Hormone Exposure in Womb May Boost Later Type 2 Diabetes Risk

THURSDAY, March 24, 2016 (HealthDay News) — Exposure to the hormone leptin in the womb may increase a child’s risk of developing type 2 diabetes, a new mouse study suggests.

Leptin is secreted by fat cells. It helps maintain energy balance in the body, the study authors explained.

The findings from experiments in mice could improve understanding of how type 2 diabetes develops in children, particularly for those with obese mothers, the researchers said.

It’s important to note, however, that animal research often doesn’t produce similar results in humans.

The study was published online March 24 in the journal Cell Reports.

“We showed that exposure of the embryonic mouse brain to leptin during a key developmental period resulted in permanent alternations in the growth of neurons from the brain stem to the pancreas, resulting in long-term disturbances to the balance of insulin levels in the adult mouse,” Sebastien Bouret said in a journal news release. He’s a researcher in the developmental neuroscience program at Children’s Hospital of Los Angeles.

The pancreas produces and releases insulin, the hormone that controls blood sugar (glucose) levels. Lack of sufficient insulin can lead to diabetes.

“This breakdown in communication from the brain to the pancreas resulted in impaired glucose regulation, or homeostasis, in the adult mouse,” Bouret added.

Bouret said that babies born to obese mothers have high levels of leptin. This, he said, “might put them at a higher risk for type 2 diabetes and obesity.”

More information

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

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Kids’ Fruit Drinks, Juices Contain Day’s Worth of Sugar

THURSDAY, March 24, 2016 (HealthDay News) — Many commercially sold fruit drinks and juices give kids a full day’s worth of sugar in a single serving, a new British study shows.

One U.S. expert said she wasn’t surprised by the finding.

“I believe the results would be very similar if this study was conducted with fruit drink products available in the United States,” said Pamela Koch, executive director of the nutrition program at Teachers College, Columbia University, in New York City.

“Many fruit drinks are excessively high in added sugars, as this study found. Yet, these are often marketed as healthful products, confusing parents and children,” she said.

The British study was led by Simon Capewell, a professor at the Institute of Psychology, Health and Society at the University of Liverpool. His team calculated levels of “free” sugars in 200-milliliter sizes (nearly 7 ounces) of 203 fruit drinks, 100 percent natural juices and smoothies marketed specifically to children.

Free sugars include those added to products — such as glucose, fructose, sucrose and table sugar — as well as naturally occurring sugars in honey, syrups, fruit juices and fruit juice concentrates. Naturally occurring sugars in whole fruits and vegetables are not free sugars.

Nearly half of the children’s products in the study had at least a child’s entire daily recommended maximum sugar intake of 19 grams (five teaspoons) of sugar, the researchers report.

In a university news release, Capewell said that as parents learn more about the high sugar content of sodas and other sweetened drinks, many “opt for seemingly healthier fruit juice and smoothie alternatives.”

“Unfortunately, our research shows that these parents have been misled,” he said. “The sugar content of the fruit drinks, including natural fruit juices and smoothies tested, is unacceptably high. And smoothies are among the worst offenders.”

The solution? When possible, parents should give children fresh fruit instead of fruit juice, Capewell said. When giving children fruit juice, choose unsweetened juice, dilute juice with water, only serve it during meals, and limit the amount to 150 ml (about 5 ounces) a day, the researchers recommended.

In the meantime, “manufacturers should stop adding unnecessary amounts of sugars, and therefore calories, to their fruit drink/juice/smoothie products,” Capewell said.

However, a group representing makers of 100 percent fruit juices took issue with the findings.

“Parents should feel good about serving 100 percent juice to their children in appropriate amounts as a body of research shows drinking 100% juice is not associated with dental [cavities] in early childhood and in fact, some studies show greater frequency of juice drinking may even have a protective effect on dental health in children,” the U.S.-based Juice Products Association said in a statement.

“Weight is also not an issue, as a systematic scientific review of the evidence found drinking appropriate amounts of 100 percent juice is not associated with weight status or obesity in children,” the group said.

Nancy Copperman, a nutritionist and assistant vice president of public health at Northwell Health in Great Neck, N.Y., begged to differ. She agreed with the study authors that the excessive amounts of “empty calories” in fruit drinks and juices is a problem that “crosses continents.”

“The 2015 U.S. Dietary Guidelines recommends limiting added sugars to less than 10 percent of children’s total calories and promotes eating fruit, rather than drinking 100 percent juice, to meet the suggested daily servings of fruits and vegetables,” Copperman said.

She did make one distinction, however.

