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Do alternative medicine treatments help us save money?

October 24, 2012 By 2 Comments

As our society continues to debate how to improve the U.S. health care system, some researchers and policy makers are asking whether alternative therapies such as massage, acupuncture and aromatherapy are effective, and whether they help save money by resolving medical problems.

On a personal note, I’ve always been intrigued by medical treatments that fall outside of western medicine. I received acupuncture when I was pregnant with my son. He was breech, and there is some evidence that acupuncture can help babies to turn into the right position. (After trying several other treatment options including chiropractic adjustments and yoga, he did turn around, although it’s difficult to determine exactly what helped.)

A new systematic review published in British Medical Journal Open analyzes cost studies on complementary and integrative medicine from 2001-2010. For the analysis, the researchers found 204 cost analysis studies of alternative medicine treatments. But only 22 of the studies met quality standards to be included in the review.

In an analysis that reviews broad array of medical conditions, it’s difficult to come up with a single conclusion. But the review did find that some alternative treatments yielded the same or better results as traditional medical treatments. In total, ten treatments showed cost savings. Among them are acupuncture for breech delivery, acupuncture for low back pain, tai chi for avoiding hip fractures and nutritional supplements to prevent cataracts.

The review concludes that there is some real potential in saving money in our health care system and helping people heal faster through alternative medicine treatments. But more high-quality studies are needed that measure economic as well as health outcomes, and combine alternative treatments with typical care methods to measure how they work together.

Filed Under: Evidence-Based Living Tagged With: , , ,

Do exercise programs for kids really work?

October 17, 2012 By 1 Comment

Nearly 12.5 million children – or 17 percent of the U.S. population ages 2-19 – are obese.  As a response to this growing problem, schools and community groups have launched intervention programs designed to get kids moving.  But do they work?

A new meta analysis published last month in the British Medical Journal was designed to answer just that question. It included 30 studies on exercise programs for children published worldwide between January 1990 and March 2012.

Studies in the review measured the effects of intervention programs that targeted children under 16 years old and lasted for at least four weeks. To be included, studies had to definitively measure levels of physical activity in children throughout the day – not just during the intervention class period – with devices like motion sensors.

In each case, the investigators expected that the programs would increase the children’s overall daily physical activity.

The review uncovered some surprising evidence: programs designed to encourage increased physical activity among kids didn’t work. On the whole, the programs increased  children’s overall physical activity levels by about 4 minutes a day – even though the programs themselves ranged from 30 to 90 minutes in length.

One explanation is that children unconsciously compensate for the energy they use during structured activity programs by being doing sedentary activities aftewards, Brad Metcalf, a research fellow and medical statistician at Peninsula College who led the review, told the New York Times. Another explanation is that many of the programs took place after school, replacing a time period when children are typically most active anyway.

This analysis did yield some clear results: that we need to come up with additional strategies for encouraging physical activity among children.

Filed Under: Evidence-Based Living, Health and Wellness, Youth Development Tagged With: , , ,

Gender bias in the field of medicine?

October 11, 2012 By Leave a Comment

In the early- and mid-1900s, women were forbidden to attend medical school or practice medicine across the United States.   While our society has made great strides in encouraging women to join and even become leaders in professions like medicine, it is important to understand how these efforts are playing out in real life.

For a new review published in the Journal of General Internal Medicine, researchers conducted a survey of 4,578 full-time faculty at 26 U.S. medical colleges. They found that women made up only 19 percent of full professors and only 12 percent of department chiefs. Their survey also found that while men and women were engaged in their work to a similar degree and both groups had similar aspirations for leadership roles, women did not feel the same sense on inclusion in their profession and were not as confident about their ability to be promoted.

The study confirms research by Cornell Professors Wendy Williams and Steve Ceci, who have dedicated their careers to understanding why women are more likely to pursue advancement in science and technology fields like  physics, chemistry, mathematics and engineering.

The husband-and-wife team has published a major systematic review that concludes women tend to drop out of math and science related fields because they shoulder more responsibility of caring for young children – and this duty often coincides with the most demanding years of their careers.

What’s the answer?  It’s clear that more research is needed to find out the support systems and environments needed to help women fulfill their career goals. From my perspective, more flexible schedules, accessible and quality childcare and longer maternity leaves would go a long way in helping women to achieve career advancement and raise their families at the same time.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: , ,

The evidence on arsenic and rice

October 9, 2012 By 2 Comments

The magazine Consumer Reports released a study last month that revealed low levels of arsenic – a chemical element that is toxic when consumed in higher doses – in rice and rice products grown across the world.

