All posts by SRH Matters

What is gestational diabetes?

Reproductive Health

What is gestational diabetes?

2013-08-02

By Alisha Ebrahimji

Babies may be born larger than normal because of a condition called gestational diabetes. That explains why baby Jasleen, born in Germany last week, weighed more than 13 pounds.

Her mother had gestational diabetes, but her condition wasn’t discovered until she went into labor and checked herself into University Hospital Leipzig.

Gestational diabetes develops during pregnancy and resembles other forms of diabetes in that it affects how your cells use sugar (glucose).

With gestational diabetes, a mother’s blood sugar should return to normal soon after delivery. However, the condition puts women at risk for type 2 diabetes in the future.

For every 100 pregnant women in the U.S, two to 10 will have gestational diabetes, the Center for Disease Control and Prevention says.

A woman who has gestational diabetes during pregnancy and maintains a high blood-sugar level may have a baby born abnormally large, weighing 9 pounds or more, the CDC says. A baby’s large size creates problems for the delivery of the child through the birth canal and may cause nerve damage in the child’s shoulder during birth.

“A very large baby has an increased chance of being overweight or obese later in life,” the CDC says. “Being overweight or obese increases the chance of also having diabetes later in life.”

Gestational diabetes results from hormonal changes that every woman has during pregnancy, according to the Cleveland Clinic. Elevated levels of certain hormones made in the placenta disrupt insulin’s ability to manage glucose, a condition called insulin resistance. (The placenta is the organ connecting the baby by the umbilical cord to the uterus and sends nutrients from mother to child.)

As the placenta becomes larger throughout pregnancy, it creates more hormones, which, in turn, increases the insulin resistance, the Cleveland Clinic said.

The mother’s pancreas is typically able to make three times the normal amount of insulin to beat this resistance, according to the Cleveland Clinic. If the pancreas can’t produce the required amount of insulin, however, sugar levels will rise, and the woman will have gestational diabetes.

You may be at risk for gestational diabetes if you are overweight before becoming pregnant, have a family history of diabetes, are older than 25, have previously giving birth to a baby over 9 pounds, previously gave birth to a stillborn baby, have had gestational diabetes with a previous pregnancy or have been diagnosed with pre-diabetes, the Cleveland Clinic said.

Women typically find out whether they have gestational diabetes between the 24th and 28th weeks of pregnancy, according to the Cleveland Clinic. That’s when insulin resistance usually begins.

If you previously had gestational diabetes or if your doctor is concerned about your risk of developing it, you can be tested for the condition before the 13th week of pregnancy, according to the Cleveland Clinic.

An oral glucose tolerance test is used to screen for gestational diabetes. This involves consuming 50 grams of glucose in a beverage. Your body will absorb the glucose and cause your blood sugar levels to rise within 30 to 60 minutes, according to the Cleveland Clinic. Blood samples are taken from a vein in your arm 30 minutes after consuming the sweetened drink so that your doctor can evaluate how your body processes glucose.

According to the Mayo Clinic, expectant mothers can control gestational diabetes by eating healthy foods, exercising and, if required, taking medication.

Treatment may include monitoring blood sugar four to five times a day, which involves drawing a drop of blood from your finger and testing it with a blood glucose meter.

Your health care providers will monitor and manage your blood sugar levels during labor and delivery. Following up with blood sugar checks after the baby is born is also important.

You can reduce your risk of developing type 2 diabetes later on by continuing to eat a healthy diet and getting regular exercise.

CNN’s Dana Ford contributed to this report.

Your happiness type matters

Psycological Health

Your happiness type matters

2013-08-01

By Jen Christensen,

You feel happiness all the way down to your genes, scientists say. But the kind of happiness you’re feeling matters, as different kinds can have wildly different effects on your physical well-being.

In fact, the happiness you get from instant gratification — eating that giant cupcake or buying that fabulous pair of shoes — may have the same physical impact on your genes as depression or stress, according to a groundbreaking study published in the Proceedings of the National Academy of Sciences.

