Diet and Health for Life

Perfect Weight... How Low Should You Go

2009-03-12T08:24:00.001-07:00

Wait! What IS your perfect weight? I know you�ve heard people talking about getting down to their ideal weight, but do they really know what it is? Do you know yours?

One�s weight is a highly personal matter, and many of us have no idea how low we should go.

So what is it that makes a weight perfect? Is it the image in your mind or do you have solid facts for determining your magic number? Those are but a few of the questions to consider when dropping pounds, but truth be known, there�s only one true answer: Weight doesn�t matter!

Your body -- and its needs -- is unique and highly stylized. Simply grabbing a �perfect weight� out of thin air does not equate to a healthy body. After all, you may not be built like your best friend or the person on the magazine cover, so to pick their weight as your own could be hazardous.

Many of my clients insist that they want to weigh a certain number, and yet usually the chosen digits fail to take into consideration their muscle-to-fat ratio.

You may be surprised to learn that many people actually weigh more than we�d ever imagine for the simple reason that their bodies boast more muscle than fat. Others might have a layer of fat that obscures any muscle, and yet the scale still offers only a number -- a gauge, if you will -- but nothing that gives the true picture.

If you really want the perfect body, don�t think pounds � think measurements. The clothes you wear and the way they fit should determine where you need to lose fat, add muscle, or curb cookie cravings.

According to the World Health Organization, over one billion adults in this world are overweight (and 300 million of those are considered obese). Those are astonishing numbers. How do you get rid of fat? The race is on to burn calories and lose weight, but if we don�t understand where the added weight and calories come from, we might be burning muscle instead of fat.

Exercise for fat loss is different than exercise for weight loss. Losing fat is achieved by a hormonal response, or an after-burn effect, that continues working 24 to 48 hours beyond the actual workout.

The best method for fat loss, therefore, is intense resistance training and aerobic bursts followed by a period of rest. While traditional aerobic exercise performed over long periods of time burns fat, the hormonal effect produced reduces valuable muscle. Because muscle is a key component of one�s fat-burning metabolism, it�s best to perform activities that build muscle to enable the shedding of fat.

My Visibly Fit exercise program allows for the natural building of muscle. What�s more, they are exercises that can be done anywhere, anytime, because your body becomes the only gym you need.

Studies have shown that the fat-related hormones leptin and insulin positively affect people who workout at a high intensity for less time (e.g., 20 minutes) than those who workout for 40 minutes or longer at a steady pace. Studies prove that it is not the quantity of exercise that makes a difference in your overall health, but the quality.

Squeezing in a few Visibly Fit exercises throughout your day offers a short, intense form of exercise that allows optimal results.

Obviously, nutrition is a big part of the equation if you desire results. My advice is to eat 5-6 small meals daily. Stick with "living foods" such as fresh fruits and vegetables, lean protein, and whole grains. Remember, the goal is to look and feel good. With Visibly Fit as part of your daily regimen, you�ll be perfect in no time!

WENDIE PETT is a mother and fitness expert, the author of Every Woman�s Guide to Personal Power and co-author of The Miracle Seven. She�s a personal trainer/coach and conducts seminars to corporate groups to help teach others how to maximize their wellness through the balance of mind, body, and spirit. For more information on Wendie visit www.wendiepett.com.

Buying & Preparing Lamb: The Basics

2009-03-12T08:23:00.004-07:00

The family is coming over for a festive spring dinner but you don�t want to serve yet another casserole� so how about lamb? It seems so elegant, but it really is easy, especially if you are armed with the basics.

What To Look For When Purchasing Lamb

Lamb is widely available in grocery stores and gourmet food retailers across the country. When shopping, look for American lamb as it typically yields more meat on the bone than imported lamb.

Also, most American lamb is fed mixed grains and grasses giving the meat a milder flavor than its European counterparts. When shopping for a cut, look for meat that has a soft pink to red coloring with white marbling.

How to Store/Freeze Lamb
Fresh lamb should be stored in the refrigerator or freezer immediately after purchasing. Refrigerate fresh lamb at 40 degrees or below. Ground lamb or stew meat should be used within 2 days. Lamb chops and roasts should be used within 3-5 days.

If you plan to freeze lamb for long periods of time, be sure to wrap the original packaging with airtight freezer wrap or place in an airtight freezer bag to prevent freezer burn. To maintain optimum quality, frozen lamb should be used within 3-4 months.

How to Thaw Frozen Lamb
In the refrigerator: once frozen lamb has thawed in the refrigerator, lamb roasts and chops should be used within 3-5 days and ground lamb or stew meat should be used within 1-2 days.

In cold water: leave frozen lamb in its packaging, making sure it is air tight. If not, transfer it to a leak-proof bag. Keep the lamb submerged in cold water, changing the water every 30 minutes to continue thawing. Cook lamb immediately after thawing. It should not be re-frozen unless cooked first.

In the microwave: as with the cold water method, when frozen lamb is thawed in the microwave, it must be cooked immediately. It should not be re-frozen unless cooked first.

Cooking Lamb
For those that don't have a lot of experience cooking with lamb, determining when it is done is the biggest challenge. An overcooked rack of lamb is an expensive mistake and carving into an undercooked roast can be an embarrassment at a dinner party.

Don't rely on guesswork. A good meat thermometer will provide reliable results. DO NOT cut into a roast or chop to check doneness. Use an instant read thermometer to give you a quick, accurate reading.

Lamb, like any cut of meat, always benefits from rest before serving. The rest allows the meat's juices to settle. Give thin cuts like chops 5 minutes before serving and allow 20 minutes before carving roasts.

Keep in mind, as the meat rests, its internal temperature typically rises 5-10 degrees. Remove lamb from cooking heat when the thermometer reads 5-10 degrees less than your desired temperature.

To ensure lamb remains safe throughout cooking, the USDA makes recommendations for safe cooking temperatures.

Grilled American Lamb Loin Chop with Tomatillo Chutney
For four people

8 6-oz. loin chops
1/4 cup olive oil/canola oil blend
coarse salt and cracked pepper

for chutney
12 tomatillos husks removed and quartered
1 medium white onion fine dice
1 serrano chile minced
1 tablespoon of roasted garlic chopped
1 tablespoon sugar
1 tblespoon olive oil
1/4 cup chopped cilantro or mint if you prefer mint essence

for the chops
Bring chops to room temperature before starting.

Heat grill to at least 400 and no hotter than 800 degrees.

Brush room temperature chops with olive oil and season liberally with salt and pepper.

Place on the hottest part of the grill for 45 seconds to 1 minute and then quarter-turn and cook another 45 seconds to one minute.

Then flip and cook for 45 second to 1 minute and quarter-turn and cook again.

