We are what we eat: facts and myths! Let's talk about this!

Myth: Red meat is bad for health. 

Fact: Red meat is not bad when you choose leaner cuts of beef (top round, flank or sirloin) and pork (tenderloin or center cut) and eat a healthy portion (3-4 ounces). Poultry can contain more saturated fat than lean meats depending on preparation methods or if skin is not removed.  

Myth: Whole wheat/whole grain breads, cereals, pastas, etc. are lower in calories. 

 Fact: Most whole wheat products are equal in calories to their more refined partner (ie white bread, white pasta, etc). However, the whole wheat/whole grain food provides more fiber and nutrients making it a healthier choice. Mary Ellen Richards, RD, CDE, PinnacleHealth skipping-meal.jpg Try eating 3 meals daily and include small snacks between meals. 

Myth: Skipping meals will help you lose weight. 

Fact: When you skip a meal, your body’s metabolism tends to slow down to compensate for the lack of energy (food). Bodies with slower metabolisms require fewer calories. In addition, those who skip meals tend to overcompensate and eat more at the next meal which may result in more calories being consumed. For better appetite control, try eating three meals daily and include small (100 calorie) snacks between meals. 

 Myth: Most of the sodium in our diets comes from added salt. 

 Fact: Actually only about 6% of the sodium in our diets comes from added salt. The largest source of sodium comes from processed packaged food and restaurant foods. Deb Gochenour, MEd, RD, LDN, CDE PinnacleHealth Outpatient Clinical Nutrition Manager healthy-restaurant.jpg Don’t be afraid to make special requests and ask questions. 

Myth: If I’m trying to lose weight, I have to avoid eating in restaurants. 

 Fact: Restaurants often serve foods higher in salt than we would eat at home, and restaurant meals tend to be higher in fat and overall calories. Eating out can be tricky when you’re attempting to lose weight. But don’t let it stop you from trying. Don’t be afraid to make special requests and ask questions. Ask for a salad without the cheese, and dressing on the side. If an entrée contains bacon, maybe ask to hold the bacon. Inquire as to how a food is prepared. If a fish is breaded or fried, request that it be grilled. The great thing about restaurants is that they aim to give us delicious food that we enjoy, and they can prepare grilled or broiled entrées that are just as enjoyable as the higher fat counterparts. 

 Myth: High-carbohydrate foods are high in fat and calories. 

 Fact: Carbohydrate and fat are both considered macronutrients, each of which provides calories in the diet. The carbohydrates in a food have nothing to do with the fat in a food. In fact, one gram of carbohydrate in a food provides 4 calories, whereas one gram of fat provides 9 calories. In order to maintain a healthy weight, it is most important to eat the amount of calories that your body burns in a day. So, high-fat foods will provide more calories that your body must burn, compared to foods that are high in carbohydrate. Monitor overall calorie intake to maintain a healthy weight.

Materials given from www.transforminghealth.org 

#Study Finds No #Change In #Hospital #Heart #Attack #Death #Rates

One of the great medical advances in recent years has been the improved treatment of acute myocardial infarction. As the enormous benefits of earlier reperfusion became evident, medical systems in many parts of the world aimed to treat increasing numbers of patients in a shorter time frame. The door-to-balloon (D2B) time as a performance measure has emerged as a key part of this initiative. Now a study published in the New England Journal of Medicine finds that in-hospital mortality for acute MI patients receiving PCI has not fallen despite improvements in the D2B time. But some experts fear this finding may be misinterpreted, as it more accurately reflects a growing and changing population receiving PCI than any shortcomings in the D2B initiative.

Using the CathPCI Registry of the National Cardiovascular Data Registry, Daniel Menees and colleagues analyzed data from almost 100,000 hospital admissions for primary PCI between July 2005 and June 2009.

• Median door-to-balloon times declined over time, from 83 minutes to 67 minutes (p<0.001).
• A greater percentage of patients were treated in 90 minutes or less: from 59.7% to 83.1% (p<0.001).
• No significant change in unadjusted in-hospital mortality: 4.8% and 4.7% (p=0.43 for trend)
• No significant change in adjusted in-hospital mortality: 5.0% and 4.7% (p=0.34).