“I’ve been studying the physical and psychological impact of positive emotion for 20 years, (and) the pattern of results we found with this study completely surprised me,” said the lead author, Barbara Fredrickson.

Fredrickson is a professor of psychology and the principal investigator of the Positive Emotions and Psychophysiology Lab at the University of North Carolina.

“I’ve known anecdotally that positive emotions impact us on a cellular level, but seeing these results have given us proof that there is a real difference in the kinds of happiness we feel and its potential long-term consequences.”

The experts divide well-being into two different types: hedonic and eudaimonic. These are fancy words to describe happiness that comes from two different sources.

Hedonic well-being comes from an experience a person seeks out that gives them pleasure. As study co-author Steve Cole describes it, it’s “having lots of positive experiences that come from, say, eating great food or smelling beautiful flowers.”

Eudaimonic well-being is a kind of happiness that comes not from consuming something but from a sustained effort at working toward something bigger than you. In other words, it’s working toward a sense of meaning in your life or contributing to some kind of cause. Think of the happiness you see on the Dalai Lama or Mother Teresa’s face.

While the two kinds of happiness are conceptually different, they can and do influence each other, so it has been hard for scientists to measure which kind has had a greater positive influence on someone’s physical or psychological well-being.

Cole, a professor of medicine, psychiatry and biobehavioral sciences at UCLA, studies the biological pathways by which social environments influence gene expression.

“I know what misery looks like on a genetic level,” Cole said. “I can look at white blood cells and see a physical response to stress and misery, but we knew very little about how — if at all — positive psychology gets disseminated to the body. That’s what this study does.”

If you experience misery and stress, your genes react to it. Essentially, there is an increased expression of genes involved in inflammation and a decreased antiviral response. People who are subjected to long periods of stress have white blood cells that make slightly more pro-inflammatory proteins on a constant basis.

Inflammation is the first line of defense against infection, so that would be a very useful kind of protein to have; however, something that causes your body to create inflammation over a sustained amount of time can cause collateral damage to healthy tissue.

Colorado College microbiologist Phoebe Lostroh, who is not affiliated with the study but is familiar with its contents, explains it this way: “The immune system of someone stressed out is not at the normal level of green on the terrorism alert scale. Instead, it’s on yellow or orange, if not all the way on red. So there’s this low level of constant inflammation, which is not healthy.”

Low levels of inflammation can cause exhaustion. They also increase a person’s risk for cancer, heart disease and Alzheimer’s and can damage various tissues wherever the white blood cells are causing inflammation where they shouldn’t be, Lostroh said.

With this understanding in mind, the scientists in the new study took blood from 80 healthy adults who were screened for the two types of happiness. None of them reported being depressed or stressed.

Scientists extracted the RNA from their blood and took a closer look at the inflammatory and antiviral responses.

The study found that people who experienced the well-being that comes from self-gratification had high inflammation and low antiviral and antibody gene expression, a result similar to what people who are depressed or experience great stress have.

Tell us your story!
We love to hear from our audience. Follow @CNNHealth on Twitter and Facebook for the latest health news and let us know what we’re missing.
The people who found happiness by pursuing a greater good had a lower level of this inflammatory gene expression and strong antiviral and antibody gene expression.

Bottom line? Happiness that comes from working for the greater good has a much more positive genetic impact.

“Keep in mind positives go with both kinds of well-being,” Fredrickson said. “But emotions you feel today … really will effect who you are at a cellular level.”

The study didn’t get at why the two kinds of well-being have different genetic impacts, but Cole has a theory.

“Hedonic well-being is dependent on your taking self-involved action to constantly feed this positive emotion machine,” he said. “If something threatens your ability to seek out this kind of personal happiness — if you get injured, for instance, or you experience a loss — your entire source of well-being is threatened. You are living closer to the edge of that kind of stress.

“But if you find well-being in the connections you have to others and in pursuing something that involves collaborating with other people, if in that circumstance you get sick or injured or suffer a personal loss, that community you’ve worked so hard to connect to, they will help you get through.”