Remove chops from grill and let rest for at least 10 minutes.

Place back on the grill on the warm part of your grill and close lid or place on top rack and close lid.

Remove chops from the grill when they are hot. This produces medium rare. If you prefer a more well done chop just leave on the rack until desired doneness.

For the chutney
Heat olive oil on medium high heat in a cast iron skillet.

When the oil begins to smoke, add every ingredient except sugar and the herbs.

Saute while stirring frequently until vegetables are soft.

Add sugar and herbs and continue to cook until all the sugar is dissolved.

Season with salt and pepper.

Serve the lamb chops warm with warm chutney on top.

Do Men Really Want Thin Women

2009-03-12T08:23:00.003-07:00

Do most guys want thin women? They make fun of overweight women, and drool over emaciated actresses, so what kind of a chance do mere mortals have?

Well, thin may be in (at the moment), but I believe there may be a difference between what looks good and what feels good to men.

Let�s face it, very few of us in the real world resemble television or movie stars, but men still want to get some lovin'... if ya know what I mean.

Many people are turned off by extremes: extremely heavy, extremely thin, or extremely tall and extremely short. This seems to be human nature, but nature is often self-correcting. For instance, a very short guy may find a very short woman attractive, so who cares what the masses think?

There is certainly a culture of men who believe large is lovely, and feel secure wrapped in the physical and psychological comfort of a large body. Latino and black men seem to lust after ultra curvy (dare we say meaty) mates. Certainly there are women who feel safe in the arms of big men.

Many men may admire models, but may not like to squeeze a bag o� bones. In fact, many men would probably be happy to accept a few extra pounds on their women if they just stopped complaining about their weight, or talking about what they ate, wanted to eat, will eat or shouldn�t have eaten! I think they�ve heard enough about your huge thighs and fat butt!

Confidence, kindness and sensuality create more attraction than a particular body weight. Good sexual techniques make men forget about your cellulite! Initial appearances wear thin rather quickly. Who cares how much you weigh if you're annoying to be with, because deprivation makes you cranky?

A fit body works best, and healthy living produces a vehicle with which to enjoy all the wonders of life. Too many people don�t realize that healthy bodies come in all sizes, and that can feel good to you as well as him.

Successful Weight Loss: The Missing Piece

2009-03-12T08:21:00.001-07:00

So you want to lose weight? And you have tried many diets: Caloric restriction, carbohydrate cutting, low fat, high fat, low protein, high protein... and on and on.

None of the popular current diets are superior to another.

According to the New England Journal of Medicine, by the end of a two-year period the same amount of weight was lost and maintained regardless of the particular diet followed and the best recipe for success takes into account an individual�s personal and cultural preferences.

So if there is no magic diet, then how does a person secure a positive outcome once the decision has been made to lose that excess weight?

Certainly healthy food choices in the correct portions for your ideal size and weight combined with physical exercise is ideal, but it is well known that this is often challenging to implement and sustain.

It is likely the behavior that caused the current overweight has been gradually repeated over time to become a deeply ingrained habit reinforced by classical and operant conditioning and unconscious forces at play.

Have you tried using the power of sound to effect the desired change in your life?

It is well known that controlled, deep breathing, progressive relaxation, affirmations and visualization have positive physiological and psychological effects, and the combination of these elements serve to help in the manifestation of desires and achievement of weight loss goals when combined with right action.

Listening to the combination of specifically engineered sound consisting of:

1. carefully chosen words and affirmations spoken with caring and focused intention

2. soothing original musical tones and sounds from nature

3. binaural audio synergistically blended provides you, the listener with an effective and readily available tool to enhance your desired behavior

A Sight for Healthy Eyes

2009-03-12T08:18:00.003-07:00

Did you know that the eye has its own special defense system? It's true. But you've got to feed it this: salad.

Research suggests that people age 65 or older could preserve the health of their retinas by getting lots of vitamin C, zeaxanthin, and alpha-tocopherol (a form of vitamin E). Luckily, a veggie-rich salad bar can load you up on all three.

The Antioxidant Ante
A study of older people revealed that low levels of key antioxidants were associated with higher rates of a certain kind of macular degeneration, a sight-robbing disease. To up your intake of sight-saving veggies, try these recipes:

* Make this recipe with orange bell peppers, an excellent source of zeaxanthin: Bruschetta with Roasted Peppers and Mozzarella.
* Get a dose of alpha-tocopherol with the almonds in this salad (bonus: the spinach is rich in zeaxanthin): Warm Spinach Salad with Chicken, Apples, and Toasted Almonds.
* Dose yourself up with vitamin C using this recipe: Chicken, Charred Tomato and Broccoli Salad.

More Ways to Watch Out for Eyes
Hats and sunglasses can help guard your eyes. Keep your eyes looking -- and feeling -- fine with these tips, too:

* Parched peepers? 5 ways to fight dry, irritated eyes.
* Tired eyes? Give your eyes this do-it-yourself spa treatment.
* Blurry vision? Here's what is a normal part of aging, and what is not.

Abnormal Heart Rhythm Boosts Death Risk for Diabetics

2009-03-12T08:16:00.005-07:00

Researchers found that participants who had atrial fibrillation (AF) at the start of the study were 61 percent more likely to die from any cause, 77 percent more likely to die from cardiovascular causes such as a heart attack or stroke, and 68 percent more likely to develop heart failure or other problems such as stroke.

But the study also found that the risk of developing complications or dying was lower if doctors gave more aggressive treatments to diabetic patients with AF. In this study, treatment involved a combination of the blood pressure lowering drugs perindopril and indapamide.

"Active treatment produced similar relative benefits to patients with and without AF. However, because of their higher risk at the start of the study, the absolute benefit associated with active treatment was greater in patients with AF than without. We estimate that five years of active treatment would prevent one death among every 42 patients with AF and one death among 120 patients without AF," noted study leader Professor Anushka Patel, director of the Cardiovascular Division at The George Institute for International Health at the University of Sydney in Australia.

The researchers also found that the association between AF and deaths from cardiovascular disease was much stronger in women than in men. Women with AF were twice as likely to die as women without AF, while men with AF were 50 percent more likely to die than men without AF.

The findings were published March 12 in the European Heart Journal.

"This study informs clinicians that AF is a marker of greater risk of cardiovascular events and mortality among diabetics, both men and women. Such patients should have their cardiovascular risk factors, such as blood pressure and cholesterol, controlled more aggressively," Patel advised.

"This is a separate issue from rate and rhythm control [or the use of anticoagulants to prevent thromboembolic events], which is the usual therapeutic focus in patients with AF. These issues are important, but we believe our data suggest that heightened awareness and management of overall cardiovascular risk is also important."

