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NEW YORK (Reuters Health) – Despite concerns by some that vaccines might cause a crippling nerve disorder called Guillain-Barré syndrome, a new study finds that people who receive vaccines after previously having been diagnosed with the condition do not experience any flare-ups.
“Vaccines are OK for people with Guillain-Barré syndrome,” said Dr. Roger Baxter, the lead author of the study and the co-director of the Kaiser Permanente Vaccine Study Center.
Guillain-Barré is a rare autoimmune disorder that can cause muscle weakness and paralysis.
While there is no cure, some treatments can help the symptoms.
About one to two out of every 100,000 people develop the syndrome every year.
The cause is unknown, but Baxter said there’s evidence that a number of cases were related to a shot against the swine flu outbreak that occurred during the 1970s.
“A relationship to a flu vaccine is possible,” Baxter said, though he added that studies on Guillain-Barré and other vaccines have not found a link.
“We don’t really think that other than the 1976 swine flu vaccine that there’s any connection between the two,” he told Reuters Health.
In fact, recent studies have found that the flu itself might be tied to the syndrome (see Reuters Health reports of June 24, 2011 and January 28, 2009).
CDC URGES CAUTION
The Centers for Disease Control and Prevention (CDC) caution against giving a flu shot to anyone with Guillain-Barré whose disease surfaced within six weeks of a previous immunization against the flu.
The recommendation is relevant to only a very small subset of people with Guillain-Barré, but Baxter’s concern is that some physicians expand it to include anyone with a history of the syndrome.
As part of a large study looking for any connection between Guillain-Barré and vaccines, Baxter and his colleagues collected medical records from 550 people with the syndrome.
All the patients had been treated at Kaiser Permanente of Northern California, and the researchers searched for any immunizations and Guillain-Barré recurrences over more than a decade.
Among this group, 279 had received at least one vaccine subsequent to their diagnosis, including 107 people who got a flu shot.
In total, the patients received nearly 1,000 vaccines, and none had a flare-up of Guillain-Barré in the two months following the shots.
Only one person had a flare-up within a year of a vaccine, and it occurred four months after receiving a combination shot for measles, mumps and rubella, according to findings published in Clinical Infectious Diseases.
There were 18 people who fell into the category targeted by the CDC’s recommendations against flu immunization — those who had originally developed the syndrome within six weeks of a flu shot — and two of them ended up receiving a flu shot later on with no record of the syndrome recurring.
Baxter — who along with one of his co-authors has received funding from several vaccine makers — said that even though his results show no relationship between flu shots and Guillain-Barré flare-ups, there are still too few cases to say definitively that there’s no risk.
“The problem with our study is that because there were so few of our Guillain-Barré syndrome patients who had Guillain-Barré syndrome that developed within six weeks of a flu shot, there wasn’t enough data to say you can vaccinate those who got it,” he said.
However, “for the vast majority of Guillain-Barré syndrome people, go ahead and get flu shots,” he said.
The study was funded through the CDC.
In an emailed statement from Dr. Claudia Vellozzi, the deputy director of the Immunization Safety Office at the CDC, she said, “this study adds evidence that (Guillain-Barré syndrome) recurrence after vaccination is quite rare. It provides reassurance for people with a history of (Guillain-Barré syndrome) who would like to receive vaccinations to prevent illness.”
SOURCE: http://bit.ly/zu4Vzt Clinical Infectious Diseases, online January 19, 2012.
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NEW YORK (Reuters Health) – Children born to a parent over age 35 are at greater risk for developing an autism spectrum disorder — but the risk is the same whether just one or both parents are older, according to a new study of Danish families.
“Parental age doesn’t appear to be synergistic. That is having an older mom and an older dad doesn’t increase risk more than having one or the other,” said Marissa King, a professor at the Yale School of Management, who was not involved in the study.
“The data clearly demonstrate that older parents are more likely to have kids with autism, but it doesn’t establish why that is the case,” King told Reuters Health in an email.
The findings throw a monkey wrench into the idea that perhaps older sperm or eggs have more mutations that could increase the odds of having a child develop autism.
