Author Archives: Rachel Zimmerman

Blogger, CommonHealth Rachel Zimmerman worked as a staff reporter for The Wall Street Journal for 10 years in Seattle, New York and in Boston as a health and medicine reporter. Rachel has also written for The New York Times, the (now-defunct) Seattle Post-Intelligencer and the alternative newspaper Willamette Week, in Portland, Ore., among other publications. Rachel co-wrote a book about birth, published by Bantam/Random House, and spent 2008 as a Knight Science Journalism Fellow at MIT. Rachel lives in Cambridge with her husband and two daughters.

Workout Supplements: Does Overuse Signal An Eating Disorder Among Men?

(USMC/Flickr)

(USMC/Flickr)

By Marina Renton
CommonHealth Intern

You’ve seen them at the gym: extremely body conscious men, driven to achieve a level of physical perfection through grueling workouts.

Well, new research suggests that overusing popular supplements like whey protein and creatine to improve workout performance may signal an emerging eating disorder.

Researchers presented their findings at the American Psychological Association’s annual convention in Toronto earlier this month.

Almost 200 18- to 65-year-old men who consumed legal appearance- and performance-enhancing drugs (APEDs) and worked out at least twice a week participated in the study, led by co-authors Richard Achiro and Peter Theodore, both from the California School of Professional Psychology at Alliant International University, Los Angeles. In addition to asking about their supplement use and eating habits, researchers surveyed the participants about their psychological well-being, asking about their body image, self-esteem and gender role conflicts.

Almost 30 percent of the people surveyed said they were worried about their supplement use. Over 40 percent had increased their supplement intake over time. Twenty-two percent said they consumed the supplements instead of a meal, even when that wasn’t their intended use. Eight percent had been advised by their doctor to curb their use of supplements, and 3 percent had been hospitalized for kidney or liver problems stemming from their supplement intake.

Continue reading

Cut Your Risk Of Alzheimer’s? Growing Evidence Says Maybe You Can — Modestly

Alexis McKenzie, right, executive director of The Methodist Home of the District of Columbia Forest Side, an Alzheimer’s assisted-living facility, puts her hand on the arm of resident Catherine Peake, in Washington, Feb. 6, 2012. (Charles Dharapak/AP)

Alexis McKenzie, right, executive director of The Methodist Home of the District of Columbia Forest Side, an Alzheimer’s assisted-living facility, puts her hand on the arm of resident Catherine Peake, in Washington, Feb. 6, 2012. (Charles Dharapak/AP)

It was the “two-thirds” in the press release headline that grabbed me: “Nine risk factors may contribute to two thirds of Alzheimer’s cases worldwide.”

So of course I read more about the new study:

Nine potentially modifiable risk factors may contribute to up to two thirds of Alzheimer’s disease cases worldwide, suggests an analysis of the available evidence, published online in the Journal of Neurology Neurosurgery & Psychiatry.

The analysis indicates the complexity of Alzheimer’s disease development and just how varied the risk factors for it are. But the researchers suggest that preventive strategies, targeting diet, drugs, body chemistry, mental health, pre-existing disease, and lifestyle may help to stave off dementia. This could be particularly important, given that, as yet, there is no cure, they say.

How I wish this meant that we can reduce our risk of Alzheimer’s by two-thirds. But no matter how I mangle the statistics, it doesn’t. Here’s what it does suggest, according to Dr. James Hendrix, director of global science initiatives for the Alzheimer’s Association: that for up to two-thirds of people who have Alzheimer’s, these modifiable risk factors may have contributed to it, and probably to when they got it.

“So,” he says, “if you were going to get Alzheimer’s, because maybe you had a genetic predisposition, and you take very good care of yourself, maybe you don’t get it until you’re 85 or 95. But if you smoke or you’re overweight or don’t exercise, maybe you get Alzheimer’s at 75. That’s really what this says — these could be contributing factors to if you get Alzheimer’s or when you get Alzheimer’s. It increases your risk.”

Of course, we’ve been hearing for years — at least since those smart Minnesota nuns got famous in 2001 — about how mental challenges like crossword puzzles could be linked to lower Alzheimer’s risk. But this latest paper seems part of a broad shift based on growing evidence about a far greater array of “modifiable risk factors.”

