Antibiotic-Resistant Gonorrhea: A Growing Threat

By Alan Mozes
HealthDay Reporter

MONDAY, Jan. 18, 2016 (HealthDay News) — Public health experts are expressing growing anxiety over the prospect of antibiotic-resistant gonorrhea.

Just last month, health officials in Great Britain cautioned that nation’s physicians and pharmacies about the dangers posed by drug-resistant strains of the sexually transmitted infection.

That concern is now being echoed by Dr. Robert Kirkcaldy, a U.S. Centers for Disease Control and Prevention epidemiologist in the division of STD prevention.

“Resistant gonorrhea and the prospect of untreatable gonorrhea are real threats,” he said, with resistant strains now detected in many parts of the world.

“The threat of untreatable gonorrhea underscores the importance of identifying new treatment options, ensuring adherence to screening and treatment guidelines — including treatment of (infected) partners — and increasing awareness among individuals on how they can best protect themselves from infection,” Kirkcaldy added.

Gonorrhea spreads through unprotected vaginal, anal and oral sex. More than 350,000 new cases were reported in the United States in 2014, according to the CDC. But, the agency believes that the exact number is much higher. Young people, especially those under 24, appear to be most at risk of gonorrhea, the CDC says.

Symptoms of the infection are often absent. Undiagnosed and untreated gonorrhea may lead to pelvic inflammatory disease, infertility, ectopic pregnancy (a pregnancy that occurs outside of the uterus) and/or chronic pelvic pain, the CDC reports.

To prevent such complications, the U.S. Preventive Services Task Force vice chair Dr. Kirsten Bibbins-Domingo said that at-risk older women and all sexually active women aged 24 and younger should be routinely screened for the infection.

The task force didn’t issue specific guidance for men. But the CDC said that anyone who’s sexually active is at risk of gonorrhea. The CDC recommends that all men who have sex with other men get tested yearly for the infection.

Currently, gonorrhea is curable.

Since 2012, the CDC has advised doctors and other health professionals to use a combination therapy to treat the infection. The combination includes the injectable antibiotic ceftriaxone along with the antibiotic pill azithromycin. By 2014, more than 97 percent of U.S. cases were treated this way, up from 9 percent in 2006, the CDC said.

The bad news? The CDC estimates that at least 2 million Americans contract infections — including gonorrhea — that are resistant to at least one antibiotic.

Still, “no patients have had confirmed failures of (gonorrhea) treatment with the currently recommended combination of ceftriaxone and azithromycin in the United States,” Kirkcaldy stressed.

“However, a small but growing number of gonorrhea infections that were unsuccessfully treated with cefixime, ceftriaxone, or azithromycin by themselves have been observed in other countries,” he said.

“And at least one azithromycin treatment failure has occurred in the U.S.,” Kirkcaldy added. This means that “it is only a matter of time before gonorrhea becomes resistant to the only remaining treatments currently available,” he said.

The alarm in the United Kingdom followed antibiotic-resistant cases that popped up earlier in 2015 in the British city of Leeds. That government’s letter urged medical professionals to adhere to the recommended two-drug combination treatment, given that antibiotic misuse could open the door to resistance.

In the United States, antibiotic overuse or misuse “is probably not the largest contributor to the problem,” Kirkcaldy said. Instead, he suggested, the threat more likely stems from resistant strains being imported from abroad.

Regardless, the fear of a “post-antibiotic era” remains.

“Losing effective treatment will cripple our ability to fight and prevent gonorrhea, and will also leave patients at greater risk of serious health complications from untreated gonorrhea,” Kirkcaldy warned.

The solution: fast reporting of all treatment failures to public health authorities, coupled with prevention.

“It has never been more important for men and women to protect themselves from gonorrhea,” he said, with particular concern for men who have sex with other men. Condoms are key for prevention, he added.

“If someone is diagnosed with gonorrhea, she or he needs to be treated right away with two antibiotics,” said Kirkcaldy. “And she or he needs to tell all of her or his recent sexual partners to make sure they are checked by a health care provider and treated.”

More information

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

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No Antibiotics for Common Respiratory Infections: Experts

MONDAY, Jan. 18, 2016 (HealthDay News) — Antibiotics are not needed for adults who have the common cold, bronchitis, sore throat or sinus infections.

