Fitness in Youth Can Pay Off Decades Later: Study

MONDAY, Nov. 30, 2015 (HealthDay News) — Hitting the gym or playing field in your 20s may bring health benefits that last a lifetime, new research suggests.

The study of nearly 5,000 young adults found that those with good heart/lung fitness had a lower risk of heart disease and death later in life.

One cardiologist who reviewed the study wasn’t surprised by the finding.

“Despite all the remarkable medical and technological advances in the treatment of heart disease, it remains clear that the best prescription for adults is to be active and routinely exercise,” said Dr. Kevin Marzo, chief of cardiology at Winthrop-University Hospital in Mineola, N.Y.

The new study was led by Dr. Joao Lima of Johns Hopkins Medical School in Baltimore and focused on people who were between 18 and 30 at the start of the study. All of them underwent treadmill exercise tests to assess their cardiorespiratory fitness.

Over a median follow-up of nearly 27 years, 273 (5.6 percent) of the participants died and 193 (4 percent) had heart disease-related problems. Overall, 73 of the deaths were heart-related.

Fitness levels in youth seemed to matter, Lima’s team reported. The treadmill tests the young adults took included as many as nine two-minute stages of gradually increasing difficulty.

According to the researchers, for each additional minute the participants were able to stay on the treadmill, they had a 15 percent lower risk of death over the course of the study, and a 12 percent lower risk of heart-related death, specifically.

Some of the participants had another treadmill test seven years into the study. In that group, a one-minute reduction in being able to remain on the treadmill was associated with a 21 percent increased risk of death and a 20 percent increased risk of heart-related death, the team said.

The bottom line, according to the researchers, is that “efforts to evaluate and improve fitness in early adulthood may affect long-term health at the earliest stages” of heart disease.

Dr. Sonia Henry directs echocardiography at North Shore-LIJ Health System in New Hyde Park, N.Y. She said the findings highlight “the importance of promoting and mandating exercise and fitness early on.”

The study was published online Nov. 30 in the journal JAMA Internal Medicine.

More information

The U.S. National Heart, Lung, and Blood Institute has more about physical activity and your heart.

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After Concussion Symptoms Fade, Slowed Blood Flow in Brain May Persist

By Amy Norton
HealthDay Reporter

MONDAY, Nov. 30, 2015 (HealthDay News) — Young football players who suffer a concussion can show signs of reduced blood flow in the brain, even after their symptoms have subsided, a new, preliminary study suggests.

Using an advanced form of MRI, researchers found that concussed football players typically showed lower blood flow in the brain eight days after the injury. That was despite the fact that their symptoms had usually gone away by that point.

However, the study involved just 18 athletes and it’s too early to know what the findings might mean, experts said.

“Does the decreased blood flow indicate a window of cerebral [brain] vulnerability? Nobody has shown that yet,” said Kenneth Podell, co-director of the Methodist Concussion Center in Houston.

According to Podell, who was not involved in the study, it’s remarkable that the athletes’ brain blood flow actually declined as their concussion symptoms improved, since that’s counterintuitive on the surface.

But if the symptoms have gone away, Podell said, it’s not clear that the blood flow change would be something to worry about — especially if it’s short-lived.

Study leader Dr. Yang Wang, an associate professor of radiology at the Medical College of Wisconsin in Milwaukee, called the findings “interesting,” but just a first step.

“We don’t have enough data to tell parents or doctors what to do at this point,” Wang said.

He was to present the findings Monday at the annual meeting of the Radiological Society of North America, in Chicago. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

The study comes at a time of growing concern over the possible long-term effects of concussions — especially repeated concussions — in young athletes. According to the U.S. Centers for Disease Control and Prevention, more than 248,000 U.S. children and teens land in the ER each year because of a concussion suffered during sports or other physical activities, like bike riding.

Concussions can cause a range of symptoms: a headache that gradually worsens, nausea, dizziness, confusion and irritability are among them.

