How Much Salt Should You Allow?

Dr. Michael Omidi looks at the arguments posed by the Institute of Medicine and American Heart Association over salt intake.

Institute of Medicine, an institution that commonly guides the United States government on issues of health and medicine, released a report today calling into question the advice provided to Americans on a healthy daily intake of salt. The report claims that there is not enough evidence to support the American Heart Association’s suggested daily intake of 1,500 milligrams of sodium and instead advises Americans to institute a daily allowance of 2,300 milligrams of sodium or less.

The report states that while there is an abundance of evidence to suggest that Americans should reduce their salt intake to 2,300 milligrams or less, there was not nearly enough evidence, in the opinion of the Institute of Medicine, to warrant recommendations as low as 1,500 milligrams.

In a statement, CEO Nancy Brown of the American Heart Association stated:

“While the American Heart Association commends the IOM for taking on the challenging topic of sodium consumption, we disagree with key conclusions. The report is missing a critical component – a comprehensive review of well-established evidence which links too much sodium to high blood pressure and heart disease.”

Both organizations can agree on one thing: Americans are consuming far too much salt. On average it is estimated that Americans are consuming roughly 3,400 milligrams of salt a day, and this is primarily due to salt in processed foods like fast food, cereal, and bread. With statistics showing that about 90% of the population of the US will suffer from hypertension as they grow older, and hypertension being linked to consistent consumption of sodium over the years, it is imperative that we all do something to address our salt intake.

By Dr. Michael Omidi

Brain Exercises May Be Key in Cognitive Decline Prevention

As the United States population ages, there is more and more concern regarding dementia. Dr. Michael Omidi looks at how brain exercises may prove to be more effective than medications in preventing cognitive decline.

Dementia, a growing concern in America, is the collection of mental conditions that lead to instability and confusion such as Parkinson’s disease or Alzheimer’s. Roughly 10% to 20% of adults over the age of 70 experience mild cognitive impairment which, unlike dementia, does not seriously impair daily activities, although about 10% of those individuals will go on to experience dementia. By 2050 the percentage of the population over the age of 65 is expected to increase from 12.7% in 2000 to 20.3%.

As of yet there are few effective treatments for these conditions, but a new analysis from the Canadian Medical Association Journal is claiming that there may be hope in brain exercises compared to current medications.

Researchers took under review 32 randomized trials that covered interventions in cognitive decline through drugs, herbal remedies, physical activity, and mental exercises such as performing crossword puzzles and compared them to studies that examined a control group who were left to decline.

The studies found the following about those different attempts at treatment:

• Medications – There was no strong evidence to support the theory that medications including donepezil or a cholinesterase inhibitor would keep neural circuits active.
• Natural Remedies – Some studies have looked at whether or not dementia might be treated through the use of vitamin B, ginkgo, or omega-3 fatty acids, but found that there was little to no improvement on memory or other cognitive functions.
• Hormone Therapy – The use of estrogen and testosterone had been analyzed to judge whether they might be used to help with dementia , but one study found that estrogen therapy in women could be linked to an increase in dementia risk by 80% over five years.
• Physical Activity – Physical activity seemed to help in certain areas. Aerobic activities and resistance training helped to improve some short and long term memory in patients, while aerobic exercise could be linked to improved planning, organization, and other executive functions.
• Mental Exercise – This proved to have the most dramatic benefits. In trials where computer-based training programs or exercises in reasoning, memory, and speed-processing were performed better attention skills and memory were reported even into five-year follow up examinations for some individuals. The popular game Brain Age was show to even improve declining abilities in some patients at least in the short-term.

The best thing to do for those who are beginning to approach the age where dementia poses a significant risk may be to start getting them involved in brain activities such as crossword puzzles, sudoku, or other brain exercises, although further studies will need to be conducted.

By Dr. Michael Omidi

Are Controversial Smoking Ads Effective?

The CDC has released a new campaign of graphic smoking ads in order to encourage people to quit. Dr. Michael Omidi looks at studies that discuss the effectiveness of these campaigns.

In the spring of 2012, the CDC ran a series of graphic anti-smoking ads that featured many real-life smokers who had paid a significant cost due to their habit. The ads ran for 12 weeks and featured former smokers such as Terrie Hall, who has had to use a hands-free device speaking device that is connected through a stoma in her neck ever since she was diagnosed with throat cancer and had to have her larynx removed. Since her initial diagnosis she has been diagnosed a dozen times with various types of cancers that primarily involve her lungs, head, and neck.

