A beloved pet’s death. The tremendous stress of a divorce. Life is sure to be full of emotional hurdles, and the children who can endure them in stride may have their mothers to thank. In a new study published in the journal Archives of Disease in Childhood, children who were breast-fed cope better with stressful situations than those who were bottle-fed. The calming effect of breast feeding appears to influence a child’s ability to cope with emotionally testing situations long after the children are weaned. “In children who are breast-fed, there is less of an association between parental divorce and separation and childhood anxiety,” explains Dr. Scott Montgomery, one of the researchers of the study and an epidemiologist at the Karolinska Insitute in Sweden.

Breast milk—full of nutrients, enzymes, and antibodies—has long been correlated with reduced infection rates, respiratory illnesses, and diarrhea in children who were breast-fed. It has even been shown to contribute to a higher IQ, reduce chances of obesity and decrease the risk of asthma. This was the first study to correlate a child’s anxiety level to whether they were breast-fed as infants.

Montgomery and his team compared the different anxiety levels of breast- and bottle-fed 10-year-olds in coping with the stresses of their parents’ relationships. Researchers looked at data from a 1970 British Cohort Study. There were 5,671 children who were formula fed in the study, and 3,287 who were fed breast milk. These children were monitored from birth, and researchers asked their teachers to rate their anxiety level on a scale of 0-50 (50 being extremely anxious) when the children hit the age of 10. Parents were also interviewed about major family disruption, including divorce or separation. Stressful marital problems in their parents caused a higher level of stress all around, but the breast-fed children’s anxiety was much less obvious.  Bottle-fed children were almost twice as likely to be highly anxious about parental divorce/separation.

What it Means: Researchers still don’t fully understand why breast-fed babies become less anxious children. They point to the possibility that physical contact between mother and child plays a part in reducing anxiety by increasing the quality of bonding between mother and baby. They also suggest that breast feeding itself may not help children cope better with life’s stressors, but might be a marker of some maternal or parental factor. Physiologically, the nutrients from breast feeding could also influence the development of neurological responses in the body that could help deal with stress. Breast feeding is a beneficial practice for all mothers, nonetheless, and is beneficial to a child’s short-term and long-term development.

From the Archive

July 28, 2006: Keeping Baby Allergy-Free
May 20, 2002: Of Brains and Breast Milk 

Blood clots can be deadly, and men who have already suffered one should take particular note. According to a new study in The Lancet, men have a 50% higher relative risk than women of suffering from recurrent blood clots after a first episode. Dr. Simon McRae from the Department of Hematology at Queen Elizabeth Hospital in Woodville, Australia, and his colleagues at McMaster University in Hamilton, Canada, discovered this finding by conducting a meta-analysis of studies of both men and women who were being treated for deep vein thrombosis—a condition where a blood clot forms within a deep vein, commonly in the thigh or the calf. They also studied men and women who were receiving treatment for pulmonary embolism—a clot that detaches from a deep vein and lodges in the lung. This can be fatal with the possibility of death within hours.

Observing patients that had stopped taking preventative anticoagulant (blood-thinning) medication, the researchers found that the 5416 patients (50% men and 50% women) showed distinctly different outcomes. There were 816 recurrent blood clots, but 523 of those cases (64%) were in men and 293 (36%) in women.

What it Means: If one could identify the risk factors for recurrent blood clots in individual patients, it would be easier to pinpoint who would benefit from long-term blood-thinning treatments. Although the studies suggest that men have a significantly higher risk than women, the cause of heightened risk is unclear. The authors state that it could be caused by differences in age, body mass index, or inherited susceptibility to blood clots. Further studies are needed before firm recommendations can be made to use a patient’s gender in deciding the duration of blood-thinning treatment.

From the Archive:

May 17, 2006: Fly Clot-Free
May 29, 2006: Danger in the Window Seat

A combination of estrogen and testosterone used to treat the symptoms of menopause can increase a woman’s risk of breast cancer, stroke and heart attack, according to a long-running study. The results of the study, published in the July 24 issue of Archives of Internal Medicine, show that older women who took estrogen and testosterone hormone supplements had more than double the risk of breast cancer than those who had never used hormones.

Taking into account other breast cancer risk factors—such as family history, weight and age at menopause—researchers tracked 70,000 nurses as a part of the Nurses’ Health Study, which began in 1976. They found that women who took estrogen and testosterone for menopausal symptoms had a 2.5 times higher risk of developing breast cancer than women who never took hormones. Women who used only estrogen had an increased risk of 15%.

The women took supplements to treat the symptoms of menopause, including decreased sex drive and mood swings. “This type of hormone therapy may help with mood, libido, and bone mineral density,” explains study co-author Rulla Tamimi of Harvard Medical School, “but the possible risk of breast cancer may outweigh these benefits.”

