How Can I Stop Drinking So Much Soda?

Do you have a soda habit? Here's some advice on how to cut back.

By Elaine Magee, MPH, RD
WebMD Weight Loss Clinic - Expert Column

Soda -- it's everywhere! Even if you wanted to drink something else, you'd be hard-pressed to find it as prominently displayed in vending machines, at fast-food chains, and supermarket checkouts. You might not realize how ubiquitous Coke, Pepsi, and the like are in our society until you try to stop drinking soda.

For some people, drinking several sodas a day is a fierce habit. You know drinking soda is a habit when you find yourself going to the grocery store at 10 p.m. because your refrigerator is tapped out, or you feel like having a tantrum when the drive-through attendant tells you the soda machine is broken. If the idea of drinking one token soda a day is unfathomable, you just might have a serious soda habit.

Why Stop Drinking So Much Soda?

So why would you want to make the effort to kick the soda habit? As the beverage industry out, soft drinks, in and of themselves, aren't necessarily a dietary "don't."

"All of our industry's beverages -- including regular or diet soft drinks -- can be part of a healthy way of life when consumed in moderation and as part of a balanced lifestyle," says Tracey Halliday, a spokesperson for the American Beverage Association.

The problem, say many health experts, is that Americans don't always drink their sodas in moderation. Many believe we should cut back on our intake of the two sweeteners used in sweetened soda: fructose (like the high-fructose corn syrup often used in sodas) and sugar. Calories from beverages make up 21% of the total daily calories consumed by Americans over 2 years old, according to a 2004 article in the American Journal of Preventive Medicine. And the proportion of calories Americans consume from sweetened soft drinks and fruit "drinks" has tripled between 1977 and 2001.

"Many people either forget or don't realize how many extra calories they consume in what they drink, yet beverages are a major contributor to the alarming increase in obesity," Barry Popkin, PhD, director of the University of North Carolina Interdisciplinary Obesity Program, says in an email interview.

In 2006, a panel of experts assembled by Popkin developed the first Healthy Beverage Guidelines, which recommended people should drink more water and limit or eliminate high-calorie beverages with little or no nutritional value.

So is simply switching to diet soda the answer? Not necessarily, some experts believe.

Popkin has said there's no proof that artificial sweeteners are bad for you, but because the data are slim, the Beverage Guidance Panel was uneasy about recommending them.

Michael Jacobson, executive director of the advocacy group Center for Science in the Public Interest (CSPI), suggests that people who drink diet sodas should choose those sweetened with Splenda when possible.

Of the alternative sweeteners used in soda, CSPI gives the "avoid" label to Acesulfame-K, aspartame, and saccharin, but the "appears to be safe" label to sucralose (Splenda). All these sweeteners have received FDA approval. And, in a 100-page report published in Critical Reviews in Toxicology in September, an expert panel said it was confident aspartame poses no health risks. But CSPI believes those on its "avoid" list need more or better testing.

Still, while Jacobson believes "less is better" when it comes to alternative sweeteners, he concedes that drinking diet soda is better than gulping down the equivalent of 10 teaspoons of sugar -- which is what you'll get in a can of regular soda.

And just how do you go about kicking a soda habit? If you want to stop drinking so much soda, it basically comes down to four steps, according to the experts:

1. Make Up Your Mind. You have to make up your mind to give it up, notes Jacobson. Even if you're just trying to cut back on your soda consumption, it can take a firm commitment to make it happen.

2.Switch to Diet Sodas. Gradually make the switch to diet sodas, suggests Paul Rozin, PhD, a psychology professor at the University of Pennsylvania. "Just make a small decrease at a time, like one sugared soda a day," he says in an email interview. If you're drinking much more than one soda a day, work toward decreasing the amount of diet sodas you drink as well -- eventually.

3. Go Caffeine-Free. Popkin and Jacobson believe that caffeine, and the fact that it is mildly addictive, is part of the reason soda is such a hard habit to break. Look for caffeine-free soft drinks, and gradually decrease the number of caffeinated drinks you have each day as you work toward kicking the soda habit completely. If you're addicted to the caffeine in soda, you're really kicking two habits -- the soda habit and the caffeine habit. "It takes a few weeks to truly forget the craving," Popkin says.