“In this study, the sugar content of 100 percent juices were higher than juice drinks. However, the sugar in the pure juice was from the naturally occurring form of sugars found in fruit,” Copperman said. “Fruit drinks and smoothies contained added sugars — such as high fructose corn syrup — which are not naturally present in fruit or fruit juices and significantly add to empty calories.”

The study was published March 24 in the online journal BMJ Open.

More information

The American Heart Association has more on added sugars.

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Could Lots of Time Spent on Social Media Be Tied to Depression?

By Alan Mozes
HealthDay Reporter

THURSDAY, March 24, 2016 (HealthDay News) — The more time young adults spend using popular social media, the greater the link to depression, new research suggests.

The finding stems from research — which involved nearly 1,800 men and women between the ages of 19 and 32 — that tried to get a handle on how depression and social media habits may interact.

But does greater involvement with social media actually promote depression? Or, are people who are already depressed simply more likely to gravitate to social media? The jury, according to the study authors, is still out.

“One strong possibility is that people who are already having depressive symptoms start to use social media more, perhaps because they do not feel the energy or drive to engage as many in direct social relationships,” said senior study author Dr. Brian Primack. He is the director of the Center for Research on Media, Technology, and Health at the University of Pittsburgh.

“However, there are also a few reasons why increased social media use may lead to more depressive thoughts,” Primack added. “For example, people who engage in a lot of social media use may feel they are not living up to the idealized portraits of life that other people tend to present in their profiles. This phenomenon has sometimes been called ‘Facebook depression.’ “

Primack also suggested that there might be a “vicious circle” at play, in which depressed people turn to social media only to have their depression worsen.

And the study only showed an association, and not a cause-and-effect relationship, between social media use and depression.

“What we found were just overall tendencies for the entire population. These findings do not suggest that every person who engages with more social media use is depressed,” Primack stressed.

“In fact, there certainly are many groups of people who actually find solace and lessening of their depression through social media,” he added. “However, the overall findings [of the new study] suggest that, on a population level, more social media use and more depression are correlated.”

Primack and his colleagues reported their findings in the April 1 issue of the journal Depression and Anxiety. The research was funded by the U.S. National Institutes of Health.

In the study, investigators administered a questionnaire that tallied the amount of time study participants spent on 11 well-known social media platforms: Facebook, YouTube, Twitter, Google Plus, Instagram, Snapchat, Reddit, Tumblr, Pinterest, Vine and LinkedIn.

The team found that, on average, participants checked in with social media 30 times each week, for just over an hour a day.

Depression testing further revealed that roughly one-quarter of the participants appeared to be at high risk for depression.

When social media patterns were stacked up against depression status, the researchers found that those who used social media the most were about 2.7 times more likely to be depressed than those who used such forums the least.

The findings held up even after accounting for age, gender, race/ethnicity, relationship status, and economic and educational status.

The researchers suggested that, going forward, doctors might do well to explore social media habits among their depressed patients.

Joe Bayer, a Ph.D. candidate in communication studies at the University of Michigan, was hesitant to draw too firm a conclusion from the study findings.

“I’m surprised at the size of the effect the authors are reporting, but skeptical about the measures and analyses used,” he said. For example, Bayer noted that efforts to assess the ramifications of social media use purely on the basis of the amount of time people spend online can lead to “inaccurate” and less-nuanced findings.

He also expressed skepticism about “any implications for causation,” when it comes to depression risk and social media use.

“As such,” Bayer said, “there is a great deal more work needed to establish a reliable link between social media use and depression.”

More information

There’s more on depression at the U.S. National Institute of Mental Health.

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Spare Dying Patients Electric Shocks From Heart Device, Docs Say

THURSDAY, March 24, 2016 (HealthDay News) — Dying patients with an implantable heart defibrillator don’t know the device can be turned off so that it doesn’t give them painful shocks during their last days of life, researchers report.

Implantable cardioverter defibrillators (ICDs) are surgically implanted in people with certain heart conditions. They deliver a shock to restore normal heart rhythm when they detect a potentially deadly abnormal rhythm.

Doctors are encouraged to inform patients with an implantable cardioverter defibrillator about the benefits of deactivating the device when they are near death. But research shows that up to 31 percent of people with an ICD receive shocks in their final days.

Two new studies provide further proof that many doctors aren’t following the Heart Rhythm Society and European Society of Cardiology recommendations.

A Spanish study of 243 patients with implantable cardioverter defibrillators found that only 38 percent knew they could choose to deactivate their ICD after consulting with their doctor. And only 37 percent knew that ICD deactivation is ethical and recommended by major medical groups.

And a study in the Netherlands of 328 patients with ICDs found that 73 percent knew their device could be turned off, but just 12 percent had talked with their doctor about it.