After running ads like Terrie’s, the CDC was able to study the effectiveness of their ad campaign, and they found ads that personalize the health risks associated with smoking can be very effective. During the 12-week period that the ads ran last spring the number of call that came into the national toll free quit line of the CDC (800-QUIT-NOW) doubled to 365,000 calls during that period. Additionally, the CDC found that the number of unique visits to their smoking cessation website, smokefree.gov, increased to 630,000 or five times those seen during the same period in 2011. As soon as the ads stopped running, reports Dr. Tom Frieden, the director of the CDC, the number of visits and calls returned to normal levels.

The cost of smoking on the lives of Americans, their health, and the healthcare system is substantial: Smoking is the leading cause of preventable disease and death in the United States and accounts for not only 443,000 deaths annually, but also results in as many as 8 million people to suffer serious illness and $100 million in additional annual health care costs.

The controversy resides in whether these graphic ads are appropriate at a preventative level for children or if they are indeed too graphic. While the CDC has not required age verification for viewing on YouTube for their previous ads, and there has been no mention of doing this for the 2013 ads, they have stated that they are attempting to protect younger children from being subjected to them; Tim McAfee, who runs the CDC’s Office on Smoking and Health explained that they won’t be running ads on children’s television like the Disney Channel, for example.

The CDC has already begun airing the videos on the CDC Streaming Health YouTube channel.

By Dr. Michael Omidi

Is the HPV Vaccine Safe?

With new studies finding that parents are concerned about the safety of the HPV vaccine, Dr. Michael Omidi examines the debate around the HPV vaccine and its effectiveness. 

Published in the journal Pediatrics, the Official Journal of the American Academy of Pediatrics, a new study has found that many young women are not receiving the HPV vaccine at an early age due to the safety concerns of their parents. While the study did find that the number of young girls ages 13 to 17 who have received the vaccine has increased, the number of parents who stated that they had no intention of vaccination their child increased from 2008 to 2010.

In the past there has been controversy over children receiving the vaccination for the human papillomavirus due to a perceived implication that it condones early sexual contact; HPV is a sexually transmitted disease that can cause warts on the genitals and lead to certain types of cancer such as cervical cancer. In the case of this study, this controversy was not the reason provided by participants for not intending to have their child vaccinated. From 2008 to 2010 the number of parents that answered “safety concerns/side effects” as their reason for not having their child receive the vaccine rose from 4.5% to 16.4%.

This rise in parental concern over the safety of the vaccine has many health officials baffled. The lead researcher of the study, Dr. Paul Darden, had this to say about the findings of the study:

“We thought perhaps many parents would think the HPV vaccine would give kids permission to have sex, and therefore not allow their children to get it. But that wasn’t it. They seemed to be skeptical of its safety, which is odd, because it’s shown to be effective with few side effects. We have a vaccine that protects against cancer. Why not vaccinate your child? I don’t get it.” [1]

The evidence for the safety of the HPV vaccine has increased over the years, despite parental confidence decreasing. So what are the potential side effects of the vaccine? According to the CDC the side effects of the vaccine could include:

• Headaches and upper respiratory infections can occur in about 1 in 3 individuals
• Stuffy nose or join pain can occur in 1 in 6 patients
• Fever has been associated with about 1 in 100 people
• In less than 1% of patients inflammation can occur in the stomach or intestines or experience pneumonia or blood in the urine or stool

The CDC also has this to say about the vaccine in its report:

“A vaccine, like any medicine, could cause a serious reaction. But the risk of a vaccine causing serious harm, or death, is extremely small.”

All of the evidence strongly suggests that the HPV vaccine is indeed safe and will help in preventing the development of dangerous cancers later in life.

By Dr. Michael Omidi

[1] http://www.cbsnews.com/8301-204_162-57574877/side-effect-fears-stop-parents-from-getting-hpv-vaccine-for-daughters/

Potential Cure for HIV Found in Young Child

There has recently been a case of a newborn baby with HIV being reportedly cured through repeated administrations of powerful antiretroviral drugs.  In the following article, Dr. Michael Omidi discusses the potential consequences of these findings on global pediatric AIDS patients. 

In an exciting new medical development regarding the treatment of newborns with HIV, a baby seems to have had the HIV viral load completely eliminated via aggressive antiretroviral drug treatments, effectively curing the child.[1]

While it is a matter of some dispute whether the child was actually infected with the virus – the physician that administered the drug treatments insists that it was – this could potentially become the new standard of care for babies born with HIV all over the world.

