Can running be deadly?


Every now and again, a high-profile runner or participant in a major marathon dies of cardiac arrest – inevitably raising the question: Is long-distance running bad for your heart.

Being a long-distance runner myself, my personal inclination is to dismiss the question. Afterall, I reason, hundreds of thousands of people complete marathons each year and only a small handful of them suffer heart problems. It just happens that the problems are what we hear about in the news.

Still, it was a relief to find that the evidence supports my own personal conclusion.  In fact, I found two separate studies that found marathon running is not associated with any increase in cardiac risk or death.

The first, published in the New England Journal of Medicine earlier this year, looked at the incidence of cardiac arrest during marathons and half-marathons in the United States over the course of a decade. Overall, the study considered nearly 11 million race performances. Of those 11 million racers, the researchers found 59 cases of heart attacking during the race, with 42 resulting in death – a fairly slim risk.

The second study, published in the American Journal of Sports Medicine just last week, scoured news sources to documents participants who died during or up to 24 hours after marathon races in the U.S. from 2000 to 2009.  In examining 3.7 million marathon, the researchers identified 28 people who died during the marathon race and up to 24 hours after finishing – a similar conclusion to the previous study.

The take-home message: Long distance runners who suffer from heart problems often make the news, but that doesn’t mean running increasing your chance of having a hear attack. In reality, the benefits of running well outweigh the risk.

The evidence on check-ups for kids

With a one- and a three-year-old, I find myself at the pediatrician’s office fairly frequently – and not because my kids are sick. In the first two years of their lives, they visit the pediatrician every 3 months for well visits.

As a new mom, the visits provide a welcome opportunity to ask questions and make sure you’re not making any major mistakes. But the second time around, they can seem unnecessary. So I went out hunting for some evidence to determine whether well-visits are good for kids.

It turns out that they are essential.  A systematic review published in the Journal of the American Medical Association examined the found that primary medical care in the first three years of life promotes optimal development for children.

The review evaluated 47 studies published from 1979 to 1999 that looked at how activities in primary care settings such as counseling about children’s sleep habits, temperament and behavior encourage healthy development.

The review found behavioral counseling for parents with fussy infants and poor sleepers is effective in helping both parents and babies. It also found that soliciting parents’ concerns about their children’s development helped identify problems. And that structured and systematic approaches to asking about parents’ concerns are most effective.

The review did find some areas for improvement. Among them, efforts to identify developmental problems in young children need to be more methodical and identifying psychosocial risk factors can be improved by using questionnaires and parent-child assessments.

All in all, the evidence makes me feel better about our frequent trips to the pediatrician.

A roadmap: How to use research to help people

The idea of translational research initially sprung out of the field of medicine, where doctors and scientists have teamed up to move laboratory discoveries more rapidly into clinical settings to help patients improve their health and recover from ailments.

Since its beginnings several decades ago, researchers working in other disciplines have latched onto the idea of translation. Now a new book offers models for social and behavioral scientists who want to transfer their findings into real world settings.

The book – “Research for the Public Good: Applying the Methods of Translational Research to Improve Human Health and Well-Being” – includes chapters by experts in the fields of psychology, child development, public policy, sociology, gerontology, geriatrics and economics that offer road maps for translating research into policies and programs that improve the well-being of individuals and communities. It  is co-edited by Cornell professors Elaine Wethington and Rachel Dunifon.

The book grew out of second Biennial Urie Bronfenbrenner Conference on translational research held at Cornell and attended by leading experts in the social sciences and medical fields.

“Translational research has gained prominence in biomedical research, where there’s an emphasis on speeding lab findings into practice,” Wethington told the Cornell Chronicle. “It also goes back to the work of Urie Bronfenbrenner and his colleagues, however, who were ahead of their time with an ecological approach to human development that brought together research, policy and practice. This book defines the term in that context and provides practical insights for doing translational research.”

Graduate students and early-career scientists unfamiliar with translational research methods should find the book valuable, Wethington said. “There is a surge of interest in the field right now, so the book should be a great resource,” she said.

Exaggerating neuroscience in the news

The 1990s were proclaimed the “Decade of the Brain” by President George W. Bush – an action that bolstered neuroscience research and continues to spur discoveries about one of the most important human organs.

Neuroscience researchers have made strides in a myriad of realms – personality, economics, human develop and medicine, to name a few.  Of course, these discoveries have been reported and discussed across news channels and the Internet, including here on EBL.  (We’ve written about the impact on video games on the brain and the benefits of meditation, to name a few.)

Now a new study in the journal Neuron calls into question how well the media have explained neuroscience research. The study reviewed articles publishes in six major British newspapers from 2000 to 2010. The study found three ways that the brain is commonly portrayed in the media.

The first is the idea of brain as a resource that needs to be protected an optimized through, for example, doing crossword puzzles or avoiding television.  This concept makes it seems like “exercising” the brain is as simple a strengthening a muscle, which is an inaccurate simplification.

The second is the idea of the brain as a way to quantify the difference between people – the idea that gender, sexual orientation and conditions like substance abuse and obesity show up in our brains. While differences in our personalities and behaviors certainly do show up in our brains, it doesn’t mean that women, or gay people or alcoholics are the same.