The authors write that their “findings raise questions about the role of door-to-balloon time as a principal focus for performance measurement and public reporting” and “suggest that additional strategies are needed to reduce in-hospital mortality in this population.” They point out that D2B is only “one component of total ischemic time; as door-to-balloon time is reduced, it becomes a smaller fraction of total ischemic time, making the time before arrival at a hospital a more important factor.”

In an accompanying editorial, Eric Bates and Alice Jacobs write that “the primary opportunity for reducing total ischemic time and time to treatment, and for improving outcomes, now lies in the prehospital STEMI system of care, where logistic challenges remain…. Although door-to-balloon time remains important, it’s time to turn our attention to the further development of systems that address the continuum of STEMI care, from symptom onset through return to the community.”

Another way to view the study results is that they show that the D2B initiative is an apparent victim of its own success by  bringing many more difficult-to-treat patients into the system at an earlier period. Harlan Krumholz, a leader of the D2B initiative, explains:

At a patient level shorter times translate into better outcomes and reaffirm the importance of rapid treatment. The paper also reveals the remarkable improvement in care over this period. And overall mortality rates for AMI (not shown in this paper) are dropping impressively. The lack of improvement in mortality over these years for the population of patients undergoing PCI may say more about the changing population of patients being referred for primary PCI over this period (volume grew rapidly – the mortality of those treated in more than 90 minutes increased) than the effectiveness of rapid (as opposed to delayed) reperfusion therapy.

In an interview to be published on CardioExchange, study authors Daniel Menees and Hitinder Gurm propose that

It may be time to move away from D2B time, or at least recognize its limitations and consider its use in the context of other measures. We need to start trying to track total ischemic time (i.e., onset of symptoms) better as well as take a closer look at the false activation rates across different regions and hospital systems. We think this is the real message behind our study – it’s time to look beyond D2B times, and we need start looking at other ways we can favorably impact patient outcomes.

what makes #people think that the #diet #program really #work

It seems that just about every week brings a new diet craze. From low-fat to low-carb to food combining, the diets come and go in the magazines and on the best-seller lists. Some prove lastingly popular, but many go the way of the latest dance fad. (Anyone remember the macarena? How about the cabbage soup diet?)

Meanwhile, dietitians keep giving the sensible advice they've been advocating for years: To lose weight, we need to eat less and exercise more.

Let's face it: We all know better than to keep falling for every fad that comes along. So why do we keep doing it?

"I think most people are put off by the fact that what we usually promote is life-long change," says Robyn A. Osborn, RD, PhD, a dietician and educational psychologist in Indianapolis, Ind.

Fad diets are often programs you're supposed to follow for just a few weeks. Butnutrition experts insist that the right approach to weight loss is to change your lifestyle -- permanently.

Anyway if you think that the diet is the best way to lose weight for you, then we highly recommend you to pay attention on the fat loss factor program. It's easy and "stress-free" method. Click for details>>

The Effect of Steroids on the Body

Before we get into the effects of steroids, its important to note what exactly they are. Specifically, steroids are pills, gels, creams or injections that artificially produce hormones to increase sports performance. The two main types of steroids are anabolic, which helps produce androgens such as testosterone, and steroidal supplements, which are essentially weaker types of anabolic steroids. 

Both types of steroids can help improve strength, endurance and muscle mass, which is why so many athletes sought and continue to seek them out. But they also produce certain side effects in subjects, such as acne, balding, insomnia, mood swings, high blood pressure, aggression, jaundice, liver damage and an increased risk of heart disease, stroke, blood clots and certain types of cancer. Other risks are the shrinking of the genitalia, painful urination, impotence and infertility. What's more is that users who inject are at risk of becoming infected with HIV, Hepatitis C or other bacterial infections from needle usage.

But there's more than just the health risks mentioned above. Steroid users can also suffer psychologically. Delusion, paranoia, aggression and mistrust are common psychological issues. Steroids can also become addictive. In fact, prolonged steroid use can worsen both the medical and psychological effects. 

As you can tell, steroids can be extremely detrimental to one's health, which is part of the reason why MLB, and all other sports leagues, are cracking down on use and enforcing severe punishments on those that violate their respective drug testing policies. Still, the side effects - and suspension risk - are worth the chance to many aspiring athletes who want to be the very best at what they do, whether that's by artificial enhancement or not.

