American Marriages Are Much Better — and Much Worse — Than Ever

The Newlywed Game. Photo: ABC Photo Archives/Getty Images

When your partner is your best friend — someone who really gets you, you know? — it’s a wonderful thing. And yet thinking of marriage as the ultimate BFF-ship potentially comes with its own set of problems, setting some lofty expectations for the relationship. It often means that this is the one person to whom you look to meet your deepest psychological and personal growth requirements; it’s the tippy-top of the old Maslow’s Hierarchy of Needs pyramid, in other words.

When it works, it’s bliss. But according to the authors of a new paper in Current Directions in Psychological Science — lead-authored by Northwestern University’s Eli Finkel — it’s also incredibly difficult to meet these huge and time-consuming demands, meaning the modern American marriage has the potential to be both much better and much worse than ever before. Because here’s the twist: At the same time Americans are asking more out of their marriages than ever, they’re also spending less time with their spouses. 

Modern American marriages are more strongly linked to psychological well-being — happiness, basically — than they were in decades past, according to a review of 93 studies from 1980 to 2005, and the authors on this current paper, led by Northwestern University’s Eli Finkel, believe they know why. Basically, they think Americans have begun understanding their marriages in a different, historically unusual way than they used to.

To Finkel and his co-authors, there have been three major eras of marriage in American history, cultural shifts in what’s largely considered the fundamental purpose of the institution. In the country’s earliest years, marriage was there to help people meet basic economic needs — someone to help harvest the crops and keep warm in the winter. Then there was a middle era, from about 1850 to 1965, when employment shifted to outside the home, and the point of marriage was to be a source for love and passion.

Today, Finkel and his colleagues argue, it’s a “self-expressive era” of marriage, in which Americans look to the institution “to fulfill needs like self-esteem, self-expression and personal growth.” Finkel expanded on that in an email to Science of Us:

As we have increasingly come to look to our marriages to help us achieve our deepest psychological needs—rather than helping us harvest crops or even just loving us, for example—we need much stronger communication and responsiveness than ever before. More and more marriages are struggling to achieve those lofty standards, especially on top of all of the other stresses in our lives.

However, those of us who succeed in building a marriage that can meet our deepest psychological needs—a marriage that helps us become closer to our ideal self—are immensely satisfying. That is, achieving a successful marriage today is tougher than in the past, while at the same time the payoff for such achievement is larger than in the past.

Helping your partner harvest crops or weather a drought or prepare for winter wasn’t easy, in other words, but these things also didn’t require deep contemplation and understanding of his or her innermost thoughts and desires. Meeting these self-actualization expectations takes some serious face time together, and yet the evidence shows that at the same time Americans are demanding more out of their marriages, they’re also putting less time into them.

To wit, as Finkel and his co-authors point out: From 1975 to 2003, the amount of times childless couples spent together, just the two of them, dropped from 35 to 26 hours per week. The decline in togetherness-time is most likely explained by a rise in time spent working. During that same time period, couples with kids saw a similar dip in time spent one-on-one, from 13 to 9 hours per week. This decline appears to be owed to an uptick in what the researchers called “time-intensive parenting.” 

And these problems are likely exacerbated for lower-income couples, who likely have less time or money to devote to the kind of quality time needed to meet today’s marriage expectations than their wealthier counterparts. But the research shows that lower-income couples still very much want the same things out of marriage as higher-income spouses.

It’s not hopeless, however. There are a few ways of improving marriage quality, none of which take huge amounts of time, which Finkel and his co-authors helpfully outline in their paper:

If you want to get nerdy about it, you guys can take on some writing exercises. The researchers cite a study that found couples who spent just 21 minutes a year writing about their conflicts through the eyes of an impartial third party saw improvements in their relationships over the following two years. It’s not going to magically turn a dissatisfying relationship into a blissfully happy one, but it’s a pretty simple way to give it a nudge.

Schedule regular “date nights.” (There’s a reason it’s a cliché.) It’s because scheduling time together really works to improve the relationship, the research suggests. Spending more fun hang-out times for just the pair of you will likely help increase the odds that you meet each other’s psychological needs.  

