Health Check Qatar

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ISSUE 18

Wednesday, September 30, 2015

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Health Minister’s Statement on ‘Organ Transplant Law’

SCH AND HMC OFFER HEALTH SAFETY TIPS FOR HAJJ PILGRIMS

HIS EXCELLENCY THE MINISTER OF PUBLIC HEALTH

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he new law promotes the State’s persistent exerted efforts to organize the process of human organs transplant to be in compliance with the most stringent rules and regulations and the application of the highest medical and ethical standards which constitute a firm guarantee against human organs trafficking practices” said HE the Minister, adding: “the law comprises severe penalties against any breaches of its provisions as well as clear-cut mechanisms to ensure effective control and supervision. HE the Minister further underlined that the law shall be followed by a package of executive decisions specifying the terms and procedures to be secured by the hospitals seeking license to perform organs, tissues or cells transplant and the formation of medical ethics committees at the licensed hospitals, identify the material, insurance and therapeutic benefits granted to donors and their families and establish bio-banks for the storage and conservation of tissues and cells at both public and private hospitals. HE the Minister pointed out that as stated by the provisions of the law the current decisions shall continue to be effective, until the issue of these decisions, provided that they should not be in contradiction with the provisions of the new law. HE the Minister confirmed that Qatar is in the lead and plays a pioneering role in the provision of advanced, comprehensive and high quality services in the field of organ transplant applying the latest and high standard criteria in this regard. HE the Minister finally expressed his thanks and appreciation for all nationals and expatriates who took the initiative and register in the National Registry for Organ Donation and support the efforts exerted to reach self-sufficiency in this field confirming that all legislations and agreements enforced in this regard are fully respected in letter and spirit.

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s many Muslims are traveling to Saudi Arabia to against seasonal flu. Individuals who are at an increased perform Hajj in fulfilment of their religious acts of risk of severe influenza diseases, particularly pregnant worship during this period, the Supreme Council women, children under five years, the elderly and individuals with underlying health conof Health (SCH) and Hamad Mediditions such as human immunodecal Corporation (HMC) are remindficiency virus, asthma, chronic heart ing pilgrims to take the necessary DR. SAAD AL NUAIMI, or lung diseases, are urged to take steps to ensure they are safeguarded SENIOR CONSULTANT the annual seasonal flu vaccine this against infectious diseases while on IN EMERGENCY year,” he explained. the holy pilgrimage. MEDICINE AT HMC, Dr. Al-Romaihi added that pneuAccording to the SCH, three immococcal vaccination is recomSTRESSED THAT portant vaccines are recommended mended for high risk people aged for those going on Hajj during this PILGRIMS MUST TAKE between two and 64 years with year. The vaccines are meningoHEALTH PRECAUTIONS chronic medical conditions like coccal meningitis, seasonal flu and sickle cell anemia, splenectomy and PRIOR TO TRAVEL, pneumococcal. The SCH recomrenal failure; healthy adults aged DURING THEIR mends that pilgrims should comfrom 18 – 64 years with unknown or plete these vaccinations at least 10 JOURNEY, AND AT THE incomplete pneumococcal vaccine days before their departure to Saudi END OF THEIR TRIP series in childhood; and healthy Arabia. adults aged 50 – 64 years with no “It is mandatory for all adults and pneumococcal vaccine after 18 children over two years to receive meningococcal vacyears. All high risk individuals are also advised to protect cine at least 10 days before traveling to Saudi Arabia. themselves by receiving the flu vaccine. Meningococcal vaccine may be used with caution in Dr. Saad Al Nuaimi, Senior Consultant in Emergenpregnancy. However, it is not mandatory for pregnant cy Medicine at HMC, stressed that pilgrims must take women going for Hajj,” said Dr Hamad Eid Al-Romaihi, health precautions prior to travel, during their journey, Manager of Health Protection and Communicable Disand at the end of their trip. ease Control at SCH. (Continued on page 2...) “Furthermore, all pilgrims should be vaccinated


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... REPORT ...

(Continued from page 1...)