#Cigarette pack #health #warnings 'have little #impact on #teens'

Health warnings in the form of pictures or text on the back of cigarette packets are common in many countries, serving to deter smokers from the habit. But according to a new study, they have little impact on teen smokers.

In the US, cigarette packets carry health warnings in the form of text only. In 2011, the US Food and Drug Administration (FDA) published a final rule stating that health warnings in the form of images must be present on all cigarette packets to deter smokers.

However, this ruling was challenged in court by tobacco companies, and the rule was dropped.

But in many countries, such as the UK, this ruling is very much in place, with some pictures covering more than 75% of the main surface area on a cigarette packet, alongside text warnings. Researchers from the UK wanted to find out exactly what effect this had on smokers, particularly teenagers.

They conducted a study involving two waves of a Youth Tobacco Policy survey of adolescents 11 to 16 years of age. One survey was completed in 2008 by 1,401 teens, and the other in 2011 by 1,373 teens.

For each survey, the same text warnings appeared on the front and back of the cigarette packets, while pictorial health warnings were present on packets for the 2011 survey.

All teenagers were required to share their thoughts regarding the visibility and impact of the warnings, and their responses were scored on a sliding scale of 1 to 5. They were asked:

• How well the health warnings served as visual cues
• How easy they were to understand and believe, and
• How persuasive they were.

90% of teens ignore health warnings

Teenage smokers are not deterred by health warnings on cigarette packs, the study shows.

The surveys showed that 68-75% of teens had never smoked, 17-22% had experimented with cigarettes, while 1 in 10 were deemed as regular smokers (smoked at least one cigarette a week).

Results from the health warning questions revealed that only 1 in 10 teenagers said they thought about the warnings when the cigarette packet was not in sight.

At the time of both surveys, around 85% of teens said they found the warnings credible. However, from the 2011 survey, those who had never smoked were less likely to find the warnings easy to understand, but experimental smokers were more likely to find them trustful and believable.

Those who had never smoked were more likely to think about the warnings "often" or "very often."

Additionally, while the proportion of teens who thought the warnings were capable of deterring them from smoking increased between 2008 and 2011, this was only apparent in never and experimental smokers, with no change in regular smokers.

Teens more likely to remember images

When it came to the teens remembering the health warnings on the cigarettes, the recall of text health warnings stating "smoking kills" fell from 58% in 2008 to 47% in 2011, while the recall of the text "smoking seriously harms you and others around you" fell from 41% in 2008 to 25% in 2011.

However, memory of three images on cigarette packets, including rotten teeth, diseased lungs and neck cancer, all increased.

But the researchers add that when the pictures were only present on the back of the cigarette packet and not the reverse, they had less impact.

The study authors say:

"The findings have implications for warning design. Positioning pictorial warnings only on the back of packs may have had a deterrent effect on never and experimental smokers, but for most measures no significant differences were observed."

They add that the EU ruling endorsed by the European Parliament's Committee on the Environment, Public Health and Food Safety in July 2013, which said large pictorial warnings should cover 75% of the pack on both sides, is likely to increase the impact warnings have for all adolescents, irrespective of smoking status.

Research in 2012 from the University of South Carolina suggested that health warning labels containing pictures have proven to be effective in causing awareness in adult smokers.

Other research from Susquehanna University in Selinsgrove suggested that graphic cigarette packet warning labels could significantly reduce demand.

#healthy #diet #fat #loss #factor #weightloss: does it really #work or not?

How the Fat Loss Factor #Diet Works

The Fat Loss Factor Diet is a 12 week online based program that was designed to be able to be done regardless of a participant’s fitness level. There are four program choices with the Fat Loss Factor Diet that include the Beginner program, the Intermediate program, Rapid Weight Loss program, and the Extreme Weight Loss Program.

The first two weeks of any of the Fat Loss Factor Diet programs consist of the participant eating only all natural and organic foods. This is supposed to be done in order to cleanse the body of impurities as well as rid the body’s dependency on unhealthy food. To boost results, participants can also do the “Master Cleanse” which involves fasting and consuming a drink made up of water, fresh lemon juice, maple syrup, and cayenne pepper. During this phase walking of 30 to 60 minutes each day is required.