Seek at least some of that self-actualization stuff elsewhere. Find a hobby, join a group, call your friends — shift at least some of that personal-growth burden off of your relationship. “Doing so can bring the demands on the marriage into closer alignment with the available resources,” the authors write, “thereby reducing dissatisfaction from unmet expectations.”

It’s not impossible to have a successful marriage in this “self-expressive” era, Finkel said, but we’re only just starting to learn how to do it. (Incidentally, he’s currently writing a book on that very subject.) Finding a balance between sky-high expectations and the time people can realistically invest in their relationships seems like one way to start.

More from Science of Us:

Married People Are Happier People

What Happens When Rich People Marry Poor People

3 Ways Your Text Messages Change After You Get Married

Americans Now Slightly More Relaxed About Casual Sex That They Were in the ’90s

Why Men Always Think Women Are Flirting

The Case Against ‘Soul Mates’

Science of Us is a smart but playful window into the latest science on human behavior, with the goal of enlightening, entertaining, and providing useful information that can be applied to everyday life.

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A Healthy Body Often Equals a Healthy Brain

By Dennis Thompson
HealthDay Reporter

TUESDAY, June 30, 2015 (HealthDay News) — People who want to stay sharp as they age often turn to brain teasers, puzzles and games, figuring correctly that they’ll lose it if they don’t use it.

But a healthy body is also key to maintaining a healthy brain, and that’s something many people tend to overlook, experts say.

“We’re just now starting to get people to recognize that eating right and exercising and maintaining your health can play into the graceful aging of your brain,” said Dr. Mary Ann Bauman, an Oklahoma City physician and chair of the American Stroke Association advisory committee.

Healthy living tips make up more than half of the “10 Ways to Love Your Brain” recently released by the Alzheimer’s Association, as part of June’s Alzheimer’s & Brain Awareness Month.

An estimated 47 million people worldwide are living with dementia in 2015, and this number is projected to triple by 2050, according to the Alzheimer’s Association.

Medical science cannot stop the progression of either dementia or Alzheimer’s disease, but everyone can take steps to maintain their ability to think, problem solve and remember as they grow older, said Heather Snyder, director of medical and scientific operations for the Alzheimer’s Association.

“There’s no one specific thing that if you do this, you will reduce your risk,” Snyder said. “It’s really a balance of these top 10 ways to love your brain. By doing all these things in balance, you’re going to age as healthfully as you can.”

Maintaining the health of your heart and your circulatory system appears to be a key factor in protecting your mental capabilities, Bauman said.

Researchers now believe that micro-strokes — tiny decreases in blood flow to the brain — can add up and, over time, cause a person to suffer a loss of their faculties, she said.

By keeping the brain both healthy and active, a person can preserve what’s called their “brain reserve” — the ability of the brain to weather various insults, including aging, said Dr. Norman Relkin, a neurologist at Cornell University’s Weill Cornell Medical College in New York City and a board member of the American Federation of Aging Research.

“The more brain reserve a person brings to the table, the older they can get without showing signs and symptoms of memory loss,” Relkin said.

The Alzheimer’s Association tip sheet urges everyone to:

• Engage in regular physical activity. A number of studies have linked exercise to reduced risk of brain decline, Bauman said.
• Quit smoking. Smoking increases risk of brain decline, and quitting can reduce a smoker’s risk down to levels comparable to people who have never smoked, the association says.
• Treat conditions that can affect heart health. Chronic problems like obesity, high blood pressure, high cholesterol and diabetes take a toll on your brain as well as your heart, Bauman said.
• Get enough sleep. Studies have linked sleeplessness with problems in memory and thinking, the association says.
• Maintain your mental health. Depression, anxiety and stress can speed a person’s brain aging, if they are left untreated. “We know that stress hormones, when produced in excess, causes the brain to shrink more rapidly,” Relkin said.
• Protect your head. Brain injuries as mild as a concussion can increase risk of brain decline and dementia. Wear a seat belt, use a helmet when on a bike or playing contact sports, and try to avoid falling down.
• Eat a healthy low-fat diet that’s rich in fruits and vegetables. A good diet can help address nearly all chronic illnesses, and therefore will ultimately help your brain, Relkin said. “Diet clearly impacts not only our risk of developing cognitive [brain] disturbances, but also affects our longevity,” he said. “I think we’re going to see more and more in terms of dietary interventions that are going to impact the aging process.”