Babies born from infected mothers generally will not carry the virus themselves if the mother undergoes antiretroviral treatments during pregnancy. However, the population of infected mothers in underdeveloped countries is far less likely to receive prenatal care than in the western world, so cases of babies born already infected with the virus are much higher. If these results can be replicated, it could drastically reduce the number of babies and children living with HIV.  For pediatric medicine, this discovery could be very promising for the eradication of pediatric AIDS.

Thus far, there has been one documented case of a patient being cured of HIV. A leukemia patient who received a stem cell transplant from a donor who was genetically HIV resistant (a very small percentage of the population carries a gene that renders them immune to the ravages of the HIV virus) was found to have been cured by the donor’s mutation taking hold in his own body.[2]

The stem cell transplant is a very dangerous and difficult treatment, and completely untenable as an actual cure for the rest of the population. However, there is very encouraging research regarding how this genetic mutation could possibly be harnessed into a vaccine or cure for HIV.

There have been some detractors regarding the perception that the baby was “cured.” Many argue that the baby was not infected at all; the hallmark of HIV’s notorious lack of curability is the fact that parts of the virus can mutate and secrete themselves in organs away from the effects of drug therapy. The reason drug treatment must be maintained for the rest of a patient’s life is because once it stops the hidden virus then invades the rest of the body and the blood stream. In the case of the baby, there might not have been time for the virus to have collected in small hidden “pockets,” thereby allowing the antiretroviral drugs to fully take hold on the infection in its entirety.

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[1] McNeil, Donald G; Pollack, Andrew: In Medical First, a Baby With HIV Is Deemed Cured New York Times 3/3/2013 http://www.nytimes.com/2013/03/04/health/for-first-time-baby-cured-of-hiv-doctors-say.html?ref=health&_r=0

[2] Rosenberg, Tina: The Man Who Had HIV and Now Does Not New York Magazine 5/29/2011 http://nymag.com/health/features/aids-cure-2011-6/

Dr. Michael Omidi Reviews Benefits of Mediterranean Diet

Dr. Michael Omidi looks at new research that isolates the benefits of the “Mediterranean Diet.” Dr. Michael Omidi looks at the cardiovascular benefits of this particular diet and how it may help you.

The Mediterranean Diet encompasses many different components, but they can be broken down in this way:

• Sparing consumption of meats and sweets
• Moderate portions of food items such as poultry, eggs, and dairy
• Eating fish and seafood at least twice a week
• Meals that are predominately based on fruits, vegetables, grains, and legumes
• Regular exercise

In the past studies have suggested that this type of diet could lead to a healthier heart and cardiovascular system, but the studies were unable to prove that other factors not included in the research did not contribute to overall heart health. A recent study, however, has allowed researchers to rule out many of those outside factors and determine how beneficial the diet itself really is. What they found was that a diet high in fresh fruits, vegetables, nuts, fish, and olive oil can help to prevent strokes and heart disease.

The study encompassed 7,500 adults with diabetes or other health risks and placed them into three separate groups, two of which were on a Mediterranean diet. They found that the participants who maintained a Mediterranean diet were 28% to 30% less likely to develop cardiovascular disease compared to diets that were low in fat.

Additionally, the study found that there was not one component of the diet that improved heart health, but that all of the components together worked to improve the cardiovascular system. The researchers did isolate several of the reasons this diet is good for heart health and they included the quality of fat that was consumed, the emphasis of meals that focus on plants, that good sources of calories are encouraged and bad sources of calories (such as soda, sweets, red meat, and refined bread) were discouraged, and replacing snack foods that are high in carbohydrates with nuts.

Despite some of the participants being on medications for the study the doctors believed that diet still had a “substantial additional benefit.”

If you are worried about your heart health or in a high-risk group for diabetes or cardiovascular disease it may be a good idea to consult with your physician about starting on the Mediterranean Diet.

By Dr. Michael Omidi

Pittman, Genevra. “Mediterranean Diet Can Ward off Heart Disease: Study.” Reuters. Thomson Reuters, 25 Feb. 2013.

Dr. Michael Omidi Examines Early, Preventative Mental Health Treatment

Dr. Michael Omidi examines the lack of early mental healthcare resources for Americans with emotional disorders; resources that could prevent the mentally ill from being either perpetrators of violence or victims of violence.

According to a panel of mental health experts, the United States mental health system is in need of a reevaluation and overhaul with regard to early, preventative treatment; so much so that millions of men, women and children do not receive the type of care that could possibly prevent dangerous consequences.

