Category: Research Findings

Quit with the puffMarker

If you are a smoker, chances are you have tried to quit. You know smoking is expensive and detrimental to your health and those around you. However, quitting is difficult and what works for a friend may not work for you. Don’t give up yet! Researchers are developing a wearable proposed to help smokers quit by collecting “big data” and analyzing trends to help improve cessation programs.

A study conducted by Center for Excellence for Mobile Sensor Data-to-Knowledge (MD2K) used a wearable, named the puffMarker, which comprised of a wrist and chest sensor. The wrist sensor detects hand motions typical when smoking and the chest sensor detects respiratory patterns typical when smoking. The device was about 85% accurate at detecting relapse smoking among participants trying to quit.

This data will be used to help predict relapse and assess different intervention efforts more accurately. It could also be used to communicate with doctors, cessation support staff, and caregivers, who could then provide better support for individuals trying to quit. Simply wearing the sensors and seeing the data can be motivating for some smokers to abstain too. For example, Tom has tried to quit several times and because he has worn the puffMaker each time, his doctor and family know that he tends to relapse on day 3 or 4 and they can then provide more support during this time. Tom can also reduce environmental triggers that lead to relapse such as avoiding bars or refraining from hanging out with other smokers during the most challenging times of his quit attempt.

This technology is expected to be developed for other addictive behaviors such as alcohol and drug abuse. More research needs to be done, but once again wearables show promise in helping promote healthy behaviors.

Photo Source: Flickr

Just ‘How’ Effective Are Weight-Loss Apps?

Do weight loss apps really work?

Since young adults (ages 18-35) own smartphones more than any other age group, researchers at Duke University wanted to see how effective a low-cost app would be at helping those within that age group that are overweight or obese at losing weight.

The researchers conducted a study in which 365 overweight/obese young adults were divided among three groups. One group used an Android app that tracked caloric intake, weight and exercise, as well as offered interactive features like social support, games and goal setting (the app was specifically developed for the study).

The second group gave participants six weekly coaching sessions that were personalized for the individual, followed by monthly follow-ups. Members in this group were also asked to track calories, weight, and exercise using their smartphone. The remainder of the participants served as a control group, and was only given handouts on healthy eating and exercise tips.

Researchers tracked participant progress a six, 12-, and 24-month intervals, and found that at six months, the personal coaching group had the most weight loss; however, this diminished at the next two follow-ups. The group using the smartphone app never led in weight loss at any follow-up interval.

Needless to say, lead researcher Laura Svetkey and her team were surprised at the results, given the vast number of young adults who own smartphones. The team had hypothesized the ease of using an app directly through their smartphone would enable young people to be more inclined to lose weight.

After reviewing the results, the researchers determined that although a smartphone app is easy and relatively cheap to use, is simply isn’t as engaging as personal coaching. Because weight loss usually requires outside motivation, individualized training is often the method that holds a person’s attention span the longest. And the more engaged a person is in their weight loss, the more likely they will be to continue with it and witness observable results.

For this reason, the researchers concluded with a discussion that included the need to make weight loss intervention apps more engaging. They believe that doing so would help more young people reach a healthy weight, reducing their future risk of health issues, such as cardiovascular disease.

One note worth mentioning is that these results were based on an app that was developed specifically for the study, and therefore cannot be generalized to commercial weight loss apps in general, although implications are likely. And although weight loss apps may not be as effective as we had hoped, they can still serve a valuable purpose. The results simply demonstrate a need for increasing efforts to develop apps that lead people to maintain healthy eating and exercise behaviors.

Photo source: huffingtonpost.com

Wellness Wednesdays: The Dangers of (Un)‘Natural’ Supplements

Millions of people take nutritional supplements every day. Used by a variety of demographics, from fitness enthusiasts to couch potatoes, the Nutrition Business Journal recently reported that the supplement industry in the United States was worth nearly $37 billion annually. That is serious money, and with such high stakes in an unregulated market, consumers have to be very careful to protect themselves from fraudulent manufacturers who are just out to make a buck (or a few million…)

Many consumers may still not understand that, unlike prescription drugs or over-the-counter medications, dietary supplements are almost entirely unregulated. In February 2015, an investigation by the New York State attorney general’s office found that 80% of the ‘herbal supplements’ they tested contained none of the active ingredient they claimed. Some even contained potential allergens like gluten, while marketing themselves as ‘gluten-free’.