After the initial two weeks the diet and exercise plans will depend on the program that is chosen. At the end of the 12 weeks, if your weight loss goals have not been met you are then instructed to reevaluate your progress, see what you can learn, then redo the entire program.

Do Dieters Lose Weight on the Fat Loss Factor Diet?

Within the first two weeks there should be at least some weight loss. Only eating organic foods and not much of them will make almost anyone lose weight as will fasting. However, fasting can be dangerous as can cutting out too many calories from your diet, so caution should be taken.

Is the Fat Loss Factor Diet Easy to Follow?

The Fat Loss Factor Diet is an all natural type of diet and is very specific on the kinds of foods you can have while on the diet. Many of the foods and food groups that you might love will be a thing of the past. Cravings should be expected, especially in the first two weeks so your resolve must be strong.

In addition, much of the food that is required in order to do the Fat Loss Factor Diet properly will not be readily available. Some of what you consume will only be able to be obtained by visiting a specialty store in your area which can cost you additional time and money.

What people think about the program?

The Fat Loss Factor Program works to combine both the physical and mental aspects of the body so as to facilitate faster results. That is why stress relief exercises have also been included in the numerous guides and support information provided.

The reason why the Fat Loss Factor program has become popular is its simplicity. After the 2 week cleansing period, following the program becomes an easy affair and one will not have to give up most of their favorite meals just to stay on course. That is because the program raises one's body metabolism so food is broken down faster than before. All that is required is focus and discipline and a thinner healthier life can be within reach in 12 weeks time.

For more information visit the official site of the program, just click here.

#healthy #diet #fat #loss #factor #weightloss: does it really #work or not?

How the Fat Loss Factor #Diet Works

The Fat Loss Factor Diet is a 12 week online based program that was designed to be able to be done regardless of a participant’s fitness level. There are four program choices with the Fat Loss Factor Diet that include the Beginner program, the Intermediate program, Rapid Weight Loss program, and the Extreme Weight Loss Program.

The first two weeks of any of the Fat Loss Factor Diet programs consist of the participant eating only all natural and organic foods. This is supposed to be done in order to cleanse the body of impurities as well as rid the body’s dependency on unhealthy food. To boost results, participants can also do the “Master Cleanse” which involves fasting and consuming a drink made up of water, fresh lemon juice, maple syrup, and cayenne pepper. During this phase walking of 30 to 60 minutes each day is required.

After the initial two weeks the diet and exercise plans will depend on the program that is chosen. At the end of the 12 weeks, if your weight loss goals have not been met you are then instructed to reevaluate your progress, see what you can learn, then redo the entire program.

Do Dieters Lose Weight on the Fat Loss Factor Diet?

Within the first two weeks there should be at least some weight loss. Only eating organic foods and not much of them will make almost anyone lose weight as will fasting. However, fasting can be dangerous as can cutting out too many calories from your diet, so caution should be taken.

Is the Fat Loss Factor Diet Easy to Follow?

The Fat Loss Factor Diet is an all natural type of diet and is very specific on the kinds of foods you can have while on the diet. Many of the foods and food groups that you might love will be a thing of the past. Cravings should be expected, especially in the first two weeks so your resolve must be strong.

In addition, much of the food that is required in order to do the Fat Loss Factor Diet properly will not be readily available. Some of what you consume will only be able to be obtained by visiting a specialty store in your area which can cost you additional time and money.

What people think about the program?

The Fat Loss Factor Program works to combine both the physical and mental aspects of the body so as to facilitate faster results. That is why stress relief exercises have also been included in the numerous guides and support information provided.

The reason why the Fat Loss Factor program has become popular is its simplicity. After the 2 week cleansing period, following the program becomes an easy affair and one will not have to give up most of their favorite meals just to stay on course. That is because the program raises one's body metabolism so food is broken down faster than before. All that is required is focus and discipline and a thinner healthier life can be within reach in 12 weeks time.

For more information visit the official site of the program, just click here.

Common Nutrient Keeps Flies Sharp into Old Age

Like humans, Drosophila fruitflies become forgetful with age.