In testimony before the Senate Health, Education, Labor and Pensions Committee hearing on Jan. 24^th, a group of representatives from various mental health institutes said that 75 percent of mental illnesses make themselves apparent in a patient by 24 years of age, but less than one fifth of teenagers and children with emotional problems that could be diagnosed by a mental health expert are treated. Ignoring these signs leaves the door open for aggressive, violent behavior and/or suicide.

Of the approximately 45 million Americans that suffer from some kind of mental disorder – including depression, eating disorders, addiction or trauma – only 38 percent are ever treated.

The Senate Health, Education, Labor and Pensions Committee called the hearing in response to the tragic events that occurred in Newton, Connecticut, where a 20-year-old with a history of mental disorders gunned down 20 school children and 6 teachers and staff.  There has not been a committee hearing on the subject of mental health since 2007.

While only a small percentage of the mentally ill suffer from the types of delusions that render them extremely violent or homicidal, a great number of people with mental and emotional disorders are in danger of harming themselves, as it is estimated that 90 percent of suicides are initiated by people with mental disorders.

Mental illnesses are degenerative; symptoms that might seem as though they are indications of an eccentric personality in the early stages, and therefore ignored by family and friends, could become considerably worse with age.  The longer a person with an emotional disorder goes without treatment, the greater the likelihood that the person will begin to self medicate and/or engage in other destructive behaviors. He or she will find it difficult to maintain steady employment, keep up healthy relationships with others, and even to care for themselves.

The healthcare reform law is set to provide increased mental healthcare access to millions of mentally unstable, uninsured Americans. It is estimated that approximately 10 million Americans will be able to get the treatment they need after the January 1, 2014 start date. Included in the healthcare provisions for mental health are a series of initiatives that will help parents, teachers, and caregivers identify the signs and symptoms of mental illnesses in children and teenagers.

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Morgan, David: U.S. Mental Health Experts Urge Focus on Early Treatment Reuters 1/24/2013 www.reuters.com/article/2013/01/24/us-usa-healthcare-mental-idUSBRE90N0PB20130124

Michael Omidi Looks at The Decline of Health in America

Michael Omidi examines a recent report conducted comparing the health of 17 developed nations including the United States and how the research shows the declining health of the country.

Asked by the National Institute of Health to compare the health of those living in the United States to residents of 16 other developed countries, researchers from the National Academy of Sciences found that Americans are unhealthier than these countires in many significant areas.

A report provided and compiled by the National Research Council and Institute of Medicine - which act as part of the National Academies of Science – discovered that in areas such as infant mortality, obesity and diabetes, heart disease, lung disease, drug abuse, STDs, the AIDS virus, and injury and homicide rates, we are significantly lacking behind many developed nations. Developed nations that were investigated included Japan, Britain, France, Australia, Canada, and Germany.

Some of the following findings were concluded by the report:

• When compared to these other nations Americans are seven times more likely to be murdered and 20 times more likely to be killed by a gun.
• Americans spend more on healthcare than the other nations (about $8,600 per person per year) and have worse health.
• Lifestyle factors that contribute to the health deficiency include deficits in education and physical activity, disparity in health care, poor eating habits, and high rates of drug abuse among others.

The study compiles over 378 pages of data and found that it is not so much the elderly that suffer but those currently under the age of 50. According to the report about two-thirds of the difference in life expectancy compared to other nations is accounted for by deaths under the age of 50. This is greatly affecing infants, children, and adolescents who die at a higher rate in the US than in the other developed countries; for example, the infant mortality rate is 32.7 deaths per 100,000 compared to rates that do not exceed 25 deaths per 100,000 in the other countries and are much lower in these instances.

Life expectancy for men was 75.6 years, which took last place out of the 16 other countries, and life expectancy for women, at 81 years, was ranked second-to-last.

There were areas that the United States was successful in the health of its citizens: Americans have much lower death rates as a result of cancer and do a better job of controlling cholesterol and blood pressure. Additionally, when Americans reach the age of 75 they can expect to live longer than in other countries.

What is to be done about these issuse have been overwhelming researchers though there will no doubt be many attempts to identify and potentially resolve these issues. We will have to wait and see what solutions can be provided to put the US back on top in terms of health and life expectancy.

By Michael Omidi

Dr. Michael Omidi on MS and Potential of New Eye Scan

Dr. Michael Omidi examines the disorder known as Multiple Sclerosis and what a new test may provide in the way of identifying the progression of the disease in patients. 

What is Multiple Sclerosis and Who Does it Affect?