That’s the advice from the American College of Physicians and the U.S. Centers for Disease Control and Prevention, which just issued guidelines for prescribing antibiotics for acute respiratory tract infections (ARTIs) in adults.

These types of infections are the most common reason for visits to the doctor and for outpatient antibiotic prescriptions for adults, the researchers said.

The advice, published Jan. 18 in Annals of Internal Medicine, is designed to combat what the two organizations see as overuse of such treatments.

According to an ACP news release, unpublished CDC data estimates “50 percent of antibiotic prescriptions may be unnecessary or inappropriate in the outpatient setting, which equates to over $3 billion in excess costs.”

“Inappropriate use of antibiotics for ARTIs is an important factor contributing to the spread of antibiotic-resistant infections, which is a public health threat,” ACP President Dr. Wayne Riley said in the news release.

“Reducing overuse of antibiotics for ARTIs in adults is a clinical priority and a High Value Care way to improve quality of care, lower health care costs, and slow and/or prevent the continued rise in antibiotic resistance,” he added.

According to the guidelines:

• Doctors should advise patients with the common cold that symptoms can last up to two weeks and they should follow up only if the symptoms worsen or exceed the expected time of recovery.
• Antibiotics should also not be prescribed for uncomplicated bronchitis unless pneumonia is suspected: “Patients may benefit from symptomatic relief with cough suppressants, expectorants, antihistamines, decongestants and beta-agonists.”
• In most cases, antibiotics should be prescribed for a sore throat only if a strep test confirms streptococcal pharyngitis. “Physicians should recommend analgesic therapy such as aspirin, acetaminophen, nonsteroidal anti-inflammatory drugs, and throat lozenges, which can help reduce pain.”
• Uncomplicated sinus infections typically clear up without antibiotics. Antibiotics should be prescribed only if there are persistent symptoms for more than 10 days, or if a patient develops severe symptoms or a high fever, has nasal discharge or facial pain for at least three days in a row, or “worsening symptoms following a typical viral illness that lasted five days, which was initially improving.”

More information

The American Academy of Family Physicians has more about antibiotics.

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Mouse Study Shows Cocaine Ravages Brain Cells

MONDAY, Jan. 18, 2016 (HealthDay News) — In mice, high doses of cocaine cause brain cells to eat themselves, researchers report.

The Johns Hopkins University scientists also found such destruction in the brain cells of mice whose mothers were given cocaine while pregnant.

However, they also identified a possible antidote to this process.

In their laboratory work, the investigators found that high doses of cocaine — the powerful and addictive stimulant — trigger out-of-control autophagy, a process in which cells digest their own insides. Autophagy is typically a normal and vital process that helps keep cells clean.

“We performed ‘autopsies’ to find out how cells die from high doses of cocaine,” said Dr. Solomon Snyder, a professor of neuroscience at John Hopkins’ School of Medicine in Baltimore.

“That information gave us immediate insight into how we might use a known compound to interfere with that process and prevent the damage,” he said in a university news release.

The possible antidote is an experimental compound dubbed CGP3466B. It has already been tested in unsuccessful clinical trials to treat Parkinson’s disease and amyotrophic lateral sclerosis (ALS), and is known to be safe for people, the researchers said.

However, it will take many more years of research to determine if the compound can prevent cocaine-related damage in brain cells, first in mice, then in humans, the study authors said.

Also, results attained in animal studies are often not replicated in humans.

The study was published online Jan. 18 in the Proceedings of the National Academy of Sciences.

More information

The U.S. National Institute on Drug Abuse has more about cocaine.

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Lyme-Causing Ticks Expand Their Range in U.S.

MONDAY, Jan. 18, 2016 (HealthDay News) — Ticks that transmit Lyme disease are now found in nearly half of all counties in the United States, a much broader swath than was seen in the late 1990s, researchers report.

The findings show “that the distribution of Lyme disease vectors has changed substantially over the last nearly two decades and highlights areas where risk for human exposure to ticks has changed during that time,” said study author Dr. Rebecca Eisen, a research biologist at the U.S. Centers for Disease Control and Prevention.

Lyme disease — transmitted by black-legged and western black-legged ticks often called deer ticks — can cause symptoms such as fever, headache and fatigue. It is often mistaken for the flu.

Knowing where these ticks are found can help doctors make a correct diagnosis of Lyme disease, experts said.