Exercise for Bone Health

2009-03-12T08:16:00.003-07:00

Besides recommending that you get enough bone-building vitamin D and calcium in your diet, the American Academy of Orthopaedic Surgeons offers these exercise recommendations:

* Walking and jogging.
* Hiking.
* Cross-country skiing.
* Stair-climbing machines, or climbing stationary stairs.
* Dancing and jumping rope.
* Sports such as soccer, volleyball, basketball, field hockey and softball.

Prevent Bleeding Gums

2009-03-12T08:16:00.001-07:00

The U.S. National Library of Medicine offers these suggestions to help keep gums healthy:

* Don't smoke or use other forms of tobacco.
* Take vitamin supplements, as recommended by your doctor.
* Don't take aspirin, unless your doctor advises otherwise.
* If medication is causing your gums to bleed, ask your doctor about possible alternatives.
* Massage your gums gently with an oral irrigation tool. Set the device on low.
* Make sure dentures fit properly, and talk to your dentist if they cause bleeding or soreness.
* If your gums do bleed, wet a gauze pad with ice water and hold it to the affected area.

New debate on how to decide best health treatments

2009-03-12T08:15:00.001-07:00

So some prominent health industry and patient advocacy groups are trying to reframe the debate over how such decisions are made in order to ensure their interests are protected.

Spurred by $1.1 billion in the recent economic stimulus bill for "comparative effectiveness research," their coalition was unveiling a new campaign Thursday with a prominent Democrat and disability rights advocate, former California Rep. Tony Coelho, as its spokesman.

Coelho, who suffers from epilepsy and was a key sponsor of the Americans With Disabilities Act, said the issue comes down to whether disabled people and other patients would get the medical care they need.

"On this issue we need to be at the table," Coelho said in an interview with The Associated Press prior to Thursday's announcement of his new role. "Comparative analysis is wonderful, if it's done appropriately."

Coelho's concerns about what could happen if it's not done right line up with those articulated most loudly until now by Republicans and conservative commentators — that "comparative effectiveness" could morph into "cost effectiveness," with bean-counting government bureaucrats refusing treatments to patients who need them.

It's a big concern for drug and biotech companies too since they could lose out if a treatment they've developed is found to be less effective than a competitor's. But a drug company's bottom line isn't likely to draw as much public sympathy as a disabled person's needs.

That makes Coelho a good face for the Partnership to Improve Patient Care, which formed as the issue began to surface last fall and is funded by groups including the Easter Seals, Friends of Cancer Research, the Alliance for Aging Research, the Advanced Medical Technology Association and the powerful pharmaceutical and biotech industry lobbies.

Obama administration officials have sought to quell concerns over comparative effectiveness research, insisting their goal is simply to make health care more effective and efficient.

Obama's budget director, Peter Orszag, told a Senate committee this week that the research would "help patients and providers get the information they need for the highest quality care."

"The information from this research should help improve the performance of the U.S. health care system," Orszag said.

But controversy was stoked when language accompanying a House version of the bill suggested the result of comparative effectiveness research would be that less effective and in some cases more expensive procedures "will no longer be prescribed."

The final bill used different language, specifying there was no intention to "mandate coverage, reimbursement or other policies for any public or private payer."

Minority and women's groups have concerns about comparative effectiveness research too, saying they can be underrepresented in studies of medical procedures. The Partnership to Improve Patient Care counts a handful of such groups as member organizations, including the Society for Women's Health Research and MANA, a Hispanic women's advocacy group, though they don't provide funding for the group.

Migraines in Pregnancy Boost Vascular Risks

2009-03-11T06:34:00.001-07:00

Women who have migraines during pregnancy are 15 times more likely than other women to suffer a stroke, twice as likely to have heart disease and three times more likely to have blood clots and other vascular problems during pregnancy, says a U.S. study.

"Good prenatal care is essential. Women with persistent and severe migraine during pregnancy should be aware of their risk factors, such as high blood pressure, high cholesterol, diabetes, history of blood clots, heart disease and prior stroke," the study's lead investigator, Dr. Cheryl Bushnell, a neurologist at Wake Forest Baptist Medical Center, said in a Wake Forest news release. "There also seems to be a relationship between migraines and preeclampsia, one of the most common and dangerous complications of pregnancy."

The researchers also found that women 35 years and older were more likely to have migraines during pregnancy. Women age 40 and older were 2.4 times more likely to have migraines than women younger than 20, and white women were more likely to have them than women of any other race or ethnicity.

"Migraines, particularly those associated with an aura or visual changes around the time of the headache, have been previously linked to stroke and heart disease in women," Bushnell said. "This study further validates the association between the two."

For the study, she and her colleagues analyzed data from 33,956 pregnant women diagnosed with migraine. The findings were published in this week's issue of BMJ.

As many as 26 percent of women of childbearing age experience migraines.

"While some women experience relief from migraine headaches while pregnant, others have migraines that are more frequent and severe," Bushnell said. "The reasons these severe migraines are associated with stroke and vascular disease is not clear, but it may be that some women do not compensate as well for the increased vascular stresses of pregnancy, such as increased blood volume, stroke volume and heart rate."

"Regardless of the cause," she added, "active migraine during pregnancy should be viewed as a potential marker of vascular disease."

Obesity, Diabetes and Heart Disease May Speed Dementia

2009-03-11T06:29:00.003-07:00

One expert thinks these papers, published in the March issue of Neurology, deliver a key message, namely that people can take steps to reduce their risk of developing dementia and Alzheimer's disease. People think about lifestyle factors in preventing heart disease, he says, but not always when it comes to losing mental abilities.

"This is an important message," said Dr. Ronald C. Petersen, chairman of the Medical and Scientific Advisory Council of the Alzheimer's Association and director of the Alzheimer's Disease Research Center at the Mayo Clinic. "Development of cognitive decline need not be a passive process."

"We are not all just sitting here and aging, and sooner or later it's going to hit us," said Petersen, who was not involved in the studies. "In fact, there may be some modifiable lifestyle factors that may influence our risk of developing cognitive impairment and Alzheimer's disease down the road."

In one report, Dr. Kristine Yaffe, a professor at the University of California, San Francisco, and director of the Memory Disorders Clinic at the San Francisco Veterans Affairs Medical Center, found that among older women, obesity, high blood pressure and a low level of HDL, the "good" cholesterol -- collectively labeled metabolic syndrome -- were each associated with a 23 percent increase in risk for cognitive impairment.

Yaffe's research team collected data on 4,895 women who averaged 66 years old and who had no cognitive impairment at the start of the study. Among the 497 women with metabolic syndrome, about 7 percent developed cognitive impairment, compared with 4 percent of the women without the condition.