4. Stock Up on Alternatives. Keep plenty of tasty non-soda drinks on hand to make giving up soda as convenient as possible.

What Are Some Soda Alternatives?

Here is a list of non-soda beverage possibilities to consider. You'll notice the drinks that contain calories also contribute important nutrients like calcium or vitamin C.

1. Give Soy Milk a Chance. If you'd like to work in a serving of soy a day, give soy milk a try. Lots of brands and flavors are available. If calories are an issue, try one of the lower-calorie options.

2. Don't Skimp on Skim Milk. Skim milk is a great way to boost your intake of protein, calcium, vitamin D, and other important nutrients. One cup of skim milk has only around 85 calories. The Beverage Guidance Panel recommends up to two servings a day of nonfat or 1% milk and fortified soy beverages.

3. Pimp Your Water. To an avid soda drinker, water can seem a little unexciting. One of the best ways around that is to add noncaloric flavors to your water. A sprig of mint or a slice of lemon or lemon will do wonders. If you like subtler flavors, try a slice or two of cucumber or a frozen strawberry.

4. Make Green or Black Tea Your New Drink Habit. Popkin says tea is a healthy alternative to water for people who prefer flavored beverages. Tea is calorie free and contains powerful phytochemicals like the antioxidant in green tea, epigallocatechin gallate (EGCG). Great-tasting green and black teas abound in supermarkets and specialty stores. If you're cutting back on caffeine, look for caffeine-free teas.

 

5. Think Outside the Juice Box. Although 100% fruit or vegetable juice contains important nutrients, the Beverage Guidance Panel recommends having no more than one serving a day because they can also contain plenty of calories (about 100 in 1 cup of fresh orange or carrot juice). One way to cut those calories is by making a homemade juice spritzer: Combine one or two parts seltzer, mineral water, or club soda with one part 100% fruit juice (try fresh orange juice). Or try the new vegetable juice flavors in your supermarket, as well as fruit and vegetable juice blends. While they're not super low in calories, each serving contains a serving of fruit and a serving of vegetable.

6. Discover the Coffee Cure. For java lovers, coffee can be a calorie-free, flavorful alternative to soda. And you can easily find lower-caffeine coffees in coffee shops and supermarkets. But to keep coffee low-calorie, be sure to keep it simple -- skip the syrups, whipped cream, and whole milk.

7. Make Good Old H2O Convenient. The Beverage Guidance Panel recommends at least 4 servings a day of water for women and at least 6 servings for men. When you need to quench thirst or hydrate your body, nothing does it better than water. If cold, refreshing water was more convenient, and if we were reminded to drink it during our day, a lot more people would reach this daily goal. So keep water bottles ready to go in your refrigerator, and every time you leave the house, take a bottle with you. If chilled water is sitting in your car or on your desk at work, you'll be more likely to get into the water-drinking habit.

 

Reference Link:

http://www.webmd.com/diet/features/how-can-i-stop-drinking-so-much-soda?

5 Easy Ways to Cut Back on Salt

5 Easy Ways to Cut Back on Salt

Yes, you should still watch your sodium. Here are tips on how to do it.

By Elaine Magee, MPH, RD
WebMD Weight Loss Clinic - Expert Column

Too much salt in the diet is a bad thing -- or is it?

Most of us have long heard that it's best to go easy on the salt shaker. But a recent study has confused the issue somewhat.

In the study, published in the March 2006 American Journal of Medicine, people who reported eating limited salt were found to be 37% more likely to die of cardiovascular disease (conditions such as stroke and heart disease) than people who ate more salt. The researchers concluded that their findings raise questions, and that further studies are needed.

But, experts say, it's important to keep in mind that this is just one study, compared with scores of others that have found health benefits to avoiding a high-sodium diet.

According to the American Heart Association, 1,500 milligrams of sodium is the ideal daily goal for African-Americans, middle- and older-aged Americans, and people with high blood pressure. The rest should aim for less than 2,300 milligrams of sodium a day -- the equivalent of about 1 teaspoon of salt.