Researchers analyzed available data and found black-legged ticks reported in more than 45 percent of U.S. counties, compared with 30 percent of counties in 1998. They also found that the black-legged tick is now considered established in twice as many counties as in 1998.

Most of the ticks’ expansion in range has occurred in the northern United States. Its distribution in southern states has remained fairly stable, with the range of the western black-legged tick only increasing to 3.6 percent of counties from 3.4 percent in 1998, the study found.

The findings were published Jan. 18 in the Journal of Medical Entomology.

“The observed range expansion of the ticks highlights a need for continuing and enhancing vector surveillance efforts, particularly along the leading edges of range expansion,” Eisen said in a journal news release.

More information

The U.S. Centers for Disease Control and Prevention has more about Lyme disease.

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Catch-Up Sleep May Reverse Type 2 Diabetes Risk Tied to Sleep Loss: Study

By Alan Mozes
HealthDay Reporter

MONDAY, Jan. 18, 2016 (HealthDay News) — Though prior research warns that sleep deprivation may increase the risk of type 2 diabetes, a new study suggests that “catch-up” sleep might reverse that risk — at least in the short-term.

Short-changing sleep during the week only to sleep in for long periods on the weekend is a common pattern in the United States, according to the study authors. And, previous research has suggested that getting just four or five hours of sleep a night can boost type 2 diabetes risk by nearly 20 percent.

But the new study hints that that risk might be reversed with just two days of extra sleep.

“I have to say that this is a small, very short-term controlled study involving only healthy men,” said study lead author Josiane Broussard, an assistant research professor with the Sleep and Chronobiology Laboratory at the University of Colorado in Boulder.

“In real life, you’d be losing sleep week in and week out, so we don’t know whether catch-up sleep can give you this kind of risk improvement in that context. But the good take-away from this work is that at least in terms of diabetes risk, it seems that you’re not necessarily totally screwed if you experience sleep loss,” said Broussard.

The study findings were published online Jan. 18 in Diabetes Care.

Initially, 19 healthy, young and lean men were allowed up to 8.5 hours of sleep per night (between 11 p.m. and 7 a.m.) for four consecutive nights in a sleep lab. They slept an average of 7.8 hours a night, the study authors said.

The four-day “normal” sleep period was followed by a glucose tolerance test to see the young men’s usual diabetes risk.

The same group was then placed on a lab-controlled sleep deprivation schedule. Each volunteer could sleep just 4.5 hours a night (between 1 a.m. and 5:30 a.m.) for four consecutive nights. After the four nights, they had another glucose tolerance test. On average the men slept 4.3 hours a night, the researchers said.

After that, the men were given two days of “recovery” sleep. They were allowed up to 12 hours of sleep on the first recovery day (from 10 p.m. to 10 a.m.) and up to 10 hours of sleep on the second recovery day (from 10 p.m. to 8 a.m.). This sleep was followed by glucose (blood sugar) testing. On average the men slept 9.7 hours a night.

The men had a 23 percent drop in insulin sensitivity compared to normal levels after four days of too little sleep, the study showed. Similarly, a key diabetes risk measure called the “disposition index” (based on the interaction between insulin sensitivity and the acute insulin response to blood sugar) also dropped by 16 percent following sleep restriction.

But testing following the two days of recovery sleep showed that both insulin sensitivity levels and the disposition index fully rebounded after the catch-up sleep, the researchers said.

The investigators concluded that catch-up sleep may reverse the negative short-term impact of sleep loss on diabetes risk, at least in otherwise healthy fit young men.

“Whether a pre-diabetic or overweight person would improve is really not known,” cautioned Broussard. “And while I would hypothesize that women — who also have impairments when sleep-deprived — would also improve, there could be a difference in the degree of their improvement. So really this study raises many more questions than we answer.”

That point was seconded by Frank Scheer, an associate professor of medicine at Harvard Medical School, and a neuroscientist at Brigham and Women’s Hospital in Boston.

“This is one of the first well-controlled studies on the effects of sleep recovery on blood glucose regulation, using a relevant weekday-weekend sleep restriction-recovery design,” he said.

But he added that “follow-up studies are needed to test whether weekend sleep recovery is as effective when the weekday restricted sleep occurs repeatedly, week after week, as is common in many of us.”

Plus, Scheer said, the study was done on healthy people, so it will be important to see if the results are similar in people with pre-diabetes or type 2 diabetes, or for people with chronic sleep disorders.