Exhibit No. 1: This summer, the Alzheimer’s Association ran a campaign on “10 Ways to Love Your Brain,” encouraging people to exercise, keep learning and quit smoking, among other advice. Exhibit No. 2: A round-up paper in the journal Alzheimer’s & Dementia laying out the levels of evidence on which lifestyle and health changes could protect people against Alzheimer’s.

The findings are relentlessly commonsensical: Many of the usual suspects that we already know are good for our health — exercise, heart-healthy diet, sleep, weight and blood pressure control — also appear to help fend off Alzheimer’s.

I asked Dr. Gad Marshall — a neurologist and associate medical director of clinical trials at the Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital — how he’d respond to a neighbor who says, “Hey, I hear I can really move the needle on my risk of Alzheimer’s!” Continue reading

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Shameful Operating Room Moments: Medical Journal On Calling Out ‘Dirtball’ Doctors

(Just Us 3/Flickr)

An essay published in the Annals of Internal Medicine begs the question: How many of us are being mocked and crudely disrespected while we’re at our most vulnerable? (Just Us 3/Flickr)

Imagine this scene:

A female patient under general anesthesia is being prepped for a vaginal hysterectomy. As the attending doctor washes and scrubs her labia and inner thighs, he turns to a medical student and says: “I bet she’s enjoying this.” Then he winks and laughs.

No, this account doesn’t come from a racy British tabloid. It was published this week in a reputable medical journal, Annals of Internal Medicine.

The account, written by an anonymous doctor and titled “Our Family Secrets,” also describes an incident involving an obstetric patient, Mrs. Lopez, who experienced hemorrhaging and other complications after childbirth. To stop the bleeding and ultimately save the patient, her doctor performs what is called an “internal bimanual uterine massage,” which means he must get his entire hand inside her vagina. From the piece:

“…something happened that I’ll never forget. Dr. Canby raises his right hand into the air. He starts to sing ‘La Cucaracha.’ He sings, ‘La Cucaracha, la cucaracha, dada, dada, dada-daaa.’ It looks like he is dancing with her. He stomps his feet, twists his body, and waves his right arm above his head. All the while, he holds her, his whole hand still inside her vagina. He starts laughing. He keeps dancing. And then he looks at me. I begin to sway to his beat. My feet shuffle. I hum and laugh along with him. Moments later, the anesthesiologist yells, ‘Knock it off, assholes!’ And we stop.”

Stomach Churning

Dr. Christine Laine, editor in chief of Annals of Internal Medicine, said this is the first time in her tenure that such a profanity has been printed in the journal. But, she said in an interview, it seemed appropriate in this case. When she first read the essay she says it made her “stomach churn,” and it made her angry.

“Angry for the patients … angry for the younger physicians who encountered this behavior, angry at myself and others who have witnessed colleagues being disrespectful to patients but were too timid to speak out,” Laine said.

In an accompanying editorial condemning the behavior described in the essay, Laine and her colleagues wrote: “The first incident reeked of misogyny and disrespect — the second reeked of all that plus heavy overtones of sexual assault and racism.”

So how did this series of unfortunate medical events unfold?

Here’s the backstory: The anonymous author of the essay (the journal decided to keep the doctor’s identity a secret) was leading a course on medical humanities for senior medical students. The topic was “the virtue of forgiveness.” At one point the doctor put a question to the class: “Do any of you have someone to forgive from your clinical experiences? Did anything ever happen that you need to forgive or perhaps still can’t forgive?” Continue reading

Carter’s Cancer: Melanoma Is ‘Bad’ Skin Cancer, But Better To Have Now Than Past

Former President Jimmy Carter discusses his cancer diagnosis at the Carter Center in Atlanta, on Thursday. Carter, 90, said the cancer has spread to his brain, and he will undergo radiation treatment at Emory University Hospital. (Phil Skinner/AP)

Former President Jimmy Carter discusses his cancer diagnosis at the Carter Center in Atlanta, on Thursday. Carter, 90, said the cancer has spread to his brain, and he will undergo radiation treatment at Emory University Hospital. (Phil Skinner/AP)

Ninety-year-old former President Jimmy Carter announced Thursday morning that he’s being treated for melanoma, and the cancer has been found in his brain and liver.

My reaction: “Melanoma? Isn’t that supposed to start with weird spots on your skin?”

I turned to Dr. Elizabeth Buchbinder, melanoma expert at Dana-Farber Cancer Institute. Our conversation, lightly edited:

So is our popular conception of melanoma — odd, mole-like things on sun-hit skin — not consonant with reality?