The study tested 223 types of rice and rice products – such as rice-based cereals and rice milk – purchased in the United States in April, May and August of this year. It found arsenic in every product it tested, and dangerous levels of inorganic arsenic in dozens of products. Consumer Reports the story points out that their study is “a spot check of the market and “too limited to offer general conclusions about arsenic levels in specific brands within/across rice product categories.”  Nevertheless, their article raises some surprising questions about toxins in our food supply.

Following the Consumer Reports study, the U.S. Food and Drug Administration released some preliminary results of a long-term study on arsenic levels in our food supply. Their study found levels of arsenic in rice similar to the Consumer Reports study.

So, what’s a rice-lover to do?  Consumer Reports recommends limiting consumption of rice and rice products, while the FDA is not recommending any limits on rice consumption.

Since the FDA and Consumers Reports found the same level of arsenic in food, the question in my mind is: Exactly how dangerous is low-level exposure to arsenic? A search of systematic reviews yielded some interesting results.

  • One meta-analysis found consuming arsenic in drinking water is associated with a higher risk of lung cancer.
  • Another analysis found chronic arsenic exposure can lead to mental retardation and developmental disabilities such as physical, cognitive, psychological, sensory and speech impairments – although in higher levels that measured in the rice products tested by Consumer Reports and the FDA.
  • Other analyses found inconclusive results on the relationship between arsenic exposure and diabetes and arsenic exposure and cardiovascular disease – although both of these reviews identified limitations in the study methodology and called for additional research.

My plan is to think more carefully about the rice products my family consumes.  I’m not going to throw out the brown rice in my pantry, and we will still enjoy stir fry and sushi on a regular basis. But I certainly plan to steer way from rice cereals and other rice products at the grocery store.

Filed Under: Evidence-Based Living, Health and Wellness, policy Tagged With: , , , , , , ,

What we know – and what we don’t – about Omega-3 fatty acids

October 4, 2012 By 2 Comments

Over the past four decades, there have been thousands of studies examining the health benefits of Omega-3 fatty acids – building blocks our bodies use to create cell membranes and maintain the connections between brain cells.

The medical community’s excitement over this nutrient began when observational studies of non-western diets – in Japan and among Eskimos in Greenland, for example – found significantly lower rates of heart disease and other chronic medical conditions.  (Humans can’t produce omega-3 fatty acids, so we must get them by eating fish, walnuts, flaxseed and green vegetables.)

Dozens have studies have identified these types of correlations. But earlier this year, a meta-analysis published in the Journal of the American Medical Association, which included 20 clinical trials involving nearly 70,000 people, concluded omega-3 fatty acids did not prevent heart attacks, strokes or deaths from heart disease.

Proponents of omega-3s point out that the authors of the JAMA analysis used the an especially strict standard to determine statistical significance. (Using the typical standard would have found a 9 percent reduction in cardiac deaths.)

But other systematic reviews – like this one by the Cochrane Collaboration – found it unclear whether omega-3 supplements reduce the risk of cardiac deaths.

So, what’s the bottom line?  This is one case where the evidence is truly unclear. One challenge is that longitudinal diet studies are difficult to perform because there are so many variables in what people eat over long periods of time. The it can be tough to differentiate between omega-3s consumed as part of a diet versus those taken in a supplement.  It is clear that foods like salmon, tuna and green vegetables are good for us – and including them in our diets is a step in the right direction. But we need more evidence to determine their exact effects, and to establish whether it’s worthwhile to take omega-3 supplements.

Filed Under: Cornell Cooperative Extension, Evidence-Based Living, Health and Wellness Tagged With: , , , ,

The facts on Social Security

October 1, 2012 By Leave a Comment

More than 75 years ago, the U.S. government created Social Security, the federal insurance program that provides benefits to individuals and their families who can no longer work because of disability, retirement or death. The program is complex, and its details are often debated among politicians.

Earlier this year, the Economic Policy Institute and the National Academy of Social Insurance published a guide that explains the facts about the Social Security program to young people. The document includes detailed, evidence-based explanations of Social Security’s history, beneficiaries, financing, and shortfalls. It pulls data from the Office of the Chief Actuary of the Social Security Administration, Congressional Budget Office, the Employee Benefits Research Institute, and the Center for Retirement Research.

Here’s a sampling of interesting facts from the document:

  • In 2012, about 159 million individuals or 94% of the American workforce, worked in Social Security-covered employment. (Those not covered include government employees covered by other insurance programs, farm workers who do not meet minimum work requirements and students.)
  • Approximately 55 million Americans received Social Security benefits in 2011. Seventy percent were retirees; 19 percent were disability beneficiaries and 11 percent were survivors of deceased workers.
  • Without Social Security income, it is estimated that nearly half senior citizens would be living in poverty. Instead, fewer than 10 percent of seniors live in poverty.
  • Because the U.S. population is aging and people are living longer, the Social Security program is projected to run up a deficit. The projected shortfall is 2.67% of taxable earnings over the next 75 years.
  • There are a variety of ways to compensate for the deficit including raising taxes, expanding coverage, investing in equities, increasing the retirement age and reducing cost-of-living increases.

