Obesity Before Pregnancy Tied to Raised Risk of Newborn Death

FRIDAY, Jan. 22, 2016 (HealthDay News) — Infants whose mothers were obese before pregnancy appear to have an increased risk of death, according to a new study.

But even though the researchers found that pre-pregnancy obesity was related to worse outcomes for infants, it’s important to note that the study wasn’t designed to prove a cause-and-effect relationship.

Still, the study’s lead author, Eugene Declercq of Boston University School of Public Health, said, “There is a need for more open, honest discussions about avoiding the possible risks of maternal obesity on infant health.”

For the study, researchers reviewed data from more than 6 million newborns. The babies were born in 38 states between 2012 and 2013.

Infants born to obese women were twice as likely to die from preterm birth-related causes than those born to normal-weight women, the investigators found.

Infants born to obese women were also more likely to die from birth defects and sudden infant death, the study showed. And, the more obese the mother, the greater the risk of infant death.

Even if obese women adhered to weight-gain guidelines during pregnancy, it had little effect on infant death risk, the study authors said.

The study highlights the need to address obesity before pregnancy, and for more research into what increases the risk of death in infants born to obese women, said Declercq, a professor of community health sciences at Boston University School of Public Health.

“The findings suggest that primary care clinicians, ob-gyns and midwives need to have conversations about weight as part of well-woman care, and when women are contemplating getting pregnant,” he said in a university news release.

The obesity rate among American women aged 20 to 39 years is about 32 percent, the researchers said in the news release.

The findings were published online recently in the journal Obstetrics and Gynecology.

More information

The U.S. Office of Disease Prevention and Health Promotion offers healthy pregnancy advice.

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Should You Get Tested for the Breast Cancer Gene?

Photo: Getty Images

If you’re keeping up with the Kardashians, you may already know that they got the BRCA gene test on last week’s episode. The reality show matriarch, Kris, thought it would be a good idea since they have a family history of breast cancer. But Khloe, 31, took some convincing. After watching her father succumb to esophageal cancer in 2003, she didn’t want to obsess over the possibility that she might suffer a similar fate: “If I’m going to get something, I’m going to get something,” she explained. “I’m not going to live my life in fear.”

Khloe’s concern is not uncommon—and the episode raised important awareness about the BRCA gene mutations. (Fortunately all four women received negative results.) However, the producers glossed over a few key details. We reached out to genetic experts to learn more about what you should keep in mind if you’re considering the test.

RELATED: 12 Things That Probably Don’t Increase Breast Cancer Risk

What exactly is the BRCA test?

It detects harmful variations in the BRCA1 and BRCA2 genes. (If one of your parents carries a mutation, there is a 50 percent changes that you have it too.) A positive result means you are at risk of developing breast, ovarian, and other cancers. While there is no way to “rid your body” of a BRCA mutation, “knowledge is power,” says Susan Klugman, MD, director of Reproductive and Medical Genetics at Montefiore Health System and professor of Clinical Obstetrics & Gynecology and Women’s Health at Albert Einstein College of Medicine in New York City. Knowing the mutation is there gives you options. You can work with your doctor to make sure you are getting the proper screenings (including MRIs, mammograms, and pelvic sonograms), she says. Prophylactic surgeries (to remove your breasts or ovaries) may also be an option.

Who should get tested?

A family history of cancer isn’t the only factor to weigh, says Mary Freivogel, the president-elect of the National Society of Genetic Counselors (NSGC). It isn’t that simple. The National Cancer Institute has developed a series of screening tools to help evaluate whether a woman may have inherited a mutation. For example, if one of your relatives had both breast and ovarian cancer—or breast cancer that was diagnosed before she turned 50—you would be a candidate for the test. If you’re concerned, Freivogel recommends making an appointment with a genetic counselor. All families are different and some signs may not be as obvious, she explains. “What [a counselor is] able to do is take a family history and figure out if this is a pattern that concerns something hereditary, or if it is a pattern that’s probably explained by something else.” (You can use the NSGC’s online directory to find a counselor in your area.)

RELATED: 25 Breast Cancer Myths Busted

What if I just don’t want to know?