"As the obesity and sedentary lifestyle epidemic escalates throughout the world, identification of the role of these modifiable behaviors in increasing risk for development of deleterious outcomes, such as cognitive impairment, is critical," the authors concluded.

In a second study, Yaffe's group found a cognitive risk for obese men, too. For that study, the researchers collected data on 3,054 older men and women.

Comparing people's scores on tests given at the beginning of the study and again three, five and eight years later, the researchers discovered that obese men were more likely to show signs of cognitive decline. However, there was no correlation between obesity and cognitive decline among women, the study reported.

A third report found a different trend. In that study, Annette L. Fitzpatrick, a research associate professor of epidemiology at the University of Washington, in Seattle, and colleagues found that obesity in middle age increased the risk for dementia. However, after age 65, underweight people rather than obese people were at higher risk for dementia.

In fact, obesity appeared to have a protective effect, the researchers noted.

They had collected data on 2,798 men and women who averaged 75 years old and who did not have dementia at the start of the study. During more than five years of follow-up, 480 people developed dementia; in 245 people, it was determined to be Alzheimer's disease.

"The greatest dementia risk was found in underweight individuals at older ages," the researchers concluded. "These findings suggest the predictive ability of BMI [body-mass index] changes across time." They added that the findings "help explain the 'obesity paradox' as differences in dementia risk across time are consistent with physical changes in the trajectory toward disability."

In the fourth report, Elizabeth P. Helzner and colleagues from Columbia University Medical Center in New York City collected data on 156 people diagnosed with Alzheimer's disease at an average age of 83.

They found that people with higher total and LDL, or "bad," cholesterol levels and diabetes had a more rapid cognitive decline after developing Alzheimer's disease.

The study "provides further evidence for the role of vascular risk factors in the course of Alzheimer's disease," the researchers concluded. "Prevention or treatment of these conditions can potentially slow the course of Alzheimer's disease."

More and more data are showing the connection between lifestyle and cognitive decline, Petersen stressed. "This series of articles underlines that," he said.

And people need to improve these lifestyle factors in middle age, he said.

"People should start paying attention now, regardless of your age or stage in life," he said. "It may be when you are in midlife, when you are in your 40s or 50s, what you do then with respect to your lifestyle -- your diet, your weight, your activity level -- may have a bigger impact on what's going to happen to you at age 70 and beyond than if you wait until you start getting a little forgetful or a little bit fuzzy."

Health Tip: Help Keep Anxiety Under Control

2009-03-11T06:27:00.001-07:00

The U.S. National Library of Medicine offers these suggestions to help control anxiety and stay calmer:

* Try to figure out what's causing your anxiety.
* Create a diary or journal detailing your anxious thoughts, and what you think triggers them.
* Talk to a friend, therapist or family member about what's concerning you.
* Get plenty of sleep and frequent exercise.
* Stick to a healthy diet, avoiding caffeine, alcohol, nicotine and illicit drugs.
* Make time for fun.
* Try relaxation techniques.

Antidepressant Use Tied to Cardiac Death in Women

2009-03-11T06:26:00.003-07:00

The finding doesn't necessarily mean that antidepressant drugs are dangerous, the researchers said.

"We suspect that their use is a marker for people with worse depression," explained study lead author Dr. William Whang, an assistant professor of clinical medicine at Columbia University Medical Center in New York City. "The elevated risk seems more specific for antidepressant use, but that use may well be a marker of more severe symptoms."

The link between depression and heart trouble is more likely physical than psychological, Whang added. "We found that women who had worse depressive symptoms had higher rates of risk factors such as hypertension, diabetes and smoking," he said.

Women with clinical depression were more than twice as likely to experience sudden cardiac death, the report said.

The findings were published in the March 17 issue of the Journal of the American College of Cardiology.

The researchers relied on data on more than 63,000 American women in the Nurses Health Study. And while the research team did find a link between depression and heart risk, the incidence of sudden cardiac death was associated more strongly with the use of antidepressant drugs than with symptoms of depression.

Antidepressant drug use was not associated with a higher risk of heart attacks or overall fatal heart disease, just with sudden cardiac death, the study found.

Previous studies have shown a link between depression and higher mortality for people who already had heart disease, Whang said. "But this was a group of women without heart disease, and that makes it different," he noted.

The results do not necessarily apply to men because only women were in the study, Whang said. "It's hard to make more generalized conclusions," he said.

But for doctors seeing women with depression, there is a clear message, Whang said.

"The biggest clinical implication is that management of coronary heart disease risk factors may be especially important for those with depressive symptoms," he said. "Taking care of those risk factors can modify the risk for coronary disease."

Dr. Sanjiv M. Narayan, an associate professor of medicine at the University of California, San Diego, School of Medicine and co-author of an accompanying editorial, said in a statement that the "data indicate the link between depression and serious heart rhythm problems may be more complex than previously thought."

His editorial called the relationship between antidepressant use and sudden cardiac death "surprising" and added it "merits scrutiny."

But it is possible that "antidepressant use merely indicates that depression is of sufficient severity to merit treatment," the editorial said. One recent study of people with heart failure found that depression was associated with increased mortality but that use of antidepressants was not.

Another report in the same issue of the journal said that feelings of anger and hostility are significantly associated with a higher risk of heart disease in healthy people and a poorer outcome in people with heart disease.

Anger and hostility predicted a 19 percent increased risk of such coronary heart disease events as heart attacks among healthy people, and a 24 percent increased risk among those with existing heart disease, said the report by researchers at University College, London.

The British study, which reviewed 42 studies, found the same relationship seen in the study of depression and heart disease: an increase in behavioral risk factors for coronary problems. A subset analysis found that the increased risk could be explained by such factors as smoking, physical activity and obesity, the report said.

Experts use nanotech to deliver anti-cancer genes

2009-03-11T06:25:00.001-07:00

The therapy has so far only been tried out on mice, but the aim is to test it in humans within two years.

If it works in people, it would provide a highly targeted mechanism for delivering cancer-fighting gene therapy.

Cancer Research UK's Andreas Schatzlein, based at the School of Pharmacy in London, said it was the first time that nanoparticles had been shown to target tumors in such a selective way.

Schatzlein and colleagues packaged anti-cancer genes in very small particles that are only taken up by cancer cells, leaving healthy cells unharmed. Once taken up, the genes force the cell to produce proteins that can kill the cancer.

The approach may be particularly useful for people with cancers that are inoperable because they are close to vital organs such as the brain or lungs.

"We hope this therapy will be used to treat cancer patients in clinical trials in a couple of years," Schatzlein said in a statement.

Results of his team's study were published online in the journal Cancer Research.