Multiple Sclerosis affects roughly 400,000 people in the United States, with an additional 200 individuals being diagnosed every week. Worldwide about 2.1 million people are affected by MS. Multiple sclerosis is caused by the protective covering around nerve cells, known as the myelin sheath, is damaged by inflammation, causing nerve signals to slow down or stop completely. The severity, frequency, and location of these attacks vary for each patient but they can result in:

• Loss of balance
• Muscle spasms
• Numbness
• Issues moving extremities
• Pain

These are not the only symptoms, in fact there are a multitude of symptoms of which you can find a more comprehensive list here, but the myriad number of symptoms often makes the disorder difficult to diagnose. In many instances diagnosis relies on eliminating other nervous system disorders.

Testing for MS

Although there are new tests that are being engineered to assist in the diagnosis of MS, no single laboratory test currently exists for diagnosis. In ruling out other nervous system disorders doctors may use:

• Lumbar Puncture
• MRI Scan of the Brain
• Nerve Function Study

However, a new test may assist in monitoring the progression of the disorder among patients that have been diagnosed.

Optical Coherence Tomography

The imaging known as Optical Coherence Tomography, a type of eye scan, may be used to help monitor patients with MS. A team of researchers at John Hopkins University School of Medicine conducted a trial involving 164 patients diagnosed with Multiple Sclerosis and noticed that those patients that exhibited thinning of the retina tended to have earlier and more active MS. The researchers believe that because the nerve cells in the retina are not covered by the protective myelin that the nerves in the retina may indicate the earliest signs of damage caused by MS.

Treatment

While there is some debate on whether or not this new test will be able to diagnose Multiple Sclerosis in patients, it may help in measuring the effectiveness of new treatments and the progression of the disease. Currently there is no cure for MS, but there are different types of therapies available to slow the progression including:

• Interferons
• Steroids
• Methotrexate
• Intravenous Immunoglobulin
• Medications for Muscle Spasms
• Antidepressants for Mood or Behavior Symptoms

In most cases the best that can be done is to treat the symptoms with the appropriate medications but, hopefully with this new method of testing, it may help identify those treatments that aid in slowing the progress of the disease.

By Dr. Michael Omidi

Dr. Michael Omidi on New Alzheimer’s Studies and Treatments

Dr. Michael Omidi takes a look at the news that many upcoming studies regarding Alzheimer’s may influence dramatically the way the disease is treated. Dr. Michael Omidi examines the potential of these new studies and what they may mean for treatment in the very near future.

Those Afficted with Alzheimer’s Disease

Approximately one in eight older Americans suffers from the most common form of dementia known as Alzheimer’s disease. As of 2006 there were over 26.6 million sufferers worldwide, with the expected number of Alzheimer’s patients expected to rise to 16 million in the United States alone by the year 2050. Not only is the disease the number six killer in the U.S., it also results in the patient’s complete loss of self in a slow, degenerative process that can be particularly painful to those that love and care for them as well as the patient themselves.

New research is being conducted to help fight against Alzheimer’s disease and provide a treatment solution that can eliminate or at least slow the progression of this disorder. The chief medical officer of the Alzheimer’s Association is predicting that there may be a solution available within the next three years.

Posssible Treatment

In order to properly study new treatment methods it will require not only funding from the government and other sources, but also the involvement of patients to take part in clinical trials for potential new medications and methods of treatment.

Currently, treatment revolves around easing the symptoms of the disease, and doing so has resulted in significant costs to taxpayers, adding another reason that finding a cure or effective treatment method is so imperative. Presently the cost to taxpayers of care for those suffering from Alzheimer’s sits at $200 billion, wth costs expected to rise dramatically to over $1 trillion by 2050 if a solution is not found.

One of several medications that have the potential to slow down the functional and mental decline caused by Alzheimer’s is a BACE inhibitor that has entered late-stage study phase, a drug known as MK-8931. In research already conducted on the drug, formation of toxic amyloid plaques – which lead to Alzheimer’s – were blocked almost entirely.

The largest concern for most of these studies is making sure that there are no detrimental side effects posed by certain medications, as treatment using these compounds would potentially last many years.

Hopefully these studies will end with conclusive data regarding the effectiveness and safety of potential medications to treat Alzheimer’s disease, and no doubt those who currently care for those with the disease as well as those who suffer from it are anxious about the results.

By

Dr. Michael Omidi

Source:

Associated Press. “Upcoming Alzheimer’s Studies May Change How Disease Is Treated.” CBSNews. CBS Interactive, 03 Dec. 2012. Web. 03 Dec. 2012. http://www.cbsnews.com/8301-204_162-57556824/upcoming-alzheimers-studies-may-change-how-disease-is-treated/.