Like Khloe, many women worry that a positive test result will feel like a death sentence, and create unwanted anxiety about the future. Freivogel suggests that you should think about whether a positive result would change what you are currently doing to protect your health. “If I had a patient that said, ‘I’ve already had my ovaries removed for some other reason, I would not consider a preventative mastectomy, even if I had a BRCA mutation, and my family history puts me at enough risk that I’m already getting screened very carefully, I’m getting mammograms.’ Would that person do anything differently if she got a BRCA result? Maybe not.”

But if there are preventative steps that you’re not already taking, knowing your BRCA status could literally save your life. And if you’re thinking about getting pregnant in the future, the test could potentially help protect your baby too. Dr. Klugman explains that a procedure (called Preimplantation Genetic Diagnosis) performed during an IVF cycle can help doctors identify the embryos that don’t carry the treacherous mutation.

Like Freivogel, Dr. Klugman also recommends talking to a health care provider—like a genetic counselor or an oncologist—to help you understand the pros and risks of analyzing your DNA. But ultimately, she points out, “any genetic testing is up to the patient.”

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Flu Season Stays Mild, With Slow Uptick in Activity

By Steven Reinberg
HealthDay Reporter

FRIDAY, Jan. 22, 2016 (HealthDay News) — Halfway through this year’s rather mild flu season, disease activity is still increasing, albeit slowly, a U.S. health official said Friday.

“Activity is continuing to increase; it looks a little bit more impressive this week,” said Lynnette Brammer, an epidemiologist with the U.S. Centers for Disease Control and Prevention.

So far, this flu season has been much milder and kicked in later than last year. By this time last year, flu was already severe and sending thousands of older Americans to the hospital, Brammer said. In fact, “by this time last year we had peaked and were coming down,” she noted.

Unlike last year, this season the H1N1 strain of the flu is the most common circulating strain, replacing the H3N2 strain, Brammer said. “But H3N2 is still hanging in there, it’s not going away,” she said. “We’ve got a little bit of everything out there.”

Both of these strains, and another besides, are included in the current flu vaccine, Brammer said, making this year’s flu shot a better match than the one from the 2014-2015 season.

As to the illness’ reach, “we are seeing flu everywhere, but it is most active still in the Southeast, Arizona and the West Coast,” Brammer said.

Worse activity could come, she added.

“I would be very shocked if we didn’t see flu activity increase in the next couple of weeks,” Brammer said. And with flu still at moderate levels but increasing, it’s a great time to get vaccinated, she said, noting that plenty of vaccine is still available.

Milder weather may be one factor delaying this year’s flu, Brammer said. But it’s only one factor of many that affect how flu spreads. Other factors include how many people are immune because they’ve been vaccinated and the low number of people with flu who could infect others.

In a typical flu season, flu complications — including pneumonia — send more than 200,000 Americans to the hospital. Death rates linked to flu vary annually, but have gone as high as 49,000 deaths in a year, the CDC says.

Virtually everyone older than 6 months of age is advised to get a flu shot. The exceptions are people with life-threatening allergies to the flu vaccine or any ingredient in the vaccine, according to the CDC.

Pregnant women are at high risk and should get vaccinated. Women with newborns also need to get their flu shot to help protect their infants, who can’t be vaccinated until they are at least 6 months old. Also at risk are seniors and people with chronic health problems, such as lung and heart disease, the CDC says.

How effective the vaccine is in preventing the flu depends on how good a match it is to the strains of flu virus circulating that year. Most years, the vaccine is between 40 percent and 60 percent effective, according to the CDC.

More information

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

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How Zendaya Learned to Embrace Her Curls

You Asked: Is Yoga Good Exercise?

Photo: Getty Images

From CrossFit to Insanity workouts, exercise has lately trended toward the extreme. But physical activity doesn’t always have to be vigorous to be effective. While it may seem mellow compared to most training programs, yoga’s health benefits keep pace—and often outdistance—what many people would call “traditional” forms of exercise.

For starters, research shows regular yoga practice lowers your risk for heart disease and hypertension. Yoga may also lessen symptoms of depression, headaches, diabetes, some forms of cancer and pain-related diseases like arthritis.