Of the sports that carry a concussion risk, football has gotten the most scrutiny — partly because of high-profile cases in which professional football players suffered long-term damage attributed to repeated blows to the head.

Just last week, the family of football great Frank Gifford announced that he suffered from chronic traumatic encephalopathy (CTE) prior to his death at the age of 84 in August. CTE, which is linked to repeated hits to the head and concussions, has been detected in many ex-NFL players in recent years. It can only be diagnosed after death, but typical symptoms include depression, aggressive behavior, impulse control issues and loss of memory.

But, Podell pointed out, no one knows whether kids and teenagers who play football suffer any lasting brain damage from knocks to the head, including those that cause a concussion.

Still, Podell said, young athletes’ concussions must be taken seriously: They should be removed from the field and not allowed to return to activity — physical or mental — until their symptoms have resolved and a doctor gives the OK.

The problem, both Podell and Wang said, is that doctors have to rely on imperfect measures — including whatever a young athlete says about their symptoms. And kids who are in a rush to get back in the game might not tell the truth.

An objective biological marker — whether it’s measured with a brain scan or a blood test — is the “holy grail” of concussion research, Podell said. That could give doctors a more precise way to diagnose concussion, and to gauge whether a patient has recovered.

However, no one knows whether the MRI technique used in this study could be the answer. Wang said much more research is needed.

The current findings are based on 18 football players, with an average age of 18, who’d suffered a concussion. Each athlete had their symptoms evaluated and underwent brain scans one day after the injury, and again one week later. The researchers used an advanced MRI method that can measure blood flow in the brain.

On average, the study found, the athletes’ symptoms had faded by the second evaluation. But their brain blood flow had actually declined. No such change was seen in a comparison group of 19 uninjured players.

According to Podell, larger, longer-term studies are needed to know how long the reduced blood flow lasts — and, even more importantly, what it means.

“Right now,” he said, “the best road back from concussion is a gradual return to physical and mental activities. Parents should seek help from a professional with expertise in concussion.”

But Podell also cautioned against getting overly alarmed by the concussion risk that comes with sports.

“Sports, including contact sports, have a lot of value,” he said. “And keeping kids out of contact sports won’t eliminate their concussion risk.”

Falls and car crashes are actually the leading causes of hospitalization for concussion among children and teenagers, according to the CDC.

More information

The U.S. Centers for Disease Control and Prevention has more on sports-related concussions.

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After Concussion Symptoms Fade, Slowed Blood Flow in Brain May Persist

By Amy Norton
HealthDay Reporter

MONDAY, Nov. 30, 2015 (HealthDay News) — Young football players who suffer a concussion can show signs of reduced blood flow in the brain, even after their symptoms have subsided, a new, preliminary study suggests.

Using an advanced form of MRI, researchers found that concussed football players typically showed lower blood flow in the brain eight days after the injury. That was despite the fact that their symptoms had usually gone away by that point.

However, the study involved just 18 athletes and it’s too early to know what the findings might mean, experts said.

“Does the decreased blood flow indicate a window of cerebral [brain] vulnerability? Nobody has shown that yet,” said Kenneth Podell, co-director of the Methodist Concussion Center in Houston.

According to Podell, who was not involved in the study, it’s remarkable that the athletes’ brain blood flow actually declined as their concussion symptoms improved, since that’s counterintuitive on the surface.

But if the symptoms have gone away, Podell said, it’s not clear that the blood flow change would be something to worry about — especially if it’s short-lived.

Study leader Dr. Yang Wang, an associate professor of radiology at the Medical College of Wisconsin in Milwaukee, called the findings “interesting,” but just a first step.

“We don’t have enough data to tell parents or doctors what to do at this point,” Wang said.

