Smoking in Pregnancy May Be Under-Reported

THURSDAY, July 7, 2016 (HealthDay News) — A significantly higher percentage of American women may be smoking while pregnant than researchers have previously believed, a new study suggests.

The finding is based on urine tests that can measure nicotine exposure compared to what pregnant women report about their smoking habits.

“We have long suspected that smoking status during pregnancy is under-reported,” study senior author Dr. Jim Greenberg, director of the Perinatal Institute at Cincinnati Children’s Hospital, said in a hospital news release.

“But now we know just how many women struggle to quit smoking when they are pregnant,” he added.

Smoking while pregnant boosts the risk for premature birth by as much as 25 percent, the study authors noted. Smoking is also associated with the three most common causes of infant death. It’s also considered to be a risk factor for both sudden infant death syndrome (SIDS) and birth defects, the researchers said.

For the study, the investigators reviewed the birth records of more than 700 women who gave birth at a single hospital in Ohio between 2014 and 2015. In Ohio, such records include pregnant women’s self-reported smoking habits during their last trimester.

These self-reports were cross-referenced with urine samples taken from the same women. Those samples are now routinely obtained in maternity centers in southwest Ohio to test for drug use, so that babies exposed to opioids in the womb can be treated quickly after birth, the study authors explained.

Just under 9 percent of women admitted to smoking while pregnant, but markers for tobacco found in the urine suggested that 16.5 percent had high levels of nicotine exposure during pregnancy. An additional 7.5 percent had low-level nicotine exposure, the study found.

Another 7.5 percent of the women tested positive for exposure to secondhand smoke while pregnant, the findings showed.

About 8 percent of black women in the study group admitted to smoking cigarettes. But urine tests suggested that 21 percent were smokers, according to the report.

“This is extremely important new information for us as we work to better understand risk factors for preterm birth,” Greenberg noted.

The investigators said that the findings point to a need for increased public health efforts to help women — especially minority women — quit smoking during pregnancy.

The study was published online July 7 in the Journal of Perinatology.

More information

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

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Researchers Get Closer to Test Predicting Colon Cancer’s Return

THURSDAY, July 7, 2016 (HealthDay News) — A blood test that detects bits of DNA shed from colon cancers may someday help doctors predict a relapse, researchers report.

This “liquid biopsy” predicted — with imperfect accuracy — the return of colon cancer in patients with early forms of the disease, the team said.

“Although this and other DNA-based blood tests are not perfect, this study shows that when we find tumor DNA circulating in the blood of cancer patients, recurrence is very likely,” said study co-author Nickolas Papadopoulos. He is professor of oncology at the Johns Hopkins University School of Medicine in Baltimore.

As the researchers explained, stage 2 colon tumors generally have not yet spread to other organs in the body. This makes it tough to determine which patients stand to benefit from chemotherapy after their surgery.

“Some of these [stage 2] cancers will recur, and we need to improve our diagnostic approaches to detect recurrence earlier than it can be found with current, conventional methods,” Dr. Bert Vogelstein, co-director of the Ludwig Center at the Johns Hopkins Kimmel Cancer Center, said in a hospital news release.

A test that could spot patients with a high chance of cancer recurrence would help with those decisions, the researchers said.

In the study, investigators at Johns Hopkins and the University of Melbourne followed 230 patients with stage 2 colon cancer treated at 13 hospitals in Australia for four years.

The researchers collected more than 1,000 blood samples from the participants before and after surgery, and also performed genetic analysis of tissue samples derived from the patients’ tumors.

During the study, cancer-related mutations in each blood sample were monitored using DNA tests. Patients also underwent a CT scan of their entire body every six months after surgery for two years, looking for tumor recurrence.

Among the 230 patients, 20 did show telltale cancer-linked DNA fragments in their blood, the study authors reported.

Of these 20 patients, six went on to receive additional chemotherapy, and three of those six did experience a cancer recurrence.

Of the 14 who did not undergo additional chemotherapy, 11 developed a recurrence of their tumor, detected on a CT scan, according to the report.