Yoga also seems to combat weight gain. One 4-year study from Seattle’s Fred Hutchinson Cancer Research Center found middle-aged adults who practiced yoga at least once a week gained 3 fewer pounds than those who stuck with other forms of exercise. The same study found overweight adults who practice yoga lost 5 pounds, while a non-yoga group gained 13 pounds. Those results held even when the authors accounted for different eating habits.

How can a little bending and stretching do all that? Unlike exercises like running or lifting weights—both of which crank up your heart rate and stimulate your nervous system—yoga does just the opposite. “It puts you in a parasympathetic state, so your heart rate goes down and blood pressure goes down,” says Dr. Tiffany Field, director of the Touch Research Institute at the University of Miami School of Medicine.

Field has published an in-depth review of yoga’s potential health benefits. She says the types and varieties of movement involved in yoga stimulate pressure receptors in your skin, which in turn ramp up your brain and body’s vagal activity. Your vagus nerve connects your brain to several of your organs, and it also plays a role in hormone production and release.

“Stress hormones like cortisol decrease as vagal activity increases,” Field says. At the same time, this uptick in vagal activity triggers the release of the hormone serotonin, which helps regulate everything from your mood and appetite to your sleep patterns.

All of this may explain yoga’s research-backed ties to a healthier heart, as well as its ability to slash your stress, improve your mood, quell your appetite, and help you sleep more soundly, Field says. When you consider the health perks linked to each of those brain and body benefits—lower inflammation, lower body weight, lower disease risk—you could make an argument that few activities are as good for you as yoga.

One thing yoga doesn’t do, though, is burn loads of calories. Even hot forms of yoga like Bikram result in modest energy expenditures—roughly the number of calories you’d burn during a brisk walk.

While more and more research suggests calories shouldn’t be your sole focus when it comes to diet and exercise, there’s no question that running, swimming, lifting weights, and other more-vigorous forms of exercise are great for your brain and body.

Yoga is unquestionably good for you, Field says, but it should be done in tandem with traditional forms of physical activity—not in place of them.

This article originally appeared on Time.com.

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High Deductibles Don’t Prompt People to Shop for Best Health Care Deal: Study

FRIDAY, Jan. 22, 2016 (HealthDay News) — Having a high-deductible health insurance plan doesn’t mean people will shop around for the best health care prices, a new study finds.

“Simply increasing a deductible, which gives enrollees skin in the game, appears insufficient to facilitate price shopping,” Neeraj Sood, of the University of Southern California, and co-authors concluded.

High-deductible plans, which are becoming more common, are thought to encourage consumers to comparison shop when seeking health care, since patients are footing a bigger share of the tab. But while these plans have been linked with lower health care spending, previous research suggests the main reason for those savings is reduced use of health care, the researchers noted.

For this study, Sood’s team surveyed more than 1,900 insured U.S. adults, aged 18 to 64, who used medical care in the last year — 1,099 with high-deductible plans and 852 in traditional plans.

For the last time they sought medical care, those with high-deductible plans were no more likely than those with traditional plans to consider going to another health care provider (11 percent versus 10 percent) or to compare out-of-pocket cost differences between health care providers (4 percent versus 3 percent), the study found.

Those in high-deductible plans were more likely to be white, employed and have higher education and income levels, the researchers said.

The study was published online Jan. 19 in the journal JAMA Internal Medicine.

More information

The American Academy of Family Physicians has more about health insurance.

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Majority of Americans Wants Medicare to Cover Obesity Treatments

FRIDAY, Jan. 22, 2016 (HealthDay News) — Most Americans believe Medicare should cover approved medicines to treat obesity, a new survey shows.

“Public policy and society seldom associate obesity with advanced age,” James Appleby, chief executive officer of the Gerontological Society of America (GSA), said in a news release from the organization.

“But recent research has shown that, for those who are over 65 and significantly overweight, the risk of mortality is far greater that it is for younger individuals with excessive body weight. The preponderance of evidence is clear: Obesity at an older age carries with it a plethora of health problems like diabetes and heart disease and the likelihood of premature death,” Appleby said.