So often, when people think of skin cancer, they think of the more traditional basal cell, squamous cell, where you go in to the dermatologist, they cut it off, maybe you need to get a little bit of liquid nitrogen, or something else, but really, once they’ve done that, the risk in terms of it affecting your survival or anything else is very low. They’re really very controllable cancers.

Melanoma is kind of the exact opposite of that. It’s the real bad actor among the skin cancers, because melanoma likes to get into the blood and spread. It likes to go anywhere it wants in the body. Some of the places it likes to particularly go are the liver and the brain. It can also go into the lungs and other areas of the body. It’s kind of the ‘bad boy’ of the skin cancers; it’s definitely a bad actor in terms of cancers in general, but then also in terms of skin cancers as a group.

And you can have melanoma without ever having seen a spot?

First of all, melanomas predominantly arise on the skin and are most commonly associated with sun or UV exposure. However, they can arise in areas of the skin that never see the sun. They can also arise on other membranes that are not visible; for example, the inside of the mouth or the inside of the intestine. They can also arise within the eye.

“Melanoma treatment is so exciting right now. The real cutting-edge is basically using the immune system to fight the cancer itself.”

– Dr. Elizabeth Buchbinder,
Dana-Farber Cancer Institute

Although most of them arise on skin that are seen, some melanomas may arise on the skin and never necessarily be detected. We have a fair rate of what’s called ‘unknown primary,’ where we never find that skin spot, and one of the thoughts is that that skin spot either has been attacked by the person’s own immune system and kind of gotten rid of, or that something else has happened; it’s been scraped off or itched, or who knows? It just never was found. So there’s some rate of that.

And so what is the cutting-edge of melanoma research and treatment now?

Melanoma treatment is so exciting right now. The real, real cutting-edge is basically using the immune system to fight the cancer itself. What we’ve known for a long time is that the immune system has a relationship with cancer, and sometimes can keep it from growing or prevent new cancers from forming, but often the cancer kind of overcomes that somehow. And what’s happened with new treatments and with new research and understanding of how the immune system works is we’ve been able to use medications to make the immune system attack the cancer. Continue reading

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Possible Key To Weight Loss? Researchers Find ‘Master Switch’ To Crank Up Fat-Burning

Researchers say new science on a “metabolic master switch"  may hold the promise of someday making a dent in the obesity epidemic. (Courtesy UConn Rudd Center for Food Policy & Obesity)

Researchers say new science on a “metabolic master switch” may hold the promise of someday making a dent in the obesity epidemic. (Courtesy UConn Rudd Center for Food Policy & Obesity)

Here’s my fantasy: I’ve overindulged — let’s say, purely theoretically, on Cape Cod fried clams, french fries and beer — and would normally face the greasy regret and resign myself to extra carrots and cardio in the days to come.

But no. Instead, I simply pop a pill that cranks up my metabolism for a few hours so that I burn the extra calories instead of storing them as fat. I don’t gain an ounce.

That’s a very distant prospect. But new science on a “metabolic master switch,” just out in the New England Journal of Medicine, brings my dream one step closer to reality — and, researchers say, may hold the promise of someday making a dent in the obesity epidemic.

Until now, weight-loss treatments have focused on altering appetite and exercise, says MIT computer science professor Manolis Kellis, senior author on the paper. Now, “what we have in our hands is a third knob, if you wish, for controlling body fat,” he says. “It’s working directly on your fat cells to reprogram them to burn more energy rather than to store it as fat.”

In normal-weight mice, Kellis says, the effects of turning that knob are dramatic: “By changing the expression of one gene in these mice, they lose 50 percent of their body weight. You can feed them all the fat you want and they will not take on weight. They do not exercise more and they do not eat less, what they do is simply burn more energy when they’re awake, or even in their sleep.”

Dr. Melina Claussnitzer is lead author on the fat-burning paper just out in the New England Journal of Medicine. (Courtesy of Lovely Valentine)

Dr. Melina Claussnitzer (Courtesy of Lovely Valentine)

But mice are not men, of course. Could this work in humans?

“We experimented on human fat cells,” says Melina Claussnitzer, first author of the paper, a visiting professor at MIT and faculty member at Beth Israel Deaconess Medical Center. “And we found that we could flip them from energy-storing to energy-burning by altering the expression of a single gene — and, even more remarkably, by altering a single letter from our 3-billion-letter genome. And we could flip that switch back in either direction.”