The test was not perfect: The researchers noted that another 14 patients experienced cancer recurrences, even though their blood tests did not detect cancer-linked DNA.

Good methods to predict patients’ risk for cancer recurrence are needed, the researchers said, and labs around the world are working to develop DNA-based tests. However, at the present time there are no such tests for cancer approved by the U.S. Food and Drug Administration.

Cost could be an issue, too: According to the study authors, it’s estimated that, if approved, these blood tests would cost hundreds or even thousands of dollars, and it’s unclear if insurance companies would reimburse the cost.

Two colon cancer experts agreed that the new study is promising, but more research is needed.

“This study is an important first step, but it remains a first step of a likely long road ahead to perfect this technology to the point where it can be clinically useful and affordable to our health system,” said Dr. David Bernstein, chief of hepatology at Northwell Health in Manhasset, N.Y.

Dr. David Rivadeneira directs colon and rectal surgery at Huntington Hospital in Huntington, N.Y. He agreed that although the new findings are “encouraging . . . it is still early in the process and is not to be considered standard of care.”

The study was published July 6 in Science Translational Medicine.

More information

The American Cancer Society has more about colon cancer detection.

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HPV-Linked Cancers Still Climbing in U.S.

THURSDAY, July 7, 2016 (HealthDay News) — Cancers linked to the sexually transmitted human papillomavirus (HPV) keep rising in the United States, even though most cases are preventable, health officials reported Thursday.

Cervical cancer, and mouth and throat cancers in men, accounted for most of the nearly 39,000 HPV-associated cancers diagnosed annually from 2008 to 2012, according to the U.S. Centers for Disease Control and Prevention.

HPV vaccination and cervical cancer screening could keep more than 28,000 of these cancers from developing, the agency estimated.

“Most cervical cancers are preventable with regular screening for precancerous lesions among women aged 21 to 65 years, linked with follow-up for abnormal test results,” the CDC researchers wrote in the report.

But cancer experts said that public perception may have to change first, especially with respect to HPV vaccination.

“In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer,” said Electra Paskett. She is co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer in Columbus.

“Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes — and we would have a dramatic decrease in HPV-related cancers across the globe,” Paskett added.

At current rates, these sexually linked cancers are developing in almost 12 of every 100,000 persons, the CDC said. In the previous five-year period, fewer than 33,500 of these HPV-linked cancers were diagnosed annually.

Using data from national cancer registries, CDC analysts looked for certain cancer types — cervical, head and neck, and anal, among them — that have links to HPV. They found an average of 38,793 such cancers annually from 2008 to 2012.

When looked at closely, researchers confirmed the HPV connection in 79 percent — or 30,700 — of cases. This included about 19,200 cancer diagnoses in females and 11,600 diagnoses in males.

The agency estimates that as many as 28,500 of these were preventable with recommended HPV vaccination.

In men, the head and neck cancers mainly involved the tongue, tonsils and pharynx — or “oropharyngeal” cancers, the agency reported. They’re often symptom-free, but may include persistent sore throat, earaches and pain when swallowing, according to the CDC.

Breaking down the figures, whites had higher rates of oral and throat cancers than blacks and Hispanics, the report found.

However, Hispanics and blacks were more likely to have cervical cancer than whites. The state with the highest cervical cancer rate was West Virginia; Vermont’s rate was the lowest, according to the report.

“Full vaccination coverage of the U.S. population could prevent future HPV-attributable cancers and potentially reduce racial and ethnic disparities in HPV-associated cancer incidence,” according to report author Dr. Laura Viens and colleagues.

The findings were published in the July 8 issue of the Morbidity and Mortality Weekly Report.

The CDC recommends routine HPV vaccination at ages 11 to 12 for boys and girls, and through age 26 for females and age 21 for males if they were not previously vaccinated.

Anyone who has ever had sex — genital or otherwise — can get HPV, scientists say.

Oral cancers in particular are HPV-related, said Dr. Jill Rabin of Northwell Health in New Hyde Park, N.Y.

