Posted at 7:00 AM ET, 07/ 9/2009

Celiac Disease Increases Sharply

Celiac disease, an immune system disorder that causes people to react to gluten in their diet, has increased dramatically in the past half-century, according to new research.

Gluten is a protein found in wheat, rye and barley. People with Celiac disease get severe abdominal pain, diarrhea, vomiting, constipation and other symptoms when they consume gluten. They are also prone to a host of health problems later in life. Originally thought to be a rare childhood syndrome, Celiac disease is now known to be more common. Perhaps as many as 2 million people in the United States may have the disease.

Joseph Murray of the Mayo Clinic and colleagues tested 9,133 blood samples that were gathered at Warren Air Force Base in Wyoming between 1948 and 1954 for the antibody that people with Celiac disease produce in reaction to gluten. They compared the blood tests with those from two recently collected 12,768 sets of blood collected in Olmsted County in Minnesota. One set matched the ages of those from 1948 to 1954 at the time the blood was drawn while the other matched their birth years.

The researchers found that young people today are 4.5 times more likely to have Celiac disease compared to young people in the 1950s, while those whose birth years matched the Warren Air Force Base subjects were about 4 times as likely, the researchers reported in the journal Gastroenterology.

The reason for the increase remains unknown. But the researchers said the most likely explanation probably has something to do with changes in the way wheat and bread are processed. Another possibility is the "hygiene hypothesis" which argues that increase in a variety of allergies and immune system disorders are the result of growing up in environments that are too clean.

To read more about that trend, see this story.

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Posted at 7:00 AM ET, 07/ 8/2009

Do Food Safety Fixes Miss the Mark?

A working group created by President Obama to recommend ways to fix the nation's faltering food-safety system yesterday released proposals for ensuring eggs contaminated with salmonella don't make their way into consumers' hands. The guidelines are a long time coming; they've been kicking around for at least a decade now, according to The Post's The Federal Eye blog yesterday. (According to the U.S. Food and Drug Administration, eggs contaminated with a single strain of salmonella cause an estimated 142,000 illnesses a year.) The group intends soon to issue recommendations for reducing salmonella contamination of poultry and E. coli contamination of beef.

Great start. But in those ten years, raw or undercooked eggs and poultry have been joined by many other sources of salmonella-related sickness. The U.S. Centers for Disease Control and Prevention maintains a list of outbreaks of illness from salmonella contamination. None of the high-profile outbreaks in recent years has involved eggs. (Don't forget: Nestle recalled its raw Toll House cookie dough products recently because of contamination with E. coli, bacteria not commonly associated with eggs.) Instead, major culprits have been jalapeno peppers, alfalfa sprouts, dry dog food and, most recently, peanut butter. Prompt recalls of pistachios contaminated with salmonella apparently averted a big outbreak of illness related to their consumption.

The working group's proposals also include plans to issue by the end of the month guidelines for protecting consumers against melons, tomatoes and leafy greens containing microbial contaminants. While a minor outbreak of salmonella contamination in April 2008 involved melons, tomatoes were wrongly accused of being the source of a big outbreak last summer (though they did cause smaller outbreaks in the fall of 2006); jalapeno peppers turned out to be the actual source.

I appreciate any efforts to clean up the food supply. But so far the new proposals don't sound like government at its most nimble or responsive to me. What am I missing?

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Posted at 7:00 AM ET, 07/ 7/2009

Weighty Thoughts

How many times a day do you think about your weight?

I believe there are people out there who can honestly say they never, or at least rarely, think about how much they weigh. I have several friends whose weight doesn't seem to fluctuate, who appear to eat when they're hungry and stop when they're full, and who never ever bring up the topic of weight in conversation.

I would like to become one of those people.

For this week's "Eat, Drink and Be Healthy" column about whether overweight and obesity are as bad for your health as they're made out to be, I interviewed Linda Bacon, author of Health at Every Size. Bacon believes that our collective and individual obsessions with our weight are, paradoxically, preventing too many of us from attaining and maintaining our ideal body shape and size.