Still, it’s a very long way from genetically editing human cells in a Petri dish to altering the metabolism of a breathing human, the researchers caution. The team has filed patents on their switch-flipping manipulations and are seeking to commercialize the approach and lead it into human clinical trials, Kellis says, but cannot speculate on a time frame.

So meanwhile, there’s no such thing as a free fried clam. But we can at least savor the story of how this cutting-edge science came to be.

Let’s begin in 2007, when researchers turned up the first genetic link to obesity, a region of the genome called FTO. To this day, it remains the strongest genome-obesity link: Some 44 percent of Europeans, it turns out, have a version that predisposes them to weigh more, on average five to seven pounds.

The natural next question was: How does it work? Does it make people eat more? Move less? Both?

Or neither, says Claussnitzer. “Despite seven years of intense efforts to hunt down a mechanism, no link has been made between the genetic differences in the region and altered functions in the brain.” Continue reading

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Women’s Health World Abuzz On ‘Pink Viagra’ Approval, But Are Expectations Realistic?

In this June 22 photo, a tablet of Flibanserin sits on a brochure for Sprout Pharmaceuticals in the company's Raleigh, N.C., headquarters. (Allen G. Breed/AP)

In this June 22 photo, a tablet of Flibanserin sits on a brochure for Sprout Pharmaceuticals in the company’s Raleigh, N.C., headquarters. (Allen G. Breed/AP)

Everyone, it seems, has an opinion on the FDA’s approval this week of the drug Flibanserin, aka “pink Viagra,” to boost women’s sexual desire.

“This is the biggest breakthrough for women’s sexual health since the pill,” Sally Greenberg, executive director of the National Consumers League, told The New York Times.

Others have their doubts. Cindy Pearson, of the National Women’s Health Network, told NPR that approval of the drug “is a triumph of marketing over science” and added: “To have any chance of benefit from this drug they’re going to have to take it every day for months on end, years…We just don’t know what the long-term effects will be of changing brain chemistry in this way.”

Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research (CDER), said the approval “provides women distressed by their low sexual desire with an approved treatment option…The FDA strives to protect and advance the health of women, and we are committed to supporting the development of safe and effective treatments for female sexual dysfunction.”

The drug, which will be sold under the brand name Addyi, is expected to go on sale Oct. 17, according to its maker, Sprout Pharmaceuticals. And along with the potential to ignite a low (or non-existent) libido among some women, the drug comes with a boxed warning, the strongest kind, on contraindications and potential side effects, including low blood pressure, fainting, nausea, dizziness and sleepiness.

Here’s more on the site Throb, about how the drug actually works.

Still others have extreme doubts.

Emily Nagoski, a feminist sex educator and author of the book “Come As You Are,” wrote a smart, thoughtful piece on the site Medium about why Flibanserin isn’t addressing the true nature of women’s sexual desires. Here’s a bit of that piece, called: “Pleasure is the Measure:”

I believe that the folks at Sprout Pharmaceuticals — the company that owns Flibanserin, the so-called “pink viagra” — have good intentions. I believe that they want to help women who are struggling with sexual desire.

And I believe that they feel sure — as most people do— that lack of spontaneous, out-of-the-blue desire for sex is a problem. A disease.

They are wrong — as you now know.

It’s not their fault, really, that they’re wrong. Cindy Whitehead, Sprout CEO, isn’t a sex researcher, educator, or therapist. She’s a marketing professional, and she’s darn good at her job. But why would she believe anything except what mainstream culture taught her?

In fact the drug is designed — they’ve said explicitly — as though responsive desire were a disease, as though spontaneous desire were the only “normal” way to experience desire.

And that’s a problem. Continue reading

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Where Does Life Begin, And Other Tough Abortion Questions For Doctors In Training

Our recent post on how residents training to be OB-GYNs think about providing abortions (or not providing them) went viral earlier this month and triggered a broader conversation among readers. The topic was also featured on Radio Boston and WBUR’s All Things Considered.

I asked Janet Singer, a nurse midwife on the faculty of Brown University’s obstetrics-gynecology residency program, and the person who organized the initial discussion among the residents, to follow up. She, in turn, ​asked Jennifer Villavicencio, a third-year resident​, to lead a discussion digging even more deeply into the topic.