Erik Thorlund Parner at the University of Aarhus School of Public Health in Denmark said that if genetic problems arising from older sperm or eggs explain the results, then having both an older sperm and an older egg together should total up to an even higher risk of autism for the child.
Yet Parner, who led the study, and his colleagues did not find a higher risk of autism among kids with two older parents compared with just one.
The researchers collected information on more than 9,500 children in Denmark who had been diagnosed with an autism spectrum disorder.
These disorders range from mild Asperger’s Syndrome to severe mental retardation and social disability.
In the new study, kids born to fathers in their late thirties had up to a 28 percent higher risk of being diagnosed with an autism spectrum disorder than kids born to dads under age 35. The increase in risk was not tied to the mother’s age.
For kids born to dads over age 40, the risk for developing an autism spectrum disorder was 37 to 55 percent greater than for kids of dads under age 35, and the mother’s age didn’t seem to matter.
According to the Centers for Disease Control and Prevention, about 10 in 1,100 children have an autism spectrum disorder. A 55-percent increase in risk, for instance, would push that number up to about 15 out of every 1,100 children.
Similar to the findings on dads, children whose moms had them in their late 30s were 21 to 37 percent more likely to develop autism than kids with moms under age 35, and the dad’s age did not change the numbers.
And just like with dads over age 40, kids born to moms over age 40 were 28 to 65 percent more likely to have autism than kids with moms under age 35, regardless of the age of their dad.
“The result was surprising in that there was no additive effect of maternal and paternal age,” Parner said in an email to Reuters Health.
“We do not really have a qualified guess on the explanation to the non-additive effect,” he said. “I don’t believe that one can yet say anything conclusive about whether (having an) older parent is biologically related to autism.”
Some earlier studies have also found that older parents are more likely to have a child with autism, but they have not had consistent results.
For example, one study found that having an older mother increases a child’s risk of autism, but having an older father only increases the risk if the mom is under the age of 30 (see Reuters Health report of February 8, 2010).
Parner said he and his colleagues are planning on an even larger analysis of autism and parental age using data from Denmark, Finland, Israel, Norway, Sweden and Western Australia.
SOURCE: http://bit.ly/wFRsAK Annals of Epidemiology, online January 24, 2012.
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NEW YORK (Reuters Health) – A low-key, long term approach to teen weight loss produced modest benefits in a clinical trial, Australian researchers report, though a version of the program that added texts and emails didn’t help kids slim down any further.
The study, by Binh Nguyen at the University of Sydney and colleagues, included 151 teenagers in a 24-month program called Loozit, based on group behavior-modification sessions for teens and their parents.
At the 12-month mark, 40 percent of the teens had reduced their body mass by at least five percent and a quarter had reduced by at least 10 percent, though most remained overweight.
Despite the small effect on weight, Elissa Jelalian of Brown University in Providence, Rhode Island, said the results are promising because the program was less intensive than other weight loss efforts, and yet had nearly the same impact.
“I think it’s certainly worthy of further investigation,” Jelalian, who was not involved in the new work, told Reuters Health.
During the first two months of Loozit, the kids, who were between 13 and 16 years old, participated in seven weekly group sessions that focused on healthy eating habits, increasing physical activity, decreasing time spent in front of a screen and improving self esteem.
They also spent some time exercising and preparing and tasting foods during the sessions.
Parents, too, attended weekly group sessions where lifestyle-modification was discussed.
For the next 22 months, teens and parents went to booster sessions every three months.
The study’s results, published in the Archives of Pediatrics & Adolescent, only include outcomes from the first 12 months of the program, which 124 kids completed.
Jelalian said other weight loss programs for kids have relied on group interventions, “which I think can be helpful. They try to mobilize other kids their age who are dealing with similar challenges and to create a peer group.”
The differences between Loozit and other programs is that the kids only go through 14 sessions over two years, compared to about 20 in other cases, and the discussions are held in community locations rather than in academic or hospital settings.
Most studies of teen weight-loss approaches have centered on more intensive and heavily monitored interventions, sometimes in in-patient settings, the researchers note.
The other thing Nguyen’s group did differently is that half of the kids also received text messages, emails and phone calls to follow up and coach them through the program.
“That’s the direction a lot of people are going. And it makes sense, teens are plugged in,” said Jelalian, who was not involved in this study. “Unfortunately, it didn’t look like that added anything to their findings.”