The remaining tips offered by the Alzheimer’s Association focus on keeping your brain busy and active, which also can help by forcing the brain to preserve and build up its neural connections, Relkin said.

These brain-centered tips from the Alzheimer’s Association include:

• Keep learning. Continuing education can help reduce risk of brain decline and dementia.
• Remain social. People who have an active social life have been shown to have more active and healthy brains, Relkin said.
• Challenge your brain. Do something that requires thought, whether that is solving a puzzle, creating a piece of art, building something for your home, or playing a game that forces you to think strategically.

“All these pieces of advice seem to bear out in the reduction of the development of dementia,” Relkin said. “We have a lot of knowledge about ways to prevent the deterioration of the brain due to aging, and they all appear to be beneficial in terms of preserving the health of the brain.”

More information

Visit the U.S. National Institutes of Health for more on brain health.

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‘Novice Driver’ Car Decals Don’t Cut Crash Rates: Study

MONDAY, June 29, 2015 (HealthDay News) — Adding decals to the license plates of drivers with learner permits doesn’t reduce their rate of crashes, a new study finds.

The experimental safety strategy was implemented in New Jersey in 2010 as part of its graduated driver-licensing policy for drivers under 21.

Red reflective decals were placed on the license plates of drivers with learner permits or intermediate licenses. The decals are intended to make other drivers and police aware that a novice driver is behind the wheel.

Using information compiled in New Jersey’s driver-licensing database and police-reported crash database, researchers estimated the monthly rate of incidents for every under-21 driver with a permit from January 2006 to June 2012.

After taking age, gender, gas price and the month into account, the researchers determined that the decal program did not alter crash rates among drivers with learner permits. Nor did it affect the rate of citations for violation of the state’s graduated driver-licensing policy.

Authors of the study, published online June 29 in Injury Prevention, included Dr. Allison Curry of the U.S. Center for Injury Research and Prevention.

The researchers theorized that drivers with learner permits already comply with passenger and night-time restrictions, and they said crash rates among these adult-supervised drivers are already low. As a result, they said, there is little room for improvement so the initiative didn’t appear to have a significant effect.

They noted, however, that using the decals could potentially boost compliance with traffic safety laws.

Several other states have or are considering similar decal provisions, the researchers said.

More information

The U.S. Centers for Disease Control and Prevention provides more information on motor vehicle safety.

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1 in 3 American Adults Owns a Gun, Survey Finds

By Alan Mozes
HealthDay Reporter

MONDAY, June 29, 2015 (HealthDay News) — Guns are owned by nearly one in three Americans. And many of those people are part of a “social gun culture” that includes hunters and gun club members, a new survey finds.

“We were not surprised by the degree of gun ownership,” said study lead author Bindu Kalesan. “But what is never really emphasized in studies that quantify ownership is how it relates to the concept of gun culture — meaning involvement in social events that revolve around guns.”

The poll of 4,000 adults indicated that gun owners are more than twice as likely as non-owners to engage in gun-related activities involving friends and family.

Overall, the survey determined that roughly 29 percent of Americans own one or more of the estimated 300 million firearms in private hands in the United States.

Most gun owners are white men who are married and over 55, according to the study published online June 29 in Injury Prevention.

Gun ownership varies widely from state to state. Ownership is 50 percent higher in states with higher gun death rates, compared with states with lower gun death rates, said Kalesan, an adjunct professor in the epidemiology department at the Mailman School of Public Health at Columbia University in New York City.

Alaska tops the gun ownership list, with nearly 62 percent of residents owning guns. Arkansas, Idaho, Montana, West Virginia and Wyoming are next, with more than half of adults in those states possessing firearms.

Gun ownership is least common among five East Coast states. Less than 6 percent of Delaware and Rhode Island residents own guns. In New York, New Jersey and New Hampshire, guns are owned by 10 percent, 11 percent and 14 percent of residents, respectively, the survey found.

If guns are a part of their social life, people are far more likely to own one, the researchers concluded.

Among those who don’t own a gun, only about 6 percent said they were exposed to gun culture through activities, friends or family.