Two of the residents ​in the discussion ​perform abortions, two have chosen not to do so. ​But they are colleagues and friends who have found a way to talk about this divisive issue in a respectful and productive way. ​Here, edited, is ​a transcript of ​their discussion, which gets to the heart of a particularly fraught question: When does life truly begin? ​Three of the residents have asked that their names not be included, for fear of hostility or violence aimed at abortion providers.

Jennifer Villavicencio (Resident 3): Let’s talk about a woman who comes in, has broken her water and is about 20 to 21 weeks pregnant and after counseling from both her obstetricians and the neonatologist [a special pediatrician who takes care of very sick newborns] has opted for an abortion. Let’s talk about how we each approach these patients.

Resident 2: As a non-abortion provider I will start just by saying that a patient of this nature in some ways is on one extreme of the spectrum. As an obstetrician, I view the loss of her pregnancy as an inevitability. I think we would all agree with that. So, taking part in the termination [another word for abortion] of her pregnancy is different to me than doing that for someone whose pregnancy, but for my involvement, would continue in a healthy and normal fashion.

Opponents and supporters of an abortion bill hold signs outside the Texas Capitol on July 9 in Austin. (Eric Gay/AP)

Opponents and supporters of an abortion bill hold signs outside the Texas Capitol on July 9 in Austin. (Eric Gay/AP)

JV: Would your opinion change if she were 22 or 23 weeks and theoretically could make it to viability [the concept that a fetus could survive outside of the mother. Currently, in the U.S., the generally accepted definition of viability is 24 weeks gestation or approximately six months pregnant]?

Resident 2: Personally, it wouldn’t, because I feel there is a very slim chance of an intact survival [refers to an infant not having significant mental or disabilities] of an infant. If she were 22 or 23 weeks gestation and could potentially make it to the point of a survivable child, that likelihood is so rare. But for my involvement, she will still lose this pregnancy. My point is, if I help terminate this pregnancy, I am not playing an integral role in the loss of this pregnancy. I feel that supporting her in proceeding in the safest possible way, protecting her while accepting the loss of her pregnancy, is my job.

Future Health Of The Child

JV: Does the future health of the child really play a role in it for you?

Continue reading

Autism, Then And Now: Sweeping New Book Puts ‘Epidemic’ In Perspective

In May of 2000, Wired magazine writer Steve Silberman was covering an Alaskan cruise for a hundred distinguished computer programmers, and asked one of the most distinguished, Larry Wall, creator of the programming language Perl, if he could interview him later on at home.

“Sure,” was the answer. “But just so you know, we have an autistic daughter.”

Six months later, Silberman was writing about another high-profile Silicon Valley family, and asked for another home interview. The reply was eerily similar: Yes, but “I should tell you, we have an autistic daughter.”

Soon after, Silberman recalls, he was sitting at a San Francisco cafe and telling a friend about that odd coincidence, when “a woman at the next table blurted out, ‘Do you realize what’s happening? I’m a special-ed teacher in Silicon Valley. There is an epidemic of autism in Silicon Valley. Something terrible is happening to our children.”

Author Steve Silberman (courtesy)

Author Steve Silberman (courtesy)

He got a chill — the kind of chill that makes him want to start reporting and researching. At that point, he says, “I was very naive about autism. Like most people at the time, everything I knew about autism I had learned from ‘Rain Man.’ ”

He is naive no longer. First, he wrote a landmark article in Wired, “The Geek Syndrome,” about why the autism diagnoses in Silicon Valley might be going up. (The theory: People carrying genes for autism who were working in the technology industry had more social opportunities to meet one another and have children together than they’d ever had in history — a process that geneticists call “assortative mating.”)

And now, Silberman has written “NeuroTribes: The Legacy of Autism and the Future of Neurodiversity,” a history of society’s changing attitudes toward autism, as seen through the eyes of parents, clinicians and autistic people themselves. It’s due out Aug. 25 and — if my appreciation for its breadth, depth and power is any indication — it’s likely to make a big splash. (Also provoke some controversy, given its unflinching takes on some of autism’s more contentious issues, from possible causes to biomedical “cures”.)