After the 12 months there were no differences in weight loss, cholesterol levels, mental health and behavioral measures between the two groups.
“It is possible that the (additional contact) provided was too mild and that participants could have benefited from more frequent, intensive contact,” Nguyen wrote in an email to Reuters Health.
She added that the results don’t prove that coaching through texts or emails is ineffective, and future research should look at whether more frequent contact could help make a difference.
There were positive differences between where the teens started out and where they ended up, the researchers point out.
The kids had lower cholesterol and triglyceride levels at the end of the year as well as higher scores on measures of self worth, academic and athletic abilities, and social acceptance.
On average, the kids actually gained weight — which isn’t necessarily surprising, given that they grew more than an inch during the study period.
To account for this, the researchers looked at changes in the kids’ body mass index (BMI), a measure of weight relative to height.
After adjusting for a child’s age and sex, the researchers found a slight drop in BMI after 12 months, indicating that the kids were shifting toward a more normal body size, although they were still overweight.
Jelalian said it’s important to try new approaches to getting overweight and obese kids to lose weight, because research has typically focused on adults or younger children.
“There are some developmental considerations for adolescents that are unique,” she said, such as the onset of puberty and a growing independence from parents.
“There are few other programs for this age group and that are sustainable in community-based settings,” Nguyen said. “We know of no others in Australia that have been tested in research studies.”
She said she would definitely recommend Loozit for overweight teens. And that her team is following up with a study on the results of the full 24 months of the trial.
So far, “These findings highlight the potential benefits of a low intensity weight management program targeted at adolescents that is sustainable in community settings,” Nguyen and her colleagues write in their report.
SOURCE: http://bit.ly/yuGsmr Archives of Pediatrics & Adolescent Medicine, February 2012.
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NEW YORK (Reuters Health) – People over 100 years old may say they feel “helpless” and “worthless” because they can’t do the things they used to, but that doesn’t mean they’re not in good spirits suggests a new study.
The researchers say their findings indicate that people around 100 years old may see life differently than people 20 or 40 years their junior and traditional tests for depression may not be effective in the extremely old.
“We’re saying look at more of the components that make up depression,” said Peter Martin, a gerontology researcher at Iowa State University and one of the study’s authors. “Some may be more relevant to centenarians than others.”
Martin and his fellow researchers examined existing information collected from 323 people living in Georgia between 1988 and 1997 who were over 60, 80 or 100 years old. Of these, 139 participants were over 100 years old, 93 were in their 80s and 91 were in their 60s.
Each of the study’s participants answered a survey known as the Geriatric Depression Scale, which asks 30 yes-or-no questions about whether the person was depressed in the past week. The more yeses, the more likely they’re depressed.
Overall, the100-year-olds scored higher for depression than the people in their 80s or 60s according to the survey’s summary score of all 30 questions.
The centenarians answered “yes” to about 13 questions on the survey while people in their 80s answered “yes” to about 12 and people in their 60s said “yes” to about 11 questions.
All of the 100-year-olds, however, said they were in “good spirits.”
Indeed, when the researchers looked at subsets of questions, they found the participants in their 60s and 80s said yes more often to statements like, “I feel downhearted,” “I am not satisfied with life,” “I am afraid of something bad,” and “I do not enjoy getting up in the morning.”
“If you look (just) at the summary score you might come to the wrong conclusion,” Martin told Reuters Health.
Even though the survey was developed for geriatric subjects, he says, some of the questions may yield misleading answers when it comes to the oldest old.
Some of the “yes” answers on the scale could be chalked up to the 100-year-olds’ advanced age — especially those relating to being less active, being unable to start new projects or saying they had lost interest or energy.
Other than physical impairments and limitations, Martin said, there are differences in other symptoms when you compare younger people to those who are over 100 years old.
“You know a centenarian is probably going to tell you, ‘I’m not going to live much longer,’” said Martin. But he added, while that statement may sound disturbing coming from a younger person, it’s reality for someone over 100 years old.
Instead, Martin said, a 100-year-old saying they feel sad or “blue” may be a better sign of depression.