By contrast, one-third of those who said they’re part of a gun-culture social life reported owning a gun, evidence of a “strong association” between gun ownership and gun culture, said the study authors.

Jeffrey Swanson, a professor in the department of psychiatry and behavioral sciences at the Duke University School of Medicine in Durham, N.C., agreed that gun culture is firmly rooted in the United States.

“It’s important to realize that this is the country we live in,” he said. “Guns are domesticated. We celebrate them, and have a lot of them. It’s part of the landscape.”

Many people own guns “not just because they want to hunt but also because they simply like guns and are part of a group that likes guns,” he said. They feel a sense of meaning and belonging that’s “centered around guns, and also around the ethic of personal protection and the constitutional right to have a gun,” he added.

“All we can do is try and figure out who are the dangerous people who should not have guns,” Swanson said. “There actually is some common ground on this need, shared by both gun owners and non-owners.”

About 34,000 Americans died in 2013 as a result of gun-related violence, the study authors said. In January 2014, a study reported in the journal Annals of Internal Medicine found that people with access to a gun are three times more likely to die by suicide and almost twice as likely to be the victim of a homicide as people without such access.

Efforts by HealthDay to reach the National Rifle Association for comment on the survey were unsuccessful.

More information

Safe Kids Worldwide talks about gun safety.

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6 Ways to Get MORE Out of a Push-Up

Photo: Getty Images

The push-up is one of the most overlooked exercises in the metaphorical exercise book. Sure, it looks pretty easy and most of us know the basics: heels together, wrists underneath shoulders, bend and press your elbows, and voila, a move that works your entire body pretty much.

But there are certain tweaks you can make to take your push-up technique to the next level. Here are 6 key ways to perfect this exercise—and get the most out of it. All you have to do is follow these tips.

RELATED: 20 Ways to Do a Plank

Press Your Hands Into The Floor

When performing a push-up, you want to press the palms of your hands firmly into the floor as if to push away from your wrists. Simultaneously, rotate the arms externally so that the elbows and biceps face forward. This pressure provides a natural tension in your arms, shoulders, and upper back, which will help you maintain stability in the upper body throughout the exercise, which helps keep you working hard in proper form.

Squeeze your lats

Another way to stabilize the upper body is to engage your lats. These muscles are found underneath your armpits and run along the sides of your body. By pressing your palms firmly into the floor you can start to activate them. Then, in addition, think of squeezing your armpits as tightly as possible, like you are holding something in between them. This will keep your upper body completely stable.

RELATED: The Sexy Side Arm Push-Up

Draw your shoulder blades down and back

Keeping your shoulders shrugged up to your ears puts excess strain on the neck, and makes it harder to work the muscles you’re trying to tone: your arms, shoulders, and core. The body needs to move as one solid unit. Before you bend your elbows, check to make sure your shoulder blades are pulled down and back away from the ears, engaging your back muscles. To do this, act as if you are trying to squeeze your shoulder blades together.

Keep your neck in line with your spine

Dropping your head too far down or tilting it too far upward can put too much pressure on the spine and put you at greater risk for injury—the opposite of getting stronger. Find a neutral spine: Instead of tucking your chin completely or looking straight out in front, gaze about 6 inches or so in front of your fingertips and keep your eyes focused there as you push up.

RELATED: 4 Ways to Get Awesome Arms

Keep your core engaged

The core is made up of more than just your abdominal muscles. It’s the entire midsection of your body, basically everything but your extremities. Activating all of your core muscles,  including your obliques, abs, and glutes, takes stress off the lower back in addition to stabilizing your hips so your body stays in one long line, even as you lower down. By actively squeezing your navel towards your spine, the push up becomes just as much of an abdominal workout as performing a plank.

Master the breath

If we were listing these in level of importance, this would probably be number one. As with any exercise, breath is always going to help improve your form. It is what drives the movement. Remember to always exhale on the effort of the movement. In this case, that means inhale when you go down and exhale when you press up. As you exhale, you are essentially trying to empty the lungs of as much air as possible to help contract the core and give more power to your movement.