More than two years ago, the American Medical Association declared obesity a disease.

The GSA online poll of more than 1,000 people 18 and older found that 71 percent believe Medicare should expand coverage to include U.S. Food and Drug Administration-approved prescription obesity medicines.

And, 68 percent said Medicare should invest in programs to lower the nation’s obesity rate, the survey found.

The survey also found that: 89 percent believe obesity is a problem in their state; 77 percent didn’t know that federal law currently forbids Medicare from covering prescription obesity medicines; and 73 percent didn’t know that the FDA concluded that current prescription obesity medicines are safe and effective.

A law passed in 2003 prohibits Medicare from covering prescription obesity medicines. Since then, a number of such medicines have been approved by the FDA. A bill currently before Congress would require Medicare to cover such medicines, the GSA said.

“Medicare must begin covering medicines to treat obesity because chronic diseases are a primary driver of higher costs in the Medicare system — and, as we know, obesity is a primary cause of chronic disease,” former U.S. Health and Human Services Secretary Tommy Thompson said in the news release.

“Common sense tells us that if Medicare begins covering these medicines, it would reduce the long-term costs associated with obesity-related chronic diseases,” he added.

More information

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

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Migraines May Worsen as Menopause Approaches

FRIDAY, Jan. 22, 2016 (HealthDay News) — For women who suffer migraines, the frequency of these debilitating headaches seems to increase as they approach menopause, a new study finds.

“Changes in female hormones such as estrogen and progesterone that occur during the perimenopause might trigger increased headaches during this time,” said study co-author Dr. Richard Lipton. He is director of the Montefiore Headache Center and vice chair of neurology at Albert Einstein College of Medicine in New York City.

The new research included more than 3,600 women who suffered migraines before and during menopause. The risk of high-frequency migraines (10 or more a month) rose 60 percent during the transitional time into menopause marked by irregular menstrual cycles (perimenopause).

The risk of migraine was highest during the later stage of perimenopause, when women have low levels of estrogen, the study found.

“Women have been telling doctors that their migraine headaches worsen around menopause, and now we have proof they were right,” study author Dr. Vincent Martin, co-director of the Headache and Facial Pain Program at the University of Cincinnati Neuroscience Institute, said in a news release.

There is help for women who have migraines and are approaching menopause, said study co-author Dr. Jelena Pavlovic, an attending physician in neurology at the Montefiore Headache Center and an assistant professor in the neurology department at Albert Einstein College of Medicine.

“Physicians can prescribe hormonal therapies that level out these changes that occur during the perimenopause and menopause time periods. If the patient is in early perimenopause, you can give birth control pills that level things out. If they are in the late perimenopause and they start skipping periods, they can be put on estrogen patches,” Pavlovic said.

But hormones may not always be the culprit. Although the number of migraines rose 76 percent during menopause, some headaches may be the result of medication overuse, which is common in this age group, according to Martin.

“Women, as they get older, develop lots of aches and pains, joints and back pain, and it is possible their overuse of pain medications for headache and other conditions might actually drive an increase in headaches for the menopause group,” he said.

About 12 percent of Americans get migraines, and women get them three times more often than men, the researchers said.

The study was published online Jan. 21 in Headache: The Journal of Head and Face Pain.

More information

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

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Gecko Study Squashes Dreams of a Real ‘Spiderman’

FRIDAY, Jan. 22, 2016 (HealthDay News) — The hopes of all Spiderman wannabees may have been shattered by a new study.

British researchers at the University of Cambridge looked at a variety of creatures that manage to easily scale vertical walls.

The new findings suggest that sticky-footed geckos represent the size limit for any animal that can safely do so.

According to the research, larger animals would need unmanageably large, sticky feet to clamber up walls, Spidey-style.

In fact, any real-life Spiderman would need adhesive pads on 40 percent of their total body area — about 80 percent of their front — to scale a wall, the researchers said.

“If a human, for example, wanted to walk up a wall the way a gecko does, we’d need impractically large sticky feet — our shoes would need to be a European size 145 or a US size 114,” study senior author and zoologist Walter Federle said in a university news release.