He was to present the findings Monday at the annual meeting of the Radiological Society of North America, in Chicago. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

The study comes at a time of growing concern over the possible long-term effects of concussions — especially repeated concussions — in young athletes. According to the U.S. Centers for Disease Control and Prevention, more than 248,000 U.S. children and teens land in the ER each year because of a concussion suffered during sports or other physical activities, like bike riding.

Concussions can cause a range of symptoms: a headache that gradually worsens, nausea, dizziness, confusion and irritability are among them.

Of the sports that carry a concussion risk, football has gotten the most scrutiny — partly because of high-profile cases in which professional football players suffered long-term damage attributed to repeated blows to the head.

Just last week, the family of football great Frank Gifford announced that he suffered from chronic traumatic encephalopathy (CTE) prior to his death at the age of 84 in August. CTE, which is linked to repeated hits to the head and concussions, has been detected in many ex-NFL players in recent years. It can only be diagnosed after death, but typical symptoms include depression, aggressive behavior, impulse control issues and loss of memory.

But, Podell pointed out, no one knows whether kids and teenagers who play football suffer any lasting brain damage from knocks to the head, including those that cause a concussion.

Still, Podell said, young athletes’ concussions must be taken seriously: They should be removed from the field and not allowed to return to activity — physical or mental — until their symptoms have resolved and a doctor gives the OK.

The problem, both Podell and Wang said, is that doctors have to rely on imperfect measures — including whatever a young athlete says about their symptoms. And kids who are in a rush to get back in the game might not tell the truth.

An objective biological marker — whether it’s measured with a brain scan or a blood test — is the “holy grail” of concussion research, Podell said. That could give doctors a more precise way to diagnose concussion, and to gauge whether a patient has recovered.

However, no one knows whether the MRI technique used in this study could be the answer. Wang said much more research is needed.

The current findings are based on 18 football players, with an average age of 18, who’d suffered a concussion. Each athlete had their symptoms evaluated and underwent brain scans one day after the injury, and again one week later. The researchers used an advanced MRI method that can measure blood flow in the brain.

On average, the study found, the athletes’ symptoms had faded by the second evaluation. But their brain blood flow had actually declined. No such change was seen in a comparison group of 19 uninjured players.

According to Podell, larger, longer-term studies are needed to know how long the reduced blood flow lasts — and, even more importantly, what it means.

“Right now,” he said, “the best road back from concussion is a gradual return to physical and mental activities. Parents should seek help from a professional with expertise in concussion.”

But Podell also cautioned against getting overly alarmed by the concussion risk that comes with sports.

“Sports, including contact sports, have a lot of value,” he said. “And keeping kids out of contact sports won’t eliminate their concussion risk.”

Falls and car crashes are actually the leading causes of hospitalization for concussion among children and teenagers, according to the CDC.

More information

The U.S. Centers for Disease Control and Prevention has more on sports-related concussions.

---

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Long-Distance Running Takes Toll on Joints, But It May Be Temporary

MONDAY, Nov. 30, 2015 (HealthDay News) — Runners who run very long distances suffer cartilage damage in their lower joints — but the cartilage can regenerate, a small study suggests.

The researchers also found that the runners had lost about 6 percent of their brain’s gray matter by the end of the race. But eight months later, their gray matter volume had returned to normal.

The study included 44 runners taking part in the 2009 Trans Europe Foot Race, which involved running nearly 4,500 kilometers (about 2,800 miles) over two months without any days of rest.

Using a mobile MRI truck, the researchers scanned the runners every three or four days during the event. Nearly all cartilage in knee, ankle and hind-foot joints showed significant deterioration in the first 900 to 1,550 miles of the race. The findings are to be presented Monday at the annual meeting of the Radiological Society of North America, in Chicago.

“Interestingly, further testing indicated that ankle and foot cartilage have the ability to regenerate under ongoing endurance running,” said Dr. Uwe Schutz. He is a radiologist and specialist in orthopedics and trauma surgery in the department of diagnostic and interventional radiology at the University Hospital of Ulm, in Germany.