The Salt Connection

New research shows that a high-salt diet may have a negative effect on our bodies' levels of vitamin D -- a vitamin considered important to many aspects of health.

Older women who had high blood pressure caused by salt were found to have lower concentrations of a certain marker of vitamin D than women with normal blood pressure, Myrtle Thierry-Palmer, PhD, a biochemistry professor at Morehouse School of Medicine in Atlanta, tells WebMD.

There is also some evidence that a high-sodium intake increases calcium losses in the urine -- which is bad news for bone density. Too much sodium may also contribute to the development of kidney stones.

And what about heart disease? Research has shown a connection between high-salt intake and an increase in blood pressure in certain people who are considered "salt sensitive."

High blood pressure is a major risk factor for cardiovascular disease. That's important information for the nearly one in three American adults who have high blood pressure, according to the American Heart Association (AHA).

Studies have shown that cutting back on salt can lower blood pressure in people with and without high blood pressure, according to a statement from the AHA.

"Reduced salt intake can blunt the rise in blood pressure that occurs with age and reduce the risk of atherosclerotic cardiovascular disease events and congestive heart failure," according to the January 2006 statement.

Here's something baby boomers need to know: People tend to become more sensitive to sodium as they get older. Likewise, their blood pressure is more likely to drop when they cut back on salt in their later years.

Further, sodium may increase the risk for stroke even beyond its affect on blood pressure, according to research reported at the 2005 American Stroke Association International Conference.

The risk of stroke was higher in people who ate more sodium, regardless of their blood pressure, reported researchers. Their results also showed that people who took in more than 4,000 milligrams of sodium a day almost doubled their stroke risk compared with those getting 2,400 milligrams or less.

Are You Salt-Sensitive?

The reason salt-sensitive people's blood pressure responds strongly to salt intake is through sodium's effect on blood volume. When you eat more salt, your blood pressure tends to rise and when you eat less salt, your blood pressure lowers.

What portion of the population is salt-sensitive? Some researchers have estimated that about a quarter of the American population with normal blood pressure is salt-sensitive, while about half of the people with high blood pressure seem to be salt-sensitive. The black population has demonstrated a greater susceptibility to salt sensitivity than the white population, adds Thierry-Palmer.

5 Steps to Less Salt

1. Pass Up Processed Foods

The Food Standards Agency of the United Kingdom estimates that 75% of salt intake comes from processed food. Some food companies are developing products with less sodium, so keep an eye out for sodium listed on food labels. Only small amounts of sodium occur naturally in foods, eating mostly natural, whole foods will help keep levels of sodium down.

2. Cut Back on Condiments

Always dress your sandwiches and burgers yourself. This way, you can not only control the amounts of condiments used, you can choose those that are lower in calories, fat, and sodium, such as:

• Balsamic vinegar. 2 teaspoons has 14 calories, 0 grams fat, and 2 milligrams sodium
• Mustard. 1 teaspoon has 10 calories, 0 grams fat, and 100 milligrams sodium
• Pickle relish. 1 tablespoon has 21 calories, 0 grams fat, and 109 milligrams sodium
• Horseradish. 2 teaspoons has 4 calories, 0 grams fat, and 10 milligrams sodium
• Low-sodium light mayonnaise. 17 calories, 1.3 grams fat, and 27 milligrams sodium (the numbers may vary depending on brand).
• Lemon juice (from 1/2 lemon). 8 calories, 0 grams fat, and 1 milligram sodium

Feel free to load on all the lettuce, tomato, and onion your heart desires. Each adds 5 calories or less per serving, and is mostly sodium-free.

3. Beware of Dressings and Sauces

If you think a little bit of dressing or sauce won't add that much sodium to your meal, think again. Take a gander at some of the dressing offered at the Jack in the Box fast-food restaurant:

Creamy Southwest Dressing (71-gram serving): 1,060 milligrams sodium
Bacon Ranch Dressing (71-gram serving): 810 milligrams sodium
Asian Sesame Dressing (71-gram serving): 780 milligrams sodium

4. Opt for Alternatives

Purchase a battery-operated pepper grinder and your favorite flavor of salt-free herb and spice blend (like Mrs. Dash). Then keep them front and center on your kitchen table to help you break the habit of salting your food.