We’re Living Longer — and Healthier

Uncategorized

We’re Living Longer — and Healthier

2013-07-30

By

There’s no doubt that we’re living longer than previous generations. Now there’s encouraging news that those added years may be healthy ones as well. According to the latest tallies from the Centers for Disease Control and Prevention (CDC), in 2010 the average life expectancy rose from 78.6 years in 2009 to 78.7 in 2010. But the data has not been as definitive about whether that means people are stronger and healthier and therefore adding years to their lives, or whether medical innovations are extending lives, but leaving people sicker for longer.

Researchers from Harvard University report that there is some reason to be optimistic about our longevity. “Effectively, the period of time in which we’re in poor health is being compressed until just before the end of life. So where we used to see people who are very, very sick for the final six or seven years of their life, that’s now far less common. People are living to older ages and we are adding healthy years, not debilitated ones,” said David Cutler, the Otto Eckstein Professor of Applied Economics at Harvard University and author of the latest study, in a statement.

Continue reading We’re Living Longer — and Healthier →

My Name is John and I Am a Sex Addict. (Or Maybe Not)

Sexual Health

My Name is John and I Am a Sex Addict. (Or Maybe Not)

2013-07-24

By

Is it or isn’t it? A new study undermines the theory that sex addiction is a brain-based disorder similar to other addictions.

For most of the public, the concept of addiction is pretty straightforward— it involves taking something, or doing something, that brings you pleasure and that you can’t control. But scientifically, addiction means something much more specific, if not precisely quantifiable.

For much of the 20th century, psychiatrists and lay people defined addictions as use of substances or behaviors that required ever-increasing doses to maintain a satisfying “high.” These addictions also conspired to form some type of physiologic dependence, which led to physical symptoms such as vomiting and diarrhea when the addictive substance or activity was stopped.

Continue reading My Name is John and I Am a Sex Addict. (Or Maybe Not) →

Are you ‘normal’ in bed?

featured

Are you ‘normal’ in bed?

By Ian Kerner

How does your sex life measure up? That’s the central premise of “The Normal Bar,” a new book by Chrisanna Northrup and sociologists Pepper Schwartz and James Witte.

Based on the responses of an Internet survey of some 70,000 people, “The Normal Bar” endeavors to ease people’s concerns about their sexual relationships by providing readers with an idea of what’s “normal” for most couples — from how often they have sex, to how sexually adventurous they are, to how they romance each other outside the bedroom.

“It isn’t about a 98.6 kind of normal — just the normal of exceptionally happy couples (gay and straight) and what we can learn from them,” Schwartz says.

Continue reading Are you ‘normal’ in bed? →

Why you should talk about sex before marriage

featured

Why you should talk about sex before marriage

2013-07-23

By Ian Kerner, Special to CNN

Most couples tying the knot don’t want to wait until the honeymoon to know if things are going to work in the bedroom, and would agree that having sex before marriage is an important way to estab if there’s a basic level of sexual compatibility.

But — without getting into the moral pros and cons of premarital sex — that may not always be the case.

“Just because you have good sex, and a lot of it, before marriage doesn’t mean it will be that way for your entire life,” says social psychologist Justin Lehmiller.

Continue reading Why you should talk about sex before marriage →

Hormone-Replacement Therapy: Could Estrogen Have Saved 50,000 Lives?

Reproductive Health

Hormone-Replacement Therapy: Could Estrogen Have Saved 50,000 Lives?

2013-07-22

By @acsifferlin

For more than a decade, doctors have cautioned women about the risks associated with hormone-replacement therapy. But those warnings may have put one group of women at increased risk of dying early, according to the latest study.

Researchers at Yale University say nearly 50,000 women may have died prematurely after they stopped taking hormone-replacement therapy (HRT) to treat menopause symptoms, following a much publicized 2002 study that revealed the treatment increased risk of heart disease and breast cancer.

Continue reading Hormone-Replacement Therapy: Could Estrogen Have Saved 50,000 Lives? →

Sick Before Their Time: More Kids Diagnosed With Adult Diseases

featured

Sick Before Their Time: More Kids Diagnosed With Adult Diseases

2013-07-17

By

Diabetes, obesity and elevated blood pressure typically emerge in middle-age, but more young children are showing signs of chronic conditions that may take a toll on their health.