Gene therapy is viewed as promising area of research for treating cancer and other diseases, but getting genes to exactly the right place in the body is a major challenge.

(Reporting by Ben Hirschler, editing by Will Waterman)

Tests could find ovarian cancer early

2009-03-11T06:24:00.001-07:00

Scientists have long searched for a way to identify ovarian cancer early, which kills nearly 100,000 women worldwide every year. If it is found early, nearly 90 percent of women survive.

However, most women are currently only diagnosed with the disease after it has spread, when there is only a maximum 30 percent chance of survival.

In the British study, doctors enrolled approximately 200,000 post-menopausal women aged 50 to 74 across the United Kingdom from 2001 to 2005. About 100,000 of those women received no screening tests.

The remaining half were split into two groups. Roughly 50,000 were screened with a blood test. If the blood test results suggested an abnormality, they then had an ultrasound. The rest of the women, nearly 50,000, received an ultrasound only.

In the women who had a blood test first, researchers found 38 who had cancer. In those who only had an ultrasound, there were 32 cancer cases. Using the blood test method, ovarian cancer was picked up 89 percent of the time. With the ultrasound, the rate was about 75 percent.

In these preliminary results, doctors found nearly half of the cancers detected were at an early stage. Normally, doctors would only catch about 15 percent of early ovarian cancer patients.

The study was published online Wednesday in the medical journal, Lancet Oncology.

"I'm cautiously optimistic," said Robert Smith, director of cancer screening at the American Cancer Society. Smith was not connected to the study.

"This may make a difference to saving lives, but we don't know that right now," he said. Smith said the tumors detected in screening are sometimes not the ones that kill.

To know if catching ovarian cancer early saves lives, researchers must wait until the study finishes in 2014 to look at all the data. The study was mainly paid for by Britain's Medical Research Council, Cancer Research UK and the Department of Health.

"Picking up cancer early is a prerequisite to saving lives," said Ian Jacobs, one of the study's authors and dean of health sciences research and director of the Institute for Women's Health at University College London. "But the question is, is this early enough?"

Experts will also have to weigh the tests' benefits against its costs. "It's a big and expensive jump to decide that (national) screening programs might be beneficial," Smith said.

With any screening test, authorities must determine whether the tests save enough lives to merit the financial and other costs, like patients who will have unnecessary surgeries or psychological distress.

Several companies in the United States are seeking approval from the Food and Drug Administration to sell their tests.

Simple Checklist Makes Surgery Safer

2009-01-15T05:27:00.001-08:00

“Surgical complications are a considerable cause of death and disability around the world,” the researchers wrote in the online edition of The New England Journal of Medicine. “They are devastating to patients, costly to health care systems and often preventable.”

But a year after surgical teams at eight hospitals adopted a 19-item checklist, the average patient death rate fell more than 40 percent and the rate of complications fell by about a third, the researchers reported.

The senior author of the study, Dr. Atul A. Gawande of the Harvard School of Public Health, said it was hard to identify which items on the checklist had proved the most important.

But even a small change, like having surgical team members take a moment to say who they are and what they do before scalpel touches skin, can have important consequences later on should one of them develop a concern during the operation. Earlier studies have shown that communication problems are fairly common in operating rooms, with junior members of the team sometimes hesitant to speak up.

“Giving them a chance to say their names allows them to speak up later,” Dr. Gawande said.

Other items on the checklist are of more obvious importance, like a requirement that the nursing staff confirm that everything has been sterilized and that all equipment needed is present. Team members must also confirm that the patient has been given antibiotics ahead of the surgery, if called for, to reduce the chance of infection.

The checklist also requires team members to verify that there is enough blood on hand if there is a risk of blood loss, that a piece of equipment that measures blood oxygenation is working and that all the medical images needed are present.

Before the operation begins, the checklist calls for the team to confirm the identity of the patient and the nature of the procedure. Afterward, the doctors and nurses are supposed to review what has been done, including discussing any special steps that need to be taken to aid recovery and confirming no equipment has been left in the patient.

The researchers, working with the World Health Organization, conducted the study over a year at hospitals in the United States, Canada, England, Jordan, New Zealand, India, the Philippines and Tanzania. The lead author of the study was Dr. Alex B. Haynes of Harvard.

The researchers reviewed the outcome of 7,688 patients who were undergoing noncardiac surgery at the hospitals. About half the patients had surgery before the checklists were adopted, and half after. At the end of the study, the average death rate dropped to 0.8 percent from 1.5 percent, and the average complication rate fell to 7 percent from 11 percent.

Some of the hospitals in the study have already begun using the checklist regularly, the researchers said. The changes can be made quickly and at little cost, they said.

The improvements in outcome, the researchers said, most likely came about not because of any one or two items on the checklist but from a combination of factors. Beyond that, the changes in procedure may have brought about a broader change in behavior that improved safety. The fact that the surgical teams knew that they were being studied may also have kept them on their toes, the researchers said.

Meningitis Vaccine Seems to Work Like a Charm

2009-01-15T05:26:00.001-08:00

The declines have been seen not only in children given the vaccine but also in adults, suggesting a herd immunity effect, the researchers noted. To assess the effect of the vaccine, researchers from several universities analyzed surveillance data from 1998 to 2005 in eight states.

Overall, the number of cases of the disease dropped 30 percent in that time, but the effect on the very youngest and oldest was even more pronounced: Incidence decreased by 64 percent in those younger than 2 and by 54 percent in those older than 65.

"This vaccine has really had a very profound effect on the incidence of pneumococcal disease," said study co-author Dr. Nancy Bennett, a professor of medicine at the University of Rochester Medical Center, in New York. The report appears in the Jan. 15 issue of the New England Journal of Medicine.

The study goes beyond previous research in terms of looking at population groups as well as different forms of Streptococcus pneumoniae, which causes pneumococcal meningitis, an inflammation of the meninges, or membranes, surrounding the brain and spinal cord.

"This is a pretty comprehensive study looking at a number of different serotypes [groupings of bacteria within a family] and all age groups. It gets a nice survey of the population," said Jeffrey Cirillo, an associate professor of microbial and molecular pathogenesis at Texas A&M Health Science Center College of Medicine, in College Station. "It is only in eight states so it's not throughout the entire country, but it's probably the most comprehensive analysis, and no one else had looked at it over that long of a period."

The vaccine, known as Prevnar and made by Wyeth Pharmaceuticals, is part of the standard vaccination recommendation for children in the United States ages 2 to 23 months, as well as for children 24 to 59 months old who are at high risk for pneumococcal disease.

Since the vaccine came out in 2000, there have been a number of studies reporting on its effect on meningitis and blood infections.

"This is the first to focus specifically on meningitis," Bennett said.