“This is important since oral-genital contact may be quite prevalent and teens may not consider this as ‘true’ sexual activity,” Rabin said. Oral-genital sex also places teens at risk for penile, rectal and vulvar-vaginal cancers, she said.

“The reason the vaccine is given to girls (aged 9 to 26) and boys (aged 9 to 21) is that the younger the person is vaccinated, the better they will respond in making antibodies which help fight and prevent the HPV,” Rabin explained.

“We give the vaccine now, in other words, to protect against exposure to HPV later, when they are older,” she said.

More information

The U.S. National Cancer Institute has more on HPV vaccination.

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Depression Strikes Nearly 3 Million U.S. Teens a Year

THURSDAY, July 7, 2016 (HealthDay News) — In just one year, almost 3 million U.S. teens suffered a major bout of depression, a new government report shows.

“Adolescence is a critical time in a person’s development, and battling with depression can be devastating for teens unless they receive effective treatment,” said Paolo del Vecchio, director of the Center for Mental Health Services at the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

“Effective treatment is available, but parents, teachers and all concerned members of the community must work to assure that adolescents in need get help,” del Vecchio said in an agency news release.

These young people feel depressed and lose interest in their activities for at least two weeks. They may also have trouble sleeping, eating or concentrating, the agency explained.

The overall rate of depression among young people jumped to 11 percent between 2013 and 2014, up from 9.9 percent the previous year, the SAMHSA report found. The report was published July 7.

While 13 states saw statistically significant increases in the prevalence of major depressive episodes among teens, 37 states and District of Columbia saw little change.

Rates of major depressive episodes among young people between the ages of 12 and 17 were highest in Oregon, with an annual average of 14.6 percent. Other states with a greater prevalence of depression included Arizona, Indiana, Maine, New Hampshire, Rhode Island, Utah, Virginia, Washington state and Wisconsin.

On the opposite end of the spectrum, the District of Columbia had the lowest prevalence of major depressive episodes among teens, with an annual average of 8.7 percent. Rates of this condition were also low among teens in Alaska, Connecticut, Georgia, Hawaii, Kentucky, New Mexico, North Dakota, South Dakota and Tennessee.

More information

The U.S. National Institute of Mental Health provides more information on teen depression.

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Innovative Trials Produce Promising Breast Cancer Drugs

By Dennis Thompson
HealthDay Reporter

THURSDAY, July 7, 2016 (HealthDay News) — An innovative set of clinical trials have identified two drugs that could provide a fighting chance for women with advanced breast cancer.

The drugs, neratinib and veliparib, both appear effective in helping women diagnosed with stage 2 or 3 breast cancer, researchers report.

These are the first two drugs to come out of the I-SPY clinical trials, a research effort intended to streamline drug testing by better guiding treatments to those who would most benefit from them, said one of the study authors, Dr. Laura Esserman. She is director of breast cancer care at the University of California, San Francisco’s Comprehensive Cancer Center.

The results:

• Neratinib halted the spread of cancer in 56 percent of women with HER2-positive, hormone-receptor-negative breast cancer, compared with 33 percent of a control group receiving standard chemotherapy alone.
• Veliparib stopped the spread of cancer in 51 percent of women with triple-negative breast cancer, compared to 26 percent in the chemo-only control group.

The I-SPY clinical trials use genetic information from patients to steer them to experimental drugs that are most likely to work, Esserman explained.

The trials also use adaptive design, a process in which doctors use early data from current patients to steer treatment for the next patients in line, she added. For example, a patient might be given a different drug in the trial that is working better in women with her particular type of breast cancer.

“The whole idea of the framework is to allow us to be more innovative and thoughtful, and to drive faster to combinations that might make a huge difference in the response to these agents in women who need them most,” Esserman said.

Dr. Otis Brawley, chief medical officer for the American Cancer Society, said that adaptive design is the wave of the future for clinical trials of cancer drugs.