Most of the women used Estratest and Estratest H.S manufactured by Solvay Pharmaceuticals, the only combination of estrogen and testosterone sold in the U.S. The treatment has been on a Washington, D.C.-based advocacy group’s list of “Worst Pills” because of its purported link to breast cancer.

What it Means: In 1998, 550 women in the Nurses' Health Study were taking hormone combination, up from only 33 a decade earlier. Doctors say that's a worrisome trend. Before estrogen and testosterone is used for a short-term benefit, its long-term effects need to be better understood.“We strongly urge women not to use this product or similar products from compounding pharmacists,” said Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group, which released the “Worst Pills” list. A spokesman for Solvay said that the company has not yet had the opportunity to review the details of the study.

From the Archive:

May 22, 2006: Weight Gain and Breast Cancer
Apr. 24, 2006: Estrogen Again

If you take care of your teeth, you may be helping your heart. This is the conclusion reached by researchers in a new study published in the Journal of Periodontology. The presence of specific bacteria in periodontal pockets—the area of tissue surrounding teeth—might be an explanation for the relationship between periodontal disease and acute coronary syndrome (ACS). ACS is the umbrella term used to describe insufficient blood supply to the heart muscle that results in heart disease.

By comparing 161 subjects diagnosed with ACS to a control group of people without cardiovascular disease, the researchers found that the amount of oral bacteria twice as high  in the ACS group for the combination for the bacteria streptococci spp, P. gingivalis, T. forsythia and T. denticola. These findings suggest that this combination of bacteria is shared in occurrences of periodontitis and ACS.

“This might be one of several explanations as to why elevated bacteria and the combination of specific pathogens in periodontal pockets can be linked to a history of ACS,” explains researcher Stefan Renvert, DDS, PhD from the Department of Health Sciences in Kristianstad University. He observed that the amount of periodontal bacteria results in an inflammatory response that elevates the white blood cell count and increases high sensitivity C-reactive protein levels in the blood, a factor which has been linked in past studies to heart disease.

Alveolar bone loss—atrophy of the bones that support teeth—was also found to be significantly greater among subjects with ACS. The extent of bone loss was more severe in the ACS group than in the non-ACS group with 77%of the participants in the ACS group afflicted with periodontitis versus 42% in the control group.

What it Means: This study supports past findings linking periodontal bacteria to heart disease, but further research is needed to evaluate the effects of reducing specific bacteria in order to lower the risk of ACS. Another possible reason for the link between high oral bacteria count and ACS is the fact that bacteria flourish in individuals without adequate responses to inflammation. This may induce vascular effects that play a role in the onset of ACS. Regardless, researchers agree that the study highlights the importance of routine periodontal examinations and at-home dental care if you are concerned about the health of your heart.

From the Archive:

June 8, 2006: The Mystery of the Double Cardiac Arrest

June 12, 2006: Omm for the Heart

Eczema—the inflammation of skin that results in rashes or flaking—is a serious skin condition. But just how much of an impact does it have on the lives of its sufferers?  It turns out that, for children, it affects them as much as a major serious illness would. According to new research published in the British Journal of Dermatology, children with eczema feel that their quality of life is as impaired as those who have chronic illnesses such as epilepsy, renal diseases or diabetes.

A team of Scottish researchers surveyed 379 five to 16 year-olds who had been suffering from skin diseases like acne and eczema for more than six months. They asked the children and their parents how much the skin condition impaired quality of life when it came to factors such as pain, loss of sleep, dietary restrictions, interference with school and play, friendships, teasing, and medical treatment. The researchers then compared the answers with quality of life scores given by the parents of 162 children with chronic diseases in the same age group.

The researchers found that children with psoriasis (red scaly patches) and eczema—the two skin conditions that caused them the greatest distress—resulted in a 31% impairment in quality of life scores. This was followed by urticaria (itchy allergic skin rash) at 20%, and acne at 18% impairment. When compared to the overall results for chronic illnesses, the quality of life rates were very similar. Cerebral palsy had the worst affect on quality of life at 38%, and kidney disease followed with 33%.  While the biggest concern for children with eczema, psoriasis and uticaria was itching or pain, children rated bullying as the fourth greatest factor affecting their quality of life.

What it Means: “Although skin diseases may not shorten life in the same way as serious conditions like cystic fibrosis, they can cause children as much, if not more, distress in their everyday lives,” explains co-author of the study, Dr. Sue Lewis-Jones.  Skin diseases can have a lasting impact on children’s quality of life, and measuring the quality can be a useful insight onto the patient’s perspective.

From the Archive:

Mar. 6, 2006: A Superbug's Alarming Spread

Feb. 12, 2006: Thread of Hope

As humidity and temperatures climb this month, older people may have another concern to add to their lists besides staying comfortable. In a new study published by the medical journal Heart, high humidity—even in a relatively mild climate—boosts the risk of heart attack among the elderly.