But we’re not talking about multi-vitamins or protein powders here. The biggest concern right now are workout supplements, products plastered with fitness models and bold claims like ‘clinically proven to boost muscle gains, decrease fatigue’, etc. and so forth – snappy marketing aside, some of these products contain dangerous synthetic chemicals that have been associated with several deaths.

This week, the United States Justice Department filed criminal and civil charges against more than 100 companies engaged in the manufacture and sale of nutritional supplements, and their executives. The fallout of these charges remains to be seen, but it seems unlikely to put more than a temporary dent in sales for the booming supplement industry.

Still, how many people would be willing to pay big bucks for promises of six-pack abs if they knew they were risking their lives? Everybody wants a ‘quick fix’, the shortcut to a perfect bod – just remember, if it sounds too good to be true, it probably is.

 

Photo credit: www.ibtimes.com

Yoga Poses Shown to Be Safe During Pregnancy

Many mothers-to-be may not consider yoga — or at least certain yoga positions — to be healthy during pregnancy, but recent research seems to have provided evidence to the contrary.

A gynecologist in Lexington, Ky., was having difficulty finding any previous evidence of studies that looked at the impact of yoga on the fetus, so she decided to conduct her own.

Dr. Rachel Polis, at Kosair Children’s Hospital, started with 25 healthy pregnant women, each in their third trimester, and held a one-on-one yoga class that included 26 poses that involved standing, twisting, and stretching. They even tried poses some yoga instructors have advised pregnant women to avoid, such as downward-facing dog, the corpse pose, and the happy baby pose. Women are usually told to lie on their sides—not their backs—during pregnancy, particularly during the final stages.

To determine if these poses (as well as others) affected the fetus, women were placed on continuous fetal monitoring throughout the class. Results showed the women responded well to the yoga — vital signs all remained within normal ranges and fetal heart rate remained normal for all 26 poses. After a 24-hour follow-up, none of the women reported decreased fetal movement, contractions, leakage, or vaginal bleeding.

The results were published recently in Obstetrics & Gynecology, and although they are preliminary, they do demonstrate that healthy women in their third trimesters of pregnancy can tolerate yoga with no adverse changes to mom or baby.

Of course, women should be evaluated by their OB/GYN first before rolling out their yoga mat. Namaste.

 

photo credit: popsugar.com

FDA Docket for Tech in Clinical Trials

On October 29th, the FDA established a public docket for input on strategies for using innovative technologies in clinical research. They are interested in hearing the public’s opinions concerning barriers, challenges, and considerations that may affect the use of technology in different clinical trials, from drug studies to medical device reviews.

Recently, new technologies have been utilized to improve data collection and communication between participants and investigators in clinical trials. In many cases, participants no longer need to be physically present at a study site in order for data to be collected. In fact, remote sensors, such as accelerometers, can provide more accurate data, more frequently, which reduces geographical and logistical barriers for many participants who would not otherwise be able to take part in a trial. This allows for a more comprehensive and inclusive clinical trial due to a more diverse participant pool.

Remote monitoring can also be beneficial because it records or transmit data without any conscious effort from the participant. For example, a participant can agree to take their blood pressure daily with a wireless blood pressure monitor which then automatically sends the results to the investigator. The participant is no longer required to self-report data which eliminates any intentional or unintentional errors. In addition, the issue of missing data is greatly reduced, assuming the technology is functioning properly. Another benefit, participants are more likely to complete a clinical trial because it requires less effort; thus, the attrition rate is reduced and the trial conclusions are more meaningful.

Technology clearly has its advantages, but what are some of the disadvantages?

Share your thoughts on the FDA public docket and below.

Text source: FDA; Photo source: Flickr

 

CDC Finds Women Gain Too Much Weight During Pregnancy

A recent report published by the Centers for Disease Control and Prevention (CDC) has revealed that nearly half of American women gain too much weight during pregnancy.

In fact, less than one third of women maintained the correct pregnancy weight according to their body mass index (BMI), implying the majority of child-bearing women run the risk of having a complicated labor and delivery, or becoming obese and developing health problems later in life. These women also run the risk of passing off health problems to their offspring.

