Weight gain after quitting smoking higher than previously thought

ScienceDaily (July 10, 2012) — Giving up smoking is associated with an average weight gain of 4-5 kg after 12 months, most of which occurs within the first three months of quitting, finds a study published on the British Medical Journal website.

See Also:Health & MedicineDiet and Weight LossFitnessObesitySmokingMen's HealthDiseases and ConditionsReferenceLiposuctionGeneral fitness trainingStretch marksOverweight

Although this figure is higher than previously thought, an accompanying editorial argues that the health benefits of quitting far outweigh this modest gain in body weight and should not deter people from quitting.

It is well known that giving up smoking is often followed by an increase in body weight, but estimates vary. Concern about weight gain is also widespread among smokers and it may deter some -- particularly women -- from trying to quit.

So a team of researchers based in France and the UK analysed the results of 62 studies to assess weight change among successful quitters -- with and without the help of nicotine replacement therapy -- after 12 months.

In untreated quitters, the average weight gain was 1.1 kg at one month, 2.3 kg at two months, 2.9 kg at three months, 4.2 kg at six months, and 4.7 kg at 12 months.

This is higher than the typical 2.9 kg often quoted in smoking cessation advice leaflets and more than the 2.3 kg many female smokers report being willing to tolerate, on average, before attempting to quit, say the authors.

However, the changes in body weight varied widely, with around 16% of quitters losing weight and 13% gaining more than 10 kg after 12 months. This, say the authors, indicates that the average value does not reflect the actual weight change of many people who give up smoking.

Estimates of weight gain for people using nicotine replacement therapy were similar, as were estimates from people especially concerned about weight gain.

Previous reports have underestimated the average amount of weight gained when people stop smoking, they conclude. "These data suggest that doctors might usefully give patients a range of expected weight gain."

They suggest that further research is needed to identify the people most at risk of gaining weight and to clarify the best way to prevent continued weight gain after quitting.

In an accompanying editorial, experts from the Catalan Institute of Oncology/University of Barcelona and University of Sydney say that more data is needed to settle this question, and they point out that previous studies have shown that many smokers gain more weight than never smokers for a few years, but then the rate of weight gain falls to that seen in people who have never smoked.

"Although obesity is positively associated with an increased risk of all cause mortality, cohort studies indicate that modest weight gain does not increase the risk of death; smoking does," they conclude.

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Fewer iron supplements during pregnancy work just as well for preventing anemia, study suggests

ScienceDaily (July 11, 2012) — Taking iron supplements one to three times a week instead of every day is just as effective at preventing anemia in pregnant women, according to the findings of a new Cochrane systematic review. The authors of the review also showed that women experienced fewer side effects when taking iron supplements intermittently rather than daily.

See Also:Health & MedicineAnemiaPregnancy and ChildbirthFolic AcidSickle Cell AnemiaNutritionDiet and Weight LossReferenceNutrition and pregnancyB vitaminsMicronutrientGynecologic hemorrhage

Lack of iron can cause anemia in pregnant women, potentially increasing the risk of complications at delivery. It may also be harmful to their babies, through increased risk of low birth weight and even delayed growth and development later in life. anemia is diagnosed as a low level of hemoglobin in the blood. However, hemoglobin levels should be carefully controlled during pregnancy, as high concentrations have also been associated with an increased risk of babies being born early or with low birthweight. Traditionally, anemia during pregnancy is prevented by daily supplements containing iron and folic acid, started as early in the pregnancy as possible. However, some countries, such as the UK, do not recommend routine preventive iron supplementation to all women.

The researchers analysed data from 18 trials involving a total of 4,072 pregnant women who took iron supplements alone, with folic acid or with multi-vitamin and mineral supplements. According to the results, women who took iron supplements once, twice or three times a week on non-consecutive days were no more likely to suffer from anemia by the end of their pregnancies than those who took them daily, and their babies were no more likely to be born early or have a low birth weight. Furthermore, those taking the supplements intermittently rather than daily were less likely to experience side effects including nausea, constipation and high hemoglobin levels during pregnancy.

"Intermittent iron supplementation could be considered as a feasible alternative to daily supplementation for preventing anemia during pregnancy, particularly in developed countries where anemia in pregnancy is not a public health problem and there is good antenatal care for monitoring anemia status," said lead author Juan Pablo Peña-Rosas, Coordinator of Evidence and Programme Guidance of the Department of Nutrition for Health and Development at the World Health Organization in Geneva, Switzerland. "At the moment evidence is limited and the quality of the trials included in our review was generally low."

The review authors say further research is needed to clarify safe maternal iron doses and their effects on infants. "It is important to evaluate new regimens to be able to respond to the need of the different countries that face different challenges in anemia prevention during pregnancy. We would advise that trials make an effort to evaluate the health of newborns and infants from birth to six months of life or more," said Peña-Rosas.

