TipSheet : To Your Health

Should You Go Generic?

Newsweek — Sat, 04 Oct 2008 20:31:27 GMT

By Mary Carmichael
October 13, 2008

A new study says Medicare patients prefer cheap generic drugs only when they’re footing the bill themselves—when government pays, they want brand names. Recent news may shed some light on why: the FDA is investigating reports of faulty generic Wellbutrin, and last month it banned 28 generics made in India. If you’re taking a generic, should you switch to a brand name? Probably not. All generics, prescription or over-the-counter, go through a rigorous approval process. Generics are supposed to be “bioequivalent” to their costlier cousins (their active ingredients are equal in dose, safety, strength and efficacy). Although their inactive ingredients (such as flavors and dyes) differ, it’s very rare for those to cause reactions. Generics made in the United States are manufactured under the same standards as brand names. But the FDA has no authority to oversee those made abroad. (India and China make about a fifth of the generics sold here.) The agency’s only option is to ban those drugs and demand manufacturing upgrades, as it did last month. It also assured consumers there’s “no evidence of harm” from what’s already on the market.

Don’t Forget Your Vitamins

Newsweek — Sat, 15 Mar 2008 16:18:38 GMT

By Tina Peng

More than half the U.S. population—including about 70 percent of the elderly and 90 percent of minorities—is vitamin-D deficient, according to Dr. James E. Dowd, author of “The Vitamin D Cure.” The nutrient helps maintain normal levels of calcium and phosphorus in the blood. It also helps the body absorb calcium and keeps bones strong. Vitamin D may also protect against osteoporosis, hypertension, cancer and other diseases, according to the Mayo Clinic.

Vitamin D is mostly produced in the skin after UV exposure from the sun, but it can also be derived from milk, fish, egg yolks and vitamin supplements. It’s harder for the obese and people with more melanin in their skin to absorb vitamin D. It doesn’t help that we’ve become a nation of sunscreen wearers who eat low-vitamin processed foods and work mostly indoors; that all leads to D deficiency, which can cause susceptibility to seasonal affective disorder, fatigue, headaches and a variety of immune-related diseases, according to Dowd.

Luckily, the cure is hardly painful: the National Institutes of Health prescribes a balanced diet and weekly sun exposure in order to produce the body’s natural require-ment of vitamin D. Other easy sources of the nutrient include cod-liver oil, salmon and milk. Raw fish is even better. Some doctors recommend an additional vitamin supplement, available at health stores, but go easy on those. Overzealous pill-popping can result in vitamin-D toxicity, for which the side effects include nausea, vomiting, constipation and an increase of calcium in the blood. That, in turn, can lead to mental confusion. Check online at dietary-supplements.info.nih.gov for NIH’s recommended daily intake levels; the older you are, the more you require.

Doctors say keeping track of your vitamin-D intake is especially important for people at risk of deficiency—those with dark skin, the elderly, the overweight, those who suffer from diseases that interfere with the body’s absorption of fat, and infants who were exclusively breast-fed.

Surprisingly, people who wear sunscreen whenever they go out are at risk, too. Although sunscreen protects your skin from UV damage, SPF numbers as low as 8 can reduce vitamin-D absorption by 95 percent, according to the Linus Pauling Institute at Oregon State University.

Although most doctors balk at suggesting that Americans cut back significantly on sunscreen usage, many recommend 10 to 15 minutes of sunshine, three times a week— without the lotion.

Get Your Sperm Moving

Newsweek — Sat, 16 Feb 2008 16:03:08 GMT

Illustration: Mark Matcho for Newsweek

By Karen Springen

Like many couples, Brian Delaney, 35, and his wife, Daniela, 34, turned to in vitro fertilization after failing to conceive on their own. But after five attempts and an investment of $150,000, IVF failed them as well. Then Brian saw a male-infertility specialist, Columbia University’s Dr. Harry Fisch, who discovered that Brian’s low sperm production could be corrected through microsurgery. Three months later, Daniela was pregnant. Last November she delivered a baby boy, Harrison.

