology.

“We know that inadequate birth spacing is associated with more adverse pregnancy outcomes, including preterm birth, in many countries like the U.S.,” John Thorp, BJOG‘s deputy-editor-in-chief, said in a journal news release. “This large population-based study further strengthens this and puts more emphasis on the importance of optimal birth spacing, of 18 months or more, especially among women with additional risk factors for preterm birth.”

According to the U.S. Centers for Disease Control and Prevention, preterm birth — before 37 weeks’ gestation — affects nearly 500,000 babies every year. That’s one of every eight infants born in the United States. Some problems that a baby born too early may face include: breathing and feeding difficulties, cerebral palsy, developmental delays, and hearing and vision problems.

More information

For more on preterm births, visit the U.S. Centers for Disease Control and Prevention.

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