SCH AND HMC OFFER HEALTH SAFETY TIPS FOR HAJJ PILGRIMS Among the most common illnesses contracted during Hajj are respiratory illnesses, including throat and upper respiratory tract and lung infections which are usually caused by viruses that spread rapidly among crowds.” To protect against these infections, pilgrims should follow simple ‘cough hygiene’ safety measures such as using tissue paper when coughing or sneezing, in addition to ensuring that used tissues are disposed of carefully. “Washing hands frequently with soap and water, and avoiding hand contact with the eyes, nose and mouth as much as possible can also be very useful,” Dr. Al Nuaimi said. He recommended seeking urgent medical advice if pilgrims experience cough, fever and any breathing difficulty. He noted that such precautions are important measures in guarding against contracting the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), a major respiratory illness which is a major concern in the region. “The virus has been reported to spread from person to person through extended close contact so it is advisable to avoid direct contact with people who exhibit symptoms such as coughing, sneezing, runny nose, vomiting and diarrhea,” Dr. Al Nuaimi advised. While performing Hajj, it is important to remember that daytime temperatures can be very high, so loss of body fluid through excessive sweating (dehydration) and many heat-related illnesses such as heat cramps, heat syncope, heat exhaustion and even heat stroke can occur. “To avoid such illnesses, pilgrims should ensure they remain well hydrated, drinking plenty of clean water, preferably bottled or boiled and cooled water. Other preventive steps include regularly applying high protection sunscreen (at least SPF 15), and carrying umbrellas to shade away sunlight. Whenever feasible, it is advisable to do circumambulation (Tawaf) in the evening or at night,” Dr. Al Nuaimi advised. He added that the risk of trauma and injuries is heightened with the influx of pilgrims to Mecca during Hajj.

“Pilgrims should avoid peak times to circumambulate and chose times when the number of people is likely to be less,” he said. Another important issue to be aware of is making sure that when men shave their heads after the completion of Hajj, they use clean blades. “Unclean shaving blades can transmit blood-borne viruses, such as Hepatitis B, Hepatitis C and Human Immuno-deficiency virus. Therefore, pilgrims should never share shaving blades,” Dr. Al Nuaimi cautioned. Other useful precautions include carrying medical/first

aid kits, which contain plasters, dressings and painkillers in case of emergency, and also taking a good supply of regular medicines, copies of prescriptions, as well as a doctor’s letter that describes the pilgrim’s medical history in detail. If upon return any pilgrim develops an illness and notices worsening symptoms, especially a fever that is higher than 38 degrees Celsius, a cough or breathing problems, the individual should seek immediate medical assistance from any urgent care center, Dr. Al Nuaimi said, adding that the person should inform the treating physician about their Hajj trip for any further advice.

High-risk groups urged to get PD vaccinations before Hajj W

ith the Hajj pilgrimage less than a month away, doctors are urging travellers as well as residents in the Kingdom to adopt preventive measures well in advance to avoid Pneumococcal Disease (PD). According to medical research, mass gatherings are associated with the spread of the infectious disease. Director of Saudi Society for Medical Microbiology and Infectious Diseases Dr. Nezar Bahabri said: “Mass gatherings such as Hajj and Umrah provide the ideal overcrowded conditions for the transmission of infections.” In the Kingdom, the incidence rate of pneumococcal disease is over 17 percent, with a fatality rate of 15 to 20 percent among elderly adults, Saudi Gazette reported. Pilgrims should take extra precautions to prevent pneumonia, meningitis, respiratory tract infections, tuberculosis, viral infections, community-acquired pneumonia, polio virus, blood-borne diseases and even food poisoning.

All of these conditions can lead to hospitalization and can result in further fatalities. “Adult vaccination against pneumococcal disease conditions such as meningitis, respiratory infections and pneumonia, can save lives and prevent these infections from spreading and potentially taking on epidemic proportions,” Bahabri said. Some factors that contribute to the spread of these diseases include close contacts with pilgrims, large crowds, shared accommodation and airborne dust. Pneumococcal disease poses a serious threat, with individuals carrying the bacteria potentially exposing others through close contact, sneezing, coughing or even exhaling. The Health Ministry and local authorities have established facilities to ensure travelers can have access to vaccination facilities, with doctors working with each patient individually to ascertain the best course of vaccination. (Source : APP)

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Wednesday, September 30, 2015

... MEDICAL NEWS ...

