Sleeping Pills Linked to Higher Risk for Dementia

Alan Mozes wrote . . . . . . . . .

Seniors who frequently take sleeping medications may be raising their risk for developing Alzheimer’s disease, a new study warns.

Sleep medications are one of the most commonly used medications in older adults, the authors say, but their frequent use may not be without harm.

Researchers found that older white adults who said they “often” or “almost always” took sleep aids had a 79% higher chance of developing dementia compared to those who “never” or “rarely” used them.

The connection was only seen among white adults, not Black participants.

In addition, “further studies are needed to confirm whether sleep medications themselves are harmful for cognition in older adults or [if] frequent use of sleep medications is an indicator of something else that links to an increased dementia risk,” said study lead author Yue Leng.

In other words, the investigation “cannot prove causation,” stressed Leng, an assistant professor in the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco.

Percy Griffin, director of scientific engagement with the Alzheimer’s Association, seconded the thought.

“We do want to be careful,” said Griffin, who wasn’t part of the study. He noted that observational studies of this kind can only identify an association between a “modifiable risk factor” — like medication habits — and dementia risk. “They don’t prove cause and effect,” he said.

For the study, Leng and her team enlisted roughly 3,000 seniors to share their sleep medication routines starting in 1997.

Participants were between 70 and 79 years old, and none had dementia. All lived in Memphis or Pittsburgh. Nearly 6 in 10 were white and 4 in 10 were Black.

Three times over five years all were asked how often they took sleeping aids: never, rarely (once a month or less), sometimes (2 to 4 times a month), often (5 to 15 times a month), or almost always (16 to 30 times a month).

Participants also discussed the quality of their sleep, indicating how frequently they struggled with falling asleep and/or getting up too early in the morning. Routine sleep duration was also noted.

Sleep aids encompassed both over-the-counter and prescription medications. Common over-the-counter options included antihistamines, melatonin and valerian. Prescription meds included antidepressants, antipsychotics, benzodiazepines and so-called Z-drugs such as Ambien (zolpidem).

Overall, 7.7% of the white participants said they took some type of sleep medication often or almost always.

Yet 2.7% of Black participants reported a similar level of routine usage.

Among white and Black participants, frequent usage was highest among women, those struggling with depression and the more highly educated.

The team noted that benzodiazepine use for chronic insomnia — including Halcion (triazolam), Dalmane (flurazepam) and Restoril (temazepam) — was twice as high among white seniors compared with Black seniors. White participants were also seven times more likely to take a Z-drug like Ambien, and 10 times as likely to take the antidepressant trazodone (Desyrel and Oleptro).

After tracking participants for up to 15 years, the researchers found about one-fifth developed dementia.

While white seniors who used sleeping pills frequently faced a 79% higher risk for dementia, that was not the case among Black seniors — and not just because far fewer Black adults took sleeping aids frequently. Those who did use them often appeared to face no higher risk for developing dementia than those who rarely or never took a sleeping med.

Leng said the racial gap her team identified was “surprising to us,” particularly since prior research suggests that Black people generally face a higher risk for developing Alzheimer’s than their white peers.

“One possible explanation could be that Black adults who have access to sleep meds are a selected group of people with high socio-economic status,” which might afford them a mental health leg up that’s protective against dementia, Leng said.

Yet even among white seniors, Leng “wouldn’t say sleep meds ‘boost’ Alzheimer’s disease risk” based on the findings. And her team stressed that “it remains controversial whether sleep medications are good or bad for cognition in the long run.”

It could turn out that certain meds might contribute to dementia risk, while others don’t. Or that having sleep problems — the reason for using sleep meds — is a symptom of dementia onset, Leng suggested.

Both she and Griffin agreed additional research is needed.

“More work needs to be done,” said Griffin. “And we shouldn’t be sounding the alarm bells just quite yet.”

Meanwhile, he offered some cautionary advice: “In general, before anyone takes any sleep medication, or any medication for that matter, they should have a conversation with their doctor to see how it might interact with any other medication they might already be taking.” Their medical history and life story in general should also be considered, he added.

The study results appear online in the Journal of Alzheimer’s Disease.

Source: HealthDay






CDC Warns of Dangerous Infection Risk With EzriCare Eyedrops

Cara Murez wrote . . . . . . . . .

U.S. health officials are investigating whether a specific brand of over-the-counter eyedrops are behind one death and dozens of bacterial infections in several states.

The infections have not been traced to preservative-free EzriCare Artificial Tears, but a majority of people who became ill reported using the drops, the U.S. Centers for Disease Control and Prevention said in a statement.

The agency found the bacteria in bottles of the eyedrops, and it’s now testing to see if the strain found in the eyedrop bottles matches that found in patients.