The amount of weight a woman gains during pregnancy, also known as gestational weight gain (GWG), is important for the longterm health of the mother and child. The Institute of Medicine (IOM) has provided recommended weight gain ranges, depending on the woman’s BMI. To find out if women were adhering to their recommended GWGs, the CDC analyzed 2013 birth data from women in 41 states. Since 2003, birth certificates are required to include the mother’s height, pre-pregnancy weight, and delivery weight. For the five states that have yet to use the revised birth certificate, a questionnaire was distributed to mothers to gather pregnancy-related information.

Overall, 32.1% had appropriate GWG, while nearly 50% were in the excessive range for GWG. More than 20% were in the inadequate GWG range. Women in the excessive range tended to be overweight before pregnancy. The high prevalence of excessive GWG is of concern because excessive GWG increases the risk for macrosomia, postpartum weight retention, and obesity in mothers and possibly their children.

Experts say women of normal weight should add 25 to 35 pounds during pregnancy, while overweight women should gain only an additional 15 to 25. Obese women should only add 10 to 20. And while women may need to consume extra calories (350-450 per day) to support the metabolic demands during pregnancy, this should typically occur later, in the second and third trimesters.

The fact that so many women fell in GWG ranges not recommended by IOM or the CDC indicates the need for effective interventions, encouraging women about the importance of reaching a recommended weight given their BMI. Such interventions might include focusing on dietary goals and increased physical activity. Pregnant women are encouraged to engage in at least 150 minutes of physical activity (i.e., brisk walking, jogging) per week. Overweight women who are looking to diet during pregnancy are also encouraged to keep an account of their dietary intake, as well as maintain regular prenatal appointments to ensure they are receiving an adequate amount of calories per day. Of course unusually thin women need to remain cautious during pregnancy as well. Underweight women run the risk of delivering a very small baby, which could lead to health problems later on.

A good rule of thumb to remember is that it’s not about eating twice as much — it’s about eating twice as healthy.

 

Photo credit: The Guardian

Risk of Breast Cancer Rising Among Black Women

It used to be a safe assumption that African American women had a relatively low risk getting of breast cancer, but a recent study published on behalf of the American Cancer Society (ACA) has found that black women now have an equal risk of developing the disease as white women.

Previously, the disease was most common among white women, but as rates among black women increase, researchers are seeing the rates for white and black women become more balanced. Since 2008, the risk of occurrence among African American women has increased 0.4 percent each year, translating into roughly 124 black women per 100,000 being diagnosed (the rate for white women still remains slightly higher, around 128 per 100,000). Incidence increased slightly for Asian and Pacific Islander women (88 per 100,000), while the rate for Hispanic women remained the same 91 per 100,000).

In terms of mortality, black women continue to be the most at-risk group, with nearly 32 per 100,000 women dying from the disease (compared to 22 per 100,000 white women). One significant reason for this is likely due to the fact that African American women tend to receive a later diagnosis, and thus, the cancer is more likely to have spread to other areas of the body. Another occurrence being looked at is the amount black women being diagnosed with estrogen-positive breast cancer. Researchers believe this could be due to an increase in obesity rates among black women, since more fat increases estrogen, a known risk factor for certain forms of breast cancer. According to ACA, in 2012, 58 percent of black women are obese, compared to only 33 percent of white women.

Another interesting fact resulting from the study’s results was that rates of breast cancer among black women tended to be higher in the South – Alabama, Kentucky, Louisiana, Mississippi, and Tennessee (rates were higher in Missouri and Oklahoma as well).

Of course, all women, regardless of race, should be aware of common risk factors for breast cancer, and should be proactive in maintaining a healthy weight, getting enough physical activity, and limiting their alcohol intake. One of the single most important acts a woman can take at decreasing her chances of developing the disease is by getting mammograms on a regular basis, to ensure treatment begins at the earliest stage possible.

Breast Cancer: A Look at How Far We’ve Come

As National Breast Cancer Awareness month comes to an end, it’s important to reflect on how far we’ve come. Breast cancer mortality has fallen by more than a third since its peak in the 1980s, and can be attributed to the vast improvements made in regards to breast cancer screening, treatment, and prevention over the last 20 years. Here is a quick look at some of the most effective advancements so far:

Screening- Early detection of breast cancer by mammography has a variety of benefits, including a greater range of treatment options. A combined effort of both the increase of programs designed to improve access to breast cancer screening and improvements with early detection testing techniques (mammograms, clinical breast exams, genetic testing and magnetic resonance imaging) has allowed for over 90 percent of breast cancers to be diagnosed at an early stage.