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NONSMOKERS ACCOUNT FOR RISING PROPORTION OF LUNG CANCER CASES, STUDIES FIND

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onsmokers account for a growing percentage of aggressive lung cancer cases in the United States and the United Kingdom, new research finds. In one study, British researchers found that over seven years the proportion of U.K. never-smokers with non-small cell lung cancer jumped from 13 percent to 28 percent. Similarly, a study of lung cancer patients at three U.S. hospitals reported that never-smokers accounted for a growing percentage of non-small cell lung cancer patients between 1990 and 2013. These nonsmokers with lung cancer were more likely to be women, the researchers said. The findings didn’t surprise Dr. Karen Reckamp, medical director of the lung cancer and thoracic oncology program at the City of Hope Cancer Center in Duarte, Calif. “As smoking rates declined, we continue to see more patients diagnosed with lung cancer who do not have a prior smoking history,” said Reckamp, who wasn’t involved in either study. The lung cancer that affects nonsmokers appears to be a different disease, Reckamp said. “We know that nonsmoking lung cancer is a distinct entity and often presents with specific genetic changes in the cancer that drive tumor growth,” she said. She and other experts suspect genet-

ic and environmental factors may be to blame. Non-small cell cancer -- by far the most common type -- is aggressive and usually diagnosed at a later stage when it is harder to treat, according to the American Cancer Society. It is especially challenging to detect in nonsmokers because there are no known risk factors that merit screening, researchers said. The British findings were based on medical records for 2,170 U.K. patients who underwent surgery for lung cancer between 2008 and 2014. In the U.S. study, a team led by Dr. Lorraine Pelosof analyzed data on more than 12,000 lung cancer patients at the University of Texas Southwestern Medical Center at Dallas, Parkland Hospital in Dallas and Vanderbilt University in Nashville. Pelosof and colleagues compared data compiled from 1990-1995 and 2011-2013. “In 1990 to 1995, 9 percent of non-small cell patients were never-smokers. By 2011-2013, nearly 15 percent were,” said Pelosof, an assistant professor of hematology-oncology at the University of Texas Southwestern Medical Center. In comparison, nonsmokers with small cell lung cancers -- a less common form of disease -- increased only slightly, from 1.7 percent to 2.5 percent in the later period, the study found.

Small cell cancers account for about 10 percent to 15 percent of U.S. lung cancer cases, the American Cancer Society says. Results of both studies were scheduled for presentation this week in Denver at a conference organized by the International Association of the Study of Lung Cancer. Data and conclusions should be considered preliminary until they’re published in a peer-reviewed medical journal. Experts said they can’t explain why nonsmokers are a growing proportion of lung cancer diagnoses, or why women seem especially vulnerable. Besides smoking, Pelosof said, exposure to asbestos and radon are known risks for lung cancer. Genetic factors are thought to play a role, too.

The increased proportion of nonsmokers with lung cancer doesn’t seem to be due to better diagnostic methods, she said. However, Pelosof acknowledged her team’s findings need to be confirmed in other studies, noting that one limitation of her research is that participants’ smoking status was self-reported. Reckamp said other studies are looking at genetic risk and family history to zero in on who might be at risk for these cancers, despite no tobacco exposure. Most lung cancers don’t cause noticeable symptoms until the disease is advanced, says the American Cancer Society. However, if you have a persistent cough or bronchitis or hoarseness, the society recommends seeing your doctor for a checkup. (Source: webMD.com)

Overview of the Middle East Respiratory Syndrome Corona Virus A novel coronavirus was identified in 2012 as the cause of respiratory illness in people. The new virus is a beta coronavirus. It is different from any other coronavirus previously found in people. The novel coronavirus is not the same virus that caused severe acute respiratory syndrome (SARS) in 2003. Most people who got infected with the MERS-CoV developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. Some people were reported as having a mild respiratory illness. The virus has been shown to spread between people who are in close contact. Transmission from infected patients to healthcare personnel has also been ob-