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Weight loss resulting from a low-fat diet may help eliminate menopausal symptoms

ScienceDaily (July 11, 2012) — Weight loss that occurs in conjunction with a low-fat, high fruit and vegetable diet may help to reduce or eliminate hot flashes and night sweats associated with menopause, according to a Kaiser Permanente Division of Research study that appears in the current issue of Menopause.

See Also:Health & MedicineDiet and Weight LossMenopauseObesityWomen's HealthFitnessNutritionReferenceMenopauseHormone replacement therapyHysterectomySouth Beach diet

This Women's Health Initiative study of 17,473 women found that women on a diet low in fat and high in whole grains, fruit and vegetables, who had menopausal symptoms, who were not taking hormone replacement therapy, and who lost weight (10 or more pounds or 10 or more percent of their baseline body weight), were more likely to reduce or eliminate hot flashes and night sweats after one year, compared to those in a control group who maintained their weight.

Many women experience hot flashes at some point before or after menopause, when their estrogen levels are declining, explain the researchers.

"While the mechanism is not completely understood, hot flashes and night sweats are thought to be caused by a complex interaction that involves fluctuating hormone levels, the hypothalamus region of the brain that regulates body temperature, brain chemicals and receptors, and the body's blood vessels and sweat glands," said Candyce Kroenke, ScD, MPH, a research scientist with the Kaiser Permanente Northern California Division of Research and lead author of the study.

Although previous research has shown that high body weight and weight gain are associated with hot flashes and night sweats associated with menopause, this study is the among the first -- and the largest to date -- to analyze whether weight loss on a diet designed to reduce fat and increase whole grains, fruit and vegetable intake might ameliorate symptoms. It is also among the first to examine the influence of a dietary change on symptoms that include hot flashes and night sweats, said Kroenke.

"Since most women tend to gain weight with age, weight loss or weight gain prevention may offer a viable strategy to help eliminate hot flashes and night sweats associated with menopause," said Bette Caan, DrPH, a research scientist with the Kaiser Permanente Northern California Division of Research and the senior author of the study.

She explained that greater body fat provides insulation that may hinder heat loss, and hot flashes and night sweats provide a way to dissipate that heat.

"Weight loss, especially loss of fat mass but not lean mass, might also help alleviate hot flashes and night sweats," added Kroenke.

The investigators emphasize that further research is needed to better understand the relationship between diet, weight and hot flash/night sweat symptoms. They explain that the beneficial impact of a healthy diet alone (regardless of weight change) may also help ameliorate symptoms.

This study follows a related study published in March in the Journal of Clinical Oncology in which Kaiser Permanente researchers found that preventing weight gain after a breast cancer diagnosis may offer a viable intervention for relief of hot flashes. The researchers noted that intentional weight loss in breast cancer survivors requires further study.

The Women's Health Initiative Dietary Modification trial enrolled a diverse group of 48,835 post-menopausal women between 1993 and 1998 at 40 United States clinical centers to evaluate the effects of a low-fat dietary pattern on heart disease, breast and colorectal cancer, and fracture in post-menopausal women. The dietary intervention was aimed at reducing fat intake and increasing fruit, vegetable and whole grain intake. Although weight loss was not a goal, participants assigned to the intervention group lost on average 4.5 pounds between baseline and year one, compared to the control group.

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HPV Vaccine Protects Even Those Who Skip It

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Homophobic Blood Donation Ban Contributes to Shortage

Last year, I went to participate in a local blood drive. It was routine enough. The nurse checked my heart rate, weighed me, and then asked me a few questions. "In the last twelve months," she droned, "Have you had sex with an intravenous drug user?" No. "A person who has been exposed to HIV?" No. "A prostitute?" Of course not. "A man who has had sex with men?" I paused. My fiance is, like me, bisexual. Knowing that we were both perfectly healthy, I considered lying, but ultimately decided to be honest. "Yes," I told her, and was immediately brushed away and told that I couldn't donate.

Since the 1980s, people like me and my partner -- healthy adults with no blood-transmissible illnesses -- have been prohibited by the FDA from donating blood. The homophobic, outdated ban on blood donations from gay and bisexual men, as well as their female partners, is costing people their lives. The Red Cross is currently experiencing a significant shortage of blood donations, with donations dropping a full 10 percent in June, according to CNN. Their strict criteria designed to prevent the spread of HIV is likely contributing to the problem. The FDA forces organizations to refuse healthy donors because of these outdated fears and homophobic judgment.

A comprehensive report in 2010 examined the patterns of blood donation and eligibility among gay and bisexual men, demonstrating how essential it is for the FDA to lift this ban. The authors of the study estimated that some 2,603,004 healthy men would be eligible to donate blood in any given year if the ban were lifted, and nearly half of them would actually donate. This estimate accounts only for men who have sex with men. If the ban for their female partners were to also be lifted, it would open the door for many more life-saving donations from people like myself.

