Are you ‘normal’ in bed?

2013-07-24

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

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 →

Sick Before Their Time: More Kids Diagnosed With Adult Diseases

2013-07-17

By Alexandra Sifferlin

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.

Back pain? 7 ways to strengthen your spine

2013-07-02

By Dr. Kenneth Hansraj, Special to CNN

Slouching may be fashionable for some red carpet regulars, but it’s one of several reasons why about 80% of us will have spinal problems in our lifetime.

And yet, most of us can cure or even avoid back pain and surgery by taking a few daily preventive steps. Spinal problems can start as early as age 29, so it’s never too early or too late to start.

People tend to forget the spine is part of the central nervous system, along with the brain, and relies on the peripheral nervous system: the millions of nerves that send messages to the brain that control the body’s functions. An unhealthy spine interferes with this entire system, causing a host of unwelcome health issues such as pain, numbness, and weakness in the arms and legs, impaired breathing and digestion and impaired control of the bowel and bladder.

Here are a few tips to help you take better care of your spine and back:

Good posture is essential

Remember your mother saying “Stop slouching”? You would think it goes without saying, but too many of us simply don’t maintain good posture, which is critical for a healthy spine.

Your smartphone is a pain in the neck

Good posture is defined as ears aligned with the shoulders and the “angel wings,” or the shoulder blades, retracted. In proper alignment, spinal stress is diminished. It is the most efficient position to achieve the best posture possible.

Good posture also has other health and wellness benefits. Researchers at San Francisco State University have found a link between poor posture and depression, and many experts believe stooping and slouching could be associated with weight gain, heartburn, migraines, anxiety and respiratory conditions.

Proper posture leads to a taller appearance, deeper breathing, improved well-being and increased energy with enhanced human performance.

Deep belly breathing can improve your posture

Place your hands on your abdominal area and feel your belly move as you inhale and exhale. Do this as many times a day as possible to improve your posture and overall spinal health. Deep belly breathing enables the spinal nerves to move within the spinal channels, diminishing pain and providing a sense of well-being.

Targeted simple exercises can strengthen your core and joints

According to the American College of Sports Medicine, exercise is therapeutic. Just 10 minutes per day is all you need to perform some simple spine-strengthening exercises.

Neck stretches, including bending and extension range-of-motion exercises, are just a series of simple side-to-side, up-and-down and ear-to-shoulder stretches that can dramatically improve the health of the cervical spine.

Using light weights to improve posture and performing some yoga poses like downward dog, which opens up the chest and stretches the spine, can also improve spinal health. Push-ups can strengthen the spinal and postural muscles as well.

Steroid injections common for back pain sufferers

What you eat can directly impact your spine

You may not think that your diet affects your spine, but it actually plays a key role. A healthy diet consisting mostly of lean proteins, healthy fats and lots of fresh fruits and vegetables is ideal for building a lean body and muscles that support the spine.

To improve the condition of your spine, supplement your diet with a multivitamin along with a B-complex and Omega-3s, as they have been shown to help decrease pain in the nerves of the spine.

Spend a little time in the sun every day

Believe it or not, the sun can have a magical effect on your body, including your spine. Sunlight energizes the whole body, literally waking it up and encouraging the body to stand up straighter.

Further, sunlight contains vitamin D, which is required for strong bones, including the spinal column, and is manufactured in the body through sun exposure. Try to spend 10 to 20 minutes in sunlight daily.

Pay attention to how — and how long — you sleep

Studies suggest that insufficient sleep is associated with increased neck and back problems. It is important to get a sufficient amount (between six and eight hours) and of course, to sleep in a position that enables the spine to relax. The ideal position is on your side, as that puts the least amount of pressure on the spine.

You should also create a proper sanctuary for sleep, choosing a suitable mattress and pillow for comfort, eliminating all outdoor light and providing fresh cool air. Avoid interacting with any electronic devices at bedtime.

Why your back, feet hurt: Blame evolution

Don’t hesitate to meditate

Meditation can restore alertness, improve your mood, increase productivity and prolong life, not to mention the positive effects it can have on your spine and posture. People who meditate tend to focus on their core, automatically straightening their spines in the process.