served. Clusters of cases in Saudi Arabia, Jordan, the UK, France & Tunisia are being investigated. There are no specific treatments for illnesses caused by the MERS-CoV. Medical care is supportive and to help relieve symptoms. Lab tests (polymerase chain reaction or PCR) for the MERS-CoV are available at HMC Virology Lab. Since the discovery of the virus, scientific literature, databases and the media have used various names for it. To provide uniformity and facilitate communication about the disease, the Coronavirus Study Group of the International Committee on Taxonomy of Viruses has decided to call the new virus Middle East respiratory syn-

drome coronavirus (MERS-CoV). WHO and other Committee members strongly urge the use of this name in scientific and other communications. The standardized name was announced in the “Journal of Virology” on 15 May. To date there is no conclusive evidence on the mode of transmission of the virus but there is a strong possibility that like other Coronaviruses it might be spread through direct contact with patients or their body secretions, through droplets expelled from the patient during coughing and sneezing or indirect transmission through touching services contaminated with the virus and then touching the mouth, eyes or nose. SCH advises all to practice good hand

hygiene especially after contact with a sick patient and to cover the cough and sneeze with a tissue or upper arm. The Supreme Council of Health is closely following all acute respiratory distress patients admitted in the hospitals and the HMC lab is running the MERS-CoV tests for such patients as a part of the routine respiratory panel. Moreover, SCH is also in close communication with WHO & CDC for any updates on recommendations and international situation regarding the MERS-CoV.


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... MENTAL HEALTH ...

COULD EATING FISH HELP WARD OFF DEPRESSION? FISH IS RICH IN MULTIPLE BENEFICIAL NUTRIENTS, INCLUDING OMEGA-3 FATTY ACIDS, HIGH-QUALITY PROTEIN, VITAMINS AND MINERALS, WHICH WERE ASSOCIATED WITH DECREASED RISK OF DEPRESSION

Forgiveness May Boost Older Women’s Moods T he old adage that forgiveness is divine may be true for older women, but it may always not make men feel any better, a new study suggests. The researchers found that older women who forgave others were less likely to be depressed. And, that was true even if they felt unforgiven by others. However, men who forgave others, but also felt unforgiven had the highest levels of depression, the study revealed. The research stemmed from a survey of more than 1,000 American adults. The study participants were all aged 67 and older. The survey asked about their mental and physical health, as well as their religious beliefs. “When we think about forgiveness and characteristics of people who are forgiving -- altruistic, compassionate, empathetic -- these people forgive others and seem to compensate for the fact that others aren’t forgiving them,” study co-author Christine Proulx, an associate professor in the department of human development and family science at the University of Missouri, said in a university news release. “It sounds like moral superiority, but it’s not about being a better person. It’s ’I know that this hurts because it’s hurting me,’ and those people are more likely to forgive others, which appears to help decrease levels of depression, particularly for women,” Proulx said. The findings suggest that mental health counselors may have to use different, gender-specific approaches when dealing with older women and older men, the researchers said. Many people begin to reflect on their lives as they get older, including how they may have been hurt by or hurt others, Proulx noted. And while forgiving others may reduce some people’s risk of depression, forgiving oneself doesn’t seem to help. “Self-forgiveness didn’t act as the protector against depression. It’s really about whether individuals can forgive other people and their willingness to forgive others,” Proulx said. (Souce : Aging & Mental Health)

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an eating a lot of fish boost your mood? Maybe, say Chinese researchers. Overall, the researchers found that people who consumed the most fish lowered their risk of depression by 17 percent compared to those who ate the least. “Studies we reviewed indicated that high fish consumption can reduce the incidence of depression, which may indicate a potential causal relationship between fish consumption and depression,” said lead researcher Fang Li, of the department of epidemiology and health statistics at the Medical College of Qingdao University in China. But this association was only statistically significant for studies done in Europe, the researchers said. They didn’t find the same benefit when they looked at studies done in North America, Asia, Australia or South America. The researchers don’t know why the association was only significant for fish consumption in Europe. The study was also only able to show an association between eating fish and the risk for depression, not that eating fish causes a lower risk for depression, Li said. Still, Li thinks there may be reasons why fish may have an effect on depression. “Fish is rich in multiple beneficial nutrients, including omega-3 fatty acids, high-quality protein, vitamins and minerals, which were associated with decreased risk of depression from our study,” Li said. The researchers pointed out that it’s possible that the omega-3 fatty acids in fish may change the struc-