5. Forgo Fast Food

Eating at fast-food chains may be fast and cheap, but you pay the price in calories, fat, and sodium. Many fast-food items are big on sodium. The following items, at a few top chains, topped the sodium scale:

Jack in the Box

• Bacon Ultimate Cheeseburger: 2,040 milligrams sodium
• Chipotle Chicken Ciabatta with Grilled Chicken: 1,850 milligrams
• Bruschetta Chicken Ciabatta Sandwich: 1,810 milligrams
• Ciabatta Breakfast Sandwich: 1,770 milligrams
• Ultimate Breakfast Sandwich: 1,700 milligrams
• Bacon Cheese Ciabatta Burger: 1,670 milligrams
• Chipotle Chicken Ciabatta with Spicy Crispy Chicken: 1,650 milligrams
• Sausage, Egg, & Cheese Biscuit: 1,430 milligrams

Wendy's

• Homestyle Chicken Strips (3) with dipping sauce: 1,690-1,890 milligrams sodium, depending on sauce
• Frescata Club Sandwich: 1,610 milligrams
• Frescata Italiana Sandwich: 1,530 milligrams
• Roasted Turkey & Swiss Frescata Sandwich: 1,520 milligrams
• Big Bacon Classic Sandwich: 1,510 milligrams

McDonald's

• Deluxe Breakfast: 1,920 milligrams sodium
• Premium Crispy Chicken Club Sandwich: 1,830 milligrams
• Premium Crispy Chicken Ranch BLT Sandwich: 1,750 milligrams
• Premium Grilled Chicken Club Sandwich: 1,690 milligrams
• Big Breakfast: 1,470 milligrams
• Sausage, Egg, & Cheese McGriddle: 1,300 milligrams

Published October 2006.

 

Reference Link:

http://www.webmd.com/diet/features/5-easy-ways-to-cut-back-on-salt

13 Food Gifts NOT to Give

Considering an edible holiday present? Before you hit the mall, check out this list of food gifts it's best to avoid.

By Elaine Magee, MPH, RD
WebMD Weight Loss Clinic - Expert Column

We've all gotten them at one time or another: gifts of food that were disappointing or misguided, even comical. Sometimes it isn't the gift itself that doesn't work so much as the match between the gift and the recipient.

For example, I was the goofball who, with all the best of intentions, gave a Starbucks gift card to a music teacher at my daughter's school. It didn't occur to me that he might be a Mormon (see No. 7 in the list below).

Here's another example: I was once given dark chocolate as a gift, when anyone who knows me well knows that I prefer milk chocolate. (The giver in this instance happened to be my mother.)

So, with some personal experience and some tongue-in-cheek reflections on gifts from Christmases past, here is my list of 13 food gifts NOT to give:

• Don't give sugar-free candies or chocolates to someone with IBS (irritable bowel syndrome) or other intestinal issues. The sugar replacement often used in these products is maltitol, which is only partially digested and absorbed. The part that isn't digested tends to ferment in the intestinal tract and attract water. To someone with diarrhea-predominant IBS, having a few pieces of these sugar-free goodies can cause some "intestinal issues". (As someone who has IBS, I can speak from sad experience.) We'll leave it at that.
• Pay attention that you don't give tea with special properties to someone whom it might offend. The Republic of Tea, for example, makes "Get Lost" tea, described as "herb tea for weight control"; "Get it Going" tea (for regularity); and "Get Gorgeous" tea (for clear skin).
• Be sure you don't give alcohol to someone who doesn't (or shouldn't) drink. Even if someone has consumed alcohol in the past, they may now be avoiding it for a number of possible reasons.
• Don't give those tins of stale popcorn to pretty much anyone. If it isn't fresh, it isn't worth the calories.
• Don't give fruitcake as a food gift, because all the fruitcake jokes known to man are bound to ensue moments after it is unwrapped.
• Don't give a gift assortment of dark chocolates to someone who is passionate about milk chocolate (or vice versa). The same goes for giving cream-filled chocolates to someone who is wild about nuts and chews.
• Don't give alcohol or anything with caffeine to a member of the Church of Jesus Christ of Latter-Day Saints. These items are not in line with their beliefs.
• If you don't know the gift recipient all that well, avoid holiday processed meat gift packs (from gourmet catalogue companies) or other foods containing meat, in case your giftee is a vegetarian.
• Don't give food gifts that include chocolate, peppermint or spearmint, garlic and onions, coffee, caffeinated tea, citrus, tomato products, or chili peppers, to someone who suffers from acid reflux.
• Don't give any food containing pork or pork products, or that combines dairy with meat products, to someone who keeps kosher or observes Muslim dietary laws.
• Don't give peanut brittle, caramel apples, or candy canes to people with braces. According to H. Dixon Taylor, DDS, an orthodontist in Concord, Calif., these are the three worst food gifts for someone with orthodontics. (And about 20% of Taylor's clients happen to be grown-ups.)
• To that friend of yours who is working hard to lose extra pounds, don't give a gift card to The Cheesecake Factory.
• Don't give chocolate-covered insects to people who might be "bugged" by it. I'm serious -- this actually happened to an acquaintance's mom, and she was definitely not amused!
• Reference Link:
• http://www.webmd.com/diet/features/13-food-gifts-not-to-give

New Weight Loss Drug Shows Promise

Modest Weight Loss Seen in Some Patients Taking Taranabant

By Salynn Boyles
WebMD Medical News

Reviewed by Louise Chang, MD

Jan. 8, 2008 -- An experimental weight loss medication in the same class as the drug Acomplia helped patients lose weight in a 12-week, phase II study, but side effects were common at higher doses.

Like Acomplia (rimonabant), which is approved for sale in Europe but not in the U.S., the Merck & Co. drug taranabant targets receptors in the brain linked to appetite.

Concerns about reports of anxiety and depression in rimonabant users have kept the drug off the market in the U.S.

Based on these reports, an FDA advisory panel voted against recommending its approval last June, prompting manufacturer Sanofi-Aventis to withdraw its application to the agency.

Depression and anxiety were also reported in the taranabant study, but these side effects were most common at the highest doses given, researcher Steven Heymsfield, MD, of Merck Research Laboratories, tells WebMD.

Based on these findings, an ongoing phase III trial of taranabant does not include the highest doses used in phase II study.

Taranabant Trial

The double-blind study included 533 obese people randomly assigned to treatment with either placebo or 0.5 milligrams, 2 milligrams, 4 milligrams, or 6 milligrams of taranabant. All the participants received counseling on diet and exercise throughout the trial.

At the end of 12 weeks, the placebo-treated participants had lost the least weight and those treated with the highest dose of taranabant had lost the most.

Patients treated with 0.5 milligrams of the drug lost an average of 3.5 pounds, compared with 5 pounds among people treated with 2 milligrams of the drug and almost 9 pounds among those treated with 6 milligrams.

A total of 27% of patients who took 0.5 milligrams of taranabant lost 5% or more of their body weight, compared with 61% in the 6-milligram group.

But patients taking the higher dosages of the drug also had higher rates of side effects, including anxiety, nausea, and vomiting.

The study drop-out rate due to side effects was also twice as high among patients treated with the highest dosage of the drug, compared with the lowest dose (10.2% vs. 4.7%). But no patients dropped out because of serious events.

The study appears in the January issue of the journal Cell Metabolism.

Heymsfield says he was surprised to find that patients treated with the lowest dose of the drug lost weight.

"We didn't expect weight loss at all doses," he says.

Seeking FDA Approval

The ongoing phase III trial includes roughly 2,000 people being treated with taranabant at doses ranging from 0.5 milligrams to 2 milligrams, a Merck spokeswoman tells WebMD.

She adds that the plan is to petition the FDA for approval in the second half of this year if the phase III results prove promising.