The studies are to be presented April 2 at an American College of Cardiology meeting in Chicago.

“When you reach the stage of palliative care, sometimes the ICD doesn’t have a role in caregiving anymore,” said Dr. Dilek Yilmaz, a fellow in cardiology at Leiden University Medical Center and lead author of the Dutch study.

“If a person is dying of a terminal cancer, for example, the ICD is not going to prolong their life, but it is fairly likely to cause pain in their last hours and prevent them from having a peaceful death,” Yilmaz explained in a college news release.

These shocks are often much more frequent on the patient’s last day than any other day of their life, said Dr. Silvia del Castillo, a cardiologist at Fuenlabrada University Hospital in Madrid and lead author of the Spanish study.

“I think it’s cruel in many cases to leave the ICD on until the very end, and when doctors don’t provide enough information about deactivation or delay that conversation until the final hours, it undercuts the patient’s right to make their own decisions,” del Castillo said in the news release.

About 100,000 ICDs are implanted each month in the United States, the researchers said. The devices can be deactivated in a cardiologist’s office without additional surgery.

Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

More information

The Heart Rhythm Society has more about ICDs.

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‘Love Hormone’ Levels in Pregnancy May Point to Risk for Postpartum Depression

THURSDAY, March 24, 2016 (HealthDay News) — Higher levels of the mother-child bonding hormone oxytocin during pregnancy may be associated with increased risk of postpartum depression in some women, researchers say.

The findings suggest it may eventually be possible to develop a test to predict postpartum depression and provide preventive treatment during pregnancy.

The study results are “not ready to become a new blood test yet,” said lead investigator Dr. Suena Massey, an assistant professor of psychiatry and behavioral sciences at Northwestern University’s Feinberg School of Medicine, in Chicago. “But it tells us that we are on the track to identifying biomarkers to help predict postpartum depression,” she said.

According to background notes with the study, oxytocin is a hormone that plays a role in aiding delivery and lactation, social bonding and stress management.

The study included 66 healthy pregnant women who were not depressed. Researchers measured their oxytocin levels in the third trimester of pregnancy and their depression symptoms six weeks after they gave birth.

Among the 13 women with a history of depression before pregnancy, the higher their oxytocin levels, the more depression symptoms they had six weeks after giving birth, according to the study.

The finding was a surprise, said Massey.

“There’s emerging research that a past history of depression can change the oxytocin receptor in such a way that it becomes less efficient,” she said in a university news release. “Perhaps, when women are starting to experience early signs of depression, their bodies release more oxytocin to combat it.”

The study was recently published in the journal Archives of Women’s Mental Health.

More information

The U.S. National Institute of Mental Health has more on postpartum depression.

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Daytime Sleepiness, Long Naps Linked to Heart Risks: Study

THURSDAY, March 24, 2016 (HealthDay News) — While getting enough sleep is key to health, a new study suggests that long daytime naps may not be doing your heart any favors.

The researchers found that long naps and excessive daytime sleepiness were associated with an increased risk for a combination of health problems that are collectively known as metabolic syndrome. And that can boost the risk of heart disease and diabetes.

Metabolic syndrome includes conditions such as high blood pressure, high cholesterol, high blood sugar and excess fat around the waist.

The investigators analyzed the findings of 21 studies that included a total of more than 307,000 people. The research showed that people who napped for less than 40 minutes were not at increased risk for metabolic syndrome. In fact, those who napped less than 30 minutes had a slight decrease in risk.

But there was a sharp rise in risk among those who napped for more than 40 minutes, the study authors said. For example, napping for more than 90 minutes appeared to increase the risk of metabolic syndrome by as much as 50 percent, as did excessive daytime sleepiness.

The review also found that napping for more than an hour or being overly tired during the day were both linked with a 50 percent higher risk for type 2 diabetes.

However, the study only found an association between these factors, and did not prove that excessive sleepiness and long naps actually cause metabolic syndrome or diabetes.

The findings are to be presented April 3 at an American College of Cardiology (ACC) meeting in Chicago. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

“Taking naps is widely prevalent around the world,” study author Dr. Tomohide Yamada, a diabetologist at the University of Tokyo, said in an ACC news release. “So, clarifying the relationship between naps and metabolic disease might offer a new strategy of treatment, especially as metabolic disease has been increasing steadily all over the world,” he added.

About one-third of American adults do not get enough sleep, according to the U.S. Centers for Disease Control and Prevention. The National Sleep Foundation recommends naps of 20 to 30 minutes to boost alertness.