“The ability of cartilage to recover in the presence of loading impact has not been previously shown in humans. In general, we found no distance limit in running for the human joint cartilage in the lower extremities,” Schutz said in a society news release.

“The human foot is made for running,” Schutz said.

Research findings presented at meetings are viewed as preliminary until published in a peer-reviewed journal.

More information

The University of California, San Francisco, offers training tips for running a marathon.

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Weight Loss May Spare Knee Cartilage, Study Finds

MONDAY, Nov. 30, 2015 (HealthDay News) — Losing a large amount of weight slows the loss of knee cartilage in obese people, a new study shows.

Obesity is a major risk factor for knee osteoarthritis, a degenerative joint disease that often leads to joint replacement surgery.

The new study included just over 500 overweight and obese Americans who either had mild to moderate osteoarthritis or risk factors for the disease. The study participants were randomly assigned to a control group that lost no weight, a group that lost a little weight, or a group that lost more than 10 percent of their body weight.

Four years of follow-up showed significant weight loss protected against cartilage degeneration and that larger amounts of weight loss provided more protection, according to the study to be presented Monday at the annual meeting of the Radiological Society of North America, in Chicago.

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

“Cartilage degenerated a lot slower in the group that lost more than 10 percent of their body weight, especially in the weight-bearing regions of the knee,” study author Dr. Alexandra Gersing, from the department of radiology and biomedical imaging at the University of California, San Francisco, said in a society news release.

“However, those with 5 to 10 percent weight loss had almost no difference in cartilage degeneration compared to those who didn’t lose weight,” she added.

Significant weight loss not only slows the loss of knee joint cartilage, it also reduces the risk of osteoarthritis. Along with moderate exercise, weight loss is one of the best ways to prevent the disease, Gersing said.

“It’s most helpful if these lifestyle interventions take place as early as possible,” she said.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about osteoarthritis.

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Obamacare Boosting Breast Cancer Screening Among Poor: Study

MONDAY, Nov. 30, 2015 (HealthDay News) — More poor women are being screened for breast cancer due to expanded Medicaid coverage under the Affordable Care Act, also known as Obamacare, a new study finds.

States now have the option to expand Medicaid coverage of breast cancer screening to people younger than 65 whose income is up to 133 percent of the federal poverty level. So far, 23 states have opted for that expanded coverage and six others are implementing alternatives, according to the new report.

California, Connecticut, Minnesota, New Jersey, Washington state, and Washington, D.C., were among the first to adopt and implement the expanded coverage, and did so by 2011, the study authors said.

In those states, breast cancer screening rates among low-income women rose 25 percent between 2008 and 2012, the study found. The findings are scheduled to be presented Monday at the annual meeting of the Radiological Society of North America, in Chicago.

“While increased use of screening mammography has significantly contributed to improved detection of breast cancer, substantial disparities in breast cancer screening exist among populations in the country,” study author Dr. Soudabeh Fazeli Dehkordy, of St. John Providence Hospital in Southfield, Mich., said in a society news release.

“Understanding the impact of Medicaid expansion on breast cancer screening rates in early expander states can provide valuable insights that can be very useful to both state and federal policymakers when considering key health policy,” she added.

“Adoption of Medicaid expansion by more states can result in considerable improvement of disparities in breast cancer screening, leading to better health outcomes for all women across the United States,” Fazeli Dehkordy concluded.

Research presented at meetings is viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Cancer Institute has more about breast cancer screening.

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Teens More Cautious About Sex When Parents Set Rules, Study Finds

By Randy Dotinga
HealthDay Reporter

MONDAY, Nov. 30, 2015 (HealthDay News) — A new analysis suggests that parents who set rules and keep tabs on their teenagers may have kids who are more cautious about sex.

“Parents really matter, and they’re influential,” said report co-author Vincent Guilamo-Ramos, co-director of the Center for Latino Adolescent and Family Health at New York University’s Silver School of Social Work.