“Depression varies in both its appearance and experience across the lifespan,” said Dr. Charles F. Reynolds III, the endowed professor in geriatric psychiatry at the University of Pittsburg Medical Center.
Reynolds, who was not involved with the new study, told Reuters Health that in diagnosing depression, it’s typical to combine the use of self reporting, like a survey, with an interview of the person, their family or someone involved with their care.
The researchers write in the Journal of the American Geriatrics Society that the study is limited because it focused on people still living in a community. So the results may not be applicable to someone living in a nursing home or other institution.
Martin told Reuters Health that treatment for depression in a very old person can include medication, but he said it could be as simple as allowing the person to contribute or be more engaged.
“Their life is not over yet. It’s the last chapter of the book, but sometimes the last chapter of the book has the most interesting stuff in it,” said Martin.
SOURCE: http://bit.ly/AfLdBd Journal of the American Geriatrics Society, online January 27, 2012.
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NEW YORK (Reuters Health)-overweight women with diabetes may be able to cut their risk of leak urine if they shed some pounds, a new study suggests.
Extra pounds, especially in the abdomen, be considered as a risk factor for urinary incontinence. And some studies have found that when overweight women even a modest amount of weight drop, they can curb their risk of incontinence.
Type 2 diabetes, which often goes hand in hand with obesity, it is also a risk factor for Urinary leakage, regardless of the weight. So weight loss could be especially useful for heavy women with diabetes–but studies had not looked at the question till now.
In the new study, the researchers found that overweight diabetic women who took diet and exercise changes lost an average of 17 pounds more than a year. And with the weight loss came a lower risk of developing incontinence.
More than a year developed 10,5% of women in the diet-and-exercise group new problems with urine leakage. That compared to 14% of the women who had not lifestyle changes.
“Overweight and obese women with type 2 diabetes should consider weight loss as a way to increase their risk of developing urinary incontinence,” said lead researcher Suzanne Phelan, California Polytechnic State University, Reuters Health by email.
And of course, she added, there are already known advantages of shedding those extra pounds–such as better diabetes control and a lower risk of cardiovascular disease.
The findings, reported in the Journal of Urology, are based on 2739 middle-aged and older women who were part of a larger diabetes study.
In the beginning, the women were randomly assigned to one of two groups. In one group were women encouraged to cut calories and exercise for three hours per week. The other group had three diabetes education sessions.
Overall, women in the lifestyle Group had a lower rate of urinary incontinence in the coming year. And it didn’t take a lot of weight loss start to make a difference, Phelan of team found.
A woman for every two pounds lost, the chances of developing incontinence baptized by three percent.
On the other hand, seems to help women who already had weight loss not urine leakage problems in the study of start.
“We are not sure why weight loss appeared to assess the impact of prevention, but not the resolution of urinary incontinence,” Phelan said.
It is possible, she said, that weight loss is more effective in preventing, instead of treating, urine leakage. Or can just there are too few women with existing to detect an effect of urinary incontinence, weight loss Phelan added.
It is also unclear how good are for the decline of incontinence risk–it could be related to exercise or the lowering of blood sugar levels, for example.
Urinary incontinence is very common among women–in large part because vaginal childbirth is a major risk factor.
A recent study by the U.S. adults found that approximately 53 percent of women older than 20 said they had problems with urine leakage in the past year. That was up from less than half of the women respondents some years earlier.
Researchers said that the increase was partly explained by rising prices of diabetes and obesity.
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WASHINGTON (Reuters) – Three U.S. consumer groups petitioned the Food and Drug Administration on Tuesday to subject a new genetically engineered salmon to a more rigorous review process than is now in place before the fish can be approved as safe to eat.
The fish at issue, AquaBounty Technologies’ AquAdvantage salmon, is currently classified as a new animal drug for the purposes of FDA review.
The FDA considers any genetically altered animal a new animal drug for approval purposes. The petition calls for the salmon to be classified as a food additive instead, which would require a more rigorous FDA review.
AquaBounty is seeking U.S. approval to market its engineered Atlantic salmon, which contains a gene from another fish species, the Chinook salmon, to help it grow twice as fast as normal.