ture of brain membranes, or these acids may alter the way certain neurotransmitters work. Neurotransmitters are the brain’s chemical messengers, sending information from brain cell to brain cell. Some neurotransmitters, such as dopamine and serotonin, are thought to be involved in depression, the researchers said. The report was published Sept. 10 online in the Journal of Epidemiology & Community Health. Depression affects 350 million people around the globe, according to background information in the study. The mood disorder is the leading cause of disability worldwide, according to the World Health Organization. Past research has suggested that dietary factors may play a role in depression, the researchers said. To look at the possible connection between eating fish and depression, Li and colleagues reviewed 26 studies published between 2001 and 2014. The studies included more than 150,000 people. Ten of the studies were done in Europe. This process, called a meta-analysis, attempts to find consistent patterns across multiple studies. In addition to an overall benefit from fish in curbing depression, Li’s team found a difference between men and women. Specifically, the researchers found a slightly stronger association between eating a lot of fish and lowered depression risk in men by 20 percent. Among women, reduction in risk was 16 percent, the researchers said. (Source: nytsyn.com)


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... WOMEN HEALTH ...

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SCREENING ALL WOMEN FOR BREAST CANCER GENES NOT FEASIBLE: STUDY S

creening all women for gene mutations that increase the risk of breast and ovarian cancer is too costly to be feasible, a new study suggests. Women with BRCA1 and BRCA2 gene mutations have a much higher risk of breast and ovarian cancer than those without the mutations. A BRCA genetic test costs about $4,000, according to the University of California, Los Angeles (UCLA) researchers. The study authors found that for every 10,000 women in the general population who were screened, about four more cases of breast cancer and two more cases of ovarian cancer would be prevented, compared with screening only women with a family history of the cancers. However, BRCA screening would only extend patients’ lives for an average of two days, the researchers

added. And for more than 99 percent of women screened, a negative genetic test would not increase life expectancy or eliminate the need for regular mammograms, and could falsely reassure women that they aren’t at risk for breast cancer, the study authors said. “The cost of BRCA testing would need to drop by 90 percent for testing to be cost-effective for the whole population,” study co-author Dr. Patricia Ganz, director of thdivision of cancer prevention and control research at the Jonsson Comprehensive Cancer Center at UCLA, said in a university news release. “It’s like looking for a needle in a haystack,” study co-author Elisa Long, an assistant professor in the School of Management, said in the news release. “If only one in 400 women across the country have one or both of the

BRCA1 or BRCA2 mutations, universal screening would cost $1 million to $2 million to detect a single BRCA mutation, or nearly $400 billion to screen all women in the United States. Perhaps this money could be better spent on other diagnostic tools for young women, such as MRIs, to have the greatest impact,” Long said. The study was published online recently in the journal JAMA Oncology. Of the 233,000 breast cancer cases diagnosed in the United States each year, only 5 percent to 10 percent are associated with BRCA gene mutations, according to background information in the news release. BRCA genetic testing should be limited to women with a known family history of breast, ovarian, tubal or peritoneal cancer, according to the U.S. Preventive Services Task Force. (Source : HealthDay News)

High BP in Pregnancy May Reappear Later in Life HIGH BLOOD PRESSURE AND PREGNANCY ISN’T NECESSARILY A DANGEROUS COMBINATION. HERE’S WHAT YOU NEED TO KNOW TO TAKE CARE OF YOURSELF - AND YOUR BABY.

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omen with high blood pressureduring pregnancy are more likely to face the same health problem later in life, a new study suggests. The researchers also said they found that the brothers and sisters of these women have a higher risk of high blood pressure later in life, and the brothers also may have

a higher chance of heart disease. “The increased risk of high blood pressure in siblings suggests that family history contributes to the increased risk of high blood pressure in women during pregnancy,” study co-leader Tracey Weissgerber, of the Mayo Clinic in Rochester, Minn., said in a news release from the American Society of Nephrology.