Mind you, ideal may mean something different to you than it does to Bacon. She believes that when people stop obsessing about how much they weigh and focus instead on eating healthfully, getting more physical activity just for the fun of it and adopting other sound health habits, their bodies will naturally gravitate toward the weight they are meant to be.

Of course, that doesn't mean everyone will be a size 6. But in Bacon's scheme (which is shared by many other health, nutrition and diet experts), so long as our bodies are healthy and our lives full and rich, we shouldn't really care about being a size whatever, any more than we should care about the number on the scale.

For me -- and, I suspect, for many others -- going on a "diet" encourages me to think about food all the time. Being constantly aware of my weight makes me do all kinds of silly things, from incessantly assessing the size of my waistline and thighs to checking my image in any reflective surface I pass. And the more I think about food and my thigh size, the more I want to eat.

On the other hand, when I get consumed with engaging activities, I somehow shed a few pounds, as if by magic. Planning a big trip, for instance, or digging into a juicy novel distracts my attention away from my weight. When food and fat no longer consume most of my waking thoughts, my body does, as Bacon predicts, tend to take care of itself.

I wish I could take back all the moments (adding up to hours, weeks, years) I've wasted thinking about my thighs so I could put that time to better use. Starting today, I'm going to try not to obsess about my weight. I'm going to work on noticing when those thoughts pop up and on nudging them aside as I shift my focus to something else. It'll be hard -- lots of habits to break.

Care to join me?

This week's poll:

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Posted at 7:00 AM ET, 07/ 6/2009

The Fat of the Land

Lordy, we're fat.

The annual state-of-our-waistlines report issued last week by the Trust for America's Health and the Robert Wood Johnson Foundation mapped out the nation's obesity situation, state by state.

It's not a pretty picture. Only in one state, Colorado, are fewer than 1 in 5 adults obese. In 31 states, more than 1 in 4 adults are obese. In no state had the obesity rate decreased since last year.

A quick look at the local numbers: While Maryland, Virginia and Washington, D.C. ranked 25th, 28th and 45th, respectively, in adult obesity (with Maryland at 26 percent, Virginia at 25.4 percent, and D.C. at 22.3 percent), the rates among kids were eye-opening. Washington, D.C. came in 9th in the nation for having 35.4 percent of its kids overweight or obese. Virginia was 23rd, with 31 percent, and Maryland was 36th, with 28.8 percent.

While much of the reporting about the new survey has focused on the fact that the baby-boom generation is mighty plump and likely to further burden the already hard-pressed public health system, I'm even more concerned about the overweight and obesity rates among kids ages 10 to 17, which have tripled since 1980.

As I write in this week's "Eat, Drink and Be Healthy" column, being overweight or even obese doesn't necessarily shorten one's life. But there's no doubt that, either merely by virtue of being fat or because of circumstances that contribute to overweight such as poor diet and low level of physical activity, overweight people tend toward chronic conditions such as heart disease, Type 2 diabetes and some kinds of cancer.

If even greater percentages of kids than of adults are overweight, what does that mean for the future?

Recent poll results: To the question "Do you think overweight people deserve sympathy?," 51 percent of 1,061 respondents said yes, while 43 percent said no. Here's today's poll:

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Posted at 7:00 AM ET, 07/ 3/2009

What's on Your July 4 Menu?


(By Julia Ewan -- The Washington Post)

Some holidays make you choose between sticking to healthful eating habits and indulging in traditional favorite foods. I usually try to strike a balance at, say, Thanksgiving time, eating mostly healthful stuff but allowing myself enough treats that I don't feel deprived.

Fourth of July's different, though, because many of the foods I associate with it -- and those that are abundantly available when it occurs -- are good for you. Corn, watermelon, steamed crabs, grilled chicken and the like are all yummy and nutritionally sound. Of course, there are also cheeseburgers, ribs, macaroni salads, strawberry shortcake and beer. Yummy, yes, but maybe not so nutritionally terrific.

What's on your plate this weekend? Will you go for a "healthy" heaping of food, or indulge in fatty favorites? Whatever you choose, enjoy!

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Posted at 7:00 AM ET, 07/ 2/2009

Is IQ Linked to Longevity?

Contrary to previous research, a new study out today finds that people with lower IQs are not necessarily more likely to die prematurely.