More information

There’s more on the negative impact of sleep loss at the U.S. National Institutes of Health.

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Teens’ IQ Drop Can’t Be Blamed Solely on Pot: Study

By Dennis Thompson
HealthDay Reporter

MONDAY, Jan. 18, 2016 (HealthDay News) — Studies have suggested that teenage marijuana use leads to a decline in intelligence. But new research with twins suggests the link may not be as clear-cut as some believe.

Confounding family issues that lead a kid to try pot in the first place may be to blame for any brain drain, according to the new study.

The researchers did report that marijuana users had lower IQ test scores, on average, when compared to those who didn’t indulge in pot.

But they also discovered that a twin who uses pot winds up with about the same IQ as a twin who doesn’t.

“We found there was no difference between twins in terms of how much their IQ changed,” said study co-author Joshua Isen, a postdoctoral research associate at the University of Minnesota. “The twin who didn’t use marijuana showed as much IQ drop as the twin who did.”

These results suggest that people who think marijuana causes IQ decline may be putting the cart before the horse, said Dr. Joseph Lee, medical director for the Hazelden Betty Ford Foundation’s youth services.

Kids likely to experience a decline in IQ for whatever reason — be it family problems, emotional turmoil or some other factor — appear more likely to try marijuana, drink alcohol or smoke cigarettes at an early age, Lee said.

“Certain kids are at higher risk for problems down the road,” Lee said. “For some reason, groups of kids who tend to adopt heavier substance use at an earlier age just do worse at life.”

Marijuana use should be a red flag to parents that their kid is struggling and needs help at home and in school, Isen and Lee said.

“This is a big red flag for their life’s trajectory,” Lee said.

About one in five older teens and young adults has used marijuana in the past month, the researchers said in background notes. Previous research has raised concerns that marijuana use could affect the structure and function of the still-developing teenage brain.

Teen pot smoking has been associated in earlier studies with decreased intelligence, reduced memory, poorer attention and lower verbal ability.

To determine whether marijuana is causing these problems, or is simply a warning sign of deeper troubles, the researchers behind the new study decided to examine pot use among more than 3,000 teenage twins.

They focused on twins because the kids have the same background and share most or all of their genes, depending on whether they are identical or fraternal twins, Isen said.

“In one fell swoop, that allowed us to control for common familial variables and shared genes,” he said.

The researchers tested the twins’ IQ at two points of their lives — between the ages of 9 and 12, before either would likely become involved with pot, and again at ages 17 to 20.

Comparing all marijuana users to all nonusers, the researchers found that the average change in IQ was 3.4 to 4 points lower in teens who had used pot.

But twins who smoked pot did not exhibit a change in IQ significantly different than that experienced by their non-using twin.

“This study’s conclusions are consistent with those of previous, well-controlled trials finding that cannabis exposure possesses little if any neurotoxicity risk, and that its cumulative consumption is not adversely associated with IQ or academic performance once investigators account for potential confounding variables, such as cigarette smoking, binge drinking or poor family environment,” said Paul Armentano. He is deputy director of NORML, which advocates for reform of marijuana laws.

Isen agreed that these kids’ problems may trace initially to their family or their emotional makeup, rather than pot or alcohol use.

“It’s the type of family that have kids who initiate marijuana use as teenagers that seem to be on that trajectory for intellectual stagnation,” he said. “Teenagers who use marijuana tend to be more delinquent and rule-breaking in general — so maybe they aren’t reading, they aren’t doing their homework, they’re skipping classes.”

The study was published Jan. 18 in the Proceedings of the National Academy of Sciences.

More information

The U.S. National Institute on Drug Abuse has information for parents about pot use.

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Kate Winslet Opens Up About Having Incontinence

Photo: Getty Images

It might be hard to believe, but even famous actresses can suffer from not-so-glamourous health conditions.

Actress Kate Winslet revealed on the U.K.’s The Graham Norton Show that she has stress incontinence, which causes accidental urine leakage when the body is under physical stress like coughing, sneezing, laughing, lifting heavy objects, or exercising.

“I can’t jump on trampolines anymore, I wet myself,” Winslet said. “It’s bloody awful, especially if you’re wearing a skirt.”

Winslet definitely isn’t alone. Anyone can suffer from the leaky-bladder condition, especially (as in her case) women who have given birth.

“When you’ve had a few children you know, it’s just what happens,” she said on the show. “It’s amazing, two sneezes, I’m fine. Three, it’s game over.”

