Marion County Medical Center

Health Shorts

February 2008

Can Salt Take Your Breath Away?
If you’re on a low sodium diet, it’s probably because you have high blood pressure. Recent research at Indiana University indicates that you might also want to consider cutting back on your salt intake if you have exercise-induced asthma.

Physiologist Tim Mickleborough, Ph.D., and his colleagues put 12 young men and women with exercise-induced asthma on a low-sodium diet (1,600 milligrams per day) and an equal number on the same diet but with extra salt (10,000 milligrams daily). At the end of two weeks, a treadmill test found that those on the low-salt diet could exhale far more air, needed their bronchodilator drugs less frequently and had fewer markers of inflammation in their sputum.

Dr. Mickleborough theorized that subjects on the high-salt diet had greater blood volume, making it harder for oxygen to be transferred within the tiny blood vessels of the lungs.
[SOURCE: Rachael Moeller Gorman, “Can eating too much salt take your breath away?” WebMD feature from “Eating Well,” 2007]

How Much Exercise Is Enough?
The typical person with metabolic syndrome has excess fat around the waist and a tendency toward high blood pressure, high triglycerides and high blood sugar. This is hardly the type of person who is likely to rush enthusiastically to the health club in response to a doctor’s recommendation to get more exercise. But how much exercise is enough to treat metabolic syndrome?

A Duke University study of 334 adults, aged 40 to 65, with metabolic syndrome found that those who exercised the most and at the greatest intensity (the equivalent of jogging 20 miles a week) got the greatest benefits. But those who did a modest amount of exercise at moderate intensity (brisk walking for 12 or more miles a week) also showed significant improvement, even without changes in diet or eating habits.
[SOURCE: Joanna Johnson, et al, American Journal of Cardiology; Miranda Hitti, “Metabolic syndrome: how much exercise?” WebMD Medical News, December 17, 2007]

PSA Less Reliable for Obese Men?
Obese males may have misleadingly low readings on the PSA test (prostate specific antigen) widely used to screen for prostate cancer, according to a study published in the Journal of the American Medical Association [November, 2007]. This may be because obese persons tend to have higher blood volume, according to the authors.

Other studies have indicated that obese men with prostate cancer have a greater chance of dying than their thinner counterparts.
[SOURCE: “Wellness Facts,” University of California, Berkeley Wellness Letter, February, 2008]

Orthotics Don’t Prevent Back Pain
Custom insoles or “orthotics” are often prescribed for persons with foot, heel or leg pain, but a recent review of six studies found that insoles were no more effective than placebo in preventing back pain. About 2,300 subjects were involved in the six studies reviewed by the nonprofit research group, Cochrane Collaboration.
[SOURCE: “Insoles do not help prevent back pain,” University of California, Berkeley Wellness Letter, February, 2008]

Adventure Travelers Face Asthma Risk
An Israeli study of 180 young persons with mild to moderate asthma traveling to developing countries found that 88 had asthma attacks during their travels. For 32, the attack was the worst ever encountered, sometimes with life threatening complications.

Most of these subjects failed to foresee the worsening of their asthma during travel and did not make adequate use of their inhaled corticosteroids.
[SOURCE: A. Bhowmik, “Identifying adventure travellers at risk of developing exacerbations of asthma,” Thorax, March, 2003]

Air Pollution Worse in 3rd World
It’s safe to assume than any major city has high levels of air pollution, but the levels in developing countries is particularly high.

Some of the worst offenders to the environment are motorcycles with two-stroke engines, which are becoming increasingly common in cities such as Bangkok, Delhi and Manila.

Mexico City, cited in 1992 as the most polluted city in the world by the World Health Organization, has significantly improved its air. Respiratory deaths in Hong Kong have been significantly reduced since restrictions were imposed on the sulfur content of fuels used by power plants and motor vehicles.

Today, 9 of the 10 most polluted cities in the world are in China. Levels of total suspended particulates, for example, were 732 per cubic meter in Lanzhou, China versus 279 in Mexico City and 9 in Stockholm, Sweden. Levels of sulfur dioxide from burning of fossil fuels were 424 micrograms per cubic meter in Guiyang, China versus 9 in Los Angeles.
[SOURCE: Christopher Sanford, “Urban medicine: threats to health of travelers to developing world cities,” Journal of Travel Medicine, December, 2004]

Laparoscopy Top Choice for Gallbladder
About 80 to 90 percent of persons having gallbladder surgery today have laparoscopic procedures requiring only small incisions. A recent Swedish study found that patients undergoing laparoscopic gallbladder removal had a lower mortality risk than the general population.