The consumer groups’ petition says the way these salmon are created substantially alters their composition and nutritional value, and so they should be treated as a food additive. Under this standard, they said, the company’s data would have to overwhelmingly prove AquAdvantage salmon are safe to eat.
The consumer groups — Food & Water Watch, Consumers Union, and the Center for Food Safety — said in a statement the “new animal drug” designation is insufficient to protect public health. The review process for food additives offers greater protection, they said.
AquaBounty had no comment on the petition.
The FDA did not comment specifically on the petition, but confirmed that the company’s application for FDA approval for AquAdvantage salmon is under review, and that genetically engineered animals are evaluated under the new animal drug provisions of U.S. law.
AquaBounty has said in the past that it sees these genetically modified salmon as a potential solution to environmental concerns associated with salmon aquaculture, and discounted fears they might accidentally escape into the wild and affect other fish.
However, Food & Water Watch Executive Director Wenonah Hauter said the company’s own study showed that genetically engineered salmon may contain increased levels of a hormone linked to breast, colon, prostate and lung cancer.
The petitioners said a proper review would require genetically engineered salmon to go through comprehensive toxicological studies to ensure the fish are safe to consume and properly labeled.
If approved, AquAdvantage would be the first genetically altered animal for human consumption in the United States.
Genetically modified vegetables such as corn have long been on the U.S. market, and the FDA allows modified animals as pets or to help produce biologic medicines.
There is no timeline for an FDA decision. As a matter of policy, the FDA does not comment on citizen petitions.
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(Reuters) – After a lengthy debate, Walmart decided that eggs are indeed healthy.
Eggs are among the foods getting a new “Great For You” icon from the world’s largest retailer as it tries to convince shoppers that they can make healthy, low-cost choices when picking out food at its U.S. stores.
The icon comes just over a year after Walmart, the main U.S. arm of Wal-Mart Stores Inc, said that it would look for ways to improve the nutritional value of the food it sells and make healthier fare less expensive.
Walmart is the largest seller of food in the United States, and food accounts for more than half of the chain’s annual sales, so any changes it makes in its food aisles can have a ripple effect on chains such as Kroger Co, Supervalu Inc and Safeway Inc.
To earn Walmart’s stamp of approval, foods must meet specific thresholds. Fresh fruits and vegetables qualify, as do lean cuts of meat. Brown rice makes the cut, while white rice does not. Skim and 1 percent milk qualify, while 2 percent and whole milk do not.
“There are no candy bars,” said Andrea Thomas, the company’s senior vice president of sustainability.
The company spoke with food and nutrition experts, health organizations, government entities and others to decide on its criteria.
“We had a nice, long debate about eggs,” said Thomas.
While some people felt that eggs should not be on the list because of the cholesterol they contain, she said, others argued that they are a good, low-cost source of protein. After hearing the various reasons, Walmart decided that eggs made the cut.
The U.S. Food and Drug Administration has not yet introduced a standardized seal to show foods that meet certain health criteria.
“At the point in time that there is a standardized label that comes out from the FDA then we’ll be happy to make a switch,” said Thomas. “At this point we feel like our customers need help right now; we don’t know how long that’s going to take.”
At first, Walmart’s green and white “Great For You” icon will appear on signs for fresh fruits and vegetables and then pop up on packages of about 20 percent to 25 percent of the company’s Great Value brand food and on some of its Marketside items. Brand-name foods may also qualify for the seal.
Walmart’s efforts also include lowering the amount of sodium and added sugars in some of its food. The company said it cut 15 percent of the sodium in Great Value ketchup, an average of 15 percent of the sodium in Great Value canned vegetables such as corn, green beans and carrots, and more than 70 percent of the sodium in fresh steaks, roasts and certain other cuts of beef.
Walmart also said it reduced or eliminated the price difference between more than 350 “better-for-you” items such as low-sodium lunch meat and the equivalent regular product .
First lady Michelle Obama, who was with Walmart when it unveiled its plans in January 2011, said that the new seal gives parents information they need to make healthy choices, which is “a key piece of solving childhood obesity.”
Walmart, famous for its efforts to keep costs low, said it would not throw out old packaging in order to quickly bring out products with the icon. As it runs out of packaging, it will print new boxes and labels with the seal of approval.
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