The guide concludes that Social Security fulfills an important need in our society as an insurance program for American workers.  To learn more about Social Security benefits and about how your payroll taxes are used, it’s worth checking out this evidence-based document.

Filed Under: Evidence-Based Living, policy, The Learning Center Tagged With: , , ,

Coffee update: It’s actually good for you

September 26, 2012 By Leave a Comment

Here at EBL, we’ve written about coffee before. But given that more than 60 percent of Americans consume coffee on a daily basis, we think it’s an important to understand its effects. We were excited to come across a new systematic review on America’s favorite drink and its relationship to heart failure.

The review included five prospective studies of more than 140,000 people in total measuring the relationship between regular coffee consumption and the risk of heart failure. Across all of the studies, more than 6,500 participants suffered heart failure.

According to the analysis, consuming a moderate amount of coffee was inversely related to risk of heart failure: people who drank four servings of coffee a day had the smallest risk of heart failure.  Those who drank significantly more or less than four servings a day were found to have a higher risk heart failure. The review found there were no variance between men and women, or for participants who had a history of heart attack or diabetes.

Clearly, there is more to this story, and further study is warranted on the health benefits of coffee are warranted. But to date, the evidence indicates that drinking coffee regularly isn’t risky and may actually protect you against heart failure.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: , ,

The science of political campaigns, Part 2

September 21, 2012 By Leave a Comment

Next month, President Barack Obama and Republican Presidential Candidate Mitt Romney will face off on national television on four separate occasions to share their ideas for governing America and explain why voters should chose them.

While it’s not clear how many Americans make their voting decisions based on the debates, we do know they are an important part of the campaign. So I was thrilled to find some evidence on how to consider the candidates responses critically.

Todd Rogers, a behavioral psychologist at Harvard University, is among a growing group of researchers applying social science to issues effecting political campaigns. (We’ve written about his work on get-out-the-vote phone calls.)  He wanted to address the issue of how candidates respond when get asked a question that they don’t want to answer – and whether the public notices when politicians dodge a question by talking about a different topic instead.

Rogers and his colleague Michael Norton, an associate professor at the Harvard Business School, designed a study to determine under what conditions people can get away with dodging a question, and under what conditions listeners can detect what’s happening.

In their study, published in the Journal of Experimental Psychology, they recorded a speaker answering a question about universal healthcare. Then they paired that answer with three separate questions: the correction question about health care, one about illegal drug use and another about terrorism.  They showed the three question-and-answer pairings to separate groups of people and asked them to rate the truthfulness of the speaker.

Their research found that when the question and answer sounded somewhat similar – such as in the case where the speaker was asked about drug use but responded about healthcare –  the audience rate the speaker as trustworthy.  (In fact, most of the people who head the answer about illegal drug use couldn’t even remember the question.) But when the answer was very clearly addressing a different topic – such as when the speaker was asked about health care but responded about terrorism – the audience detected the dodge.

In another part of the study, Rogers and Norton used the same questions and answers, but posted the question on the screen in for some viewers. They found  viewers who saw the question posted on the screen while the speaker answered were more than twice as likely to detect a dodge, even in subtle cases.

Rogers advocates for posting the questions on the screen during the presidential candidates debates, although he concedes it’s unlikely to happen this year.

You can hear an interview with Rogers  and learn about other research on political campaigning in last week’s episode of NPR’s Science Friday.

Filed Under: Evidence-Based Living, In The Media, policy Tagged With: , , ,

Can we fend off chronic disease? The evidence says yes

September 18, 2012 By 1 Comment

We have all heard that physical fitness is an important factor in health, but how important a factor?  And is it ever too late to get fit?

A study published earlier last month in the Archives of Internal Medicine suggests that becoming fit in middle age, even if you haven’t previously exercised, can stave off illness later in life.

In the study, researchers collected medical records for more than 18,000 healthy middle-aged men and women who’d visited the Cooper Institute in Dallas, Texas for a check-up since 1970. Each subject took a treadmill test to determine their aerobic fitness at their first check-up. Then the researchers checked their Medicare records from 1999 through 2009.

The study found that people who were least fit at the time of their initial check-up were the most likely to developed chronic conditions such as heart disease and cancer early in the aging process. Those who were most in middle-age developed the same conditions, but significantly later in life compared to the less fit.

The take-home message of this study actually parallels a lesson shared in Karl’s book 30 Lessons for Living, which shares advice from America’s elders. The lesson is: It’s not dying you should worry about – it’s chronic disease.

This study provides evidence that you can actually do something to help prevent chronic disease later in life – exercise!