But at least their memory deficits can be reversed by eating a #diet rich in polyamines, according to a study published online today in Nature Neuroscience. (Scientific American is part of Nature Publishing Group.)

“There’s a great need for cognitive enhancers to keep us healthy into old age — now polyamines are offering a new approach,” says learning and memory specialist Ronald Davis at the Scripps Research Institute Florida in Jupiter, who was not involved in the study. “There are reasons for optimism that this fly work will translate into humans.

Polyamines—which include the graphically named putrescine, cadaverine and spermidine—are small molecules that are essential for cells to survive and grow. But their cellular levels decline with age.

Some foods that are popularly considered to have health benefits—such as wheatgerm and fermented soya beans — contain high levels of polyamines. Japanese scientists have shown that natto, a fermented soya-bean product, raises the level of polyamines in the blood in hum an

But there is a long way to go before anyone can say that polyamines can help to stave off memory decline in ageing people, cautions Stephan Sigrist of the Free University of Berlin, one of the study's principal investigators. “Still, the polyamine system does offer a new target for those interested in developing therapies.”

Other scientists had already shown that feeding polyamines to fruitflies, as well as worms or yeast, increases the organisms' lifespan. It seems to do so by reversing the age-related decline in autophagy—a mechanism that cells use to clear themselves of debris. Longevity in fruitflies can also be increased by promoting autophagy, either by genetic techniques or by restricting calorie intake. But neither tactic had been clearly proven to be effective against age-related memory decline.

So the study’s scientists didn’t know exactly what to expect when they began their two-year polyamine study, says Sigrist. “Still,” he says, “we reasoned that spermidine is a natural and potent inducer of autophagy through a novel mechanism, so it might just affect memory decline.”

Return to youth

The team trained their flies to associate a particular odour with a mild electric shock. Youthful flies quickly learn to avoid the odour and remember to avoid it for many hours. Older flies learn more slowly. But when the researchers fed the older flies a polyamine-rich diet, the insects' polyamine levels were restored to youthful levels—and the age difference in learning and memory was nearly wiped out.

“We were very impressed with how strong the effect was,” says Sigrist. “But that also made us a bit nervous.”

To be sure that the effect was real, Sigrist asked other researchers in his lab to independently repeat the experiments in a double-blind fashion. The team also threw in a second approach: instead of feeding polyamines to the insects, they cranked up the activity of an enzyme that manufactures these molecules in cells. In each case, they got the same result.

In other experiments, the scientists showed that the effect on memory was specific, and was not a general consequence of the flies becoming healthier as a result of the diet. They also showed that the mechanism was independent of that promoting extension of life.

The researchers are now starting studies to see whether a polyamine-rich diet has a similar effect in mice and humans.

Cholesterol-lowering drugs may help prevent dementia

A study of nearly 58,000 people finds high-dose statins -cholesterol-lowering drugs - appeared to prevent dementia in older people, U.S. researchers say.

Dr. Tin-Tse Lin of Taiwan and colleagues examined whether statin use was associated with new diagnoses of dementia from a random sample of 1 million patients covered by Taiwan's National Health Insurance.

From this they identified 57,669 patients age 65 and older, who had no history of dementia in 1997 and 1998. The analysis included pre-senile and senile dementia but excluded vascular dementia.

"Statins are widely used in the older population to reduce the risk of cardiovascular disease. But recent reports of statin-associated cognitive impairment have led the U.S. Food and Drug Administration to list statin-induced cognitive changes, especially for the older population, in its safety communications," Lin said in a statement.

The study found 5,516 new diagnoses of dementia during approximately 4.5 years of follow-up. The remaining 52,153 patients age 65 and older formed the control group.

Subjects were divided into tertiles -- thirds -- according to their mean daily equivalent dosage and total equivalent dosage.

The adjusted risks for dementia were significantly inversely associated with increased total or daily equivalent statin dosage.

For example, "patients who received the highest total equivalent doses of statins had a three-fold decrease in the risk of developing dementia. Similar results were found with the daily equivalent statin dosage," Lin said. "It was the potency of the statins rather than their solubility which was a major determinant in reducing dementia. High potency statins such as atorvastatin and rosuvastatin showed a significant inverse association with developing dementia in a dose-response manner. Higher doses of high potency statins gave the strongest protective effects against dementia."