A spokeswoman for Sanofi-Aventis says several phase III trials of rimonabant are also under way, and the findings could help address the FDA advisory panel's safety concerns about the drug.

Julissa Viana tells WebMD that the company will likely petition the FDA once again to approve the drug for sale in the United States.

"I can't speculate on when we will submit or what those indications [for use] will be," she says. "We are looking forward to the results of our ongoing trials."

Weight loss specialist Louis Aronne, MD, says the FDA may be more likely to approve the drug the second time around as safety issues are addressed.

Aronne directs the comprehensive weight control program at New York-Presbyterian/Weill Cornell Medical Center.

"Rimonabant is now approved in 51 countries, and it is being actively sold in 20," he says. "I think as time goes on and the evidence builds that this class of drugs has a manageable side effect profile, the FDA will become more comfortable with it."

Reference Link:

http://www.webmd.com/diet/news/20080108/new-weight-loss-drug-shows-promise

BRCA Breast Cancer Gene Risk Varies

Odds of Breast Cancer Vary for Relatives of Breast Cancer Patients With BRCA1 and BRCA2 Gene Mutations

By Miranda Hitti
WebMD Medical News

Reviewed by Louise Chang, MD

Jan. 8, 2008 -- Scientists have some new clues about breast cancer risk among the sisters, daughters, and mothers ofsome breast cancer patients.

Those clues center on the BRCA1 and BRCA2 gene mutations, which make breast cancer and ovarian cancer more likely.

In a new study, nearly 1,400 women diagnosed with breast cancer before age 55 got BRCA1 and BRCA2 genetic tests. They were also asked if their mother, daughters, or sisters had ever been diagnosed with breast cancer.

The vast majority of the breast cancer patients had no BRCA1 or BRCA2 gene mutations.

But 5% of the patients who had had breast cancer in one breast and 15% of those who had had breast cancer in both breasts had BRCA1 or BRCA2 gene mutations. Their close female relatives were more likely to have had breast cancer than the relatives of patients without BRCA1 or BRCA2 gene mutations.

Age also mattered. Younger breast cancer patients were more likely to have a mother, daughter, or sister with a history of breast cancer.

Besides BRCA1 and BRCA2, other genes likely "play a major role" in the study's breast cancer risk variation, and environmental and lifestyle factors may also have been involved, write the researchers.

They included Colin Begg, PhD, of New York's Memorial Sloan-Kettering Cancer Center. Their study appears in the Jan. 9/16 issue of The Journal of the American Medical Association.

Reference Link:

http://www.webmd.com/breast-cancer/news/20080108/brca-breast-cancer-gene-risk-varies

Get to the Bottom of Your Sore Throat

A scratchy throat can be more than just an annoyance. Experts offer tips for assessing your sore throat “threat level.”

By Tom Valeo
WebMD Feature

Reviewed by Louise Chang, MD

As a symptom of illness, sore throat rivals fatigue for being both commonplace and a potential sign of catastrophe. Usually, having a sore throat is nothing to worry about -- most are caused by cold and flu germs. In rare cases, however, a sore throat can signal something much more serious. One of the first symptoms of infection caused by the dreaded ebola virus, for example, is a sore throat.

And strep bacteria, a common cause of sore throat, especially in children, can spread like wildfire if it gets into the blood, damaging the liver, brain, kidneys, and other organs.

Jim Henson, creator of the Muppets, came down with a sore throat caused by a strep infection late Sunday, May 13, 1990. He was admitted to the hospital with pneumonia on Tuesday and died 20 hours later of septic shock, a life-threatening response to a severe infection.

"In the preantibiotic era, people died from sore throats all the time," says Robert T. Sataloff, MD, associate dean for clinical academic specialties at Drexel University College of Medicine in Philadelphia. "They'd end up with general toxicity and seed infections in the brain or lungs, and they'd die."

So how do you know the difference between a scratchy throat that will disappear on its own and the start of a potentially deadly infection?

Sore Throat Threat Level: Always "Guarded"

When it comes to sore throat, forget the "low" threat level. The symptom always merits "guarded" or even "elevated" alertness. Pay attention, but don't panic.

