Dr. Walt’s Take on the Health Headlines – May 23, 2008

Here are Dr. Walt’s takes on today’s health headlines

McCain Appears Cancer-Free, Healthy

Three-time cancer thriver (not just survivor), John McCain appears cancer-free, has a strong heart, and is in otherwise general good health, according to eight years of medical records reviewed by The Associated Press.

Like me, who is much younger, McCain takes medicine to keep his cholesterol in check. Unlike me, McCain’s performance on a heart stress test was incredible. He sweated it out for 10 minutes. I’m like most patients my age, who can do no more than five or seven minutes on the treadmill.

Evidence of what great shape he is in is found in his “rim-to-rim” Grand Canyon hike in 2006. Most people half his age couldn’t do that.

Like my wife, Barb, McCain had benign colon growths (called polyps) taken out during his last routine colonoscopy in March.

But, the best thing McCain has going for him is his family history. He has often campaigned with his energetic mother, who is age 96.

Experts Revisit Food Additives and ADHD

In my book (ADHD Doesn’t Mean Disaster), I observed that the theory that artificial colors and preservatives in foods may play a role in hyperactivity had been largely disproven. But, there may be signs that this is being reconsidered.

In an editorial published in the British Medical Journal, pediatrics professor Andrew Kemp, MD, of the University of Sydney, called “for removal of food additives from the diet to be part of standard initial treatment for kids with attention deficit hyperactivity disorder (ADHD).”

Kemp cited a recent controlled trial showing an increase in hyperactivity among children without ADHD who were fed a diet high in food colorings and the preservative sodium benzoate.

The editors of BMJ wrote, “The overall findings of the study are clear and require that even we skeptics, who have long doubted parental claims of the effects of various foods on the behavior of their children, admit we might have been wrong.”

So, what do I say? Well, without doubt, these dietary modifications won’t work for every child with ADHD – but, no treatment works for every child. And, there is no harm, especially for parents that want to try to avoid drugs with their children, to try dietary modifications for a month or two and see if it helps.

Why? As Dr. Kemp notes, “(Of the) 22 studies conducted between 1975 and 1994, 16 found dietary modification to have a positive impact on at least some children with ADHD.”

“In view of the relatively harmless intervention of eliminating colorings and preservatives,” Dr. Kemp writes, “and the large number of children taking drugs for hyperactivity, it might be proposed that an appropriately supervised and evaluated trial of eliminating colorings and preservatives should be part of standard treatment for children.”

Oral hormone therapy pills double clot risk: study

Put this in the “don’t worry too much about this” category.

Although these French researchers found that menopausal women who take hormone-replacement therapy pills more than doubled their risk of developing a potentially fatal blood clot, this “horrible” sounding risk is only a relative risk.

The real question is what is the absolute risk? In healthy menopausal women, age 50 to 59, the risk is about 11 additional cases per 10,000 women per year for combined therapy (estrogen and progestin) and two additional cases per 10,000 women per year for estrogen only.

And, because the studies reviewed have shown that a dose response seems to exist, these absolute risks may be lower with lower doses of hormones.

Furthermore, the “risk was most pronounced during the first year of treatment, and in women who were overweight or predisposed toward developing blood clots.” So, if you have these risks, you may want to seek an alternative to oral estrogen – such as an estrogen patch. Notably, “women currently using the patch had only a slightly elevated risk, compared to women taking no estrogen.”

And, don’t forget the statement released earlier this week in which experts reviewed dozens of studies found HRT is safe for early menopause and that it did not raise the risk of heart disease for women aged 50 to 59.

My take? This very slightly increased risk of a blood clot should not discourage healthy women from using HRT if it is needed.

One-Time 10-Ounce Baby Well on Way to Terrible Two’s, Mom Says

A little girl born almost 19 months ago after just 22 weeks gestation and weighing less than 10 ounces is well on her way to her terrible two’s, her mother told a British Newspaper.

You might think that this fact would give pause to the MPs (Members of Parliament) who just overwhelmingly voted against a ban on abortions of unborn children at 20 to 24 weeks gestation.

Amillia Sonja Taylor, the first known baby to survive after a gestation period of fewer than 23 weeks, is proof that they are wrong. Dead wrong.

Drinking water can be harmful to smallest babies

A reminder to new moms: Babies younger than six months old should never be given water to drink without a doctor’s recommendation. Consuming too much water can put babies at risk of a potentially life-threatening condition known as water intoxication.

In addition, parents should also avoid using over-diluted formula.

The Benefits of Home Blood-Pressure Monitoring

People with high blood pressure should use home monitors to keep track of their blood pressure and help them manage their disease, according to a new joint recommendation from the American Heart Association, the American Society of Hypertension and the Preventive Cardiovascular Nurses’ Association.

Blood pressure readings vary considerably even during the course of one day, so a reading in the doctor’s office every few months is not enough to give patients a true picture of their situation.

The recommendation is that patients buy monitors that have a cuff for the upper arm – NOT wrist monitors – and that patients should take 2-3 readings at a time, 1 minute apart.

What do I think? Home BP monitoring should be done in all patients who have a family history of hypertension or who are being treated for it.

Why? Four out of five large studies of home blood pressure monitoring found that it was better than office measures for predicting problems like heart attacks or strokes.

However, don’t forget that there are a lot of monitors out there, and some of them aren’t very good. Consumer Reports has reviewed cuffs. But, once you get one, take your device to your doctor or nurse to make sure it agrees pretty well with the device being used in the office.

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