Patients having open surgery, on the other hand, had a higher short-term risk of dying. This may have been because they were, on average, 10 years older than patients having laparoscopic surgery and more likely to have an emergency need for gallbladder removal. They were also more likely to have other medical problems.
[SOURCE: Mats Rosenmuller, et al, “Cholecystectomy in Sweden 2000-2003: a nationwide study on procedures, patient characteristics, and mortality,” BMC Gastroenterology, August 17, 2007]

Meat Eaters, Weight Cyclers at Risk
Twenty percent of American women and 10 percent of men can expect to have painful gallstones by the time they reach age 60.

For women, the increased incidence is associated with the effect of estrogen on the concentration and chemical makeup of bile.

Men most at risk include 1) those who ingest large amounts of heme iron, such as that found in red meat, poultry and seafood and 2) “weight cyclers”–those who lose and regain weight frequently. The larger the weight loss, the greater the risk.
[SOURCE: “Gallstones: advances in treatment,” Duke Medicine, May, 2007]

Bariatric Surgery Ups Gallstone Risk
Rapid weight loss–whether through diet or bariatric surgery–increases a person’s risk of developing gallstones. More than 30 percent of persons undergoing bariatric surgery experience painful gallstones within a few months.

The gallbladder stores bile, a digestive fluid, until it’s released after a meal to be used by the intestines to help break down fatty acids. When a person is losing more than three pounds a week, bile accumulates longer than usual in the gallbladder, increasing the likelihood that a stone will develop.
[SOURCE: “Gallstones,” MayoClinic.com, July 25, 2007]

Thyroid Cancer Rates Up in WomenT
The incidence of thyroid cancer has been increasing in American women since 1981, but recently the upswing has been more dramatic. From 1981 to 1993, for example, incidence increased by 2.2 percent a year; from 1993 to 2000, the increase was 4.6 percent a year; and since that time, the increase has jumped to 9.1 percent a year.

Part, but not all, of this increase can be attributed to more aggressive detection efforts.
[SOURCE: National Cancer Institute, “Annual report to the nation finds cancer death rates continue to drop,” September 6, 2006]

Uninsured Less Likely To Get Colorectal Cancer Screening
Americans with health insurance are more likely than uninsured persons to get recommended colorectal cancer screening tests. About 44 percent of those with health insurance but only 17 percent of uninsured Americans reported having recent
colorectal screening.

Adults aged 65 and over are more likely to have colon cancer screening than those aged 50 to 64, probably in part because Medicare covers the cost of such screening.
[SOURCE: American Cancer Society, “Cancer prevention & early detection facts & figures, 2007”]

The High Cost of Cigarettes
If you’re a cigarette smoker worried about the high cost of cigarettes, you should consider some of the hidden costs. For each pack of cigarettes smoked in 1999, according to the American Cancer Society, $3.45 was spent for medical care related to smoking. Another $3.73 was lost in productivity.

More than 8.5 million Americans have chronic medical conditions such as bronchitis, emphysema and heart disease directly related to smoking. Of persons who continue to smoke, half can expect to die from smoking-related illness.
[SOURCE: American Cancer Society, “Cancer Facts & Figures, 2007"]

When Your Feet Swell in the Air
Even an athlete can experience foot swelling during a long airline flight, and it’s usually nothing to worry about. The swelling can be attributed to lower air pressure in the cabin, dehydration and prolonged sitting in a position that causes blood to pool in the leg veins. If you have hypertension or are taking certain medications, the swelling may be worse.

The best prevention is drinking plenty of non-alcoholic fluids, wearing clothes that fit loosely around the waist, elevating your feet and legs whenever possible, rotating your ankles frequently and getting up and walking at least once an hour.
Excessive swelling, particularly if it occurs in one leg only and is accompanied by pain, could be a sign of deep vein thrombosis or a blood clot in the leg–a condition requiring medical attention.
[SOURCE: “Foot swelling during air travel: a concern?” MayoClinic.com, January 15, 2007]

Health Shorts

February 2008

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