The findings were presented at the European Society of Cardiology Congress in Amsterdam.

Amgen, Cytokinetics heart failure drug misses goal in study

An experimental heart failure drug from Amgen and Cytokinetics missed its goal of improving shortness of breath in a mid-stage clinical trial, leaving its future uncertain.

Despite the setback in the 613-patient trial using an intravenous formulation of the medicine omecamtiv mecarbil in hospitals, Amgen said it would continue testing an oral version of the drug in a separate Phase II study.

The combined results from the tests will determine whether the medicine advances into final Phase III testing or is discontinued.

"We are going to look at all the data very, very carefully before making a decision around the future of the molecule," said Scott Wasserman, Amgen's executive medical director.

Heart failure, in which heart muscle is unable to pump enough blood around the body, is an often deadly disease. About half of people diagnosed with the condition die within five years and treatments have changed little since the 1970s.

Omecamtiv mecarbil, which Amgen licensed from Cytokinetics, takes a novel approach to tackling heart failure by activating cardiac myosin, a protein in heart cells that is responsible for converting chemical energy into muscle contraction.

The data from the intravenous drug study were unveiled on Tuesday at the European Society of Cardiology congress in Amsterdam, where the difficulty of developing new drugs to treat heart failure has been a major talking point among doctors.

Dr. Christopher Grainger of Duke University Medical Center, who was not involved in the research, said results from the trial were disappointing, even though there were some encouraging trends towards a favourable response.

"I would be discouraged by this in terms of the implications for the drug having an important effect," he said, noting there had been better results with another product from Novartis .

But Dr. Mariell Jessup, president of the American Heart Association and a specialist in heart failure, said it would be premature to dismiss the Amgen drug, noting it was very difficult to show efficacy in a hospital setting.

"There is still hope. Even if you can't show efficacy in the acute setting, as long as there is not an adverse signal I think it is worthwhile studying the oral equivalent," she said.

U.S. biotech giant Amgen has traditionally focused on oncology but more recently has diversified into cardiology, where it is also in a race to develop a new class of cholesterol-lowering drugs known as PCSK9 inhibitors.

In July, it also clinched a deal to secure commercial rights to a drug from French drugmaker Servier for chronic heart failure and angina.

Bronze Aged: As Teens Turn to Tanning Salons, States Look the Other Way

The harmful effects of ultraviolet (UV) light on the skin apparently do not scare off teenagers, who are flocking to indoor tanning salons. Among non-Hispanic white high-school students, about 29 percent of girlsand about 7 percent of boys admit to indulging in frequent trips to tanning salons. Now medical researchers are taking state governments to task for lax or nonexistent regulations surrounding teenage indoor tanning. “This is no longer just a prom phenomenon—kids are using tanning beds frequently,” says Alan Geller, a public health researcher of Harvard University School of Public Health and co-author of a new studyof tanning regulations. “And all we have to protect these teenagers is a patchwork quilt of poor regulation.”

Protecting young skin from the sun’s rays is especially important because early exposure increases the risk of skin cancer later in life. Although people who develop melanoma, the most serious form of skin cancer, have a 98 percent chance of surviving the next five years, the survival rate drops to 62 percent if melanoma is detected late. During the past 20 years, the incidence of melanoma in young women has doubled. No single cause can account for this increase, but many doctors point to the parallel rise in tanning bed use, which increases the risk of melanoma by 59 to 75 percent for those under the age of 35.

In light of these trends Geller and his colleagues analyzed tanning laws in all 50 states, accounting for age bans, parental consent laws as well as operating and warning requirements, and the overall enforcement of these regulations. The researchers found that the lion’s share of regulations rely on parental consent or parental accompaniment, and that both requirements, Geller says, are “really quite weak.”

Currently, six U.S. states have strong parental consent enforcement procedures, such as regular salon inspections, and another six have banned underage indoor tanning altogether. Yet 13 states continue to have no underage tanning regulations.