Genetic research has provided a bevy of new ways to attack cancer, by finding very specific targets against which different drugs can be utilized, Brawley said. Unfortunately, traditional clinical trial design cannot keep up with the pace of genetic revelations concerning cancer, he added.

Brawley noted that in the I-Spy Trials, researchers are using a 70-gene panel to help determine which drugs might be right for which breast cancer patients. Testing each gene or combination of genes with individual drugs would be costly and time-consuming.

“The real aim here is to use the smallest number of people in the shortest period of time to figure out if a drug works,” Brawley said. “It’s especially important to do that as we learn that the number of diseases that we’re going to be testing these drugs on is increasing exponentially as we better understand and define cancer genomically [based on genes].”

A traditional clinical trial focuses on a single drug or combination of drugs, comparing the new treatment to the current standard of care, Esserman said. This amounts to a costly “educated guess” of the experimental treatment’s effectiveness, with no way to change things until the trial is completed.

It typically costs more than $2 billion and takes 12 to 15 years with the involvement of 2,000 to 8,000 patient volunteers to bring one drug to market, the I-Spy Trials notes on its website. Despite the cost and painstaking research, 60 percent to 70 percent of these drugs fail their clinical trials.

The I-SPY Trials currently are in their fifth year, Esserman said, and have included 12 different experimental drugs in the stable of options available to patients. Drugs are cycled in and out of the trials, with about four or five active at any one time.

Neratinib is a tyrosine kinase inhibitor, which fights cancer by interrupting chemical signals that drive tumor growth. Researchers found that neratinib is particularly helpful in women with HER2-positive breast cancer, in which a protein called human epidermal growth factor receptor 2 promotes the growth of cancer cells.

On the other hand, veliparib is a PARP inhibitor, which helps kill cancer cells by weakening them and leaving them more vulnerable to traditional cancer treatments like chemotherapy or radiation therapy.

When combined with traditional carboplatin chemotherapy, veliparib showed promise in treating women with so-called “triple-negative” breast cancer — a tumor that isn’t linked to the three best-known genetic causes for breast cancer.

“All of a sudden you have something that shows really good results against triple-negative breast cancer,” Brawley said. “For the longest time we have not had really good therapy for [triple-negative breast cancer].”

The reported results are for the phase 2 trials of neratinib and veliparib, which establish that a drug has the potential to treat a specific disease, Esserman said. The researchers now will proceed to phase 2 international trials, which are aimed at confirming the results found in phase 2.

The I-SPY Trials are a public/private partnership between QuantumLeap Healthcare Collaborative, Foundation for the National Institutes of Health, the U.S. Food and Drug Administration, the U.S. National Cancer Institute, 16 leading academic centers and the Safeway Foundation, according to the trials’ website.

More information

Here’s more on the I-SPY trials.

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Fish taco bowls with three salsas recipe

 

Get your Mexican fix with this fish taco recipe by pro surfer Sally Fitzgibbons. 

 

What you'll need (serves 4)

• 8 flour tortillas
• 600g white fish fillets
• Canola oil spray
• Flour (for dusting)
• Butter (for frying)
• 1⁄2 iceberg lettuce, finely chopped

 

Guacamole

• 2 ripe avocados 1⁄2 red onion, finely diced 1⁄2 red chilli, deseeded, pith removed, finely sliced 1⁄2 cup coriander leaves, finely chopped
• Juice of 1⁄2 lime Juice of 1⁄2 lemon.

Tomato salsa

• 4 fresh tomatoes, diced 1⁄2 cup coriander leaves, finely chopped 1 red chilli, deseeded and pith
• removed, nely sliced

Mango salsa

• 1 ripe mango, diced 1⁄2 red chilli, deseeded and pith removed, finely sliced Juice of 1 lime 1⁄2 cup mint leaves, finely chopped

Method

1. To shape the tortilla bowls, preheat your oven to 180°C. Wrap four of the tortillas in foil and place on oven tray for 10 minutes just to warm them up.