“Sleep is an important component of our healthy lifestyle, as well as diet and exercise,” Yamada said. “Short naps might have a beneficial effect on our health, but we don’t yet know the strength of that effect or the mechanism by which it works.”

More information

The American Academy of Family Physicians has more on metabolic syndrome.

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More U.S. Women Delivering Babies at Home or Birth Centers

By Kathleen Doheny
HealthDay Reporter

WEDNESDAY, March 23, 2016 (HealthDay News) — More women in the United States are choosing to deliver their babies at home or in birth centers, a new study indicates.

In 2014, nearly 60,000 babies were born outside a hospital, the researchers said. While that is still a small minority of all births, the trend has been gathering steam in the last decade, the study authors added.

In 2004, less than 1 percent of U.S. births occurred out of hospitals, said report author Marian MacDorman. She is a research professor at the Maryland Population Research Center at the University of Maryland, in College Park.

By 2014, the number of out-of-hospital births had increased to 1.5 percent, the study found.

Women who opted for home or birth centers to deliver their babies tended to have low-risk pregnancies, MacDorman said.

The researchers looked at birth certificate data over the years from 47 states and the District of Columbia. MacDorman’s team found both geographic variation and other differences between mothers who went to the hospital and those who chose to give birth at home or in a birth center.

The Pacific Northwest had the highest rate of out-of-hospital births, while the deep South had the lowest. Mothers who gave birth at home were half as likely to be obese before getting pregnant, less likely to smoke and more likely to plan on breast-feeding. They were also more likely to be college graduates, the researchers said.

Nearly 79 percent of those who planned home births and over 92 percent who opted for birth centers had a midwife help deliver the babies. Only 8 percent of hospital births had midwives deliver the babies, the findings showed.

To make home births safer, MacDorman said women should be sure they are at low-risk, have a properly trained midwife, and be sure the midwife has relationships with doctors and hospitals so the mother and baby can be transferred if necessary.

A low-risk woman would have no high blood pressure, no diabetes or other chronic conditions, MacDorman said. “About 10 to 15 percent of women who labor at home end up having to go to the hospital,” she noted.

The study findings were published online this month in the journal Birth.

One expert pointed out that any birth outside a hospital can be risky.

“The bottom line is [that] any home delivery is a risk,” said Dr. David Mendez, neonatologist at Nicklaus Children’s Hospital in Miami.

In a hospital birth, he said, the risk of a baby dying is two in 1,000. “That number doubles with home delivery,” he said.

Mendez views birth centers as a good compromise for women who want a more natural experience, because they have medical personnel on hand if something goes wrong. “Birth centers are set up for a possible emergency, but the home birth experience isn’t,” he said.

One major concern, Mendez said, is the number of women in the study who chose home births but wanted a vaginal birth after a cesarean delivery, known as a VBAC.

“A lot of hospitals still don’t let women do a VBAC,” he said. Uterine rupture, an emergency situation, is a known risk for these women.

Despite the pros and cons, Mendez said he respects a woman’s right to decide where she wants to deliver her baby. Being aware of the risks, however, is crucial in making that decision, he added.

More information

To learn more about home births, visit the American Pregnancy Association.

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The Weird Thing That Can Happen to Your Teeth Before Your Period

Photo: Getty Images

Every few weeks, I get some uncomfortable sensations in my mouth. My teeth feel achy and loose. My gums are swollen and sensitive. And I have a desire to brush my teeth every couple of hours. These symptoms go away after a few days, but until then nothing seems to help.

The last time this happened, I finally consulted Dr. Google and came upon a condition called menstruation gingivitis—an inflammation of the gums that typically begins just before a woman’s period and goes away once her period starts.  

The symptoms matched mine, and after glancing at the calendar, I realized the timing made perfect sense. Mystery solved!

RELATED: Your Guide to Healthy, White Teeth

In search of more info, I called ob-gyn Mary Rosser, MD, PhD, at Montefiore Health System in New York City, who explained that women are more susceptible to gingivitis thanks to natural fluctuations in our hormone levels.

“A surge in the female hormones estrogen and progesterone causes an increase in blood flow to the gums, and a decrease in the way that we can fight off plaque and other toxins,” says Dr. Rosser. Plaque build-up irritates the gums, which become tender, swollen, and red, and some women see blood while they’re flossing or brushing their teeth. They may also develop sores on the insides of their cheeks. These symptoms tend to strike before menstruation and during pregnancy.

RELATED: 20 Things That Can Ruin Your Smile

There are a few other times in a woman’s life when she might develop periodontal problems due to changing hormones: during puberty, after menopause, and if she takes oral contraceptives (especially progesterone-only pills), says Dr. Rosser.