Overall 25 million Americans have incontinence, and of those, 75% to 80% are women. Stress incontinence is not uncommon among women post-pregnancy, because muscles that support the bladder may get weaker after giving birth. Plus, new moms go through some major hormonal changes, which can affect the pelvic floor muscles. For some, the symptoms of stress incontinence start immediately after delivery and then improve, while others have symptoms that get worse with age.

RELATED: My Incontinence Started After I Gave Birth

Unfortunately, people shy away from this topic, since it’s viewed as embarrassing. But it shouldn’t be—which is why it’s great Winslet is bringing this issue into the spotlight.  The good news is, there are things that can help remedy the problem. Here are some steps you can take if you have stress incontinence.

Lose weight
Staying fit and shedding pounds is an important way to lessen the severity of symptoms. If you are overweight, dropping pounds can help reduce pressure on your pressure on your bladder and pelvic muscles.

Train your body
One way to help restore control is through Kegel exercises, otherwise known as pelvic floor exercises, which involve flexing the same muscles you use to hold your pee. Squeeze those muscles for five seconds at a time, 10-15 times a day, and you should see an improvement. And if you want some help, there are a number of kegel-assisting products on the market designed to help you get the most out of your workout. But the jury is still out on whether such devices help, so it’s fine to keep it old-school and just do the exercises on your own. (Added benefit? Kegels are thought to increase the strength of orgasms, so it’s really a win-win.)

RELATED: 12 Myths and Facts About Incontinence

Adjust your diet
When you have incontinence, certain beverages can make symptoms worse, like caffeine and alcohol. Both are diuretics, which can increase urine output, which can be a problem for people with incontinence.

RELATED: 10 Foods to Avoid If You Have an Overactive Bladder

Get a new gadget
There are other products on the market meant to make living with incontinence easier. One device is a pessary, a soft silicone ring that’s inserted into the vagina (almost like a tampon) to lift and support the bladder. You can keep it in for a week at a time to help prevent leakage.

RELATED: 11 Drugs Used To Treat Incontinence

Surgery
If your symptoms are severe, surgery can be an option. Many surgeries for incontinence, which include retropubic suspension and sling surgery, can have variable results and carry a risk of complications, so they’re generally recommended as a last resort. For a slightly less invasive option, you could try an outpatient procedure where bulking materials (collagen or silicone) are injected around the urethra to make the area thicker and able to control leakage. However, this type of treatment isn’t permanent. If successful, you’ll probably have to get additional injections every few months to a year.

RELATED: 15 Must-Know Facts About Incontinence Surgery

Biofeedback
If you don’t love the idea of surgery or injections, consider seeing a physical therapist who specializes in pelvic floor dysfunction. These aren’t your typical sports PTs, these specialists can guide you through Kegels, biofeedback, and behavioral techniques to help manage symptoms. You can also talk to your gynecologist for guidance and support for dealing with the condition. Some people with incontinence turn to acupuncture or hypnotherapy to restore balance and control of their bodies. Researchers have yet to confirm if either is a legitimate treatment, but since some women have shown improvement, they do believe there’s potential.

 

 

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Exercise Regularly and Your Heart Will Thank You

MONDAY, Jan. 18, 2016 (HealthDay News) — Regular exercise is essential for keeping your heart healthy, and the more the better, experts from the American College of Cardiology’s Sports and Exercise Cardiology Council say.

The study authors examined recent research and found that even small amounts of exercise, including standing, can reduce the risk of heart disease. Even greater reductions in risk can be achieved with more exercise, the researchers said.

But only half of American adults get the recommended 150 minutes of moderate or 75 minutes of vigorous exercise a week, the report authors noted.

The new research also reviewed recent studies that have suggested that excessive aerobic exercise — such as endurance races — may harm the heart. While that possibility warrants further investigation, current research shows that even for people with extremely high levels of training, the benefits of exercise outweigh the risks, according to the report, published Jan. 18 in the Journal of the American College of Cardiology.

“The public media has embraced the idea that exercise may harm the heart and disseminated this message, thereby diverting attention away from the benefits of exercise as a potent intervention for the primary and secondary prevention of heart disease,” Dr. Michael Scott Emery, co-chair of the Sports and Exercise Cardiology Council, said in a journal news release.

