To Your HealthTYH Archives

October 7, 2003 [Volume 4, Issue 21]

 

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In this issue of To Your Health:

Are Your Children Being Unnecessarily Medicated?

These days, it seems many medical doctors' first course of action is to recommend or prescribe drugs for any patient complaint; disturbingly, this trend seems to hold true whether the patient is an adult or a child.

An eye-opening study published in the May issue of Pediatrics revealed that many pediatricians have recommended the use of medication for children who suffer from sleep disturbances. In fact, of the 671 U.S. pediatricians surveyed, 75 percent said they had advised parents to administer an over-the-counter (OTC) medication, and more than 50 percent had prescribed a sleep aid.

Surprisingly, antihistamines were common OTC medications recommended, while a commonly prescribed sleep aid was clonidine, which is used to treat behavioral problems. Neither of these medications was specifically designed to treat insomnia; in fact, little is known about their safety and effectiveness for treating sleep-related problems. Moreover, they were administered to children who had difficulty sleeping and/or awoke frequently during the night, which most would agree is a fairly natural occurrence - especially in children.

On the flip side, many of these doctors may be overlooking more serious health problems masked as insomnia, including depression, attention-deficit/hyperactivity disorder, psychological problems, and other medical conditions. And according to the study, the practitioners themselves expressed "a range of concerns about sleep medication appropriateness, safety, tolerance and side-effects in children."

If your child suffers from sleep-related difficulties, ask your doctor about all the options before opting for a "quick fix" with medication. There are many reasons for insomnia (in children and adults); make sure your physician determines the reason behind your child's problem - and its severity - before deciding the best manner in which to treat it.

Reference: Owens JA, Rosen CL, Mindell JA. Medication use in the treatment of pediatric insomnia: results of a survey of community-based pediatricians. Pediatrics (online version), May 2003: Volume 111, Number 5, p.e628.

To learn more about common childhood health issues, go to www.chiroweb.com/find/tellmeabout/childhood.html.

More Reason to Worry About Combined Hormone Replacement Therapy

Recent studies have established a fairly conclusive link between some forms of hormone replacement therapy (HRT) and an increased risk of breast cancer - particularly HRT regimens that rely on combined (e.g., estrogen and progestin) therapy. The latest study on combined HRT therapy goes one step further in suggesting that women need to be wary.

The purpose of this study was to determine if a correlation exists between the duration of replacement therapy use and breast cancer. The study assessed women between 65-79 who had been diagnosed with invasive breast cancer, and who use unopposed estrogen replacement therapy (EST), combined hormone replacement therapy (CHRT), or both.

The results of this study showed that women who used EST exclusively for extended periods of time were not more prone to developing breast cancer, while women who used CHRT showed an increased risk for breast cancer, especially when using CHRT for longer durations and regardless of whether CHRT was utilized in a sequential or continuous fashion.

Natural alternatives to hormone replacement therapy do exist, and each woman should weigh the benefits and risks before starting any regimen, particularly one based on combined hormone administration. Additional information on the benefits and risks of HRT can be found at www.amwa-doc.org/healthtopics/hrt_breastcancer_qa.htm or www.acog.org/from_home/publications/press_releases/nr08-30-02.cfm.

Reference: Li CI, Malone KE, Porter PL, et al. Relationship between long durations and different regimens of hormone therapy and risk of breast cancer. Journal of the American Medical Association, June 25, 2003: Volume 289, Number 24, p.3254.

For more information on women's health, visit www.chiroweb.com/find/archives/women.

Workplace Exercise Plus Job Stress: A Bad Combination?

So, exercise is always a good thing, right? Not necessarily. A recent study published in the American Journal of Medicine indicates that people who get the most on-the-job exercise also tend to suffer the most job stress - a combination that could lead to an increased risk for heart attack.

Researchers followed the physical activity of 500 middle-aged employees while monitoring the progression of their atherosclerosis (buildup of fatty tissue along the inner lining of artery walls), a condition that can lead to heart disease and life-threatening heart attacks and strokes. Interestingly, although atherosclerosis progressed more slowly in those who exercised more in their leisure time, the condition progressed faster among those who were physically active at work. According to James Dwyer, PhD, "Atherosclerosis progressed significantly faster in people with greater stress, and people who were under more stress also were the ones who exercised more in their jobs."

However, when the workers were grouped based on work stress alone, the connection between physical activity and atherosclerosis disappeared, suggesting that the problem is actually due to stress, not exercise; this means that the physical benefits of exercise with regard to hardening of the arteries may be ineffective when the exercise is combined with a stressful job environment. Of course, it also reinforces the fact that physical exercise can play an important role in keeping the heart healthy and free of disease.

So, what does this mean for people who have physically demanding jobs that are also major sources of stress? Exercise outside of work, too! The study also found that the progression of atherosclerosis slowed in those whose level of physical activity increased during leisure time. To learn more about the benefits of consistent, moderate exercise, go to www.chiroweb.com/find/archives/sports.

Reference: Dwyer J, Nordstrom CK, Dwyer KM, et al. Leisure time physical activity and early atherosclerosis: the Los Angeles Atherosclerosis Study. American Journal of Medicine July 2003: Volume 115, Number 1, pp.19-25.

A Portfolio You Can Be Proud Of

It seems as if there's a new fad diet on the market every week. The latest one to make the headlines is the "Portfolio" diet, which is high in plant sterols, viscous fiber, almonds, beans and soy protein, and is designed to cut the amount of cholesterol in the blood. A recent study has shown that the Portfolio diet works as well as some cholesterol-lowering drugs, and without causing unwanted side-effects.

The study, published in the Journal of the American Medical Association, involved 46 people with high cholesterol, and compared the effectiveness three diets: 16 people used the National Cholesterol Education Program's Step 2 diet, a low-saturated fat diet that emphasizes whole-wheat cereals and low-fat dairy foods; 14 took the Step 2 diet, along with a daily, 20-milligram dose of the cholesterol drug lovastatin; and the remaining 16 followed the Portfolio diet. The patients remained on their respective diets for one month; fasting blood samples, blood pressure and body weight were measured at the start of the study and at two- and four-week intervals.

Patients in all three groups lost similar amounts of weight, and there were no significant differences in blood pressure. When it came time to measure blood cholesterol, however, patients in the lovastatin and Portfolio groups had significant reductions in LDL, or "bad," cholesterol levels. LDL levels dropped 31 percent in the lovastatin patients and 29 percent in the Portfolio patients. The control group, on the other hand, reported only an 8-percent reduction in LDL levels.

Before you write off the Portfolio diet as too strict for your taste, bear in mind that a wide variety of foods fit into the diet's plan. In addition to the foods mentioned above, okra; legumes; tofu; soluble fiber; and meatless "chicken" and "hamburger" patties were acceptable options for subjects in the Portfolio group. Other foods that can be eaten as part of the Portfolio plan include oat bran; most fruits; tomatoes; vegetarian chili and/or curry; eggplant; cauliflower; onions; and red peppers.

Reference: Jenkins D, Kendall C, Marchie A, et al. Effects of a dietary portfolio of cholesterol-lowering foods vs. lovastatin on serum lipids and C-reactive protein. Journal of the American Medical Association, July 23, 2003: Volume 290, pp.502-510.

Additional information on nutrition can be found at www.chiroweb.com/find/archives/nutrition.

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