2. Remove tortillas from foil and spray lightly with oil. Place them between the holes of an upside-down muffin tray, lightly pressing them down in the centre to form the base of the bowl. Repeat with three remaining tortillas. Bake for 10 minutes or until golden. Remove from oven, allow to cool, and repeat with the other four tortillas.

3. To fry the fish, coat both sides of the fillets with our. Heat 2 tbsp of butter in a pan and cook 2 fillets at a time on medium-high heat, 2 minutes per side. The fillet will fall apart when cooked.

4. Serve fish in the tortilla cups with chopped lettuce and salsas.

*If you prefer to a hit of chilli, add the chilli as you go to suit your tastes. 

Catch Sally at the Perth Fitness & Health Expo, August 20-21 at the Perth Convention & Exhibition Centre and the Brisbane Fitness & Health Expo, October 22-23 at the Brisbane Convention & Exhibition Centre. For more information visit the official website.

 

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Repaired ACL More Likely to Tear Again in Young Women

THURSDAY, July 7, 2016 (HealthDay News) — Female athletes younger than 25 have the highest risk for a repeat tear of the knee’s anterior cruciate ligament (ACL) after surgery to repair it, a new study says.

The study included just over 500 male and female athletes who underwent ACL reconstruction with a hamstring graft and were followed for two years. Their average age was 27. They were allowed to return to sports six to 12 months after surgery if they were pain-free, had equal quadriceps/hamstring strength, and had finished a rehabilitation program.

“Our research noted that female patients under the age of 25 with a [smaller] graft size of less than 8 millimeters have an increased chance of re-tearing their ACL following reconstruction,” study lead author Dr. Duong Nguyen said in an American Orthopaedic Society of Sports Medicine news release. He is an orthopedic surgeon and adjunct clinical professor at McMaster University in Toronto.

Nguyen said factors such as estrogen levels, anatomical differences and decreased knee strength might also contribute to repeat tears in some female patients. More research will be needed to determine the exact causes, he added.

“Given the results of our study, we feel that surgeons should counsel their younger, female patients accordingly and consider modifying their surgical techniques to utilize larger size grafts and/or rehabilitation strategies to lessen the chance of a re-tear,” Nguyen said.

The study is scheduled for presentation July 7 at the society’s annual meeting in Colorado Springs, Colo. Research presented at medical meetings is typically considered preliminary because it’s not subject to the same scrutiny as studies in peer-reviewed medical journals.

More information

The U.S. National Library of Medicine has more on ACL injury.

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New Drug Eases Huntington’s Disease Symptoms: Study

By Steven Reinberg
HealthDay Reporter

THURSDAY, July 7, 2016 (HealthDay News) — An experimental drug may help control the involuntary, sudden muscle movements associated with Huntington’s disease, with fewer side effects, according to the results of a small trial.

“Deutetrabenazine is not yet FDA-approved, but assuming it becomes available, practicing clinicians may have another choice for their individual patients,” said lead researcher Dr. Samuel Frank. He is a neurologist and instructor at Harvard Medical School in Boston.

The involuntary movements associated with Huntington’s disease are called chorea.

Huntington’s disease is a fatal genetic disorder. It causes the progressive destruction of nerve cells in the brain. Symptoms vary from person to person. People who have Huntington’s lose their physical and mental abilities over 10 to 25 years. The disease has no cure, according to the Huntington’s Disease Society of America (HDSA).

Every child with a parent with Huntington’s disease has a 50 percent chance of carrying the faulty gene. Approximately 30,000 Americans have symptomatic Huntington’s disease. More than 200,000 are at risk of inheriting the disease, the HDSA says.

The choice of drugs to treat chorea should be based on safety, effictiveness, cost to patients and the best chance of compliance, Frank said.

“The opportunity to possibly improve quality of life should be part of the decision-making process as well,” he said. “If approved by the FDA, deutetrabenazine may provide another treatment option, making Huntington’s disease an increasingly treatable condition.”