Long overlooked, male infertility has become a fruitful field of research. Doctors now know that, when a couple fails to conceive, the problem lies with the man as often as with the woman. And as the Delaneys learned, recent advances have dramatically improved experts’ understanding of how to diagnose, treat and prevent the condition. “Anything that makes the body unhealthy—a disease, toxins, excessive alcohol—will hurt fertility,” says UCSF urologist Paul Turek. “But most of these things that hurt fertility are reversible.” Some tips for men:

Prune your prescriptions. Among the commonly prescribed medicines that can affect fertility or libido are SSRI antidepressants like Prozac, beta blockers for hypertension, alpha blockers like Flomax (used to treat the symptoms of an enlarged prostate), the stomach-ulcer drug Tagamet and pain medications like morphine and oxycodone.

Men who are trying to conceive should also avoid using anabolic steroids and testosterone creams and injections because they shut down the body’s production of testosterone and sperm. “The body loves it, but the testicles hate it,” says Turek. “They say, ‘Well, there’s plenty of testosterone. I don’t need to make testosterone or sperm myself’.”

Have more sex. It sounds obvious, but some busy couples don’t make enough time for it. During ovulation—about 10 to 18 days after a woman’s period starts—couples should have sex every other day to “optimize sperm motility,” says Fisch, who is also the author of “The Male Biological Clock.” After five days without sex, a man has a higher volume of fluid, which dilutes the concentration of sperm and makes them less active.

Stay fit. Doctors are seeing more men with obesity-caused infertility. Fat converts testosterone to estrogen, and obese men (or those with a waist circumference of more than 40 inches) are more prone to erectile dysfunction. Men with type 2 diabetes, often associated with obesity, are more prone to low testosterone levels, which negatively affect libido and sperm production.

Doctors can prescribe anti-estrogens like Clomid, used to increase egg production in women, to stimulate testosterone production and, in many men, sperm production.

Stay cool. Heat can damage sperm cells, so stay out of hot tubs, avoid putting your laptop on your lap and don’t sit for long periods of time with your legs crossed or pressed together, says Dr. Peter Schlegel, chairman of urology at NewYork-Presbyterian/Weill Cornell Medical Center in New York. There’s also some evidence linking cell-phone radiation with altered sperm cells in men, so don’t “live on the cell phone,” and keep the device in your jacket or holstered to your belt rather than in your front pants pocket, he says.

See a urologist. “Even those men who we considered to be sterile in the past, we almost always can treat them now,” says Schlegel. Urologists can provide treatments such as vasectomy reversals and outpatient microsurgery for conditions like blocked ducts, scarring from STDs and varicoceles, a type of varicose vein.

Men who want to boost their fertility should also quit smoking, cut back on alcohol, avoid illegal drugs (especially marijuana) and exercise regularly. “Anything that improves medical health is likely to improve sperm,” says University of Illinois at Chicago andrologist Craig Niederberger. Then be patient. “In the world today, people want to act too quickly. ‘We tried for two months, we didn’t get pregnant, we want IVF’,” says urologist Robert Oates, director of male reproductive medicine and surgery at Boston University School of Medicine. Sometimes “try, try again” comes with its own rewards.

The ‘How To’ of Leading a Happy Life

Jennifer Barrett — Sat, 19 Jan 2008 17:58:35 GMT

Illustration: Chris Gash for Newsweek

If your parents are unhappy, are you destined for unhappiness, too? Psychologists used to believe that genes played a determining role in our state of mind. But new research is finding that people can do more than previously thought to improve their outlook on life. “Things are more complex than simple genetic models suggest,” says Ed Diener, a professor of psychology at the University of Illinois who researches subjective well-being. “People are stuck with the genes they have … but we know that adult personality can change, and people probably have some control over this.”