To remind yourself to carve out 10 minutes or so per day to perform these exercises and rituals (especially in the middle of a busy workday), you can set an alarm on your smartphone.

You can also utilize apps — Healthy Back Workouts provides three apps devoted to the neck and upper back, strong spine and core and posture and lower back. They’re designed to accommodate the beginner, intermediate or advanced individual with step-by-step photos and detailed instructions.

Through awareness of posture, breath, meditation, nutrition, exposure to sunlight and exercise, people can strengthen and condition their spines and create overall well-being in the process.

Opinion: Alternative healing or quackery?

2013-06-19

By Dr. Paul Offit, Special to CNN

It used to be called “fringe” or “unconventional” medicine — or simply quackery. Today, it’s called “alternative,” “complementary,” “holistic” or “integrative.”

And it has moved into the mainstream. Hospitals now have dietary supplements on their formularies (list of stocked medications); offer reiki masters to cancer patients; or teach medical students how to manipulate healing energies.

Forty-two percent of hospitals offered some form of alternative therapies to their patients, according to a 2010 survey of 5,800 facilities. When asked why, almost all responded “patient demand.”

Further, private practitioners encourage megavitamins, dietary supplements, acupuncture, chiropractic, homeopathy and naturopathy.

Although nontraditional therapies can be valuable, sometimes a line is crossed. So how can you tell if your alternative healer is a quack? Here are a few red flags:

The therapist offers medicines that don’t work instead of those that do

Steve Jobs, for example, suffered from a neuroendocrine tumor of the pancreas. With early surgery, Jobs had a 95% chance of recovery. But Jobs chose acupuncture, herbal remedies, and bowel cleansings instead, and died as a consequence.

Homeopaths have recommended their products (which are diluted to the point that active ingredients aren’t there anymore) for treatable diseases such as cancer, malaria, cholera and AIDS.

In 2006, a 6-year-old boy with severe asthma was treated with a homeopathic remedy instead of the bronchodilator that would have saved his life. In Canada, homeopathic vaccines, which have no chance of preventing illness, are worrisomely popular.

Also, naturopaths’ objections to the contrary, many studies have shown that garlic doesn’t lower low-density-lipoprotein cholesterol (bad cholesterol), chondroitin sulfate and glucosamine don’t treat arthritis, and saw palmetto doesn’t treat prostatic enlargement; in each of these cases, conventional treatments are available that actually do work.

Warning: Men’s natural sex supplements may not be

The therapist doesn’t tell you about the dangers of alternative therapies

Alternative medicine is perceived as more natural and less harmful than conventional medicine. But medicine is medicine, and any drug or therapy that has a positive effect can have a negative effect.

For example, at least 86 people have died when acupuncture needles have lodged in hearts, lungs or livers or inadvertently transmitted viruses like hepatitis A, hepatitis B, or HIV. Chiropractic manipulations have killed at least 26 people, virtually all by ripping the vertebral artery in the neck.

Dietary supplements also have unseen harms. For example, kava can cause severe and occasionally fatal liver damage; blue cohosh can cause heart failure; nutmeg can cause hallucinations; comfrey can cause hepatitis; monkshood can cause heart arrythmias; wormwood can cause seizures; stevia leaves can decrease fertility, concentrated green tea extracts can damage the liver, bitter orange can cause heart damage, and Aristolochia, found in Chinese herbs, can cause kidney failure and bladder cancer.

Because dietary supplements and herbs aren’t regulated by the Food and Drug Administration, most people don’t know about these problems.

The therapist makes a fortune off your misfortune

Perhaps no one is more susceptible to quackery than parents of children with autism: a disorder without a clear cause or cure.

Bogus treatments have included ion-exchange machines, lymphatic drainage massage, electrical or magnetic stimulation, Rife machines, hyperbaric oxygen chambers, intravenous immunoglobulins, and stem-cell transplantation. Some of these same therapies are offered for “chronic” Lyme disease and cancer.

Dramatically different disorders, identical cures. All quite expensive and all without any chance of actually working.