At issue: How can parents convince their children to engage in less sexual activity, especially risky unprotected intercourse?

The study authors said that statistics suggest that hundreds of thousands of U.S. teens become pregnant each year, and more than 75 percent of the pregnancies are unplanned. Sexually transmitted disease is another risk for teens and young adults: Research shows that in 2012, people aged 20 to 24 had the highest rate of new infections with HIV, the virus that causes AIDS.

In the new report, researchers combined and analyzed the results of 30 studies from around the world. The studies, completed from 1984 to 2014, analyzed the effects of parental activities such as knowing what kids are doing or setting rules for them. The goal of the studies was to see whether the kids of more watchful parents were more likely to skip sexual activity — defined in different ways — or use birth control.

The investigators found that kids whose parents set rules and monitored them — kept an eye on what they were doing and who they were with — had sexual intercourse later in life. Those whose parents monitored them were also more likely to use condoms and other forms of birth control, but making rules didn’t seem to have an effect on that front.

“When kids are sexually active, it’s less about setting clear rules and more about having a better relationship and better communication,” said Guilamo-Ramos.

Due to the designs of the studies, the researchers couldn’t tell if parental monitoring or rule making directly caused kids to be more cautious about sexuality. Other factors could explain the apparent connections in the statistics.

It’s possible, for example, that kids who don’t do risky things communicate more with their parents about their lives, allowing more monitoring, said Atika Khurana, an assistant professor of counseling psychology and human services at the University of Oregon. Still, she said, lots of research suggests that parental monitoring does matter.

While the new report doesn’t show “anything new except that a number of papers show that monitoring works,” the findings do “give parents the green light to parent,” said Dr. Richard Rupp, chief of adolescent and behavioral medicine at University of Texas Medical Branch, in Galveston.

In general, he said, research shows that parents can do three effective things to delay sexual activity in teens: They can model good behavior in their own actions, communicate with their kids, and keep an eye on them.

“Very similar results have been found for other adolescent risk behaviors,” Rupp said.

“Perhaps the clearest is for driving, probably because it is a rather simple behavior,” he said. “Parents communicate to their kids to be safe and the family rules for driving, and the consequences of unsafe driving. Parents then monitor and control the keys.”

But how do these kinds of parental strategies actually affect what kids do?

Khurana said that one theory is that awareness and rules are “an indicator of positive and supportive family climate that protects teens from negative outcomes. Also, parents who solicit information from their teens about their friends or whereabouts send an implicit message to their teens that they care about them and their well-being.”

However, research has also shown that firm parenting can backfire when kids see it as too controlling, Khurana said. In these cases, kids may rebel. “Parents have to be mindful of their child’s growing autonomy needs,” she said.

Guilamo-Ramos said it’s important to avoid being unfair and harsh. “When it starts to get problematic is when it’s controlling and doesn’t reflect that young people have to weigh in and provide their perspective,” he said.

The study was published online Nov. 30 and will appear in the December print issue of the journal Pediatrics.

More information

Planned Parenthood has more about talking to your teenager about sex.

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Dogs May Ease a Child’s Fears

SUNDAY, Nov. 29, 2015 (HealthDay News) — The companionship of a dog may lower a child’s anxiety levels, a new study suggests.

The researchers looked at almost 650 children aged 18 months and older who were screened for anxiety. Of those children, 58 percent had a dog at home.

Only 12 percent of children with dogs tested positive for anxiety, compared with 21 percent of those without dogs, the researchers at Bassett Medical Center in Cooperstown, N.Y., found.

The study was published recently in the journal Preventing Chronic Disease.

Having a dog may reduce a child’s anxiety — particularly social and separation anxieties — in a number of ways, such as by triggering conversations and helping break the ice with new people, the researchers suggested. However, the study did not prove a cause-and-effect link between dogs and lower anxiety levels in children.