If you were talking loudly at a noisy, smoky bar, you may have strained your vocal cords, resulting in throat soreness. If you have hay fever, or if your allergies are acting up, that can make your throat feel scratchy. Even sleeping with your mouth open in the winter, when the air can get as dry as the Sahara, can cause a sore throat.

Even if your sore throat is caused by a viral infection, such as a cold or the flu, you probably can wait it out while drinking hot tea with honey and sucking on throat lozenges to ease the discomfort. Because most sore throats are caused by viruses that don't respond to antibiotics, there's not much you can do about them outside of resting so your immune system is strong and ready to fight the invaders.

"Wait a day, drink plenty of fluids, take pain medication if you'd like," Sataloff tells WebMD. "You might as well try vitamin C. The data are controversial, but vitamin C doesn't do any harm, and there's some suggestion that vitamin C and antioxidants may have some efficacy. These are not unreasonable things to do when helping your body fight off an infection, and that's what it has to do since we don't treat viral infections with antibiotics."

Some people with gastroesophageal reflux disease (GERD) may experience hoarseness with a sore throat, but this will probably be accompanied by other symptoms, such as heartburn or the sour reflux of stomach contents.

(Do you have a favorite sort throat remedy? Tell us about it on the Health Cafe message board.)

When Sore Throat Hits "High" Threat

If your sore throat is accompanied by an achy feeling all over and you have a fever, you should elevate your threat level to "high." You might want to go to the doctor for a throat culture to see if you have a strep infection, especially if you have been around children, who frequently harbor strep bacteria.

"A strep infection can be dangerous for adults or kids," Sataloff says. "The greatest dangers are local inflammation and rapid spread to the throat and adjacent structures like the tonsils and lymph tissues. They can swell and obstruct the airway, and the bacteria can get into the bloodstream and cause infections elsewhere, such as the heart valves."

Inflammation is what makes a sore throat sore, and the greater the inflammation, the greater the danger, Sataloff explains.

"Extreme" Sore Throat Threat: Know the Symptoms

Raise your threat level to "extreme" if you are having difficulty swallowing or breathing, or if you develop a high fever with painful swelling of your lymph nodes. That could indicate tonsillitis, mononucleosis, or some other potentially dangerous infection. These symptoms can also signal strep throat.

"A simple sore throat can cause lots of problems," Sataloff says.

Lemierre's syndrome, for example, is a rare disorder that begins with a fever and sore throat. Soon blood clots form in the jugular vein, and when these infected clots break away, they carry the infection to other parts of the body.

The good news is that prompt treatment can forestall almost all the serious consequences of sore throat.

"We don't see them very often because people get treated," Sataloff says of the life-threatening complications of sore throat. "And if they don't get treated and the sore throat gets worse, then they get treated."

Reference Link:

http://www.webmd.com/cold-and-flu/features/get-to-the-bottom-of-your-sore-throat

Children's Nightmares Less Common

Nightmares Among Preschoolers Linked to Their Personality

By Jennifer Warner
WebMD Medical News

Reviewed by Louise Chang, MD

Jan. 3, 2008 -- Nightmares among young children may be less common than thought. A new study suggests most children's nightmares may be linked to the child's personality traits.

Researchers found most parents of preschoolers reported that their children had nightmares "never" or "sometimes," with less than 4% having nightmares "often" or "always."

The survey also showed that children with frequent nightmares were more likely to be considered anxious by their parents or to have a difficult temperament.

Researchers say the results show that young children with frequent nightmares are a lot like adults with frequent nightmares, who generally suffer from distress and other emotional problems.

Nightmares Tied to Personality Traits

In the study, published in the journal Sleep, researchers surveyed parents of 987 children in the Canadian Province of Quebec at ages 29 months, 41 months, 50 months, 5 years, and 6 years. Parents were asked about the frequency of their child's nightmares without having to assess whether the nightmares caused them to wake up during the night.

The results showed that less than 4% had nightmares often or always.