CDC officials recommended that “patients immediately discontinue the use of EzriCare Artificial Tears until the epidemiological investigation and laboratory analyses are complete.”

At least 50 people in 11 states have been infected with the bacterium Pseudomonas aeruginosa, which is resistant to most antibiotics. One of those infected died after the bacterium entered the patient’s bloodstream.

“That’s what’s so concerning,” Dr. Jill Weatherhead, an assistant professor of tropical medicine and infectious diseases at the Baylor College of Medicine in Houston, told NBC News. “Our standard treatments are no longer available” to treat this infection.

In 11 cases, people developed eye infections. Three were blinded in one eye. Some of those infected had respiratory or urinary tract infections.

P. aeruginosa infections typically happen in hospital settings in people with weakened immune systems, though the bacteria can be found in water and soil. People can also carry it on their hands.

The eyedrops may have been contaminated during manufacturing or as a person with bacteria on their hands opened them. The drops being investigated do not contain preservatives to inhibit the growth of germs, NBC News reported.

Health officials have not said whether those infected had an underlying eye condition that would have made them more vulnerable to infections.

Cases were reported in California, Colorado, Connecticut, Florida, New Jersey, New Mexico, New York, Nevada, Texas, Utah and Washington.

EzriCare Artificial Tears have not been recalled at this time. They were sold on Amazon and at stores such as Walmart, NBC News reported.

Eye infection symptoms include pain and swelling. A person may experience redness, discharge, blurry vision, light sensitivity and the feeling of having a foreign object in the eye.

Source: HealthDay





U.S. Leads in Health Care Spending, But Is Last for Health Outcomes Among Rich Nations

Denise Mann wrote . . . . . . . . .

The United States spends up to four times more on health care than most wealthy nations, but it doesn’t have much to show for it.

Life expectancy in America continues to decline even though this country spends nearly 18% of its gross domestic product on health care, according to a new report from the nonprofit Commonwealth Fund.

“The U.S. stands out as the only nation in the Organization for Economic Co-operation and Development [OECD] without universal health coverage, our life expectancy is dropping, and we have higher rates of avoidable deaths than other nations,” said report author Munira Gunja. She is a senior researcher for the Commonwealth Fund’s International Program in Health Policy and Practice Innovation, in New York City.

Besides the lack of universal health care coverage, the United States has too few primary care providers and doesn’t spend enough on primary care, which makes it difficult for folks to get basic preventive health care and sets them up for chronic conditions, she added.

In the report, Gunja’s team compared health care spending and outcomes in the United States with those of 12 other high-income nations and the averages for 38 OECD member nations between January 2020 and December 2021.

What did the team find? The United States fell short on many measures.

Americans had the lowest life expectancy at 77, which is three years younger than the average among people in other wealthy nations.

Despite spending more on health care than other nations, the United States also continues to have the highest rates of preventable deaths from diabetes, high blood pressure-related diseases and certain cancers, and the highest rate of people living with multiple chronic conditions, the report found. The obesity rate in the United States is nearly double what is seen in other OECD nations.

What’s more, the United States also had the highest rate of death from COVID-19 compared with other nations. And Americans are more likely to die from physical assault, including gun violence, while the country has the highest infant and maternal death rates among OECD nations.

Even though screening rates for breast and colon cancer and flu shots in the United States are among the highest in the world, COVID-19 vaccination rates are falling behind many nations, the new report showed.

There has been some progress in expanding access to health insurance in the United States, but more work is needed to fill in the gaps and get people the health care they need, the researchers said.

Enacted in 2010, the Affordable Care Act (ACA, or “Obamacare”) opened up a marketplace for purchasing affordable health insurance. More than 3 million new people signed up for health insurance under the ACA this year, raising enrollment numbers to a record 16.3 million Americans.

Despite the ACA, millions of Americans still can’t afford coverage and/or live in health care deserts without access to physicians. “Many states haven’t expanded Medicaid, so they have no good affordable options,” Gunja noted.

“We have to make sure everyone has access to a health insurance plan that is affordable and that preventive care is free with no co-payment,” Gunja said. “We need to invest in the primary care workforce, provide incentives for physicians to enter primary care, and enact loan forgiveness for medical school debt, or we will never be able to solve this crisis.”

But it’s still possible to turn things around. “Other countries did it, so we should be able to do it, too,” she said.

U.S. health care policy experts have ideas about how to solve the health care crisis in the United States.

“We are financially out of control in the U.S. and spend too much on what others get for far less money, with no effect on the health outcomes,” said Dr. Arthur Caplan, a bioethicist and founder of the division of medical ethics at NYU’s Grossman School of Medicine in New York City.

In addition to improving access to health insurance, the United States needs to make sure that health care is available everywhere, Caplan added. “We need to find ways to get services to rural or poor people, because even if they have insurance, it doesn’t mean that there is a physician nearby,” he said.