The third idea is that the brain provides biological proof of our experiences. While it’s true that our experiences do show up in our brains, the review found that media stories often overextend brain research. For example, a study showing that informational overload can crowd out empathy was presented as evidence that social networking websites like Twitter rob people of compassion, even though there’s no proof that the evidence extends that far.

“You can do without a lot of your body parts – but without your brain, you just aren’t you,” said Barbara Ganzel, a researcher at Cornell’s College of Human Ecology who studies the impact of trauma on the brain. “The mystery of the connection between your brain and ‘you’ is exciting and scary and complicated. While we’re beginning to better understand the connection, there is a long road ahead before we will fully comprehend the answers to many of these questions.”

The take-home message: While we’re making great strides in neuroscience research, the media often extends the actual evidence in ways that may not be completely accurate. The brain is the most complex organ in the human body, and one we’re not likely to understand fully for a very long time.

Probiotics and antibiotics: A good combo?

If you have taken antibiotics or cared for a small child taking them, you have likely seen first-hand the effects the medicines can have on the digestive system.  The problem comes from the antibiotics – which are designed to kill bacteria – wiping out the productive bacteria that help the digestive system function properly.

One treatment doctors have explored is using probiotics – live microorganisms that can be consumed – to replenish the body’s productive bacteria. But what does the evidence say?

A systematic review this week in the Journal of the American Medical Association compiled data from 82 randomized, controlled clinical trials to come up with the best advice we have on using probiotics together with antibiotics.

The review concluded that probiotics do reduce the prevalence of diarrhea associated with taking antibiotics, but the data available didn’t provide additional details.

An article in the publication Family Practice News did note that most of the studies included in the review did not demonstrated a significant benefit from using probiotics when looked at on their own. But the complication of data show a benefit.


The review also noted that, on the whole, the quality of the research on probiotics is considered low. Many of the studies lacked enough evidence to evaluate the risk of probiotics and did not report on adverse events related to them.

The bottom line: Probiotics are a good avenue for treating diarrhea associated with taking antibiotics, but much more evidence is needed to develop solid clinical guidelines. Sometimes a systematic review serves the purpose of spotlighting areas that need additional research. That seems to be the case here.

Zinc lozenges to treat a cold? Worth a try

The phrase on the front of the packaging for Cold-Eeze zinc lozenges says it all: “Clinically proven to reduce the duration of the common cold.”

While I always give them a try when I feel a cold coming on, I’ve always wondered if the package is referring to one small study, or if there’s conflicting evidence.

So this week, I was excited to see a systematic review on zinc for the treatment of the common cold.  The authors found 17 randomized controlled trials comparing orally administered zinc with placebo or no treatment. And those studies included more than 2,000 patients.

The results?  Zinc did shorten the duration of cold symptoms in adult patients compared to those given placebo by a little over a day. No effect was seen for children taking zinc. The lozenges did cause some bad taste and nausea in study participants.

The authors also called for more extensive research solidify recommendations and  take an in-depth look at adverse effects.

For the time being, I’m going to keep up the zinc. A day or two without sniffles and body aches seems well worth it to me.

Energy drinks: Bad for kids, bad for your teeth

Brightly-colored, sugar-filled energy and sports drinks are everywhere – in vending machines, cafeterias and gas stations.

While they may seem like a healthy alternative – athletes drink them, after all – most lack nutritional value, and many contain caffeine. The evidence actually shows these drinks can be detrimental to kids and harmful to teeth.

First off, a systematic review commissioned by the American Academy of Pediatrics found that sports drinks – which don’t contain caffeine, but do have a lot of sugar – lead to obesity and tooth decay among children. And energy drinks – which do contain caffeine – can interfere with sleep, lead to anxiety and cause dehydration.

A more recent study published in the journal General Dentistry and covered by National Public Radio found both energy and sports drinks contain high levels of citric acid, which erodes tooth enamel, leaving teeth more prone to cavities and decay.

There’s certainly a place for sports drinks – specifically to replace electrolytes and energy stores in both children and adults who exercise vigorously for more than an hour at a time. But for the public at large, these drinks are essentially empty calories.

So help to discourage children from downing sports drinks unless they’re actually playing a sport.  And the next time you’re picking up a beverage to go with that sandwich or need to quench your thirst on a long drive, stick with water.  It’s the healthier choice.

The link between happiness and health

A positive mood can certainly make for a brighter day, but now there’s new evidence that is also makes for a healthier heart.

A systematic review by researchers at Harvard University looked at more than 200 studies on cardiovascular risks and emotional state – the largest ever reviewed in one paper. They found that patients who reported a positive mental state were less likely to suffer from heart disease and stroke.

Feeling such as optimism, happiness and hope seemed to protect against cardiovascular disease independently of risk factors like smoking and obesity.

While the link provides an interesting insight, it is difficult to tell whether happiness produces health, or whether healthier people are, by nature, happier. In either case, it’s prudent to cultivate a positive mindset.