“However, women who had high blood pressure in pregnancy were still more likely to develop high blood pressure later in life than their sisters who had normal blood pressure in pregnancy,” she added. The study only uncovered an association between high blood pressure during pregnancy and potential problems later in life; it did not prove cause-and-effect. The long-term study included over 900 brothers and nearly 1,500 sisters in 954 sibling groups across the United States. Compared to women who had normal blood pressure during pregnancy, women with high blood pressure during pregnancy were 75 percent more likely to develop high blood pressure later in life, the findings showed. In addition, brothers and sisters of women who had high blood pressure in pregnancy were 24 percent and 15 percent more likely, respectively, to develop high

blood pressure later in life, compared with brothers and sisters of women who did not have high blood pressure during pregnancy. Brothers, but not sisters, of women who had high blood pressure in pregnancy also had an increased risk of heart disease later in life, according to the study published online Aug. 27 in the Journal of the American Society of Nephrology. “Further studies are needed to determine whether this increased risk in women who had high blood pressure in pregnancy is due to stronger genetic predisposition to high blood pressure, other risk factors, or lasting damage caused by high blood pressure in pregnancy,” Weissgerber said in the news release. High blood pressure develops in about 8 percent of pregnancies. (Source : WebMD.com)


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... MEDICAL SCIENCE ...

A NEW WAY TO TREAT HIGH CHOLESTEROL?

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new class of medications can lower “bad” LDL cholesterol to unheard-of levels. The new class is called PCSK9 inhibitors. The FDA approved the first drug, called alirocumab (Praluent), on July 24, and the second, evolocumab (Repatha), on Aug. 27. PCSK9 drugs have worked particu-

larly well for people with a family history of high cholesterol and those who may not be able to tolerate widely-prescribed statin drugs. But their estimated price tag is steep. We asked two experts for their opinions on these new medications. “Statins work by reducing the production of cholesterol in the liver,” says

Melina Jampolis, MD, a physician nutrition specialist in California. “These drugs work by pulling [cholesterol] out of the bloodstream more effectively.” More specifically, these drugs allow the molecules that sweep up your bad cholesterol to keep working longer and harder than they would normally. Up to 20% of people on statins stop taking them “because they complain of muscle aches, memory loss, and flu-like symptoms, and we see changes in their liver function,” Jampolis says. That means PCSK9 inhibitors might be ideal for them. Also, some people with genetically high cholesterol are unable to get their numbers down with statins alone, she says. They face an incredibly high risk of heart disease and might benefit greatly from these drugs, she says. With this new class of medications, “one can get cholesterol levels down to what we’re born with, so never-before-seen low levels,” says Christopher Cannon, MD, a professor of cardiology at Harvard Medical School. He was involved with the research into these drugs. Also, they can be used in addition to statins to boost how much someone benefits. “They can reduce cholesterol, and the bad cholesterol in particular, by 50% more, and that’s on top of statin medica-

tions,” Cannon says. Unlike statins, which come in pill form, PCSK9-inhibitors come as a shot only. You have to give yourself a shot under the skin, Jampolis says. The good news, she says, is that it only needs to be done every 2-4 weeks. That may be a plus for people who often forget to take their statin pills, Cannon says. “Many of us have thought, ‘Well, who would want to take an injection when you could take a pill?’” he says. “On the other hand, if you do that every 2 weeks, or sometimes every 4 weeks, maybe that’s easier, and you don’t have to worry about taking your pills every day.” “So far they’ve looked at the drugs in over 6,000 patients, and there have been no major side effects that have come up,” Jampolis says. Investigators like Cannon are still on the hunt for any potential dangers. “So far, there have been no surprises or any big safety issues,” he says. Some mild side effects in clinical trials include headache, limb pain, and confusion. Because these drugs are injected, there is also a risk of injection-site reactions, such as redness, swelling, or tiny infections in the skin. (Source : WebMD.com)