I asked Silberman to answer what seem to me the most burning questions about autism: Is prevalence really rising? How to explain kids who lose their diagnosis? What does the research promise? Our conversation, lightly edited, beginning with more about “The Geek Syndrome”:

SS: The article came out, it was very well received, and I got tons of email about it — and then I kept getting email about it for 10 years, which is very unusual. But here’s the thing: When I wrote the article, most of the families I talked to were keenly interested in what had caused their child’s autism. Some believed that it was vaccines, some believed that it was environmental contaminants, some thought it was genetics.

But by the time a decade had gone by, what they were worried about was not what had caused their child’s autism; what they were worried about was the shocking lack of services for autistic teenagers and adults — like transitional services to help them go from school to the workplace, services to help them learn how to live independently in the community, and so on.

So I began to be haunted by the fact that my narrow focus on the dynamics of autism in high-tech communities had, in a sense, led me astray, and that there was a much larger problem for autistic people and their families worldwide, which is the availability of services. That’s what parents are really wrestling with on a day-to-day basis.

neurotribes

So you moved with the times…and also, services are something we can actually do something about right now.

Exactly. That’s actually a more profound statement than one might think. Some very well-meaning people think that society’s best investment would be to ‘cure autism.’ Well, we’ve been working on curing schizophrenia for a very long time, and for decades, psychoanalysts were working on ‘curing’ homosexuality. But these are very, very complex genetic conditions, and have a lot of contributing factors; perhaps a much more humane thing to do is to ensure that autistic people and their families have access to happier, healthier, safer, more secure, more engaged and more productive lives. That goal is within our reach right now and doesn’t depend on the next medical breakthrough.

You’ve done a lot of reporting over the years into potential risk factors for autism in the environment — this week’s cause-of-autism du jour — and you know what happens to those stories: They make a big splash, everyone’s talking about them, and then they quietly go away.

If we look at what has been blamed for causing autism over the last few years, it’s everything from autoimmune dysfunction, impaired sugar metabolism, antidepressants in the water supply, mitochondrial disorders, living near a freeway, too little oxytocin, too much testosterone… the list goes on and on.

“So it’s an epidemic of recognition, really.”

– Author Steve Silberman

Might some of those things contribute to autism? Sure. But what we have to remember is that there have been, in recent years, at least three big studies that look at the crucial question: Is autism actually increasing in the population or is it just that we’re getting better at diagnosing it, and becoming more aware of it as a society, and learning how to spot it in early childhood?

And the conclusion of all three studies — including one in Sweden in 2015 that involved over 1 million children, including 19,000 twin pairs, and one in England by a researcher named Terry Brugha — was that the rates of autism have not really been going up. What has been going up is the rates of diagnosis. So it’s an epidemic of recognition, really.

So given the latest, biggest, best studies, it really does look like that’s what’s going on, and not an actual rise in prevalence? Continue reading

Sexting Among Adults May Be More Common Than You Think, Survey Suggests

A middle-aged woman I know recently confessed that she’s been doing quite a bit of provocative, R-rated texting with a man she’s involved with.

When I referred to it as “sexting” she was shocked. “It’s not like we’re sending naked pictures back and forth,” she said. “Just a little suggestive ‘What are you wearing?’ kind of thing. It’s fun.”

Welcome to the new world of sexting.

It turns out grownups in committed relationships are, increasingly, doing it for pleasure and “fun,” as one survey found. Also, according to researchers, the whole concept of “sexting” has evolved, or at least is evolving: from a risky, sordid and sometimes-dangerous activity among teens, to, as one therapist (more below) says, a way to add some sexual “simmering” to a relationship that may need spicing up. Even the AARP acknowledges the trend: “…the reality is that more and more of the 50-plus set, both single and married, routinely use text messaging to send tantalizing pictures and provocative words to their partner…”

Reframing Sexting

Indeed, sexting may be more popular among adults than you think.

A new survey on sexting found that 88 percent of respondents, ages 18-82, said they’d done it, and 82 percent said they’d done it in the past year (including the 82-year-old). Also, nearly 75 percent said they sexted in the context of a committed relationship, while 43 percent said they sexted as part of a casual relationship. (On the darker side, 12 percent reported sexting someone “in a cheating relationship.”) The findings were presented at the American Psychological Association annual convention in Toronto earlier this month in a paper called: “Reframing Sexting as a Positive Relationship Behavior.”

(Photo illustration by Mike Licht/Flickr, taking inspiration from the artist Edward Armitage)

(Photo illustration by Mike Licht/Flickr, taking inspiration from the artist Edward Armitage)

The survey of 870 heterosexual individuals in the U.S. also found that in general, more sexting was associated with a higher level of sexual satisfaction. More than half of the responses came from women; the average age of participants was 35, according to the study authors.