There was a 73.3 percent decrease in the incidence of PCV7 serotype (bacteria types covered by the vaccine) in all age groups. Researchers also found declines in antibiotic-resistant serotypes not specifically targeted by the vaccine.

"There were small increases in the rates of meningitis caused by serotypes that are not included in the vaccine," Bennett noted. The study reported a 60.5 percent increase in cases of meningitis types not protected by the vaccine, but Bennett said that "even a 60 percent increase in something that doesn't happen much has a small effect overall."

The increases were "outweighed by the overall decrease in disease," she said.

However, she continued, "it is something that we need to closely observe and that will be addressed with vaccines that cover more serotypes."

Prevnar was developed by researchers at the University of Rochester, who sold the technology to Wyeth, according to a university spokesman. Several authors of the study, including Bennett, have received funding from Wyeth and other pharmaceutical companies.

Cirillo described the study results as "very promising."

"This is a pretty significant finding, especially the large impacts the vaccine has on serotypes it covers," he said. "And within the serotypes that were covered, the efficacy was up to about 90 percent," referring to certain groups that showed the incidence of pneumococcal meningitis decreasing by almost 93 percent. That's amazing."

Superbugs in decline despite doctors failing on hygiene

2009-01-15T05:25:00.003-08:00

RATES of the superbugs MRSA and Clostridium difficile are falling in Scotland – despite doctors still failing to comply with hand-hygiene rules, new reports revealed yesterday.
Figures showed that nurses were complying with hand-hygiene guidance, with a score of 95 per cent, against a target of 90 per cent. For doctors the figure was 84 per cent.

Other figures yesterday showed rates of superbugs were falling.

There were 149 cases of MRSA between July and September – the lowest since monitoring began in 2003. The figure was down from 185 the previous quarter and 210 in the same period in 2007.

Cases of C difficile also fell to 1,433 – down 17 per cent from the previous quarter, when there were 1,729 cases, and down 2 per cent from the same time last year.

Health secretary Nicola Sturgeon welcomed the falling number of cases.

C. difficile cases still falling

2009-01-15T05:24:00.000-08:00

Between July and September, there was a 19% drop in cases in the over 65s compared with the previous quarter - from 8,696 to 7,061 cases.

The Health Protection Agency said the figures showed the hard work of NHS staff was "paying off" but hospital infections remained a challenge.

NHS trusts have a target to cut C. difficile infections by 30% by 2010/11.

C. difficile is a bacterium found in the gut, and in healthy adults and children it rarely causes problems.

Healthcare-associated infections are a global problem and remain a challenge for all of us
Professor Mike Catchpole, Health Protection Agency

But people over the age of 65 years are more susceptible to contracting infection, particularly if they are on antibiotics which disrupt the "normal" bacteria in the gut.

Symptoms range from mild diarrhoea to severe inflammation of the bowel, which can occasionally be fatal.

The latest quarterly figures show that rates of the infection have fallen by 35% compared with the same period in 2007.

It follows an 18% drop between April and June.

Hard work

Professor Mike Catchpole, director of the Health Protection Agency's Centre for Infections, said: "NHS staff are working hard to fight healthcare associated infections, such as C. difficile, and their hard work is paying off.

"But winning against these infections will only happen if this hard work continues.

"Healthcare-associated infections are a global problem and remain a challenge for all of us."

He said some infections were hard to avoid as the use of antibiotics in patients who are very sick can leave them susceptible to C. difficile which would normally be kept at bay in healthy people.

"However, this shouldn't lead to complacency around tackling the infections that are preventable."

Ministers have set a target of a 30% reduction in C. difficile rates over the next three years.

Health Secretary Alan Johnson said the NHS was on track - but said that to meet the target a reduction of at least 30% against the average quarter in 2007/08 would have to be sustained for four consecutive quarters.

"This is very good news, and shows that the relentless focus on tackling infections has been working effectively.

"It isn't just about extra investment and tighter regulation - it's also about ensuring that everyone follows the hand-washing routine, the bare below the elbows dress code, the proper hygiene measures and responsible prescribing of antibiotics."

Maggie Kemmner, head of safety at the Healthcare Commission, added: "Constant vigilance is required to guard against rises in rates in the future."

Liberal Democrat health spokesman Norman Lamb said the figures would come as an "enormous relief" to patients.

Coffee linked to hallucinations

2009-01-15T05:23:00.000-08:00

People who consume coffee and other caffeinated products are more likely to have hallucinations, according to a study published today.

The more caffeine students had, the more likely they were to hear voices, smell things and see things that were not there, researchers at Durham University found. They suggested that increased levels of the hormone cortisol caused by caffeine could be behind the link.

Although caffeine found in coffee, tea and chocolate can cause heart palpitations, there is patchy evidence of a relationship to psychotic behaviour such as schizophrenia.

Academics at Durham wanted to check if caffeine made people more prone to hallucinations and feelings of persecution and whether those symptoms were most pronounced in stressed people.

They asked 219 non-smoking students to fill out questionnaires on their caffeine consumption, lifestyle and whether they hallucinated or felt persecuted. The answers ruled out a link with stress or feelings of persecution.

But as caffeine consumption increased, so did hallucinations. For instance, in the top 10 per cent of caffeine users averaging 330mg a day - seven cups of instant coffee or eight cups of tea - nine people had heard things when nobody was there. By contrast, among the 22 people in the bottom 10 per cent, only 3 people reported such hallucinations.

"The present study offers some support for our first hypothesis, namely that when levels of stress are accounted for, caffeine intake is positively related to levels of psychosis-like experiences," said the study.

However, its authors Dr Charles Fernyhough and Simon Jones, pointed out it was not clear if the caffeine had caused the hallucinations. It was possible that people with such psychological disturbances had been drinking coffee to help them cope, they noted in the journal Personality and Individual Differences.

They also acknowledged the non-clinical trial had relied on "retrospective self-report" by the students.

Nonetheless, changes in food and drink consumption, including caffeine intake, might help people cope with hallucinations or reduce their occurrence, the psychologists said, calling for more research.

Mr Jones, a PhD student at Durham’s Psychology Department, said: "This is a first step towards looking at the wider factors associated with hallucinations. Previous research has highlighted a number of important factors, such as childhood trauma, which may lead to clinically relevant hallucinations."

He added: "Hallucinations are not necessarily a sign of mental illness. Most people will have had brief experiences of hearing voices when there is no one there. Around three per cent of people regularly hear such voices."

Caffeine is found in varying levels in a number of drinks, foods and some medicines. A medium cup of tea has 40mg, an instant cup of coffee 45mg, a Starbucks espresso drink 188mg and a Red Bull 80mg.