How much control is still a matter of debate within the field. In a new book, “The How of Happiness” (Penguin Press. $24.95), Sonja Lyubomirsky, a psychology professor at the University of California, Riverside, proposes that a full 40 percent of our happiness is within our control. Using data from research on identical and fraternal twins, she concludes that an additional 50 percent is determined by genetics. The remaining 10 percent is dictated by circumstance—like a recent divorce or a financial windfall. “In the past, we’ve heard you can’t make people happy sustainably because happiness is genetic or because life’s circumstances won’t allow it,” says Lyubomirsky. “I argue that there are things we can actually change.”

Lyubomirsky, who has been studying happiness for nearly two decades, offers a dozen so-called happiness intervention strategies in her book, all backed by her own or others’ research. With help from a National Institute of Mental Health grant, she and colleague Ken Sheldon have conducted or reviewed dozens of studies with participants who, for example, wrote letters of gratitude, performed conscious acts of kindness or kept a “best possible selves” journal to outline future goals over six or more weeks. When compared with control groups, those who performed the activities regularly reported “significantly bigger” increases in their happiness levels, as compared with before the intervention. “Even nine months later, we still saw the effects: those who continued to practice these strategies had more sustained happiness,” she says. Here’s more advice from the book:

Don’t overthink it. When you catch yourself stewing over something, tell yourself, “Stop.” Or set aside 30 minutes late in the day to do nothing but ruminate. Chances are, when the appointed time comes, the issues that plagued your thoughts earlier will seem less consequential.

Learn good coping skills. Write down traumatic experiences and learn how to recognize, and argue with, overly pessimistic thoughts.

Savor life’s joys. Relish ordinary experiences, like a good meal or a hot shower; conjure up a favorite memory when you’re down.

Cultivate optimism. After studying Lyubomirsky’s strategies, photographer Kelly Radinsky, 45, set aside time each evening when she, her husband and two kids, ages 5 and 9, take turns sharing the favorite parts of their day.

Lyubomirsky recommends only trying strategies that match your personality and repeating them only as often as they fit into your schedule (otherwise, they could seem like obligations). She admits that some suggestions may sound “hokey” but stresses that they are based on controlled studies or correlational data showing they can significantly improve participants’ level of happiness compared with those who do not perform the exercises.

“This isn’t someone standing up and saying, ‘Just think positive thoughts.’ She’s doing rigorous research,” says Alan Kazdin, professor of psychology at Yale University and president of the American Psychological Association. “We’ve learned over the past few decades that there are strategies you can use that can actually change the brain, change behavior and then mood and understanding follow.”

Radinsky, who inherited “dark genes” from an abusive father and suicidal mother, says she sometimes has to work at making Lyubomirsky’s strategies a habit, but it’s worth it. “I think they can make the difference between a happy and an unhappy life,” she adds. That’s good news for the pessimists among us.

Hold The Salt, Please

Jennifer Barrett — Sat, 15 Dec 2007 18:32:51 GMT

Photo Illustration by C.J. Burton for Newsweek

Ed Goldston used to sprinkle salt on almost everything he ate—from soups and salads to steak. That changed about 15 years ago when his doctor diagnosed him with hypertension and told him to go on a low-sodium diet. The Pittsburgh real-estate investor agreed to stop adding salt to his meals, but that wasn’t enough. “I found out there was so much salt added to food before I even picked up a shaker.”

French fries were an obvious source, but he didn’t realize that ketchup was packed with sodium, too. He stopped topping his pizza with anchovies, then realized that even a slice of plain cheese can have more than 750 milligrams of sodium, about a third of the recommended daily allowance. Goldston, now 72, started avoiding pizza altogether. Soon he’d added packaged lunchmeats, snack foods and canned soup to his blacklist. “I was really amazed at how much salt I was consuming without even realizing it,” he says.

Stories like Goldston’s have doctors concerned. The U.S. Department of Health and Human Services recommends no more than 2,300 milligrams of sodium a day, or about a teaspoon of salt. Those with, or at risk for, high blood pressure should limit their intake to 1,500 milligrams. But most Americans consume triple that amount—about three quarters of it from processed foods.

