Author Archives: Carey Goldberg

We’re Baaack! CommonHealth Podcast ‘The Checkup’ Relaunches With Slate

(From Panoply.fm)

(From Panoply.fm)

“Refreshing.” “Science-based.” Free of “whiney snotty affectedness.” These are some of the glowing terms that iTunes reviewers used to describe our first six episodes of “The Checkup,” the 2013 health podcast that WBUR produced in partnership with Slate. (Oh, come on, yes we are hip enough to work with Slate.) The Checkup even won a prize from the Society for Professional Journalists.

Now, we’re thrilled to announce that The Checkup is back, still produced in partnership with Slate but now part of the new podcast network Panoply. To subscribe, you can use iTunes or go to Panoply.fm, where you can scroll down and click on the image circled above.

What do you get for your money? Well, it’s no money. It’s free. And you get typical CommonHealth style — what we call “solidly reported and somewhat opinionated” — in audio form. Our first episode of the relaunch is titled “Scary Food Stories,” and includes tales you may have missed of how food can mess you up. It features our most viral post ever — Rachel’s The Dark Side Of Kale (And How To Eat Around It) — along with a cautionary tale of chia choking and far more frightening exploration of sugar addiction and its effects.

Coming up soon in future episodes: “Grossology” — from stool banks to C-section bacteria; “On The Brain,” including new science on dyslexia and depression; and a different look at pain.

And in case you missed the previous episodes, they’ve got shelf life and are still worth a listen, on topics that include college mental health and “below the waist” disorders. Listen at your leisure but we hope you’ll subscribe now — at Panoply.fm or via iTunes.

Baker Deputies Outline Plan To Tame MassHealth Costs

Leaning heavily on the extraction of savings from MassHealth to balance their state budget proposal, top Baker administration health officials on Thursday said that changes to benefits for patients were mostly taken off the table, but the administration may look at co-payments or other commercial market solutions to control cost growth in the future.

According to the Baker administration, MassHealth will cost the state $14.5 billion this fiscal year. The program covers low- and moderate-income adults and children, and is projected to service 1.7 million enrollees in fiscal 2016. Under Baker’s $38.1 billion state budget, the program’s cost will grow to $15.3 billion next fiscal year. Continue reading

Why To Exercise Today: Avoid Brain Shrinkage As You Age

MilitaryHealth/flickr

MilitaryHealth/flickr

Middle-age adults take note: the exercise you shirk today may lead to shrunken brain tissue in a couple of decades.

This, according to research presented at the American Heart Association Epidemiology/Lifestyle meeting in Baltimore this week.

After reviewing exercise data taken from more than 1,200 adults who were around 40 years old — a subset of the Framingham Heart Study — researchers found that twenty years later when these same individuals underwent MRI scans, those with “lower fitness levels in midlife also had lower brain tissue levels in later life,” said Nicole L. Spartano, Ph.D., lead author and a postdoctoral fellow at the Boston University School of Medicine.

Though the findings are preliminary, Spartano says it looks like there’s a link between lower fitness levels and faster brain aging. Since the MRI’s in this study were done on people about 58 years old, the researchers didn’t expect to see high rates of dementia, but they did detect “the beginning of shrinkage,” Spartano said. “We look at the brain MRI as an early warning sign for deterioration. This may give us some idea of decreased cognition a decade or so later.”

Specifically, the researchers evaluated fitness based on how the heart changes in the early stages of exercise. Continue reading

Blue Cross To Expand Results-Based Doctor Payments System

The state’s largest health insurer, Blue Cross Blue Shield of Massachusetts, is moving to expand its system of paying doctors for the quality of their service. It replaces the traditional system of paying doctors for the number of services provided.

To talk about what’s driving this, Andrew Dreyfus, the company’s CEO, joins Morning Edition.

To hear the full interview, click on the audio player above.

Sip Of Latte With Binky? Study Finds Coffee Drinking ‘Not Uncommon’ Among Boston Toddlers

When Boston researchers asked mothers what types of fluids they were feeding their babies, they expected typical answers: breast milk, formula, water, juice.

But what they heard was surprising: a number of moms were giving their 1- and 2-year-olds coffee to drink. Not much, but still.

According to a new study on the links between early feeding and childhood obesity, researchers report approximately 15 percent of 2-year-olds were receiving up to 4 ounces of coffee every day (though the average was just over an ounce). Among the 1-year-olds in the Boston-based study, the rate of coffee consumption was 2.5 percent of children.