The latest report on the trend, from researchers at Harvard Medical School found that children and adolescents are increasingly suffering from elevated blood pressure. Published in the American Heart Association journal Hypertension, the study showed a 27% increase in the proportion of children aged 8 years to 17 years with elevated blood pressure over a thirteen-year period.

The scientists compared over 3,200 children involved in the National Health and Nutrition Examination Survey (NHANES) III in 1988-1994 to over 8,300 who participated in NHANES in 1999-2008. The national survey records health, eating and lifestyle behaviors of the volunteers. More kids in the recent survey were overweight, with larger waistlines than those in the previous cohort. And the children with body mass index (BMI) readings in the top 25% of their age group were two times more likely to have elevated blood pressure than the kids in the bottom 25%.

The kids did not have diagnosed hypertension, which requires a threshold of 140 -90, but elevated blood pressure — anything above 120-80 — at such young ages could prime them for hypertension later. “High blood pressure is dangerous in part because many people don’t know they have it,” said lead study author Bernard Rosner, a professor of medicine at Harvard Medical School in a statement.

The results are only the latest to reveal the first signs of chronic conditions that normally don’t occur until middle-age, in children and teens.

Earlier this year, the American Academy of Pediatrics released its first guidelines for type 2 diabetes, sometimes called adult-onset diabetes, among kids. Pediatricians are not typically trained to treat this form of the disease; they are more familiar with type 1. As TIME reported in January,:

Children have long been diagnosed with Type 1 diabetes, in which the body fails to make enough insulin-producing cells to process glucose in the blood, but doctors are now seeing an increasing number of children with type 2 diabetes, in which fat cells that enlarge with weight gain thwart the body’s ability to break down sugars. Up to a third of cases being diagnosed in kids these days are Type 2, which generally develops later in life, generally after age 40.

What’s driving today’s children to develop these diseases before their time? Obesity may be play a major role in many of these conditions, from diabetes to blood pressure and joint problems, says experts. “When I was in residency we didn’t learn too much about obesity or type 2 diabetes. Type 2 diabetes happened to adults. Every once in a while you had a type 2 diabetes case. Now, those are the norm. We see type 2 diabetes happening in children and teenagers all the time now,” says Dr. Dyan Hes, a New York City pediatrician and obesity specialist and founder of Gramercy Pediatrics. Hes is unaffiliated with the Hypertension study.

The list of symptoms and diseases that Hes now sees among her young patients could just as easily apply to patients who are decades older — high blood pressure, type 2 diabetes, pre-diabetes, worsening asthma symptoms, sleep apnea, joint pain, and swelling in the brain caused from being morbidly obese.

And to treat these conditions, more young children are taking medications for longer periods of time, so the long term health consequences of that trend is starting to worry many pediatricians. “It is creating youth who are disabled or medicated. They can’t participate in regular sports that other kids do. They are taking medicine at such young ages. So many of these medicines have bad side effects,” says Hes. “Medicines are expensive so it is a huge burden to the health care system. You have kids going to cardiologists or orthopedic doctors for joint pain.”

Dr. Pamela Singer of the division of pediatric nephrology at the Children’s Hospital at Montefiore Medical Center in New York says an estimated 60% of referrals to her division are for elevated blood pressure. “In the past, children with hypertension tended to be those with underlying conditions such as renal disease, or those with specific vascular or genetic abnormalities,” she says. “However, now the vast majority of hypertension that we are seeing is “adult-type” hypertension, related in large part to diet and lifestyle. That’s not just true for hypertension, but also for other diseases classically thought of as “adult diseases,” such as type 2 diabetes, which are becoming more common in the pediatric population. These conditions may all be interrelated – obesity, elevated blood pressure, high cholesterol, insulin resistance – and physicians and researchers are trying to elucidate those relationships.”