“The greatest benefit is to simply exercise, regardless of the intensity,” Dr. Valentin Fuster, editor-in-chief of the journal, said in the news release.

Exercise can also help heart disease patients. But, research reviewed by the study authors found that only 62 percent of heart attack patients were referred to cardiac rehabilitation after leaving the hospital. Of those, only 23 percent went to more than one rehab session. And, just 5 percent completed more than 36 sessions, the study showed.

“The available evidence should prompt clinicians to recommend strongly low- and moderate-exercise training for the majority of our patients,” Emery said.

“Equally important are initiatives to promote population health at large through physical activity across the life span, as it [influences] behavior from childhood into adult life,” he added.

More information

The U.S. National Heart, Lung, and Blood Institute offers a guide to physical activity.

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Candy-Flavored E-Cigarette Ads Appeal to Young: Study

By Dennis Thompson
HealthDay Reporter

MONDAY, Jan. 18, 2016 (HealthDay News) — Ads featuring e-cigarettes with flavors like chocolate or bubble gum appear to increase kids’ interest in buying and trying an e-cigarette, a new British study has found.

However, the ads don’t increase the overall appeal to kids of either smoking traditional tobacco cigarettes or using e-cigarettes regularly, the researchers reported.

E-cigarettes, or electronic cigarettes, are battery-powered devices that heat nicotine and flavorings to create a vapor that is inhaled by the user. E-cigarettes are marketed in thousands of different flavors, including some that seem to appeal directly to children, the researchers said in background notes.

Flavors other than menthol have been banned in tobacco cigarettes in the United States. But, e-cigarettes currently remain unregulated and companies are free to add flavors, said Erika Sward, assistant vice president of national advocacy for the American Lung Association.

“We know that flavors appeal to kids, and that is what the e-cigarette industry is banking on,” Sward said. “Kids like sweet flavors. That is why there are sugar-sweetened cereals. These flavors have always appealed to a kid’s palate.”

“Vaping” flavors for e-cigarettes include products marketed as tasting like Sweet Tarts, Hawaiian Punch, Kool-Aid, Gummi Bears and Froot Loops, said Cliff Douglas, director of the American Cancer Society Tobacco Control Center.

“It doesn’t get much more blatant,” Douglas said. “It’s quite clearly targeted at kids.”

A recent U.S. Centers for Disease Control and Prevention study found that nearly seven in 10 middle school and high school students have been exposed to e-cigarette advertising. And experts are concerned that kids might be further enticed to try e-cigs if companies play up flavorings in the ads, Sward said.

To examine this possibility, the University of Cambridge researchers recruited about 600 kids, aged 11 to 16, and randomly assigned them to one of three groups. One group looked at ads for candy-flavored e-cigarettes, another saw ads for non-flavored e-cigarettes, and the third group saw no advertisements at all.

“Answering this question is important because e-cigarette use amongst children in the last year has tripled in the USA [from 4.5 percent to 13 percent] and almost doubled in England [from 5 percent to 8 percent],” said lead author Milica Vasiljevic, a research associate at the Cambridge Behavior and Health Research Unit in England.

The school children were then asked questions to gauge the appeal of using e-cigarettes or smoking tobacco, the perceived harm of smoking, how much they liked the ads, and how interested they might be in buying and trying e-cigarettes.

The children shown the ads for candy-flavored e-cigarettes liked the ads more, and expressed a greater interest in buying and trying e-cigarettes than their peers.

However, showing the ads made no significant difference in the overall appeal of tobacco smoking or of using e-cigarettes — in other words, how attractive, fun or cool those activities seemed to kids, the study found.

The study findings were published in the Jan. 17 online edition of the journal BMJ Tobacco Control.

“The primary question they [the researchers] set out to ask in this study was whether e-cig advertisements serve as a ‘re-normalization’ to smoking,” said Cynthia Cabrera. She is president of the Smoke-Free Alternatives Trade Association, an e-cigarette industry advocacy group.

“In this study, the answer was ‘no.’ This experimental evidence suggests that what e-cigarette advertising influences is attitudes towards vaping, not smoking, in line with basic marketing and advertising theory,” Cabrera said.

But, Douglas said, while the ads didn’t make tobacco seem more attractive, experts are concerned that kids who try e-cigarettes will become addicted to the nicotine contained in the products and ultimately wind up smoking tobacco.