Better use of technology, including telemedicine, may help fill some of these gaps, he said. Primary care delivered by physician assistants, nurse practitioners and pharmacists can also improve access to health care.

“We have to get more creative than we have been to get services out there,” Caplan said.

Focusing on prevention and wellness in schools and other community settings may also help people live longer, Caplan suggested.

Improving access to primary care doctors is an important part of the solution, said Emma Wager, a policy analyst at Kaiser Family Foundation, in San Francisco.

“We have fewer physicians than other countries, and fewer Americans see a primary care doctor every year, and that is a major reason why we have poorer health outcomes,” said Wager, because people who see primary care doctors tend to fare better.

Source: HealthDay





How Many Daily Steps Do You Need to Lose Weight?

Cara Murez wrote . . . . . . . . .

It’s clear that staying active is key to being healthy, and fitness trackers and smartwatches have become popular tools for tracking activity.

But just how many steps does someone need to take to lose weight?

That’s not such a simple a question.

While evidence is limited on exactly how many steps a day it takes to lose weight, experts say to get about 150 to 300 minutes of moderate- to vigorous-intensity exercise weekly, said Amanda Paluch, an assistant professor in the department of kinesiology and Institute for Applied Life Sciences at the University of Massachusetts, Amherst.

That’s about an average of 22 minutes per day on the low end and 45 minutes on the high end, Paluch said.

“And we do know that for weight loss and weight maintenance, you really need to get to that higher end,” Paluch said.

“We do need to exercise more often at this moderate to vigorous intensity to really see weight loss,” Paluch added, but “we really haven’t figured out how much that equates to in terms of steps per day.”

Tracking steps

That doesn’t mean a person shouldn’t track their steps.

“These types of devices can really help us with tracking and goal-setting,” Paluch said.

Harvard Health cited a review of recent studies that found people who were overweight or obese and who had chronic health conditions were helped in losing weight by wearing fitness trackers.

In the reviewed studies, participants had weekly goals for steps or minutes walked and were most successful when those programs lasted at least 12 weeks.

Those 10,000 steps

The idea of getting 10,000 steps is not new, but proving that number works is more challenging.

Yet, a study published in the journal Obesity found that getting 10,000 steps per day, with about 3,500 of those as moderate to vigorous physical activity for at least 10 minutes at a time, was found to be associated with enhanced weight loss in a behavioral intervention that included a calorie-restricted diet.

Another study, published recently in the journal JAMA Internal Medicine, found that for every 2,000 steps a study participant logged, their risk of early death dropped by between 8% and 11%, up to 10,000 steps. Researchers also found that 9,800 steps per day showed the greatest benefit.

And a recent study published in the journal Nature Medicine, found walking 10,000 steps a day reduced the risk for dementia, heart disease and cancer.

More walking or running equals more calories burned, Dr. Chip Lavie, medical director of cardiac rehabilitation and prevention at John Ochsner Heart and Vascular Institute in New Orleans said about the study when it was published.

“Generally, we say 100 calories are burned per mile walked or run,” Lavie noted.

Getting started on walking to lose weight

Don’t get discouraged if you get only modest weight loss. Even that can have big benefits. Losing just 5% to 10% of total weight can improve blood pressure, blood sugar and blood cholesterol, according to the U.S. Centers for Disease Control and Prevention.

Walking can also reduce the risk of obesity, heart disease, diabetes, high blood pressure and depression, according to the Mayo Clinic, which says most Americans walk about 3,000 to 4,000 steps per day.

Figure out how much you walk, then add 1,000 extra steps every two weeks, the Mayo Clinic suggests, by walking the dog, hiking together as a family or parking farther away from your destination.

Setting the pace

Pacing can also make a difference.

“We do know that intensity does tend to matter for weight loss. So, getting in more brisk walking, that’s really where we feel confident that if you do enough of it that could support weight loss,” Paluch said.

This could be done in short intermittent bouts or in longer organized workouts.

It may be that for a particular person the goal isn’t the steps but the minutes of physical activity. Or it could be counting the miles per day and being aware of how many they achieve at a brisk pace.

Even with robust exercise, in most cases, diet is crucial for weight loss, Paluch noted.

“Physical activity can provide lots of additional improvements in other health factors, but without any nutritional program, it’s very difficult to lose weight,” Paluch said. “They really go hand in hand when we think about weight loss. It is the combination of being active and following a structured diet.”

Source: HealthDay





Fiber: It’s Important to Your Child’s Diet, Too

Steven Reinberg wrote . . . . . . . . .

Just like adults, children need lots of fiber in their diets.