Eating a healthy diet, for example, is not just about food itself but the food environment, which is constructed around cultural, social and economic factors that determine the diversity of food choices and the accessibility of these options. In the recent study, the researchers found that kids with the highest sodium intake were 36% more likely than kids who consumed less salt to have elevated blood pressure, and over 80% of the kids ate more than 2,300 milligrams of sodium a day. The American Heart Association currently recommends people consume 1,500 milligrams of sodium a day, but that may be a challenge for those who don’t have access to fresh fruits and produce and rely on processed or fast food, which tend to be higher in salt.

Hes is hopeful that recent efforts by the USDA to make school lunches and food environments healthier will have some effect on worrisome health trends among students. In June, the agency announced that by next school year, schools nationwide will provide healthier snacks in vending machines that are low in fat, sodium and salt.

“I wish they would have a soda tax, but they don’t. They made tobacco prohibitively expensive and that’s why smoking has gone down. The need to make sugary drinks and snacks more expensive too,” she says. Hopefully the next cohort of children won’t show the same increase in adult diseases, and more youngsters can enjoy a childhood free of medications and disease symptoms.

How Writing Heals Wounds — Of Both the Mind and Body

Psycological Health

How Writing Heals Wounds — Of Both the Mind and Body

2013-07-16

By

Talking about difficult experiences can be a way of easing the emotional pain of trauma, but the latest research shows that expressing emotions in words can also speed physical healing.

The study is the latest delving into the mind-body connection to suggest that expressing emotions about a traumatic experience in a coherent way may be important to not just mental but physical health as well. It showed that the calming effect of writing can cut physical wound healing time nearly in half.

Researchers led by Elizabeth Broadbent, a senior lecturer in health psychology at the University of Auckland in New Zealand, studied 49 healthy senior citizens, aged 64 to 97.  For three days, half were assigned to write for 20 minutes a day about the most traumatic event they had experienced, and were encouraged to be as open and candid as they could about exactly what they felt and thought at the time. If possible, they were also asked to share thoughts or emotions that they had never expressed to others about what they had undergone.

The other participants wrote for the same duration about their plans for the next day, avoiding mentioning their feelings, opinions or beliefs. Two weeks after the first day of writing, researchers took small skin biopsies, under local anesthesia, that left a wound on the arms of all participants.  The skin tissue was used for another study.

A week later, Broadbent and her colleagues started photographing the wounds every three to five days until they were completely healed.  Eleven days after the biopsy, 76% of the group that had written about trauma had fully healed while only 42% of the other group had.

MORE: How Child Abuse Primes the Brain for Future Mental Illness

“This is the first study to show that writing about personally distressing events can speed wound healing in [an older] population that is at risk of poor healing,” says Broadbent.

It’s not the first, however, to reveal the intriguing connection between state-of-mind and physical health. In previous studies, this type of emotionally expressive writing, as opposed to writing on neutral topics, reduced viral load in HIV-positive patients and increased their levels of virus-fighting immune cells. The practice also increased the effectiveness of the hepatitis B vaccination by increasing antibody levels generated by the vaccine and speeding wound healing in young men.

But in terms of psychological health, the results are more conflicting. A recent study found that writing about disturbing combat experiences may improve marital satisfaction among soldiers returning home from war zones while another paper in which patients with post-traumatic stress disorder (PTSD) wrote about their difficult experiences did not find that the practice reduced symptoms. Putting emotions down in words did, however, improve mood and reduce levels of stress hormone  in these patients.

One way that writing about distressing events could give the body a boost is by promoting sleep. “We found that people who got at least seven hours of sleep most nights had faster healing than those who got less sleep,” Broadbent says. Sleep deprivation can lower levels of growth hormone, which is important for repairing injuries. And writing about their traumatic experiences also seemed to help participants to actually get more sleep.  “Many people who have written about their negative experiences report that it allowed them to gain greater insight into what happened and to put the event into perspective,” says Koschwanez, “This might reduce the extent to which the event troubles them and possibly improve their sleep.”

The writing may also help the body by reducing stress; less anxiety means fewer stress hormones, which can interfere with chemicals needed for wound healing. While Broadbent’s study did not find such a link, it’s possible the researchers were not evaluating the right anxiety measures.  “It might be that our perceived stress questionnaire was not assessing the right type or duration of stress,” says Heidi Koschwanez, a study co-author and postdoctoral fellow at the University of Auckland.