Funding for the trial was provided by the maker of the drug, Auspex Pharmaceuticals, a subsidiary of Teva Pharmaceutical Industries, Ltd.

Currently, tetrabenazine (Xenazine) is the only drug approved by the U.S. Food and Drug Administration for treating chorea in Huntington’s disease, the study authors said.

Although the drug is effective, tetrabenazine often has to be taken three times a day and can cause side effects, such as sedation, fatigue, anxiety or nausea, the researchers said.

For the new study, Frank and his colleagues randomly assigned 90 patients with Huntington’s disease and chorea to receive either deutetrabenazine or a placebo.

Over eight weeks, the dose of deutetrabenazine was increased to a level at which it was most effective. That dose was maintained over four weeks, the study authors said.

“We found that deutetrabenazine reduces chorea, the hallmark movement disorder in Huntington disease,” Frank said. “There was also an overall improvement in participants’ condition and improvement in a quality-of-life measure. There was, however, no improvement in balance.”

The rate of side effects was similar for the drug and a placebo, which included depression, anxiety and akathisia (a movement disorder), the researchers found.

Frank said larger trials are underway to assess the long-term safety and effectiveness of deutetrabenazine.

The study findings were published July 5 in the Journal of the American Medical Association.

One neurologist said he would like to have seen a head-to-head comparison between deutetrabenazine and tetrabenazine.

“I wish they had included a tetrabenazine arm and a placebo arm,” said Dr. Michael Geschwind. A professor of neurology at the University of California, San Francisco, he co-wrote an editorial accompanying the study results.

Such a trial is needed to see which drug is superior, Geschwind said. “But for FDA approval, they only have to show it’s better than placebo,” he said.

Looking at this trial and another that compared tetrabenazine with a placebo, Geschwind found that both drugs appeared to be equally effective. However, deutetrabenazine had fewer side effects, he said.

“If a patient is doing well on tetrabenazine and tolerating it well, I wouldn’t consider changing it,” Geschwind said. “But if I were starting a new patient and the drugs were similar in cost, I’m probably going to go to the new drug because out of the starting gate I’m probably going to have less side effects.”

More information

To learn more about Huntington’s disease, visit the Huntington’s Disease Society of America.

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U.S. Teens Less Sweet on Soft Drinks

By Dennis Thompson
HealthDay Reporter

THURSDAY, July 7, 2016 (HealthDay News) — American teens are turning their backs on soft drinks, says a new government survey that shows soda consumption among youth declined by almost a third in just two years.

Instead, bottled water has become the drink of choice for many, the researchers found.

“Over the past 15 years, a great deal of research has demonstrated that sugar drinks promote weight gain and obesity, diabetes and heart disease,” explained Michael Jacobson, president of the Center for Science in the Public Interest. “That evidence has fueled campaigns to reduce consumption.”

These efforts have led to sugary drinks being banned from schools, government agencies reducing or eliminating sugar-sweetened beverages from cafeterias and vending machines, and adoption of sales taxes on sugary drinks, said Jacobson, who was not involved in the survey.

Even the beverage industry has joined up. In 2014, the three largest soda companies — Coca-Cola, PepsiCo and the Dr. Pepper Snapple Group — pledged to cut the amount of calories that Americans get from sugary drinks by one-fifth over the coming decade.

The government survey, conducted recently by the U.S. Centers for Disease Control and Prevention, revealed that in 2015:

• 20 percent of students reported drinking a sugar-sweetened beverage one or more times per day during the previous week, down from 27 percent in 2013 and 34 percent in 2007.
• 26 percent of teens said they had not consumed any sugary soda at all in the previous seven days, up from 22 percent in 2013 and about 19 percent in 2007.

Public campaigns appear to be convincing kids that they shouldn’t guzzle soda loaded with empty calories, experts said.

The banning of sugary sodas from vending machines has also played a large role in reducing soft drink consumption, said Dr. Ronald Tamler. He is medical director of the Mount Sinai Clinical Diabetes Institute in New York City.