In November the Food Standards Agency advised pregnant women to consume no more than 200mg caffeine a day from all sources to lower the risk of miscarriage.

The British Coffee Association, the trade body for coffee processors, erroneously asserted that the Durham University study had only involved high caffeine users.

"Whilst the results from this preliminary investigation are interesting, the study has only investigated a very high level of caffeine intake - equivalent to consuming more than six cups of coffee per day," said Dr Euan Paul, the BCA’s executive director.

"Importantly for this population, whilst cigarette smokers were excluded from the study, no details of other substances consumed that may have hallucinogenic effects were included in the data."

He said thousands of published studies had concluded moderate caffeine intake of 400 to 500mg a day was safe for the general population.

How Certain Vegetables Combat Cancer

2009-01-14T08:48:00.001-08:00

While it has been known for some time that eating cruciferous vegetables, such as broccoli, cauliflower, and cabbage, can help prevent breast cancer, the mechanism by which the active substances in these vegetables inhibit cell proliferation was unknown — until now.

Scientists in the UC Santa Barbara laboratories of Leslie Wilson, professor of biochemistry and pharmacology, and Mary Ann Jordan, adjunct professor in the Department of Molecular, Cellular, and Developmental Biology, have shown how the healing power of these vegetables works at the cellular level. Their research is published in this month's journal Carcinogenesis.

"Breast cancer, the second leading cause of cancer deaths in women, can be protected against by eating cruciferous vegetables such as cabbage and near relatives of cabbage such as broccoli and cauliflower," said first author Olga Azarenko, who is a graduate student at UCSB. "These vegetables contain compounds called isothiocyanates which we believe to be responsible for the cancer-preventive and anti-carcinogenic activities in these vegetables. Broccoli and broccoli sprouts have the highest amount of the isothiocyanates.

"Our paper focuses on the anti-cancer activity of one of these compounds, called sulforaphane, or SFN," Azarenko added. "It has already been shown to reduce the incidence and rate of chemically induced mammary tumors in animals. It inhibits the growth of cultured human breast cancer cells, leading to cell death."

Azarenko made the surprising discovery that SFN inhibits the proliferation of human tumor cells by a mechanism similar to the way that the anticancer drugs taxol and vincristine inhibit cell division during mitosis. Mitosis is the process in which the duplicated DNA in the form of chromosomes is accurately distributed to the two daughter cells when a cell divides.

Hundreds of tiny tube-like structures, called microtubules, make up the machinery that cells use to separate the chromosomes. SFN, like the more powerful anticancer agents, interferes with microtubule functioning during mitosis in a similar manner to the more powerful anticancer drugs. However SFN is much weaker than these other plant-based drugs, and thus much less toxic.

"SFN may be an effective cancer preventive agent because it inhibits the proliferation and kills precancerous cells," said Wilson. It is also possible that it could be used as an addition to taxol and other similar drugs to increase effective killing of tumor cells without increased toxicity.

Nutritious Fast-food Kids' Meals Are Scarce, Researchers Find

2009-01-14T08:46:00.004-08:00

Michigan State University’s Sharon Hoerr, a food science and human nutrition researcher with the Michigan Agricultural Experiment Station, teamed up with economist Sharon O’Donnell and pediatrician Jason Mendoza from Baylor College of Medicine in Houston to assess the nutritional status of kids’ meals in the Houston market.

The small percentage of meals that did meet dietary guidelines included fruit as a side dish and milk, and nearly all were deli-sandwich meals. They also had about one-third the fat, one-sixth the added sugars, twice the iron and three times the amount of vitamin A and calcium as did meals not meeting the criteria.

“This report is the first to characterize and compare the nutrient quality of all combinations of fast-food kids’ meals in a major metropolitan market,” Hoerr said. “Because 25 percent of children aged 4 to 8 years consume fast food on a typical day, the diet quality of kids’ meals offered by fast-food companies contributes significantly to their overall health and well-being.

“Two trends motivate the need for an evaluation of the nutrient quality of fast-food kids’ meals: the increased prevalence of childhood obesity and the amount of food consumed away from home.”

The team assessed the quality of kids’ meals in the fourth largest U.S. city by using nutrient values provided by the major fast food companies, the seven nutrient criteria from the National School Lunch Program (NSLP) and dietary guidelines for sodium, fiber, added sugar and trans fat.

“We chose Houston because its fast-food restaurants include 12 of the 13 national and regional fast-food companies, represented by 477 restaurants that sell kids meals,” O’Donnell said. “Virtually every meal combination is offered in this market, so it provides a pretty comprehensive snapshot of what’s out there.”

Of the meals that did not meet the NSLP guidelines, more than 65 percent exceeded guidelines for total fat, 75 percent were deficient in calcium, 82 percent were deficient in iron and 85 percent were deficient in vitamin A.

The choice of main entree by itself didn’t influence the nutrient content of typical meals studied, the group found, but side choices did. Raisins appeared to be the most nutritious fruit side, due to their high iron content.

“This suggests that parents should carefully read the nutrition information to determine what is included in these meals,” Hoerr said. “Sparing use of dipping sauces and other condiments will also help to keep sodium, added sugars and fat low.”

Although only a small percentage of the meals met NSLP guidelines, researchers believe fast-food kids’ meals can be designed to taste good and meet a basic level of nutrient quality.

“Fast-food companies are not required to produce meals that meet the nutrient protocol of the NSLP, so finding even a small percentage of meals that met the protocol is encouraging,” Mendoza said. “Further, 42 percent of all the meal combinations in the study met four or more of the criteria.”

Hoerr and her colleagues agree it is the responsibility of the restaurant industry to develop and market more nutritious kids’ meal options and for parents to choose healthy kids’ meals for their children.

“Through public policy efforts and purchasing choices, parents, physicians, consumer groups, policymakers and public health professionals can deliver a strong, united message to fast-food companies that kids’ meals are most desirable when they are nutritious as well as tasty,” Hoerr said.

New Anti-cancer Components Of Extra-virgin Olive Oil Revealed

2009-01-14T08:46:00.003-08:00

Javier Menendez from the Catalan Institute of Oncology and Antonio Segura-Carretero from the University of Granada in Spain led a team of researchers who set out to investigate which parts of olive oil were most active against cancer. Menendez said, “Our findings reveal for the first time that all the major complex phenols present in extra-virgin olive oil drastically suppress overexpression of the cancer gene HER2 in human breast cancer cells”.

Extra-virgin olive oil is the oil that results from pressing olives without the use of heat or chemical treatments. It contains phytochemicals that are otherwise lost in the refining process. Menendez and colleagues separated the oil into fractions and tested these against breast cancer cells in lab experiments. All the fractions containing the major extra-virgin phytochemical polyphenols (lignans and secoiridoids) were found to effectively inhibit HER2.