On one level, it’s not surprising that sexting is becoming more mainstream.

“If we look at how technology has been integrated into our society — it’s so much part of our daily lives — it makes sense that it would become part of our dating and sexual lives as well,” said Emily Stasko, MPH, a doctoral candidate in psychology at Drexel University in Philadelphia and the survey’s co-author, along with Pamela Geller, PhD, associate professor of psychology, ob/gyn and public health at Drexel.

Attitudes about sexting seem to be changing too. The survey found that people who sexted more rated it as more “carefree and fun” and had higher beliefs that sexting was expected in their relationships.

(Sexting, for the purposes of the survey, was defined broadly as sending or receiving sexually suggestive or explicit content via text message, mainly using a mobile device, Stasko said.)

Of course, this doesn’t mean that every grownup out there is under the covers with their phone at night shooting off racy texts. These survey findings are preliminary, and come with big caveats, Stasko says. The findings may not be representative: Participants were recruited online and responded to a posting asking them to take a survey about sexting, so the sample could be skewed toward more seasoned sexters.

Don’t Forget Pleasure

The main goal of the study was to look at sexting through a new filter, Stasko said. The practice has historically been viewed as a risky activity among teens, associated with other sexual risk-taking (like having unprotected sex) and negative health outcomes, like sexually transmitted infections. She said she and her colleagues wanted to reevaluate sexting in a new light — as a potential positive force in a relationship and a way to potentially enhance open sexual communication. “There seems to be a missing discourse about pleasure,” Stasko said. “We wanted to talk not just about risk, but also introduce the idea that pleasure is a part of it.”

The takeaway, she said, is that when sexting is wanted by both parties, is can be a good thing. “The findings show a robust relationship between sexting and sexual and relationship satisfaction,” the study concludes.

Sexual ‘Simmering’

Aline P. Zoldbrod, Ph.D., a certified sex therapist in Lexington, Massachusetts, agrees that sexting can play an important role in adult relationships.

I asked her for her thoughts on the survey, and here’s what she wrote:

Sexting is not just for hookups, as a follow up to an interlude on sex chat roulette or for trolling on Craigslist. Sexting actually has some amazing benefits for people in ongoing relationships.  Continue reading

Calcium, Vitamin D For Osteoporosis: Are Recommendations Skewed By Conflicts Of Interest?

A photo illustration shows over-the-counter calcium supplements. (Bebeto Matthews/AP)

A photo illustration shows over-the-counter calcium supplements. (Bebeto Matthews/AP)

By Marina Renton
CommonHealth Intern

Might commercial influences be driving the widespread recommendation of calcium and vitamin D supplementation for the prevention and treatment of osteoporosis?

That’s the conclusion of an analysis published in the journal BMJ, written by Andrew Grey and Mark Bolland, endocrinologists and associate professors at the University of Auckland.

The analysis — strongly refuted by organizations that advocate for osteoporosis research — further complicates the already contentious issue of whether it’s a good idea to take the supplements and if so, at what dosage.

The Supplement Conundrum

Women over 50 are most likely to develop osteoporosis, a bone disease affecting millions of Americans that results in bone weakness and increased risk of fracture. Calcium and vitamin D supplements are widely recommended to prevent and treat the condition.

“But as we point out, the considerable body of randomized trial evidence doesn’t support that practice,” Grey, the study’s co-author, wrote in an email.  “We wondered why practice hasn’t changed to reflect the evidence.”

To promote bone health, over half of older Americans take calcium and vitamin D supplements, which can be prescribed by a doctor or purchased over the counter, the authors write.

The Institute of Medicine (IOM) recommends adults take in 1,000 mg of calcium per day (1,200 for adults 70+ and women 51-70) and 600 IU (international units) of vitamin D — 800 IU for the 70+ set.

As of 2013, the U.S. Preventive Services Task Force does not recommend daily calcium and vitamin D supplementation for non-institutionalized postmenopausal women to prevent fractures. This, they note, is not necessarily inconsistent with the IOM’s recommendations, which do not specifically discuss fracture prevention.

The supplements have been standard clinical practice in preventing or treating osteoporosis in older adults since the early 2000s. Since then, however, studies have emerged to contest their effectiveness, according to the paper. Continue reading