Treatment- When treatment for breast cancer first began, radical mastectomies were one of the only options, regardless of the stage of the disease. Now, many women have the option to receive much less evasive surgery, such as lumpectomies, with no loss in effectiveness for treatment. Refined chemotherapy regimens and improved radiation techniques have also allowed for women to safely undergo less extensive surgery and has overall improved the quality of life for patients.

Prevention- Recent clinical trials have shown that the drugs such as tamoxifen and raloxifene can significantly reduce the risk of breast cancer in women known to be at increased risk. [1] Preventative surgeries have also developed and been proven effective in reducing cancer risk.

National Breast Cancer Awareness month may be at its end, but it is still important to be aware of the risks and screening options available year-round. For more information visit: http://www.cdc.gov/cancer/breast/basic_info/index.htm

 

[1] Nelson HD, Smith ME, Griffin JC, Fu R. (2013). Use of medications to reduce risk for primary breast cancer: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 158(8):604-14

Wellness Wednesdays: Is Cheese Addictive?

In a word…No. Yet it seems as though this question has been brought up more and more frequently over the past few years, with a broad array of foods, from bread to milkshakes, being treated as scapegoats for the world’s obesity crisis.

 

So why cheese? According to a recent study from the University of Michigan, people rated cheese (and foods containing cheese) as the ‘most addictive’. Now, that seems like pretty limited evidence, particularly because the sample included only 500 people (all Americans), and the list of foods included some of America’s favorite foods, such as pizza and cheeseburgers. But is there more to this story?

 

Maybe. But not in the way ‘they’ might want you to believe. Cheese is a dairy product, meaning it contains a protein called casein. After you eat it, your body converts casein into a number of different molecules, some of which fall into a class of compounds called casomorphins. These compounds attach to the same receptors in the brain that the powerful narcotic drugs morphine and heroin do, hence where the ‘addiction’ claim comes into play.

 

The thing is, the same claim has been made about gluten…and sugar. Foods contain thousands of different molecules that our bodies use to create everything we need to survive (which is kind-of why we have to eat in the first place…) That includes endogenous opioids – the ‘natural’ painkillers responsible for the runners’ ‘high’ and other normal human phenomena, like child birth.

 

But let’s talk about the real question – can a food every really be ‘addictive’? I studied habit- and goal-directed behavior in animals for several years, working in a neuroscience lab that studied the effects of a neurotransmitter called dopamine. Some of the research I did centered around this question. However, food is very different from drugs of abuse like alcohol and cocaine – drugs provide no essential function for our bodies. But foods do – cheese, for example, contains essential minerals like calcium, iron, and zinc, in addition to macronutrients like protein and fat. Some research even suggests that the saturated fats found in cheese aren’t even as unhealthy as we used to think.

 

So feel free to enjoy your cheese – just please enjoy responsibly.

Low protein bad for bones?

Like many runners, I experienced a stress fracture in a foot bone a couple months after my first half marathon. Being winter in New England, my physician attributed it in part to a lack of enough Vitamin D, which helps your body absorb dietary calcium. Without enough vitamin D to absorb calcium, your body must access its reserves – from your bones. This has implicated calcium and vitamin D as the dynamic duo when it comes to preventing osteoporosis, the most common disease of the bones.

Now, preliminary research findings are connecting low-protein diets to calcium malabsorption in young women. Because the best time to take action to prevent osteoporosis is when you’re young, this research could have important consequences for those at risk (genetically, or otherwise) for osteoporosis.

The study, conducted by researchers from the University of Connecticut and the Yale University Bone Center, hoped to fill a gap regarding dietary components such as protein and its association with bone health. The research aimed to examine the impact of low-protein diets in young Asian and Caucasian women, two groups with higher risks for osteoporosis later in life.

While this research is in it’s early stages, the association certainly warrants further research and consideration. Osteoporosis causes almost 9 million fractures each year – in fact, 1 in 3 women over age 50 will experience osteoporotic fractures. Men aren’t off the hook though – 1 in 5 over the age of 50 also experiences fractures related to osteoporosis. Although most Americans don’t have trouble getting enough protein, many older adults consume inadequate protein due to an increased need and sometimes lack of appetite. Young and old – make sure you’re getting at least 1.0 gram /kilogram of body weight and adequate calcium and vitamin D to keep bones healthy for life!

 

Photo source: Quinn Dombrowski via Flickr.com