“We didn’t ask if it was decaf,” says the study’s principal investigator, Anne Merewood, PhD, MPH, director of the Breastfeeding Center at Boston Medical Center and associate professor of pediatrics at Boston University School of Medicine. The majority of the coffee-drinking children had Hispanic mothers who were born outside the U.S., the researchers wrote; and female infants and toddlers were more likely than males to drink coffee.

Merewood said while she was surprised by the findings, the practice does make cultural sense. “I’m English and I’ve been drinking tea since I was a very small child,” she said. “It’s a cultural thing, they just feed the baby what everyone else is eating.”

The researchers did not ask whether the children’s minimal coffee consumption impacted behavior, or whether the kids got hyper with the additional caffeine. Still, Merewood said: “It’s probably not a great idea to give caffeine to young children. We we need to investigate more.”

(Soul 2 Amor/Flickr)

(Soul 2 Amor/Flickr)

The study of 314 pairs of mothers and babies specifically looked at breast feeding and other eating habits of children at age 1 and 2 years. The findings, published in the Journal of Human Lactation, which is edited by Merewood, cites some earlier research on the downside of coffee drinking by young children:

Although coffee consumption in the first years of life has not been well documented, several risks of coffee and caffeine consumption in older children and adolescents have been identified. Research suggests an association between coffee consumption and higher rates of type 1 diabetes in children. Caffeine use among children and adolescents has been associated with depression, sleep difficulties, substance use, and concerning physiological, behavioral, and psychological effects…

It is unknown if these same risks apply to very young children and coffee. One study that did explore the risks of coffee consumption among toddlers found that 2-year-olds who consume coffee or tea between meals or at bedtime had “triple the odds of severe kindergarten obesity.”

The researchers also point out that: “In a recent statement, the US Food and Drug Administration expressed an intent to establish an acceptable limit for caffeine use by children, recognizing that the AAP discourages this practice.”
Continue reading

In Memory: A Fat Kid’s Love For Mr. Spock

By Steven Schlozman, M.D.

I remember the exact moment I realized that I could be Mr. Spock.

I was 9 years old, trapped in the “Husky” jeans section of the local Macy’s department store. Looking around at the selection of very big pants, I understood viscerally what I had known intellectually for years.

“Husky” meant “fat.” It meant that I was fat.

Not super fat, but fat enough to be in the Husky section.

I was awkward, developing in that tortured way that evolution see’s fit to make us endure. Staring at the mirror while my Mom gathered trousers for me try on, I was pissed off that because of this shopping trip, I was missing the rerun of “Star Trek” that aired on weekday afternoons.

(Daniel Arrhakis/Flickr)

(Daniel Arrhakis/Flickr)

“What would Spock think about the ‘Husky’ designation?” That’s what I was pondering. I was wondering how the master of logic would justify and make sense of the clearly derogatory way I was feeling about myself.

“Fascinating,” I imagined him saying, and he would raise that patented eyebrow.

Then I looked in the mirror, furrowed my brow, took note of the barely present peach fuzz growing under my nose, and with all the power of a Vulcan mind meld, I imagined that my right eyebrow was being pulled by a thread towards the stars. That one eyebrow was to boldly go where no eyebrow of mine had ever gone before.

And I did it. I raised that eyebrow.

“Fascinating,” I muttered. And then I did it again, and again. It was like a teeny Bar Mitzvah moment. “Today, I am a Vulcan.”

Spock meant that much to me. Spock could be friends with a tough guy like Kirk. Spock was unfazed by McCoy’s insults. Spock tolerated with admirable self-control the romantic advances of Nurse Chapel. Spock would, I was certain, be emotionally impervious to the Husky section of Macy’s.

“Fascinating,” I said, and again I raised my right eye brow.

I share the world’s sadness for Leonard Nimoy’s passing. I am grateful that he stuck around so long after he began his “five year mission.” I feel like a kid every time I hear his voice in the Imax theater at Boston’s Museum of Science. Every time I hear his voice, I am wearing Husky jeans but feeling OK about it.

These days I’m still raising one eyebrow on an almost daily basis. I even had a patient’s parent give me Vulcan ears for Christmas a few years ago.

“They’re not because you’re emotionally cold,” she explained.

No, I thought, Spock wasn’t cold.

“They’re because you’re not freaked out by our child. They’re because you’re interested.” Continue reading

‘Am I Normal?’ Check Biggest Study Yet Of Penis Size, Among 15,000 Men

From the paper "Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men" in the British Journal of Urology International, © BJU International, posted with permission granted by Wiley.