Now that you know how to do the perfect push-up, you can try different variations with 7 Ways to Do a Push-Up

Jennifer Cohen is a leading fitness authority, TV personality, entrepreneur, and best-selling author of the new book, Strong is the New Skinny. With her signature, straight-talking approach to wellness, Jennifer was the featured trainer on The CW’s Shedding for the Wedding, mentoring the contestants to lose hundreds of pounds before their big day, and she appears regularly on NBC’s Today Show, Extra, The Doctors, and Good Morning America. Connect with Jennifer on Facebook, Twitter, G+ and on Pinterest.

RELATED: 5-Minute Workout: Get Total-Body Toned

 

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What Your Harry Potter House Reveals About Your Personality, According to Science

Photo: Giphy

 

Any true Harry Potter fan has daydreamed about hopping on the train at Platform 9 and ¾ and heading straight for Hogwarts. But once you get there, faced with the chatty sorting hat, a larger question remains—Gryffindor, Ravenclaw, Hufflepuff, or Slytherin?

Luckily, the internet is filled with quizzes to find out which Hogwarts house you belong in, but the arguably best one is found on the Pottermore website (created by J.K. Rowling herself). And according to a new study published in the journal Personality and Individual Differences—the results are surprisingly accurate.

“When J.K. Rowling came out with the Pottermore quiz, I wanted to know what, if anything, her personality test measures,” lead author Laura Crysel, PhD, an assistant professor of psychology at Stetson University, told Health. “Our findings suggest that fiction can reflect real underlying personality dimensions.”

RELATED: 12 Worst Habits For Your Mental Health

For the study—aptly titled, “Harry Potter and the measures of personality: Extraverted Gryffindors, agreeable Hufflepuffs, clever Ravenclaws, and manipulative Slytherins”—Crysel and her fellow researchers asked 132 Harry Potter fans (who had already completed the Pottermore sorting questionnaire) to complete an additional series of personality assessments. These questions—intended to determine if the participants’ personalities held true to those of their selected house—were based on common psychological identifiers, including everything from extraversion and agreeableness to the “Dark Triad” traits: narcissism, Machiavellianism, and psychopathy.

And, for the most part, the participants matched right in with their house. Ravenclaws had a high “need for cognition,” while Hufflepuffs were exceptionally agreeable. Most ominously, Slytherins scored the highest out of all the participants on the Dark Arts, ahem, I mean the “Dark Triad” traits.

Crysel (who’s a Gryffindor through and through, for the record) has two explanations for the uncanny quiz results. “For one, people may be relating to the groups that really are more like them, and Rowling’s quiz may be measuring a piece of those qualities,” she says.

RELATED: 10 Ways Your Personality Affects Your Weight

“For another, fans may be changing how they see themselves based on the feedback from the Pottermore quiz. Imagine someone tells you that you are very smart and value learning. You may internalize that feedback and use it to guide how you respond to questions about your intelligence later. Being a part of a group, even a fictional one, may be a similar process. For example, thinking that Slytherins are cunning, and being told that you are a Slytherin, may make you want to be more cunning to be part of the group.”

The only house that didn’t match up to their personalities belongs to our four heroes (aka Harry, Hermione, Ron, and Crysel): Gryffindor. Crysel surmises that it had to do with their difficulty in finding a measurable personality trait that would show bravery, arguably the main characteristic of a Gryffindor.

“We tried to measure things related to bravery (extraversion and openness to experience),” she explains. But their very small pool of Gryffindor participants likely added to the problem. “I actually think we would have found an association between extraversion and Gryffindor status if we had more Gryffindor participants, but that is speculation on my part.”

RELATED: The Best Workout for Your Personality

And while the discovery that Slytherins like Draco may actually be as conniving as their reputation is fairly shocking, Crysel was most surprised to discover that people who took the Pottermore quiz weren’t able to “cheat” and answer the questions in a way that ensured getting sorted into their favorite house.

“Only about half of participants got the house they wanted from Rowling’s quiz,” she explained. “Now, this is higher than chance, suggesting that some people are either A—wanting to be part of the group that actually describes them, or B—are answering the quiz to get the result they want.  However, I believe that if Rowling’s quiz was truly measuring only what people want to hear, this number would be much higher. So, I think the Pottermore quiz may be actually giving somewhat accurate feedback.”