While the hormonal changes don’t cause gum disease, they can exacerbate any symptoms that you already have. That’s why Dr. Rosser stresses the importance of maintaining good dental hygiene year-round, and visiting your dentist every six months. Damage from gingivitis can be reversed if you’re diligent about those biannual appointments and the proper at-home cleaning routine—that means brushing, flossing, and rinsing with mouthwash twice a day.

RELATED: Best and Worst Food for Your Teeth

If your gums start to bleed when you floss before your period or during pregnancy, it may be tempting to quit this healthy habit. Don’t, Dr. Rosser cautions. Flossing will help lower your risk of developing more serious periodontal disease down the road.

Another tip: Consider cutting back on sugar and carbohydrates, she suggests. That may help ease the inflammation. But if at any point you notice that your symptoms are worse than usual, it’s worth scheduling a visit with your dentist to get checked out, says Dr. Rosser.

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Statewide Training on Cardiac Arrest Saves Lives in N. Carolina

WEDNESDAY, March 23, 2016 (HealthDay News) — A North Carolina program to increase bystander action in cases of cardiac arrest saved lives and reduced brain damage among survivors, a new study shows.

The statewide program trained family members and the general public to recognize the signs of sudden cardiac arrest and to perform CPR and use automated external defibrillators (AEDs).

“You can do something,” said study author Dr. Christopher Fordyce, of the Duke Clinical Research Institute in Durham, N.C. “You don’t have to just call 911 and stand while your loved one is on the floor. Start chest compressions immediately. Your actions actually make a difference.”

Cardiac arrest is the sudden loss of heart function in someone with or without known heart disease, according to the American Heart Association.

The North Carolina study found that the rate of bystander CPR for cardiac arrests that occurred in public places rose from 61 percent in 2010 to more than 70 percent in 2014. And, the rate of bystander CPR for cardiac arrests that occurred in homes rose from just over 28 percent to just over 41 percent.

In-home defibrillator use by bystanders rose from about 42 percent to more than 50 percent. There was no increase in AED use in public places, likely due to timely defibrillator use by emergency medical service personnel, according to the study authors.

The study is to be presented April 3 at an American College of Cardiology meeting in Chicago.

Meanwhile, rates of patients who survived until they left the hospital rose from about 11 percent to nearly 17 percent for public cardiac arrests, and from less than 6 percent to 8 percent for in-home cardiac arrests.

Gains in brain function were reported as well. Rates of patients who had minor or no loss of brain function rose from almost 5 percent to slightly more than 6 percent for in-home cardiac arrests, and from 9.5 percent to close to 15 percent for public cardiac arrests, the researchers said.

“The absolute rates are small, but the relative changes were pretty large. That’s only over five years, so if we continue to educate the public, we can continue to improve outcomes,” Fordyce said in a cardiology meeting news release.

“What’s interesting about this study is it’s the first time a statewide intervention has improved both public and residential cardiac arrest outcomes,” he noted.

Each year, more than 420,000 out-of-hospital cardiac arrests occur in the United States, the researchers said.

Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.

More information

The American Heart Association has more about cardiac arrest.

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Depression Tied to Worse Outcomes for Heart Patients

WEDNESDAY, March 23, 2016 (HealthDay News) — People who develop depression after being diagnosed with heart disease may be more likely to have a heart attack or die than those without depression, a new study finds.

The study included nearly 23,000 heart patients in the Canadian province of Ontario who were diagnosed with heart disease between late 2008 and late 2013.

During an average follow-up of three years, those with depression were 83 percent more likely die of any cause and 36 percent more likely to have a heart attack than those without depression.

Depression did not affect the chances of needing bypass surgery or heart artery stents.

However, the study did not prove that depression caused an increased risk for heart attack and death in these patients. It only found an association between those factors.

The study will be presented April 4 at an American College of Cardiology meeting in Chicago. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

“Patients who develop depression after being diagnosed with heart disease have a much worse prognosis,” said lead researcher Dr. Natalie Szpakowski, an internal medicine resident at the University of Toronto.

“Our findings suggest that these patients may need to be screened for mood disorders, whether it’s by their family doctor or cardiologist,” she said in an American College of Cardiology news release.

The researchers also found that patients with depression were more likely to be women and to have more severe chest pain. Other factors associated with depression included smoking, diabetes and having a higher number of other health problems.

“This is consistent with the literature in that women are more prone to depression, whether it’s due to sex hormones or social roles, we don’t fully know,” Szpakowski said. “Other studies have also found that more severe chest pain has been linked to depression, and we know people with more medical illnesses are more susceptible to being depressed.”

More information

The U.S. National Library of Medicine has more on heart disease and depression.

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