Although these findings provide new insights on the mechanisms by which good quality oil, i.e. polyphenol-rich extra-virgin olive oil, might contribute to a lowering of breast cancer risk in a HER2-dependent manner, extreme caution must be applied when applying the lab results to the human situation. As the authors point out, “The active phytochemicals (i.e. lignans and secoiridoids) exhibited tumoricidal effects against cultured breast cancer cells at concentrations that are unlikely to be achieved in real life by consuming olive oil”.

Nevertheless, and according to the authors, “These findings, together with the fact that that humans have safely been ingesting significant amounts of lignans and secoiridoids as long as they have been consuming olives and extra-virgin oil, strongly suggest that these polyphenols might provide an excellent and safe platform for the design of new anti breast-cancer drugs”.

High Caffeine Intake Linked To Hallucination Proneness

2009-01-14T08:44:00.001-08:00

People with a higher caffeine intake, from sources such as coffee, tea and caffeinated energy drinks, are more likely to report hallucinatory experiences such as hearing voices and seeing things that are not there, according to the Durham University study.

‘High caffeine users’ – those who consumed more than the equivalent of seven cups of instant coffee a day - were three times more likely to have heard a person’s voice when there was no one there compared with ‘low caffeine users’ who consumed less than the equivalent of one cup of instant coffee a day. With ninety per cent of North Americans consuming some of form caffeine every day, it is the world's most widely used drug.

The researchers say the findings will contribute to the beginnings of a better understanding of the effect of nutrition on hallucinations. Changes in food and drink consumption, including caffeine intake, could place people in a better position to cope with hallucinations or possibly impact on how frequently they occur, say the scientists.

In the study, funded by the Economic and Social Research Council and the Medical Research Council, 200 students were asked about their typical intake of caffeine containing products, such as coffee, tea and energy drinks as well as chocolate bars and caffeine tablets. Their proneness to hallucinatory experiences, and their stress levels, were also assessed. Seeing things that were not there, hearing voices, and sensing the presence of dead people were amongst the experiences reported by some of the participants.

The researchers, whose paper is published in the academic journal Personality and Individual Differences, say their finding could be down to the fact that caffeine has been found to exacerbate the physiological effects of stress. When under stress, the body releases a stress hormone called cortisol. More of this stress hormone is released in response to stress when people have recently had caffeine. It is this extra boost of cortisol which may link caffeine intake with an increased tendency to hallucinate, say the scientists.

Lead author, Simon Jones, a PhD student at Durham University’s Psychology Department, said: “This is a first step towards looking at the wider factors associated with hallucinations. Previous research has highlighted a number of important factors, such as childhood trauma, which may lead to clinically relevant hallucinations. Many such factors are thought to be linked to hallucinations in part because of their impact on the body’s reaction to stress. Given the link between food and mood, and particularly between caffeine and the body’s response to stress, it seems sensible to examine what a nutritional perspective may add.”

Co–author Dr Charles Fernyhough, also from Durham University’s Psychology Department, noted “Our study shows an association between caffeine intake and hallucination-proneness in students. However, one interpretation may be that those students who were more prone to hallucinations used caffeine to help cope with their experiences. More work is needed to establish whether caffeine consumption, and nutrition in general, has an impact on those kinds of hallucination that cause distress.”

Mr Jones added: “Hallucinations are not necessarily a sign of mental illness. Most people will have had brief experiences of hearing voices when there is no one there, and around three per cent of people regularly hear such voices. Many of these people cope well with this and live normal lives. There are, however, a number of organisations, such as the Hearing Voices Network, who can offer support and advice to those distressed by these experiences.”

Caffeine use can lead to a condition called caffeine intoxication. Symptoms include nervousness, irritability, anxiety, muscle twitching, insomnia, headaches, and heart palpitations. This is not commonly seen when daily caffeine intake is less than 250mg.

Got the flu? CDC says Tamiflu may not be much help

2009-01-13T12:24:00.000-08:00

The medical arsenal against the flu just got weaker. Government health officials said Friday that a leading flu medicine, Tamiflu, might not work against all cases of the flu this year. The most common flu bug right now is overwhelmingly resistant to Tamiflu, they said. The alert is "an early heads-up" for doctors. If current trends continue, they may need to change how they treat patients this flu season, said Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention.

Health officials say they aren't too worried, for several reasons. First, it's early in the flu season, and it's not clear this strain will dominate through the next several months. Second, not many people take antiviral medications for the flu.

Third, the flu vaccine — the primary weapon against flu — seems well matched against the circulating bugs.

But doctors need to take it seriously, said William Schaffner, a Vanderbilt University infectious diseases expert.

"Each influenza seasons provides a bit of a surprise and we got our (surprise) a little early this year," he added.

The flu causes 200,000 hospitalizations and 36,000 deaths annually, according to official estimates. The elderly, young children and people with chronic illnesses are considered at greatest risk.

For the public, the best course of action is vaccination, health officials said. Only about 30 percent of U.S. adults had gotten a flu vaccination this flu season, according to an online survey conducted by the RAND Corporation in November. A flu shot is recommended for those 50 and older, children from 6 months to 18 years, pregnant women, nursing home patients and those with certain medical conditions or who care for people with those conditions.

For people who get the flu, the two most commonly used antivirals are Tamiflu, a pill also known as oseltamivir, and Relenza, an inhaled drug also called zanamivir. The drugs are most effective if taken within two days of getting sick but most people don't see a doctor that quickly.

Early tests indicate that 49 of 50 samples of the main flu virus circulating this year — H1N1 — were resistant to Tamiflu. The samples came mainly from Hawaii, Texas and ten other states. Widespread flu has not yet been reported in most of the country.

"It could fizzle out," or H1N1 could become the dominant strain, Gerberding said.

A spokesman for Tamiflu's manufacturer — Roche, a Swiss company — said it's too early to draw strong conclusions about the drug's usefulness this flu season. The basis of the CDC's alert "is a small sample in a limited number of states, and Tamiflu is showing good activity against other circulating viruses," said spokesman Terry Hurley.

For those sick with the flu, doctors cannot simply choose Relenza instead of Tamiflu. That treatment is not approved for children younger than 7 or people who have asthma or certain other breathing problems. GlaxoSmithKline PLC, which makes Relenza, said Friday it has enough to meet the demands of the current flu season.

An option for some patients, Gerberding said, may be a combination of Tamiflu and rimantadine, another antiviral medication that works against H1N1 but lost effectiveness against another kind of flu virus.

However, it's not clear how well that combination will work, Schaffner said.

"This is a 'best advice with our back against the wall' kind of thing," he said.