Previous studies have found low IQ to be associated with a greater risk of dying young. To try to examine that more closely, Tomas Hemmingsson of the Karolinska Institute in Stockholm, Sweden, and colleagues analyzed data about 43,283 people born between 1949 and 1951. For military service, the men underwent extensive testing, including an IQ test and screening for physical and mental health problems. The researchers then followed the men through 2003. It's the largest study of its kind.

When those who died during the study period were analyzed by IQ alone, the researchers found a clear pattern: the lower the IQ the greater the chance of dying between the ages of 40 and 54. In fact, those with the lowest IQ were more than three times more likely to die early in middle age than those with the highest score.

But when the researchers took other risk factors into consideration, such as childhood social circumstances including socioeconomic status, adolescent behavior and mental health and adult social circumstances, the association between IQ and premature death disappeared, the researchers reported in a study that will be published in the Journal of Epidemiology and Community Health.

The researchers say the findings indicate that it's not IQ per se that increases someone's risk of dying prematurely. Instead, it could be that lower IQ leads to poorer socioeconomic status or other circumstances that are really to blame.

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Posted at 12:52 PM ET, 07/ 1/2009

Suicide Warnings Required for Anti-Smoking Drugs

The Food and Drug Administration announced today that it is requiring the smoking-cessation drugs Chantix and Zyban to carry the strongest type of safety warning possible to alert patients that the medications can cause serious mental health problems, including depression and suicide.

The agency said it took the action requiring "boxed warnings" after finding a surprisingly high number of reports of problems involving changes in behavior among people taking the medications, including depression, hostility, suicidal thoughts and attempted and successful suicides. The agency had received 98 reports of suicide among patients taking Chantix and 188 reports of attempted suicide, and 14 suicides and 17 suicide attempts among patients taking Zyban, officials said.

Agency officials said they were unsure why the drugs would cause these problems and noted that many of the symptoms can occur from nicotine withdrawal as well. The agency is requiring the companies that make the drugs to conduct follow-up studies to try to explore how commonly mental health problems occur.

The agency previously had issued warnings about mental health problems among patients taking Chantix, and required similar warnings on Zyban when it is sold as Wellbutrin and in generic forms for use as an anti-depressant.

The move is the latest in a serious of actions the FDA has taken after becoming concerned about psychiatric side effects of medications, including anti-depressants. The agency recently issued similar warnings about drugs used to treat epilepsy.

The FDA stressed that it was not advising people against using the medications because smoking causes serious health problems and quitting smoking is important. But patients taking the drugs and their doctors need to be aware of the potential problems and monitored closely, officials said.

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Posted at 9:01 AM ET, 07/ 1/2009

Acetaminophen Worries

The Food and Drug Administration is pondering what to do about the wildly popular painkiller in Tylenol, Excedrin, Vicodin, Percocet and many other commonly used drugs to treat aches and pains and alleviate fevers.

That's after an FDA panel called for sweeping changes yesterday at the conclusion of a a two-day meeting the agency convened to review the safety of acetaminophen, the active ingredient in those drugs.

Acetaminophen is generally very safe and effective, but in excess doses it can cause liver failure. And because acetaminophen is so common -- more than 24 billion doses were sold last year in the United States -- even rare side effects can add up to a lot of problems. Acetaminophen overdoses are the leading cause of liver damage in the United States. The FDA estimates that more than 400 people die each year from overdoses and thousands more are hospitalized.

Because years of public education efforts have failed to alleviate the problem, the panel recommended reducing the highest dose of acetaminophen allowed in over-the-counter medications. The drug is an ingredient in so many products that people often don't realize they are getting multiple doses that could exceed the safe levels. The panel even went as far as to narrowly recommend pulling Vicodin, Percocet and similar products that combine acetaminophen with powerful narcotics from the market altogether.

Now, while the FDA usually follows the advice of its advisory panels, it doesn't have to. And officials say they're not sure yet exactly what they'll do, especially given how split the panel was about pulling drugs like Vicodin, Percocet --and how important these drugs are to so many millions of people. More than 200 million doses of those drugs that combine acetaminophen with narcotics were sold last year in the United States, making them the most common prescribed class of drugs.