Docs should know about kids and alternative medicine

The therapist promotes ‘magical thinking’

Reiki masters who claim they can manipulate healing energies; chiropractors who claim that all diseases are caused by misaligned spines; homeopaths who claim that their highly diluted potions contain even a single molecule of an active ingredient; acupuncturists who claim that healing can only be achieved by balancing yin and yang; or naturopaths who claim that a drug found in nature is different from a drug synthesized by a pharmaceutical company (when they have the exact same molecular structure) are appealing to our sense of magic.

And although the notion of something beyond our level of understanding is attractive, current gaps in medical knowledge aren’t going to be filled by energy fields, acupuncture meridians, or the notion that all things natural must be good for you.

“Isn’t it enough to see that a garden is beautiful,” wrote Douglas Adams in “The Hitchhiker’s Guide to the Galaxy,” “without having to believe that there are fairies at the bottom of it, too.”

Like conventional therapies, alternative remedies shouldn’t be given a free pass. They should be held to the same high standards of safety and efficacy. And where scientific studies don’t exist, we should insist that they be performed. Otherwise, we’ll continue to be susceptible to the worst kinds of quackery.

Complementary and alternative medicine: Evaluate treatment claims

The opinions expressed in this commentary are solely those of Dr. Paul Offit.

Smoking Alcohol: The Dangerous Way People Are Getting Drunk

2013-06-10

To get drunk, people are getting creative. But a new form of drinking, known as “smoking” alcohol, has doctors concerned.

Whatever happened to taking shots? Any sort of excessive drinking is dangerous, be it via beer bongs or pouring shots into the eye socket. But now some drinkers are taking it even further and “smoking” alcohol. The questionable practice, which has potentially scary consequences, has various permutations.

An individual can pour alcohol over dry ice and inhale it directly or with a straw, or make a DIY vaporizing kit using bike pumps. The alcohol of choice is poured into a bottle, the bottle is corked, and the bicycle pump needle is poked through the top of the cork. Air is pumped into the bottle to vaporize the alcohol, and the user inhales.

In 2004, the U.S. saw a brief (Alcohol Without Liquid) device, but the product was quickly banned in the U.S. and lost its following.

Nearly a decade later, clinicians are seeing evidence that the practice is gaining some traction — and not just among college kids and adolescent risk takers. It’s popular among people who want to lose weight and don’t want the calories that come from consuming alcohol. “People think it is a great way to get the effects of alcohol without gaining the weight because alcohol has an enormous amount of empty calories. You can’t be ingesting a lot of alcohol if you’re on a diet and want to lose weight,” says Dr. Deni Carise, the deputy chief clinical officer at CRC Health Group, a treatment- and educational-program provider for individuals struggling with behavioral issues, chemical dependency and eating disorders. “I think adolescents are also particularly susceptible to this because it is novel and exciting.”

In a North Texas man, Broderic Allen, says he stopped drinking to lose 80 lb. (36 kg) and started smoking alcohol to avoid calories:

When alcohol vapor is inhaled, it goes straight from the lungs to the brain and bloodstream, getting the individual drunk very quickly. Because the alcohol bypasses the stomach and liver, it isn’t metabolized, and the alcohol doesn’t lose any of its potency.

Drinkers feel the effects almost instantly, but the risks are also much higher. People who smoke their alcohol are at a much greater risk of getting alcohol poisoning and potentially overdosing. When people drink too much alcohol, they tend to vomit. Getting sick is one of the ways that prevents an alcohol overdose, but when alcohol circumvents the stomach and liver, the body can’t expel it.

It’s also much harder to know just how much alcohol you’re consuming in one sitting if you’re not stringently measuring. If a cup of alcohol is poured into a bottle and then vaporized, the drinker cannot tell if they are inhaling a few sips or the whole cup, since the liquid remains in the bottle.

“It’s also terrible for your lungs and nasal passages,” says Carise. “Your lungs are not meant to inhale something that can turn back into a liquid. When you think of liquid in the lungs, you think of drowning.”

The prevalence of the trend is unclear, since there are no current studies tracking the cases, says Carise. But like other drinking fads, YouTube videos of drinkers inhaling and smoking alcohol have increasingly popped up online.