One of those states is Missouri, where 65 percent of tanning salon operators say they would be okay with having kids as young as 10 years old use their facilities, according to a 2013 survey. The reasoning behind this answer, according to 80 percent of operators, is the belief that tanning “prevents sunburns,” which means they are providing a public service. In truth, any change in skin color because of sunlamp or sun exposure is a sign of UV radiation damage, which is unequivocally bad for the skin. Having a “base tan,” Geller says, is equivalent to sun protection factor (SPF) 3, “far less than what you need to prevent really bad sunburns or suntans.” And for each indoor tanning session, customers increase their lifetime risk of melanoma by 1.6 percent per year.

Although some legislation has attempted to address this $5-billion industry’s impact on the health of Americans—in 2010 the Obama administration passed a 10 percent federal tax on tanning services—teenage tanning bed use continues to hold steady. A 2003 study, for instance, reported that 28 percent of white female adolescents and 6 percent of young white males frequented tanning facilities regularly. The apparent persistence of teen indoor tanning begs the question as to why so many states have not clued into the need for regulation. Geller says some of this delay has to do with push-back from tanning salon operators. “They talk about the ‘nanny state’ and how regulations are bad for business,” he says. “Many argue it should be the job of the parents to enforce these rules.”

But many parents do not know about the risks. “We need broad counteradvertising,” Geller says, but the U.S. Food and Drug Administration should also implement a countrywide law banning indoor tanning for children under the age of 18. “If we leave it up to each state,” he says, “it will take an extraordinarily long period of time.”

In England salons are inspected regularly and can face fines of up to about $30,000 if they fail to turn teenagers away. In France, where underage tanning has been banned since 1997, researchers report that 1.4 percent of minors engage in illegal tanning bed use compared with the 15.6 percent of American adolescents who frequent tanning salons today. Moreover, since 2003 the number of countries that have bans on underage indoor tanning has increased from two to 11—an increase due, in part, to the World Health Organization’s 2009 reclassification of sunlamps, tanning beds and UV light as high-level carcinogens. Indoor tanning is a serious health concern, Geller says, and because of lax regulations we do not know if 10-year-olds are using tanning beds. “That’s why we need a ban across the country.”

Doctors get good and bad safety news on diabetes drugs

(Reuters) - Diabetes pills known as DPP-4 therapies got a mixed safety report on Monday as studies showed they did not raise the risk of heart attacks but might be linked to heart failure, where the heart fails to pump blood adequately.

Reassuringly, the medicines were not associated with increased rates of either inflammation of the pancreas or cancer - something that has been a worry in the past.

However, in the case of AstraZeneca and Bristol-Myers Squibb's approved drug Onglyza, there was a small increase in hospitalizations for heart failure.

"It is a little bit concerning," said Dr. Christopher Grainger of Duke University Medical Center, who was not involved in the research. "I'm sure the FDA (U.S. Food and Drug Administration) will want to know more about it."

Doctors and regulators are wary of the cardiovascular safety profile of diabetes drugs following past problems, including with GlaxoSmithKline's Avandia pill, since patients with diabetes are at increased risk of heart troubles.

Researchers from Brigham and Women's Hospital in Boston, who studied Onglyza over two years in 16,492 patients, said the heart failure finding was unexpected and deserved further investigation.

AstraZeneca and Bristol had already given headline results from the study in June showing that Onglyza did not increase heart attack risk - although it did not reduce it either, as the companies had initially hoped.

Detailed results of the Onglyza study were presented at the European Society Cardiology (ESC) congress in Amsterdam, alongside a 5,380-patient study of Takeda's Nesina, which showed no increase in overall cardiovascular risks.

Both studies were also published in the New England Journal of Medicine.

Dr. Heinz Drexel, a heart doctor at Feldkirch Hospital in Austria and an ESC spokesman, said DPP-4s offered several advantages, including a lack of weight gain seen with some other antidiabetics, which would offset the heart failure worries.

Dr. Anthony DeMaria, editor-in-chief of the Journal of the American College of Cardiology, said the absence of severe adverse events was reassuring but it might be that DPP-4s were best avoided for certain patients at high risk of heart failure.

Drugs like Onglyza and Nesina work by inhibiting dipeptidyl peptidase-4, or DPP-4, to enhance the body's ability to lower elevated levels of blood sugar.