The agency could leave drugs like Vicodin and Percocet on the market with stronger, more prominent warning labels. They could also work out a compromise with the companies that make these products where they voluntarily reduce the dosages and take other steps to make them safer.

In the meantime, officials say consumers should pay careful attention to how much acetaminophen they are getting from various products to reduce the chances of suffering complications.

For a good explanation of some of the issues, take at look at this Q&A from the FDA.

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Posted at 7:00 AM ET, 07/ 1/2009

Peter Tork's Cancer, In His Own Words


(Photo: Ivan Iannoli)

My blog last week about musician Peter Tork's taking his current battle with a rare form of cancer to the pages of Facebook drew passionate responses from readers, many of whom thought I'd been unfair to Mr. Tork. So I invited Tork (my favorite former Monkee) to write about his experience with cancer and his decision to talk about it on Facebook for The Checkup. Here's what he had to say.

CORRECTION: Peter Tork has had only had one course of radiation, which he is currently in the midst of. This blog entry incorrectly stated that he had had two courses.

By Peter Tork

Late last year, after a few months of my not swallowing in a normal way, a friend mentioned that my voice sounded funny, kind of squawky and nasal. I'd meant to get it checked out, but her observation pushed me to doing something about it sooner rather than later. I went to an ear, nose and throat doctor, who sprayed my nostrils with anesthetic and sent a length of fiber-optic cable up my nose and down my throat. He came back with bad news. There was a growth on the lower region of my tongue. He suspected squamous cell carcinoma.

I don't count myself as being afraid to die, but the news hit me like a fist to the chest.

A subsequent biopsy and pathology exam showed that I had adenoid cystic carcinoma.

Adenoid cystic carcinoma, ACC to the cognoscenti, is a relatively rare cancer, usually occurring in the salivary glands. Mine occurred on the lower part of my tongue; that's even rarer. I wound up in New York at Memorial Sloan-Kettering Cancer Center, where one Dr. Jatin Shah told me I should get surgery as soon as possible. I thought about it a second and said I wasn't doing anything that afternoon....

Dr. Shah laughed and amended: as soon as practicable. That turned out to be the following Wednesday, which was March 4. I woke up from that surgery with another tube up my nose and down my throat -- this one for feeding me. About three months later I began a follow-up course of radiation at a high-tech hospital in Boston, where they rev up a cyclotron and pipe protons down the hall and through a giant metal tube into my throat. (Remember electrons, neutrons and protons? Those.)

My friend Therra Gwyn, who is also my editor and publicist, suggested that if the news of my cancer seeped out without my having a say in it, it would most likely get so distorted that there'd be 30 stories out there, none of them with more than a tangential relationship with the actuality. Better she said -- and I agreed -- to tell the story myself, as best I could. Besides making sure the record was straight, telling the story out loud on a Web site and Facebook page might help the world (or that part of it that was interested) relax some fears about cancer in general and might boost attention to adenoid cystic carcinoma in particular. Also, it might just help me keep a right-sized attitude about life and myself. Otherwise, you know, it'd be like: I'm a celebrity, get me offa this planet! Can't have that.

As of this writing, I'm just beginning to feel the effects of the second course of radiation, a bit of soreness on the tongue, some unpleasant effects when swallowing. So far, not too bad.

I have a couple of performance dates lined up, which I've opted not to cancel. I know I'm taking a chance here, because one of the side effects of the radiation is supposed to be hoarseness. The radiologist told me, "Well, you play guitar and you sing. Perhaps you won't sing, but maybe you'll play guitar a lot more."

I recovered very quickly after my surgery, and I've been hoping that my better-than-average constitution will keep the worst effects of radiation at bay. My voice and energy still seem to be in decent shape, so maybe I can pull these gigs off after all. Just in case, though, I've invited some friends to join me, including my friend Lauren, a world-class slide guitar player. People will be so dazzled by her that they won't notice whether I'm doing well. I'm also bringing in belly dancers, and I'm expecting a fly-over by the Royal Canadian Air Force. Maybe elephants.

I mean to do those shows.