So if you sat under the (virtual) sorting hat and got Ravenclaw, you probably are as clever as Cho Chang (and perhaps as kooky as Luna Lovegood). And if you’re wary of a new coworker, or maybe your BFF’s new boyfriend, it might be worth it to ask them which house they most identify with—and maybe send them a link to Pottermore to verify their leanings.

RELATED: The 11 Best Beach Reads of the Summer 

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Fish-Related Food Poisoning in Florida Under-Reported

MONDAY, June 29, 2015 (HealthDay News) — A rare toxin carried by barracuda, grouper and other locally caught sport fish sickens Floridians in greater numbers than previously believed, a new analysis suggests.

Consuming the foodborne toxin, called ciguatera, can result in severe nausea and vomiting, and sometimes long-term tingling in the limbs or joint pain.

“The rate of illness was found to be higher than previously estimated. Areas around Miami and in the Florida Keys are particularly affected,” wrote study author Elizabeth Radke.

Radke said the findings confirm current warnings to avoid eating barracuda, while also indicating that in Florida, at least, grouper, amberjack, hogfish, snapper, mackerel and mahi mahi were also associated with illness. Most of the fish causing infections in Florida are caught in the Bahamas and the Florida Keys, the researchers concluded.

However, experts say the absolute risk for contracting ciguatera poisoning remains rare. And it doesn’t appear to be increasing statewide, even if earlier estimates now need to be revised upward.

The findings are published in the June 29 issue of the American Journal of Tropical Medicine and Hygiene.

“I don’t think that people necessarily need to stop eating these other fish, but they need to be aware there is a risk, and if they start feeling sick after eating, they should see a physician,” Radke added in a journal news release.

Hispanics had the highest rate of ciguatera poisonings in Florida, possibly because of cultural tendencies to eat barracuda, she said.

For the study, researchers from the University of Florida’s Emerging Pathogens Institute and the state department of health surveyed thousands of recreational salt-water fishermen in the state and compared the results with public health records.

The investigators estimated that 5.6 cases occur per every 100,000 people in Florida — far more than the previously recorded 0.2 cases per 100,000 state residents.

The reasons for the discrepancy: Many anglers who said they developed the illness didn’t visit a doctor, while others saw doctors who didn’t make a proper diagnosis.

Ciguatera poisoning is the world’s most common form of fish-related food poisoning, the researchers noted. The toxin is found in algae growing on coral reefs in warm tropical and subtropical ocean waters, with the risk highest in fish from the Caribbean Sea and the Pacific and Indian Oceans, they said.

More information

There’s more on ciguatera poisoning at the U.S. Centers for Disease Control and Prevention.

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The Safe Way to Get Medical Advice From Your Facebook Friends

Social media is a great resource for staying in touch with friends, sharing the latest viral videos, and even keeping tabs on that old college crush (admit it—you do it too!). Even more popular is crowdsourcing everything from where to spend your summer vacation to the best yoga deal in your neighborhood.

Model Chrissy Teigen recently went a step further and tried the tactic for medical advice. After she thought a bee sting looked a little more inflamed than usual, she posted a picture of it with the caption, “Help is this a normal bee sting I feel pass outy #instagramMD”

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RELATED: Hilarious Proof That Chrissy Teigen Isn’t Ashamed of Her Stretch Marks

In response, she received thousands of comments speculating that she had everything from a bee allergy to Lyme disease. Not everyone has the reach Teigen has, but is it okay to ask your network for medical advice?  David Katz, MD, director of the Yale University Prevention Research Center explained to Health that, surprise, it’s actually a fine idea—as long as you proceed with appropriate caution.

“My suggestion is to poll the hive for ideas, then run those ideas by an actual expert,” Dr. Katz told Health. “This actually follows the pattern of the best medical screening tests: a highly sensitive test first, to be sure not to miss anything important, and a highly specific test after, to be sure not to mistake bath water for baby.”

RELATED: The Latest on Lyme Disease

Indeed, he says, crowdsourcing is a great way to get an idea of specific questions to ask your doctor when you go in to see him or her (and you should). For instance, Teigen—had she visited her MD—could’ve brought up a possible allergy or the prospect of Lyme, just to rule them out.

Another tip: Don’t follow the advice you get without carefully considering the source first.