Researchers found children with risk factors for nightmares shared common traits that emerged as early as 5 months of age. For example, children with risk factors for nightmares:

• Were more likely to have a difficult temperament as rated by their mother at 5 and 17 months old
• Were more likely to be restless during the day at 5 and 17 months old
• Were more likely to be anxious and difficult to calm at 17 months old

Protective factors included parents who provided emotional nurturing after children awoke from nightmares.

Researcher Valerie Simard, MSc,of the University of Montreal says the results suggest that carefully targeting early anxiety symptoms in young children may help prevent nightmares and other emotional issues.

reference link:

http://children.webmd.com/news/20080103/childrens-nightmares-less-common?src=RSS_PUBLIC

Hormones Delay Prostate Cancer Growth

Short-Term Androgen Deprivation Therapy Has Long-Term Benefits

By Salynn Boyles
WebMD Medical News

Reviewed by Louise Chang, MD

Jan. 2, 2008 -- Short-term hormone therapy to lower testosterone levels can significantly delay the progression of prostate cancer in some patients treated with radiation, a study shows.

Just four months of androgen deprivation therapy (ADT) before and during radiation was found to slow cancer growth by as much as eight years in patients with high-risk, locally advanced disease. The patients had either declined or were not considered candidates for longer-term hormonal treatment, researcher Mack Roach III, MD, of the University of California San Francisco, tells WebMD.

The findings were reported today in the American Society of Clinical Oncology (ASCO) publication Journal of Clinical Oncology.

ADT and Heart Risk

The researchers also found no evidence of an increase in heart risk among the hormone-treated patients, compared with patients treated with radiation alone.

This finding should allay concerns about the treatment raised by a recent study, Roach tells WebMD.

In mid-October, Harvard researchers reported that short-term ADT prior to prostate cancer surgery was associated with a more than twofold increase in death from cardiovascular causes in men with localized disease.

That study did not include patients treated with ADT and radiation, and there is no clinical evidence of an increase in cardiovascular risk in these patients, Roach says.

"Our findings clearly show that the benefits [of short-term hormone treatment] outweigh the risks in this group of patients," Roach tells WebMD. "If there is an increase in heart attack risk, we didn't see it in this long-term follow-up."

8-Year Delay in Progression

The goal of ADT is to lower levels of the male sex hormones, which fuel the growth of prostate cancer.

Long-term hormone suppression of two years or more has been shown to improve survival in prostate cancer patients treated with radiation who are considered high risk due to high tumor burden, high prostate-specific antigen (PSA) scores, or other prognostic indicators.

But long-term ADT is also associated with an increased risk for osteoporosis, diabetes, and other health problems.

In an effort to assess the risks vs. benefits of shorter-term ATD, Roach and colleagues followed 456 older men with high-risk prostate cancer for 13 years.

Roughly half the men were treated with ADT for four months, immediately before and during radiation treatment. The rest of the patients were treated with radiation alone.

After about five years of follow-up, 40% of patients treated with radiation alone had cancer that had spread to the bones. It took an additional eight years for the same percentage of patients treated with ADT and radiation to develop bone metastases, says Roach.

Fewer prostate cancer deaths were reported in ADT-treated patients over 10 years of follow-up, and these men were also more likely to show no evidence of disease after 10 years.

Fatal cardiac events occurred in 12.5% of the ADT-treated patients, compared with 9.1% of the patients treated with radiation alone -- a difference that could have been due to chance.

"Men who took hormone therapy were 25% more likely to be alive after 10 years," Roach tells WebMD.

The findings confirm the long-term benefits of short-term ADT when combined with radiation, University of Michigan radiation oncology professor Howard Sandler, MD, tells WebMD.

"Even when hormone therapy is used for only four months, the benefits of hormones and radiation can last for many years," he says.

Sandler recommends two to three years of ADT for his highest-risk patients, but he says short-term hormone therapy appears adequate for patients at the higher end of the intermediate-risk scale.

 

reference link:

http://www.webmd.com/prostate-cancer/news/20080102/hormones-delay-prostate-cancer-growth?src=RSS_PUBLIC