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Posted at 7:00 AM ET, 06/30/2009

A Simple Vinaigrette, Two Ways


Julia Child's classic vinaigrette calls for stirring shallots with mustard and salt before adding liquid ingredients. (Photo by Charlie Huget)

When you buy a bag of Cheetos, you know just what to do with it: Rip it open and devour the DayGlo-colored contents.

But it's harder for some of us to figure out what to do with a bag of fresh brussels sprouts, green beans or other offerings from the local farm stand or farmer's market. As Roger Doiron, founder of Kitchen Gardeners International, notes in today's "Eat, Drink and Be Healthy" column, it's great to encourage folks to eat swiss chard and kale. But if they don't know how to turn those vegetables into a tasty dish, they may never try them again.


Whisking oil into the vinegar mixture drop by drop creates an emulsion. Instead of whisking, you can just shake everything together in a jar. The result's not as pretty but tastes great. (Photo by Charlie Huget)

Doiron, who's helping mount a campaign to get people to celebrate Independence Day by eating locally produced foods, says knowing how to make a simple vinaigrette is a good step toward learning to enjoy fresh-picked vegetables. Sprinkled atop a bed of greens or drizzled on lightly steamed or grilled veggies, a vinaigrette brings out produce's flavor without overpowering it.

Because it's so simple, though, vinaigrette depends on your using quality vinegar and oil. It doesn't take a lot of either ingredient, so you should splurge on buying the best-tasting kinds you can afford.


Here's my whisked vinaigrette, ready to meet a salad! (Photo by Charlie Huget)

Doiron recommends Julia Child's recipe, which tweaks the classic vinaigrette proportions (one part vinegar to three parts oil) in favor of going light on the vinegar, at least at first. As he notes, you can always add more, but you can't remove it once it's in there. (You can of course add more oil to compensate, but it's easier just to work with one variable here.)

It's up to you to decide which other tastes you like in your vinaigrette, from shallots to scallions, Dijon mustard, salt and pepper, and in what quantities. It's fun to play around and come up with a mix that suits you best.

When making vinaigrette, there's the classic way -- slowly whisk the oil into the other ingredients, drop by drop, creating a stable emulsion -- and there's the shortcut -- throw everything into a jar and shake till it's blended. I tried both the other day, and though the whisked version was prettier (its color was lighter), both tasted pretty much the same. I didn't add salt to either, as I find Dijon mustard salty enough, but you might want to add a dash.

If you have a favorite vinaigrette (or other home-made dressing), please share your recipe in the comments section.

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Posted at 7:00 AM ET, 06/29/2009

Paying Girls Not to Get Pregnant

With the recent rise in teen pregnancy, it's clear that efforts to get young people to either abstain from sex or use birth control are falling short.

Any ideas as to how to fix the problem are welcome, so it's not surprising that a program that aims to get girls through high school without getting pregnant is getting a lot of media attention. In short, the young women in the College Bound Sisters program at the University of North Carolina Greensboro are offered a simple bargain: They're paid a dollar for every day they don't get pregnant.

The program, funded through a state grant and private donations, is open only to girls ages 12-18 who have an older sister who had a baby as a teen. Participants have to express interest in attending college, can never have been pregnant themselves and are required to attend an hour-and-a-half-long weekly meeting at the university (so they have to live nearby). And they don't get to spend the money right away; it's socked away and disbursed upon the girls' enrolling in a college.

Seems fine to me -- even though nobody ever paid ME not to get pregnant. But some folks have raised objections, saying offering incentives for behaving well isn't appropriate; one source likened it to offering kids cash for not smoking pot. (I remember being jealous of friends who got paid for good grades; my parents told me they expected me to get good grades without being bribed.)

One odd thing about this story: The program is not new -- it's been around at least since 2002 and probably before -- and I can't figure out why it's suddenly in the news. I tried to contact the folks who run the program but hadn't heard from anyone yet. I want to know, for instance, how successful the program's been over the years and how many participants in fact go on to college, among other things. I'll post an update when I get return call.

What do you think? Is this dollar-a-day idea a good one that perhaps deserves to be implemented more broadly, or is it just a bribe?

Posted by Jennifer LaRue Huget | Permalink | Comments (24)
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