At Cornell, psychologist Anthony Ong’s research focuses on how people maintain a positive attitude, even when they experience stressful events like the loss of a loved one. His work has shown that social connectedness – having a supportive relationships with those around you – contributes these daily positive emotions, and leads people to be more resilient in the face of adversity.

The take home message: Get out in your community and cultivate some good feelings!

Building and maintaining relationships is one key to healthy aging

There are some clear risk factors that lead to an earlier death such as smoking, alcohol consumption and obesity. But are there other factors that influence health and wellness later in life – behaviors that researchers have yet to study?

Until recently, one of those unknown factors was social relationships. Anecdotal evidence suggested that people with strong social relationships reduced their risk of mortality, but there was little evidence to back up the suggestion. While many medical studies included a measure of social isolation, no one had looked at the issue on a broader scale.

That is, until researchers at Brigham Young University conducted a systematic review of the literature on how social relationships impact the risk of dying later in life.  They reviewed 148 studies that included more than 300,000 participants that included information about how people died, their initial health status and pre-existing health conditions, as well as type of assessment of social relationships.

Over all the data they reviewed, they found a 50 percent increased likelihood of survival for participants with stronger social relationships. The lack of social relationships had more influence on mortality rates that other risk factors like physical activity and obesity.

The researchers noted that more complex measurements of social relationships – instead of simple indications such as marital status –  were more predictive of death.

The take-home message is that your relationships later in life are just as important as what you eat and drink, how much exercise you get, and other important health behaviors. More research is needed to determine how relationships improve well-being, and specific characteristics that contribute to the trend. In the meantime, it’s important for medical professionals to consider social relationships in their treatment plans for older adults.

New information on how food stamps help families

Nearly 45 million American received help purchasing food each last year through the Supplemental Nutrition Assistance Program, commonly called food stamps.

The large federal program – which provides annual benefits of more than $72 million – routinely comes up in political debates. Newt Gingrich, a Republican candidate in the presidential primaries, suggested the program supplementing the diets of wealthy Americans. And a budget proposal in the House of Representatives this month proposes cutting funding to the program.

But new evidence from the U.S. Department of Agriculture’s Economic Research Service shows the program helps keep families out of poverty.

The analysis found that food stamps led to a 4.4 percent decline in poverty from 2000 to 2009, despite a nationwide economic downturn. The program had a particularly strong impact on child poverty, which was reduced by 15.5 percent over that period.

In addition to analyzing poverty rates, the report also looked at the depth and severity of poverty. It found that food stamps reduced the severity of poverty by 21 percent, on average, from 2000 to 2009.

The program was especially effective in 2009, when benefits were increased by the American Recovery and Reinvestment Act. That year, it reduced the depth of child poverty by 20.9 percent and the severity of child poverty by 27.5 percent.

“Research has shown that SNAP indirectly protects children’s health by reducing food insecurity,” said Joan Doyle Paddock, a senior extension associate at Cornell’s College of Human Ecology who helps develop and evaluate nutrition education programs for SNAP “Children receiving SNAP are significantly more likely to be considered ‘well’ than those not receiving SNAP.”

To qualify for food stamps in 2012, a family of three would have to earn less than $24,096 a year.  That’s a meager amount to support the needs of three people. It’s clear the Supplemental Nutrition Assistance Program is making a difference to families across the nation. That’s good evidence to have on hand.

Are antipsychotic medications helpful for nursing home patients?

A systematic review published in the Journal of the American Geriatrics Society looked at medical records nearly 84,000 nursing home patients in 45 states to determine if taking antipsychotic medications increased the risk of other medical problems, specifically heart attack, stroke, serious bacterial infections and hip fracture.

The review found that within 180 days of starting antipsychotic medicines, nursing home patients were at higher risk for bacterial infections, heart attack and hip fracture, but not at higher risk for stroke. The study also identified which specific medications lead to increased problems, and which doses proved to be safer for residents.

On the whole, this is exactly the kind of information that medical providers need to make the best decisions for patients with complex medical issues.  The scope of this study – encompassing thousands of patients across the nation – and detail of data about specific medicines and doses provides a roadmap to help residents stay healthy.

Real evidence linking taxes and death

With U.S. income taxes due today, there will surely be banter around water coolers across the country on the subject of taxes, including a myriad of jokes about paying Uncle Sam.

“If my business gets much worse, I won’t have to lie on my next tax return.”

“When it comes to taxes, there are two types of people. There are those that get it done early, also known as psychopaths, and then the rest of us.”

“Drive carefully. Uncle Sam needs every taxpayer he can get.”

It turns out, there’s actually something to that last one.

A study in the most recent issue of the Journal of the American Medical Association, reviewed data on fatal road crashes from the National Highway Traffic Safety Administration from the past 30 years. The study found there are consistently more fatal car crashes on Tax Day each year, compared with other days. On average there are 13 more deaths – approximately a 6 percent increase – compared with other days.

What is going on?  The study authors speculate that added stress of a deadline could lead to more distracted driving, or that people could be consuming more alcohol on tax day.  Whatever the reason, they suggest a public health campaign to remind people to drive carefully on Tax Day.

Drive safely today!

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