The study is backed up by several systematic reviews. One published in the Journal of Science and Medicine in Sport found physical activity helps prevent heart disease, cancer and diabetes. Another published in Obesity Reviews found individual who are overweight but have good aerobic fitness are at lower risk of cardiovascular disease compared with individuals with normal weight and poor fitness.

The bottom line: Physical fitness can help you lead a healthier, happier life no matter what your age.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: , , ,

Is organic food really better for you?

September 10, 2012 By 7 Comments

Over the past decade, our society is growing increasingly aware of our reliance on chemical products and their impacts on the environment and our health. So last week, a new study by Stanford University researchers on the benefits of organic foods received a lot of media coverage.

The systematic review, published in the Annals of Internal Medicine, examined 240 studies organic and non-organic fruits, vegetables, grains, meat, poultry eggs and milk — 17 studies of humans and 223 studies of nutrient and contaminant levels.

It found that more one-third of conventional produce had detectable pesticide residues, compared with 7 percent of organic produce samples. And it found organic meats were one-third less likely to carry bacteria resistant to antibiotics than conventionally produced meat.

But the study also found that organic foods, on the whole, don’t contain any more vitamins or nutrients than conventional foods.

It’s good to have a wide-ranging review of organic foods. Even more interesting is the media coverage of the study. Some new stories, like this one from the Guardian, have focused on the lack of a difference in nutrient levels. Other news coverage has pointed out that the purpose of purchasing organic foods is to avoid pesticide use because of its impact on human health and the environment.

The bottom line: it’s important to understand all of the findings in a study. Sometimes, that requires looking past the headlines in media outlets so that you can get the full story.

Filed Under: Evidence-Based Living, Health and Wellness, In The Media

Football frets: The evidence on repetitive head injuries

September 6, 2012 By 1 Comment

With football season underway, many Americans are spending their weekends cheering on their favorite teams at stadiums and tuning in to watch televised games.  Personally, I enjoy following my college football team. But I always feel a sense of dread when a player takes an especially hard hit.

It turns out, those repeated hits add up to some real neurological problems for football players.

A study published this week in the journal Neurology followed nearly 3,500 football players who played at least five seasons in the N.F.L. from 1959 to 1988.

Over the course of the study, 334 of the players died. When researchers from the National Institute of Occupational Safety and Health reviewed their death certificates, they found Alzheimer’s disease was an factor in seven of the deaths and Lou Gehrig’s disease was a factor in seven others. These rates are more than three times what you would expect to see in the normal population.

This new study is part of a growing body of research on the neurological repercussions of repeated head injuries. Another study published earlier this year found repetitive head impacts over the course of a single season may negatively impact learning in some collegiate athletes.

And a center at the Boston University School of Medicine has documented evidence of a condition called Chronic Traumatic Encephalopathy, or CTW, a progressive degenerative disease of the brain found in people with a history of repetitive brain trauma.

The N.F.L. is investing in more research. This week, the organization donated $30 million to the National Institutes of Health for research on the connection between brain injuries and long-term disorders. That’s a good thing, because this is one topic we need more evidence on.

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: , ,

Slimming it down? New evidence on low-calorie diets

September 4, 2012 By 5 Comments

Over the past few years, you may have heard the buzz about the potential for a low-calorie diet to prolong life and prevent chronic medical conditions like heart disease and cancer.

While the concept of restricting calories has been around for decades, a longitudinal study of monkeys published in 2009 seemed to provide definitive evidence that eating less was good for you. The study by researchers at the University of Wisconsin found a diet of moderate caloric restrictions over 20 years lowered the incidence of aging-related deaths and reduced the incidence of diabetes, cancer, cardiovascular disease, and brain atrophy.

But last week, a new longitudinal study of different species of monkey raised questions about the idea of restricting calories to improve health. The study included 121 monkeys split into two groups. The experimental group was fed 30 percent fewer calories than the control group.

In the study published last week, which was sponsored by the National Institute on Aging, the monkeys on restricted diets did not live any longer than those with normal diets. Rates of cancer and heart disease were the same for monkeys on restricted diets and normal diets. While some groups of monkeys on restricted diets had lower levels of cholesterol, blood sugar and triglycerides, they still did not live longer than the monkeys who ate normally.

The study is interesting from a health perspective because it raises questions about the notion of restricting calories to improve health. But it’s also a prime example of why it’s important to collect data from more than one study.

“This shows the importance of replication in science,” Steven Austad, interim director of the Barshop Institute for Longevity and Aging Studies at the University of Texas Health Science Center, told the New York Times. Austad, who was not involved in either study, also explained that the first study was not as conclusive as portrayed in the media.

The take home message: It’s important to collect evidence from multiple studies before drawing conclusions, even when the data seems extremely convincing.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: , , , , ,
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