From the paper “Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men” in the British Journal of Urology International, © BJU International, posted with permission granted by Wiley.

In Dr. Abraham Morgentaler’s 26 years as a urologist who treats issues of male sexuality, he has seen thousands of patients, and “probably there hasn’t been a single one who hasn’t paid attention to his penis size on some level,” he says.

“Most men tend to believe they’re smaller than average, and there’s some distortion about what reality is,” says Morgentaler, director of Men’s Health Boston and author, most recently, of “The Truth About Men and Sex: Intimate Secrets From the Doctor’s Office.”

A new study could help combat some of that reality distortion.

Combining 17 previous published studies for a total of 15,521 men, it amounts to the biggest review to date of medically measured penis size, says its lead author, Dr. David Veale of King’s College London. It processed the data into “nomograms,” or graphical diagrams, like the one above, familiar to parents as the typical form for the growth charts that pediatricians use.

From the press release on the paper (metric conversions mine), which is titled “Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men”:

The nomograms revealed that the average length of a flaccid penis was 9.16 cm [3.6 inches], the average length of a flaccid stretched penis was 13.24 cm [5.21 inches], and the average length of an erect penis was 13.12 cm [5.165 inches]. The average flaccid circumference was 9.31 cm [3.66 inches], and the average erect circumference was 11.66 cm [4.59 inches]. There was a small correlation between erect length and height.

So those are the averages, but the great beauty of a nomogram is that it can also give you a sense of the distribution of the variation, and you may have already noticed that the curve above looks strikingly flat. That is, there’s just not much difference, except at the extreme edges.

If your erect penis is 11 centimeters, that puts you down in the 10th percentile; if your erect penis is 15 centimeters, that puts you way up in the 85th percentile. Quite a jump, for a little over an inch.

“What’s interesting is, when you look at the curves, you see that most penises actually are fairly similar in size,” Dr. Morgentaler says. “You really have to go to the extremes — the top or bottom 5 or 10 percent — to really see some big differences. And truthfully, in my practice, I would say that’s exactly right. Most men have penises roughly the same size.”

But somehow, many men who are average think they’re below average. The study notes:

“Men may present to urologists or sexual medicine clinics with a concern with their penis size, despite their size falling within a normal range. This type of concern is commonly known as ‘small penis anxiety’ or ‘small penis syndrome.’ Continue reading

Blue/Black Or White/Gold, And Why Care? A Neuropsychiatrist Examines ‘The Dress’

Sometimes it just seems like the whole world has gone crazy. Like when your colleagues, all serious people, cluster for precious minutes around a computer screen debating the color of a dress. And you see that, online, many other serious people are doing the same thing — say, at On Point or The New York Times.

So though I was curious about the science behind the recent viral phenomenon known as “The Dress,” my first question for Boston-area neuropsychiatrist Dr. Jon Lieff was a more mundane “Why?” To quote one top Slate commenter, “How is this a thing?”

Not that it’s a bad thing. The dress phenomenon “informs people that perception is not what it seems,” Dr. Lieff says. “We think we see reality when in reality, what we see is what the brain wants us to see. And that leads us into philosophy…”

But let’s not go into philosophy just yet. (And you can read Dr. Lieff’s thoughts at more depth on his website, Searching for the Mind.) Let’s talk instead about why this of all optical illusions swept the Internet.

His bottom line: “Our brain is correcting for an imagined light source. That’s the problem.”

And what’s unusual about it: “This doesn’t usually happen with an illusion: In any crowd, you have half the people saying one thing and the other half saying another thing. And because of the type of illusion it is, once it’s fixed, your brain is going to keep you on the blue side or the white side. I’m sure you’ve seen other kinds of illusions where it flips back and forth.  This is different. Once people choose their sides, they’re saying, ‘This is it, and I’m the right one and you’re the wrong one.’ So it’s captured the imagination, but in truth there are hundreds of these occurring all day long, that people don’t realize.”

“An example: if you’re watching a waterfall on the TV and your hand is on the desk, your hand thinks the desk is rising up. Continue reading

Study: Well-Water Can Raise Arsenic Levels In Formula-Fed Babies

Parents already concerned by recent revelations about arsenic in rice, grains and juices, brace yourselves: A new study found higher levels of arsenic excreted by infants exclusively fed formula, compared to breast-fed babies. A likely culprit: well-water.