The blood donation ban for these men and their partners is based in bigotry, not science. Citing strong evidence of overall safety, the American Red Cross regards the ban as "medically and scientifically unwarranted." Since the 1980s, donated blood has been thoroughly tested for any trace of HIV or other transmissible diseases. Infection through donated blood is so rare in the United States that the staff at Harvard Medical School calls the risk "close to zero." Even if a person with advanced HIV were to donate blood repeatedly, it would be eliminated from the donation pool each time through rigorous testing.

The blood donation ban is grossly unfair in its stereotype of men who have sex with men. While gay and bisexual men do have slightly higher than average rates of HIV infection, many are diligent about practicing safe sex and routinely seek testing to confirm that they are free of the virus. Many others, including my own fiance, are involved in committed, monogamous relationships with partners -- male or female -- who have been confirmed to be virus-free. It is grossly unfair to lump all of these men and their partners into one "high risk" category, ignoring the factors that vary between individuals. It is also blatantly ignorant to exclude men who may have been with the same healthy partner for twenty years, while accepting men who might have had dozens of unprotected female partners in just a few short months. Unsafe sex is not limited to the GLBT community.

The Red Cross's recent shortage of donated blood has the capacity to cost people their lives. Unless the shortage is addressed promptly through an influx of new donations, people in desperate need of blood transfusions might die. Given this -- and the organization's own support of an overturn of the ban on gay male blood donations -- it's appalling to think that eligible, healthy donors are being turned away. I am a responsible adult with a desire to save the life of someone in need, and my donation is needed now more than ever. My orientation, and the orientation of the person I love, should not block me from being able to help another individual.

Juniper Russo is a freelance writer, health advocate, and dedicated mom living in Chattanooga, Tenn.

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Teens' Lifestyle Choices Affect Their Blood Pressure

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Bavarian says U.S. expands group eligible for Imvamune

Reuters – 22 hrs ago COPENHAGEN (Reuters) - Danish biopharmaceutical company Bavarian Nordic said on Wednesday the U.S. government had expanded the population eligible to receive its attenuated smallpox vaccine, Imvamune, during an emergency.

The company said on Wednesday that in the event of a public health emergency involving smallpox, the government may now authorize the use of Imvamune to protect individuals of all ages with HIV infection or atopic dermatitis (AD), a type of eczema.

Children, pregnant women, and nursing mothers with HIV or AD are eligible to receive Imvamune, despite limited clinical data in these specific populations, the company said.

Previously, only certain people with HIV were eligible.

(Reporting by Mette Fraende; Editing by Dan Lalor)

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GSK's HIV drug beats Gilead market leader in study

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Pills to prevent HIV raise many questions: studies

"A pharmacist shows anti-retroviral drugs in 2006 at the Mildmay Centre in Seguku, near Kampala, Uganda. Various trials examining the use of anti-retroviral drugs in healthy heterosexuals as a way to prevent HIV have shown drastically different results, research showed Wednesday. (AFP Photo/Stuart Price)" title

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Studies Show Value of AIDS Drugs as Prevention

HealthDay – 1 hr 3 mins ago WEDNESDAY, July 11 (HealthDay News) -- Researchers have released the final results of two studies that suggest AIDS drugs can prevent exposed people in Africa from getting infected with HIV by their sexual partners. However, another study indicates that it's a tough job to convince African women who aren't at the highest risk to take preventive medications.

In the big picture, the studies show that "we have a new HIV-prevention strategy, one that's quite powerful but also depends on adherence," said Dr. Jared Baeten, an associate professor of global health at the University of Washington, in Seattle. "The next step is figuring out how to motivate people to take it."

The studies appeared online July 11 in the New England Journal of Medicine.

The general findings of the studies have been previously released, but only now has the research become available in a medical journal after going through a peer-review process.

Two studies offer promising details about the potential for the drugs to prevent -- although not all the time -- the transmission of HIV to heterosexual men and women from their infected partners.

One study in Kenya and Uganda looked at heterosexual couples -- almost all married -- in which one person was infected with HIV, the virus that causes AIDS. The uninfected partners were randomly assigned to take an inactive placebo or a once-daily dose of the drug tenofovir (Viread) or a tenofovir-emtricitabine combination (Truvada) for up to three years. Nearly 5,000 people completed the study.

Those who took Truvada had a 75 percent lower risk of becoming infected with HIV compared to those who received a placebo. The risk was 67 percent lower in those who took Viread compared to a placebo. Even in those who got the placebo, the overall risk of getting infected was low: 52 of 1,468, or a little more than 3 percent, did so.