Researchers have long known that rising temperatures are correlated with heat stroke and dehydration, but a group of investigators in Athens looked specifically at the temperature trends from daily weather reports and compared them with the incidence of heart attacks.

The scientists analyzed all reported deaths in Athens for the whole of 2001 and studied the data put out by the National Meteorological Society on temperature, pressure levels, and humidity for the same year. Temperatures in Athens for that year hit a sweltering peak of 102 degrees Fahrenheit (39 degrees Celsius), with an average of 93 degrees Fahrenheit (34 degrees Celsius). Maximum humidity levels reached 91%.

The researchers found 3,126 deaths from heart attack in 2001. They documented sharp seasonal variations in the timing of the deaths. For example, deaths rates among those who were 70 years old or more were 3.5 times higher in June than rates in other age groups. 

Interestingly, the average daily temperature for the preceding week influenced the daily death rate the most. But when it came to average monthly death rates from heart attack, average humidity in the month was the single most important factor.

What it Means: It pays to relax in the summer, especially as you get older. Even in a relatively mild Mediterranean climate, such as that enjoyed by Athens, changes in temperature and humidity appear to have a significant impact on the chances of dying from a heart attack. The study does not, however, explain how exactly humidity patterns work to physiologically affect the heart.

The report points out that there was another peak in seasonal death rates: December. For the 70-and-over age group, heart attack death rates were seven times higher in December than the rates in other age groups. Obviously, humidity is not the problem there. The authors suggest this might be the result of a “Merry Christmas Coronary,” caused by a combination of emotional stress and overindulgence in food and alcohol.

From the Archive:
07/28/2005 Seniors and Blood Pressure Meds
09/05/2005 How New Heart-Scanning Technology Could Save Your Life

Often the hardest part of quitting smoking is fighting the urge to start up again once you’ve stopped. Nearly 41% of smokers try to quit every year. Unfortunately, only 10% succeed in never lighting up again. Most of the rest find the cravings simply too strong to ignore.

The odds may now have improved, thanks to a new anti-smoking drug called varenicline.

In a head-to-head comparison with bupropion (an anti-depressant that also reduces cravings), varenicline was shown to be 30% more effective at helping smokers quit for the long haul, according to a study in the Journal of the American Medical Association.

Varenicline, which was approved under the name Chantix by the Food and Drug Administration in May, works by stimulating the release of the chemical dopamine in the brain. This reduces cravings while simultaneously blocking the reinforcing effects of nicotine. The result is a reduction in the pleasurable emotions often felt by smokers when they light up—thereby decreasing their risk of relapse.

In the JAMA study, researchers form Oregon Health Sciences University measured the success of varenicline compared to a long-acting version of bupropion and to a placebo (or dummy pill) in 1,025 otherwise healthy adult smokers. More than 40% of the participants on varenicline were no longer smoking by weeks 9 through 12 compared to 29.5% on bupropion and 17.7% on the placebo. By the end of the  two-year treatment, more than 2.5 times as many participants on varenicline were still not smoking as compared to those who took the placebo.

What it Means: Quitting is still tough but the health benefits are worth it and now smokers have another option to help them kick the habit.

From the Archive:
08/22/2005 Stolen Breath
06/20/2005 Behind the Tobacco Retreat

High blood pressure has long been linked to congestive heart failure (CHF)—that is, the heart’s failure to pump adequate amounts of blood--but the sort of blood pressure test you get at the doctor's office may not be enough to adequately gauge the risk. That's because, according to a new study published in the Journal of the American Medical Association, having a relatively high blood pressure level at night, when no doctor is around to measure it, may be an especially important risk factor.

In the first study of its kind, researchers in Sweden analyzed the blood pressure of 951 elderly men who were free of any signs of congestive heart failure between 1990 and 1995, and who weren't confined to the hospital, and monitored their blood pressure around the clock until the end of 2002. 

By the end of the study, researchers found that 70 men had developed heart failure, and that the onset of congestive heart failure correlated with a 9-mm Hg increase in nighttime diastolic blood pressure. Researchers also found that the presence of “non-dipping” blood pressure--blood pressure that remains at the same as daytime levels (you'd expect it to drop)—was associated with an increased risk of CHF.

What it means: Congestive heart failure is a deadly disease, with 1 in 3 diagnosed patients dying within one year. After five years, the chance of death increases to 2 in 3 patients--a death rate  exceeding that of most cancers. Given this new study, doctors may now consider finding ways to check their patients' blood pressure around the clock and to monitor its pattern of rise and fall.  Traditional office blood pressure measurements may not convey the risk in the ways that 24-hour blood pressure monitoring can.

From the Archives:
Jan 26, 2006: Hispanics and High Blood Pressure
Dec. 5, 2005: High Blood Pressure and Cognition

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