“This research highlights the likely impact of the use of flavors in interesting kids in using these addictive drug-delivery products, and also highlights the concern that this process may lead brand new users of nicotine eventually into conventional cigarette smoking, which is demonstrably more harmful,” Douglas said.

The U.S. Food and Drug Administration has announced its intention to regulate e-cigarettes, and is expected to issue rules giving it that power in the very near future, Sward said.

But that’s just the first step, Douglas said. The FDA then would have to issue specific regulations regarding e-cigarettes, and those could take months or even years to finalize.

“The FDA does need to step in, without question, and as soon as possible,” Douglas said.

More information

For more about e-cigarettes, visit the U.S. Department of Health and Human Services.

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Here’s What Health and Wellness Experts Bring to Eat on Airplanes

“I can’t wait to eat on the plane!” said no one, ever. Airline food has never been the best, and nowadays it’s possible to spend a fortune buying on-board fare that’s… let’s just say less than optimal. While some airports do have decent food options, if you’re traveling at an odd hour or don’t have tons of time, it can still be difficult to seek out the best healthy choices. So what’s a health-conscious traveler to do? The answer: Plan and pack ahead. We asked four health and wellness experts to share their secrets for keeping hunger at bay while up in the friendly skies.

RELATED: 10 Healthy Flavored Popcorn Recipes

1. The doctor

“I always have some Miso Tahini Dip in the refrigerator. For travel, I use less water to make a thicker spread and put it on thin-sliced whole grain bread. I also may take carrot sticks along, as well as some raw nuts and dark chocolate.” —Andrew Weil, MD, drweil.com

Bonus: Here’s the recipe for Dr. Weil’s Miso-Tahini Dip from his new cookbook Fast Food Good Food ($20; amazon.com).

You’ll need: ½ cup raw sesame tahini, 1 ½ Tbsp. red miso, ¼ cup water, 2 cloves of pressed garlic (allow it to sit for 10 minutes)

Directions: Mix tahini and miso in a bowl until well combined. Add water gradually, stirring. The mixture will first thicken and then turn smooth and creamy. Add just enough water to get the consistency you want for the dip. Add the pressed garlic and mix well. Serve with vegetable crudités like carrot and celery sticks, cucumber spears, or red and orange bell pepper slices. Yields ¾ cup of dip.

RELATED: 30 Quick-and-Easy Fat-Burning Recipes

2. The nutritionist

“Sometimes I take bars. My favorite are Amrita Chocolate Maca Energy Bars ($40 for 12; amazon.com). Or I’ll take snacks that kind of make a meal, like raw veggies (usually sliced red bell pepper, cucumber, and grape tomatoes), roasted chickpeas, nuts, and fresh fruit.” —Health‘s contributing nutrition editor Cynthia Sass, RD, MPH, cynthiasass.com

RELATED: 16 Easy, Guilt-Free Cookie Recipes

3. The natural medicine guru

“My favorite snacks to take along are homemade spicy kale chips, Epic Food Bars (made with grass-fed beef, $20 for six; amazon.com), Goji berries ($15; amazon.com), Lydia’s Organic Crackers (made with veggies, herbs, and seeds, $9.50 for a 5-oz. box; amazon.com). Sometimes I also make homemade protein bars.” —Josh Axe, DNM, draxe.com

RELATED: The Best Fat-Burning Breakfasts

4. The fitness manager

“When I travel, I like to bring a pouch of tuna ($35 for 12 2.6-oz. pouches, amazon.com), some chopped fruit (usually green apples and/or strawberries), and peanuts.” —Mary Onyango, group fitness manager, Equinox Brooklyn Heights

RELATED: 26 Quick, Healthy Juice and Smoothie Recipes

5. The food editor

Just for good measure, here’s what I take along: I cut up whatever raw vegetables I have in the fridge (usually carrots, celery, cucumber, and radishes, sometimes fennel) and put them in a container. I drizzle them with MCT Oil ($35; amazon.com) or extra-virgin olive oil and sprinkle with pink Himalayan salt ($10; amazon.com). Depending on how long the flight is, I may also bring a couple of hard-boiled eggs, a piece of in-season fruit, and a bar. My favorite bars are Bulletproof Vanilla Max Collagen Bars ($35 for 12; bulletproof.com) and Health Warrior Chia Bars ($22 for 15, amazon.com).

from Health News / Tips & Trends / Celebrity Health http://ift.tt/1SsancF