The DPP-4 market is dominated by Merck's Januvia, which has annual sales of around $5 billion, including a related combination treatment called Janumet. But growth of the class has slowed this year, partly on concerns over pancreatic safety.

Onglyza, which had sales of $709 million in 2012, is a crucial product for AstraZeneca, which is banking on diabetes to help revive falling group sales due to patent expires on several of its biggest-selling drugs.

Briggs Morrison, AstraZeneca's head of global medicines development, said the overall results of the latest trial were reassuring and the small increase in heart failure hospitalizations did not change the risk profile of the drug.

A similar heart study of Merck's Januvia in more than 14,000 patients is being conducted with results expected next year.

Daiichi Sankyo’s New Blood Thinner Matched Warfarin in Study

Daiichi Sankyo Co. (4568)’s experimental blood thinner edoxaban was as effective and less risky than standard treatment warfarin in a study that may position the Japanese company to compete with drugmakers including Pfizer Inc., Johnson & Johnson (JNJ) and Bristol-Myers Squibb Co. (BMY)

The 8,240-patient study found that a once-daily edoxaban pill given after initial heparin therapy was equivalent to the generic medicine warfarin at preventing new blood clots in patients who have had clots in a vein or lung. Patients who took edoxaban had significantly less bleeding, a feared side effect of blood thinners, than did patients on warfarin.

The results may help Daiichi Sankyo join the race to replace warfarin, a half-century-old therapy that requires close monitoring to avoid side effects such as severe bleeding that can be life-threatening.

“The bar is high, but if we look at analogous areas like the development of ACE inhibitors” to treat high blood pressure, “there was scope for the development of several,” Keith Fox, professor of cardiology at the Center for Cardiovascular Science at the University of Edinburgh, said in an interview before the results were released.

Fox is chairman of the program committee for the European Society of Cardiology’s meeting in Amsterdam, where the data were announced today. The study was also published online today in the New England Journal of Medicine.

Patent Protection

Daiichi Sankyo is seeking to offset a drop in sales when its best-selling Benicar hypertension drug loses patent protection in 2016 with edoxaban and another anti-clotting treatment called Effient, which was approved in the U.S. in 2009.

Benicar generated 258.8 billion yen ($2.6 billion) for the year ended March for Daiichi Sankyo, or 26 percent of its total sales.

Today’s four-year-long study, dubbed Hokusai-VTE, is part of the last stage of patient trials generally required for regulatory review. Patients were given edoxaban or warfarin for as long as 12 months after being diagnosed with a blood-clotting condition called venous thromboembolism.

Edoxaban caused less bleeding across a broad range of patients, including those with severe blockages in the arteries of the lungs, the researchers said.

In venous thromboembolism, clots form in veins deep in the body, often in the legs. The clots can then break off and travel into the lungs, causing a potentially deadly pulmonary embolism.

Heart Rhythm

From 300,000 to 900,000 people in the U.S. are affected by VTE each year, according to the Centers for Disease Control and Prevention in Atlanta. Almost half of the conditions occur either during or soon after discharge from a hospital stay or surgery and an estimated 60,000 to 100,000 Americans die of the illness each year.

Daiichi Sankyo is also testing the drug in patients with a heart rhythm disorder called atrial fibrillation, to prevent blood clots from forming in the heart. If it’s approved in both groups of patients, sales of edoxaban are expected to reach 40 billion yen by the year ending March 2018, according to SMBC Nikko Securities Inc.

“Edoxaban will face intense competition when it reaches the market,” Yasuhiro Nakazawa, a health-care analyst at SMBC Nikko in Tokyo, said in a telephone interview before the study results were published. “Patients and doctors don’t seem to switch brands once they are on medication, so it’ll be a slow start for Daiichi Sankyo.”

Edoxaban will compete with Boehringer Ingelheim GmbH’s Pradaxa, J&J and Bayer AG (BAYN)’s Xarelto, and Pfizer and Bristol-Myers Squibb’s Eliquis.

“The important point for the VTE trials is the safety profile of the drug, how it can minimize the risk of major hemorrhage,” SMBC Nikko’s Nakazawa said. Eliquis has a good safety profile, Nakazawa said.

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