“We were looking at vastly different animals — a spider and a gecko are about as different as a human is to an ant — but if you look at their feet, they have remarkably similar footpads,” added study lead author David Labonte, also a zoologist.

His team determined that in climbing animals such as mites, spiders, tree frogs and geckos, the percentage of body surface covered by sticky footpads increases with body size. For example, mites use about 200 times less of their total body area for adhesive pads than geckos.

While the findings are disappointing news for would-be superheroes, they could have practical applications, perhaps in the development of powerful new adhesives.

“Our study emphasizes the importance of scaling for animal adhesion, and scaling is also essential for improving the performance of adhesives over much larger areas,” Labonte said. “There is a lot of interesting work still to do looking into the strategies that animals have developed in order to maintain the ability to scale smooth walls, which would likely also have very useful applications in the development of large-scale, powerful, yet controllable adhesives.”

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

More information

The San Diego Zoo has more about geckos.

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U.S. Ob-Gyn Group Supports Zika Virus Travel Precautions

FRIDAY, Jan. 22, 2016 (HealthDay News) — The American College of Obstetricians and Gynecologists (ACOG) — the largest organization representing obstetricians and gynecologists in the United States — said Thursday that it supports new guidelines aimed at shielding pregnant women from the mosquito-borne Zika virus.

The virus — now present in many countries and regions in Central and South America and the Caribbean — can cause a serious birth defect, according to the U.S. Centers for Disease Control and Prevention.

Thousands of babies in Brazil were born last year with microcephaly, a brain disorder that experts associate with Zika exposure. Babies with the condition have abnormally small heads, resulting in developmental issues and, in some cases, death.

The CDC also said that cases of the neurological disorder Guillain-Barre syndrome have been reported in patients with probable Zika virus infection in Brazil and French Polynesia, although more study is needed to confirm the link.

According to a statement released late Thursday, ACOG is urging pregnant women and those planning a pregnancy to follow Zika virus travel and health guidelines recently issued by the CDC.

“Travel to regions with ongoing Zika virus outbreaks is not recommended for women who are pregnant or women who are considering pregnancy,” ACOG President Dr. Mark DeFrancesco said in the statement.

One week ago, the CDC issued a travel warning for pregnant women or women planning to get pregnant for the following countries and territories: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and Puerto Rico.

On Friday, the CDC added eight new countries to that list: Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin, Guyana, Cape Verde, and Samoa.

The CDC says doctors should ask all pregnant patients about recent travel and specific symptoms, such as a sudden fever or rash. If Zika virus infection is possible, doctors should have the patient tested for the virus.

If tests reveal signs of infection, ultrasounds should be considered to monitor the fetus’ development, and referral to a maternal-fetal medicine or infectious disease specialist with expertise in pregnancy management is also recommended, the CDC advised.

According to ACOG’s DeFrancesco, “there is much that we do not yet know about the Zika virus and its effects during pregnancy, for example whether pregnant women are of greater risk of infection than non-pregnant individuals. However, because of the associated risk of microcephaly, avoiding exposure to the virus is best. That’s why pregnant women and women who are considering pregnancy should delay planned travel to areas where Zika virus outbreaks are ongoing.”

Moreover, he added, “women traveling to areas where Zika virus has been reported should take all precautions to avoid mosquito bites, including covering exposed skin, staying in indoor- or screened-in areas, and using EPA-approved bug spray with DEET (which is safe for use during pregnancy),” DeFrancesco said.

“Because some women may have traveled to affected areas prior to this advisory, obstetrician-gynecologists and other health care providers should ask all pregnant women about recent travel, and women who have traveled to these regions should be evaluated for Zika virus infection,” DeFrancesco advised.

“Because there is no treatment for Zika virus at this time, women should be counseled about all options available to them,” he said. “When possible, delivery at a center with the appropriate levels of neonatal expertise may be warranted,” he suggested.

“Of course, this is an evolving area,” DeFrancesco noted. “We encourage health care providers and patients to continue to monitor the CDC for updated information.”

More information

The U.S. Centers for Disease Control and Prevention has more about the Zika virus.

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