To my Patients and Friends,
Here are the latest health news highlights… enjoy!
Flu shots for healthy pregnancies
According to a study by CDC investigators recently published in the journal Birth Defects Research, adverse birth outcomes are more common in infants born to women with the flu. These findings were based on data that were collected during the 2009 H1N1 influenza pandemic, at which time infants born to moms with H1N1 flu were more likely to be born prematurely and to have low APGAR scores compared with those born to unaffected moms. The findings of this study support the importance of ensuring that pregnant women (and all those with whom she may come in contact) receive the influenza vaccine. And don’t believe the irresponsible, uninformed messaging propagated by “anti-vaxers”… please get vaccinated!
Hormone replacement therapy and blood clots
Historically, doctors have warned female patients about the increased risk of vein clots or embolisms associated with estrogen replacement therapy, particularly with the oral formulations. Recently, researchers in England have confirmed that transdermal estrogens (i.e., gels or patches) appear to be safer than oral formulations in terms of these risks, as published in the British Medical Journal. And women who choose bioidentical estradiol (brands include Elestrin, EstroGel, Estrace, Climara, Vivelle, Minivelle) over conjugated equine estrogen (brands include Premarin, Prempro, Premphase) are also at significantly lower risk for these complications. So be sure to speak with your prescriber about your options if you’re considering (or are already using) hormone replacement therapy.
More plugs for plants
Three articles on a plant-based dietary pattern recently caught my attention:
- The first is an analysis just published in the journal Lancet which serves to reinforce our understanding that greater consumption of whole grains and dietary fiber is associated with a significantly lower risk for several diseases, including diabetes, heart disease, and colon cancer.
- The second is a review published in the journal Nutrients in which it was shown that a plant-based diet improves both cardiovascular health and recovery time in endurance athletes.
- Finally, you may have read about the “Planetary Health” diet recently unveiled by scientists at the Harvard T.H. Chan School of Public Health. The dietary pattern- described as most ideal for the “health of the planet and its populations” – entails a doubling of consumption of nuts, fruits, vegetables and legumes, and a significant reduction of our intake of meat and sugar. The researchers conclude that if the world were to follow the “planetary health” diet, more than 11 million premature deaths could be prevented each year, while greenhouse gas emissions would be cut and more land, water, and biodiversity would be preserved. The article linked above is an interesting read.
ADHD overdiagnosis in Kindergarteners?
Kindergartners who start school at a younger age (specifically for those born in August, just prior to the usual September 1st kindergarten cutoff date) may have a 30% greater risk of being diagnosed and treated for attention deficit and hyperactivity disorder (ADHD), as suggested in a study recently published in the New England Journal of Medicine. But that doesn’t necessarily indicate that these 5-year-olds actually have ADHD; it may just be a sign that they are acting age-appropriately. The findings of this study imply- at least in some cases- that teachers and doctors are mistaking normal, age-appropriate behavior for a neurological condition that may not actually be present, and that some kids are prescribed ADHD medications that they wouldn’t need were they just a bit older, or if classroom demands were different. So, if your child happens to fall into this category, it may be worth pursuing a more thorough evaluation before starting medication for ADHD, or perhaps waiting a year or so to see if his or her “symptoms” subside.
The head and the heart
Migraine with aura (generally described as a migraine headache that is preceded by particular sensory disturbances) is associated with an elevated risk for developing a heart rhythm abnormality known as atrial fibrillation (AF), according to a study published in the online journal Neurology. Those with AF are at increased risk for complications such as stroke or congestive heart failure (CHF). Just to be clear, most people who suffer from migraine with aura do not develop atrial fibrillation. That said, for those who do suffer from migraine with aura, it would be wise to make every effort to live a heart-healthy lifestyle, to see your doctor regularly, and to watch for symptoms of AF (such as heart palpitations, unexplained fatigue, chest discomfort, shortness of breath or lightheadedness).
That’s all for this installment… be well and stay warm!
Larry Leibowitz, MD