MORE: Blogging Helps Socially Awkward Teens

It’s also possible that emotional writing is not helpful for everyone. In one study published last month, when people who typically are stoic wrote about their worst trauma, their anxiety actually increased.  Those who were accustomed to being emotionally open, however, showed a drop in worry measures. That suggests that different people may have different ways of coping with traumatic events, and that writing may be an effective outlet for those who are normally more expressive, while pushing people to express feelings when they are not inclined to do so can actually increase risk for PTSD.

For those who do experience relief from expressing their emotions, however, writing may become an important part of helping them to recover —both in mind and in body— from difficult situations.

Does your relationship need a ‘love drug’?

Sexual Health

Does your relationship need a ‘love drug’?

2013-07-12

By Ian Kerner, CNN Contributor

It’s a Saturday night. You get the kids to bed, wash the dishes and plop down on the couch for a marathon of reality TV. Across the room, your partner is engrossed in his or her iPad.

Later, you give each other a chaste kiss good night, roll over and go to sleep.

On one hand, you wish the magic of your heady early days would return. On the other, you’re not sure if you really care that much anymore.

It’s a scene so typical in many marriages and long-term relationships that it’s no wonder only an estimated 37% of couples say they’re still very happy together.

But what are your options? Divorce? Therapy? How about a “love drug” guaranteed to keep you both content?

That’s the premise of a recent report in Current Opinion in Psychiatry that examined the implications of a potential pharmaceutical drug aimed at keeping couples happy and in love.

Surveys suggest that humans may not be meant to stay in lifelong, monogamous relationships: Roughly half of all marriages end in divorce, while up to 72% of husbands and 52% of wives cop to cheating on their spouses.

Yet many couples want to remain married, despite the potential problems. Based on this concept, researchers at the University of Oxford considered what might happen if couples had access to an intranasal spray containing oxytocin.

Oxytocin is the “cuddle hormone” that’s released during childbirth, nursing and orgasm, resulting in feelings of closeness, bonding and connection. Could a spritz of liquid oxytocin have the same effects on your romantic relationship? Some research suggests that it might.

For example, one study published last year in the journal Social Cognitive and Affective Neuroscience found that, of 47 couples, those who sniffed oxytocin before discussing a disagreement were more likely to react positively toward each other than those who used a placebo spray. Such a product, say the authors of the more recent report, could be used under the direction of therapists and other clinicians to “enhance marital well-being.”

Yet other evidence suggests that the effects of this hormone may not always be so beneficial: In some research, oxytocin was found to amplify negative memories, while studies of the prairie vole — one of few animals that remain in lifelong relationships, presumably because of its high levels of oxytocin — show that this critter is also prone to infidelity. When it comes to supplemental oxytocin, there are ethical issues to consider, too.

“Pharmaceutical companies are pushing the medical approach because it’s profitable, while doctors and patients are increasingly demanding medications because taking a pill or using a spray is cheaper and ‘easier’ than therapy,” said social psychologist Justin Lehmiller. “I’m uncomfortable with the notion that the key to solving relationship problems is taking a drug.”

Of course, that hasn’t stopped manufacturers from jumping on the bandwagon: Safe or not, a slew of oxytocin-based products are for sale, no prescription necessary. Aimed at improving relationships between partners and supposedly increasing attraction among strangers, these products are pricey — and unproven.

Instead, I recommend boosting oxytocin naturally. It could be as easy as simply giving each other a nice long squeeze. In her book “The Female Brain,” Dr. Louann Brizendine says that hugging your partner for 20 seconds or more has been shown to trigger the release of oxytocin.

Added Lehmiller, “If couples make an active effort to be more intimate and touch each other more often, they can likely boost their oxytocin levels without the aid of a drug. It’s also likely that enhancing intimacy in this way will do more good for your relationship in the long run than any pill ever could.”

You’ll save your money — and maybe your relationship, too.