Fiber is part of what fuels a child’s normal growth and development. It helps them feel full longer, controls blood sugar levels, reduces cholesterol and promotes regular bowel movements, according to Children’s Health of Orange County, Calif. (CHOC).

“We see improvements in disease management like diabetes with lower spikes in blood sugar after meals when fiber intake is adequate. Improved satisfaction and satiety from the food we are consuming is evident when they contain more fiber, and this ultimately impacts weight management,” said Stephanie Di Figlia-Peck, nutrition coordinator at Cohen Children’s Medical Center in New York City.

A child who is still hungry will continue to eat, she said, so “a filling, satisfying, higher fiber meal will end the eating episode sooner.”

However, most American children aren’t getting enough fiber in their diet. A recent study in the journal BMC Pediatrics found that few young children were getting the recommended amount of fiber in their diet. Those who got more fiber tended to eat more whole grains, fruits, vegetables, nut butter and legumes, along with fewer fats.

“Fiber tends to be the misunderstood, scarcely present dietary constituent that eludes many. This is especially true for today’s youth who eat more processed, and ultra-processed, foods than generations of the past,” Di Figlia-Peck noted.

Foods are stripped of their natural dietary fibers as they are transformed into packaged items with innumerable ingredients, combined to manufacture convenient, doctored versions of the foods they once were, she said.

“Many high-fiber items contain prebiotics that fuel the gut microbiome, facilitating a winning partnership as undigestible plant components from dietary fibers, like inulin, chicory root and resistant starch, provide a fuel source for the abundant, vitally important network of bacteria and organisms that modulate health, impact disease risk and enhance well-being,” Di Figlia-Peck said.

These microbiome benefits are important for all ages and it is never too early to start eating more fiber, she said.

How much fiber do kids need?

Children ages 1 to 3 need about 14 grams of fiber a day, children ages 4 to 8 need about 16-20 grams, kids ages 9 to 13 need about 22-25 grams and those ages 14 to 18 need about 25-31 grams, CHOC says.

It can be difficult to know how much fiber is in foods by reading the package label, Di Figlia-Peck said.

“Food labels are inherently confusing when the wording on packaging fails to match numbers on the nutrition facts panel,” she said.

A common example encountered on cereal packaging may highlight “made with 12 grams of whole grains,” yet the label reflects a mere 1 or 2 grams of fiber in the box.

High-fiber foods for kids

Fiber-rich foods for kids include fruits, vegetables, whole grains and legumes.

There’s lots of fiber in grains like oatmeal, brown rice, whole wheat pasta and air-popped popcorn. Fiber-rich legumes include kidney beans, lentils and black beans. Edamame (soybeans) and almonds are also fiber-rich, according to CHOC.

Vegetables rich in fiber include broccoli, avocado and jicama. Fruits like raspberries, blackberries, pears, oranges, bananas and apples are also rich in fiber.

One large pear with skin has 7 grams of fiber, one cup of fresh raspberries has 8 grams of fiber, half of a medium avocado has 5 grams of fiber, 1 ounce of almonds has 3.5 grams of fiber, half a cup of cooked black beans has 7.5 grams of fiber, 3 cups air-popped popcorn has 3.6 grams of fiber, and 2 tablespoons of chia seeds have 10 grams of fiber, Di Figlia-Peck said.

Some less well-known fiber powerhouses include dark chocolate (70% or higher) and apples. “Dietary fiber intakes are best tolerated with adequate hydration and a gradual introduction and increase in fiber sources,” she noted.

For even more fiber-rich foods see the U.S. Department of Agriculture. . . . . .

Getting fiber into your kid’s diet

“Making food fun and enjoyable improves acceptance, and theme nights can be a fun way to entice children and adolescents with catchy names and wordplay,” Di Figlia-Peck said. “Meatless Monday, Taco Tuesday and Salad-Bar Saturday are all the craze.”

Here are more tips to increase the amount of fiber in your child’s diet:

  • Leave the skins on fruits and vegetables
  • Use whole wheat flour
  • Replace white bread and cereals with whole grains
  • Add fruit to whole-grain cold or hot cereals
  • Add fruit, nuts or whole-grain granola to yogurt
  • Add vegetables to scrambled eggs, omelets or pasta
  • Aim to offer whole grains that have at least 3 grams of fiber per serving
  • Choose whole fruit instead of juice
  • Include fruit and vegetables with every meal
  • Put veggies, like lettuce, tomato or avocado on sandwiches
  • Add beans to soups and salads
  • Add bran to baked goods

For snacks, offer air-popped popcorn, whole-grain crackers, fruit or vegetables.
“Enormous potential exists to shape habits and make eating high-fiber foods the norm, not the exception, with family-based meal planning,” Di Figlia-Peck said. “Families have a multitude of options to utilize plant-based sources to create high-fiber versions of common delicacies.”

Source: HealthDay