“Ask for more than unsubstantiated opinions and ask where the opinions come from,” Dr. Katz said. “Value opinions that can be traced back to convincing substantiation over those that cannot”—read: trust medical professionals and legitimate scientific research over information that someone “read somewhere” or cures someone “heard about from a friend.” Warns Dr. Katz: “If it sounds too good to be true, it almost certainly is.”

As for Teigen, that “passouty” feeling seems to have passed, according to her Instagram. The former Sports Illustrated cover girl was recently in London visiting hubby and singer John Legend.

RELATED: 4 Tips for Treating a Bee Sting

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Can Orange Juice, Grapefruit Raise Your Melanoma Risk?

By Amy Norton
HealthDay Reporter

MONDAY, June 29, 2015 (HealthDay News) — People who enjoy a glass of orange juice or some fresh grapefruit in the morning may face a slightly increased risk of melanoma — the least common but most deadly form of skin cancer.

That’s the finding from a study of more than 100,000 U.S. adults followed for about 25 years. Researchers discovered that those who regularly consumed orange juice or whole grapefruit had a higher risk of developing melanoma, compared to people who avoided those foods.

Experts were quick to stress that the findings, reported online June 29 in the Journal of Clinical Oncology, do not prove that citrus foods help cause skin cancer.

It is plausible, however, that certain compounds in citrus explain the association, said senior researcher Dr. Abrar Qureshi, chair of dermatology at Brown University and a dermatologist at Rhode Island Hospital, in Providence.

Citrus foods contain particular “photoactive” chemicals — namely, psoralens and furocoumarins — that are known to make the skin more sensitive to the sun when they’re applied topically, Qureshi said.

“You’ll see children get a sunburn in spots where a citrus popsicle dripped down the chin, for example,” Qureshi explained.

But even if citrus foods potentially make some people susceptible to sunburn, it’s not orange juice that should be avoided, Qureshi said.

“The citrus can’t hurt you without the excessive sun exposure,” he pointed out.

So the message remains the same, Qureshi said: Protect your skin from soaking up too many rays by staying in the shade, using sunblock and wearing a hat.

That advice was echoed by Marianne Berwick, a skin cancer researcher who wrote an editorial published with the study.

“I don’t think the general public should make any changes based on this study,” said Berwick, a professor of dermatology at the University of New Mexico in Albuquerque. “You should still have a wide variety of fruits and vegetables in your diet.”

For the study, the researchers analyzed data from two long-running studies of U.S. health professionals. Every couple of years, the participants answered detailed surveys on their health and lifestyle.

Over about 25 years, more than 1,800 people developed melanoma and the risk was higher among those who regularly drank orange juice or ate whole grapefruit. That was true, the researchers found, even when several other factors were taken into account — including people’s reports of their overall sun exposure and history of bad sunburns.

People who had orange juice at least once a day were about 25 percent more likely to develop melanoma than those who drank the juice less than weekly. Similarly, people who ate whole grapefruit at least three times a week had a 41 percent higher melanoma risk, versus those who never ate it.

On the other hand, there was no connection between melanoma risk and either whole oranges or grapefruit juice, the researchers found.

Berwick said there’s no clear explanation for that. And in general, she added, the findings need to be replicated in other study groups, to make sure the citrus-melanoma link is real.

Dr. Gary Schwartz, a spokesman for the American Society of Clinical Oncology (ASCO), agreed.

“While the findings are intriguing, it’s far too soon to recommend any broad changes to grapefruit or orange consumption,” Schwartz said in a statement from ASCO. “Until conclusive data are available, we should continue to be cautious about protecting our skin from sun exposure.”

Qureshi did offer a potential explanation for why only orange juice and whole grapefruit may be tied to melanoma risk.

“There are different types of these photoactive compounds in different parts of the fruit,” he said. So, it’s possible that not all citrus fruits are alike when it comes to melanoma risk.

Plus, Qureshi said, heat — like that used in pasteurizing juice — neutralizes the photoactive compounds. That might help explain why grapefruit juice was not connected to melanoma risk.

But then why was orange juice? In general, Qureshi noted, Americans drink much more orange juice than grapefruit, and that may have allowed the researchers to find a statistical link to melanoma risk.

For now, though, that remains speculation. And Qureshi agreed that the findings need to be confirmed in other studies.