“Interacting with a friendly dog also reduces cortisol levels, most likely through oxytocin release, which lessens physiologic responses to stress,” the researchers wrote. “These hormonal effects may underlie the observed emotional and behavioral benefits of animal-assisted therapy and pet dogs.”

More information

Children’s Mental Health Ontario has more about anxiety.

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Could Your ‘Holiday Blues’ Be Seasonal Affective Disorder?

SUNDAY, Nov. 29, 2015 (HealthDay News) — Some people who think they have the holiday blues may actually have seasonal affective disorder (SAD), an expert suggests.

“SAD usually occurs in those who already are diagnosed or afflicted with a type of depression. It occurs with the change of the seasons, beginning in the fall and staying with you throughout the cold, dark winter months,” Dr. Jason Hershberger, chair of psychiatry at Brookdale Hospital and Medical Center in New York City, said in a hospital news release.

“Your energy drops and your mood will swing. Many shrug off the depressed feeling as the winter doldrums, denying that they may be suffering from mild to severe seasonal depression,” he explained.

Lack of sunlight is the main cause of SAD, but age, sex, where you live, and your family history also affect risk, researchers have found.

“If you are a young woman living far from the equator with a family history of SAD or a previous diagnosis of clinical depression or bipolar disorder, you are most at risk,” Hershberger said in the news release. “Women are found to have more severe symptoms, while young people are often at higher risk than older adults,” he added.

“Living far from the equator means there is less sunlight, especially during the winter. Any family or personal history of depression, bipolar disorder or SAD makes the disorder hereditary,” Hershberger explained.

If you think you have SAD, seek medical help or talk to a family member or friend, especially if you have any thoughts of suicide, he advised.

“Before you see your doctor, make a list of your symptoms; recent life changes like divorce, work or school; medications and supplements — including vitamins; notes on when your depression started or became worse; and a list of questions you have for your doctor,” Hershberger suggested.

People suspected of having SAD will undergo a physical and mental examination, followed by blood tests to check for any other possible causes of symptoms, he said.

Doctors will usually recommend phototherapy, which is “a form of light therapy to help your brain produce the chemicals, like serotonin, you need to feel healthier and happier,” Hershberger said. Light boxes are widely available for less than $100 to about $300.

Antidepressant medication may also be prescribed along with so-called “talk therapy” to help you identify negative thoughts, and learn how to cope with your stress and anxiety, he added.

More information

The American Academy of Family Physicians has more about SAD.

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Why You Need Flexibility Exercises

SATURDAY, Nov. 28, 2015 (HealthDay News) — Flexibility exercises should be part of your regular workouts, an expert says.

Effective fitness programs should include cardiovascular training, strength building and flexibility exercises, but the flexibility component is often overlooked, according to the American Academy of Orthopaedic Surgeons.

“Increasing your flexibility improves your ability to move easily,” orthopedic surgeon Dr. Raymond Rocco Monto, of Nantucket, Mass., said in an academy news release.

“Some joints lose up to 50 percent of motion as we age. There are many ways to improve your joint flexibility, including controlled stretches held for 10-30 seconds, stretches that rely on reflexes to produce deeper flexibility, as well as yoga and pilates,” explained Monto.

Including flexibility exercises in your workouts helps reduce back and joint pain, increases circulation, improves joint motion, boosts athletic performance and improves muscle health, he added.

To get the most out of flexibility training, always warm up before you stretch, Monto said. Stretching cold muscles can lead to injuries.

He advises stretching slowly and gently, and breathing into your stretch to avoid muscle tension. Relax and hold each stretch for 10 to 30 seconds.

Don’t bounce while stretching because doing so can cause injuries. Also, stretching should not hurt, Monto said. If you feel pain, go easier on the stretch, breathe deeply and relax into it.

More information

The Women’s Heart Foundation offers more stretching tips.

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