In the small study of private well-water users in New Hampshire, overall arsenic exposure was relatively low for most 6-week-old infants regardless of how they were fed. “So that’s good news,” says Kathryn Cottingham, a professor of biological sciences at Dartmouth and the study’s co-lead author. “That said, infants fed exclusively with breast milk were less exposed to arsenic than infants fed with formula, and some infants fed with formula may have been exposed to very high levels of arsenic due to high concentrations in their home tap water.”

In the study, published in the journal Environmental Health Perspectives, researchers measured arsenic in the home tap water of 874 families, urine from 72 infants and breast milk from nine mothers.

(Donald Clark/Flickr)

(Donald Clark/Flickr)

Arsenic levels in the tap water tended to be well below the EPA’s recommended upper limit, researchers report. Still, they found that: “measured urinary arsenic concentrations were 7.5 times higher in exclusively formula-fed infants compared to breast-fed infants,” says Cottingham.

The bottom line, she says, is get your well-water tested.

“In terms of fear mongering, that’s the fear I’d like to instill: if you have well-water, get your water tested,” she says.”I don’t want to freak people out about feeding their babies formula.”

Arsenic is a naturally occurring element found in groundwater around the world — and in some places, in very high concentrations.

Exposure to high levels of arsenic, a human carcinogen, has a number of potential health consequences, the study authors note, including cancer, cardiovascular disease, diabetes, obesity, adverse birth outcomes and altered immune systems. Continue reading

What New Peanut Study Means For Kids With Food Allergies — And What It Doesn’t

In this undated photo provided by Cambridge University Hospitals NHS Foundation Trust, Dr. Andrew Clark of Cambridge University, right, performs a skin prick test, which is used to diagnose food allergies, on Lena Barden, 12, during clinical trials at Addenbrooke's Hospital Clinical Research Facility, Cambridge, England. An experimental therapy in Britain that fed children with peanut allergies small amounts of peanut flour has helped more than 80 percent of them eat a handful of the previously worrisome nuts safely. (Cambridge University Hospitals NHS Foundation Trust/AP)

In this photo provided by Cambridge University Hospitals NHS Foundation Trust, Dr. Andrew Clark of Cambridge University, right, performs a skin prick test, which is used to diagnose food allergies, on Lena Barden, 12, during clinical trials at Addenbrooke’s Hospital Clinical Research Facility, Cambridge, England. (Cambridge University Hospitals NHS Foundation Trust/AP)

By Richard Knox

Erin Brazil is frustrated. She’d hardly had time to digest the peanut allergy study that got heavy media coverage this week when, she says, she got “inundated by calls and emails and Facebook posts saying ‘There’s a cure, there’s a cure!’ ”

Brazil is a Boston food-allergy activist whose 4-year-old son Gabriel is severely allergic to peanuts and other foods. So she knows better than anyone that the new study, while a landmark in the field, represents no cure. “It doesn’t do anything for Gabriel,” she says.

What it does mean is that many future children will be able to avoid a life of worry about whether the merest trace of peanut protein — even an invisible smear from a candy bar left by another child on playground equipment — could send them to the emergency room gasping for breath.

I can finally look a mother in the eye and give her some advice that I feel confident in.

– Dr. Hugh Sampson

And the new study means that the recommendations parents have been given over the past 15 years — to withhold peanuts until the age of 3 in children deemed at risk — “were exactly wrong,” says Dr. Wayne Shreffler, director of the Food Allergy Center at Massachusetts General Hospital.

“I strongly suspect they made things worse,” Streffler adds, because at-risk children who were deprived of peanut exposure in food during infancy were more likely to suffer a lifelong allergy from later exposure to, say, house dust. It’s almost impossible to avoid it.

In 2008, the American Academy of Pediatrics withdrew its recommendation to withhold peanuts until age 3, but until now there’s been no solid evidence in favor of deliberately feeding peanuts to at-risk kids. That’s what the new study strongly suggests parents should do — strictly under the supervision of their pediatricians. That flip-flop is widely expected to be enshrined in the next set of official guidelines.

It’s a big change, but not only does it offer nothing to children like Gabriel who already have peanut allergy, it provides no answer to the really big question: Just why have food allergies soared lately, more than quadrupling among the current generation of American children?

Even though the study doesn’t solve that mystery, allergy experts say it’s certain to accelerate research already under way to unravel the causes and devise treatments, if not outright cures.

Six million U.S. children currently have food allergies, one out of every 13 kids, according to the largest recent study. Peanut allergy is the most common, and the most troublesome — not only because it’s so hard to avoid exposure, but because peanut allergy is usually permanent, unlike those involving other foods. And peanut allergies are more likely to be fatal.

That explains why allergists are so enthusiastic about the new study. Continue reading