Truvada treatment in the United States costs several thousand dollars a year, Baeten said, but the discounted price can be as cheap as 25 cents a day in Africa. The drug, which stops the AIDS virus from reproducing in people who are infected, appears to do the same thing in uninfected people who are exposed to the virus, he said. In their cases, the virus doesn't already have a foothold in the body so it dies off.

In this study, 10 percent or less of those who took the drugs reported side effects such as fatigue, diarrhea and nausea, and only in the first month.

The second study of 1,219 HIV-negative adults in Botswana looked at Truvada versus a placebo. Comparing the 33 participants who became infected during the trial -- nine people in the drug group and 24 people on a placebo -- the study found those who took Truvada were 62 percent less likely to become infected with HIV.

In this study, significant loss of bone mineral density was a side effect for participants receiving the drug, compared to those on a placebo.

Another study, in Kenya, South Africa and Tanzania, assigned 2,120 women at higher risk of HIV infection to receive Truvada or a placebo. However, there wasn't much difference in HIV infection rates between the two groups -- about 5 percent in both became infected.

Baeten explained the finding, saying many women stopped taking the drug, which prevented an accurate assessment of its effectiveness.

The next step in research into the use of the drugs to prevent infection is to "figure out how to make them work in the real world, outside of an intensive research setting," Baeten said. In the United States, for example, researchers are studying their use in gay men who are at high risk for infection.

As for condoms, another major player in HIV prevention, Baeten said the prevention drugs will add to their level of security or provide some protection in cases where people can't use condoms.

In an editorial accompanying the studies, two experts stressed that medications should never be viewed as a substitute for the condom.

"Although no evidence of increased risky sexual behavior or decreased condom usage was reported in these studies, we must ensure that pre-exposure prophylaxis does not indirectly encourage such behavior," wrote Dr. Myron Cohen of the University of North Carolina at Chapel Hill and Dr. Lindsey Baden of Brigham and Women's Hospital, Boston.

They added that more research is needed to properly assess who stands to benefit most from these drug regimens, the best timing and dosage, as well as any potential side effects from long-term use.

More information

For more about AIDS, visit the U.S. National Library of Medicine.

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HIV Drug May Prevent Bone Marrow Transplant Complication

HealthDay – 1 hr 3 mins ago WEDNESDAY, July 11 (HealthDay News) -- An HIV drug significantly reduced the risk of graft-versus-host disease, an all-too-common complication in blood cancer patients following bone marrow transplants, new research finds.

Bone marrow is the spongy tissue inside the bones that contains immature cells, or stem cells. In an "allogeneic" bone marrow transplantation, also called a stem cell transplant, a patient's own stem cells and immune system are wiped out by chemotherapy and radiation. Then, the patient receives the transplant, or bone marrow, from a closely matched donor.

The treatment is used for several types of blood cancers, including lymphoma and leukemia.

But a common complication of a bone marrow transplant is graft-versus-host disease. It occurs when transplanted immune cells attack patients' healthy tissue, a complication that can be minor or life-threatening.

"Graft-versus-host disease affecting the skin, liver, gut and other organs is a dreaded complication of allogeneic stem cell transplantation either from a related or unrelated donor," said one expert, Dr. Jasmine Zain of NYU Langone Medical Center in New York City. "The rates are 35 percent with related donors and up to 57 percent by day 100, even in reduced-intensity transplants," added Zain, who is director of the Bone Marrow Transplant Program and assistant professor in the division of hematologic malignancies and medical oncology at the center.

The study was conducted by a team at the University of Pennsylvania's Perelman School of Medicine and included 38 patients with several types of blood cancers. The cancers included acute myeloid leukemia, myelodysplastic syndrome, lymphoma and myelofibrosis. All of the patients were given the drugs tacrolimus and methotrexate, which suppress the immune system and are a standard treatment to prevent graft-versus-host disease.

The patients were also given a 33-day course of the HIV drug, maraviroc, beginning two days before their transplant.

None of the patients treated with maraviroc developed graft-versus-host disease in the gut or liver within the first 100 days after their transplant. The liver and gut are the most serious locations for the complication, the researchers noted.

After six months, 6 percent of these transplant patients developed severe graft-versus-host disease compared to 22 percent of a group of similar patients who weren't treated with the HIV drug.

In addition, fewer in the group given the HIV drug developed graft-versus-host disease in their liver or gut compared to those given the standard treatment.

One year following transplant, about 15 percent of patients given the HIV drug developed severe graft-versus-host disease compared to 29 percent of patients who received standard therapy.

The study was published in the July 11 edition of the New England Journal of Medicine.

Researchers explained that the HIV drug redirects these immune cells without having to suppress patients' immune systems. Because their immune systems aren't compromised by the drug, patients should be less vulnerable to infections and to a relapse of their cancer.

"It appears that our new approach allows us to prevent some patients from developing

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U.S. cracks down on "world's largest" medical marijuana dispensary

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