“We certainly wouldn’t want people to avoid fruits that are generally good for their health,” he said. “Just be aware that there’s an association with melanoma, and perhaps be extra careful about sun protection on days you’re eating citrus fruits.”

More information

The American Cancer Society offers sun safety advice.

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Heart Association’s Stroke Guidelines Support Clot-Removing Device

By Dennis Thompson
HealthDay Reporter

MONDAY, June 29, 2015 (HealthDay News) — A device that grabs and drags a blood clot out through the blood vessels should be used to treat certain stroke victims, according to new guidelines issued by the American Heart Association.

Nearly nine out of 10 strokes are caused by a blood clot that blocks one of the arteries supplying blood to the brain, the American Heart Association (AHA) said. Standard stroke treatment relies on powerful blood-thinning medications that break up the clot and restore blood flow to the brain.

But when those drugs don’t work, doctors now can turn to a new catheter-based device that will physically remove the blood clot, said Dr. William Powers, lead author of the updated AHA guidelines and chair of neurology at the University of North Carolina at Chapel Hill.

The tool, called an endovascular stent retrieval device, is made up of wire mesh that resembles a tiny ring of chicken wire, Powers said.

Skilled surgeons run the device up through a person’s arteries via a catheter, and then open it smack in the middle of a stroke-causing blood clot.

“If you actually deploy or open one in the middle of a clot, it smooshes out and the clot gets caught in the chicken wire, and then you pull the whole thing out back through the artery,” Powers said.

The new guidelines were published June 29 in the journal Stroke.

The AHA issued its updated guidelines based primarily on the results of six new clinical trials released within the past eight months, Powers said. All of these studies showed that the device can safely and effectively stop a stroke by removing blood clots, he added.

A number of other medical societies have endorsed the AHA’s new guidelines, including the American Association of Neurological Surgeons and the Society of Vascular and Interventional Neurology.

As with other stroke treatments, time is of the essence. The procedure must start within six hours of the onset of a stroke, which means that emergency teams and hospitals will have to move fast, Powers said.

The guidelines provide added incentive to quickly transfer stroke victims from a local hospital to a major stroke center capable of advanced treatment, said Powers and Dr. David Kandzari, director of interventional cardiology and chief scientific officer for the Piedmont Heart Institute in Atlanta.

Local hospitals currently are urged to “drip and ship” people experiencing a major stroke — essentially, start an IV drip of the powerful clot-busting drug called tissue plasminogen activator (tPA), and then ship them by ambulance or helicopter to the nearest comprehensive stroke center for further treatment, Kandzari said.

Stent retrieval devices make that quick hospital transfer even more important, since the gadgets provide a crucial backup for tPA but are more tricky to use.

“These are procedures performed by very specialized individuals,” Kandzari said. “They are not regularly performed by cardiologists or radiologists or neurologists. Hospitals must make plans to get people to other centers that are capable of this catheter-based therapy,” he explained.

Powers said, “I think what’s going to happen is that we will develop systems of rapid triage and rapid transport. A lot of this at this point depends on logistics and manpower. The people who do this are specially trained. You need a lot of special training to get those catheters up into the brain and pull things out.”

The guidelines specifically recommend using a stent retrieval device for people who:

• Didn’t have any significant disability prior to their current stroke.
• Received tPA within 4.5 hours of their stroke onset, and can start the procedure within six hours after stroke symptoms started.
• Are at least 18 years old, as clinical trials have not been conducted with children.
• Have imaging scans that show more than half of the brain on the side of the stroke is not permanently damaged.
• Have a clot blocking a large artery supplying blood to the brain.

That last point is especially important, because the stent retrieval device will not fit into the smaller blood vessels that branch out further into the brain, Powers said.

The major risk of using the device is that it could tear an artery and cause bleeding in the brain, particularly since it will be used on people who have already received very potent blood thinners, Kandzari said.

But clinical trials have shown that the risk of brain bleeding for people who received tPA and then went through mechanical clot removal is no greater than for people who just receive the blood thinner, Powers said.

“The outcomes were uniformly positive in all of the trials,” he said. “It’s really, really good evidence.”

More information

For more about stroke, visit the National Stroke Association.

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