If the body’s kidneys can’t eliminate enough sodium, it starts to accumulate in the blood. That increases blood volume, which makes the heart work harder and puts more pressure on the arteries. Studies have linked high-sodium diets with an increased risk of stroke, heart disease and high blood pressure. “It’s a major health problem,” says Dr. Daniel Jones, president of the American Heart Association.

Last month the Food and Drug Administration called a hearing to review its policies on salt in food. The Center for Science in the Public Interest has asked the agency to add health warnings to salt packets a half ounce or larger and to impose stricter limits on salt in processed foods, a move the American Medical Association supports. Richard Bonnette, a consumer-safety officer at the FDA, says implementing such regulations would be “challenging” and could take several years.

What to do in the meantime? Madelyn Fernstrom, founder and director of the University of Pittsburgh Medical Center’s Weight Management Center (where Goldston is a patient), urges her clients to read nutrition labels and avoid high-sodium processed foods like canned vegetables, rice and noodle mixes and microwavable meals. She recommends buying sodium-free foods or products marked “low sodium,” which must contain 140 milligrams or less per serving. And though only about 10 percent of the salt Americans consume comes from the shaker (some is also found naturally in foods), Fernstrom suggests using other seasonings instead. Ultimately, says Dr. Christine Gerbstadt, a physician and spokesperson for the American Dietetic Association, “If you leave it to chance, you’re going to eat too much salt. You have to be conscious about it.”

That strategy has worked for Goldston, who lowered his blood pressure from 172 over 82 to 120 over 70 with the added help of a hypertension drug. “I still try to stay under 1,500 milligrams of sodium each day, and that’s hard,” he says. “But it’s worth it. I feel great.” Doctors hope that with more publicity about the benefits of a low-sodium diet, millions of other Americans will feel better, too.

Logging On to Lose Those Extra Pounds

Newsweek — Sat, 10 Nov 2007 17:44:56 GMT

Photo illustration by Viktor Koen for Newsweek

Jeanne Dulaney is a time-crunched software consultant who often eats out on the company expense account. But the 51-year-old from Montgomery, Ala., paid the price for her frequent restaurant dining: 40 extra pounds on her 5-foot 5-inch frame. With little time to commit to a real-world weight-loss program, Dulaney became a mouse-clicking dieting maven after seeing an ad for ediets.com. “I’m on my computer all the time, so I figured I’d give it a try,” she says.

Three years later, Dulaney is nearly 50 pounds lighter. She’s even started to run half-marathons with some new- found friends, other members of ediets.com. “Everyone who is trying to lose weight needs help,” she says. “I got mine from my computer.”

No one actually knows how many people like Dulaney have found weight-loss success with Internet-based commercial programs. But what is clear is that Web-based diets are becoming a booming part of the $30 billion U.S. weight-loss industry. The choices are endless. Internet-only weight-loss programs like ediets.com, diet.com and WebMD, and diet icons like Weight Watchers and South Beach are all competing for your weight-loss bucks. Even fitness franchise Curves opened a new online dieting site last week.

Although research into the effectiveness of online dieting is in its infancy, science is showing that it probably won’t hurt you. And, depending on the program’s components, these online purveyors may help you drop some pounds. With 24/7 access and anonymity, the sites may be helpful for folks who are too busy, or too shy, to attend a more structured program.

In a study published in The Journal of the American Medical Association, Brown University researchers found that Internet dieters who received weekly e-mail advice from behavioral therapists and had peer support through bulletin boards lost three times as much weight in six months as those who received only Internet-based diet and exercise information.

“There are a lot of unanswered questions about how the Internet can help people lose weight,” says Rena Wing of the Warren Alpert Medical School of Brown University and a cofounder of the National Weight Control Registry. “But what’s clear is, there needs to be some type of professional guidance available.” Look for programs that allow you to interact with a dietitian or other weight professional who can help individualize a program. Wing also recommends looking for sites that incorporate proven real-world strategies like nutrition guidance, physical activity and a tracking system that allows you to log meals and exercise.