Blood Pressure: How Low to Go? W

hen it comes to treating high blood pressure, lower is better, a new study shows. The study, which was stopped early on Friday because the results were so clear and positive for one group of patients, found that getting high blood pressure back down to normal levels -- at least 120/80 -dramatically cuts the risk of heart attacks, strokes, and deaths compared to currently recommended BP targets. “Monday morning, this will be all we talk about,” says Mary Norine Walsh, MD, a cardiologist and vice president of the American College of Cardiology. “This can have a very large effect on thousands and thousands of people. One in three people in the United States have hypertension, and the majority of those people are over the age of 50,” says Walsh, who was not involved in the research. The results are contrary to current clinical guidelines. New blood pressure targets released last year advised doctors to loos-

en treatment targets for patients with high blood pressure. Most patients over age 60, for example, were advised to shoot for a goal of 150/90. “The trend, I think, in the thinking of the community of physicians who treat high blood pressure has really been more towards higher goals,” says David Reboussin, PhD, professor of public health sciences at Wake Forest Baptist Medical Center in Winston-Salem, N.C. Reboussin was part of a team of doctors who led the study for the National Institutes of Health. “But most of those opinions were formed really without the benefit of a definitive, large clinical trial to test the hypothesis of whether it is better or not. That’s what we set out to do,” Reboussin says. The study had enrolled more than 9,000 adults over the age of 50. All of them had high blood pressure. And they all had at least one additional heart risk factor, like a history of heart disease. Study participants were randomly as-

signed to two groups. Doctors treated patients in the first group to get their systolic blood pressure to a goal of 140. The goal for the second group was to get their systolic blood pressure back to normal -- anything under 120. Both groups were told to follow a low-sodium diet and to exercise, and doctors could use any combination of medications needed to meet those targets. On average, the participants needed three dif-

ferent medications to get to a goal of 120, compared to two medications in the group that aimed for a goal of 140. The results were striking. Patients in the lower blood pressure group had roughly a third fewer heart attacks, strokes, and diagnoses of heart failure compared to patients that had the slightly higher blood pressure target goal. The lower group also had about 25% fewer deaths. (Source : WebMD.com)


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... PAEDIATRICS & CHILD HEALTH ...

Wednesday, September 30, 2015

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CHILDREN TOSSING SCHOOL LUNCH FRUITS AND VEGETABLES

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ou can lead a child to vegetables, but it appears you can’t make him eat. Since 2012, the US Department of Agriculture has required as part of the school lunch program that children select a fruit or a vegetable at each meal. School lunch offerings have been altered to fit the new regulations, but a new study suggests they are not working well. Researchers videotaped 498 children during school lunch before the new vegetable rules were imposed. And then they videotaped another 944 children as they went through vegetable-enhanced lunch lines. After the new rules went into effect, more children selected fruits or vegetables — taking an average 0.89 cups from the lunch line compared with 0.69 cups before the rules were in place. But actual consumption dropped after the new vegetable rules were im-

posed. Vegetable and fruit consumption dropped to 0.45 cups, down from 0.51 before, and children were throwing out the required foods at a rate 35 percent higher than before the rules were instituted. The study is in Public Health Reports. Despite the findings, the lead author, Sarah A. Amin, a postdoctoral researcher at Tufts, is not inclined to give up on the guidelines. “We’re advocating that the guidelines be supplemented with other efforts — taste testing, slicing fruits and vegetables to make them easier to eat, serving vegetables with a dip, recognizing what fruits and vegetables children already prefer,” she said. “We’re optimistic that in the long run, these guidelines will accomplish what they set out to do.” (source : nytsyn.com)

Longer Lunch Periods Mean Fuller Students I

n schools with short lunch periods, children eat less and discard more than in schools where they are allowed more time to eat, a new study has found. Researchers tracked the eating habits of 1,001 students in grades three to eight at six elementary and middle schools in low-income school districts during the 2011-12 school year. Compared with schools where children could sit at the table for 25 minutes or more, those who had 20 to 24 minutes consumed an average of 6.9 percent less of their entrees, 3.7 percent fewer vegetables and 2.3 percent less milk. In schools that allowed less than 20 minutes, students consumed 12.8 percent less of their entrees, 11.8 percent fewer vegetables and 10.3 percent less milk. The study is in The Journal of the Academy of Nutrition and Dietetics. “We need to focus on how to get kids to select and consume the appropriate food,” said the lead author, Juliana F.W. Cohen, an assistant professor at Merrimack College in North Andover, Mass. “Giving kids enough time to eat appears to play an important role.” There are things parents can do to help, she added. “Push for longer lunch periods, more lunch lines, automated point-of-sale equipment, anything that will get the kids through the lunch line faster so they can spend more time eating.” (source : nytsyn.com)


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