The trend is also picking up in the bar scene, with vaporizing methods like the which is legally sold in all 50 states. The site boasts: “This has the advantage of no calories; no carbs, no impurities and the effects of consuming alcohol are immediately felt, making it easier to responsibly imbibe.”

Fortunately, these beverages are usually consumed in a wide glass, so the effect is not as concentrated, says Carise. Still, she finds the concept disturbing. “It is amazing what our culture will do to get drunk,” she says.

How Exercise May Lower Breast Cancer Risk

2013-05-08

By Alexandra Sifferlin

Breaking a sweat does more for your body than just trim your waistline. Exercise may lower a woman’s risk for breast cancer and researchers are finding out why.

Scientists from the University of Minnesota in St. Paul conducted a study of 391 inactive, healthy, premenopausal women whom they split into two groups. They found that the 179 women in the intervention group, who received 30 minutes of moderate-to-vigorous exercise five times a week for over 16 weeks, showed changes in their estrogen metabolism that could explain the anti-cancer benefits of working out.

Continue reading How Exercise May Lower Breast Cancer Risk →

Working Too Hard? Physically Demanding Jobs Tied to Higher Risk of Heart Disease

2013-04-23

By Alexandra Sifferlin

While physical activity can lower the risk of heart disease, two studies suggest that jobs involving hard manual labor may harm, rather than help the heart.

Presenting at the annual EuroPRevent 2013 meeting, two separate groups report on the potential dangers of physically demanding work and provide deeper understanding of how manual labor may differ from a gym workout or a run with respect to the heart.

The first, from researchers at Harokopio University in Athens, involved 250 first-time stroke patients, 250 patients who experienced their first heart event, and 500 healthy controls, all of whom ranked their jobs on a scale of how physically demanding they were. Those reporting more labor-intensive occupations showed higher rates of heart events; for each one unit drop in the ranking of physical intensity, the participants showed a 20% decline in their chances of having a heart event. The association held even after the researchers adjusted for possible heart disease risk factors such as sex, BMI, smoking, diabetes and diet.

A second study conducted by researchers from the Department of Public Health at the University of Ghent in Belgium found similar evidence that physically demanding labor could increase risk of heart problems, particularly among those who also exercised during their leisure time. The trial, involving a cohort of over 14,000 middle-aged men without heart disease, provided more details about how occupational and leisure activity might interact. The participants answered questions about their jobs, heart health and any physical activity they did for leisure between 1994 and 1998.

After following the men for slightly more than three years on average, the researchers found that those with jobs involving lower levels of physical labor who also engaged in moderate to intense leisure-time activity enjoyed a 60% reduced risk of heart events. But men whose jobs were more physically demanding and who also exercised when they were off the clock showed a nearly 70% increased risk of heart problems. After adjusting for other factors that could contribute to heart disease risk, the men with the physically demanding jobs were more than four times likely as those with less physically-oriented occupations to develop heart disease if they also exercised regularly.

“The hypothesis based on our study and other recent literature is that physical activities done on the job usually include more static activity types which do not have a training effect on the cardiovascular system, but have an overloading effect on the system,” says study author Dr. Els Clays. Jobs that require activities like heavy lifting, awkward postures and high physical exertion are known to increase blood pressure and heart rate. “If people are exposed to that for a long time, like multiple hours during the day, that can really have an adverse effect on their cardiovascular health,” says Clays.

Jobs that demand a lot of heavy lifting appear to be more taxing on a body in a way that doesn’t benefit health like going for a run, according to Clays. The researchers of the first study also suggest that the stress accompanying physically demanding jobs may counteract the positive effects of exercise. It’s also possible that those with physically draining jobs may have less access to health care; such occupations generally involve manual labor and often pay less and provide limited health insurance. With less access to preventive health therapies, rates of chronic conditions such as heart disease may be higher.

The findings reinforce the complex relationship between physical activity and heart disease, and suggests that doctors should take into account the types of physical activity people do in different settings. “There is increasing evidence in recent years showing occupational demands do not have the beneficial effect general physical activity has. This study really confirms that,” says Clays. “The basic message is we really need more detailed measures for physical activity.”