The good news is that many online programs do offer a combo platter of personalized service, with most costing about $5 a week. At diet.com, you can get a customized diet-and-exercise program based on your personality type. If you’re too busy to cook, ediets.com will send you fresh, chef-prepared meals five ($99) or seven ($131.60) days a week. WebMD will give your favorite family recipe a healthy makeover

Check out consumerreports.org or onlinediet-services-review.toptenreviews.com to get an idea of what these programs can do for you and your waistline. In Dulaney’s case, she lost weight and gained some new best friends.

With Roxana Popescu

Health: For Safer Baby Bottles

Newsweek — Sat, 10 Nov 2007 17:40:32 GMT

As if parents didn’t have enough to worry about with the confusing and seemingly never-ending toy recalls, now comes a new concern: bisphenol A, or BPA, a component of the polycarbonate plastic that makes up many baby bottles and sippy cups, which has shown the potential to cause a variety of health problems. While the Food and Drug Administration has not found reason to ban the chemical, some studies have shown that even low doses of the chemical in lab animals can cause neural and behavioral effects, and possibly lead to obesity, decreased fertility and some cancers. It’s enough to get environmental organizations to press for change. “We think it’s health-protective to really regulate this chemical to decrease human exposure,” says Anila Jacob, senior scientist at the Environmental Working Group (ewg.org).

If you think it’s better to play it safe, here’s what you can do to protect your infant:

• Breast-feed if possible.

• Don’t heat bottles with liquid in them or put warm liquid into the bottle. Heat can cause the BPA to leach from the bottle into the liquid. Get rid of bottles that are scratched or cloudy. Studies have shown that the more bottles age, the more likely the chemical will leach into what’s in the bottle.

• Buy bottles made of glass or of polypropylene or polyethylene. Many manufacturers are now marketing “BPA-free” bottles made with these alternative plastics. Born Free (newbornfree.com) and Sassy Baby (sassybaby.com) are two such companies. Thermos and Luv ’N Care make BPA-free sippy cups (both available at buybuybaby.com).

—Christina Gillham

America's Test Kitchen: Produce Protection

Newsweek — Sat, 10 Nov 2007 17:38:24 GMT

In recent kitchen tests we discovered that spraying produce with vinegar is the best way to remove surface wax and pesticides, but could this method destroy bacteria as well? Here is what we found:

The Experiment: We cleaned apples and pears four different ways: rinsing under cold running tap water, scrubbing with a brush, washing with a vinegar solution and scrubbing with antibacterial soap. We took surface samples from the produce and grew the bacteria in petri dishes.

Results: After four days, we compared the petri dishes and found that rinsing under cold water had removed only 25 percent of bacteria, and scrubbing with a brush removed 85 percent. The vinegar removed 98 percent of surface bacteria, which made it nearly as effective as the antibacterial soap.

Recommendation: We recommend washing produce in a solution of 3 parts tap water to 1 part distilled vinegar applied with a spray bottle. This method should work for any firm, smooth-skinned produce like apples, pears, tomatoes and carrots.

These Poles Are Made For Walking

Newsweek — Sat, 10 Nov 2007 17:33:49 GMT

Invented in Scandinavia, Nordic walking is an increasingly popular activity for seniors and non-athletes who want to maximize the benefits of a daily stroll. Participants use poles as in cross-country skiing to push off with each stride. This engages more muscle groups and results in a full-body workout. Poles also improve stability and take weight off of creaky knees and joints. Better still, studies show that Nordic walking burns more calories than just plain walking.

Interested? Any old ski poles will do in a pinch, but specially designed models work best. They have rubber tips that grab pavement and wrist straps that secure the poles to your arms so you can maintain a loose, comfortable grip on the handle. The Instructor has an adjustable-length, lightweight carbon and aluminum shaft, and each pair comes with an instructional DVD ($149.95; leki.com). Trekking poles are heavier and sturdier than Nordic walking poles and are made for mountain hikes over rocks and roots. The Trail by Black Diamond features a durable metal tip, and the shaft telescopes down for easy storage when not in use ($79.95; bdel.com).