“If you go to Mount Sinai Hospital, you literally cannot get a sugar-sweetened soda from the vending machine,” Tamler said. “Increasingly, there are schools that have the same model, so children find it more difficult to get sodas.”

In the meantime, water appears to have become a popular alternative to soft drinks.

The CDC survey found that in 2015, nearly 74 percent of students drank one or more glasses of water per day during the previous week, and 64 percent said they drank two or more glasses of water.

A recent industry report from the Beverage Marketing Corp. revealed that bottled water consumption grew 120 percent in 15 years, between 2000 and 2015. At the same time, soft drink consumption fell by 16 percent.

But Tamler is concerned that students might be picking up other sugar-loaded drinks as an alternative to soda — energy drinks, fruit juice or sweetened coffee products among them.

“The question is, are they swapping out sodas for something else?” he said. “Are they switching to other high-calorie beverages such as sugar-sweetened iced tea? That’s something that requires further drilling into the data.”

The Beverage Marketing Report indicated that people likely aren’t substituting another sugary beverage for soda. It found that between 2000 and 2015, individual Americans decreased their consumption of all alternatives to water.

In the United States, consumption of these alternatives — including soft drinks, fruit juice, energy drinks, sports drinks, bottled tea and coffee, and all forms of milk — dropped from 95.7 gallons per person in 2000 to 80.1 gallons per person in 2015. Overall consumption dropped from 27 billion gallons to 25.8 billion gallons.

According to Jacobson, “Overall, there’s been a 27 percent per-capita decline in carbonated sugar-drink consumption since 1998. A one-third decrease for Coke, and a 54 percent decrease for Pepsi. It’s especially gratifying and important to see major decreases among high school students.”

Jacobson believes that soft drinks are on the way out, although he shares Tamler’s concerns about sugar-loaded alternatives.

“I think that soda consumption will continue to decline, because it’s increasingly not cool to drink soda, though energy drinks are still growing in popularity,” he said.

Kristi King, a senior dietitian with Texas Children’s Hospital in Houston, said she’s seen a promising change in the way teens approach their own health.

“As a society as a whole, we’re having more of a focus on being healthier, and we have to give teenagers credit,” said King, a spokeswoman for the Academy of Nutrition and Dietetics. “I’m starting to see a lot more teenagers wanting to take responsibility for their health. I see that on a daily basis here in clinic.”

More information

For more on sugary soft drinks, visit the Harvard T.H. Chan School of Public Health.

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How to Stay Safe When the Power Goes Out

WEDNESDAY, July 6, 2016 (HealthDay News) — Sudden power outages can be frustrating, but what if your power is knocked out for a prolonged period? Would you be ready?

The American Red Cross recommends preparing for emergency outages by putting together a kit that contains these essentials:

• Water (each person in the household needs one gallon per day),
• Non-perishable, easy-to-prepare foods,
• Flashlights (avoid candles, which could start a fire),
• Battery-powered or hand-crank radio,
• Extra batteries,
• First aid kit,
• A week’s supply of medications and required medical items,
• Multi-purpose tool,
• Sanitation and personal hygiene items,
• Copies of personal documents, such as a list of medications and medical information; deed/lease to home; birth certificates; passports; insurance policies,
• Cellphone with chargers,
• Family and emergency contact information,
• Extra cash.

People who are being evacuated should have a three-day supply of these items, according to the Red Cross. Those staying at home should store a two-week supply.

Provide a backup power source if someone in the home is dependent on electric-powered, life-sustaining equipment.

It’s also a good idea to keep the gas tank of at least one car full and to have a non-cordless telephone at home. It will probably work during a power outage.

Perishable food isn’t apt to spoil if an outage lasts less than two hours, the Red Cross noted in a news release. For prolonged outages, you should have at least one cooler on hand.

Surrounding food with ice in a cooler or in the refrigerator will keep it colder for a longer time. Use a digital quick-response thermometer to check internal food temperatures and make sure food is cold enough to use safely.

More information

The U.S. Department of Homeland Security provides more power outage safety and preparation tips.

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