People who already walk for fitness might notice some fatigue in their arms as they put their upper bodies to work for the first time. Group walks, clinics and instructional classes are held in some cities, and the American Nordic Walking Association (anwa.us) provides information on proper technique and the fitness benefits of walking with poles. So grab a pair and hit the slopes—er, streets.

—Paul Tolme

Look, Ma, I’m Going Meatless!

Newsweek — Sat, 10 Nov 2007 17:30:33 GMT

Is your kid turning vegetarian? While some do so simply because they’re following in the footsteps of Mom and Dad, other kids choose to go veggie for environmental reasons or because they’re animal lovers (younger kids simply might not like the texture of meat). If you’re worried they’re not getting adequate nutrients, relax. Doctors and dietitians say you can raise healthy herbivores at any age, even from birth. The American Academy of Pediatrics says it’s OK as long as the diets are supervised by a doctor and not too restrictive. In fact, plant-based diets can be lower in cholesterol and saturated fats and higher in fiber than carnivorous fare. And vegetarians tend to reduce their risk of obesity, heart disease, high blood pressure, type 2 diabetes and some cancers.

Vegetarian kids can get protein from eggs, dairy products, soy, seeds and nuts. Vitamin B12, found naturally in meat and dairy products, can come from fortified foods like cereal. Omega-3 fatty acids, found in fish, also come from canola oil and walnuts. For extra insurance, ask your pediatrician about adding a multivitamin.

Just make sure that if your child is eliminating meat, he or she is substituting with something healthy, not meatless junk like cookies. For recipe ideas, log onto vrg.org and veganlunchbox.com. Then chill out. “There are many cultures in the world that are primarily, if not exclusively, vegetarian, and the kids do fine,” says Oak Park, Ill., mom Sharon Bloyd-Peshkin, whose two adolescents are lifelong herbivores. “The average American diet is unbelievably unhealthy.”

—Karen Springen

Ask the Pro: Chef! This Dish Needs Pain Relief

Newsweek — Sat, 10 Nov 2007 17:25:38 GMT

Some spices improve your health, as well as your cooking. Tip Sheet’s Anna Kuchment asked Dr. Mark Lee, medical editor of the “Mayo Clinic Book of Alternative Medicine,” for details.

NEWSWEEK: What herbs and spices have the strongest scientific data to back their health benefits?
LEE: Traditionally, there have not been many scientific studies done on spices. But garlic has some data behind it, and so does cayenne pepper and cinnamon.

How can garlic improve your health?
There is some data that shows garlic may lower LDL, or bad cholesterol, if taken orally. But the studies were done with raw garlic and in very high doses—you wouldn’t have many friends if you were taking that much garlic. The active ingredient in garlic is allicin, the same chemical that gives garlic its pungent odor. No one has really shown that freeze-dried garlic has the same effect.

What about cooked garlic?
If you can smell the garlic, it probably has some of the active ingredient in it. But is it enough to affect your health? We don’t really know.

What does the data on cayenne show?
We’ve been able to isolate its active ingredient, capsaicin, which creates fiery heat. When applied topically, in a lotion, capsaicin can relieve pain in joints close to the skin surface, like fingers, knees and elbows. It overwhelms the nerve. When the burning disappears, that’s when you get the pain relief.

And cinnamon?
We have some clear data showing that cinnamon can lower your blood sugar. But the amount that has been studied is one to six grams, more than anyone would consume in one sitting.

Would you recommend taking supplements?
I don’t take vitamins myself. I recommend using these herbs fresh, like in a pesto, because they have a wonderful flavor that should be enjoyed. Generally, if you eat a well-balanced diet, eat naturally and avoid a lot of the processed stuff, you shouldn’t need one.